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The Biocompatibility of a New Type of 45S5 Bioactive Graft in a Sheep Model: A Pilot Study Erhan Okay 1, Ali Can Ozarslan 2, Özgür Başal 3, Hüseyin Cakıroglu 4, Sevil Yucel 2, Korhan Özkan 5, Mahmut Nedim Doral 6 7

Prof. Dr. Korhan Özkan
Prof. Dr. Korhan Özkan
12 Kasım 2023132 görüntülenme
Randevu Al
Background Bone is a dramatically regenerating tissue with the ability to heal after trauma, although intensive surgical management is required to treat considerable damage. In this study, 45S5 bioactive grafts were prepared through the melt-quenched method in compliance with the guidelines on medical product requirements (MDD regulations; 93/42/EEC Annex-II section 3&4 and ISO standardizations; ISO 13485:2016) for bone repair and regeneration. Methodology After preparing the graft/scaffold, it was evaluated for biocompatibility according to the principles of "lSO 10993-6 2015 Biological evaluation of medical devices: Tests for local effects after implantation, Annex D 'Test method for implantation in bone,'" "lSO 10993-2:2005 Biological evaluation of medical devices: Animal welfare requirements," and "lSO 10993-12 2012 Biological evaluation of medical devices sample preparation rules and standards." Defects were created on the tibia of the right hind leg. The defects were filled with 3-mm bioactive granules, and a cylindrical polypropylene biocompatible material was used as a negative control. After 120 days, the sheep were sacrificed, and the tibia were analyzed. Results The results demonstrated the safety of 45S5 bioactive grafts. Histological evaluation showed no signs of pathological changes around the implant area. Hematoxylin and eosin sections demonstrated the presence of a few multinucleated giant cells, macrophages, and non-irritant mild fibrotic changes on the surface of the biomaterial. Conclusions 45S5 bioactive glass was found to be biocompatible in a sheep model, demonstrating its capacity to promote bone consolidation while also justifying its further preclinical application as a bone-bonded material owing to the layer formation of the growing bone mineral. Keywords: bioactive material; biocompatibility; experimental animal model; experimental sheep surgery; preclinical research.
The Biocompatibility of a New Type of 45S5 Bioactive Graft in a Sheep Model: A Pilot Study Erhan Okay 1, Ali Can Ozarslan 2, Özgür Başal 3, Hüseyin Cakıroglu 4, Sevil Yucel 2, Korhan Özkan 5, Mahmut Nedim Doral 6 7
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Bone Regeneration and the Role of 45S5 Bioactive Grafts

Bone is a highly dynamic tissue with a remarkable capacity for regeneration and healing after trauma. However, extensive damage often requires intensive surgical management and the use of advanced biomaterials to ensure proper recovery. This study focuses on the development and evaluation of 45S5 bioactive grafts designed to enhance the bone repair process.

Production Standards and Regulatory Compliance

The 45S5 bioactive grafts used in this research were prepared using the melt-quenched method. To ensure the highest level of safety and efficacy, the production process strictly adhered to international medical product requirements:

  • MDD Regulations: 93/42/EEC Annex-II sections 3 & 4.
  • Quality Management: ISO 13485:2016 standards for medical devices.

These rigorous standards ensure that the bioactive materials are suitable for clinical bone regeneration applications.

Methodology: Preclinical Evaluation in Sheep Models

The biocompatibility of the scaffold was evaluated following the comprehensive principles of the ISO 10993 series. The experimental procedure involved creating defects in the tibia of the right hind leg of sheep. The methodology included the following steps:

  1. Implantation: Defects were filled with 3-mm bioactive granules.
  2. Control Group: A cylindrical polypropylene biocompatible material was utilized as a negative control.
  3. Observation Period: The sheep were monitored for 120 days to assess long-term biological effects.
  4. Analysis: After the period, the tibia were analyzed according to ISO 10993-6 (tests for local effects after implantation).

Results and Histological Findings

The results conclusively demonstrated the safety of 45S5 bioactive grafts. Histological evaluations confirmed that there were no signs of pathological changes within the implant area. Key observations from the Hematoxylin and eosin (H&E) sections included:

Observation TypeFindings
Pathological ChangesNone detected around the implant area
Cellular ResponsePresence of a few multinucleated giant cells and macrophages
Surface InteractionNon-irritant mild fibrotic changes on the biomaterial surface

Conclusion: Future of Bone-Bonded Materials

In conclusion, 45S5 bioactive glass has proven to be highly biocompatible in a sheep model. The material demonstrates a significant capacity to promote bone consolidation, supported by the formation of a growing bone mineral layer. These findings justify the further development and preclinical application of 45S5 as a reliable bone-bonded material for surgical interventions.

Keywords: bioactive material, biocompatibility, experimental animal model, experimental sheep surgery, preclinical research.

Yazar Hakkında

Prof. Dr. Korhan Özkan

Prof. Dr. Korhan Özkan

Prof. Dr. Korhan Özkan ;2000 yılında Marmara Üniversitesi Tıp Fakültesinden mezun oldu ve tıp doktoru ünvanını aldı. 2000-2005 yılları arasında İstanbul Üniversitesi İstanbul Tıp Fakültesi Ortopedi ve Travmatoloji A.D’ında ortopedi ve travmatoloji ihtisasını tamamladı. 2006 yılından itibaren 2023 yılına kadar İstanbul Medeniyet Üniversitesi Göztepe Şehir Hastanesinde Ortopedi ve Travmatoloji Anabilim dalında hizmet verdi. 2019 -2023 yılları arasında aynı klinikte Anabilim dalı başkanı görevini üstlendi. 2011 yılından itibaren Ortopedik Onkoloji (primer kemik tümörleri , metastatik kemik lezyonları, selim ve habis yumuşak doku lezyonları ) tanı ve cerrahi tedavisiyle uğraşmaktadır. Bu bağlamda 2011 yılında Munster Üniversitesi, 2012 yılında Royal Birmigham Ortopedi hastanesi ve 2013 yılında Viyana Üniversitesinde ortopedik onkoloji alanı ile ilgili gözlemci olarak bulundu. Ortopedik ve Travmatoloji özellikle de onkoloji konusunda çok sayıda makale, bildirileri ve kongre ile sempozyumlarda konuşmaları bulunmaktadır. 2023 yılı ekim ayı itibarıyla Acıbadem Ataşehir hastanesinde çalışmaya başladı.

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