In vivo osseointegration and erosion of nacre screws in an animal model

International audienceThe use of resorbable devices for osteosynthesis has become a subject of interest. Nacre has been proposed as a resorbable and osteoconductive material favoring bone apposition without triggering an inflammatory reaction. We compared the in vivo osseointegration and erosion of nacre screws in an animal model with titanium screws. Implantation of similar nacre and titanium screws was performed in the femoral condyles of adult rats. Animals (n = 41) were randomized in four groups sacrificed at day one, 1, 6, and 12 months. Microcomputed tomography (microCT) allowed 3D morphometry of erosion of nacre. Osseointegration was measured as the volume of trabecular bone bone volume/tissue volume (BV/TV) in a standardized volume of interest around each screw. Undecalcified bone histol-ogy was also done. Gross examination revealed a similar clinical osseointegration for titanium and nacre screws. A progressive erosion of nacre screws, but no erosion of titanium screws, was observed in microCT. The volume of nacre screws progressively decreased over time whereas no modification occurred for titanium. For titanium screws, BV/TV remained stable throughout the study. For nacre screws, the BV/TV decrease was not statistically different. A significant difference was found between nacre and titanium screws at 6 months but not at 12 months. The screw heads, outside the bone shaft, were not eroded even after 12 months. Erosion of nacre occurred during the entire study period, only within the bone shaft in direct contact with bone marrow. Bone apposition was observed on nacre surfaces without signs of erosion. Nacre is a promising biomaterial in maxillofacial surgery. K E Y W O R D S erosion, maxillofacial surgery, mother of pearl, nacre, osseointegration, resorbable device, titanium scre

The interface between nacre and bone after implantation in the sheep: a nanotomographic and Raman study

International audienceOrthopedic bone devices can be prepared from the shells of giant pearl oysters. Nacre is biocompatible and composed of calcium carbonate (aragonite). Direct welding of bone onto the biomaterial surface has been reported but poorly investigated. Nacre from Pinctada maxima was used to prepare plates, screws and rods. Five sheep were implanted in the first metatarsus under general anesthesia and killed 2 months later. Bones were harvested and fixed in formalin. Analysis was performed by nanotomography and histology after embedding in poly(methyl methacrylate). Polished sections were imaged by scanning electron microscopy then analyzed on a Raman microscope. Nanotomography and histology evidenced the newly apposed bone composed of thin trabeculae with a lower mineralization than mature bone. Erosion of the nacre was also easily observed. The bone/nacre interface presented a characteristic toothed-comb appearance. Raman spectroscopy identified the typical bands of aragonite (1091 and 711 cm−1) in the devices. At a distance from the interface, the bone matrix presented the typical bands of hydroxyapatite at 960, 1044 and 594–610 cm−1 with the amide bands of collagen at 1250 cm−1. At the bone/nacre interface, a phosphate-rich layer was observed without proteins. The newly formed bone units exhibited a band at 1075 cm−1 corresponding to a high amount of B-carbonate substitution. The carbonate/phosphate ratio decreased between new and mature bone, and crystallinity was improved. Raman spectroscopy confirmed the modifications of the bone matrix around the nacre implant and the direct apposition of bone without an interposing organic layer between the calcium carbonate (nacre) and the calcium phosphate (hydroxyapatite).</p