Histological and histomorphometric analysis of bone tissue after guided bone regeneration with non-resorbable membranes vs resorbable membranes and titanium mesh.

BACKGROUND: Guided bone regeneration (GBR) allows to achieve vertical ridge augmentation whether with nonresorbable membranes or resorbable membranes with Ti-mesh, but till now no studies are published comparing histological and histomorphometrical outcomes of these two procedures. MATERIALS AND METHODS: Forty partially edentulous patients required vertical bone regeneration to place implants in the posterior mandible: 20 patients were randomly assigned to group A (Ti-PTFE); while 20 patients to group B (Collagen plus Ti-mesh). For both groups, graft material was a 50:50 mixture of autogenous bone and bone allograft. After 9 months, tissue biopsies were taken from augmented sites (regenerated bone ROI-1; native bone ROI-2) and undergone to histological and histomorphometric analysis. Percentages of bone tissue (B.Ar), biomaterial (Mat. Ar), and soft tissue (St.Ar) were measured; measurements of perimeters were calculated too. ROI-1 values were also compared to ROI-2 in both groups. RESULTS: Twenty-five samples were collected and analyzed consecutively: 13 in group A and 12 in group B. The mean B.Ar, Mat.Ar, and St.Ar were 39.7%, 8.6%, and 52.1% in group A; similar results were obtained in group B, with mean values of 42.1%, 9.6%, and 48.3%, respectively. No significant statistically differences were observed. Differences were observed between ROI-1 and ROI-2 in both group. Finally, bone structure index of ROI-1 and ROI-2 showed statistical differences. CONCLUSIONS: The preliminary results of this study suggest that GBR using nonresorbable membranes and Ti-mesh with resorbable membranes in combination with autogenous bone and bone allograft provide similar histological and histomorphometric results.

The response of bone to nanocrystalline hydroxyapatite-coated Ti13Nb11Zr alloy in an animal model.

An in vivo study was carried out on uncoated and hydroxyapatite (HA)-coated nanostructured Ti13Nb11Zr alloy in comparison with high-grade Ti6Al4V, to investigate the effect of the different surfaces on osteointegration rate. A highly effective method to obtain a fast biomimetic deposition of a thin layer of nanocrystalline HA was applied to coat both substrates. Cylindrical pins were implanted in rabbit cortical bone and evaluated at 4 and 12 weeks by histomorphometry and microhardness tests. The results confirmed the ability of the slightly supersaturated Ca/P solution to induce a fast deposition of nanocrystalline HA on Ti alloys' surfaces. HA-coated Ti13Nb11Zr had the highest osteointegration rate at 4 and 12 weeks. Both HA-coated surfaces showed an affinity index significantly higher than those of native surfaces at 4 weeks (Ti13Nb11Zr+HA: 37%; Ti6Al4V+HA: 26%). Microhardness test showed a significantly higher bone mineralization index of HA-coated Ti13Nb11Zr in comparison with that of HA-coated Ti6Al4V surface. The study suggests that the HA coating on both alloys enhances bone response around implants and that there is a synergic effect of Ti-Nb-Zr alloy with the HA coating on bone remodeling and maturation.

Enhanced guided bone regeneration with a resorbable chamber containing demineralized bone matrix.

BACKGROUND: The effectiveness of a nonporous poly-DL-lactide tubular chamber in guiding bone regeneration through a long bone defect had already been assessed in an experimental model using the rabbit radius. The injection of bone marrow stem cells into the chamber had proven to enhance bone regeneration. METHODS: The present study reports on the development of the above research project in a subsequent stage. Demineralized bone matrix (DBM) obtained by milling New Zealand rabbit femoral and tibial diaphyses was placed into a tubular chamber. A 10-mm defect was bilaterally created in the radii of 10 rabbits. On the left side (chamber side) the defect was treated by means of a poly-DL-lactide chamber filled with DBM, whereas DBM alone was used on the right side (control). RESULTS: Controls were performed at 3 and 6 months by radiographs and histomorphometry and demonstrated better bone growth on the chamber side versus the control side. A comparison with the results previously obtained by stem cell injection into the chamber revealed significant acceleration of bone regrowth in the first 3 months because of the addition of DBM to the chamber. However, no significant difference was found between the two sides after 6 months. CONCLUSION: These results have confirmed the effectiveness of the chamber as a container for the factors promoting bone regeneration, probably because the osteogenetic activity is maintained in situ.

Absorbable screws through the greater trochanter do not disturb physeal growth: rabbit experiments.

We studied the effect of implantation of self-reinforced polyglycolic acid (SR-PGA) screws through the greater trochanter in rabbits. 15 rabbits aged 10 weeks had an SR-PGA screw inserted through the left trochanter physis. A similar drilling was made through the right greater trochanter without screw implantation. The animals were assigned to 3 groups of 5, and were killed after 1, 2 or 3 months. Radiographs of both femurs were obtained monthly and the articulo-trochanteric distance and the neck-shaft angle were measured. After killing the animals, a histological study was performed. The drilling on the right trochanter generated a bony bridge in all the animals. The SR-PGA screws did not give rise to an epiphysiodesis. The progressive peripheral degradation of the implants gave rise to the formation of only modest bridges, which were smaller in size than those observed in the control trochanter. Our findings suggest that absorbable PGA screws implanted through a growth plate cause only minor bone formation and no epiphyseodesis.