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A new synthetic granular calcium phosphate compound induces new bone in a sinus lift rabbit model
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - Ångström, Polymer Chemistry.
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2018 (English)In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 70, p. 31-39Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: The aim of this study was to investigate if a synthetic granular calcium phosphate compound (CPC) and a composite bisphosphonate-linked hyaluronic acid-calcium phosphate hydrogel (HABP·CaP) induced similar or more amount of bone as bovine mineral in a modified sinus lift rabbit model.

MATERIAL AND METHODS: Eighteen adult male New Zeeland White rabbits, received randomly one of the two test materials on a random side of the face, and bovine mineral as control on the contralateral side. In a sinus lift, the sinus mucosa was elevated and a titanium mini-implant was placed in the alveolar bone. Augmentation material (CPC, HABP·CaP or bovine bone) was applied in the space around the implant. The rabbits were euthanized three months after surgery and qualitative and histomorphometric evaluation were conducted. Histomorphometric evaluation included three different regions of interest (ROIs) and the bone to implant contact on each installed implant.

RESULTS: Qualitative assessment (p = <.05), histomorphometric evaluations (p = < .01), and implant incorporation (p = <.05) showed that CPC and bovine mineral induced similar amount of bone and more than the HABP·CaP hydrogel.

CONCLUSION: CPC induced similar amount of bone as bovine mineral and both materials induced more bone than HABP·CaP hydrogel.

CLINICAL SIGNIFICANCE: The CPC is suggested as a synthetic alternative for augmentations in the maxillofacial area.

Place, publisher, year, edition, pages
2018. Vol. 70, p. 31-39
Keywords [en]
Animal experiments, Bone implant interactions, Bone regeneration, Bone substitutes, Ceramic granules
National Category
Dentistry
Identifiers
URN: urn:nbn:se:uu:diva-341457DOI: 10.1016/j.jdent.2017.12.009ISI: 000425888900004PubMedID: 29258851OAI: oai:DiVA.org:uu-341457DiVA, id: diva2:1181551
Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-10-28Bibliographically approved
In thesis
1. Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites
Open this publication in new window or tab >>Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: With an ageing population, an increase of more challenging implant treatments is expected. In this thesis, we evaluate the outcome of two faster implant protocols, in patients with compromised alveolar bone. We examine the bone integrating abilities of two new synthetic bone substitute materials and in another paper, we discuss the effects of nonsteroidal anti-inflammatory drugs (NSAID) on bone healing.

Aim: In paper I we investigate implant survival and effect of reduced implant-tooth distance. In paper II we evaluate the long-term implant survival and function of immediately loaded implants. In paper III & IV, we analyse if added NSAID reduce postoperative pain and if it has a reduced effect on new bone formation in a rabbit sinus lift model. We also investigate if a ceramic compound (CPC, granules) and hydrogel (HABP.CaP) result in a similar or larger bone amount, in comparison with bovine bone mineral. In Paper V we assess new bone formation adjacent to a hollow CPC implant.

Material & Methods: Paper I present a clinical and radiological follow-up, performed on subjects that previously received 3.0-3.3 mm diameter implants in the aesthetic area. In paper II, clinical and radiographic examinations were performed on subjects that had received six implants each with immediate loading in the maxilla 8-11-year ago. For paper III-IV, pain was assessed by clinical examination and scoring of facial expressions from photos. Histomorphometry and histology evaluations were performed. In paper V, a critical radius defect was created and either replaced by particulate autologous bone (AB) or a CPC implant. Qualitative and quantitative radiographic and histology evaluations were performed. 

Results: In paper I, an implant survival of 97.2% up to 124 months was shown with a tooth-implant distance in many cases of  <1.5 mm. Discoloration and recession of the buccal gingiva was the most frequent patient concern. In paper II a cumulative implant survival rate was 81.9 % at the final follow-up. In paper III and IV it was shown that NSAID had no effect on pain relief or bone formation. No difference was shown between CPC and control, but both showed larger bone amount and BIC than HABP.CaP. In paper V new bone was seen in sites throughout the entire CPC implant.

Conclusion: Satisfactory long-term dental implant results can be obtained without bone augmentation in most patients with atrophic alveolar bone, but there is still a minority in this group that may benefit of bone enhancement prior to implant treatment. To avoid the negative effects of autologous bone grafting, synthetic materials as the presented CPC, have shown promising results as a solution or alternative to existing bone substitutes in animal models.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 82
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1515
Keywords
clinical follow-up, calcium phosphates, rabbit model, sinus lift, radius model, in vivo, bisphosphonates, narrow diameter implants, dental implants
National Category
Medical and Health Sciences
Research subject
Oral and Maxillofacial Surgery
Identifiers
urn:nbn:se:uu:diva-364437 (URN)978-91-513-0501-1 (ISBN)
Public defence
2018-12-14, Skoogsalen, Ing. 78/79, Akademiska sjukhuset, Uppsala, 09:15 (Swedish)
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Available from: 2018-11-23 Created: 2018-10-28 Last updated: 2018-11-30

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Mellgren, TorbjörnHilborn, JönsOssipov, Dmitri A.Thor, Andreas

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