Fortoss® VITAL is the first resorbable synthetic graft material capable of directing cell activity to produce rapid bone formation.
A material’s surface properties are pivotal in initiating biological activity. Recent research1 has highlighted the significance of relative zeta potentials of bone and different biomaterials and their influence on protein adsorption. This work has demonstrated that the adsorption of specific extracellular matrix proteins onto biomaterial surfaces provides sites for integrin mediated osteoblast attachment.
Fortoss VITAL has been engineered with an optimum surface chemistry which harnesses proteins key to bone formation. The surface chemistry is achieved through a proprietary process and controlled using Zeta potential measurements (ZPC®)2. This charge has a significant effect on the in-vivo response, biological activity and bone formation3 and has been found to be “favourable to bone regeneration and osseointegration of dental implants”4.
Fortoss VITAL consists of a unique bi-phasic composition of calcium sulphate and beta tri-calcium phospate (ß-TCP).
Fortoss VITAL is applied as a mouldable setting putty which can be contoured to the defect site. The “macroporous ß-TCP acts as a lattice for ingrowth of woven bone, while the early resorption of calcium sulphate phase creates an interconnecting pore structure”5.
Fortoss VITAL “possesses osteogenic activity and can support new bone formation”6. The use of Fortoss VITAL “produces significantly more vital new bone and preserved bone dimensions compared with the use of ß-TCP alone”7.
When Fortoss VITAL is applied, the calcium sulphate phase provides an integrated barrier function which allows ingress of fluids and micro vessels yet restricts entry of soft tissues. A dynamic SmartPore system allows the integrated barrier to resorb in synergy with the healing pathway. The developing macroporosity increasing the space up to 70% allowing the ingress of cells and nutrients. The exposed ß-TCP component supports the re-precipitation of calcium ions onto its surface and acts as a matrix for bone forming cells.
Calcium sulphate resorbs first through a process of creeping substitution in 8 to 12 weeks. ß-TCP resorbs fully at 6 to 9 months. Loading of an implant fixture within the site accelerates the remodelling process further8.
1. Smith IO, Baumann MJ, McCabe LR, “Electrostatic Interactions as a Predictor for Osteoblast Attachment toBiomaterials.” J Biomed Mats Res A. 1994; 70(3): 436-441.
2. Teng N C, et al. “A new approach to enhancement of bone formation by electrically polarized hydroxyapatite.” J Dent. Res (2001), Oct, Vol 80, No 10, 1925-1929.
3. Pandya NV, “A Treatment for Severe Periodontal and Periodontal-Endodontic Lesions Without a Membrane” Poster presentation, EuroPerio, June, 2006, Madrid, Spain.
4. Smeets R, Kolk A, Gerressen M, Driemel O, Maciejewski O, Hermans-Sachweh B, Riediger D, Stein J M, "A New Biphasic Osteoinductive Calcium Composite Material With A Negative Zeta Potential For Bone Augmentation." Head and Face Medicine 2009, 5:13 doi:10.1186/1746-160X-5-13
5. J.M. Stein, U. Hoischen, R. Smeets, S. Fickl, S. Said-Yekta. “Use of a novel biphasic calcium composite for treatment of infra-alveolar periodontal defects - a randomised controlled trial” Poster presented at The Joint Meeting ofthe DGP / ARPA, 17th-18th September 2010, Bonn, Germany.
6. Podaropoulos L, Veis AA, Papadimitriou S, Alexandridis C, Kalyvas D. Bone regeneration using beta-tricalcium phosphate in a calcium sulfate matrix. J Oral Implantol. 2009;35(1):28-36.
7. Eleftheriadis E, Leventis MD, Tosios KI, Faratzis G, Titsinidis S, Eleftheriadi I, Dontas I. Osteogenic activity of -tricalcium phosphate in a hydroxyl sulphate matrix
and demineralized bone matrix: a histological study in rabbit mandible. J Oral Sci. 2010;52(3):377-84.
8. Wolff J. Zur Lehre von der Fracturenheilung. Langenbeck’s Archives of Surgery. 1873;2.