Abstract
ABSTRACTAmong the many graft materials that have been used for the treatment of bone defects in oral and maxillofacial regions is xenograft. To improve osteoconductive effects of xenografts, they have been combined with various biocompatible materials, such as hyaluronic acid and bone morphogenetic protein.ObjectiveTo determine bone-healing capacity of high molecular weight hyaluronic acid (HA) combined with xenograft in rabbit calvarial bone defects.Material and methodsTen adult male New Zealand rabbits (mean weight 3 kg) were included in the study. Three 6-mm-diameter bicortical cranial defects were created on calvarial bone of all rabbits. These defects were filled as follows: a) xenograft; b) HA+xenograft; c) autograft. One month after the first operation, rabbits were sacrificed. Specimens were evaluated histomorphometrically.ResultsConsidering multiple comparisons, differences regarding new bone were statistically significant between all groups (p<0.05). The volume of residual graft was significantly decreased in HA group compared to xenograft group (p=0.035). Marrow space, trabecular thickness (TbTh), trabecular width (TbWi), trabecular separation (TbSp), and number of node: number of terminus (NNd:NTm) in the autograft group were significantly better than xenograft and HA groups (p<0.05). However, regarding marrow space, TbTh, TbWi, TbSp, and NNd:NTm values, xenograft and HA groups showed similar results and the difference were not significant (p>0.05).ConclusionThese results support that high molecular weight hyaluronic acid could contribute to the healing of xenograft by improving the percentage of new bone formation and reducing the percentage of residual graft. However, HA did not significantly affect the quality of newly formed bone assessed by microarchitectural parameters.
Highlights
An understanding of the mechanisms of bone repair and regeneration is basic to bone defect treatment, alveolar socket healing and dental implant surgery2
The volume of residual graft was significantly decreased in Hyaluronic acid (HA) group compared to xenograft group (p=0.035)
We aimed to examine the effects of high molecular weight HA on xenograft bone material regarding new bone formation and the bone microarchitecture in rabbit calvarial defect model
Summary
An understanding of the mechanisms of bone repair and regeneration is basic to bone defect treatment, alveolar socket healing and dental implant surgery. Various graft materials such as autografts, allografts, xenografts, and alloplasts have been used in clinical practice. Autogenous bone grafts are considered the gold standard, they have many disadvantages, including donor site morbidity, inadequate amount of graft, and extensive surgery time. Xenografts are proper alternatives for bone repair and regeneration because of their similarity to human bone. The available amount of autograft material is always limited, one can obtain as much xenograft as desired. Natural bovine bone is potentially a much better graft material than a synthetic bone substitute. Unresorbed graft remnants of bovine bone have been observed in histological analyses even after three years. Because xenografts are osteoconductive rather than osteoinductive, it is important to identify methods to improve their effectiveness in vivo
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