Guided tissue regeneration using rigid absorbable membranes in the dog model of chronic furcation defect.

OBJECTIVE: Absorbable membranes are used to promote the regeneration of periodontal defects by Guided Tissue Regeneration (GTR). However, their collapse into the defect is commonly reported, impairing regeneration. Therefore, absorbable but rigid membranes aiming at preventing such collapse were developed and analyzed in periodontal regeneration. MATERIALS AND METHODS: Membranes were analyzed in class II furcation defects in dogs; procedures included periodontal disease induction, prophylaxis and GTR (treated groups) or open flap debridement alone (control group). For GTR, the membranes were made of either 25% hydroxyapatite (HA) in polyhydroxybutyrate matrix (PHB) or 35% HA in PHB. Animals were clinically evaluated for gingival recession, clinical attachment level (CAL) and biopsies were collected at 60 and 120 days. Bone volume, trabeculae number, trabecular thickness and trabecular separation were quantified by micro-computed tomography, followed by histology. RESULTS: Membrane exposure was observed in both treated groups (25 and 35% HAP) from the 8(th) day after surgery, continuously progressing until 120 days. Mean CAL for all groups remained above normal values for dogs. Bone volumetric values were not significantly different. Partial formation of bone, cementum and periodontal ligament was observed in treated groups. An inflammatory infiltrate was observed in the dense connective tissue that partially filled the center of the treated defects with active osteoclasts on bone surface. CONCLUSION: Although partial regeneration of the defect was observed, it was limited by wound contamination. Consequently, rigid absorbable membranes made of HA and PHB failed to improve the regeneration of class II furcation defects in dogs.

Biocompatibility, osteointegration, osteoconduction, and biodegradation of a hydroxyapatite-polyhydroxybutyrate composite

In this work, biocompatibility, osteointegration, osteoconductivity, and biodegradation of a hydroxyapatite polyhydroxybutyrate new composite were evaluated. The composite was implanted in rabbits' bone defects and clinical, radiographic, histological, and histomorphometric data of these animals were compared with those of unfilled defects on the days 8th, 45th, and 90th after surgery. No significant differences existed between the groups for the evaluated clinical parameters. Radiographs showed bone-composite direct contact. Bone formed within the defect, interface and inside the composite. Significant differences were found between the bone and connective tissues percentage within the defect at all dates and at the interface on the 45th day, bone tissue prevailing. Composite's biodegradation signs were evident: giant cells on the surface of composite fragments separated from the original block in the absence of inflammatory infiltrate. These data supported that such composite was biocompatible, biodegradable, osteoconductive and integrate to bone.

A biocompatibilidade, osteointegração, osteocondução e biodegradação de um novo compósito de hidroxiapatita e polihidroxibutirato foram avaliados. O compósito foi implantado em defeitos ósseos em coelhos e dados clínicos, radiográficos, histológicos e histomorfométricos foram comparados aos de defeitos não preenchidos aos 8, 45 e 90 dias após a cirurgia. Não foram observadas diferenças significantes entre os grupos para os parâmetros clínicos avaliados. Contato direto entre osso e compósito foi observado nas radiografias. Tecido ósseo se formou dentro do defeito, interface e dentro do compósito. Foram observadas diferenças significativas entre a porcentagem dos tecidos ósseo e conjuntivo dentro do defeito em todas as datas de avaliação e na interface aos 45 dias, com predominância do tecido ósseo. Sinais de biodegradação foram observados: células gigantes na superfície de fragmentos do compósito separados do bloco original, na ausência de infiltrado inflamatório. Os dados permitem concluir que o compósito é biocompatível, biodegradável, osteocondutor e se integra ao tecido ósseo.

Comparison of in vivo properties of hydroxyapatite-polyhydroxybutyrate composites assessed for bone substitution.

This study compared 3 composites made of hydroxyapatite and polyhydroxybutyrate to determine their biocompatibility, osteointegration, and osteoconduction in rabbits bone defects. Hydroxyapatite-polyhydroxybutyrate was tested in a 10:90 vol/vol ratio for composite 1, 25:75 for composite 2, and 50:50 for composite 3, whereas defects in the control group remained unfilled. Limbs were clinically and radiographically evaluated, and samples were taken 8, 45, and 90 days after surgery for histologic and histomorphometrical analysis. No significant difference was found in the clinical parameters: pain, lameness, dehiscence, infection, and edema among the 4 groups. No signs of osteolysis or periosteal reaction were observed. Bone regeneration in groups 1, 2, and 3 occurred histomorphologically similar to the control group. No inflammatory infiltrate was present on any date of observation. More bone than connective tissue was significantly found in the defects of the 3 groups on all observation dates, and the percentage of bone tissue in the interface was similar for composites 2 and 3. Bone and connective tissue were observed in pores of composites 2 and 3. Osteoclasts were found in the bone-composite interface, and multinucleated giant cells were seen on the surface of composite fragments, found among mesenchymal tissue on the 45th and 90th days. No significant difference was observed in osteoclast number among the 4 groups. In summary, composites were considered biocompatible and able to integrate to bone. They also showed signs of biodegradability, and composites 2 and 3 were osteoconductive, the first displaying best characteristics for bone substitution.