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Assessment study on the high-performance liquid chromatography-type hydroxyapatite chromatography in the presence of sodium dodecyl sulfate.

The HPLC-type hydroxyapatite chromatography in the presence of sodium dodecyl sulfate (SDS) was assessed with special attention to the behavior of the surfactant. A significant amount of SDS was found to be adsorbed to the hydroxyapatite packed in the column from the starting buffer, 50 mM sodium phosphate buffer, pH 7.0, only when the buffer contained SDS in a concentration at or above its critical micelle concentration. When the phosphate buffer concentration was increased while the SDS concentration was kept at 1 mg/ml, the adsorbed surfactant was desorbed in advance of the release of proteins. Polypeptides derived from proteins could be successfully separated only when the column had been thoroughly equilibrated with the above-mentioned starting buffer solution. When a protein polypeptide complexed with SDS, which had been similarly equilibrated, was applied to the column, an amount of SDS corresponding to 75-90% (w/w) of the surfactant originally bound to the polypeptide was released upon its binding to the hydroxyapatite. On the other hand, porin, an Escherichia coli outer membrane protein, retaining its trimeric native structure in the presence of SDS, released a significantly smaller amount of SDS. When the membrane protein was denatured to give a single polypeptide, it behaved in a manner similar to that of the other protein polypeptides. The mechanism of binding of the protein polypeptides was discussed on the basis of these results. The native and denatured entities of porin could be efficiently separated as the result of the difference in their mode of interaction with the hydroxyapatite.

Chromatography↗

Thermal elution chromatography of nucleic acids on hydroxyapatite.

Hydroxyapatite thermal elution chromatography was studied from an empirical standpoint. The dependence of elution temperature on elution buffer concentration was determined for various types of buffer, hydroxyapatite and nucleic acid. The results are analyzed in terms of the proper design and interpretation of thermal elution experiments. The potential for serious artifacts is demonstrated and the means by which they may be avoided is described. Various commercially available hydroxyapatites were tested in conjunction with various aqueous and partially non-aqueous buffer systems. Among the materials tested, potassium phosphate and Bio-Rad HTP were found to constitute the best buffer-hydroxyapatite system for most types of thermal elution study.

Chromatography↗

Hydroxyapatite for alveolar ridge augmentation: indications and problems.

The increased use of hydroxyapatite for augmentation of residual alveolar ridges has created some problems in the subsequent fabrication of complete denture prostheses. Although hydroxyapatite appears to be an effective substitute for resorbed alveolar ridges, its use is not indicated for all patients. In addition, the premise that "if a little is good, a lot is better" does not apply. The following conclusions can be drawn. Augmentation should not be considered if vestibular extension will provide acceptable results. Placement of hydroxyapatite should improve the contour and amount of the residual alveolar ridge. Use as little as possible to accomplish the goal. Preprosthetic surgery should permit vertical as well as horizontal extension of the denture. Augmentation should not result in the need to use lining mucosa to support a complete denture. Vestibular extensions are indicated for most augmented alveolar ridges. The relative strength of the strong arch should not be increased in prognathic or retrognathic ridge relationships. Preprosthetic surgery should be a combined surgical-prosthodontic treatment endeavor. If a foundation is created that cannot be used effectively for the support, retention, and stability of an intended prosthesis, little benefit is provided for the patient. Small variations in intended treatment can significantly increase success of the prosthesis (Fig. 13). Unfortunately, the relative ease of hydroxyapatite placement has led to its use in patients who do not require augmentation and augmentation in amounts and regions that are not conducive to improving denture success. A coordinated effort between the surgeon and the prosthodontist will usually result in treatment that provides the best potential foundation for a specific patient.

Alveolar Ridge Augmentation↗

Adsorption of N-(2-hydroxy-3-methacryloxypropyl)-N-phenylglycine (NPG-GMA) on cupric ion-enriched hydroxyapatite surface to improve chemical bonding between dental resins and teeth.

In continued studies of chemical bonding between a polymer and teeth through the mediation of coupling agents, the absorption of N-(2-hydroxy-3-methacryloxypropyl)-N-phenylglycine (NPG-GMA) from ethanol solution was studied on cupric ion-treated synthetic hydroxyapatite in order to discriminate the adsorptive behaviour of the 'mordanted' as against the unmordanted (or pure) apatite. All features of the adsorption isotherm, however, agree with those of the isotherm obtained on pure hydroxyapatite. Also, polymer filled with cupric ion-treated hydroxyapatite coated with the irreversibly adsorbed NPG-GMA has a tensile strength comparable to that of the polymer filled with NPG-GMA coated pure hydroxyapatite.

Acrylates↗

Polymer-hydroxyapatite composites for biodegradable bone fillers.

A number of composites made from biodegradable polymers and hydroxyapatite were studied in vivo and in vitro in an attempt to develop biodegradable artificial bone fillers. Histological observation in rats revealed that polylactic acid, of low molecular weight (PLAoligomer), was rapidly resorbed and replaced by newly formed bone tissue when incorporated with hydroxyapatite and this suggested that the incorporated hydroxyapatite seemed to play an active role in the new bone formation. In vitro testing revealed that the solubility of hydroxyapatite was markedly enhanced when mixed with PLAoligomer.

Animals↗

Contribution of hydroxyapatite to the tensile strength of the isobutyl-2-cyanoacrylate-bone bond.

The bonding strength between bone and alpha-2-cyanoacrylate polymers, with or without the addition of powdered hydroxyapatite, was determined. The tensile strength of a bone-cyanoacrylate bond was measured for each polymer: 4.31 +/- 0.88 MPa (methyl-), 5.74 +/- 0.62 MPa (ethyl-), and 8.33 +/- 0.41 MPa (isobutyl-). The tensile strength of the isobutyl-2-cyanoacrylate bond increased to 12.03 +/- 0.72 MPa with the addition of 10% (w/v) hydroxyapatite before decreasing to 7.89 +/- 0.58 MPa on addition of 15% (w/v) hydroxyapatite. An optimal concentration of hydroxyapatite significantly increased the tensile strength of a bone-cyanocacrylate bond in vitro in a manner comparable to reinforced bone replacement materials.

Animals↗

Computer graphics of hydroxyapatite and beta-tricalcium phosphate.

Hydroxyapatite (HA) and beta-tricalcium phosphate (TCP) were studied by computer graphics with a personal computer. Crystal models of fluoridated hydroxyapatite and fluorapatite, in which F- ions are substituted into some or all OH- positions, were also drawn. Data on the structural coordinates of the hydroxyapatite and beta-TCP crystals were put into a protein graphics program in Angstrom units. The connection of each element, with front and rear, was displayed by the shade-line erasing method, and the solidity of the image was expressed by the degree of lightness from the light source. The colour tint was obtained by the Raster graphics method. A fine picture can be obtained with the photo program. Rotating the graphics freely around the X, Y, and Z axes gives a view from any direction. The computer graphics demonstrated visually that F- ions contribute to stabilize the hydroxyapatite crystal and that beta-TCP has an unstable structure due to 0.5 probability of Ca2+ ions and [PO4-Ca-Ca-Ca-PO4] zigzag chain.

Biocompatible Materials↗

Fluoridated hydroxyapatites synthesized with organic phosphate ester.

Fluoridated hydroxyapatites with various fluoride contents were synthesized with organic phosphate ester monomer as a source of P at pH 9.5 and 80 degrees C. The a-axis dimensions of the fluoridated hydroxyapatites decreased with the increase of the fluoride content in the same way as the fluoridated hydroxyapatites synthesized with inorganic phosphate under the same conditions. However, for the same calculated degree of fluoridation in the feed solution, fluoridated hydroxyapatites synthesized with organic P had higher fluoride contents than those synthesized with inorganic P. The crystallinity of the former decreased initially, then increased with increasing fluoride content; but on the whole it was lower than that of the latter. The apparent solubility at pH 4.0 and 37 degrees C decreased dramatically and monotonically with increasing fluoride content and approached an almost constant value at a fluoride content above that of fluorapatite, at which value calcium fluoride was detected.

Calcium↗

Resorption of sintered synthetic hydroxyapatite by osteoclasts in vitro.

Primary rat bone marrow cells were cultured for periods of 8 d on hydroxyapatite discs produced by sintering compressed powder at 1130 degrees C. The disc surfaces were roughened using silicon carbide paper to create three groups of samples (n = 10) of differing surface topography. The culture conditions permitted both the differentiation and fusion of cells of the osteoclast lineage. Following culture, the cells were stained in situ for tartrate-resistant acid phosphatase activity, and the samples were prepared for scanning electron microscopy. Evidence of cellular resorption of the hydroxyapatite discs was seen on all samples. Small tartrate-resistant acid phosphatase positive cells created resorption pits of 15-25 microns diameter in the ceramic surface, which were morphologically similar to those found in natural bone tissue, while multinucleate cells caused erosion of the ceramic surface without pit formation. Statistical analyses showed that the total numbers of cells, tartrate-resistant acid phosphatase positive cells, and multinucleated cells were all higher on the roughened surfaces, although the resorption pits were more easily visualized on the smooth surfaces. The results clearly demonstrate that not only are osteoclasts capable of resorbing sintered hydroxyapatite but that the rugosity of the hydroxyapatite influences the fusion of osteoclast mononuclear precursors.

Animals↗

Concentration-dependent effects of dentin phosphophoryn in the regulation of in vitro hydroxyapatite formation and growth.

The effect of dentin phosphophoryn on hydroxyapatite formation and growth was studied in an in vitro gelatin gel diffusion system. Phosphophoryn, in low concentrations (0.010-1 microgram/ml) promoted de novo hydroxyapatite formation; at a higher concentration (100 micrograms/ml) in the same system, the dentin matrix protein inhibited hydroxyapatite growth. Similar inhibition of hydroxyapatite growth was seen in solution. The intact phosphophoryn was not essential for either inhibition of seeded growth or promotion of mineralization, since the formic acid degraded protein was comparably effective. Transmission electron microscopy of the precipitates formed at 7 days showed no significant differences in crystallite size distribution in the presence and absence of phosphophoryn. However there was a dose-dependent decrease in the number of mineral clusters formed in the presence of increasing amounts of phosphophoryn, suggesting inhibition of secondary nucleation. These data provide support for the postulated 'multifunctional' role of the dentin phosphoprotein in the mineralization process.

Animals↗

Binding of serum osteocalcin to hydroxyapatite in Paget's disease of bone.

Serum osteocalcin (serum bone Gla protein, sBGP) is elevated in diseases characterized by an enhanced bone turnover. However, in Paget's disease of bone there is a discrepancy between the low increase of sBGP and the high increase of bone remodelling assessed by serum alkaline phosphatase and urinary hydroxyproline. It is possible that the relatively low levels of sBGP reflect an abnormal binding of the molecule to the bone due to an alteration of the BGP molecule and/or of the pagetic mineral phase of bone. Another possibility would be a disregulation of BGP synthesis. In the present work we studied the binding of pagetic sBGP to an experimental model of mineral phase of bone (HPLC hydroxyapatite column). Serum of 14 patients with Paget's disease of bone (sBGP = 7.8 +/- 3.5 ng/ml) and of 14 control subjects (sBGP = 3.3 +/- 0.9 ng/ml) was purified through a Sephadex G-50 medium column (2.6 x 100 cm, 5 mM NH4CO3H). The BGP peak was lyophilized and resuspended in 1 mM KH2PO4, 1 mM CaCl2, 0.02% NaN3, pH 8.4, and then injected into an HPLC gradient system (Waters 660), from 1 to 300 mM KH2PO4 through a hydroxyapatite column (BioGel HPHT, Bio-Rad, 0.78 x 10 cm). A single peak of sBGP was obtained with a retention time of 12 min in control and pagetic patients. From these results we conclude that BGP binding to hydroxyapatite is similar in pagetic patients and in control subjects, suggesting that an alteration in BGP molecule is not responsible for an abnormal binding to the bone. In order to validate our system, the binding of serum BGP from warfarin-treated rats to the hydroxyapatite HPLC column was also studied and compared to binding of serum BGP from normal rats.

Aged↗

Formation of pyrophosphate on hydroxyapatite with thioesters as condensing agents.

"Energy-rich" thioesters are shown to act as condensing agents in the formation of pyrophosphate on hydroxyapatite in the presence of water at ambient temperature. The yield of pyrophosphate based on thioester ranges from 2.5% to 11.4% and depends upon the pH and concentration of reactants. Reaction of 0.130 M hydroxyapatite suspended in a solution of 0.08 M sodium phosphate and 0.20 M imidazole hydrochloride (pH 7.0) with 0.10 M N,S-diacetylcysteamine for 6 days gives the highest yield of pyrophosphate (11.4%). Pyrophosphate formation requires the presence of hydroxyapatite, sodium phosphate and the thioester, N,S-diacetylcysteamine. The related thioester, N,S-diacetylcysteine, also yields pyrophosphate in reactions on hydroxyapatite.

Diphosphates↗

Clinical and roentgenographic evaluation of hydroxyapatite-augmented and nonaugmented porous total hip arthroplasty.

Sixty osteoarthritic patients undergoing primary, uncemented total hip arthroplasty were matched for age and weight and randomized into one of four groups with respect to implant coating and postoperative, protected weight-bearing status: group 1, hydroxyapatite-augmented, 12 weeks; group 2, nonaugmented, 12 weeks; group 3, hydroxyapatite-augmented, 6 weeks; and group 4, nonaugmented, 6 weeks. Tantalum spheres were implanted periprosthetically into the femur at the time of the arthroplasty, thus providing constant references for stereoscopic radiographs. Patients were then evaluated over a 2-year period with clinical examination, plain radiography, and roentgen stereophotogrammetric analysis. Clinical evaluation using the Charnley scoring system showed no significant preoperative or postoperative intergroup differences, whereas visual analog testing noted less thigh pain with hydroxyapatite-augmented stems at the 12-week and 6-month follow-up evaluations. Plain radiographic analysis produced no significant differences, with no instability detected, and bony ingrowth was uniform in all groups. Stereographic evaluation showed migration in all groups, but there were no significant differences between the augmented and nonaugmented stems or the 6-week and 12-week partial weight-bearing protocols. Charnley, plain radiographic, and stereogrammetric evaluations all suggest that migration is unaltered by enhanced surfaces and early, unprotected weight bearing does not jeopardize implant fixation regardless of coating design. The lower incidence of visual analog thigh pain with the hydroxyapatite-augmented stems, however, may be a reflection of bony ingrowth and, as such, add some validity to the theoretic advantages of enhanced surface prostheses.

Age Factors↗

Crystal-induced membrane damage: hydroxyapatite crystal-induced hemolysis of erythrocytes.

Microcrystals of hydroxyapatite cause severe membrane damage in human erythrocytes, as is evident from the strong hemolysis that is caused by these crystals. Hemolysis by hydroxyapatite crystals is time and concentration dependent, and is preceded by aggregation of erythrocytes. Polyvinylpyridine-N-oxide, a strong hydrogen acceptor, has no inhibiting effect on hydroxyapatite-induced hemolysis. This suggest that the mechanism of action of these crystals is different from that of urate crystals and silica particles, where hydrogen bonding interaction is supposed to be important. Negatively charged macromolecules, such as dextran sulfate, heparin, and polyglutamic acid, inhibit hydroxyapatite crystal-induced hemolysis, suggesting that positive charges, probably located on the crystals, play an important role in the membrane-damaging effect of these crystals. The structures with which these positive charges interact remain to be determined because removal of negative charges from the erythrocytes by treatment with neuraminidase does not affect crystal-induced hemolysis.

Adenosine Triphosphate↗

The influence of hydroxyapatite modification on the cross-linking of polydimethylsiloxane/HAp composites.

Hydroxyapatite (HAp) was modified by the action of various hydrophobic agents based on silicon-containing compounds. The influence of the type of applied agent on the thermodynamic and kinetic parameters of the cross-linking of poly(dimethyl siloxane)/HAp composites was investigated. All the modified HAp particles became hydrophobic and these samples were used to synthesize the polysiloxane/hydroxyapatite composites (PDMS/HAp). The possible modes of interaction between the hydroxyapatite and hydrophobing agents were discussed. The most probable interaction between hydroxyapatite and the applied hydrophobing agents is hydrogen bonding. PDMS/HAp composites were formed directly in the cell of the DSC and cross-linking was investigated in situ. It was determined that the introduction of hydroxyapatite into polysiloxane matrices changed the enthalpy of cross-linking, as well as the activation energy of cross-linking and reaction order, while the introduction of modified HAp led to thermodynamic and kinetic parameters more similar to those of the cross-linking of unfilled elastomer.

Biocompatible Materials↗

Corrective osteotomy of malunited distal radius fractures using carbonated hydroxyapatite as an alternative to autogenous bone grafting.

PURPOSE: The purpose of the present study was to report on the author's experience using carbonated hydroxyapatite as a bony substitute in distal radius corrective osteotomies. METHODS: Six patients had a corrective osteotomy for a malunited distal radius fracture using carbonated hydroxyapatite as an alternative to an autogenous bone graft. Internal fixation of the osteotomy was achieved by using 2 or 3 K-wires. RESULTS: At an average follow-up evaluation of 33 months (range, 22-45 mo) all the osteotomies united. Wrist flexion-extension motion improved from 75 degrees to 110 degrees , forearm rotation increased from 116 degrees to 157 degrees , and grip strength had an average increase of 140% at the time of the final follow-up evaluation. All patients were satisfied and there were no reports of persistent pain. Radiographic evaluation showed an average volar tilt improvement from a preoperative dorsal angulation shifting into a neutral position in the sagittal plane; radial lengthening improved from an average of 4 mm (range, 2-6 mm) before surgery to 7 mm (range, 5-9 mm) after surgery, ulnar plus deformity improved by 5 mm. Radiographically the carbonated hydroxyapatite material was integrated completely into the bone tissue with evidence of progressive re-absorption and bony calcification over time. The Mayo wrist score system, according to Cooney and Krimmer modifications, improved by an average of 88 and 98 points (0-100 points), respectively. CONCLUSIONS: On the basis of this preliminary experience it is reasonable to consider carbonated hydroxyapatite as a viable alternative to bone grafting in conjunction with surgical correction of a distal radius malunion. It must be augmented, however, with internal fixation.

Adult↗

Hydroxyapatite cement in craniofacial reconstruction.

OBJECTIVES: To evaluate the long-term efficacy of hydroxyapatite cement in craniofacial reconstruction, specifically examining the role (if any) of radiation, implant location, and cement type. STUDY DESIGN: A retrospective chart review was conducted of all patients presenting to the senior surgeon (Y.D.) for craniofacial reconstruction from September 1997 to April 2004. METHODS: Data were collected including type of cement used, size of defect, complications, need for removal of cement, reason for defect, and pathologic results of examination of removed cements. RESULTS: One hundred two patients were identified who underwent craniofacial reconstruction with hydroxyapatite cements, 7 of whom required complete implant removal (6 Norian and 1 Mimix), and 4 (2 Norian and 2 Bone source) of whom required partial implant removal for foreign body reaction. Five of the removals were in patients who underwent postoperative radiation. CONCLUSIONS: Hydroxyapatite cements are safe in craniofacial reconstruction. The highest risk of implant infection comes from reconstruction in the area of the frontal sinus, immediately beneath coronal incisions, and in patients who receive postoperative radiation treatment. Based on our results, there does appear to be a statistically significant difference in rates of infection and foreign body reaction between the different types of hydroxyapatite cement. We would not recommend implantation of this material in contact with the frontal sinus. Caution should be exercised when it is placed directly beneath an incision or in patients receiving postoperative radiation, particularly if a boost dose is given.

Bone Cements↗

Tissue breakdown and exposure associated with orbital hydroxyapatite implants.

Tissue breakdown and exposure of a hydroxyapatite implant were observed in eight patients: in four of six patients after evisceration and in four of 31 after enucleation. The reasons for evisceration were a blind, painful eye and endophthalmitis in two patients each. The reasons for enucleation were a choroidal melanoma in two patients and endophthalmitis and irreparable traumatic damage in one patient each. The patients with endophthalmitis received the implant in a second surgical procedure after intensive antibiotic treatment. Small tissue defects healed spontaneously, whereas large defects showed little tendency to heal by secondary intention. Tissue breakdown over a hydroxyapatite implant may be related to delayed ingrowth of fibrovascular tissue, and possibly related to an inflammatory reaction incited by the hydroxyapatite. Careful case selection, facilitation of tissue penetration by drilling holes into the hydroxyapatite sphere, delayed fitting of the prosthesis, and vaulting of the posterior surface of the initial prosthesis to reduce pressure on the tissues covering the anterior pole of the implant may alleviate the problems of tissue breakdown and exposure.

Adolescent↗