Abstract
Different xenogeneic inorganic bone substitutes are currently used as bone grafting materials in oral and maxillo-facial surgery. The aim of the present study was to determine the physicochemical properties and the in vivo performance of an anorganic equine bone (AEB) substitute. AEB is manufactured by applying a process involving heating at >300 °C with the aim of removing all the antigens and the organic components. AEB was structurally characterized by scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray fluorescence (XRF), and Fourier-transformed infrared (FT-IR) spectroscopy and compared to the anorganic bovine bone (ABB). In order to provide a preliminary evaluation of the in vivo performance of AEB, 18 bone defects were prepared and grafted with AEB (nine sites), or ABB (nine sites) used as a control, in nine Yucatan Minipigs. De novo bone formation, residual bone substitute, as well as local inflammatory and tissue effects were histologically evaluated at 30 and 90 days after implantation. The structural characterization showed that the surface morphology, particle size, chemical composition, and crystalline structure of AEB were similar to cancellous human bone. The histological examination of AEB showed a comparable pattern of newly formed bone and residual biomaterial to that of ABB. Overall, the structural data and pre-clinical evidence reported in the present study suggests that AEB can be effectively used as bone grafting material in oral surgery procedures.
Highlights
Bone grafting is a major treatment modality in oral surgery for bone volume preservation as well as for augmentation procedures [1].An ideal bone graft should foster natural healing through osteoconductive, osteoinductive, and osteogenic mechanisms, be biocompatible, and not evoke any inflammatory response
Optical microscopy observations showed that anorganic equine bone (AEB) consisted of particles with similar shape, having some portions rounded and others derived by fragmentation
The scanning electron microscopy (SEM) analysis of AEB showed that the particles had irregular shape and fragmented surfaces (Figure 2A,B)
Summary
An ideal bone graft should foster natural healing through osteoconductive, osteoinductive, and osteogenic mechanisms, be biocompatible, and not evoke any inflammatory response. It should be sterilizable and readily available at a reasonable cost [2]. It has been widely described in the literature that materials that feature slow resorption kinetics, without disturbing the natural bone remodeling process occurring around them, are able to obtain positive clinical results and a long-term volume stability [3,4]. To avoid unwanted immunological reactions and any risk of cross-infections, xenogeneic bone grafts undergo specific treatments of deantigenation and sterilization [7,8]
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