Purification processes of xenogeneic bone substitutes and their impact on tissue reactions and regeneration

Abstract

Xenogeneic bone substitute materials are widely used in oral implantology. Prior to their clinical use, purification of the former bone tissue has to be conducted to ensure the removal of immunogenic components and pathogens. Different physicochemical methods are applied for purification of the donor tissue, and temperature treatment is one of these methods. Differences in these methods and especially the application of different temperatures for purification may lead to different material characteristics, which may influence the tissue reactions to these materials and the related (bone) healing process. However, little is known about the different material characteristics and their influences on the healing process. Thus, the aim of this mini-review is to summarize the preparation processes and the related material characteristics, safety aspects, tissue reactions, resorbability and preclinical and clinical data of two widely used xenogeneic bone substitutes that mainly differ in the temperature treatment: sintered (cerabone) and non-sintered (Bio-Oss) bovine-bone materials. Based on the summarized data from the literature, a connection between the material-induced tissue reactions and the consequences for the healing processes are presented with the aim of translation into their clinical application.

Hyaluronic Acid/Bone Substitute Complex Implanted on Chick Embryo Chorioallantoic Membrane Induces Osteoblastic Differentiation and Angiogenesis, but not Inflammation

“…Some augmentation techniques are complex and involve invasive procedures not well tolerated by patients [4,5]. As a perspective for alveolar ridge augmentation, 3D printing allows for the production of biodegradable and bioresorbable bone scaffolds with patient-specific dimensions using computer-aided design [6,7].…”

Implantation of an Injectable Bone Substitute Material Enables Integration Following the Principles of Guided Bone Regeneration

“…Alloplastic bone substitutes, especially hydroxyapatite (HA), alpha-and beta-tricalcium phosphate (α-TCP and β-TCP) and biphasic calcium phosphate ceramics are viable alternatives to autogenous, allogeneic and xenogeneic bone grafts in surgical bone augmentation and replacement (1). Even though they lack some of the qualities of autografts, allografts and xenografts such as osteogenesis and osteoinduction, alloplastic bone substitutes are osteoconductive (2)(3)(4)(5)(6), readily available in different easy-to-use forms (7)(8)(9), and pose no risk of disease transmission or morbidities associated with bone graft harvesting (10)(11)(12).…”

“…It has been shown that these biomaterials are mainly degraded by the process of phagocytosis, which is affected by the chemical composition and physical characteristics of a biomaterial. These properties determine the cellular reactions within the host tissue, including different numbers of phagocytes such as macrophages and so-called biomaterial-associated multinucleated giant cells (BMGCs) (1,10,(13)(14)(15)(16)(17)(18)(19)(20). Even biphasic bone substitute materials (BBSM) composed of mixtures of hydroxyapatite (HA) and betatricalcium phosphate (β-TCP) have shown to be degraded in a balanced way.…”

Bone Augmentation and Simultaneous Implant Placement with Allogenic Bone Rings and Analysis of Its Purification Success

“…However, their organic components that can induce immunologic tissue reactions up to implant rejections or transfer pathogens such as prions that are related with bovine spongiform encephalopathy have to be removed prior to their application [11]. For this purpose, different purification protocols are used based on varying (combinations of) physical and chemical methods such as heat treatments [12]. Although it has been revealed that this kind of bone substitute material is secure, and its hydroxyapatite-based bone matrix seems to be comparable to that of the human bone matrix, its mechanical properties might also be low due to the different processing techniques [13].…”