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Histologic and histomorphometric evaluation of bone regeneration using nanocrystalline hydroxyapatite and human freeze-dried bone graft

An experimental study in rabbit

Histologische und histomorphometrische Evaluierung der Knochenregeneration mit nanokristallinem Hydroxylapatit und mit humanem gefriergetrocknetem Knochen

Eine experimentelle Studie am Kaninchenmodell

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Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie Aims and scope Submit manuscript

Abstract

Purpose

Bone regeneration is an important concern in periodontal treatment and implant dentistry. Different biomaterials and surgical techniques have been used for this purpose. The aim of the present study was to compare the effect of nanocrystalline hydroxyapatite and human freeze-dried bone graft (FDBG) in regeneration of rabbit calvarium bony defects by histologic and histomorphometric evaluation.

Methods

In this experimental study, three similar defects, measuring 8 mm in diameter, were created in the calvaria of 16 white New Zealand rabbits. Two defects were filled with FDBG and nanocrystalline hydroxyapatite silica gel, while the other one remained unfilled to be considered as control. All the defects were covered with collagen membranes. During the healing period, two animals perished; so 14 rabbits were divided into two groups: half of them were euthanized after 6 weeks of healing and the other half after 12 weeks. The specimens were subjected to histologic and histomorphometric examinations for assessment of the following variables: percentage of bone formation and residual graft material, inflammation scores, patterns of bone formation and type of newly formed bone.

Results

The percentages of new bone formation after 6 weeks were 14.22 ± 7.85, 21.57 ± 6.91, and 20.54 ± 10.07% in FDBG, NanoBone, and control defects. These values were 27.54 ± 20.19, 23.86 ± 6.27, and 26.48 ± 14.18% in 12-week specimens, respectively. No significant differences were found in the amount of bone formation between the groups. With regard to inflammation, the control and NanoBone groups showed significantly less inflammation compared to FDBG at the 6-week healing phase (P = 0.04); this difference was not significant in the 12-week specimens.

Conclusions

Based on the results of this experimental study, both NanoBone and FDBG exhibited a similar effect on bone formation.

Zusammenfassung

Ziel

Die Regeneration neuen Knochens ist ein wichtiges Ziel im Rahmen der Parodontologie und der Implantologie. In diesem Kontext sind unterschiedliche Biomaterialen und chirurgische Verfahren eingesetzt worden. Ziel der vorgestellten Studie war es, am Modell von Schädelkalottendefekten des Kaninchens die Effekte von nanokristallinem Hydroxylapatit und gefriergetrocknetem humanem Knochen (“freeze-dried bone graft”, FDBG) bei der Regeneration histologisch und histomorphometrisch zu evaluieren.

Methoden

In dieser experimentellen Studie wurden je 3 ähnliche Defekte (Durchmesser 8 mm) in der Kalotte von 16 weißen Neuseelandkaninchen erzeugt. Zwei wurden mit FDBG und nanokristallinem Hydroxylapatitgel aufgefüllt, der dritte blieb unbehandelt und diente als Kontrolle. Alle Defekte wurden mit Kollagenmembranen abgedeckt. Im Verlauf der Heilungsperiode verstarben 2 Tiere; die übrigen 14 wurden in 2 Gruppen aufgeteilt: eine Gruppe wurde nach 6, die andere nach 12 Wochen getötet. Die Biopsien wurden histologisch und histomorphometrisch untersucht im Hinblick auf folgende Variablen: der Prozentsatz neu gebildeten Knochens und des verbliebenen Biomaterials, Inflammation/Entzündung, Muster und Struktur der Knochenneubildung und Art des neu gebildeten Knochens.

Results

Die Prozentsätze neu gebildeten Knochens nach 6 Wochen lagen bei 14,22 ± 7,85, 21,57 ± 6,91 und 20,54 ± 10,07% bei FDBG, NanoBone bzw. Kontrollen. In den 12-Wochen-Proben lagen die entsprechenden Werte bei 27,54 ± 20,19, 23,86 ± 6,27 und 26,48 ± 14,18%. Hinsichtlich der Menge des neu gebildeten Knochens ließen sich keine signifikanten Unterschiede nachweisen. Nach 6 Wochen war die Inflammation/Entzündung in der Kontroll- und in der NanoBone-Gruppe deutlich (p = 0,04) weniger ausgeprägt als in der FDBG-Gruppe, in den 12-Wochen-Proben war dieser Unterschied nicht mehr signifikant.

Schlussfolgerungen

Auf der Basis der in der vorgestellten Studie erreichten Ergebnisse zeigten sowohl NanoBone als auch FDBG ähnliche Effekte hinsichtlich der Knochenbildung.

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Acknowledgements

We would like to thank Dr M.J. Kharrazi Fard from Tehran University of Medical Sciences for statistical analysis.

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Correspondence to Rokhsareh Sadeghi.

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R Sadeghi, M. Najafi, H. Semyari, and F. Mashhadiabbas declare that they have no conflict of interest.

All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.

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Rokhsareh Sadeghi: Assistant Professor; Mohammad Najafi: Assistant Professor; Hassan Semyari: Associate Professor; Fatemeh Mashhadiabbas: Associate Professor.

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Sadeghi, R., Najafi, M., Semyari, H. et al. Histologic and histomorphometric evaluation of bone regeneration using nanocrystalline hydroxyapatite and human freeze-dried bone graft. J Orofac Orthop 78, 144–152 (2017). https://doi.org/10.1007/s00056-016-0067-8

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