Mechanical behavior of mandibular continuity defects reconstructed using combinations of hydroxylapatite and autogenous bone

In Vivo Analysis of Porous Bioactive Silicon Carbide Scaffold for Craniofacial Bone Augmentation

BACKGROUND

Bone augmentation is a vital area of research because of its high clinical demand and the reported complications associated with the available biomaterials. Purpose: The study assess the role of decellurized skeletal muscle (DSM) when combined with synthesized porous bioactive silicon carbide (SiC) ceramic and evaluated its ability to augment bone calvaria in a rat model.

MATERIAL AND METHODS

Eighteen rats were divided into 2 groups; group 1 (n=9), SiC discs (10 × 0.2 mm) pre-treated with 20% NaOH were placed as an onlay grafts on calvarial bone. Meanwhile, in group 2 (n=9), SiC discs pre-treated with 20% NaOH (10 × 0.2 mm) were covered with DSM. After 12 weeks, the grafted tissues were harvested and examined using cone-beam computed tomography, mechanical testing, and histologic analysis.

RESULTS

Cone-beam computed tomography for group 2 showed more radio-opacity for the remnant of SiC compared with native bone. The surface area and volume of radio-opacity were 2.48 mm2 ± 1.6 and 14.9 ± 7.8 mm3, respectively. The estimated quantitative average surface area of the radio-opacity for group 1 and volume were 2.55 mm2 ± (Sd=3.7) and 11.25 ± (Sd=8.9), respectively. Mechanically, comparable values of the flexural strength and statistically significant higher modulus of elasticity of calvaria in group 1 compared with group 2 and control (P<0.001). Histologically, group 2 region of woven bone was seen close to the lamellar bone (native bone), and there was immature bone present near the implanted SiC.

CONCLUSION

The tested construct made of SiC/DSM has potential to osteointegrate into native bone, making it a suitable material for bone augmentation.

The use of TriCalcium Phosphate (TCP) and stem cells for the regeneration of osteoperiosteal critical-size mandibular bony defects, an in vitro and preclinical study

The investigation aims to assess the reconstruction of critical-size mandibular bone defects in rabbits using beta-Tricalcium Phosphate (β-TCP) scaffolding loaded with stem cells. A 20 mm-long mandibular osteoperiosteal continuity defect was created in 8 New Zealand rabbits and filled with β-TCP scaffolding. In 6 cases bone marrow stem cells (BMSCs) harvested, and enriched, from the posterior iliac crest of the same rabbit were seeded into the scaffolding, while a scaffold was used alone in two cases chosen at random. Radiographic analysis was carried out immediately following surgery and 4, 8 and 12 weeks postoperatively. Cone Beam CT (CBCT) scanning, biomechanical testing and histology assessments were carried out on the explanted mandibles three months postoperatively. The radiography showed minimal new bone formation in all the cases, with significant amounts of undegraded scaffold material visible. Sporadic areas of bone formation were seen, these did not bridge the gap of the created surgical defect. The mechanical properties of the regenerated bone were of an inferior quality when compared with that of the contralateral non-operated side. The addition of BMSCs to the biodegradable β-TCP scaffold did not improve reconstruction of the created mandibular defect. Despite successful aspiration and culture of BMSCs, the survival of these cells in vivo was questionable.

Autogenous bone with or without hydroxyapatite bone substitute augmentation in rat calvarium within a plastic cap

OBJECTIVES

We evaluated the effect of autogenous bone (AB) and hydroxyapatite bone (HA) for the assessment of bone augmentation beyond the skeletal envelope in the rat calvarium.

STUDY DESIGN

The calvaria of 12 rats were exposed and 2 plastic caps were placed with AB and HA or AB alone in the calvarium. Images of bone augmentation within the plastic caps were taken using micro-CT (R_mCT). Histologic sections were cut along the same plane as those used for the R_mCT images at 12 weeks. Bone volume (BV) was calculated using BV-measuring software.

RESULTS

BV increased at both the experimental and control sites. The newly generated tissue did not significantly differ between the experimental and control sites; however, the mineralized tissue was significantly higher at control sites compared with experimental sites.

CONCLUSIONS

The results indicate that the combination of HA and AB was biocompatible and allowed osteoconduction.

Reconstruction of the mandible by prefabricated autogenous bone grafts. An experimental study in minipigs

The aim of the present experimental study was to evaluate the use of prefabricated bone grafts for reconstruction of the mandible. In 20 adult Göttingen minipigs, prefabricated bone grafts 10 x 12 x 40 mm in size were cultivated in scaffolds of pyrolized bovine bone under a polylactic membrane on the outside of the mandible during a period of five months. The grafts were harvested and transferred to bridge 2- and 4-cm lower mandibular border defects and discontinuity defects. Five animals served as ungrafted controls and evaluation of the grafts was performed three and five months after grafting. At both intervals and in both graft-length groups, the grafted bone volume was almost completely preserved inside the scaffolds and exhibited a slight (3 months) to marked (5 months) increase in bone density by appositional bone growth. The inserted screws were histologically integrated into the transplanted bone and the grafts were linked to the adjacent mandibular bone without intervening soft tissue. The grafts, which were transferred to bridge discontinuity defects, were likewise well preserved with direct fusion between the grafted bone and local bone. It was concluded that bone grafts can be prefabricated from underlying mandibular bone and used for the repair of mandibular defects of various length and shape.

Evaluation of a high-velocity flame-spraying technique for hydroxyapatite

Titanium alloy sprayed with hydroxyapatite (HA) was developed by a high-velocity flame-spraying technique (HVFST). Biocompatible responses of bony tissues to high-velocity flame-sprayed HA (HVFS-HA) implanted into tibias of adult male rabbits was investigated 4 and 18 months after implantation by light and electron microscopy. Both light and electron microscope features in histological sections showed that inflammatory responses of tissues in situ were completely cleared and the interface between the bone and the implant was filled with newly formed bony substrate. This suggests that the HVFS-HA was sufficiently biocompatible to be adapted to the bone in situ.

Anterior maxillary osteoplasty to broaden the narrow maxillary ridge

The application of endosseous implants has extended the range of options and effectiveness of reconstructive preprosthetic surgery. Placement of endosseous implants in the edentulous maxilla is often restricted due to lack of available bone. Exposure of the underlying anterior maxillary bone frequently reveals a ridge form which is adequate in height but too narrow to accommodate endosseous implants. A horseshoe type osteotomy extending from the ridge crest into the floor of nose has been developed which allows advancement of the outer cortex to restore lost facial form and placement of an interpositional bone graft and endosseous implants to restore lost function.