Abstract
ObjectiveBone substitute (BS) size might influence the clinical outcomes of guided bone regeneration (GBR) procedures. The aim of the present study was to investigate the influence of BS size on macrophage (Mφ) and osteoblast behaviors in vitro.Materials and methodsTwo different granule sizes (S and M/L) were assessed for four different commercial BSs: deproteinized bovine bone mineral (DBBM), biphasic calcium phosphate type 1 (BCP1), BCP type 2 (BCP2), and carbonate apatite (CO3Ap). The BSs were compared for their impacts on the cell viability and differentiation potential of THP-1-derived Mφs and human osteoblast-like Saos-2 cells.ResultsThe smaller granules showed higher material volumes and surface areas than the larger granules. Significantly higher viability of Mφs and Saos-2 cells was observed with the DBBM_L-size granules than with the DBBM_S-size granules. Gene expression experiments in Mφs revealed few differences between the two sizes of each BS, although higher CD206 mRNA levels were observed in the BCP1_L group and the CO3Ap_M group than in the respective S-size groups on day 1. Only DBBM showed significantly higher mRNA levels of osteogenic markers, including Runx2 and osteocalcin, in Saos-2 cells in the S-size group than in the L-size group.ConclusionsThe S-size and L-size DBBM granules exhibited clear differences in cell outcomes: cells cultured on the S-size granules exhibited lower cell viability, higher osteopromotive ability, and no noticeable Mφ polarization changes.Clinical relevanceA smaller granule size might be advantageous due to greater bone regeneration potential in the use of DBBM granules to treat defects.
Highlights
The four essential functions of bone substitutes (BSs) are to promote osteogenesis, osteoinduction, osteoconduction, and osteointegration [1]
Tanuma et al reported that smaller octacalcium phosphate (OCP) granules combined with atelocollagen enhanced the regenerative potential of new bones compared to larger OCP granules in a rat critical-sized calvarial defect model [11]
Throughout the study assays, S-size and L-size granules were compared for deproteinized bovine bone mineral (DBBM) and biphasic calcium phosphate type 1 (BCP1), and S-size and M-size granules were compared for biphasic calcium phosphate (BCP) type 2 (BCP2) and CO3Ap
Summary
The four essential functions of bone substitutes (BSs) are to promote osteogenesis, osteoinduction, osteoconduction, and osteointegration [1]. DBBM granules provide excellent osteoconductivity and promote the stability of new bone without causing adverse effects such as disease transmission [4, 5]. Clin Oral Invest (2021) 25:4949–4958 between resorption and solubilization [6] Another type of synthetic BS, carbonate apatite (CO3Ap), which contains 6– 9 wt% carbonate in its apatitic structure (similar to that of natural bone), has been recognized as an excellent osteopromotive BS, that is, interestingly, resorbed by osteoclasts [7–9]. Ghanaati et al showed that differences in the size, shape, and porosity of β-TCP granules had an impact on material integration, multinucleated giant cell formation, and angiogenesis in a rat subcutaneous implant model [10]. Tanuma et al reported that smaller octacalcium phosphate (OCP) granules combined with atelocollagen enhanced the regenerative potential of new bones compared to larger OCP granules in a rat critical-sized calvarial defect model [11]. Dawson et al found that the increased porosity of HAp resulted in a significant increase in new bone formation due to the greater porosity and surface area of the recognized osteopromotive substrate in a rabbit femur defect model; there was more bone formation in porous Hap than in nonporous HAp in 80% of rabbits at 8 weeks and 100% of rabbits at 13 weeks [12]
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