The shape of the world a generation from now will be influenced far more by how we communicate the values of our society to others than by military or diplomatic superiority. William Fulbright, 1964

Wednesday, April 02, 2014


Growing the lovely bones                             

It’s the size of a cigarette packet, though there are no glossy images or death and cancer  warnings.  Instead the opposite - a cheering message welcoming the buyer ‘to the next generation of regenerative therapy’.
In lay terms this means helping the body repair itself.
The pack’s contents are tiny, just a small plastic phial containing a white pellet. It looks insignificant enough but this Indonesian invention, which has taken ten years to develop, could enhance dental surgery, slash costs and earn export income.
More importantly it could help improve the lives of thousands of people with damaged jaws, usually following accidents or cancer, and those seeking cosmetic surgery.
Welcome to bioceramics, the use of synthesized natural products to help heal human hurts.
In a Yogyakarta suburb a small blue-walled factory is being prepared to make the pellets, starting mid-year when essential laboratory equipment arrives.  Up to ten staff will be trained, at first producing around 100,000 units a year.
If reality matches the hype the pellets, and other products using the same technology, could nudge Indonesia closer to joining the world’s leading pharmaceutical suppliers, the US, China and India.
It’s called Gama-CHA and it’s a material that helps fractured bones graft. At present the application is mainly in dental work, though later it could be used to repair other bones, particularly the spinal column. It can be used by dentists, though most interest is likely to come from oral surgeons.
 It’s made from carbonate apatite – a calcium-phosphate mineral – and it’s being developed by PT Swayasa Prakarsa.
This commercial business is owned by the University of Gadjah Mada through a subsidiary of its holding company PT Gama Multi.  This runs several services including finance, a consultancy and the University Club.  Gama is an acronym for Gadjah Mada. CHA stands for carbonated hydroxy apatite.
Swayasa Prakarsa has been set up using a Rp 67 billion (US $522,000) loan from UGM, whose engineering and nano biomedicine research group has been creating the technology. (See sidebar)
According to Gama-CHA  inventor, Associate Professor Ika Dewi Ana (above), the product uses materials that are  widely available and cheap.
“It’s identical to human bone in terms of physical and chemical properties,” she said. “It mimics human bones but does away with the need to graft bone from another part of the body. That’s the gold standard, but it’s intrusive and risky.
“Gama-CHA acts as a scaffold.  It supports and allows bone regeneration to occur naturally. It creates an environment where bone tissue can grow.
 “It’s a major improvement on other products which have to be bought overseas. We’ve already taken out Indonesian patents, and we’ve signed a contract for Kimia Farma (the Indonesian pharmaceutical manufacturer and retailer) to distribute Gama-CHA.
“This means it will be in pharmacists across the nation for use by dentists and surgeons.  We want to make it available first to Indonesians before we start to export.”
Like slim dieticians and clear-skinned dermatologists, Professor Ika comes across as a splendid advertisement for her profession, sporting a spectacular set of teeth. She’d set her heart on a career in medicine, so when she was offered a place in UGM’s dentistry faculty rather than her chosen course, she cried in frustration. 
“Now I also teach in the medical faculty, which shows there can be something good in every setback,” she said.
Since graduating she has studied in the Netherlands and Japan and built research contacts used to develop Gama-CHA.  However all royalties will stay here because the synthesis method and formula are Indonesian.
In 2011 Professor Ika was recognized as UGM’s most innovative researcher. She exhibits the effervescent energy required of an entrepreneur and rare in academics.  It’s likely to be hard tested in the months ahead as the invention challenges its rivals, and commercial interests start to bite.
She expects the price of the Indonesian product to be around a third of similar imported products that cost up to US$70 (Rp 800,000).  Although the little pellets will be the main seller the company has also developed a sponge using the same ingredients to soak up blood and mucous during dentistry.
The sponges that sit in the mouth and surround the wound as the tooth is drilled or pulled, currently come from Germany.
The pellets can also be used as plugs after an extraction to keep the hole clean and open for later procedures.
Till now other commercial products have been made using high temperatures which affect the crystals in the composition.  It’s claimed that Gama-CHA will be better because it’s created using low temperatures more akin to the human body
Bone fractures can repair themselves, though they need a structure or scaffold to knit the parts together and ensure no kinks.  Surgeons in some countries use bone from a bone bank stocked by donated cadavers. 
Professor Ika said there were no legal prohibitions on using donated bone in either Indonesian or Islamic law, but such procedures were rare because the materials are in short supply.
“However the use of bone raises the risk of infection,” she said. “This is not a concern with Gama-CHA, which is radiated during manufacture and totally sterile. It’s safe because it degrades naturally and is absorbed by the body. It can be stored at room temperature.
“The Ministry of Health has been evaluating the product but has found problems with classification because it’s neither a drug nor a device.  So we’re helping them define and write the regulations for what’s called bone graft.
“I do not want my country to be a technology user only.  We have to be technology producers.”

Small is beautiful
Farewell electronics: Nano technology is the new frontier for applied science, and in this case it’s being used in biomedicine, also known as medical biology.
Nano means one billionth, and is the other end of the scale from billion.  One nano can be written like this: 0.000000001. US journalist Jennifer Kahn writing in the National Geographic magazine developed a handy analogy: This comma, spans about half a million nanometers.
 Nano biomedicine is the manipulation of matter at an extremely miniscule level, deep down among the atoms.  When matter shrinks it changes. Metals can become transparent. Though the science has been in existence for less than 50 years it’s considered to have enormous potential. 
One common application is in modern sunscreens to block ultra violet rays, but its uses are far more diverse. The screen on your cellphone has been developed through nanotechnology, and if you’re wearing a stain resistant shirt and have installed easy-clean glass in your shower you’re already a consumer of this new science.
(Duncan Graham was a guest in Yogya of UGM.)

First published in The Jakarta Post 2 April 2104)

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