Incorporation of nanosized calcium silicate improved osteointegration of polyetheretherketone under diabetic conditions
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BIOCOMPATIBILITY STUDIES Original Research
Incorporation of nanosized calcium silicate improved osteointegration of polyetheretherketone under diabetic conditions Rui Ma1 Yongwei Li1 Jialin Wang1 Pei Yang1 Kunzheng Wang1 Wei Wang1 ●
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Received: 14 April 2020 / Accepted: 24 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Diabetes can impair osteoblastic functions and negatively interfere with osteointegration at the bone/implant interface. Previously, we prepared a nanosized calcium silicate (CS) incorporated-polyetheretherketone (PK) biocomposite (CS/PK) and found that the CS/PK composite exhibited enhanced osteoblast functions in vitro and osteointegration in vivo, but its bioperformance under diabetic conditions remained elusive. In this study, MC3T3-E1 cells incubated on CS/PK and PK samples were subjected to diabetic serum (DS) and normal serum (NS); cell attachment, morphology, spreading, proliferation, and osteogenic differentiation were compared to assess in vitro osteoblastic functions on the surfaces of different materials. An in vivo test was performed on diabetic rabbits implanted with CS/PK or PK implants into the cranial bone defect to assess the osteointegration ability of the implants. In vitro results showed that diabetes inhibited osteoblastic functions evidenced by impaired morphology and spreading, and decreased attachment, proliferation, and osteogenic differentiation compared with the findings under normal conditions. Notably, CS/PK ameliorated osteoblastic disfunction under diabetic conditions in vitro. In vivo results from micro-CT and histologic examinations revealed that rabbits with CS/ PK implants exhibited improved osteointegration at the bone/implant interface under diabetic conditions compared with PK. Therefore, the CS/PK composite improved the impaired osteointegration induced by diabetes and is a promising orthopedic or craniofacial implant material that may obtain good clinical performance in diabetic patients. Graphical Abstract
1 Introduction
These authors contributed equally: Rui Ma, Yongwei Li * Kunzheng Wang [email protected] * Wei Wang [email protected] 1
Department of Bone and Joint Surgery, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710004 Shanxi, China
Diabetes mellitus (DM) is a chronic metabolic disorder that leads to hyperglycemia and raises multiple complications. DM could negatively interfere with the process of osteointegration at the bone/implant interface and result in a high rate of implant failure [1]. The poor osteointegration of implants in diabetic patients may be attributed to impaired osteoblast structure and function during the healing process [2]. The International Diabetes Federation estimated that the world diabetic population in 2013 was 382 million and that this will increase to 592 million by 2035 [3]. Surgery using implants is an important method to restore the structure and
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Journal of Materials Science: Materia
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