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At least 19 recordsLinked to original sources
PubMed1999

Calcium sulfate- and calcium phosphate-based bone substitutes. Mimicry of the mineral phase of bone.

Calcium sulfate and calcium phosphate have provided the orthopedic surgeon a viable alternative to autogenous bone grafting as either an osteoconductive bone void filler or a bone graft extender. These materials mimic the mineral phase of bone and are resorbed at a rate similar to the rate of bone formation. Thus, they are able to provide some structural support and prevent ingrowth of fibrous tissue while facilitating creeping substitution by the host bone.

Biocompatible Materials↗
PubMed1998

Periodontal repair in intrabony defects treated with a calcium sulfate implant and calcium sulfate barrier.

THIS RANDOMIZED, CONTROLLED, CLINICAL STUDY was designed to evaluate outcome following surgical implantation of an allogeneic, freeze-dried, demineralized bone matrix-calcium sulfate (DBM+CS) composite with a CS barrier in intrabony periodontal defects. Twenty-six patients contributing 26 deep intrabony defects completed the study. Thirteen patients received the DBM+CS implant. Thirteen patients received gingival flap surgery alone (GFS; control). Clinical outcome was assessed at 6 and 12 months postsurgery. At 12 months postsurgery, probing depth (PD) reduction (mean +/-SD) for the DBM+CS and GFS group was to 4.3+/-0.5 and 3.0+/-1.3 mm; clinical attachment gain was to 2.9+/-0.8 and 1.7+/-1.5 mm; and probing bone level gain was to 2.9+/-1.4 and 1.2+/-1.2 mm, respectively. There were no apparent differences between evaluations at 6 and 12 months postsurgery. Clinical improvements were significantly different from presurgery for both groups at both observation intervals (P < 0.01). There were no significant differences between groups in PD reduction and clinical attachment gain. Probing bone level gain was significantly greater in the DBM+CS group compared to controls (P < 0.05). In summary, surgical implantation of DBM+CS with a CS barrier resulted in reduced PD and improved attachment levels comparable to that achieved by gingival flap surgery alone. However, gain in probing bone levels in deep intrabony periodontal pockets assessed by clinical parameters was greater than that observed by gingival flap surgery alone. These changes were noted at both 6 and 12 months after surgery. This regenerative technique needs further biologic evaluation before being generally accepted.

Adult↗
PubMed1998

Effect of a calcium sulfate implant with calcium sulfate barrier on periodontal healing in 3-wall intrabony defects in dogs.

This controlled, split-mouth, preclinical study was designed to evaluate outcome following surgical implantation of an allogeneic, freeze-dried demineralized bone matrix-calcium sulfate (DBM+CS) composite with a CS barrier in 3-wall intrabony periodontal defects in 4 dogs. Control conditions included surgical implantation of DBM or CS and gingival flap surgery (GFS) alone. Three-wall intrabony defects (4x4x4 mm) were surgically created at the mesial and distal aspect of the maxillary and mandibular first and third premolars, respectively. Maxillary and mandibular defects each received 1 of the 4 experimental conditions. Experimental conditions were rotated between defect sites in subsequent animals. Block sections of the defects were collected at sacrifice 8 weeks postsurgery and processed for histometric analysis. Histometric defect height (means +/- SD) for the DBM+CS, DBM, CS, and GFS groups amounted to 4.2 +/- 0.5, 4.3 +/- 0.7, 4.0 +/- 0.2, and 4.1 +/- 0.2 mm, respectively. Connective tissue adhesion (connective tissue contact to the root without apparent cementum formation) amounted to 0.4 +/- 0.3, 0.4 +/- 0.3, 0.5 +/- 0.2, and 1.6 +/- 0.5 mm for the DBM+CS, DBM, CS, and GFS groups, respectively; the DBM+CS, DBM, and CS groups being significantly different from the GFS group (P < 0.05). Cementum regeneration amounted to 3.0 +/- 0.3, 3.1 +/- 0.4, 2.5 +/- 0.4, and 1.6 +/- 0.3 mm for the DBM+CS, DBM, CS, and GFS groups, respectively; the DBM+CS, DBM, and CS groups being significantly different from the GFS group (P < 0.05). Alveolar bone regeneration amounted to 2.7 +/- 0.4, 2.7 +/- 0.3, 1.8 +/- 0.5, and 0.7 +/- 0.1 mm for the DBM+CS, DBM, CS, and GFS groups, respectively; the DBM+CS, DBM, and CS groups being different from the GFS group (P < 0.05), and the DBM+CS and DBM groups being different from the CS group (P < 0.05). None of the DBM-containing implants provided evidence of bone metabolic activity. In summary, surgical implantation of DBM and CS, alone or in combination, may result in significantly improved regeneration of alveolar bone and cementum in this preclinical model. Observed regeneration is likely unrelated to a biologic activity inherent in DBM. Rather it appears that space-providing properties of the implants supported observed regeneration.

Alveolar Bone Loss↗
PubMedDate not supplied

Availability of calcium from skim milk, calcium sulfate and calcium carbonate for bone mineralization in pigs.

Dairy products provide abundant, accessible calcium for humans, while some calcium sulfate-rich mineral waters could provide appreciable amounts of calcium. But there is little evidence that this calcium is as available as milk calcium for making bone. The availability of calcium was studied by monitoring bone parameters in 2-month-old pigs fed restricted amounts of calcium (70% RDA) for 2.5 months. The 3 main (> or = 50% Ca intake) Ca sources were either CaCO3 or CaSO4 or skim milk powder (29% of the diet). The bones of the pigs fed the "milk" diet had higher (P < 0.01) ash contents, breaking strength and density (DEXA) than those of the two others groups, in which the bone values were similar. Thus, the calcium provided by a diet containing milk appears to ensure better bone mineralization than do calcium salts included in a non-milk diet. The calcium restriction may have enhanced some milk properties to stimulate calcium absorption in these young, rapidly growing pigs.

Alkaline Phosphatase↗
PubMed2002

The treatment of experimental osteomyelitis by surgical debridement and the implantation of calcium sulfate tobramycin pellets.

Calcium sulfate was used as a biodegradable delivery system for the administration of antibiotics in musculoskeletal infection. New Zealand white rabbits were infected with Staplylococcus aureus, debrided, and randomized to one of four treatment groups: calcium sulfate pellets with 10% tobramycin sulfate, placebo calcium sulfate pellets and IM tobramycin, placebo calcium sulfate pellets, or debridement. Serum and wound exudate tobramycin concentrations and serum calcium levels were measured. Radiographs, cultures, and histology were analyzed for efficacy and treatment. Rabbits treated with 10% tobramycin sulfate pellets showed a significantly higher eradication of infection (11/13) than rabbits treated with debridement only (5/12), placebo pellets and IM tobramycin (5/14). or placebo pellets (3/13). In the group receiving 10% tobramycin sulfate pellets, serum tobramycin concentrations peaked 3 h post-operatively at 5.87 microg/ml and were non-detectable after day 1. In the group receiving placebo pellets and IM tobramycin, serum concentrations peaked at 7.82 microg/ml 1 h post-operatively, fell to 6.12 microg/ml on day 2, and averaged 4.18 microg/ ml for the remainder of the treatment period. The wound exudate tobramycin concentrations in the animals treated with tobramycin sulfate pellets peaked at 11.9 mg/ml on day 1 and dropped to 2.5 microg/ml on day 7. There was no significant difference in the serum calcium levels in any of the treatment groups. Calcium sulfate containing tobramycin sulfate has potential utility as a biodegradable local antibiotic delivery system in the treatment of musculoskeletal infections.

Animals↗
PubMed2006

Mechanical and degradation behavior of polymer-calcium sulfate composites.

Calcium sulfate (CS) is one of the oldest bone graft materials still in use. Its main limitations are poor handling characteristics, poor mechanical properties, and a resorption rate that is too fast for some applications. The present study investigated the effect of viscous polymers, such as carboxymethylcellulose (CMC) and hyaluronan (HY), on the handling characteristics, mechanical properties, and degradation behavior of CS. CMC and HY were added to CS at concentrations from 1-10 wt%. Addition of CMC to CS at more than 4 wt% produced a putty-like material and decreased the density of the composite, while also increasing flexural and compressive strength at higher loadings. Incorporation of CMC produced a concentration-dependent increase in water absorption and degradation rate. At an equivalent loading, HY-containing CS composites showed better compressive strength than CS with CMC. Overall, addition of CMC or HY to CS resulted in composite materials with better handling characteristics and improved mechanical properties after set, however the degradation rate of the augmented materials was increased. These properties suggest that the enhanced CS materials may be useful in certain clinical situations, such as filling non-uniform bone defects and situations that require mechanical integrity of the bone graft substitute during implantation.

Biocompatible Materials↗
PubMed2005

Calcium sulfate: a review.

Calcium sulfate has a long history of use in medicine and dentistry. It exists in two forms (alpha and beta), which differ greatly in physical properties. It has been used in bone regeneration as a graft material and graft binder/extender and as a barrier in guided tissue regeneration. It is an unusually biocompatible material and is completely resorbed following implantation. It does not evoke a significant host response and creates a calcium-rich milieu in the area of implantation. These calcium ions may provide some stimulation to osteoblasts, which may account for some of the positive results reported with the material. Calcium sulfate can be used as a delivery vehicle for growth factors and antibiotics, although this application has not been thoroughly exploited in the clinical setting. It has been shown that tissue will often migrate over calcium sulfate if primary closure cannot be obtained, which provides further evidence of its biocompatibility. The raw material from which calcium sulfate is made is relatively inexpensive and abundant. Despite these advantages, calcium sulfate has never attracted the same degree of research interest as have other biomaterials. Recently, however, it has enjoyed a resurgence of sorts in the areas of periodontology, sinus augmentation, and orthopedic surgery. Future research must be directed toward improving handling characteristics and strength, while preserving the biocompatibility of the material.

Animals↗
PubMed2004

New hydraulic cements based on alpha-tricalcium phosphate-calcium sulfate dihydrate mixtures.

Calcium sulfate dihydrate (CSD) powder was added to a cement consisting of alpha-tricalcium phosphate (alpha-TCP) and water. The changes of the physico-chemical properties of the cement were investigated as a function of the CSD amount, the phosphate concentration in the mixing solution, and the solution volume. An increase of the phosphate concentration in the mixing liquid and small additions of CSD powder strongly reduced the cement setting time. Simultaneously, the fraction of unreacted alpha-TCP powder present after 1 day of incubation increased, indicating that alpha-TCP hydrolysis was inhibited. The effects of the CSD amount and the phosphate concentration were synergetic, i.e. the effect of CSD powder was increased with an increase of the phosphate concentration and vice versa. Interestingly, none of the factors affected the cement diametral tensile strength. The present results were explained based on solubility calculations. The present study shows that the use of CSD crystals in combination with phosphate ions is an easy and interesting way to control the setting time of alpha-TCP-water mixtures, in particular, because the mechanical properties of the cement are not modified.

Bone Cements↗
PubMed1992

Calcium carbonate depresses iron bioavailability in rats more than calcium sulfate or sodium carbonate.

Calcium carbonate supplements depress iron bioavailability when consumed with meals. Our objective was to determine whether this effect is due to the calcium, the carbonate or a combination of the two. A rat hemoglobin repletion assay and an in vitro digestion procedure were used to assess the effects of four salts (calcium carbonate, calcium sulfate, sodium carbonate and sodium sulfate) on iron bioavailability. The salts were added to purified rat diets (for the hemoglobin repletion study) or to iron-fortified infant formula (for the in vitro study) at three different levels. Calcium carbonate had the greatest depressive effect on iron bioavailability, depressing hemoglobin iron gain in a dose-related manner. Calcium sulfate and sodium carbonate also depressed hemoglobin iron gain but to a lesser extent and only in rats fed diets containing the highest level of these two salts. Sodium sulfate did not affect hemoglobin iron gain. Significant interactions between cation, anion and salt concentration were found, suggesting that both the cation and the anion in calcium carbonate contribute to the iron absorption-depressing action of this salt. Results from the in vitro experiments were similar to the in vivo results.

Absorption↗
PubMed2003

Healing of large defects treated with calcium sulfate pellets containing demineralized bone matrix particles.

Calcium sulfate (OsteoSet, Wright Medical Technology, Inc, Arlington, Tenn) and calcium sulfate/demineralized bone matrix (DBM) pellets (OsteoSet DBM, Wright Medical Technology, Inc) have been evaluated preclinically in a bilateral medullary defect model of a canine humerus. In this model, both short (6 week) and long (26 week) time points have been evaluated. An analysis of bone response to the pellets was conducted using radiological, histological, mechanical, and quantification techniques. The calcium sulfate/DBM pellets exhibited more rapid trabecular bone remodeling as demonstrated by the absence of the ringlet bone structure typically seen with calcium sulfate pellets. We concluded that calcium sulfate and calcium sulfate/DBM pellets are both effective bone graft substitutes.

Animals↗
PubMed2004

Bone-defect healing with calcium-sulfate particles and cement: an experimental study in rabbit.

Calcium sulfate (CaS) has been shown to be a reasonable alternative to autogenous bone graft for treating bone lesions in dentistry. The aim of this work was an histological study of the bone healing of defects treated with calcium sulfate in the form of cement or beads, in animal. Eight New Zealand rabbits, weighing about 2.5 Kg were used in this study. In each rabbit, four 6 mm bone defects were created in the tibial metaphysis. The 2 defects in the right tibia were filled with calcium sulfate as cement, while the 2 defects in the left one were filled with calcium sulfate as beads. Four rabbits were killed after respectively 2 and 4 weeks, with an intravenous injection of Tanax, and the block sections, containing the bone defects, were retrieved. A total of 16 defects filled by cement and a total of 16 defects filled by beads were retrieved. The specimens were processed to obtain thin ground sections with the Precise 1 Automated System. In the first phases of healing it was possible to observe an intense osteoblastic activity, and in some areas osteoid matrix was present. After two weeks the calcium sulfate (both cement and beads) was still present, and biological fluids and cells were present inside the material. Newly formed bone surrounded the calcium sulfate and filled about 10% of the defect. After four weeks the calcium sulfate was almost completely resorbed and substituted by new bone. Approximately 34% of the defects were filled by newly formed bone. BEI and XRM evaluations showed the structural components of the filled defects. In none of the specimens were inflammatory cells present. No significant differences were found using both calcium sulfate as cement and beads, and they both have shown a high biocompatibility, appearing to promote newly bone formation in the rabbit model, and they did not induce any untoward effect on the bone regeneration processes.

Absorptiometry, Photon↗
PubMed2004

Effects of altered crystalline structure and increased initial compressive strength of calcium sulfate bone graft substitute pellets on new bone formation.

A new, modified calcium sulfate has been developed with a different crystalline structure and a compressive strength similar to many calcium phosphate materials, but with a resorption profile only slightly slower than conventional surgical-grade calcium sulfate. A canine bilateral defect model was used to compare restoration of defects treated with the modified calcium sulfate compared to treatment using conventional calcium sulfate pellets after 6, 13, and 26 weeks. The modified calcium sulfate pellets were as effective as conventional calcium sulfate pellets with regard to the area fraction and compressive strength of newly formed bone in the treated bone defects. Mechanical testing demonstrated that the initial compressive strength of the modified material was increased nearly three-fold compared to that of conventional surgical-grade calcium sulfate. This increase potentially allows for its use in a broader range of clinical applications, such as vertebral and subchondral defects.

Animals↗
PubMed2003

Response of a calcium sulfate bone graft substitute in a confined cancellous defect.

Calcium sulfate, plaster of Paris, has a long clinical history for use as a bone graft substitute in various skeletal sites. The current authors examined the in vivo response of calcium sulfate pellets alone or in combination with autogenous bone graft in a bilateral critical-size distal femoral cancellous defect in an adult sheep model. New thick bone formation was seen in defects filled with calcium sulfate pellets alone. Increased immunostaining for bone morphogenetic protein-2, bone morphogenetic protein-7, transforming growth factor-beta, and platelet derived growth factor was seen in defects filled with calcium sulfate pellets alone and in combination with autograft. The local acidity during calcium sulfate resorption is proposed as a possible in vivo mechanism for this type of material.

Animals↗
PubMed2006

Biological effects of calcium sulfate as a bone graft substitute in ovine metaphyseal defects.

Calcium sulfate has been used as a bone graft substitute in many fields, from dentistry to orthopedics. However, the results of many studies have yielded inconclusive results. In the present study, a sheep model was used with tibial and femoral metaphyseal defects to determine whether calcium sulfate was as effective as autograft and allograft in promoting new bone formation in a critical size defect. Medical-grade calcium sulfate pellets, autograft bone, allograft bone, or nothing was used to fill the metaphyseal defects. The sheep were allowed to heal for 12 weeks. Sagittal sections from the bones were analyzed with high-resolution contact radiographs, backscattered electron microscopy, and light microscopy. The volume fractions of bone within the defect perimeter were determined, and the histologic quality of the bone was observed. The volume fraction of new bone in the autograft, calcium sulfate, and allograft were not statistically different, but all were significantly different than the untreated control. The majority of the calcium sulfate had been resorbed at 12 weeks, and the histologic quality of the bone appeared similar to the autograft-treated bone. Calcium sulfate appears to be a useful biocompatible bone graft substitute that yields results similar to autograft bone in sheep metaphyseal defects.

Animals↗
PubMed2002

Comparison of three methods using calcium sulfate as a graft/barrier material for the treatment of Class II mandibular molar furcation defects.

The purpose of this study was to compare the effectiveness of three methods using calcium sulfate as a graft/barrier for the treatment of Class II mandibular furcation defects. Thirty-six defects in 17 patients were treated with a graft/barrier of pure calcium sulfate, calcium sulfate plus doxycycline, or demineralized freeze-dried bone allograft (DFDBA) in a 2:1 ratio by volume. Defects were randomly selected for treatment, and all measurement parameters were standardized to a light-cured acrylic resin stent at baseline and 6, 9, and 12 months. Linear regression, ANOVA, and chi-squared analysis revealed that all three groups showed significant bone fill (P < .05), vertical and horizontal probing depth reduction, defect volume reduction, and a gain in vertical clinical attachment. Furthermore, the addition of either doxycycline or DFDBA to calcium sulfate significantly enhanced the clinical outcome more than did the calcium sulfate alone, and the addition of DFDBA was more effective in the treatment of Class II mandibular furcation defects than doxycycline.

Adult↗
PubMed1999

The versatility of calcium sulfate: resolving periodontal challenges.

The multifaceted properties of calcium sulfate demonstrate its usefulness in periodontal practice. Calcium sulfate can function as a resorbable space filler, a resorbable barrier (compatible with guided tissue regeneration principles) and as a vehicle for controlled-release chemotherapy. Various periodontal challenges are demonstrated through case reports using calcium sulfate.

Absorbable Implants↗
PubMedDate not supplied

The in vitro elution characteristics of vancomycin and tobramycin from calcium sulfate beads.

The purpose of this study was to determine the elution characteristics of vancomycin and tobramycin when mixed with calcium sulfate to form antibiotic beads. Calcium sulfate was combined with vancomycin and tobramycin separately to form 2 types of antibiotic beads, which were packaged and labeled separately. The packaged calcium sulfate beads with vancomycin and tobramycin were then gas sterilized. The beads were placed in phosphate-buffered saline and kept at 36 degrees C for 6 weeks. Two separate series of assays were run simultaneously for both types of beads. In one assay, a bead containing vancomycin was placed in a fresh vial of phosphate buffered saline after each assay. The same was done with beads containing tobramycin. In the second series of assays, 9 vials of phosphate buffered saline each containing 1 vancomycin bead and 9 vials of phosphate buffered saline each containing 1 tobramycin bead was arranged. The phosphate-buffered saline was then assayed at predetermined times for both the vancomycin bead series and the tobramycin bead series. The amount of vancomycin and tobramycin assayed nearly equaled the calculated amount of antibiotic per bead measured before bead construction. Also, the elution of antibiotic from the calcium sulfate was complete within 72 hours. In conclusion, the construction and gas sterilization of calcium sulfate beads containing vancomycin and tobramycin does not destroy vancomycin and tobramycin. Also, the complete elution of available vancomycin and tobramycin in calcium sulfate beads occurs within 72 hours.

Anti-Bacterial Agents↗