Volume 5, Issue 2, Pages 100-108 (June 2010)

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ABSTRACT

ABSTRACT + REFS

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In vivo evaluation of poorly crystalline hydroxyapatite-based biphasic calcium phosphate bone substitutes for treating dental bony defects

Received 4 February 2010; accepted 21 May 2010.

Background/purpose

Poorly crystalline hydroxyapatite was improved so that it has better cell affinity in vitro. We studied the efficacy of a novel resorbable poorly crystalline hydroxyapatite-based biphasic calcium phosphate, BonaGraft, for bone regeneration in vivo.

Materials and methods

The beagle was used as an animal model, and cylindrical artificial bone defects (3 mm in diameter and 6 mm long) were produced in the alveolar bone. The BonaGraft (ratio of poorly crystalline hydroxyapatite to b-tricalcium phosphate, 60:40) was used to fill in the defect, and unfilled defects served as a control group. At 5, 8 and 10 weeks after the operation, the size of the residual graft and new bone formation were evaluation by a histomorphometric analysis. In a clinical trial, 33 enrolled patients included 15 males and 18 females with ages ranging from 35 to 54 years. The main indications were ridge augmentation (n = 12), sinus lifting (n = 2), repair of periodontal disease (n= 14), and repair of radicular cysts (n= 5). The clinical outcomes of the surgery were primarily evaluated by clinical radiographs.

Results

In the animal study, implanting BonaGraft produced greater new-bone formation (74.5% ± 1.0%) at 10 weeks postoperatively than that of the control (40.2% ± 0.3%). BonaGraft particles were gradually resorbed and substituted by bone. The in vivo graft resorption time and bone healing time of 12.1 weeks were mathematically determined by the least squares method. In the clinical test, all patients implanted with BonaGraft reported satisfactory clinical outcomes without major material-related side effects. According to the radiographic pictures, implantation of BonaGraft enhanced bone formation.

Conclusion

According to the animal study results, BonaGraft has a suitable resorption period and satisfactory outcomes of new bone formation. The clinical study produced high satisfaction with clinical results both objectively and subjectively. For this reason, BonaGraft seems to be an alternative choice for a bone substitute in dental applications.

Key Words: biphasic calcium phosphate , poorly crystalline hydroxyapatite , β-tricalcium phosphate

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Article Outline

• Abstract

• References

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References

1. 1 Ilan DI , Ladd AL . Bone graft substitutes . Oper Tech Plast Reconstr Surg . 2003;9:151–160 .

2. 2 Williams A , Szabo RM . Bone transplantation . Orthopedics . 2004;27:488–495 . MEDLINE

3. 3 Garg AK . Bone Biology, Harvesting, Drafting for Dental Implant; Rationale and Clinical Applications . Chicago: Quintessence; 2004; .

4. 4 Rack A , Knabe C , Stiller M , et al. Synchrotron-tomography for evaluation of bone tissue regeneration using rapidly re-sorbable bone substitute materials. e-J Destr Test, 2006; 11 . Available at: http://www.ndt.net/article/ecndt2006/doc/Th.1.2.2.pdf [Accessed: November 2006] .

5. 5 Knabe C , Houshmand A , Berger G , et al. Effect of rapidly resorbable bone substitute materials on the temporal expression of the osteoblastic phenotype in vitro . J Biomed Mater Res A . 2008;84:856–868 .

6. 6 Branemark PI . Osseointegration and its experimental background . J Prosthet Dent . 1983;50:399–410 . Full-Text PDF (7175 KB) | CrossRef

7. 7 Jalota S , Bhaduri SB , Tas AC . In vitro testing of calcium phosphate (HA, TCP, and biphasic HA-TCP) whiskers . J Biomed Mater Res A . 2006;78:481–490 . MEDLINE

8. 8 Nery EB , LeGeros RZ , Lynch KL , Lee K . Tissue response to biphasic calcium phosphate ceramic with different ratios of HA/beta TCP in periodontal osseous defects . J Periodontol . 1992;63:729–735 . MEDLINE

9. 9 LeGeros RZ . Calcium phosphate-based osteoinductive materials . Chem Rev . 2008;108:4742–4753 . CrossRef

10. 10 Szabo G , Huys L , Coulthard P , et al. A prospective multi-center randomized clinical trial of autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevation: Histologic and histomorphometric evaluation . Int J Oral Maxillofac Implants . 2005;20:371–381 . MEDLINE

11. 11 Pearce AI , Richards RG , Milz S , Schneider E , Pearce SG . Animal models for implant biomaterial research in bone: a review . Eur Cell Mater . 2007;13:1–10 . MEDLINE

12. 12 Tamai N , Myoui A , Tomita T , et al. Novel hydroxyapatite ceramics with an interconnective porous structure exhibit superior osteoconduction in vivo . J Biomed Mater Res . 2002;59:110–117 . MEDLINE | CrossRef

13. 13 Jin QM , Takita H , Kohgo T , Atsumi K , Itoh H , Kuboki Y . Effects of geometry of hydroxyapatite as a cell substratum in BMP-induced ectopic bone formation . J Biomed Mater Res . 2000;52:491–499 . MEDLINE

14. 14 Oonishi H , Hench LL , Wilson J , et al. Comparative bone growth behavior in granules of bioceramic materials of various sizes . J Biomed Mater Res . 1999;44:31–43 . MEDLINE | CrossRef

15. 15 Tischler M , Misch CE . Extraction site bone grafting in general dentistry: review of applications and principles . Dent Today . 2004;23:1–7 .

16. 16 Yamamichi N , Itose M . In: Sinus Floor Elevation . Tokyo: Quintessence; 2008;p. 18–20 .

17. 17 Jung YS , Lee SH , Park HS . Decompression of large odontogenic keratocysts of the mandible . J Oral Maxillofac Surg . 2005;63:267–271 . Full Text | Full-Text PDF (383 KB) | CrossRef

18. 18 Horch HH , Sader R , Pautke C , Neff A , Deppe H , Kolk A . Synthetic, pure-phase beta-tricalcium phosphate ceramic granules (Cerasorb) for bone regeneration in the reconstructive surgery of the jaws . Int J Oral Maxillofac Surg . 2006;35:708–713 . Abstract | Full Text | Full-Text PDF (443 KB) | CrossRef

19. 19 Sun W , Zhang F , Guo J , Wu J , Wu W . Effects of amorphous calcium phosphate on periodontal ligament cell adhesion and proliferation in vitro . J Med Biol Eng . 2008;28:107–112 .

a Division of Oral and Maxillofacial Surgery, Department of Dentistry, Sin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

b Dental Department, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan

c School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

d Dental Department, Taipei Medical University Hospital, Taipei, Taiwan

e Graduate Institute of Biomedical Materials and Engineering, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan

f Dental Department, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan

Corresponding authors. Chien-Chung Chen: Graduate Institute of Biomedical Materials and Engineering, College of Oral Medicine, Taipei Medical University, 250, Wu-Hsing Street, Taipei 11042, Taiwan; Sheng-Yang Lee: School of Dentistry, College of Oral Medicine, Taipei Medical University, 250, Wu-Hsing Street, Taipei 11042, Taiwan

† Chien-Chung Chen and Sheng-Yang Lee contributed equally to this work.

PII: S1991-7902(10)60014-1

doi:10.1016/S1991-7902(10)60014-1

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