naturesQue MaxOss P is obtained from porcine cancellous bone and has a large and open porosity thanks to the fine and complex trabecular structure. The free spaces are connected to one another and provide plenty of room for bone regeneration, maturation, and remodeling. The large internal surface area provides enormous potential for the adhesion of cells.
Porosity is one of the most important properties of a bone substitute material. Cells can migrate into the bone substitute material through the pores and newly formed blood vessels can connect to the vascular network so that the new bone in the regeneration area is supplied with oxygen and nutrients.
Osteoblasts prefer large pore diameters ; the macropores of naturesQue MaxOss P are between 100 and 1000 µm in size and are therefore perfectly suited for the migration of osteoblasts. After bony integration, remodeling and adaptation of the bone to applied force need plenty of space, which is available in the highly porous structure of naturesQue MaxOss P.
Scanning electron microscopy image of naturesQue MaxOss P.
Plenty of space for the bone – the design of naturesQue MaxOss P is derived from the trabecular network of the bone: a complex framework made up of narrow struts and rods and large interconnected spaces. This creates a large surface area onto which the osteoblasts adhere and are able to deposit the new bone matrix. In the large pores the vascularization and the remodeling of the newly formed bone can proceed undisturbed. Thus, a stable and permanent bond is formed between naturesQue MaxOss P and the new bone.
naturesQue MaxOss P is a safe bone substitute material and satisfies the requirements
in Directive 93/42/EEC
- Porcine cancellous bone
- Mineral phase of the cancellous bone
- Preservation of the natural content of carbonate apatite
- Porcine bone
- Cleaning and removal of proteins (deproteinization) using high heat
- Washing with buffer solution
- Measurement, screening, packaging, and sterilization
- QA control
- Mixing with autologous bone preparations, patient blood, or saline is possible
- Only place in direct contact with well vascularized local bone
- Cortical bone should be manually perforated
- Granules are highly porous, so avoid placing pressure on the granules to prevent the fragile trabecular structure being crushed
- Integration into the newly formed bone
- Slow course of resorption, superficial traces of resorption
- Stable framework for the bone
- Aiken SS, Bendkowski A. In search of the “optimal” material for dental bone grafting. EDI Journal 2011;4:2-7
Publications naturesQue MaxOss P
Ghandi Y, Bhatavdekar. MIDAS (Minimally Invasive Drilling And Styptic) protocol - A modified approach to treating patients under therapeutic anticoagulants. Journal of Oral Biology and Craniofacial Research. 2019;9(3):208-211**
Igelhaut G. Neues porcines Knochenersatzmaterial. Unbedingt porös. Interview. Dental Magazin. 2019 (09)**
Guarnieri R, Stefanelli L, De Angelis F, Mencio F, Pompa G, Di Carlo S. Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study. Journal of Oral & Maxillofacial Research. 2017;8(3):e5**
Guarnieri R, DeVilliers P, Grande M, Stefanelli LV, Di Carlo S, Pompa G. Histologic evaluation of bone healing of adjacent alveolar sockets grafted with bovine–and porcine-derived bone: a comparative case report in humans. Regenerative Biomaterials. 2017;125-128**
Guarnieri R, Testarelli L, Stefanelli L, De Angelis F, Mencio F, Pompa G, Di Carlo S. Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis. Journal of Oral & Maxillofacial Research. 2017;8(4):1-9
Chen HC, Yuen D, Li ST. Porcine anorganic bone mineral for guided bone regeneration in dental surgeries Part I: Development and in vitro characterization. Front. Bioeng. Biotechnol. Conference Abstract: 10th World Biomaterials Congress. 2016;doi: 10.3389/conf.FBIOE.2016.01.02758*
Chen HC, Lee NS; Yuen D, Li ST. Porcine anorganic bone mineral for guided bone regeneration in dental surgeries. Part II: In vivo animal study and human case study. Front. Bioeng. Biotechnol. Conference Abstract: 10th World Biomaterials Congress. 2016;doi: 10.3389/conf.FBIOE.2016.01.02705*
Li ST, Chen HC, Yuen D. Isolation and Characterization of a Porous Carbonate Apatite From Porcine Cancellous Bone. Science, Technology, Innovation. 2014;1-13
Rupani A, Hidalgo-Bastida LA, Rutten F, Dent A, Turner I, Cartmell S. Osteoblast activity on carbonated hydroxyapatite. Journal of Biomedical Materials Research Part A. 2012;100(4):1089-96
Kanayama K, Sriarj W, Shimokawa, H, Ohya, K, Doi, Y, Shibutani, T. Osteoclast and Osteoblast Activities on Carbonate Apatite Plates in Cell Cultures. Journal of Biomaterial Applications. 2011;26(4):435-449
Hannink G, Arts JJ. Bioresorbability, porosity and mechanical strength of bone substitutes: what is optimal for bone regeneration? Injury. 2011;42 S2:S22-25.
Figueiredo M, Fernando A, Martins G, Freitas J, Judas F, Figueiredo H. Effect of the calcination temperature on the composition and microstructure of hydroxyapatite derived from human and animal bone. Original Research Article Ceramics International. 2010; 36(8):2383-2393
Spense G, Patel N, Brooks R, Rushton N. Osteoclastogenesis on hydroxyapatite ceramics: the effect of carbonate substitution. J Biomed Mater Res A. 2010;92(4):1292-1300
Spense G, Patel N, Brooks R, Rushton N. Carbonate Substituted Hydroxyapatite: Resorption by Osteoclasts Modifies the Osteoblastic Response. Journal of Biomedical Materials Research Part A. 2009
Klenke FM, Liu Y, Yuan H, Hunziker EB, Siebenrock KA, Hofstetter W. Impact of pore size on the vascularization and osseointegration of ceramic bone substitutes in vivo. Journal of Biomedical Materials Research Part A. 2007;777-786
Landi E, Celotti G., Logroscino G, Tampieri A. Carbonated Hydroxyapatite as Bone Substitute. Journal of the European Ceramic Society. 2003;23: 2931-2937
Deligianni DD, Katsala ND, Koutsoukos PG, Missirlis YF. Effect of Surface Roughness of Hydroxyapatite on Human Bone Marrow Cell Adhesion, Proliferation, Differentiation and Detachment Strength. Elsevier Biomaterials. 2001;22:87-96.
Ellies LG, Carter JM, Natiella JR, Featherstone JDB, Nelson DGA. Quantitative Analysis of Early In Vivo Tissue Response to Synthetic Apatite Implants. J Biomed Mater Res 1988;22:137-148
*MatrixOss is a trade name from Collagen Matrix, Inc. and identical to naturesQue MaxOss P
**MinerOss XP is a trade name from BioHorizons and identical to naturesQue MaxOss P