Bone augmentation after soft‐tissue expansion using hydrogel expanders: effects on microcirculation and osseointegration

Abstract

Pre-augmentation soft-tissue expansion with hydrogel expanders leads to higher functional microvessel density in the tissue above the augmentation material and thus, to more rapid osseointegration. The use of hydrogel expanders appears to increase the probability of success, especially of pre-implant bone augmentation.

Pre‐augmentation soft tissue expansion: an overview

“…In another in vivo study on rats, von See et al. () reported a higher density of micro‐vessels in the soft tissue surrounding the augmentation material when pre‐augmentation soft tissue expansion was utilised, in comparison with grafted area without a prior soft tissue expansion. This was in agreement with early studies which confirmed an increase in the vascularity of the expanded tissues.…”

“…Complete osseo‐integration of the bone graft was possible when the mucosal perfusion around the augmentation area was not compromised (von See et al. ). High vessel density of soft tissues seems to play a role in blood supply to the underlying bone (Chanavaz ).…”

“…Additionally, the periosteum will be subjected to tensile forces during the surgical procedure which further impairs the patency of the vessels (von See et al. ).…”

Multifunctional coatings to simultaneously promote osseointegration and prevent infection of orthopaedic implants

“…Future improvements of the coating could include a filler material, such as a hydrogel, that could expand and compress within the knit coating, providing an even greater level of gap coverage to encourage bone in-growth. [28-30] Such a hydrogel could also serve as a depot to deliver bioactive factors to promote osteogenesis and inhibit bacterial infection. [31, 32] Alternatively, much like drug-eluting stents, the nitinol wire could be coated with drugs, small molecules, or peptides that encourage osteogenesis and provide protection against bacterial infection.…”

Synthetic biodegradable hydrogel delivery of demineralized bone matrix for bone augmentation in a rat model

“…In the second study, our laboratory implanted two left/right implants (6 mm diameter, 2 mm height) per rat within screw-immobilized polypropylene cassettes [17]. Though less influential to our design, others have used subperiosteal pockets [7, 27–30], non-immobilized rings [6, 31], and groove [8, 32] or screw immobilization [33–35]. Our new model has the advantage of matching the dimensions of the rat critical-sized calvarial defect (8 mm diameter) [36] allowing scaffolds to be tested directly for bone augmentation without repeating in vitro characterization.…”