An Experimental Evaluation Of The Effect Of Deproteinized Bovine Bone Mineral BIO-OSS® On Bone Healing

Yıl 2008, Cilt: 2 Sayı: 2, 87 - 97, 01.03.2008

Süleyman Bozkaya İnci Karaca Tülin Oygür Emre Barış

Öz

Purpose: The purpose of this study was to evaluate the osseous regenarative capacity of deproteinized bone graft in different size mandibular bicortical bone defects and to investigate the dimension of mandibular critical size defect in guinea pigs model.Material and methods: 24 guinea pigs were used in this study and they were divided into three groups with eight animals in each. Two bicortical defects were created in the each segment of the mandible; in group 1, 3 mm diameter; in group 2, 4 mm diameter and in group 3, 5 mm diameter defect were created. Bio-Oss was applied in one defect of each segment and the other defect was left untreated for control. The animals were sacrified at 4. and 8 weeks postoperatively for histopathological examination of the defect sites.Results: Promoted new bone formation was observed in the defects that deproteinized bone grafts applied in comparison with control group. While spontaneous bone healing was observed in 3 mm diameter defects, 4 mm and 5 mm diameter defects did not show totally spontaneous bone healing. There were statistical differences between the bone formation in the 3 mm defects with 4 mm defects and 5 mm defects p

Anahtar Kelimeler

Deproteinized bone graft, critical size defect, mandibular bicortical defect

Deproteinize Kemik Grefti BİO-OSS® ’nin Kemik İyileşmesi Üzerine Etkisinin Deneysel Olarak İncelenmesi

Öz

Amaç: Bu çalışma deproteinize kemik greftinin mandibulada oluşturulan çeşitli boylardaki bikortikal kemik defektlerine uygulanmasının oluşturduğu etkilerin histopatolojik olarak incelenmesi ve kobay modelinde mandibuler kritik boyut defekti miktarının araştırılması amacıyla yapılmıştır.Gereç ve yöntem: 24 adet kobayın deney hayvanı olarak kullanıldığı çalışmada denekler her grupta 8 adet olacak şekilde 3 gruba ayrılmıştır. Deneklerin mandibulalarında her segmentte 2’şer adet olacak şekilde 1. grupta 3 mm çapında, 2. grupta 4 mm çapında ve 3. grupta 5 mm çapında bikortikal defektler açılmıştır. Her segmentte açılan defektlerden birisine Bio-Oss uygulanmış, diğer defekt kontrol amacı ile boş bırakılmıştır. 4., ve 8. haftaların sonunda alınan örnekler histopatolojik olarak incelenmiştir.Bulgular: Deproteinize kemik grefti uygulanan defektlerde yeni kemik yapımının kontrol grubuna göre daha üstün olduğu; 3 mm çapındaki defektlerde spontan olarak iyileşme gözlenirken 4 mm ve 5 mm çapındaki defektlerde spontan iyileşmenin defekti dolduracak kadar olmadığı görülmüştür. 3 mm’lik defektler ile 4 mm ve 5 mm’lik defektlerdeki iyileşme miktarları arasındaki fark istatistiksel olarak anlamlı bulunmuştur p

Anahtar Kelimeler

Deproteinize kemik grefti, kritik Boyut Defekti, mandibuler bikortikal defekt

Kaynakça

• Bosch C., Melsen B., Vangervik K.: Importance of the Critical-Size Bone Defect in Testing Bone-Regenerating Materials. J. Craniofac. Surg., 9(4): 310-6, 1998.
• Lemperle S.M., Calhoun C.J., Curran R.W., Holmes R.E.: Bony Healing of Large Cranial and Mandibular Defects Protected from Soft-Tissue Interposition: A Comparative Study of Spontaneous Bone Regeneration, Osteoconduction, and Cancellous Autografting in Dogs. Plast. Reconstr. Surg. 101(3); 660-72, 1998.
• Schmitz J.P., Hollinger J.O.: The Critical Size Defect as an Experimental Model for Craniomandibulofacial Nonunions. Clin. Orthop. 205: 299-308, 1986. Artzi Z., Tal H., Dayan D.: Porous Bovine Bone Mineral in Healing of Human Extraction Sockets. Part 1: Histomorphometric Evaluations at 9 Months. J. Periodontol. 71(6): 1015-23, 2000. Clokie C.M., Moghadam H., Jackson M.T., Sandor G.K.: Closure of Critical Sized Defects with Allogenic and Alloplastic Bone Substitutes. J. Craniofac. Surg. 13(1): 111-23, 2002..
• Dahlin C., Sandberg E., Alberius P., Linde A.: Restoration of Mandibular Nonunion Bone Defects. An Experimental Study in Rats Using an Osteopromotive Membrane Method. Int. J. Oral Maxillofac. Surg. 23(4): 237-42, 1994.
• Spector M.: Anorganic Bovine Bone and Ceramic Analogs of Bone Mineral as Implants to Facilitate Bone Regeneration. Clin. Plast. Surg. 21(3): 437-444, 1994. Stassen L.F., Hislop W.S., Still D.M., Moos K.F.: Use of Anorganic Bone in Periapical Defects Following Apical Surgery: A Prospective Trial. Br. J. Oral Maxillofac. Surg. 32(2): 83-5, 1994.
• Pinholt E.M., Bang G., Haanaes H.R.: Alveolar Ridge Augmentation in Rats by Bio-Oss. Scand. J. Dent. Res. 99(2): 154-61, 1991.
• Kasabah S., Simunek A., Krug J., Lecaro M.C.: Maxillary Sinus Augmentation with Deproteinized Bovine Bone (Bio-Oss) and Impladent Dental Implant System. Part II. Evaluation of Deprotienized Bovine Bone (Bio-Oss) and Implant Surface. Acta Medica. (Hradec Kralove). 45(4): 167-71, 2002. Hurzeler M.B., Kohal R.J., Naghshbandi J., Mota L.F., Conradt J., Hutmacher D., Caffesse R.G.: Evaluation of a New Bioresorbable Barrier to Facilitate Guided Bone Regeneration Around Exposed Implant Threads. An Experimental Study in the Monkey. Int. J. Oral Maxillofac. Surg. 27(4): 315-20, 1998.
• Piattelli A., Degidi M., Di Stefano D.A., Rubini C., Fioroni M., Strocchi R.: Microvessel Density in Alveolar Ridge Regeneration with Autologous and Alloplastic Bone. Implant Dent. 11(4): 370-5, 2002.
• Tadjoedin E.S., De Lange G.L., Bronckers A.L,, Lyaruu D.M., Burger E.H.: Deproteinized Cancellous Bovine Bone (Bio-Oss) as Bone Substitute for Sinus Floor Elevation. A Retrospective, Histomorphometrical Study of Five Cases. J. Clin. Periodontol. 30(3): 261-70, 2003.
• Merkx M.A., Maltha J.C, Freihofer H.P, Kuijpers- Jagtman A.M.: Incorporation of three types of bone block implants in the facial skeleton. Biomaterials. 20(7): 639-45, 1999.
• Stephan E.B., Jiang D., Lynch S., Bush P., Dziak R.: Anorganic Bovine Bone Supports Osteoblastic Cell Attachment and Proliferation. J. Periodontol. 70(4): 364-9, 1999.
• Richardson C.R., Mellonig J.T., Brunsvold M.A., Mcdonnell H.T., Cochran D.L.: Clinical Evaluation of Bio-Oss: A Bovine-Derived Xenograft for the Treatment of Periodontal Osseous Defects in Humans. J. Clin. Periodontol. 26(7): 421-8, 1999.
• Carmagnola, D., Berglundh, T., Lindhe, J.: The Effect of a Fibrin Glue on the Integration of Bio-Oss with Bone Tissue. A Experimental Study in Labrador Dogs, J. Clin. Periodontol., 29(5), 377-83. (2002).
• Hallman M., Lundgren S., Sennerby L.: Histologic Analysis of Clinical Biopsies Taken 6 Months and 3 Years after Maxillary Sinus Floor Augmentation with 80% Bovine Hydroxyapatite and 20% Autogenous Bone Mixed with Fibrin Glue. Clin. Implant. Dent. Relat. Res. 3(2): 87-96, 2001.
• Lekovic V., Camargo P.M., Weinlaender M., Vasilic N., Aleksic Z., Kenney E.B.: Effectiveness of a Combination of Platelet-Rich Plasma, Bovine Porous Bone Mineral and Guided Tissue Regeneration in the Treatment of Mandibular Grade II Molar Furcations in Humans. J. Clin. Periodontol. 30(8): 746-51, 2003.
• Skoglund A., Hising P., Young C.: A Clinical and Histologic Examination in Humans of the Osseous Response to Implanted Natural Bone Mineral. Int. J. Oral Maxillofac. Implants. 12(2):194-9, 1997.
• Su-Gwan K., Hak-Kyun K., Sung-Chul L.: Combined Implantation of Particulate Dentine, Plaster Of Paris, and a Bone Xenograft (Bio-Oss) for Bone Regeneration in Rats. J. Craniomaxillofac. Surg. 29(5): 282-8, 2001.
• Valentini P., Abensur D., Densari D., Graziani J.N., Hammerle C.: Histological Evaluation of Bio-Oss in a 2-Stage Sinus Floor Elevation and Implantation Procedure. A Human Case Report. Clin. Oral Implants Res. 9(1): 59-64, 1998.
• Van Steenberghe D., Callens A., Geers L., Jacobs R.: The Clinical Use of Deproteinized Bovine Bone Mineral on Bone Regeneration in Conjunction with Immediate Implant Installation. Clin. Oral Implants Res. 11(3): 210-6, 2000.
• Zitzmann N.U., Scharer P.: Sinus Elevation Procedures in the Resorbed Posterior Maxilla. Comparison of the Crestal and Lateral Approaches. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 85(1): 8-17, 1998.
• Carmagnola D., Berglundh T., Araujo M., Albrektsson T., Lindhe J.: Bone Healing Around Implants Placed in a Jaw Defect Augmented with Bio-Oss. An Experimental Study in Dogs. J. Clin. Periodontol. 27(11): 799-805, 2000. Merkx M.A., Maltha J.C., Freihofer H.P., Kuijpers- Jagtman A.M.: Incorporation of Particulated Bone Implants in the Facial Skeleton. Biomaterials. 20(21): 2029-35, 1999.
• Merkx M.A., Maltha J.C., Freihofer H.P.: Incorporation of Composite Bone Implants in the Facial Skeleton. Clin. Oral Implants Res. 11(5): 422-9, 2000.
• Hollinger J.O., Kleinschmidt J.C.: The Critical Size Defect as an Experimental Model to Test Bone Repair Materials. J. Craniofac. Surg. 1(1): 60-8, 1990.
• Kleinschmidt J.C., Hollinger J.O.: Animal Models in Bone Research in “ Bone Grafts & Bone Substitutes ”, ( Mutaz H.B., Reddi A.H. ed.) Vol: 13, 133-146, W.B. Saunders Company, Pennsylvania, Philadelphia, 1992. Clark A.E.: Re: Comparison of Porous Bone Mineral and Biologically Active Glass in Critical-Sized Defects (68,1043-1053.1997) J. Periodontol. 69(11): 1312-4, 1998.
• Gosain A.K., Song L., Yu P., Mehrara B.J., Maeda C.Y., Gold L.I., Longaker M.T.: Osteogenesis in Cranial Defects: Reassessment of the Concept of Critical Size and the Expression of TGF-Beta Isoforms. Plast. Reconstr. Surg. 106(2): 360-72, 2000.
• Toung J.S., Ogle R.C., Morgan R.F., Lindsey W.H.: Repair of a Rodent Nasal Critical-Size Osseous Defect with Osteoblast Augmented Collagen Gel. Laryngoscope. 109(10): 1580-4, 1999.
• Constantino P.D., Friedman C.D.: Soft Tissue Augmentation and Replacement in the Head and Neck. Otolaryngol. Clin. North Am. 27(1): 1-12, 1994.
• Çılbır Ö.: Pyrost, Demineralize Kemik Ve Solvent Dehidrate Kemik Greftlerinin Membranli Ve Membransiz Kullaniminin Kemik İyileşmesi Üzerine Etkilerinin Deneysel Olarak İncelenmesi, Doktora Tezi, Gazi Üniv. Sağlik Bilimleri Enstitüsü, Ağiz,Diş,Çene Hastaliklari ve Cerrahisi A.D., Ankara 1999. Schmitt J.M., Buck D.C., Joh S.P., Lynch S.E., Hollinger J.O.: Comparison of Porous Bone Mineral and Biologically Active Glass in Critical-Sized Defects. J. Periodontol. 68(11): 1043-53, 1997.
• Orsini G, Scarano A, Degidi M, Caputi S, Iezzi G, Piattelli A: Histological and ultrastructural evaluation of bone around Bio-Oss particles in sinus augmentation. Oral Dis. 13(6):586-93, 2007
• Valentini P., Abensur D., Wenz B., Peetz M., Schenk R.: Sinus Grafting with Porous Bone Mineral (Bio-Oss) for Implant Placement: A 5-Year Study on 15 Patients. Int. J. Periodontics Restorative Dent. 20(3): 245-53, 2000.
• Hammerle C.H., Chiantella G.C., Karring T., Lang N.P.: The Effect of a Deproteinized Bovine Bone Mineral on Bone Regeneration Around Titanium Dental Implants. Clin. Oral Implants Res. 9(3): 151-62, 1998.
• Aaboe M., Pinholt E.M., Hjorting-Hansen E.: Unicortical Critical Size Defect of Rabbit Tibia is Larger than 8 mm. J. Craniofac Surg. 5(3): 201-3, 1994.