Comparison of nanoparticular hydroxyapatite pastes of different particle content and size in a novel scapula defect model

Nanocrystalline hydroxyapatite (HA) has good biocompatibility and the potential to support bone formation. It represents a promising alternative to autologous bone grafting, which is considered the current gold standard for the treatment of low weight bearing bone defects. The purpose of this study was to compare three bone substitute pastes of different HA content and particle size with autologous bone and empty defects, at two time points (6 and 12 months) in an ovine scapula drillhole model using micro-CT, histology and histomorphometry evaluation. The nHA-LC (38% HA content) paste supported bone formation with a high defect bridging-rate. Compared to nHA-LC, Ostim(®) (35% HA content) showed less and smaller particle agglomerates but also a reduced defect bridging-rate due to its fast degradation The highly concentrated nHA-HC paste (48% HA content) formed oversized particle agglomerates which supported the defect bridging but left little space for bone formation in the defect site. Interestingly, the gold standard treatment of the defect site with autologous bone tissue did not improve bone formation or defect bridging compared to the empty control. We concluded that the material resorption and bone formation was highly impacted by the particle-specific agglomeration behaviour in this study

Improving CT image analysis of augmented bone with raman spectroscopy

In recent years, bone graft substitutes have been increasingly used in the medical field, for example, in order to promote new bone formation. Microcomputed tomography (-CT) is an image-guided technique used in medicine as well as in materials science, enabling the characterization of biomaterials with high spatial resolution. X-ray-based methods provide density information; however, the question how far conclusions on chemical structures can be inferred from any kind of CT information has not been intensively investigated yet. In the present study, a bone sample consisting of autogenous bone derived cells (ABCs) and bovine bone mineral (BBM) was investigated by -CT and Raman spectroscopic imaging, that is, by two nondestructive imaging methods. Thereby, the image data were compared by means of regression analysis and digital image processing methods. It could be found that 51.8% of the variance of gray level intensities, as a result of -CT, can be described by different Raman spectra of particular interest for bone composition studies by means of a multiple linear regression. With the better description of -CT images by the linear model, a better distinction of different bone components is possible. Therefore, the method shown can be applied to improve CT-image-based bone modeling in the future

Morphometric characteristics of cortical and trabecular bone in atrophic edentulous mandibles

OBJECTIVES: Adaptations of the alveolar ridge after tooth loss have been well described. However, studies on the morphometric characteristics of cortical bone are rare; hence, this study of human atrophic edentulous mandibles was undertaken. MATERIAL AND METHODS: Total cortical area, porosity, and thickness, and the percentage of cortical area in the complete mandibular area as well as in an area (height, 10 mm) starting at the most caudal point of the trabecular compartment and extending in the coronal direction were determined in 185 thin ground sections of edentulous mandibles (incisor region, 49; premolar region, 76; molar region, 60; 95 from females and 90 from males; mean age, 78.2 years, SD ± 7.8 years; Caucasian donors; cause of death: cardiovascular disease). Further, mandibular height and width and degree of residual ridge resorption (RRR) were recorded. RESULTS: The percentage of cortical area in the complete mandibular area increased with increasing RRR. Yet, evaluation of the 10-mm caudal portion corresponding to the basal part of the mandibular body did not confirm these changes in cortical bone. Cortical porosity and thickness decreased from the mesial to the distal region. Cortical porosity was unaffected by RRR, while cortical thickness increased, mainly at lingual aspects. CONCLUSIONS: In conclusion, cortical bone remained stable in different degrees of RRR except for some modulations in the lingual aspects. Changes in the relative composition between cortical and trabecular bone are due to loss of height and total area, mainly at expense of trabecular bone area, but not to adaptations of the cortical bone

A quantification of regenerated bone tissue in human sinus biopsies: influences of anatomical region, age and sex

Objectives: Sinus augmentation is a standard procedure to increase vertical bone supply for dental implants in the atrophic posterior maxilla. Despite the longstanding application of this method, information about some basic factors that could potentially influence bone regeneration after sinus augmentation is rare. The objective of this study was therefore to quantify the impact of the maxillary region (premolar/molar) and patients' age and sex on bone regeneration after sinus grafting. Material and methods: Sinus augmentation procedures were performed in 107 patients (66 female: 52.8 ± 11.0 years, 41 male: 50.6 ± 11.3 years). After 6 ± 1 months, 201 sinus biopsies were harvested and histomorphometrically analysed. Height (oldHt) and bone volume fraction of pristine bone (oldBV/TV), as well as the amount of new bone (newBV/TV) and bone‐to‐bone substitute contact (BBSC) in the augmentation area, were assessed. Results: In women, newBV/TV in the augmented sinus decreased significantly by 0.22 ± 0.08% per year. In men, no similar trend was observed. There were strong influences of the maxillary region and the dimensions of the host bone. In the premolar region, newBV/TV was 23.1 ± 7.9% and 25.1 ± 10.1%; in the molar region, newBV/TV averaged 20.4 ± 9.4% and 17.8 ± 8.8% for women and men, respectively. The greater the thickness of the wall of the sinus floor (mainly in the former premolar region), the greater was the amount of new bone tissue formed in the spaces in‐between bone substitute particles. Conclusions: These empirical results derived from a large human sample, link factors that influence the quality of biomaterial integration to the known clinical risks for the success of dental implants.Karoline Maria Reich, Christian Domitian Huber, Patrick Heimel, Christian Ulm, Heinz Redl, Stefan Tang

The influence of alendronate on osseointegration of nanotreated dental implants in New Zealand rabbits

Objectives: Growing clinical demands for stronger and faster bone bonding to the implant have motivated the development of methods enhancing osseointegration. Lately, the application of bisphosphonates (bis) in order to optimize bone healing has become a topic of great interest. N-containing bis, such as alendronate (ALN), are the more potent drugs of this class. It was the aim of this study to determine the effect of ALN on the osseointegration of a well-documented nanotreated implant system in a rabbit femoral condyle model. Material and methods: Thirty-two adult female New Zealand White rabbits received one implant (3.25mm in diameter and 10mm in length) in their left femoral condyle, a week after they were ovariectomized. Half of them were saline treated (control, group A) and the other half were ALN treated (group B). Rabbits from both groups were euthanized after 6 and 12 weeks, respectively. Results: The specimens were evaluated histologically and histomorphometrically. Upon histological evaluation, no obvious differences were found between the control and the treatment group. Implants showed good integration into the bone tissue surrounding them. There were also no statistically significant differences in bone-to-implant contact and the amount of bone tissue in the immediate neighborhood of the implant at both healing periods. Conclusions: The systemic administration of ALN was not found to affect histological osseointegration of implants in animals with a hormonal status resembling that of postmenopausal healthy women. Further research will be needed to investigate this approach. © 2011 John Wiley & Sons A/S

Porous Titanium Granules in comparison with Autogenous Bone Graft in Femoral Osseous Defects: A Histomorphometric Study of Bone Regeneration and Osseointegration in Rabbits

Background. The high resorption rate of autogenous bone is a well-documented phenomenon that can lead to insufficient bone quality and quantity in an augmented area. Nonresorbable bone substitutes might perform better than autogenous bone in certain applications if they are able to provide adequate bone formation and graft osseointegration. Purpose. The aim of this study was to compare the osseous regeneration and graft integration in standardized defects in the rabbit femur treated either with porous titanium granules or autogenous osseous graft. Materials and Methods. Standardized femoral osseous defects were surgically induced in 45 New Zealand rabbits. Fifteen were treated with porous titanium granules (TIGRAN™-PTG) and membrane (PTGM) 15 with autogenous graft and membrane (AGM) and 15 with membrane alone (CM control). At six weeks the defects were assessed histologically and histomorphometrically. Results. PTGM as compared to AGM presented similar percentages of newly formed bone tissue but a significantly higher fraction of the region of interest was filled with the bone substitute material. Accordingly the composite of new bone plus bone substitute material showed significantly higher volumes for PTGM. Yet the smaller amount of remaining autogenous bone was far better osseointegrated than the titanium granules which in large regions showed no connection to newly formed bone. Both PTGM and AGM as compared to CM presented higher values of newly formed bone. Conclusions. This study demonstrated that PTG was similarly effective as autogenous osseous graft in achieving osseous regeneration while PTG performed markedly better in graft volume stability. The resulting higher total percentage of new bone combined with the bone substitute material in PTG could provide a superior foundation for implant placement. © 2019 Eudoxie Pepelassi et al