Comparison of periodontal wound healing/regeneration by recombinant human fibroblast growth factor‐2 combined with β‐tricalcium phosphate, carbonate apatite, or deproteinized bovine bone mineral in a canine one‐wall intra‐bony defect model

Abstract

Aim To evaluate periodontal wound healing/regeneration of one‐wall intra‐bony defects treated with recombinant human fibroblast growth factor‐2 (rhFGF‐2) and beta‐tricalcium phosphate (β‐TCP), carbonate apatite (CO3Ap), or deproteinized bovine bone mineral (DBBM) in dogs. Materials and Methods The stability of rhFGF‐2 adsorbed onto the bone substitutes was evaluated by Enzyme‐Linked Immunosorbent Assay (ELISA). One‐wall intra‐bony defects (5 × 5 × 5 mm) created in five adult male beagle dogs were treated with rhFGF‐2 alone (rhFGF‐2), rhFGF‐2 with β‐TCP (rhFGF‐2/β‐TCP), rhFGF‐2 with CO3Ap (rhFGF‐2/CO3Ap), or rhFGF‐2 with DBBM (rhFGF‐2/DBBM). Histological outcomes (e.g., linear length of new cementum adjacent to the newly formed bone with inserting collagen fibres [NA] as the primary outcome) were evaluated at 10 weeks post surgery. Results Significantly higher amount of rhFGF‐2 was adsorbed onto CO3Ap compared with β‐TCP. Among the treatment groups, the rhFGF‐2/DBBM group showed the highest amount of periodontal tissue regeneration. The rhFGF‐2/DBBM group showed significantly greater formation of NA (3.22 ± 0.40 mm) compared with rhFGF‐2 (1.17 ± 1.00 mm, p < .01) group. Additionally, new bone area in the rhFGF‐2/DBBM group (9.78 ± 2.30 mm2) was significantly higher than that in the rhFGF‐2 (5.08 ± 1.26 mm2, p < .01), rhFGF‐2/β‐TCP (5.91 ± 1.27 mm2, p < .05), and rhFGF‐2/CO3Ap (6.51 ± 1.49 mm2, p < .05) groups. Slight ankylosis was found in the rhFGF‐2/β‐TCP (1/9 sites), rhFGF‐2/CO3Ap (3/10 sites), and rhFGF‐2/DBBM (1/9 sites) groups. Conclusions Within their limitations, the present data indicate that DBBM seems to be a suitable carrier for rhFGF‐2 and that rhFGF‐2/DBBM treatment promotes favourable periodontal regeneration compared with rhFGF‐2, rhFGF‐2/β‐TCP, and rhFGF‐2/CO3Ap treatments in one‐wall intra‐bony defects.

Preclinical evaluation of the effect of periodontal regeneration by carbonate apatite in a canine one-wall intrabony defect model

“…Previous studies have reported that in periodontal tissues, owing to carbonate and calcium ion effects, the use of CO 3 Ap resulted in enhanced promotion of osteoclast migration and osteoblast differentiation and more significant bone formation compared to deproteinized bovine bone mineral (DBBM) and β-TCP in canine three-wall intrabony defects [ 28 , 29 ]. These promising results are broadly consistent with the present findings showing mature osteogenesis and osteoclast recruitment around residual CO 3 Ap granules that exhibit higher osteoconductivity than β-TCP [ 18 ].…”

“…In the previous reports, Sato [ 17 ] and Shirakata [ 18 ] compared the regenerative ability of CO 3 Ap to that of DBBM. DBBM is composed of low-absorbable demineralized bovine bone and is recommended for its biocompatibility and new bone formation properties [ 30 ].…”

“…However, bone graft materials are rarely used alone for periodontal tissue regeneration therapy for one-wall intrabony defects; they are commonly used with growth factors and membranes [ 33 ]. DBBM has been reported to be more effective than CO 3 Ap or β-TCP when used in combination with recombinant human fibroblast growth factor-2 [ 18 ]. Reports on CO 3 Ap in combination with recombinant human fibroblast growth factor-2 are still limited, and combinations with other materials have not been reported.…”

“…In the previous clinical study, the safety and efficacy of CO 3 Ap for sinus lift procedure were revealed [ 16 ]. Some paper reported efficacy of CO 3 Ap in the periodontal regeneration of three-wall intrabony defect, or in combination with recombinant human fibroblast growth factor-2 [ 17 , 18 ]. However, as far as author's knowledge, there is no studies applying CO 3 Ap alone in one-wall defect for the periodontal regeneration, or analyzing for mineralized dynamics by the bone histomorphometric analysis.…”

Periodontal Regenerative Therapy Using rhFGF-2 and Deproteinized Bovine Bone Mineral versus rhFGF-2 Alone: 4-Year Extended Follow-Up of a Randomized Controlled Trial

“…This may explain the greater bone healing of 1–2-wall defects following the combination therapy used in the current study. Recently, Shirakata et al reported that DBBM seems to be a suitable carrier for rhFGF-2 and that rhFGF-2/DBBM treatment promotes favorable periodontal regeneration compared with rhFGF-2, rhFGF-2/β-TCP, and rhFGF-2/CO 3 Ap treatments in one-wall intra-bony defects [ 38 ]. These findings collectively suggest that DBBM may be an effective scaffold or carrier to be used with rhFGF-2.…”