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Graft
Substitutes
Moderators:
Prof. R.M.Shenoy
Presenter:
Dr. Neeraj
Date:01/12/09
INTRODUCTION
Contd...
BONE GRAFT
CLASSIFICATION SYSTEM
Modified from Laurencin et
al - 2006 Allogro,
Allograft
Osteoconduct
based
Ceramic
based
Polymer
based
Factor based
ive
(Natural)
Osteoconduct
ive
(Synthetic)
OrthoBlast
Osteoconduct
ive
(synthetic)
Osteoinductiv
Cortoss,
OPLA, Immix
Osteograf,
Norian SRS,
ProOsteon,
Osteoset
TGF-b, PDGF,
ALLOGRAFT BASED
SUBSTITUTES
Disadvantages :
>Concerns about the transmission of bloodborne diseases.
>Freezing and irradiation affect the process
of graft incorporation and structural
strength.
Contd
Contd
Contd
Diagram
Calcium phosphate:
An injectable calcium
paste
Highest mechanical
compression strength
of any of the
oseteoconductive
bone-graft substitutes
95 percent resorbed
in 26 to 86 weeks
Contd
Calcium
Phosphate
Coatings:
Wellboundtometal
implants.
Increased
osteointegrativeability
ofscrews.
Increasefixation
Contd
Coralline hydroxyapatite
: Produced from marine
coral exoskeleton.
> Have pore structures
resembling cancellous
bone .
Contd
Contd
Calcium sulfate : First introduced
as plaster of paris in 1892.
First used as a bone filler in the
early 1900s
Calcium sulfate resorbs in 4 to 12
weeks, making it the quickest of any
of the osteoconductive products
currently available
Contd
Tricalcium phosphate (TCP) : Fast
resorbing ceramic that undergoes
partial conversion to HA once
implanted into the body
Bioactive glass (bioglass) :
Biologically active silicate-based glass.
Collagen-based matrices :
Xenografts consisting of sponge like
strips of bovine collagen combined with
hydroxyapatite
FUTURE DIRECTIONS
Genetic engineering
>New bone via gene therapy in
animals.
>The vehicle for gene delivery can be
either viral (adenovirus, retrovirus) or
non-viral (liposomes, DNA-ligand
complexes).
>The gene can be selectively
transferred to a targeted cell
(osteoblast, fibroblasts) at the bone
SUMMARY
Thank
you