Kang Jingyang, Shibasaki Masaki, Terauchi Masahiko, Oshibe Narumi, Hyodo Katsuya, Marukawa Eriko
Department of Regenerative and Reconstructive Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
J Periodontal Implant Sci. 2024 Apr;54(2):96-107. doi: 10.5051/jpis.2204660233. Epub 2023 Jun 13.
Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss and Bio-Oss/Collagen) and 2 types of synthetic hydroxyapatite (Apaceram-AX and Refit). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact.
A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption).
All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance.
Overall, the materials demonstrated varying post-implantation behaviors . Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.
脱蛋白牛骨或合成羟基磷灰石是临床治疗种植体周围骨缺损常用的两种骨移植材料。然而，这些材料在骨形成方面的差异仍不明确。本研究使用两种脱蛋白牛骨（Bio-Oss和Bio-Oss/胶原蛋白）和两种合成羟基磷灰石（Apaceram-AX和Refit）评估种植体周围缺损的骨生成动力学。我们考虑了包括新生成骨体积、骨、类骨质和材料占有率以及骨与种植体接触等因素。
通过拔除双侧下颌第三和第四前磨牙建立比格犬下颌缺损模型。同时，将种植体植入缺损处，种植体与周围骨壁之间的间隙用Bio-Oss、Bio-Oss/胶原蛋白、Apaceram-AX、Refit或自体骨填充。术后3个月和6个月进行微计算机断层扫描和组织学分析（由于Refit和自体骨吸收迅速，6个月时间点未纳入）。
所有材料均表现出良好的生物相容性和骨传导性。3个月时，Bio-Oss和Apaceram-AX的形成体积明显大于其他材料，Bio-Oss的量略高。然而，6个月时情况相反，两种材料在两个时间点均无显著差异。Apaceram-AX在两个时间点的生物吸收明显较慢，残留材料量最大。相比之下，Refit的生物吸收明显更大，3个月时完全吸收并快速成熟，涉及嵴部皮质骨形成，Refit在3个月后矿化组织和类骨质占有率最高，尽管无统计学意义。
总体而言，这些材料植入后的行为各不相同。因此，在临床环境中，应考虑这些材料的特性以及需要强化的缺损的具体情况，以确定最合适的材料。
