Natural coral is a bone graft substitute, which has been

widely used' in maxillofacial, orthopaedic, ORL and

periodontal surgery

Al-Salihi, K A

Rosdan, S

Samsudin, A R

Suzina, A H

English

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In Vivo Study of CORAGRAF: APreliminary Results..S Rosdan*, K A AlrSaIihi**, A H SUZida*, A R S8:insudiil-"'School of Medical Sciences, ";"School of Dental Sciences, Universiti. Sains Malaysia Health Campus, 16150 Kubang Kerian, KeIantan,Malaysia. .IntroductionNatural coral is a bone graft substitute, which has beenwidely used' in maxillofacial, orthopaedic, ORt andperiodontal surgery. The capacity of coral to disappearand to be substituted by new bone distinguishes it fromnon-resorbable materials extensively used in ··thesesurgeries. An optimal clinical utilization of cornlrequires. thorough knowledge of factors influencingresorption, particularly regarding the interface betweenimplant and connective tissue, which is larger than thesurface in contact with the bone. 'This study wasd€$igned to evalUate coral as bone substitute forreconstruction of critical mandible bone defect in rabbitusing histological and scanning electron microscopy(SEM) observations.Materials and MethodsCoral blocks (CORAGRAF) 4mm x 4mm x 4mm fromsea .coral Porites speCies are produced by the NationalTissue Bank, Universiti Sains Malaysia (USM). Theywere immersed in hypochlorite solution, cleaned withultrasound and rinsed with distilled water before finaldrying. DHA was prepared in the same size and usedas control implant. Eight New Zealand male rabbits at~ J Malaysia Vol 59 Supplement BMay 20042 months old were anaesthetized by in1ramuscularinjection ofKet.amine and Xylazine. Muscle was bluntdisfected to reach the mandible. The defects werecreated on both sides of the mandible. CORAGRAFWas placed in the right side while the left side wasimplanted with DHA as control. Then the area wasclosed with resorbable suture. The implants wereretrieved at 2 and 4 weeks later. For the undecaIcifiedmethod, the implants were fixed in neutral bufferedformalin solution, dehydrated with alcohol andinfiltrated by alcohoV~ovit solution. All sampleswere embedded and Polymerized in plastic fixationmedium at 450 lUll wavelength and sectioned usingExakt band cutting machine. The final thin section(8p.m) were grinded and stained with Mayer's H&E.. For SEM method, coral implants were dried at 150°C for24 h and dehydrated.. The implants were coated with.gold and examined with scanning electron microscopy(Leica Cambridge S360 at 10 KV).ResultsNone of the control DHA implants showed boneformation at 2nd and 4th week or implant -boneintegration at 2tid week. However, there was goodintegration border to the host bone at 4th week. The111DHA material was surrounded by fibrous connectivetissue at all period of implantation, and unchanged insize or form with no significant inflammatory reactions.The periphery of the CORAGRAF implant wasseparated from the surrounding tissue by theconnective tissue composed of interiorly by a cellularlayer and externally by a fibrous or adipous layer. Thecentre of the pores was occupied by a fibrous tissue.This tissue contained some vessels and appeared to bemore or less dense depending on the area examined.All pores border surrounded by osteoblasts. At 4thweek, the centre of the pores of the implant appeareddenser and more vascularized. At the interface of theimplant" and soft tissue, there were good integrationwith the CORAGRAF. Mineralized bone tissueappeared at 4 weeks of implantation and successivelydeformed in the shape and size of coral block. SEMobservation showed irregular erosion at the surface ofthe CORAGRAF at 2nd week. .Ai: 4 weeks CORAGRAFbecame more deteriorated and the shape of the poreshad changed, indicating an increased coraldegradation. The pores surface were almost coveredby a dense collagenous extracellular matrix.112DiSCbssionHistological examination demonstrated that DHAimplant was surrounded by intervening fibrous tissue at2 and 4 weeks, with good integration border to the hostbone at 4 weeks while there was no bone formation inthe implant area. Compare with control DHA, theCORAGRAF promoted osteogenesis began on thesurface and border of the coral pores and proceededcentripetally toward the centre of the pores with·slightly intervening fibrous tissue surrounding theimplanted area. New mineralised bone tissue was seenat 4 weeks ·of implantation and successively deformedin the shape and size of CORAGRAF block. The SEMobservation of the CORAGRAF at 2 weeks showed thatthe implants were irregularly eroded at the surface, butthe morphology of the pores was conserved. At 4weeks the implants were more deteriorated and theshape of the· pores had changed, indicating anincreased coral degradation. This study revealed thatnatural coral has shown good biocompatibility,osteoconductivity and biodegradability properties to beused as bone substitute to reconstruct bone defects.Med J Malaysia Vol 59 Supplement BMay 2004

In Vivo Study of CORAGRAF: A Preliminary Results.

http://eprints.usm.my/8193/1/In_Vivo_Study_of_Coragraf_A_Preliminary_Results_(PPSains_Pergigian_)_2006.pdf

In Vivo Study of CORAGRAF: A Preliminary Results.

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