Abstract
Abstract Introduction The use of bone substitutes in grafting procedures as an alternative of the use of autogenous bone graft has been indicated, however, the direct comparison between these biomaterials has been little explored. Objective To evaluate the effect of different osteoconductive bone substitutes on the bone repair in critical-sized defects (CSDs) in rat calvaria. Material and method One CSD with an 8 mm diameter was made in each of the 40 rats used in this study. The animals were randomly allocated into 5 groups (n=8), according to the type of bone substitute used to fill the CSD: COA (Coagulum); AUT (autogenous bone); DBB (deproteinized bovine bone graft); HA/TCP (biphasic ceramic composed of hydroxyapatite and β-phosphate tricalcium); and TCP (β-phosphate tricalcium). A microtomographic analysis was performed to evaluate the remaining defect linear length (DLL) of the CSD and the volume of the mineralized tissues (MT) within the CSD at 3, 7, 15 and 30 days after the surgical procedure. In addition, a histometric analysis was performed to evaluate the composition of the repaired bone tissue (% Bone and % Biomaterial) at the 30-day period. Result It was shown that the COA had the lowest DLL and MT within the CSD. In addition, the COA presented the highest % of bone in CSD. The DBB had a higher MT and a higher % of bone substitute particles in the CSD than the AUT and TCP groups. The DBB and AUT groups presented higher % of bone in the CSD than the TCP group. Conclusion The use of the DBB promoted a better pattern of bone volume gain and formation compared to TCP and HA / TCP but was biologically inferior to the AUT.
Highlights
The use of bone substitutes in grafting procedures as an alternative of the use of autogenous bone graft has been indicated, the direct comparison between these biomaterials has been little explored
Among the bone substitute alternatives to autogenous bone graft, osteoconductive biomaterials, such as deproteinized bovine bone (DBB) and biphasic ceramics, which are composed of hydroxyapatite and beta-phosphate tricalcium (HA/TCP), have highly diffused clinical application[8,9,10]
The 40 animals were randomly assigned, by lot after the critical-sized defects (CSDs) confection, to 5 groups of 8 animals each: COA group - The CDS was filled with coagulum; AUT – The CSD was filled with autogenous bone graft obtained during the confection of the CSD; DBB group – The CSD was filled with deproteinized bovine bone graft (Bio-Oss®, Geistlich AG, Wolhusen, Switzerland); HA / TCP group - The CSD was filled with biphasic ceramic composed of hydroxyapatite and β-tricalcium phosphate (Straumann® Bone Ceramic, Straumann AG, Basel, Switzerland); and TCP group – The CSD was filled with β tricalcium phosphate (Beta Pro®, Procell, São Carlos, Brazil)
Summary
The use of bone substitutes in grafting procedures as an alternative of the use of autogenous bone graft has been indicated, the direct comparison between these biomaterials has been little explored. Autogenous bone graft (AUT) is considered the gold standard for bone availability enhancement techniques[4,5,6,7], the use of this graft presents some limitations, such as the donor bed morbidity, the increased surgical time, the limited amount of available graft and the elevated resorption rates, especially when used in particulate form[5] These limitations have indicated the necessity for the use of other types of bone substitutes that allow an adequate process of bone tissue formation with reduction of morbidity to the host[8,9]. These remaining particles do not participate in the direct osseointegration process of the implants due to the lack of vitality of this tissue[11]
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