DendroPrime as an adhesion barrier on fracture fixation plates: an experimental study in rabbits

Kieseritzky, Johanna von; Alfort, Henrik; Granskog, Viktor; Hutchinson, Daniel J.; Stenlund, Patrik; Bogestål, Yalda; Arner, Marianne; Håkansson, Joakim; Malkoch, Michael

doi:10.1177/1753193420932477

Cited by 6 publications

(16 citation statements)

References 19 publications

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“…The high monomer conversion avoids the issue of monomer leach out present in commonly used methacrylate dental composites. [ 18,19 ] In vivo studies in rabbits [ 20 ] and rats [ 17 ] have also demonstrated the resistance of the TEC composite to soft‐tissue adhesions.…”

Section: Introductionmentioning

confidence: 99%

Highly Customizable Bone Fracture Fixation through the Marriage of Composites and Screws

Hutchinson

Granskog

Kieseritzky

et al. 2021

Adv Funct Materials

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Open reduction internal fixation (ORIF) metal plates provide exceptional support for unstable bone fractures; however, they often result in debilitating soft-tissue adhesions and their rigid shape cannot be easily customized by surgeons. In this work, a surgically feasible ORIF methodology, called AdhFix, is developed by combining screws with polymer/hydroxyapatite composites, which are applied and shaped in situ before being rapidly cured on demand via high-energy visible-light-induced thiol-ene coupling chemistry. The method is developed on porcine metacarpals with transverse and multifragmented fractures, resulting in strong and stable fixations with a bending rigidity of 0.28 (0.03) N m 2 and a maximum load before break of 220 (15) N. Evaluations on human cadaver hands with proximal phalanx fractures show that AdhFix withstands the forces from finger flexing exercises, while short-and long-term in vivo rat femur fracture models show that AdhFix successfully supports bone healing without degradation, adverse effects, or soft-tissue adhesions. This procedure represents a radical new approach to fracture fixation, which grants surgeons unparalleled customizability and does not result in soft-tissue adhesions.

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Section: Introductionmentioning

confidence: 99%

Highly Customizable Bone Fracture Fixation through the Marriage of Composites and Screws

Hutchinson

Granskog

Kieseritzky

et al. 2021

Adv Funct Materials

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“…An excellent biological profile is essential for any material destined for biomedical applications. In the case of the TATO thermoset and composite systems, extensive studies have been previously performed including comprehensive safety evaluations and preclinical trials 13,15,16 . These studies have shown that the TATO systems display no cytotoxicity, genotoxicity, skin irritation or inflammation.…”

Section: Resultsmentioning

confidence: 99%

“…In the case of the TATO thermoset and composite systems, extensive studies have been previously performed including comprehensive safety evaluations and preclinical trials. 13,15,16 These studies have shown that the TATO systems display no cytotoxicity, genotoxicity, skin irritation or inflammation. The cytotoxicity of the 3D printed TATO systems (thermosets 4, 5, and the composite) were evaluated against human dermal fibroblasts (hDF) and mouse monocytes (Raw 264.7) to determine if the addition of PETMP, Sudan I, PYG or the combination of mHA and nHA had any impact on the biological profile of the TATO systems.…”

Section: Cytotoxicity Of 3d Printed Tec Systemsmentioning

confidence: 99%

“…Both of these applications require high stiffness, as bone fixators must keep the fractured bone fragments in alignment during the healing process and dental fillings and implants must withstand repetitive and mechanically demanding chewing actions. In vivo studies have shown the hydroxyapatite composites do not result in soft tissue adhesions when used for treating bone fractures 13,15,16 . The materials can either be applied to the patient and cured in situ or drop‐cast into molds of pre‐defined shape to create implants such as plates and screws.…”

Section: Introductionmentioning

confidence: 99%

“…In vivo studies have shown the hydroxyapatite composites do not result in soft tissue adhesions when used for treating bone fractures. 13,15,16 The materials can either be applied to the patient and cured in situ or dropcast into molds of pre-defined shape to create implants such as plates and screws. The advantage of the latter approach is the formulation of the thiol-ene resin can be tailored for strength and biodegradability through the use of different alkene and thiol monomers and fillers, resulting in highly customizable implants.…”

Section: Introductionmentioning

confidence: 99%

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Acrylate‐free tough 3D printable thiol‐ene thermosets and composites for biomedical applications

Badria

Hutchinson

Olmo

et al. 2022

J of Applied Polymer Sci

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Polymer thermosets and composites based on rigid trizaine‐trione (TATO) alkene and thiol monomers show great promise as bone fixation materials and dental composites due to their ability to efficiently crosslink via thiol‐ene coupling chemistry into stiff and strong materials. In order to broaden the scope of these materials, a TATO thermoset was optimized for sterolithography (SLA) 3D printing through the addition of either a diluent (PETMP) and photo‐absorber (Sudan I), or the addition of a free radical inhibitor (pyrogallol). A 3D printable hydroxyapatite (HA) composite was also formulated by adding a combination of nano‐HA and micro‐HA particles, which were found to increase the thermal stability and modulus of the material, respectively. The modulus of the printed thermosets containing Sudan I and pyrogallol exceeded any previously published acrylate‐free thiol‐ene SLA resins, at 1.6 (0.1) and 1.85 (0.06) GPa, respectively. The printed HA composite formulation had a modulus of 2.4 (0.2) GPa. All three formulations showed a comparable resolution to a commercially available SLA resin and were non‐toxic toward Raw 264.7 and human dermal fibroblast cells. These results demonstrate the potential of TATO based SLA resins for the construction of strong, fully‐customizable, printed implants for biomedical applications.

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Enhanced Degradability of Thiol–Ene Composites through the Inclusion of Isosorbide-Based Polycarbonates

San Jacinto Garcia,

Sanz del Olmo,

Hutchinson

et al. 2024

ACS Appl. Mater. Interfaces

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Open reduction internal fixation metal plates and screws remain the established standard-of-care for complex fracture fixation. They, however, have drawbacks such as limited customization, soft-tissue adhesions, and a lack of degradation. Bone cements and composites are being developed as alternative fixation techniques in order to overcome these issues. One such composite is a strong, stiff, and shapeable hydroxyapatite-containing material consisting of 1,3,5-triazine-2,4,6-trione (TATO) monomers, which cures through high energy visible light-induced thiol–ene coupling (TEC) chemistry. Previous human cadaver and in vivo studies have shown that patches of this composite provide sufficient fixation for healing bone fractures; however, the composite lacks degradability. To promote degradation through hydrolysis, new allyl-functionalized isosorbide-based polycarbonates have been added into the composite formulation, and their impact has been evaluated. Three polycarbonates with allyl functionalities, located at the termini (aPC1 and aPC2) or in the backbone (aPC3), were synthesized. Composites containing 1, 3, and 5 wt % of aPCs 1–3 were formulated and evaluated with regard to mechanical properties, water absorption, hydrolytic degradation, and cytotoxicity. Allyl-functionalized polycaprolactone (aPCL) was synthesized and used as a comparison. When integrated into the composite, aPC3 significantly impacted the material’s properties, with the 5 wt % aPC3 formulation showing a significant increase in degradation of 469%, relative to the formulation not containing any aPCs after 8 weeks’ immersion in PBS, along with a modest decrease in modulus of 28% to 4.01 (0.3) GPa. Osteosyntheses combining the aPC3 3 and 5 wt % formulations with screws on synthetic bones with ostectomies matched or outperformed the ones made with the previously studied neat composite with regard to bending stiffness and strength in four-point monotonic bending before and after immersion in PBS. The favorable mechanical properties, increased degradation, and nontoxic characteristics of the materials present aPC3 as a promising additive for the TATO composite formulations. This combination resulted in stiff composites with long-term degradation that are suitable for bone fracture repair.

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DendroPrime as an adhesion barrier on fracture fixation plates: an experimental study in rabbits

Cited by 6 publications

References 19 publications

Highly Customizable Bone Fracture Fixation through the Marriage of Composites and Screws

Highly Customizable Bone Fracture Fixation through the Marriage of Composites and Screws

Acrylate‐free tough 3D printable thiol‐ene thermosets and composites for biomedical applications

Enhanced Degradability of Thiol–Ene Composites through the Inclusion of Isosorbide-Based Polycarbonates

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