Abstract
Reconstruction of jaw bone defects present a significant problem because of specific aesthetic and functional requirements. Although widely used, the transplantation of standard autograft and allograft materials is still associated with significant constraints. Composite scaffolds, combining advantages of biodegradable polymers with bioceramics, have potential to overcome limitations of standard grafts. Polyethyleneimine could be an interesting novel biocompatible polymer for scaffold construction due to its biocompatibility and chemical structure. To date, there have been no in vivo studies assessing biological properties of hydroxyapatite bioceramics scaffold modified with polyethyleneimine. The aim of this study was to evaluate in vivo effects of composite scaffolds of hydroxyapatite ceramics and poly(lactide-co-glycolide) and novel polyethyleneimine on bone repair in swine’s mandibular defects, and to compare them to conventional bone allograft (BioOss). Scaffolds were prepared using the method of polymer foam template in three steps. Pigs, 3 months old, were used and defects were made in the canine, premolar, and molar area of their mandibles. Four months following the surgical procedure, the bone was analyzed using radiological, histological, and gene expression techniques. Hydroxyapatite ceramics/polyethyleneimine composite scaffold demonstrated improved biological behavior compared to conventional allograft in treatment of swine’s mandibular defects, in terms of bone density and bone tissue histological characteristics.
Highlights
Radiological analysis, done by Cone-Beam Computed Tomography (CBCT), demonstrated that in the canine area bone density was significantly lower in the BioOss group compared to HAP/PLGA and HAP/PEI
In two other investigated regions, premolar and molar, bone density was significantly lower in BioOss-treated animals compared to HAP/PEI group (Figure 1B,C, F = 8.726, p = 0.002, F = 6.553, p = 0.008 respectively) while there were no differences compared to HAP/PLGA group
We demonstrated that RANKL/OPG ratio was significantly higher in the BioOss group compared to HAP/PEI in all investigated regions, as well as compared to HAP/PLGA in premolar and molar regions (Figure 8A, p = 0.0027, Figure 8B, p = 0.0115, p = 0.0001, Figure 8C, p = 0.0012, p < 0.0001 respectively)
Summary
Craniofacial deformities, tumors, or infections in the maxillofacial area may result in significant facial deformities and dysfunctions with significant decrease in the quality of life of patients [1]. Reconstruction of the facial and jaw bone defects is a significant problem in oral and maxillofacial surgery due to specific esthetic and functional requirements [1]. Extensive clinical research on bone reconstruction with standard autograft and allograft transplantation procedures, with good clinical results, demonstrated significant limitations related to the problems of donor availability, donor site morbidity, supply difficulties, pathogen transfer, and immune system rejection [2,3]. BTE comprises interaction of several key factors in bone regeneration: a biocompatible scaffold serving as an extracellular matrix in which osteogenic cells form bone tissue matrix, morphogenic signals, and proteins that help to direct the cells differentiation to osteogenic phenotype and sufficient vascular supply [4]. In order to promote natural bone formation, scaffolds should possess adequate mechanical strength during tissue healing as well as certain surface topography characteristics and structural porosity in order to achieve good osteoconductivity, osteoinductivity, and osteointegrativity [6–8]. A requirement for biomaterials that can demonstrate complex functions leads to the development of a new generation of biomaterials characterized by nanofibers [9,10]
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