Lodoso-Torrecilla Irene, Klein Gunnewiek Raquel, Grosfeld Eline-Claire, de Vries Rob B M, Habibović Pamela, Jansen John A, van den Beucken Jeroen J J P
Dentistry - Biomaterials, Radboudumc, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
Biomater Sci. 2020 Sep 7;8(17):4792-4809. doi: 10.1039/d0bm00599a. Epub 2020 Jul 30.
Supplementation of CaP-based bone graft substitutes with bioinorganics such as strontium, zinc or silicon is an interesting approach to increase the biological performance in terms of bone regenerative potential of calcium phosphate (CaP)-based bone substitutes. However, the in vivo efficacy of this approach has not been systematically analyzed, yet. Consequently, we performed a systematic review using the available literature regarding the effect of bioinorganic supplementation in CaP-based biomaterials on new bone formation and material degradation in preclinical animal bone defect models and studied this effect quantitatively by performing a meta-analysis. Additional subgroup analyses were used to study the effect of different bioinorganics, animal model, or phase category of CaP-based biomaterial on bone formation or material degradation. Results show that bioinorganic supplementation increases new bone formation (standardized mean difference [SMD]: 1.43 SD, confidence interval [CI]: 1.13-1.73). Additional subgroup analysis showed that strontium, magnesium and silica significantly enhanced bone formation, while zinc did not have any effect. This effect of bioinorganic supplementation on new bone formation was stronger for DCPD or β-TCP and biphasic CaPs than for HA or α-TCP (p < 0.001). In general, material degradation was slightly hindered by bioinorganic supplementation (mean difference [MD]: 0.84%, CI: 0.01-1.66), with the exception of strontium that significantly enhanced degradation. Overall, bioinorganic supplementation represents an effective approach to enhance the biological performance of CaP-based bone substitutes.
用锶、锌或硅等生物无机物补充基于磷酸钙（CaP）的骨移植替代物，是一种提高基于磷酸钙的骨替代物骨再生潜力的生物学性能的有趣方法。然而，这种方法的体内疗效尚未得到系统分析。因此，我们利用现有文献，对基于CaP的生物材料中生物无机物补充对临床前动物骨缺损模型中新骨形成和材料降解的影响进行了系统综述，并通过荟萃分析对这种影响进行了定量研究。额外的亚组分析用于研究不同生物无机物、动物模型或基于CaP的生物材料的相类别对骨形成或材料降解的影响。结果表明，生物无机物补充可增加新骨形成（标准化平均差[SMD]：1.43标准差，置信区间[CI]：1.13 - 1.73）。额外的亚组分析表明，锶、镁和二氧化硅显著增强了骨形成，而锌没有任何作用。生物无机物补充对新骨形成的这种影响在二水磷酸氢钙（DCPD）或β - 磷酸三钙（β-TCP）以及双相磷酸钙上比在羟基磷灰石（HA）或α - 磷酸三钙上更强（p < 0.001）。总体而言，生物无机物补充略微阻碍了材料降解（平均差[MD]：0.84%，CI：0.01 - 1.66），但锶显著增强了降解除外。总体而言，生物无机物补充是提高基于CaP的骨替代物生物学性能的有效方法。
