{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T17:03:53Z","timestamp":1779987833643,"version":"3.53.1"},"reference-count":84,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Biomed Mater Res"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Bone regeneration scaffolds represent a promising solution for bone grafting of large and severe bone defects. The ideal bone substitute material is considered to have excellent biocompatibility, osteoconductivity, osteoinductivity, and mechanical properties similar to bone. Different scaffold materials are currently available for clinical application, but despite the broad selection, no material has yet been described that has both excellent biological and mechanical properties. Bioceramics such as zirconia and alumina matrix composites could be promising alternative materials for bone grafting. Non\u2010porous full density zirconia and alumina matrix composite implants require bioactive surface coating for osseointegration and bone formation, but porous scaffolds made of those materials may eliminate the need for bioactive porous coatings. The aim of the present study was to investigate the long\u2010term biocompatibility and osseointegration of directly foamed porous yttria\u2010stabilized tetragonal zirconia (Y\u2010TZP) and zirconia\u2010toughened alumina (ZTA) scaffolds in calvarial and femoral bone defects in an ovine model in\u00a0vivo. Cytocompatibility of ceramic material and scaffolds was investigated in\u00a0vitro. Porous Y\u2010TZP and ZTA scaffolds with different porosities (60% and 70%) were implanted into calvarial and femoral bone defects in sheep in\u00a0vivo. Osseointegration, bone formation, and host response were histopathologically analyzed 12 and 24\u2009weeks post implantation. The in\u00a0vitro studies showed no negative influence on the cytocompatibility. In\u00a0vivo, all implants were fully integrated into defect sites at both time points without any material degradation. A thick fibrous layer was present at the calvarial implant sites, which was associated with the implant's geometric misfit. After 12\u2009weeks, early osseointegration was observed with Y\u2010TZP 70% and ZTA 70%, which seemed to be rather dependent on porosity than ceramic material. After 24\u2009weeks, bone formation and osseointegration increased and were similar for all scaffolds. A slight to moderate host response was present at both time points for all scaffolds, which was manifested by rare to mild macrophage and lymphocyte tissue infiltration and was considered an essential part of the healing process. Porous Y\u2010TZP and ZTA scaffolds demonstrated early osseointegration, good cytocompatibility, and long\u2010term biocompatibility in\u00a0vivo. The porous surface of the scaffolds enables direct contact between the ceramic material and the bone, eliminating the need for additional coatings. Also, higher scaffold porosity together with pore interconnectivity facilitates intraporous bone formation, thus representing a promising alternative for bone scaffold materials for various medical applications such as orthopedics, dentistry, and cranio\u2010maxillofacial surgery.<\/jats:p>","DOI":"10.1002\/jbm.b.70083","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T09:33:51Z","timestamp":1778837631000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Osseointegration and Long\u2010Term Biocompatibility of Porous Zirconia and Alumina Matrix Composite Scaffolds in Calvarial and Femoral Bone Defects in an Ovine Animal Model"],"prefix":"10.1002","volume":"114","author":[{"given":"Ina","family":"Lackner","sequence":"first","affiliation":[{"name":"CeramTec GmbH  Plochingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Deisinger","sequence":"additional","affiliation":[{"name":"CeramTec GmbH  Plochingen Germany"},{"name":"Peter Brehm GmbH, Am M\u00fchlberg  Weisendorf Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"M\u00f6dinger","sequence":"additional","affiliation":[{"name":"CeramTec GmbH  Plochingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henriette","family":"J\u00fclke","sequence":"additional","affiliation":[{"name":"FREY\u2010TOX GmbH  Herzberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Freytag","sequence":"additional","affiliation":[{"name":"FREY\u2010TOX GmbH  Herzberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rainer","family":"Detsch","sequence":"additional","affiliation":[{"name":"Institute of Biomaterials Friedrich\u2010Alexander University (FAU) Erlangen\u2010Nuremberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"G\u00f6tz","sequence":"additional","affiliation":[{"name":"CeramTec GmbH  Plochingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nils","family":"Warfving","sequence":"additional","affiliation":[{"name":"AnaPath Services GmbH  Liestal Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al\u00e9th\u00e9a","family":"Liens","sequence":"additional","affiliation":[{"name":"AnaPath Services GmbH  Liestal Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7377-2955","authenticated-orcid":false,"given":"Aldo R.","family":"Boccaccini","sequence":"additional","affiliation":[{"name":"Institute of Biomaterials Friedrich\u2010Alexander University (FAU) Erlangen\u2010Nuremberg  Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Ortega","family":"P\u00e9rez","sequence":"additional","affiliation":[{"name":"AnaPath Services GmbH  Liestal Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1348-940X","authenticated-orcid":false,"given":"Alessandro A.","family":"Porporati","sequence":"additional","affiliation":[{"name":"CeramTec GmbH  Plochingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,15]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/polym16050706"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000000978"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-66"},{"issue":"5","key":"e_1_2_9_5_1","first-page":"716","article-title":"Comparison of Anterior and Posterior Iliac Crest Bone Grafts in Terms of Harvest\u2010Site Morbidity and Functional Outcomes","volume":"84","author":"Ahlmann E.","year":"2002","journal-title":"Journal of Bone and Joint Surgery. American Volume"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.10045"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.5301\/jabfm.5000347"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mser.2014.04.001"},{"key":"e_1_2_9_9_1","first-page":"391","article-title":"Porous Titanium\u2010Coated Polyetheretherketone Implants Exhibit an Improved Bone\u2010Implant Interface: An In\u00a0Vitro and In\u00a0Vivo Biochemical, Biomechanical, and Histological Study","volume":"11","author":"Cheng B. C.","year":"2018","journal-title":"Medical Devices"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13074"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msec.2015.04.033"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsbiomaterials.7b00615"},{"issue":"2","key":"e_1_2_9_13_1","first-page":"175","article-title":"Osseointegration in Skeletal Reconstruction and Rehabilitation: A Review","volume":"38","author":"Br\u00e5nemark R.","year":"2001","journal-title":"Journal of Rehabilitation Research and Development"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-812258-7.00007-1"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1039\/C8BM00021B"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matdes.2021.110095"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsamd.2020.01.007"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2017.08.030"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeurceramsoc.2023.09.003"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.4317\/jced.58063"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.13425"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/jpbs.jpbs_1163_25"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40712-025-00294-9"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s41779-016-0003-9"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-394619-5.00011-0"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2013.03.022"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1530\/EOR-23-0218"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.04.068"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-019-53094-5"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.a.34877"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oceram.2024.100714"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ceramint.2017.10.146"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1551-2916.2006.01328.x"},{"key":"e_1_2_9_34_1","first-page":"135","article-title":"Low Temperature Ageing Behavior of Zirconia Hip Joint Heads","volume":"10","author":"Chevalier J.","year":"1997","journal-title":"Key Engineering Materials"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01129908"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-8842(96)00033-8"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1151-2916.2000.tb01221.x"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-2391(99)90437-8"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.bioeng.3.1.307"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeurceramsoc.2008.08.025"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2005.07.034"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmst.2025.08.038"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40145-020-0375-8"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40145-020-0415-4"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1002\/term.555"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ceramint.2019.09.242"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matdes.2018.04.065"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1115\/1.4029176"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms15045426"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma14020408"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph15070879"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1021\/acsomega.0c03824"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dental.2023.10.026"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/clr.12585"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1163\/016942409X12598231568186"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msec.2019.110492"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jeurceramsoc.2019.01.029"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmbbm.2020.104164"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms20030722"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0501.2009.01735.x"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10856-008-3401-x"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.b.34078"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2023.e20128"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.1088\/1748-6041\/10\/2\/025012"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma14041049"},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.msec.2021.111950"},{"key":"e_1_2_9_67_1","doi-asserted-by":"publisher","DOI":"10.3390\/ceramics5010014"},{"key":"e_1_2_9_68_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40729-017-0082-6"},{"key":"e_1_2_9_69_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885328215627616"},{"key":"e_1_2_9_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2013.10.003"},{"key":"e_1_2_9_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-812524-3.00013-2"},{"key":"e_1_2_9_72_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885328207078075"},{"key":"e_1_2_9_73_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2023.1117954"},{"key":"e_1_2_9_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.06.020"},{"key":"e_1_2_9_75_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2014.12.018"},{"key":"e_1_2_9_76_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.02.025"},{"key":"e_1_2_9_77_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-45433-7_2"},{"key":"e_1_2_9_78_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-90142-5"},{"key":"e_1_2_9_79_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2011.05.078"},{"key":"e_1_2_9_80_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-800196-7.00001-3"},{"key":"e_1_2_9_81_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10856-015-5423-5"},{"key":"e_1_2_9_82_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-800196-7.00002-5"},{"key":"e_1_2_9_83_1","doi-asserted-by":"publisher","DOI":"10.3390\/ma8095269"},{"key":"e_1_2_9_84_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells10071794"},{"key":"e_1_2_9_85_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1151-2916.1989.tb06239.x"}],"container-title":["Journal of Biomedical Materials Research Part B: Applied Biomaterials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbm.b.70083","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jbm.b.70083","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jbm.b.70083","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:26:06Z","timestamp":1779985566000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jbm.b.70083"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":84,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/jbm.b.70083"],"URL":"https:\/\/doi.org\/10.1002\/jbm.b.70083","archive":["Portico"],"relation":{},"ISSN":["1552-4973","1552-4981"],"issn-type":[{"value":"1552-4973","type":"print"},{"value":"1552-4981","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70083"}}