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The use of biophysical methods to promote osteogenesis have been successfully used since 30 years in everyday orthopedic practice to enhance osteogenesis in such diseases as delayed unions, non unions, avascular necrosis of the femoral head. It is also used in the treatment of fracture at risk of non union and to favor spinal fusion. Biophysical therapy can be performed using inductive, capacitive, mechanic or implanted devices. The mechanism of action of physical stimuli is at a membrane level where the activation of calcium channels determines the enhancement of cell proliferation and the production of growth factors. Biophysical therapy should be performed using devices and modalities described in the literature. The biophysical stimulation of osteogenesis is effective in the enhancement of the biology of fracture healing in presence of a correct orthopedic treatment in terms of good alignment and stabilization at the fracture site. The choice of which method have to be used it depends on the segment of bone that has to be treated, the type of fracture and if it is possible to apply the device on the skin. The presence of internal or external fixation devices is not a contraindication.

Autologous cell transplantation in combination with a biodegradable scaffold is one of the most promising bone regeneration techniques in craniofacial and orthopaedic surgery. Algipore(R), a hydroxyapatite ceramic obtained from red alga, is largely employed as scaffolds in bone regeneration. For this reason, we studied how Algipore(R) can induce osteoblast differentiation in stem cells derived from dental pulp, measuring the expression levels of bone related genes and mesenchymal stem cells marker by real time RT-PCR. The obtained results demonstrated that Algipore(R) enhance differentiation and deposition of matrixin stem cells by the activation of osteoblast related genes FOSL1 and SPP1 and the disappearance of the mesenchymal stem cells marker, ENG

Osteoplant® is an equine cortical and spongy bone tissue, used to fill bone defects in orthopedic, maxillofacial and dental surgery. To study the mechanism by which Osteoplant® induce the reabsorption and the substitution of the graft with new bone, the expression of genes related to the osteoblast differentiation were analyzed using cultures of stem cells derived from adipose tissue treated with Osteoplant®. Gene expression profile, obtained with real time Reverse Transcription-Polymerase Chain Reaction demonstrated that Osteoplant® influences the differentiation of adipose derived stem cells by the activation of bone related genes like osteopontin (SPP1) and alkaline phosphatase (ALPL)

OsteoBiol(R) is a cortical collagenated porcine bone largely employed as substitute for bone grafting. In animal model porcine bone showed good biocompatibility and osteoconductive properties. To study how cortical porcine bone can induce osteoblast differentiation and proliferation in mesenchymal stem cells, the expression levels of bone related genes (RUNX2, SP7, ALPL, SPP1, COL1A1, COL3A1 and FOSL1) and mesenchymal stem cells marker (ENG) were measured in Adipose Derived stem cells (ADSCs) and Human Osteoblasts (HOb) cultivated with OsteoBiol(R). OsteoBiol(R) induces up-regulation of SPP1 and ALPL during the first 15 days of treatment both in treated ADSCs than in treated HOb. In particular the up-regulation of SPP1 demonstrated that this biomaterial is actively resorbed by human osteoclasts

Titanium is the gold standard among materials used for prosthetic devices because of its good mechanical and chemical properties. When exposed to oxygen, titanium becomes an oxide that is biocompatible and able to induce osseointegration. There are three allotropic forms of titanium dioxide: brookite, ruffle and anatase. Anatase can be prepared as a colloidal suspension and then used to coat surfaces. Anatase coating (AC) can potentially have specific biologic effects. Here we test the effect of AC on bone throughout an in vivo study by using spiral dental implants covered with AC and then inserted in rabbit tibia. The histologic analysis has demonstrated that (1) bone growth is equal around AC and standard fixtures but (2) AC fixtures have an antibacterical propriety that protect implants from subsequent peri-implantitis. This study demonstrated that AC implant inserted in rabbit tibia guarantee a good osseointegration of normal titanium implants giving in addition antibacterical propriety