Elena Bertola Impregnation of a natural surgically implantable porous structure for the controlled release of antibiotics Introduction The spongy bone tissue is commonly used in medicine for dental implantations as support for the osseous regeneration. One of the possible problems of such implantations after the surgery is the growth of infections in the treated zone. In this paper we study possibilities of transporting and depositing antibiotics all over the surface in the inner part of the micro and nano-porous structure in order to reduce risks of infection. In order to estimate the efficiency of the methods, different depositions have been realized while measuring release sizes under physiological conditions. Hydroxyapatite (HA) has been used as the osseous regeneration material, which allows osteoconduction. Studied antibiotics are Tetracycline (TC) and Amoxicillin (AC), both of them used with and without release-retarding potential. Release capacity at pH 7.4 has been analyzed in order to make simulation conditions as realistic as possible. Methods The Hydroxyapatite matrix is prepared through supercritical extraction (CO2) and deproteination with H2O2 at 700°C form an equine humerus bone. At first interaction is studied between HA and antibiotic through the contact with TC dissolved in N-methylpyrrolidone (NMP) on a milled HA column and the subsequent desorption of the HA by NMP flushing, while measuring desorbed TC with UV spectroscopy at 342 nm. Impregnation is realized with the help of a supercritical fluid extraction plant (20 mL extraction vessel) modified with HPLC pump for liquid solvent, in order to get a SAS process (Solvent-Antisolvent-Supercritical). HA cubes are in contact with TC or AC through a TC or AC supercritical solution in NMP 0.3 mg/mL (solvent solution) in which supercritical CO2 is solved at 70 bar (Vss/Vsas = 60/40) in order to obtain a supercritical solvent solution. Increased pressure of the SCCO2 until 250 bar permit the precipitation of TC or AC thanks to the antisolvent effect of the SCCO2. Finally NMP removal is realized by pure CO2 flow at 250 bar. The SAS process is first simulated at room conditions using liquid NMP as solvent and liquid pentane as antisolvent. TC deposition is verified through fluorescence at 366 nm and through desorption with NMP and UV spectroscopy of the desorbed solution at 342 nm, whereas the AC one is tested with SEM-EDX. During release tests pieces of spongy bone impregnated with tetracycline are immersed in physiologic buffer solution (NaCl/KCL/Na2HPO4/KH2PO4.at pH 7.4). Resulting solution is analyzed at intervals of approximately 10 min through a UV spectrophotometer at 361 nm.
__________________________________________________________________Elena Bertola, Liceo Lugano 2
Results and discussion Tests on HA ground permit to verify the good interaction between AI and TC: a slow flow of 0.03mg/mL NMP-TC solution for each HA gram during 10 min produce a deposition of 0.002 mg/g (about 0.3µg/m2). Impregnation rate improves to 0.04 mg/g by using pentane as antisolvent. The SAS process with supercritical NMP-CO2 provides strong fluorescent HA cubes even on internal surfaces, which indicates a TC deposition with elevated capillarity. This fact is confirmed by SEM-EDX analysis on samples that were impregnated with amoxicillin following the same process applied to the TC. TC amount tests through NMP desorbtion of impregnated HA samples give loads values of 5 mg/g (50 µg/m2). In physiological solution, measured release is at most 1.0 mg / g, corresponding to 20% of TC has been filed with the SAS process. This value is reached quickly (after a few hours) and will hardly change even after several days. Conclusions The
Obtained impregnation level is more than 100 times higher than the one that can be achieved by simple contact of the porous tissue with liquid solutions. Impregnation rate may be further increased by higher TC concentration in NMP solution. Deposition occurs in the internal micro and nano-porous structure as well as in the external surface. Most of the antibiotic (80%) is held firmly by the impregnated structure after several days of contact with the physiological solution. Results should now be assessed in medical field.
__________________________________________________________________Elena Bertola, Liceo Lugano 2
M.M. Van Benschoten, O.M.D, CA, Inc. Joe McSweyn, O.M.D, C.A. Pari Vokshori, L.Ac, D.O.M. Alan Sher, L.Ac Gila Varis, L.Ac, R.N. Steven Jarsky, L.Ac, D.A.O.M. Jordan Hoffman, L,Ac, Dipl. O.M. Tina VanBenschoten, R.N. 21201 Victory Blvd, Suite 135, Canoga Park, CA 91303 818-348-9973 phone 818-348-9974 fax www.MMVanBenschotenOMD.com Fro
In the following article, I refer to the GNU/Linux OS and various Free & Open-Source Software (FOSS) projects under the catch-all name of "Linux". It scans better. (Linux is Not Windows) If you've been pointed at this page, then the chances are you're a relatively new Linux user who's havingsome problems making the switch from Windows to Linux. This causes many problems for many