Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Effectiveness of biphasic calcium phosphate block bone substitutes processed using a modified extrusion method in rabbit calvarial defects

  • Lim, Hyun-Chang (Department of Periodontology, Kyung Hee University School of Dentistry) ;
  • Song, Kyung-Ho (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • You, Hoon (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Lee, Jung-Seok (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Jung, Ui-Won (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University) ;
  • Kim, Suk-Young (School of Materials Science & Engineering, Yeungnam University) ;
  • Choi, Seong-Ho (Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University)
  • Received : 2015.01.20
  • Accepted : 2015.02.20
  • Published : 2015.04.30
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Abstract

Purpose: This study evaluated the mechanical and structural properties of biphasic calcium phosphate (BCP) blocks processed using a modified extrusion method, and assessed their in vivo effectiveness using a rabbit calvarial defect model. Methods: BCP blocks with three distinct ratios of hydroxyapatite (HA):tricalcium phosphate (TCP) were produced using a modified extrusion method:HA8 (8%:92%), HA48 (48%:52%), and HA80 (80%:20%). The blocks were examined using scanning electron microscopy, X-ray diffractometry, and a universal test machine. Four circular defects 8 mm in diameter were made in 12 rabbits. One defect in each animal served as a control, and the other three defects received the BCP blocks. The rabbits were sacrificed at either two weeks (n=6) or eight weeks (n=6) postoperatively. Results: The pore size, porosity, and compressive strength of the three types of bone block were $140-170{\mu}m$, >70%, and 4-9 MPa, respectively. Histologic and histomorphometric observations revealed that the augmented space was well maintained, but limited bone formation was observed around the defect base and defect margins. No significant differences were found in the amount of new bone formation, graft material resorption, or bone infiltration among the three types of BCP block at either of the postoperative healing points. Conclusions: Block bone substitutes with three distinct compositions (i.e., HA:TCP ratios) processed by a modified extrusion method exhibited limited osteoconductive potency, but excellent space-maintaining capability. Further investigations are required to improve the processing method.

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References

  1. Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants 2007;22 Suppl:49-70.
  2. Aloy-Prosper A, Maestre-Ferrin L, Penarrocha-Oltra D, Penarrocha-Diago M. Bone regeneration using particulate grafts: an update. Med Oral Patol Oral Cir Bucal 2011;16:e210-4.
  3. Tinti C, Parma-Benfenati S. Clinical classification of bone defects concerning the placement of dental implants. Int J Periodontics Restorative Dent 2003;23:147-55.
  4. Park SH, Brooks SL, Oh TJ, Wang HL. Effect of ridge morphology on guided bone regeneration outcome: conventional tomographic study. J Periodontol 2009;80:1231-6. https://doi.org/10.1902/jop.2009.090090
  5. McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol 2007;78:377-96. https://doi.org/10.1902/jop.2007.060048
  6. Hwang JW, Park JS, Lee JS, Jung UW, Kim CS, Cho KS, et al. Comparative evaluation of three calcium phosphate synthetic block bone graft materials for bone regeneration in rabbit calvaria. J Biomed Mater Res B Appl Biomater 2012;100:2044-52.
  7. Petrungaro PS, Amar S. Localized ridge augmentation with allogenic block grafts prior to implant placement: case reports and histologic evaluations. Implant Dent 2005;14:139-48. https://doi.org/10.1097/01.id.0000163805.98577.ab
  8. Torres J, Tamimi F, Alkhraisat MH, Prados-Frutos JC, Rastikerdar E, Gbureck U, et al. Vertical bone augmentation with 3D-synthetic monetite blocks in the rabbit calvaria. J Clin Periodontol 2011;38: 1147-53. https://doi.org/10.1111/j.1600-051X.2011.01787.x
  9. Xuan F, Lee CU, Son JS, Fang Y, Jeong SM, Choi BH. Vertical ridge augmentation using xenogenous bone blocks: a comparison between the flap and tunneling procedures. J Oral Maxillofac Surg 2014;72:1660-70. https://doi.org/10.1016/j.joms.2014.04.003
  10. Kim JW, Jung IH, Lee KI, Jung UW, Kim CS, Choi SH, et al. Volumetric bone regenerative efficacy of biphasic calcium phosphate-collagen composite block loaded with rhBMP-2 in vertical bone augmentation model of a rabbit calvarium. J Biomed Mater Res A 2012;100:3304-13.
  11. Daculsi G. Biphasic calcium phosphate concept applied to artificial bone, implant coating and injectable bone substitute. Biomaterials 1998;19:1473-8. https://doi.org/10.1016/S0142-9612(98)00061-1
  12. Studart AR, Gonzenbach UT, Tervoort E, Gauckler LJ. Processing routes to macroporous ceramics: a review. J Am Ceram Soc 2006; 89:1771-89. https://doi.org/10.1111/j.1551-2916.2006.01044.x
  13. Hing KA. Bioceramic bone graft substitutes: influence of porosity and chemistry. Int J Appl Ceram Tec 2005;2:184-99. https://doi.org/10.1111/j.1744-7402.2005.02020.x
  14. Kim JW, Choi KH, Yun JH, Jung UW, Kim CS, Choi SH, et al. Bone formation of block and particulated biphasic calcium phosphate lyophilized with Escherichia coli-derived recombinant human bone morphogenetic protein 2 in rat calvarial defects. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112:298-306. https://doi.org/10.1016/j.tripleo.2010.10.025
  15. Lim S, Chun S, Yang D, Kim S. Comparison Study of Porous Calcium Phosphate Blocks Prepared by Piston and Screw Type Extruders for Bone Scaffold. Tissue Eng Regen Med 2012;9:51-5. https://doi.org/10.1007/s13770-012-0051-3
  16. Karageorgiou V, Kaplan D. Porosity of 3D biomaterial scaffolds and osteogenesis. Biomaterials 2005;26:5474-91. https://doi.org/10.1016/j.biomaterials.2005.02.002
  17. Chvapil M, Holusa R, Kliment K, Stoll M. Some chemical and biological characteristics of a new collagen-polymer compound material. J Biomed Mater Res 1969;3:315-32. https://doi.org/10.1002/jbm.820030211
  18. Welsh RP, Pilliar RM, Macnab I. Surgical implants. The role of surface porosity in fixation to bone and acrylic. J Bone Joint Surg Am 1971;53:963-77. https://doi.org/10.2106/00004623-197153050-00011
  19. Kuboki Y, Jin Q, Takita H. Geometry of carriers controlling phenotypic expression in BMP-induced osteogenesis and chondrogenesis. J Bone Joint Surg Am 2001;83-A Suppl 1:S105-15.
  20. Tsuruga E, Takita H, Itoh H, Wakisaka Y, Kuboki Y. Pore size of porous hydroxyapatite as the cell-substratum controls BMP-induced osteogenesis. J Biochem 1997;121:317-24. https://doi.org/10.1093/oxfordjournals.jbchem.a021589
  21. Hing KA, Best SM, Tanner KE, Bonfield W, Revell PA. Mediation of bone ingrowth in porous hydroxyapatite bone graft substitutes. J Biomed Mater Res A 2004;68:187-200.
  22. Li S, De Wijn JR, Li J, Layrolle P, De Groot K. Macroporous biphasic calcium phosphate scaffold with high permeability/porosity ratio. Tissue Eng 2003;9:535-48. https://doi.org/10.1089/107632703322066714
  23. Hing KA, Best SM, Bonfield W. Characterization of porous hydroxyapatite. J Mater Sci Mater Med 1999;10:135-45.
  24. Bohner M, Baumgart F. Theoretical model to determine the effects of geometrical factors on the resorption of calcium phosphate bone substitutes. Biomaterials 2004;25:3569-82. https://doi.org/10.1016/j.biomaterials.2003.10.032
  25. Bignon A, Chouteau J, Chevalier J, Fantozzi G, Carret JP, Chavassieux P, et al. Effect of micro-and macroporosity of bone substitutes on their mechanical properties and cellular response. J Mater Sci Mater Med 2003;14:1089-97. https://doi.org/10.1023/B:JMSM.0000004006.90399.b4
  26. Sohn JY, Park JC, Um YJ, Jung UW, Kim CS, Cho KS, et al. Spontaneous healing capacity of rabbit cranial defects of various sizes. J Periodontal Implant Sci 2010;40:180-7. https://doi.org/10.5051/jpis.2010.40.4.180
  27. Yang C, Unursaikhan O, Lee JS, Jung UW, Kim CS, Choi SH. Osteoconductivity and biodegradation of synthetic bone substitutes with different tricalcium phosphate contents in rabbits. J Biomed Mater Res B Appl Biomater 2014;102:80-8. https://doi.org/10.1002/jbm.b.32984
  28. Yip I, Ma L, Mattheos N, Dard M, Lang NP. Defect healing with various bone substitutes. Clin Oral Implants Res 2015;26:606-14. https://doi.org/10.1111/clr.12395
  29. Hassanein AH, Couto RA, Kurek KC, Rogers GF, Mulliken JB, Greene AK. Experimental comparison of cranial particulate bone graft, rhBMP-2, and split cranial bone graft for inlay cranioplasty. Cleft Palate Craniofac J 2013;50:358-62. https://doi.org/10.1597/11-273
  30. Daculsi G, Passuti N, Martin S, Deudon C, Legeros RZ, Raher S. Macroporous calcium phosphate ceramic for long bone surgery in humans and dogs. Clinical and histological study. J Biomed Mater Res 1990;24:379-96. https://doi.org/10.1002/jbm.820240309
  31. Gauthier O, Bouler JM, Aguado E, Pilet P, Daculsi G. Macroporous biphasic calcium phosphate ceramics: influence of macropore diameter and macroporosity percentage on bone ingrowth. Biomaterials 1998;19:133-9. https://doi.org/10.1016/S0142-9612(97)00180-4
  32. Lu JX, Flautre B, Anselme K, Hardouin P, Gallur A, Descamps M, et al. Role of interconnections in porous bioceramics on bone recolonization in vitro and in vivo. J Mater Sci Mater Med 1999; 10:111-20. https://doi.org/10.1023/A:1008973120918
  33. Kirchhoff M, Lenz S, Henkel KO, Frerich B, Holzhuter G, Radefeldt S, et al. Lateral augmentation of the mandible in minipigs with a synthetic nanostructured hydroxyapatite block. J Biomed Mater Res B Appl Biomater 2011;96:342-50.
  34. Eggli PS, Muller W, Schenk RK. Porous hydroxyapatite and tricalcium phosphate cylinders with two different pore size ranges implanted in the cancellous bone of rabbits. A comparative histomorphometric and histologic study of bony ingrowth and implant substitution. Clin Orthop Relat Res 1988:127-38.
  35. Jovanovic SA, Schenk RK, Orsini M, Kenney EB. Supracrestal bone formation around dental implants: an experimental dog study. Int J Oral Maxillofac Implants 1995;10:23-31.
  36. Park SH, Lee KW, Oh TJ, Misch CE, Shotwell J, Wang HL. Effect of absorbable membranes on sandwich bone augmentation. Clin Oral Implants Res 2008;19:32-41.
  37. Weng D, Hurzeler MB, Quinones CR, Ohlms A, Caffesse RG. Contribution of the periosteum to bone formation in guided bone regeneration. A study in monkeys. Clin Oral Implants Res 2000; 11:546-54. https://doi.org/10.1034/j.1600-0501.2000.011006546.x

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