Histologic and Histomorphometric Analysis of Bone Regeneration with Bovine Grafting Material after 24 Months of Healing. A Case Report.

Renzo Guarnieri,Luca Testarelli,Patricia Devillier,Fabrizio Belleggia

doi:10.3390/jfb9030048

Abstract

Anorganic bovine bone mineral matrix (ABBMM) has been reported to have osteoconductive properties and no inflammatory or adverse responses when used as grafting material in sinus augmentation procedures. However, controversy remains in regard to degradation rate of ABBMM. The aim of this study was to histologically and histomorphometrically evaluate the degradation of ABBMM in human bone samples obtained in one patient 24 months after sinus augmentation. Materials and Methods: The histologic and histomorphometric analysis was performed by means of light microscopy in three specimens harvested from the same patient, Results: After 24 months the tissue pattern appeared to be composed of residual particles, some in close contact with the newly formed bone, others separated by translucent areas and osteoid tissues. Newly-formed bone presented different levels of maturation and numerous osteocytes, with greater numbers in bone closer to the grafted particles (27.3% vs. 11.2%, p < 0.05). The histomorphometric analysis showed mean values of 40.84% newly-formed bone, 33.58% residual graft material, 23.84% marrow spaces, and 1.69% osteoid tissue, Conclusions: Even though ABBMM underwent considerable resorption, a great amount of residual grafting material was still present after two years of healing following sinus augmentation. This study confirms that the bovine grafts can be classified as long-term degradation materials.

Highlights

The final goal of any bone grafting procedure should be the achievement of 100% living and reactive tissue able to undergo a sustained state of remodeling
We investigated the biopsies taken from one patient after 24 months of maxillary sinus augmentation by using Anorganic bovine bone mineral matrix (ABBMM)
The histologic sections from the present study demonstrated multi-nucleated cells in close approximation and in contact with new bone while the osteoblastic lineage formed new bone onto the ABBMM surface (Figure 6)

Summary

Introduction

The final goal of any bone grafting procedure should be the achievement of 100% living and reactive tissue able to undergo a sustained state of remodeling. Autogenous bone has always been considered the gold standard for grafting procedures because of the reproducible healing mechanism of osteogenesis, osteoinduction, and osteoconduction [1]. Autogenous bone has disadvantages, including limited amount of available graft material, an additional surgical site, donor site morbidity, and the requirement of general anesthesia for extraoral bone harvesting [2,3]. Anorganic bovine bone mineral matrix (ABBMM) is by far the most commonly used and researched xenograft. Most of the available ABBMM consist of deproteinized and sterilized bovine bone. Such matrices provide a scaffold for cells migration and are involved in the osseointegration and remodeling processes [7]

Objectives

Methods

Findings

Discussion

Conclusion