Hench Larry L
Department of Biomedical Engineering, Florida Institute of Technology, 150 W. University Blvd., Melbourne, FL, 32901, USA,
J Mater Sci Mater Med. 2015 Feb;26(2):86. doi: 10.1007/s10856-015-5425-3. Epub 2015 Feb 3.
Two important worldwide needs must be satisfied in the future; (1) treatment of the deteriorating health of an aging population and, (2) decreasing healthcare costs to meet the needs of an increased population. The ethical and economic dilemma is how to achieve equality in quality of care while at the same time decreasing cost of care for an ever-expanding number of people. The limited lifetime of prosthetic devices made from first-generation nearly inert biomaterials requires new approaches to meet these two large needs. This paper advises an expanded emphasis on: (1) regeneration of tissues and (2) prevention of tissue deterioration to meet this growing need. Innovative use of bioactive ceramics with genetic control of in situ tissue responses offers the potential to achieve both tissue regeneration and prevention. Clinical success of use of bioactive glass for bone regeneration is evidence that this concept works. Likewise the use of micron sized bioactive glass powders in a dentifrice for re-mineralization of teeth provides evidence that prevention of tissue deterioration is also possible. This opinion paper outlines clinical needs that could be met by innovative use of bioactive glasses and ceramics in the near future; including: regeneration of skeletal tissues that is patient specific and genetic based, load-bearing bioactive glass-ceramics for skeletal and ligament and tendon repair, repair and regeneration of soft tissues, and rapid low-cost analysis of human cell-biomaterial interactions leading to patient specific diagnoses and treatments using molecularly tailored bioceramics.
（1）治疗老龄化人口日益恶化的健康状况，以及（2）降低医疗成本以满足不断增长的人口需求。伦理和经济困境在于如何在提高护理质量的同时，降低不断增加的人群的护理成本。由第一代几乎惰性的生物材料制成的假体装置使用寿命有限，这就需要新的方法来满足这两大需求。本文建议进一步强调：（1）组织再生和（2）预防组织退化，以满足这一日益增长的需求。创新性地使用生物活性陶瓷并对原位组织反应进行基因控制，有可能实现组织再生和预防。使用生物活性玻璃促进骨再生的临床成功证明了这一概念的可行性。同样，在牙膏中使用微米级生物活性玻璃粉末使牙齿再矿化，也证明了预防组织退化也是可能的。这篇观点论文概述了在不久的将来通过创新性地使用生物活性玻璃和陶瓷可以满足的临床需求；包括：针对患者的基于基因的骨骼组织再生、用于骨骼、韧带和肌腱修复的承重生物活性玻璃陶瓷、软组织的修复和再生，以及通过分子定制生物陶瓷对人体细胞与生物材料相互作用进行快速低成本分析，从而实现针对患者的诊断和治疗。
