Injectable bone substitutes

Boix D, Weiss P, Gauthier O, Guicheux J, Bouler JM, Pilet P, et al. Injectable bone substitute to preserve alveolar ridge resorption after tooth extraction a study in dog. J Mater Sci Mater Med. 2006 Nov 17(11) 1145-52. 

An alternative suggested approach to endodontic treatment is to use injectable bone substitute and calcium phosphate materials, which have been described as promising in terms of biocompatibility, bioactivity and rheological properties (Enkel et al., 2008). 

Weiss, P., Layrolle, P., Clergeau, L.P., Enckel, B., Pilet, P., Amouriq, Y., Daculsi, G. GiumelU, B. 2007, The safety and efficacy of an injectable bone substitute in dental sockets demonstrated in a human clinical trial . Biomaterials, vol. 28, no. 22, pp. 3295-3305. 

Low KL, Tan SH, Zein SH, Roether JA, Mourino V, Boccaccini AR. Calcium phosphate-based composites as injectable bone substitute materials a review. J Biomed Mater Res B Appl Biomater 2010 94B(1), 273-286. 

Song, HY, Rahman, AHME., Lee, BT. 2009. Fabrication of calcium phosphate-calcium sulfate injectable bone substitute using chitosan and citric acid. Journal of Materials Science—Materials in Medicine 20 935-941. 

Injectable bone substitute material consisting of CTS, citric acid, and glucose solution as the liquid phase, and tricalcium phosphate powder as the solid phase, was developed by Liu and coworkers [141]. Four types of cements have been used to investigate the mechanical properties and in vitro biocompatibility of the material. In the presence of citric acid, tricalcium phosphate partially transformed into HAp and dicalcium phosphate. 

Daculsi, G. 1998. Biphasic calcium phosphate concept apphed to artificial bone, implant coating and injectable bone substitute. Bioniaterials 19 1473-78. 

Bongio, M., Nejadnik, M.R., Kasper, F.K., Mikos, A.G., Jansen, J.A., Leeuwenburgh, S.C.G., et al., 2013. Development of an in vitro confinement test to predict the clinical handling of polymer-based injectable bone substitutes. Polym. Test. 32 (8), 1379-1384. 

The limitations previously described suggest the need for various handling requirements to promote a reliable and safe clinical application. In fact, easy handling is of paramount importance for the commercial success of bone substitute materials. Thus, the current challenge to potentiate the clinical application of the ceramic-based SBS lies on the development of injectable bone substitutes (IBSs), in which a binder or gel is added to the granules. 

Table 9.2 Injectable bone substitutes based on granular ceramic-polymer conjugation...

Table 9.3 Examples of injectable bone substitutes based on in situ gelation hydrogels... 

Table 9.6 Regulatory requirements of injectable bone substitutes in Europe and tbe United States...

Injectable bone substitutes Europe United States... 

Bongio, M., et al., 2012. Preclinical evaluation of injectable bone substitute materials. J. Tissue Eng. Regen. Med. http //dx.doi.org/10.1002/term.1637. Available at http //www.ncbi.nlm. nih.gov/pubmed/23135814. 

Designing ceramics for injectable bone graft substitutes 29... 

Recently, efforts towards composites of hydrogels and bone substitutes have been intensified and several products have been launched (Table 2.3). These efforts are expressed by a rapid increase in the number of publications. For example, a search in Scopus (www.scopus.com) using the two keywords Injectable and Ceramic (in all fields ) shows that almost 350 pubUcations were published in 2009 (Fig. 2.1). 

Laschke MW, Witt K, Pohlemann T, Menger MD. Injectable nanocrystalline hydroxyapatite paste for bone substitution in vivo analysis of biocompatibility and vascularization. J Biomed Mater Res B Appl Biomater. 2007 Aug 82(2) 494-505. 

Fellah, B.H., Weiss, P., Gauthier, O., Rouillon, T., Pilet, P., Daculsi, G. Layrolle, P. 2006, Bone repair using a new injectable self-crosslinkable bone substitute . Journal of Orthopaedic Research, vol. 24, no. 4, 628-635. 

Bai, B., Jazrawi, L. M., Kummer, F. J., and Spivak, J. M. (1999), The use of an injectable, biodegradable calcium phosphate bone substitute for the pto[diylactic augmentation of osteoporotic vertebrae and the management of vertebral compression fractures. Spine 24(13) 1S21-1S26. 

Liu H, Li H, Cheng W (2006) Novel injectable calcium phosphate/chitosan composites for bone substitute materials. Acta Biomater 2 557-565... 

Nilsson, M. 2003. Injectable calcium sulphate and calcium phosphate bone substitutes. PhD thesis. Lund... 

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