Garcia Daniel Cardoso, Mingrone Larissa Eckmann, de Sá Marcelo Jorge Cavalcanti
Doctoral Student at the Department of Small Animal Surgery, Faculty of Veterinary Medicine, Federal University of Campina Grande (UFCG), Patos, Brazil.
Small Animal Surgery Service, Animal Care Barueri Clínica Veterinária, São Paulo, Brazil.
Front Vet Sci. 2022 Jul 12;9:859920. doi: 10.3389/fvets.2022.859920. eCollection 2022.
The gold standard for osseointegration remains the autogenous bone graft, but biomaterials such as Beta - tricalcium phosphate (β - TCP) in its pure-phase showed promising results to be practical bone substitutes. This kind of implants are optimal candidates for bone integration due to their osseoconductive, biocompatibility, bioactivity, and absorptive properties.
A systematic review was conducted using 5 databases (Cochrane Library, PubMed, Scielo, Medline-Bireme and Google Scholar) for searching published studies between January 1st 2011 and June 15th 2021. Only clinical and experimental studies, and case reports were included in this research. Human and animal studies published only in Portuguese or English with clinical, radiologic, and histologic evidence of new bone formation, osseoconduction, and osseointegration were included. This systematic review was reported according to PRISMA guidelines.
Approximately 14.554 articles were initially found, but after advanced searching using specific including and excluding keywords, matching Boolean operators "AND," "OR" and "NOT," and after excluding duplicates, a total of 12 articles were included for this systematic review, including experimental works, a retrospective study, a randomized controlled clinical study, a randomized prospective study, a prospective observational study, and a case report. All articles showed 100% effectiveness in bone integration after β - TCP implantation by clinical, image and/or histologic assessment. Implant shape and porosity seem to have influence in osseointegration process. β - TCP can give predictable, sustainable, and adequate new bone formation with the least infection rates in implant placement cases and patient morbidity, which is the current goals for bone integration, augmentation and replacement.
β - TCP in its pure-phase is widely used in dentistry and maxillofacial surgery, but there is a lack of information about the use of this biomaterial for filling critical segmental defects of long bones in veterinary medicine. In this area, only experimental studies in small defects were carried out, with no clinical cases performed in animals with a longer observation time. β - TCP can produce predictable, sustainable, and adequate bone formation, with minimal infection rates and low patient morbidity. But more clinical studies in the future, demonstrating specific metric measurements in relation to bone consolidation, as well as showing results using other shapes of this implant are needed to evaluate further in depth osseoconductive and osseointegrative characteristics of this biomaterial, in order to develop new comparisons and quantitative analyses for its use in veterinary medicine as a bone replacement.
骨整合的金标准仍然是自体骨移植，但诸如纯相β - 磷酸三钙（β - TCP）等生物材料显示出有望成为实用的骨替代物。这类植入物因其骨传导性、生物相容性、生物活性和吸收特性，是骨整合的理想候选者。
使用5个数据库（Cochrane图书馆、PubMed、Scielo、Medline - Bireme和谷歌学术）进行系统综述，以检索2011年1月1日至2021年6月15日期间发表的研究。本研究仅纳入临床和实验研究以及病例报告。纳入仅以葡萄牙语或英语发表的、具有新骨形成、骨传导和骨整合的临床、放射学和组织学证据的人类和动物研究。本系统综述按照PRISMA指南报告。
最初发现约14554篇文章，但在使用特定的包含和排除关键词、匹配布尔运算符“AND”“OR”和“NOT”进行高级检索并排除重复项后，本系统综述共纳入12篇文章，包括实验研究、一项回顾性研究、一项随机对照临床研究、一项随机前瞻性研究、一项前瞻性观察研究和一篇病例报告。所有文章通过临床、影像和/或组织学评估显示β - TCP植入后骨整合的有效性为100%。植入物的形状和孔隙率似乎对骨整合过程有影响。β - TCP能在植入病例中以最低的感染率和患者发病率实现可预测、可持续且充分的新骨形成，这是当前骨整合、增强和替代的目标。
纯相β - TCP在牙科和颌面外科中广泛使用，但在兽医学中，关于这种生物材料用于填充长骨关键节段性缺损的使用信息匮乏。在这一领域，仅对小缺损进行了实验研究，未对动物进行更长观察时间的临床病例研究。β - TCP能产生可预测、可持续且充分的骨形成，感染率极低且患者发病率低。但未来需要更多临床研究，展示与骨巩固相关的具体测量指标，并展示使用这种植入物其他形状的结果，以便更深入地评估这种生物材料的骨传导和骨整合特性，从而为其在兽医学中作为骨替代物的应用开展新的比较和定量分析。
