Ratlarda Deneysel Olarak Oluşturulan Kritik boyutlu kemik defektlerine uygulanan sığır kaynaklı deminarelize kemik greftininin kemik iyiyleşmesine olan etkisinin otojen,allojenik ve sentetik greftlerle karşılaştırılmasının histomorfometrik olarak incelenmesi

Year 2018, Volume: 21 Issue: 4, 387 - 395, 30.12.2018

Turgay Peyami Hocaoğlu Sadık Gençoğlan Murat Arslan M. Emre Benlidayı Mehmet Kürkçü

https://doi.org/10.7126/cumudj.475498

Abstract

Amaç: Kemik dokusu iyileşme özelliğine (rejenerasyon) sahiptir ve
yaralanan kemik dokusu şekil ve fonksiyonunu yeniden
kazanabilmektedir. Fakat yaralanmanın boyutu büyük olduğu zaman
iyileşme sınırlı kalabilmektedir. Kritik boyutlu kemik defekti; kemik
dokusunda, canlının yaşamı boyunca, şekil ve fonksiyon olarak,
kendiliğinden tamamen iyileşmesinin mümkün olmayacağı boyuttaki
defekt anlamına gelir. Kritik kemik defektlerinde tedavi için otojen
greft uygulaması altın standart olarak kabul edilir. Otojen kemik
greftinin bazı dezavantajları nedeniyle araştırmacılar çalışmalarını
farklı greft materyalleri üzerinde yoğunlaştırmışlardır. Bu çalışmalar
neticesinde Ksenogreft, Allogreft ve sentetik greft materyalleri gibi
seçenekler ortaya çıkmıştır.
Çalışmamızın amacı 5mm çapında kritik boyutlu kemik defektlerinde
sığır kaynaklı demineralize kemik grefti uygulamasının kemik
iyileşmesine etkisi ile aynı çaptaki defektlere otojenik, allojenik ve
sentetik greft materyali uygulandığı zaman elde edilen iyileşmelerin
histomorfometrik olarak incelenmesidir.
Gereç ve Yöntemler: Deney hayvanları her grup 8 deney hayvanından
oluşan 4 gruba ayrıldı. Kontrol grubunda mandibulada defekt
oluşturulduktan sonra defekt sığır kaynaklı kemik grefti (Integros Bone
Plus XS Adana/Türkiye) ile dolduruldu. Daha sonraki deney
gruplarında; I. grupta oluşturulan kritik boyutlu defekte trefin frezle
çıkartılan otojen kemik tekrar konuldu. II. grupta oluşturulan kritik
boyutlu defekte insan kaynaklı kemik grefti (Korea Bone Bank (KBB)
Gasandong Keumcheongu Seoul/Korea) uygulandı. III. grupta
oluşturulan kritik boyutlu kemik defektine ise sentetik kemik grefti
grubunda yer alan β-trikalsiyum fosfat (Cerasorb North Caroline/USA)
uygulandı. 28 gün sonra ratlar öldürüldü.Her grup sakrifiye edilerek
histomorfometrik incelemeye alındı.
Sonuç: Farklı greft materyallerinin 28. günde yeni kemik oluşumuna
olan etkisinin histomorfometrik olarak incelendiğinde otojen kemik
grefti, allogreft ve sığır kaynaklı kemik grefti uygulanan gruplar
arasında yeni oluşan kemik hacmi bakımından anlamlı bir fark
bulunmazken, sentetik kemik grefti uygulanan grupla aralarındaki fark
anlamlı bulunmuştur.
Otojen kemik grefti günümüzde hala altın standart olarak kabul
edilmesine rağmen, elde edilmesi ve uygulanmasındaki zorluklar
nedeniyle çalışmamızda kullandığımız sığır kaynaklı kemik greftinin
otojen kemik greftine alternatif olarak güvenilir ve etkili biçimde
kullanılabileceği belirlenmiştir. 

Keywords

dental greft, otojen greft, allojenik greft, ksenogreft

Histomorphometric Assessment of the Impact of Bovine Demineralized Bone Graft on Bone Healing Versus Autogenous, Allogeneic and Synthetic Grafts in Experimentally- Induced Critical Size Bone Defects in Rats

Abstract

Aim: Bone tissue has the ability to heal itself (regeneration) and may
restore its morphology and function when injured. However, healing
may be limited in the case of large wounds. A “critical-size defect” is
an intraosseous wound in a particular bone and species of animal that
will not heal spontaneously morphologically and functionally during
the lifetime of the animal. Autogenous bone grafts have been regarded
as “gold standard” for treatment of critical-size bone defects. Known
drawbacks of autogenous bone graft have led to research efforts
focusing on different graft materials and resulted in several alternative
substitutes including xenografts, allografts and synthetic graft
materials.
The aim of the present study was to perform a histomorphometric study
to investigate the effect of bovine demineralized bone graft on bone
healing in comparison to autogenous, allogeneic and synthetic graft
materials when applied into critical size bone defects with a diameter
of 5 mm.
Materials and methods: Experimental animals were divided into 4
groups, each having 8 rats. In the control group, a mandibular defect
was created and then filled with a bovine graft (Integros Bone Plus XS
Adana/Turkey). In the experimental groups, autogenous bone was
reinserted into the critical-size defect which was created using a
trephine bur in Group I (autogenous group) and Group II received a
human graft (Korea Bone Bank (KBB) Gasandong Keumcheongu
Seoul/South Korea) to fill the critical-size defect. For Group III, a
synthetic bone graft β-tricalcium phosphate (Cerasorb North
Carolina/USA) was applied on the critical-size bone defect. Specimens
were obtained for histomorphometric examination and rats were
sacrificed on day 28.
Results: Histomorphometric examination performed on day 28 to
evaluate the relative effects of different graft materials on new bone
formation showed no significant difference in the volume of newly
formed bone between groups receiving autogenous bone graft, allograft
and bovine xenograft but a significant difference was observed versus
synthetic bone graft group.
Conclusion: While autogenous bone graft is currently regarded as the
gold standard for bone regeneration, the difficulties in harvesting and
application of autografts limit their use. Our results demonstrate that
bovine bone graft may be used as a safe and effective alternative to
autogenous bone graft.

Keywords

dental graft, autogenous graft, allogeneic graft, xenograft

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