Search PubMed⌕ Search

Biomedical subjects

J D de Bruijn

Publications and source records attributed to J D de Bruijn.

At least 19 recordsLinked to original sources

Studying the effect of different macrostructures on in vitro cell behaviour and in vivo bone formation using a tissue engineering approach.

In the present study, we tested the in vitro process of differentiation and mineralization as well as the process of in vivo bone formation on substrates with different macrostructures. We used carbonated apatite-coated titanium discs that were respectively smooth, plasma spayed with titanium or had a porous structure. Subcultured rat bone marrow cells were seeded on the substrates and after 7 days of culture, the tissue-coated substrates were subcutaneously implanted in nude mice for 4 weeks. After 1 week of culture in the presence of the osteogenic differentiation promoter dexamethasone, the cells had formed a continuous layer of mineralized tissue on the smooth and titanium plasma-sprayed discs. In the case of the porous titanium discs, the bone-like tissue coverage was restricted to the outer surface and the peripheral pores. The influence of the macrostructure on the process of differentiation of the cultured cells depended on the presence of dexamethasone. When dexamethasone was present, the highest ALP/DNA ratios were obtained with the smooth surfaces. In the absence of dexamethasone, the highest ALP/DNA values were obtained with the rough macrostructured discs. We postulate that these different patterns were due to the shielding of cells in pits or pores of rough structured substrates by dense overlying cell layers. These cell layers are suggested to increase the exposure of excreted osteoinductive proteins and decrease the exposure of dexamethasone to underlying cells. Four weeks post-implantation, abundant bone formation could be observed on all in vitro tissue-coated substrates. The percentage of direct bone contact on the porous discs (42.3 +/- 22.3) was significantly lower compared to the non-porous discs. This was related to the process of bone infiltration into the central oriented pores that predominantly occurred in a centrifugal manner. The percentage of direct bone contact on the smooth discs (96.3 +/- 2.3) was significantly higher compared to the titanium plasma-sprayed discs (81.5 +/- 10.7). This was not due to fibrous tissue infiltration, but due to the extensive formation of bone marrow. Nevertheless, for practical reasons regarding protection of the layer of cultured cells during the implantation procedure, the use of rough or porous surface structures is suspected to be advantageous in revision surgery.

Alkaline Phosphatase↗

Poly(ether ester amide)s for tissue engineering.

Poly(ether ester amide) (PEEA) copolymers based on poly(ethylene glycol) (PEG), 1,4-butanediol and dimethyl-7,12-diaza-6,13-dione-1,18-octadecanedioate were evaluated as scaffold materials for tissue engineering. A PEEA copolymer based on PEG with a molecular weight of 300 g/mol and 25wt% of soft segments (300 PEEA 25/75) and the parent PEA polymer (0/100) sustain the adhesion and growth of endothelial cells. The in vivo degradation of melt-pressed PEEA and PEA discs subcutaneously implanted in the back of male Wistar rats was followed up to 14 weeks. Depending on the copolymer composition, a decrease in intrinsic viscosity of about 20-30% and mass loss up to 12% were measured. During the degradation process, erosion of the surface was observed by scanning electron microscopy and light microscopy. The thermal properties of the polymers during degradation were measured by differential scanning calorimetry. During the first 2 weeks, a broadening of the melting endotherm was observed, as well as an increase in the heat of fusion. Porous matrices of PEEAs and PEA could be prepared by molding mixtures of polymer and salt particles followed by leaching of the salt.

Amides↗

Viable osteogenic cells are obligatory for tissue-engineered ectopic bone formation in goats.

In this study we investigated the bone-forming capacity of tissue-engineered (TE) constructs implanted ectopically in goats. As cell survival is questionable in large animal models, we investigated the significance of vitality, and thus whether living cells instead of only the potentially osteoinductive extracellular matrix are required to achieve bone formation. Vital TE constructs of porous hydroxyapatite (HA) covered with differentiated bone marrow stromal cells (BMSCs) within an extracellular matrix (ECM) were compared with identical constructs that were devitalized before implantation. The devitalized implants did contain the potentially osteoinductive ECM. Furthermore, we evaluated HA impregnated with fresh bone marrow and HA only. Two different types of HA granules with a volume of approximately 40 microm were investigated: HA70/800, a microporous HA with 70% interconnected macroporosity and an average pore size of 800 microm, and HA60/400, a smooth HA with 60% interconnected macropores and an average size of 400 microm. Two granules of each type were combined and then treated as a single unit for cell seeding, implantation, and histology. The tissue-engineered samples were obtained by seeding culture-expanded goat BMSCs on the HA and subsequently culturing these constructs for 6 days to allow cell differentiation and ECM formation. To devitalize, TE constructs were frozen in liquid nitrogen according to a validated protocol. Fresh bone marrow impregnation was performed perioperatively (4 mL per implant unit). All study groups were implanted in bilateral paraspinal muscles. Fluorochromes were administered at three time points to monitor bone mineralization. After 12 weeks the units were explanted and analyzed by histology of nondecalcified sections. Bone formation was present in all vital tissue-engineered implants. None of the other groups showed any bone formation. Histomorphometry indicated that microporous HA70/800 yielded more bone than did HA60/400. Within the newly formed bone, the fluorescent labels showed that mineralization had occurred before 5 weeks of implantation and was directed from the HA surface toward the center of the pores. In conclusion, tissue-engineered bone formation in goats can be achieved only with viable constructs of an appropriate scaffold and sufficient BMSCs.

Animals↗

Bone tissue-engineered implants using human bone marrow stromal cells: effect of culture conditions and donor age.

At present, it is well known that populations of human bone marrow stromal cells (HBMSCs) can differentiate into osteoblasts and produce bone. However, the amount of cells with osteogenic potential that is ultimately obtained will still be dependent on both patient physiological status and culture system. In addition, to use a cell therapy approach in orthopedics, large cell numbers will be required and, as a result, knowledge of the factors affecting the growth kinetics of these cells is needed. In the present study we investigated the effect of dexamethasone stimulation on the in vivo osteogenic potential of HBMSCs. After a proliferation step, the cells were seeded and cultured on porous calcium phosphate scaffolds for 1 week, and then subcutaneously implanted in nude mice for 6 weeks, in order to evaluate their in vivo bone-forming ability. Furthermore, the effect of donor age on the proliferation rate of the cultures and their ability to induce in vivo bone formation was studied. In 67% of the assayed patients (8 of 12), the presence of dexamethasone in culture was not required to obtain in vivo bone tissue formation. However, in cultures without bone-forming ability or with a low degree of osteogenesis, dexamethasone increased the bone-forming capacity of the cells. During cellular proliferation, a significant age-related decrease was observed in the growth rate of cells from donors older than 50 years as compared with younger donors. With regard to the effect of donor age on in vivo bone formation, HBMSCs from several donors in all age groups proved to possess in vivo osteogenic potential, indicating that the use of cell therapy in the repair of bone defects can be applicable irrespective of patient age. However, the increase in donor age significantly decreased the frequency of cases in which bone formation was observed.

Age Factors↗

Exploiting the natural diversity in adenovirus tropism for therapy and prevention of disease.

Since targeting of recombinant adenovirus vectors to defined cell types in vivo is a major challenge in gene therapy and vaccinology, we explored the natural diversity in human adenovirus tissue tropism. Hereto, we constructed a library of Ad5 vectors carrying fibers from other human serotypes. From this library, we identified vectors that efficiently infect human cells that are important for diverse gene therapy approaches and for induction of immunity. For several medical applications (prenatal diagnosis, artificial bone, vaccination, and cardiovascular disease), we demonstrate the applicability of these novel vectors. In addition, screening cell types derived from different species revealed that cellular receptors for human subgroup B adenoviruses are not conserved between rodents and primates. These results provide a rationale for utilizing elements of human adenovirus serotypes to generate chimeric vectors that improve our knowledge concerning adenovirus biology and widen the therapeutic window for vaccination and many different gene transfer applications.

Adenoviruses, Human↗

Bone induction by porous glass ceramic made from Bioglass (45S5).

Porous glass ceramic, which was prepared from Bioglass powder (45S5, U.S. Biomaterials) by foaming with diluted H(2)O(2) solution and sintering at 1000 degrees C for 2 h, was implanted as cylinders (5 mm in diameter and 6 mm in length) in thigh muscles of dogs for 3 months. Histological observation was made on thin un-decalcified sections. Bone formation was histologically found in pores of all implants (X16) retrieved from 16 dogs. The bone tissue was also identified with backscattered scanning electron microscopy observation (BSE) and energy dispersive X-ray microanalysis (EDX). This is the first report of bone induction in soft tissues of animals by glass ceramic that has long been recognized as a bioactive (osteoconductive) biomaterial. The present results justify the impetus to investigate the osteoinductivity of calcium phosphate-based biomaterials, to study the mechanism of bone induction (osteoinduction) by calcium phosphate-based biomaterials, to develop osteoinductive calcium phosphate-based biomaterials, and to examine the relation between osteoinduction and osteoconduction.

Animals↗

Cytocompatibility and response of osteoblastic-like cells to starch-based polymers: effect of several additives and processing conditions.

This work reports on the biocompatibility evaluation of new biodegradable starch-based polymers that are under consideration for use in orthopaedic temporary applications and as tissue engineering scaffolds. It has been shown in previous works that by using these polymers it is both possible to produce polymer/hydroxyapatite (HA) composites (with or without the use of coupling agents) with mechanical properties matching those of the human bone, and to obtain 3D structures generated by solid blowing agents, that are suitable for tissue engineering applications. This study was focused on establishing the influence of several additives (ceramic fillers, blowing agents and coupling agents) and processing methods/conditions on the biocompatibility of the materials described above. The cytotoxicity of the materials was evaluated using cell culture methods, according to ISO/EN 109935 guidelines. A cell suspension of human osteosarcoma cells (HOS) was also seeded on a blend of corn starch with ethylene vinyl alcohol (SEVA-C) and on SEVA-C/HA composites, in order to have a preliminary indication on cell adhesion and proliferation on the materials surface. In general, the obtained results show that all the different materials based on SEVA-C, (which are being investigated for use in several biomedical applications), as well as all the additives (including the novel coupling agents) and different processing methods required to obtain the different properties/products, can be used without inducing a cytotoxic behaviour to the developed biomaterials.

Animals↗

Biocompatibility testing of novel starch-based materials with potential application in orthopaedic surgery: a preliminary study.

This paper describes an extensive biocompatibility evaluation of biodegradable starch-based materials aimed at orthopaedic applications as temporary bone replacement/fixation implants. For that purpose, a polymer (starch/ethylene vinyl alcohol blend, SEVA-C) and a composite of SEVA-C reinforced with hydroxyapatite (HA) particles, were evaluated in both in vitro and in vivo assays. For the in vitro analysis cell culture methods were used. The in vivo tissue reactions were evaluated in an intramuscular and intracortical bone implantation model on goats, using light and scanning electron microscopy. A computerized image analysis system was used to obtain histomorphometric data regarding bone contact and remodelling after 6 and 12 weeks of implantation. In both in vitro and in vivo models, the SEVA-C-based materials did not induce adverse reactions, which in addition to their bone-matching mechanical properties makes them promising materials for bone replacement fixation.

Animals↗

Tissue responses of calcium phosphate cement: a study in dogs.

The in vivo properties of a new kind of calcium phosphate cement were investigated in this study. Calcium phosphate cement was implanted as paste into femoral bone and dorsal muscle of dogs for 3 and 6 months, and as prehardened form into thigh muscles of dogs for 1, 2 and 6 months. Histology was performed on thin un-decalcified sections. No foreign body reaction, no inflammation and no necrosis were found both in bony site and in muscles. There was no connective tissue layer between the cement and bone when cement paste was implanted in the bone. A creeping substitution of cement by bone, in which osteoclast-like cells resorbed the cement as if the cement is a part of bone and new bone was formed directly on the resorption line of calcium phosphate cement, was found. Bone formation was found histomorphologically in pores and deep rugged surface of cement samples (both paste and prehardened form) implanted in muscles of dogs. The induced bone was also identified with backscattered scanning electron microscopy (BSE) and by energy-dispersive X-ray micro-analysis (EDX). The results suggest that the calcium phosphate cement used in this study is biocompatible, resorbable in a manner of creeping substitution, osteoconductive and osteoinductive. It seems that an ideal bone substitute can be developed by using this type of calcium phosphate cement.

Absorbable Implants↗

A preliminary study on osteoinduction of two kinds of calcium phosphate ceramics.

With respect to the effect of material factors on calcium phosphate biomaterial-induced osteogenesis, the osteoinductive property of two kinds of porous hydroxyapatite ceramics, which were made by different producers, was investigated in dorsal muscles of dogs. One hydroxyapatite ceramic (S-HA), macroporous implants with rough pore walls containing abundant micropores, was made by Sichuan Union University (Chengdu, China); the other hydroxyapatite ceramic (J-HA), porous implants with smooth macropore walls composed of regularly aligned crystal grains, was provided by Mitsubishi Ceramic Int. (Japan). Different tissue response was detected histologically and microradiographically after the ceramic samples had been implanted in dorsal muscles of dogs for 3 and 6 months. Bone formation was found in S-HA at 3 months, which increased at 6 months. In contrast, no bone formation was detected in J-HA at both 3 and 6 months. These results indicate that with the special architecture, calcium phosphate ceramic can induce bone formation in soft tissue. As both materials were very similar in their chemical and crystallographic structures, but varied in their microstructures, the latter seem to be an important factor affecting the osteoinductive capacity of calcium phosphate ceramics. These data suggest that, by controlling the preparation of calcium phosphate ceramic, bone substitutes with intrinsic osteoinductive property can be developed from calcium phosphates.

Animals↗

Critical size defect in the goat's os ilium. A model to evaluate bone grafts and substitutes.

Bone defects and their treatment are a well known problem in orthopaedic surgery. A critical size defect is a suitable model to study bone replacement materials. This study describes a critical size defect in the goal and the evaluation of three bone fillers (particulate autograft, particulate allograft, and a polyethylene oxide/polybutylene terephthalate copolymer) in this defect. The goat allows for implantation of large implants and has a metabolic rate more comparable with that of humans than small animals. The critical size defect, located in the goat's iliac wing, is easily reproducible and allows qualitative and quantitative evaluation of bone grafts and bone graft substitutes. After 3 months of healing, the unfilled defects showed 13.5% bone in the defect, the autografted defects 36.3%, and the allografted 18.5%. The copolymer gave only 1.5% bone in the defect; this is in contrast to previous reports. The described model allows for the evaluation of bone graft substitutes before introduction into clinical practice.

Animals↗

Bone induction by implants coated with cultured osteogenic bone marrow cells.

The availability of osteoinductive coatings on dental and orthopedic implants will result in an improved fixation of these devices. Those cases where implants are placed in poor-quality bone or where high failure rates are obtained are especially expected to gain from such coatings. This paper presents a novel, biological approach to obtain bioactive and osteoinductive coatings on bone-replacement implant materials. This so-called tissue engineering approach utilizes osteogenic bone marrow cells that are cultured on an implant material to form a bone-like tissue. The implant materials used herein included porous calcium phosphate scaffolds and metallic plates, the latter of which were coated with a biomimetic calcium phosphate coating to facilitate cellular attachment. Bone marrow cells were obtained from a variety of species, including humans, and were grown to facilitate cellular proliferation. The cells were subsequently seeded onto the implants and cultured for an additional week to facilitate osteogenic differentiation and extracellular matrix production. The resulting hybrid implants, encompassing the biomaterial carrier and cultured bone-like tissue, were subsequently implanted subcutaneously in nude mice for 4 weeks, followed by histological examination for de novo bone formation. The results revealed that newly formed bone was seen both in porous implants and on flat metallic surfaces. This bone tissue engineering approach, therefore, offers great potential to enhance bony healing around implants in a compromised bone bed.

Aged↗

Decreased consumption of Ca and P during in vitro biomineralization and biologically induced deposition of Ni and Cr in presence of stainless steel corrosion products.

The purpose of this study was to investigate the effects of 316L stainless steel (SS) corrosion products on the in vitro biomineralization process, because tissue necrosis, bone loss, impaired bone mineralization, and loosening of orthopedic implants are associated with ions and debris resulting from biodegradation. Rat bone marrow cells were cultured in experimental conditions that favored the proliferation and differentiation of osteoblastic cells and were exposed to SS corrosion products obtained by electrochemical means for periods ranging from 1 to 21 days. Quantification of total and ionized Ca and P, as well as Fe, Cr, and Ni, ions in the culture media of control and metal added cultures during the incubation period was performed to study the influence of corrosion products on the Ca and P consumption that occurs during the mineralization process. Control cultures and metal effects on cultures were evaluated concerning DNA content, enzymatic reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), and alkaline phosphatase (ALP) activity. Histochemical detection of ALP, Ca, and phosphate deposition, and examination of the cultures by scanning and transmission electron microscopy (SEM and TEM) were also performed. The presence of SS corrosion products resulted in impairment of the normal behavior of rat bone marrow cultures. Levels of Cr and Ni in the medium of cultures exposed to 316L SS corrosion products decreased throughout the incubation period, suggesting a regular deposition of these species; these results were supported by TEM observation of the cultures. Cultures exposed to the corrosion products presented lower DNA content, MTT reduction, and ALP activity and failed to form mineralized areas. These cultures showed negative staining on histochemical reactions for the identification of calcium and phosphate deposition and SEM and TEM examination did not show mineral globular structures or mineralization foci, respectively, which is characteristic of cultures grown in control conditions. These results suggest that metal ions associated with 316L SS are toxic to osteogenic cells, affecting their proliferation and differentiation.

Animals↗

Effects of AISI 316L corrosion products in in vitro bone formation.

Rat bone marrow cells were cultured in experimental conditions that favour the proliferation and differentiation of osteoblastic cells (i.e., 2.52 x 10(-4) mol l(-1) ascorbic acid, 10(-2) mol l(-1) beta-glycerophosphate and 10(-8) mol l(-1) dexamethasone) in the absence and in the presence of stainless-steel corrosion products, for a period of 18 days. An AISI 316L stainless-steel slurry (SS) was obtained by electrochemical means and the concentrations of the major metal ions, determined by atomic absorption spectrometry, were 8.78 x 10(-3) mol l(-1) of Fe, 4.31 x 10(-3) mol l(-1) of Cr and 2.56 x 10(-3) mol l(-1) of Ni. Bone marrow cells were exposed to 0.01, 0.1 and 1% of the SS and at the end of the incubation period, control and treated cultures were evaluated by histochemical assays for the identification of the presence of alkaline phosphatase and also calcium and phosphate deposition. Cultures were further observed by scanning electron microscopy. Levels of total and ionised calcium and phosphorus in the culture media collected from control and metal exposed cell cultures were also quantified. Histochemical staining showed that control cultures presented a strong reaction for the presence of alkaline phosphatase and exhibited formation of calcium and phosphates deposits. The presence of 0.01% SS caused no detectable biological effects in these cultures, 0.1% SS impaired osteoblastic behaviour and, 1% SS resulted in cell death. In the absence of bone cells, levels of total and ionised calcium and phosphorus in the control and metal added culture medium were similar throughout the incubation period. A significant decrease in the levels of ionised calcium and phosphorus were observed in the culture medium of control cultures and also in cultures exposed to 0.01% SS after two weeks of incubation, an event related with the formation of mineral calcium phosphate deposits in these cultures. In cultures grown in the presence of 0.1 and 1% SS corrosion products, levels of calcium and phosphorus were similar to those observed in the absence of cells. Results showed that stainless-steel corrosion products above certain concentrations may disturb the normal behaviour of osteoblast-like rat bone marrow cell cultures.

Alkaline Phosphatase↗

Initial bone matrix formation at the hydroxyapatite interface in vivo.

Dense, sintered, slip-cast hydroxyapatite rods were implanted transfemorally in young adult rats. The femora were excised after 2 and 4 weeks and, following fixation, either embedded in methyl methacrylate for light microscopy, decalcified and prepared for transmission electron microscopy, or freeze fractured in liquid nitrogen for scanning electron microscopic analysis. The latter was performed on the two tissue fragments that remained after freeze fracturing, from which the first contained the implants and the second comprised tissue that had been immediately adjacent to the hydroxyapatite rods. Undecalcified light microscopic sections revealed extensive bone tissue formation around and in contact with the hydroxyapatite rods. The initial bone matrix apposed to the implant surface, as demonstrated with scanning electron microscopy, was either composed of globular deposits or an organized network of collagen fibers. The deposits, which ranged in size from 0.1-1.1 microns, fused to form a cement-like matrix to which collagen fibers were attached. Degradation of the hydroxyapatite surface resulted in the presence of unidirectionally aligned crystallites, with which the newly formed bone matrix was closely associated. Ultrastructural analysis of the bone-hydroxyapatite interface with transmission electron microscopy revealed a 50-600-nm-wide collagen-free granular zone, comprising one or more 40-100-nm-thick electron-dense layer(s). These structural arrangements most probably partially represent the globular deposits and proteinaceous material adsorbed onto and partially in the degrading hydroxyapatite surface. Although the latter change in surface topography may have enhanced bonding of the cement-like matrix to the hydroxyapatite, the cause for this change in topography and the type of bond formed are, at present, unknown.

Animals↗

Osteoclastic resorption of calcium phosphates is potentiated in postosteogenic culture conditions.

Cell-mediated resorption of densely sintered hydroxyapatite (HA1250), tricalcium phosphate (TCP), and 600 degrees or 900 degrees C calcined hydroxyapatite (HA600 and HA900, respectively), was investigated by using two culture systems. The first was an osteoclastic cell culture, and the second was a two-stage culture that was composed of a bonelike tissue formation on the substrata in the first stage and its subsequent resorption by osteoclasts in the second stage. Neither of the materials showed resorption or surface alterations in the osteoclastic cell culture, except for some limited phagocytotic activity on HA600 and HA900. In the two-stage culture, production of mineralized extracellular matrix was only observed on HA1250 and TCP, and its subsequent resorption by osteoclastlike cells was evident. Small and occasionally larger tartrate-resistant acid phosphatase positive cells produced 20-150 microns diameter resorption pits in both the mineralized extracellular matrix on HA1250 and TCP and the surfaces of HA600 and HA900. Resorption of the mineralized extracellular matrix on TCP also resulted in degradation of the underlying ceramic surface, mainly initiating from intergrain boundaries, whereas the surface of HA1250 remained unaltered. The results of this study clearly demonstrate that osteoclastic resorption of calcium phosphates is potentiated in postosteogenic culture conditions. A possible role for bone matrix constituents in cell-mediated resorption is hypothesized, whereas the occurrence of resorption seems to be mainly governed by the combined effects of material characteristics such as grain size and crystal structure.

Acid Phosphatase↗

Structural arrangements at the interface between plasma sprayed calcium phosphates and bone.

Plasma sprayed coatings of tetracalcium phosphate, magnesium whitlockite and three types of hydroxyapatite, varying in degree of crystallinity, were evaluated with light microscopy, scanning electron microscopy and backscatter electron microscopy (BSE) after implantation periods of 1, 2 and 4 wk in rat femora. BSE revealed that both tetracalcium phosphate and semi-crystalline hydroxyapatite underwent distinct bulk degradation and loss of relatively large particles. Amorphous hydroxyapatite showed a gradual surface degradation, indicated by a transition zone varying in grey level between that of the coating and bone tissue, while degradation was negligible with the highly crystalline material and magnesium whitlockite. Degradation appeared to be related to bone apposition, since more bone seemed to be present on amorphous hydroxyapatite and tetracalcium phosphate, as compared to highly crystalline hydroxyapatite and magnesium whitlockite coatings. At the interface between bone and magnesium whitlockite, a seam of unmineralized bone-like tissue was frequently seen with light microscopy, while few areas with bone contact were present. X-ray microanalysis revealed that both the magnesium whitlockite coating and the unmineralized bone-like tissue contained substantial amounts of aluminium which, in addition to possible influences of magnesium, may have caused the impaired mineralization. The results of this preliminary study indicate that, with regard to early bone formation, amorphous hydroxyapatite coatings seem to be beneficial over highly crystalline coatings. However, further experiments should be performed to give conclusive data on (i) the statistical significance of the differences in bone apposition rate, and (ii) the long-term behaviour of both amorphous and highly crystalline coatings in bone and their relation to implant performance.

Aluminum↗

The ultrastructure of the bone-hydroxyapatite interface in vitro.

Rat bone marrow cells were cultured on plasma-sprayed hydroxyapatite (HA). The cells formed a mineralized extracellular matrix (ECM) that exhibited several characteristics of bone tissue. The interface between this mineralized ECM and the HA was studied at the ultrastructural level with scanning and transmission electron microscopy and x-ray microanalysis. Initially, the deposition of a globular, afibrillar matrix was observed on HA. This was followed by the integration of collagen fibers in this matrix and their subsequent mineralization. At the bone-HA interface two distinctly different interfacial structures were observed. An electron-dense layer with a thickness of 20-60 nm was regularly present, which contained both organic and inorganic material and was rich in glycosaminoglycans. The interfaces differed however, in the presence or absence of an amorphous zone which was free of collagen fibers and had an average thickness of 0.7-0.8 microns. It was frequently seen interposed between the electron-dense layer and the hydroxyapatite. Similar interfacial structures have also been described in the in vivo environment, where they were referred to as lamina limitans-like or cement linelike. From the results of this study, it can be concluded that the described in vitro system is a suitable model to study bone-biomaterial interactions.

Animals↗