Porous titanium granules in critical size defects of rabbit tibia with or without membranes

Abstract

Recently, porous titanium granules (PTGs) have been indicated for the preservation of the dimensions of post-extraction sockets, as a filler in sinus lift procedures and for the treatment of peri-implant and periodontal defects, based on the osteoconductivity and dimensional stability of the titanium granules. However, there is a lack of information regarding the use of this material in larger defects and in conjunction with membranes. The objective of this study is to test the behavior of PTGs used to fill critical size defects in rabbit tibiae, with and without membranes. Critical defects were created in both tibiae of rabbits, divided randomly into three groups: Group A (defect filled with PTG), Group B (defect filled with PTG+collagen membrane) and a control group (empty defect). After six weeks, histomorphometric analysis was performed. The results showed more defect closures at the cortical area (87.37%±2.2%) and more bone formation at the marrow area (57.6%±1.3%) in Group B, in comparison with the other groups (P<0.05); the use of membranes improved the material stability expressed as more percentages of the original material when membranes were used (P<0.05). Finally, inflammatory reactions were observed when the granules were not protected by membranes. In spite of the limitations of this animal study, it may be concluded that PTG particles are osteoconductive and allow bone growth. The PTG particles must be covered by a membrane, especially when grafting larger defects, in order to control particle migration, promote clot stabilization and separate the PTG graft from undesired soft tissue cells.

The Comparison of Porous Titanium Granule and Xenograft in the Surgical Treatment of Peri‐Implantitis: A Prospective Clinical Study

“…An experimental study showed that the use of collagen membranes enhanced the PTG stability. Inflammatory reactions were not observed when the granules were covered by collagen membranes . It has been suggested that the synergistic effects of PRF membrane and bone graft improved soft tissue healing with the aim of stabilizing PTG particles covered by PRF membrane.…”

“…Application of porous titanum granule with barrier membranes is recommended for large defects by the manufacturers . Due to the fact that the limited and narrow regional properties of the peri implantitis defects collagen membranes were not used, in accordance with the recommendations of the manufacturer.…”

TiO2scaffolds in peri‐implant dehiscence defects: an experimental pilot study

“…These materials may be customized with respect to porosity, interconnectivity, compressive strength, and degradation. Some previously tested synthetic graft materials for bone regeneration are biphasic calcium phosphate (Cordaro et al 2008;Frenken et al 2010), porous titanium (Delgado-Ruiz et al 2014;Lyngstadaas et al 2015), hydroxyapatite (Crespi et al 2012), tricalcium phosphate (Horowitz et al 2009;Shalash et al 2013) and polymers (Bertoldi et al 2008;Park et al 2012).…”

Vertical bone augmentation with titanium granule blocks in rabbit calvaria

“…The soft tissue could then grow into the upper part of the blocks before the bone had grown into this area. Delgado‐Ruiz et al () demonstrated in a critical size defect on rabbit tibia that a membrane was essential to control PTG particle migration, promote clot stabilization and to separate the PTG from undesired soft tissue. This was most important in larger defects (Delgado‐Ruiz et al, ), suggesting that a collagen membrane should have been used to cover the blocks in this study.…”

“…PTG has been used in critical size defects on rabbit tibia. The PTG particles showed osteoconductive properties, but the authors concluded that the granules should be covered by a membrane in larger defects (Delgado‐Ruiz et al, ). However, the metallic color of the material restricted their clinical usage to contained sites, and it was difficult to be applied in esthetically demanding sites.…”