Distinct healing pattern of maxillary sinus augmentation using the vitroceramic Biosilicate®: Study in rabbits.

OBJECTIVES: To follow healing process of augmented maxillary sinus in rabbits analyzing the histological pattern of bone tissue formation, along with the osteogenic activity and vascularization using a bioactive vitroceramic in comparison to deproteinized bovine bone associated or not with autogenous bone graft. DESIGN: Forty five male adult New Zealand rabbits, 5 months of age, mean weight of 4 Kg, underwent bilateral sinus augmentation surgeries to be divided in five groups: G - (Control) particulate autogenous bone graft (AG), BO - deproteinized bovine bone, BO+G - deproteinized bovine bone + AG, BSi -vitroceramic, and BSi + G - vitroceramic +AG. After 15, 45 and 90 days, all animals were euthanized for specimen's removal to be analyzed under light microscopy, histomorphometry, and immunohistochemistry for Runx2 and VEGF labeling. RESULTS: G, BO and BO+G groups healed uneventfully, allowing the formation of mature remodeling bone at day 90, regarding the association of AG with the biomaterial. On the other hand, BSi and BSi + G groups showed an important cellular reaction and granulation/fibrous tissue formation from the first to the last period of observation. Runx-2 and VEGF immunolabeling were coherent with this result. However, histomorphometry did not reveal significant differences considering new bone formation. CONCLUSIONS: Reconstructed maxillary sinuses using Biosilicate® permitted satisfactory new bone formation in comparison to the deproteinized bovine bone and AG. However, the presence of granulation/fibrous tissue and inflammatory cells associated to the degrading biomaterial indicate that further studies should be careful performed considering the immunological aspect of this new biomaterial.

Bioactive glass-ceramic bone repair associated or not with autogenous bone: a study of organic bone matrix organization in a rabbit critical-sized calvarial model.

OBJECTIVE: The aim of the study was to analyze bone matrix (BMX) organization after bone grafting and repair using a new bioactive glass-ceramic (Biosilicate®) associated or not with particulate autogenous bone graft. MATERIAL AND METHODS: Thirty rabbits underwent surgical bilateral parietal defects and divided into groups according to the materials used: (C) control-blood clot, (BG) particulate autogenous bone, (BS) bioactive glass-ceramic, and BG + BS. After 7, 14, and 30 days post-surgery, a fragment of each specimen was fixed in - 80 °C liquid nitrogen for zymographic evaluation, while the remaining was fixed in 10% formalin for histological birefringence analysis. RESULTS: The results of this study demonstrated that matrix organization in experimental groups was significantly improved compared to C considering collagenous organization. Zymographic analysis revealed pro-MMP-2, pro-MMP-9, and active (a)-MMP-2 in all groups, showing gradual decrease of total gelatinolytic activity during the periods. At day 7, BG presented more prominent gelatinolytic activity for pro-MMP-2 and 9 and a-MMP-2, when compared to the other groups. In addition, at day 7, a 53% activation ratio (active form/[active form + latent form]) was evident in C group, 33% in BS group, and 31% in BG group. CONCLUSION: In general, BS allowed the production of a BMX similar to BG, with organized collagen deposition and MMP-2 and MMP-9 disponibility, permitting satisfactory bone remodeling at the late period. CLINICAL RELEVANCE: The evaluation of new bone substitute, with favorable biological properties, opens the possibility for its use as a viable and efficient alternative to autologous bone graft.

Cyclooxygenase-2 inhibition does not impair block bone grafts healing in rabbit model.

Success of alveolar reconstructions using onlay autogenous block bone grafts depends on their adequate integration to the recipient bed influenced by a number of local molecules. Considering the fundamental role of cyclooxygenase (COX-2) in bone repair, the aim of this study was to analyze the effect of its inhibition in the integration of endochondral (EC) iliac crest, and intramembranous (IM) calvaria bone grafts. Thirty-two rabbits were divided into 4 groups: Calvaria Control (CC) and Iliac Control--treated with oral 0.9 % saline solution, and Calvarial-NSAID (C-NSAID) and Iliac-NSAID (I-NSAID) groups--treated with oral 6 mg/Kg non-steroidal anti-inflammatory drug etoricoxib. After 7, 14, 30 and 60 days the animals were euthanized and the specimens removed for histological, histomorphometric and immunohistochemistry analysis. At day 60, a tight integration of IM blocks could be seen with the presence of remodeling bone, whereas integration of EC grafts was mainly observed at the edges of the grafts. A significant higher percentage of bone matrix in the interface region of the CC grafts in comparison to C-NSAID only at day 14, whereas no differences were detected comparing the EC grafts. No differences were observed in Runx-2 and vascular endothelial growth factor (VEGF) immunolabeling when comparing CC and C-NSAID groups, while a significant weaker Runx-2 and VEGF labeling was detected in I-NSAID group at day 60. Although some influence was detected in osteogenesis, it is concluded that drug induced inhibition of COX-2 does not impair onlay bone grafts' healing of both embryologic origins in rabbits.

Fibrovascularization and osteogenesis in high-density porous polyethylene implants.

High-density porous polyethylene (HDPP) has been extensively used in craniofacial reconstructions with high-level success and minimal complications. It is known for its biocompatibility and satisfactory stability in the receptor bone area, presenting only a few reports of mobility and infection. In the current study, attention was given to the interface area between HDPP and bone surface to analyze fibrous and bone tissue formation and ingrowth into the pores of the material placed in the mandible of rabbits. Twelve male New Zealand rabbits underwent surgical procedure to receive bilateral HDPP implants in buccal face of dentate mandibular alveolar process, fixed with titanium screws. After 7, 14, 45, and 90 days, the animals were killed, and the specimens were retrieved for histologic and immunohistochemical analyses. No implant loss or infection was detected at the retrieval of the specimens. The microscopic analysis presented satisfactory integration of the material to the bone surface, with new bone formation from the receptor bed and inside the pores of the material, observed from the 15th day. After 90 days, remodeling bone and fibrous tissue was seen in the interface region. Among some of the pores, mature lamellar bone was present. Immunohistochemistry pointed out a moderate expression either to Core binding factor protein 1/RUNX2 or to vascular endothelial growth factor for early periods evaluated, that is, 7 and 15 days after surgery. These results confirm the osteoconductive behavior and high biocompatibility of the material, associated to its adequate immobilization, leading to its lifelong presence in human biologic system.