Professional Documents
Culture Documents
Artificial Bone: Jump To Navigation Jump To Search
Artificial Bone: Jump To Navigation Jump To Search
Flexible hydrogel-HA composite, which has a mineral-to-organic matrix ratio approximating that of human bone
Artificial bone refers to bone-like material created in a laboratory that can be used in bone grafts, to
replace human bone that was lost due to severe fractures, disease, etc. [1]
Bone fracture, which is a complete or partial break in the bone, is a very common condition that has more
than three million US cases per year.[2] Human bones have the ability to regenerate themselves by cycle
of bone resorption and bone formation. The cell responsible for bone resorption is osteoclast, while the
cell responsible for bone formation is osteoblast. That being said, the human body can regenerate
fractured bone. However, if damage to bone is caused by a disease or severe injury, it becomes difficult
for the body to repair itself. When the human body is unable to regenerate the lost bone tissue, surgeons
come in and replace the missing bone using autografts, allografts, and synthetic grafts (artificial bone).
When comparing artificial bone to autograft and allograft, it is less invasive and more biocompatible since
it avoids the risk of unknown viral infections.[3]
Contents
1Overview
o 1.1Demographics of bone injury
o 1.2Current areas of bone grafting (types of bones, composites)
o 1.3Material types
o 1.43D printing of artificial bones
2Advantages
o 2.1Material properties
3Design consideration
o 3.1Clinical results
4Challenges
o 4.1Surface properties
o 4.2Fabrication limitations
o 4.3Biological response
5References
Overview[edit]
Demographics of bone injury[edit]
In the United States, more than 6.5 million bone defects and more than 3 million facial injury cases have
been reported each year. More than 2.2 million bone graft procedures are performed worldwide per year.
The common causes for bone graft are tumor resection, congenital malformation, trauma, fractures,
surgery, osteoporosis, and arthritis.[7] According to the National Ambulatory Medical Care Survey
(NAMCS), in 2010, there were approximately 63 million visits to the orthopedic surgery department and
about 3.5 million visits for fractures in the emergency departments in the U.S. Among the 6.5 million bone
fracture or defect cases, approximately 887,679 people were hospitalized. [8]
Structure of chitosan
Structure of chitin
Materials suited for use in artificial bones need to be biocompatible, osteoconductive, and mechanically
strong.[5] Hydroxyapatite is often used in artificial bone studies because it has the biocompatibility and
osteoconductivity required for an effective, long-lasting bone implant, but is quite brittle, [5] and further
exhibits a dissolution rate of about 10 wt% per year, which is significantly slower than the growth rate of
newly formed bone, necessitating measures to enhance its dissolution rate. [10] For applications that require
a material with better toughness, nanostructured artificial nacre may be used due to its high tensile
strength and Young's modulus.[11] In many cases, using one type of material limits the capabilities of an
artificial bone implant, so composites are utilized. Implants composed of chitosan and hydroxyapatite take
advantage of chitosan's biocompatibility and its ability to be molded into complex porous shapes as well
as hydroxyapatite's osteoconductivity to create a composite that features all three traits. [5] Other
composites suitable for use in artificial bone are those using alginate, a biopolymer known for its scaffold-
forming properties. Uses for alginate in composites include chitosan composites for bone tissue repair,
bioglass composites for repairing or replacing defective or diseased bone, or ceramic-collagen
composites for bone regeneration.[9] The material used in an artificial bone implant ultimately depends on
the type of implant being created and its use.
3D printing of artificial bones[edit]
3D printing is becoming an efficient way to produce artificial bones. First, a bone model is created by
means of reconstruction of CAT scan images obtained from the patient. Then the artificial bone materials
are used as “filament" for 3D printing. According to the resolution grafts, the 3D bone model would be
divided into some layers. The printer would print a layer, then next one upon the last, and finally
producing an artificial bone. Most of recently studies show hydroxyapatite (HA) nanocrystals are ideal
material for 3D printed artificial bones. HA nanocrystals are synthesized by wet synthesis
using diammonium phosphate and calcium chloride as phosphorus and calcium precursors, respectively.
[12]
Furthermore, polycaprolactone (PCL) can also be used for 3D printing producing of artificial bone in
some research reports. Compared to repairing damaged bones, 3D printing technique could produce
implants which meets personalized repair needs. On the other hand, 3D printing techniques produce
implants with few adverse effects on patients. Host cells of varying classifications, such as lymphocytes
and erythrocytes, display minimal immunological response to artificial grafts. [13]
Advantages[edit]
Material properties[edit]
Effective bone substitute materials should exhibit good mechanical strength along with adequate
bioactivity. Bioactivity, which is often gauged in terms of dissolution rates and the formation of a mineral
layer on the implant surface in-vivo, can be enhanced in biomaterials, in particular hydroxyapatite, by
modifying the composition and structure by doping.[10] As an alternative to hydroxyaptatite systems,
Chitosan composites have been thoroughly studied as one material to use for artificial bone. [5] Chitosan by
itself can be easily modified into complex shapes that include porous structures, making it suitable for cell
growth and osteoconduction.[5] In addition, chitosan scaffolds are biocompatible and biodegradable, but
have low toughness, and the material itself is not osteoconductive. [5] Hydroxyapatite, on the other hand,
features excellent biocompatibility but is hindered by its brittle nature. [14] When implemented with
hydroxyapatite as a composite, both the toughness and osteoconductivity significantly improve, making
the composite a viable option for material for artificial bone. [5] Chitosan can also be used with carbon
nanotubes, which have a high Young's modulus (1.0–1.8 TPa), tensile strength (30–200 GPa), elongation
at break (10–30%), and aspect ratio (>1,000).[5] Carbon nanotubes are very small in size, chemically and
structurally stable, and bioactive.[5] The composite formed by carbon nanotubes and chitosan greatly
improves the toughness of chitosan.[5] Nanostructured artificial nacre is another option for creating artificial
bone.[11] Natural nacre is composed of an arrangement of organic and inorganic layers similar to brick and
mortar.[9] This along with the ionic crosslinking of tightly folded molecules allow nacre to have high strength
and toughness.[9] Artificial nacre that mimicked both the structure and the effect of the ionic bonds had a
tensile strength similar to natural nacre as well as an ultimate Young's modulus similar to lamellar bone.
[11]
From a mechanical standpoint, this material would be a viable option for artificial bone.
Design consideration[edit]
Clinical results[edit]
Several aspects of any artificial bone design must be considered before implementing the design into a
patient. Artificial bone implants that are an ill fit inside a patient due to events such as leaving the recipient
bone unfixed can cause redness and swelling at the recipient region. [3] Ill fit implants may also be caused
by sintering, which can cause dimensional contraction of an implant by up to 27%. [15] Osteoconductivity is
another important consideration for artificial bone design. Sintered materials increase the crystallinity of
calcium phosphate in certain artificial bones, which leads to poor resorption by osteoclasts and
compromised biodegradability.[15] One study avoided this by creating inkjet-printed, custom-made artificial
bones that utilized α-tricalcium phosphate (TCP), a material that converts to hydroxyapatite and solidifies
the implant without the use of sintering.[15] In addition, α-TCP is biocompatible and helps form new bone,
which is better for patients in the long term.[3] Artificial bone designs must be biocompatible, have
osteoconductivity, and last for long periods of time inside a patient in order to be a viable solution
compared to autologous and allogeneic bone implants.
Challenges[edit]
Surface properties[edit]
Artificial grafts maintain comparable compressive strength, but occasionally lack similarity to human bone
in response to lateral or frictional forces.[16] In particular, the topography of artificial bone is inaccurate
compared to its natural counterpart. In Grant et al., artificial bone grafts produced by fused deposition had
on average a 20% lower coefficient of friction compared to real bone. [16] While CT scans and subsequent
bone models are highly indicative of real bone for internal composition, the final product relies on the
resolution of the printer. In cases where printer defects occur, the most likely issue is a decrease in
compressive strength due to unintentional voids.[15] After implantation, decreased cellular proliferation and
differentiation is evident as patients increase with age. This prolongs the integration of grafts and hinders
the formation of bone tissue. In animal models, the incorporation of allografts causes teratoma formation.
Whether or not the probability of this event is significantly increased remains to be seen. [2] Thus,
scaffolding with other biological agents is necessary to mimic the framework of the body. Type I collagen,
which constitutes a significant portion of the organic mass of bone, is a frequently used scaffolding agent.
Alternatively, the polymer chitosan possesses similar biological response, namely the promotion of
osteogenesis in vivo.[2]
Fabrication limitations[edit]
More modern fabrication techniques include inkjet printing. [17] In one study, a 3D inkjet printer produced
autograft implants for the lower jaw of 10 patients. The hydroxyapatite implant was produced
from tricalcium phosphate powder which hardened after hydration.[17] The surgical procedure was
conducted for both aesthetic and function. All patients indicated satisfaction with the bone product. In
another study, which examined replicate goat femurs, hydroxyapatite nanocrystals were produced and
mixed on-site before loading a 3D printer. The study noted a slight decrease in compressive strength of
the femurs, which could be attributed to imperfect printing and an increased ratio of cancellous bone. In
general, 3D printing techniques produce implants with few adverse effects in patients. Host cells of
varying classifications, such as lymphocytes and erythrocytes, displayed minimal immunological response
to artificial grafts.[2] Only in the case of improper sterilization or previous predisposition to infection did any
significant complications occur. The speed of printing is the primary rate-limiting step in artificial bone
production. Depending on the type of bone implant, printing time can range from an hour to several. [15] As
printers produce higher resolution grafts, the duration of printing increases proportionally.
Biological response[edit]
Research on artificial bone materials has revealed that bioactive and resorbable silicate glasses
(bioglass), glass-ceramics, and calcium phosphates exhibit mechanical properties that are similar to
human bone.[18] Similar mechanical properties do not assure biocompatibility. The body's biological
response to those materials depends on many parameters including chemical composition, topography,
porosity, and grain size.[18] If the material is metal, there is a risk of corrosion and infection. If the material
is ceramic, it is difficult to form the desired shape, and bone can't reabsorb or replace it due to its high
crystallinity.[3] Hydroxyapatite, on the other hand, has shown excellent properties in supporting the
adhesion, differentiation, and proliferation of osteogenesis cell since it is both thermodynamically stable
and bioactive.[18] Artificial bones using hydroxyapatite combine with collagen tissue helps to form new
bones in pores, and have a strong affinity to biological tissues while maintaining uniformity with adjacent
bone tissue.[3] Despite its excellent performance in interacting with bone tissue, hydroxyapatite has the
same problem as ceramic in reabsorption due to its high crystallinity. Since hydroxyapatite is processed
at a high temperature, it is unlikely that it will remain in a stable state. [3]
References[edit]
0. ^ "ARTIFICIAL BONE GRAFTS: PRO OSTEON". Arthroscopy.com. Archived
from the original on 2013-04-04. Retrieved 2013-11-16.
1. ^ Jump up to:a b c d Kashte, Shivaji; Jaiswal, Amit Kumar; Kadam, Sachin
(2017). "Shivaji Kashte, Amit Kumar Jaiswal, Sachin Kadam. (2017). Artificial
Bone via Bone Tissue Engineering: Current Scenario and Challenges". Tissue
Engineering and Regenerative Medicine. 14 (1): 1–14. doi:10.1007/s13770-
016-0001-6. PMC 6171575. PMID 30603457.
2. ^ Jump up to:a b c d e f Saijo, Hideto; Fujihara, Yuko; Kanno, Yuki; Hoshi,
Kazuto; Hikita, Atsuhiko; Chung, Ung-il; Takato, Tsuyoshi (2016). "Saijo, H.,
Fujihara Y., Kanno Y., Hoshi K., Hikita A., Chung U., Takato T. (2016). Clinical
Experience of full custom-made artificial bones for the maxillofacial
region". Regenerative Therapy. 5: 72–
78. doi:10.1016/j.reth.2016.08.004. PMC 6581837. PMID 31245504.
3. ^ "Creating Artificial Bones for Faster Bone Regeneration". Tokyo Institute of
Technology. Retrieved 2018-04-20.
4. ^ Jump up to:a b c d e f g h i j k l Venkatesan, Jayachandran; Kim, Se-Kwon
(2010). "Venkatesan, J., & Kim, S.-K. (2010). Chitosan Composites for Bone
Tissue Engineering—An Overview". Marine Drugs. 8 (8): 2252–
2266. doi:10.3390/md8082252. PMC 2953403. PMID 20948907.
5. ^ Ferreira, Ana Marina; Gentile, Piergiorgio; Chiono, Valeria; Ciardelli,
Gianluca (2012). "Ferreira, A. M., Gentile, P., Chiono, V., & Ciardelli, G.
(2012). Collagen for bone tissue regeneration". Acta Biomaterialia. 8 (9):
3191–3200. doi:10.1016/j.actbio.2012.06.014. PMID 22705634.
6. ^ Kashte, Shivaji; Jaiswal, Amit Kumar; Kadam, Sachin (2017). "Shivaji
Kashte, Amit Kumar Jaiswal, Sachin Kadam. (2017). Artificial Bone via Bone
Tissue Engineering: Current Scenario and Challenges". Tissue Engineering
and Regenerative Medicine. 14 (1): 1–14. doi:10.1007/s13770-016-0001-
6. PMC 6171575. PMID 30603457.
7. ^ "NAMCS: Factsheet-ORTHOPEDIC SURGERY". Centers for disease
control and prevention. Retrieved 2018-04-20.
8. ^ Jump up to:a b c d Venkatesan, Jayachandran; Bhatnagar, Ira; Manivasagan,
Panchanathan; Kang, Kyong-Hwa; Kim, Se-Kwon (2015). "Venkatesan, J.,
Bhatnagar, I., Manivasagan, P., Kang, K., & Kim, S. (2015). Alginate
composites for bone tissue engineering: A review". International Journal of
Biological Macromolecules. 72: 269–
281. doi:10.1016/j.ijbiomac.2014.07.008. PMID 25020082.
9. ^ Jump up to:a b Zhu, H.; et al. (2018). "Nanostructural insights into the
dissolution behavior of Sr-doped hydroxyapatite". Journal of the European
Ceramic Society. 38 (16): 5554–
5562. arXiv:1910.10610. doi:10.1016/j.jeurceramsoc.2018.07.056. S2CID 10
5932012.
10. ^ Jump up to:a b c Tang, Zhiyong; Kotov, Nicholas A.; Magonov, Sergei; Ozturk,
Birol (2003). "Tang, Z., Kotov, N. A., Magonov, S., & Ozturk, B. (2003).
Nanostructured artificial nacre". Nature Materials. 2 (6): 413–
418. doi:10.1038/nmat906. PMID 12764359. S2CID 6192932.
11. ^ Fan, Chunquan; Li, Jiashun; Xu, Guohua; He, Hailong; Ye, Xiaojian; Chen,
Yuyun; Sheng, Xiaohai; Fu, Jianwei; He, Dannong (2010). "Fan, C., Li, J., Xu,
G., He, H., Ye, X., Chen, Y., Sheng, X., Fu, J., He, D. (2010). Facile
fabrication of nano-hydroxyapatite/silk fibroin composite via a simplified
coprecipitation route". Journal of Materials Science. 45 (21): 5814–
5819. doi:10.1007/s10853-010-4656-4. S2CID 136591597.
12. ^ Kashte, Shivaji; Jaiswal, Amit Kumar; Kadam, Sachin (2017). "Shivaji
Kashte, Amit Kumar Jaiswal, Sachin Kadam. (2017). Artificial Bone via Bone
Tissue Engineering: Current Scenario and Challenges". Tissue Engineering
and Regenerative Medicine. 14 (1): 1–14. doi:10.1007/s13770-016-0001-
6. PMC 6171575. PMID 30603457.
13. ^ Zhou, Hongjian; Lee, Jaebeom (2011). "Zhou, H., & Lee, J. (2011).
Nanoscale hydroxyapatite particles for bone tissue engineering". Acta
Biomaterialia. 7 (7): 2769–
2781. doi:10.1016/j.actbio.2011.03.019. PMID 21440094.
14. ^ Jump up to:a b c d e Saijo, Hideto; Igawa, Kazuyo; Kanno, Yuki; Mori,
Yoshiyuki; Kondo, Kayoko; Shimizu, Koutaro; Suzuki, Shigeki; Chikazu,
Daichi; Iino, Mitsuki; Anzai, Masahiro; Sasaki, Nobuo; Chung, Ung-il; Takato,
Tsuyoshi (2009). "Saijo H, Igawa K, Kanno Y, Mori Y, Kondo K, Shimizu K,
Suzuki S, Chikazu D, Iino M, Anzai M, Sasaki N, Chung UI, Takato T. (2009).
Maxillofacial reconstruction using custom-made artificial bones fabricated by
inkjet printing technology". Journal of Artificial Organs. 12 (3): 200–
205. doi:10.1007/s10047-009-0462-7. PMID 19894095. S2CID 35626675.
15. ^ Jump up to:a b Grant, J.A.; Bishop, N.E.; Götzen, N.; Sprecher, C.; Honl, M.;
Morlock, M.M. (2007). "Grant, J., Bishop, N., Götzen, N., Sprecher, C., Honl,
M., & Morlock, M. (2007). Artificial composite bone as a model of human
trabecular bone: The implant-bone interface". Journal of
Biomechanics. 40 (5): 1158–
1164. doi:10.1016/j.jbiomech.2006.04.007. PMID 16806236.
16. ^ Jump up to:a b Xu, Ning; Ye, Xiaojian; Wei, Daixu; Zhong, Jian; Chen, Yuyun;
Xu, Guohua; He, Dannong (2014). "Xu, N., Ye, X., Wei, D., Zhong, J., Chen,
Y., Xu, G., & He, D. (2014). 3D Artificial Bones for Bone Repair Prepared by
Computed Tomography-Guided Fused Deposition Modeling for Bone
Repair". ACS Applied Materials & Interfaces. 6 (17): 14952–
14963. doi:10.1021/am502716t. PMID 25133309.
17. ^ Jump up to:a b c Hoppe, Alexander; Güldal, Nusret S.; Boccaccini, Aldo
R. (2011). "Hoppe, A., Güldal, N. S., & Boccaccini, A. R. (2011).A review of
the biological response to ionic dissolution products from bioactive glasses
and glass-ceramics". Biomaterials. 32 (11): 2757–
2774. doi:10.1016/j.biomaterials.2011.01.004. PMID 21292319.
Categories:
Artificial organs
Bone products
Navigation menu
Not logged in
Talk
Contributions
Create account
Log in
Article
Talk
Read
Edit
View history
Search
Search Go
Main page
Contents
Current events
Random article
About Wikipedia
Contact us
Donate
Contribute
Help
Learn to edit
Community portal
Recent changes
Upload file
Tools
What links here
Related changes
Special pages
Permanent link
Page information
Cite this page
Wikidata item
Print/export
Download as PDF
Printable version
Languages
العربية
Español
فارسی
한국어
Bahasa Indonesia
日本語
Edit links
This page was last edited on 22 April 2022, at 14:11 (UTC).
Text is available under the Creative Commons Attribution-ShareAlike License 3.0; additional terms may apply. By
using this site, you agree to the Terms of Use and Privacy Policy. Wikipedia® is a registered trademark of
the Wikimedia Foundation, Inc., a non-profit organization.
Privacy policy
About Wikipedia
Disclaimers
Contact Wikipedia
Mobile view
Developers
Statistics
Cookie statement