Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results

Abstract

Background:The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity.Materials and Methods:Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement.Results:Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group.Conclusions:Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer.

Molecular, Cellular and Pharmaceutical Aspects of Synthetic Hydroxyapatite Bone Substitutes for Oral and Maxillofacial Grafting

“…In one recent study it was confirmed by histological and histomorphometrical examinations that after applying a nanocrystalline sHA for sinus lift, no age-dependent differences between a younger and older aged patient group could be documented [87]. It was shown in another recent clinical and histological study, that nanocrystalline sHA proved to be useful augmentation material for a sinus lift in patients with previous oral cancer [88]. It is also critical to determine whether bone regenerative approaches with HA grafts are effective for healing craniofacial bone defects challenged by therapeutic radiation [76].…”

State and perspectives of studies on osteoplastic materials

“…И, наконец, нередко возникают ситуации, затрудняющие формирование трансплантатов сложной конфигурации, когда они по техническим причинам не могут быть изго-товлены из костного материала, который можно получить из подвздошной кости или ребра (обычный источник ау-тотрансплантатов). Результатом наличия указанных про-блем являются не столь уж редкие случаи осложнений в виде переломов донорской кости либо воспалительных реакций и длительно не поддающихся купированию бо-лей [19,26,49].…”

“…Например, обычные керамические материалы содержат оксид алюминия (AL 2 0 3 ) и, кроме того, -клеевые компоненты (фарфор) наряду с цементом и стеклом [16,17,26,31]. Важное место среди керамик медицинского назначения занимают био-стекла [25].…”

“…В исследовании, проведенном с помощью иммуноги-стохимических и количественных методов на тканевом материале от пациентов со злокачественными опухолями челюстно-лицевой области, было показано, что синтети-ческий нанокристаллический ГА эффективно стимулиру-ет репаративный остеогенез [26].…”

Manipulating fibrin structure of hematomas enhances large bone defects healing

“…Although an accumulating number of traditional approaches, such as bone substitutes, have been introduced in implantology, the use of these therapies is often unpredictable and complicated with potential safety issues, such as a foreign body reaction, which leads to fibrotic encapsulation and implant dysfunction (Ghanaati et al, 2013;Morais et al, 2010). When vascular injury occurs at a fracture site, platelets and the fibrin-producing clotting system, which mediate hemostasis, produce a functional fracture hematoma that seals the bone broken fragments and re-constructs vascular continuity .…”