Histomorphometric study of bone healing around laminar implants in experimental diabetes

The aim of this study was to evaluate the effects of experimental diabetes on the healing period leading to osseointegration. Wistar rats were injected with a single dose of streptozotocin (STZ); body weight and food intake were assessed every 48 hours. On days 2, 12, 26, and 42 post-STZ, glucemia, plasma hemoglobin, and urea were determined. Twelve days post-STZ, a titanium laminar implant was placed in the right tibia of each rat. Two groups of 20 rats each were killed on days 14 and 30 postimplantation, respectively. Results (ANOVA test) showed STZ-treated rats to have 1) a significant decrease in body weight; 2) an increase in food intake; 3) normal hemoglobin and plasma urea values; 4) a significant increase in glucemia; and 5) a decrease in tibiae length. Microscopic evaluation 14 days postimplantation revealed the presence of woven bone, and, at 30 days, laminar bone was in contact with the implant. Our findings show that, in this model of periimplant bone repair and under the experimental conditions stated herein, STZ-induced diabetes retards periimplant bone healing.     

Histomorphometric evaluation of the effect of bovine collagen granules on bone healing. An experimental study in rats

Collagen materials have been utilized in medicine and dentistry because of their proven biocompatibility and capability of promoting wound healing. The aim of the present experimental study was to perform a histomorphometric evaluation of the effect of bovine collagen granules on post-extraction alveolar wound healing in rats. Twenty male Wistar rats were submitted to bilateral extraction of the first lower molars under ketamine/xylazine anesthesia according to the technique previously described by Guglielmotti and Cabrini. Sterile Bovine collagen granules of approximately 80 +/- 10 microm (Membracel G, Lab. Celina, Buenos Aires) were hydrated with saline solution and placed into the right mesial socket (experimental side) with gentle pressure, completely filling the site. The contralateral sockets were considered as the control side. Sutures were not performed. After surgery neither special diet nor antibiotics were given. The rats were fed rat chow and water ad libitum. All the animals were killed on the 30th day following surgery by ether overdose. The jaws were dissected, radiographed, decalcified, and embedded in paraffin. Sections were obtained at the level of the first molar mesial socket in a buccolingual orientation and stained with hematoxylin-eosin. The trabecular area and volume density of trabecular bone were measured histomorphometrically. The trabecular area was greater in alveoli treated with collagen granules than in control alveoli (P<0.05). Values of volume density of trabecular bone were greater in experimental than in control sockets (P<0.05). This experimental study provides evidence for the use of bovine collagen granules as bone grafting material, as a therapeutic alternative to fill postextraction sockets.     

The effect of streptozotocin-induced experimental diabetes mellitus on calvarial defect healing and bone turnover in the rat

Tooth socket healing is delayed in diabetes mellitus due to impairment of the healing process. One reason for the poor healing may be an abnormal vascular response. The object of our experiments was to study the effect of diabetes mellitus on bone healing using a calvarial wound. Streptozotocin, injected intraperitoneally, was used to induce diabetes in rats. Both insulin-treated, streptozotocin-dosed animals and normal rats were used as controls. Bone formation was measured in the diabetic femur and tibia, and healing of bone defects by guided tissue regeneration was assessed. Cancellous bone volume and bone formation in the femur were greatly reduced in the diabetic model, indicating either a defect of mineralization or osteoid formation. The length, dry weight, ash weight and calcium content of the tibiae of diabetic rats were significantly less than those of the control groups. In a second experiment, a sterile wound was made in the calvaria of diabetic rats, and covered internally and externally with Gore-Tex membrane. Exuberant formation of a primitive bone was evident, with little evidence of osteoclastic resorption of the necrosed bone ends. This was despite the impaired bone formation observed in the long bones in the first experiment.     

Histomorphometric study of trabecular bone remodeling during condylar process fracture healing in the growing period: experimental study

Trabecular bone remodeling during condylar fracture healing in the growing period was analyzed by histomorphometry with a synchronous system. Data from the study showed displacement of the fractured condyle was compensated by the changes in remodeling ascribed to the pubertal spurt of growth, and that such remodeling still continued even after clinical healing. The regional acceleratory phenomenon, evolved to potentiate tissue healing, was observed 1 week after induction of the fracture. Mesenchymal cells were presumably modulated into chondroblasts that promoted endochondral ossification. It was concluded that trabecular bone remodeling plays an important role in healing of condylar fractures during the growth period.     

Histomorphometric study of peri-implant bone healing in the case of nerve injury: an experimental model in rats

Causes of dental implant failure are of more than passing interest. Within the group of failures caused by iatrogenic factors, injury to the epineurium has been reported to cause the formation of peri-implant fibrous tissue (fibrointegration). The aim of this study was to perform a histomorphometric evaluation of the percentage of osseointegration of implants in contact with the epineurium. Twenty Wistar rats were used. The first lower molars were extracted under xylazine-ketamine anesthesia. A titanium screw implant (diameter, 0.75 mm; length, 2.26 mm) was placed. In the control group (n = 10), apical anchorage of the implant was performed. In the experimental group (n = 10), the apical portion of the implant was placed in contact with the epineurium of the lower mandibular nerve. All animals were killed by ether overdose 30 days after implantation. Radiographs were taken, and the samples were processed for embedding in acrylic resin. Ground sections were obtained along the vestibulo-lingual axis of the mesial alveolus that contained the implant and were stained with toluidine blue. The histologic analysis revealed the presence of bone tissue in the apical portion of the control group samples. In the experimental group, the implant was in contact with the epineurium. There were no statistically significant differences in the percentage of osseointegration between both groups (control group, 39% +/- 9%; experimental group, 38% +/- 10%). The results obtained with this experimental model show that the contact of the implant with the epineurium would not impair the process of osseointegration.     

The effects of intraperitoneal metoprolol administration on healing of bone defects in rat tibia: a pilot study

Metoprolol is a cardioselective competitive beta-1 adrenergic receptor antagonist with antihypertensive properties, devoid of intrinsic sympathomimetic act     

Histomorphometric evaluation of the effect of hyperbaric oxygen treatment on healing around hydroxyapatite implants in irradiated rat bone

The effect of hyperbaric oxygen (HBO) on the tissue reaction around hydroxyapatite (HA) implants in irradiated bone of rats was investigated. A single dose of 15 Gy was delivered to the right leg of 20 rats. HA implants were placed in the bilateral tibial proximal metaphysis 3 months after irradiation. HBO was administered to half of the rats before and after 15-Gy irradiation. The healing process was examined histologically and histomorphometrically. The results indicated that HBO slightly improved trabecular bone formation in the irradiated bone, accelerated bone remodeling in the nonirradiated bone, and improved HA-bone contact in both the irradiated and nonirradiated bones.     

Long-term results of the application of solvent-dehydrated bone xenograft and duramater xenograft for the healing of oroantral osseous defects: a pilot experimental study

Abstract –  The aim of this study was to investigate the long-term effects of the use of human cadaveric solvent-dehydrated bone graft and duramater as a barrier membrane for the treatment of oroantral communication. Standard oroantral osseous defects were created in five minipigs. Subjects received cancellous bone graft in the form of block or microchips, duramater or a combination of bone and membrane. Uneventful healing was achieved in all of the subjects, clinically including the control site which did not receive any material. The operated bone segments were evaluated both by radiological and histological examinations after 6 months. Radiological evaluation was carried out using bone density analysis software and histological evaluation made by light microscopy. Radiological and histological results revealed that bone grafting of oroantral osseous defects improved the bone quality. However, application of duramater did not change this activity, both alone or combined with bone grafts. Within the limits of this experimental study, although solvent-dehydrated bone grafts were found superior and could be applied for the healing of osseous oroantral defects, resorbable membranes did not contribute to this process.     

Histomorphometric evaluation of the effect of systemic and topical ozone on alveolar bone healing following tooth extraction in rats

The aim of this study was to investigate the effects of systemic and topical ozone applications on alveolar bone healing following tooth extraction. One hundred and twelve male Wistar rats were divided into eight groups of 14 rats each; seven groups were experimental (A–G) and one formed the control group (K). The experimental groups were further divided into two sub-groups, with seven rats in each – sacrificed on days 14 and 28 (subgroups 1 and 2). The maxillary right central incisors were extracted under general anaesthesia following the administration of local anaesthesia. After sacrifice, semi-serial histological sections were prepared, and mineralized and trabecular bone and osteoid and osteoblast surfaces were measured. Measurements of the trabecular bone showed statistically higher values in the groups treated with systemic ozone (D₂: 50.01 ± 2.12; E₂: 49.03 ± 3.03; F₂: 48.76 ± 2.61; G₂: 50.24 ± 3.37) than in the groups that underwent topical ozone administration (A₂: 46.01 ± 3.07; B₂: 46.79 ± 3.09; C₂: 47.07 ± 2.12; P = 0.030 (G₂–A₂, G₂–B₂, G₂–C₂)). Within the limitations of the current study, it may be concluded that postoperative long-term systemic ozone application can accelerate alveolar bone healing following extraction. However, additional studies are required to clarify the effects of the different ozone applications on new bone formation.     

The effect of diabetes mellitus on osseous healing

Abstract: Diabetes mellitus and, in particular, type 1 diabetes has been associated with impaired osseous wound healing properties. The scope of the present review is to discuss the clinical evidence supporting a higher rate of complications during fracture healing in diabetic patients and the histological evidence indicating impaired potential for intramembranous and endochondral ossification in the presence of uncontrolled experimental diabetes. The article further provides a synthesis of our current understanding of the plausible molecular mechanisms underlying the diabetic bone healing pathophysiology and of the role of insulin treatment in promoting osseous healing in the diabetic status. To cite this article:
Retzepi M, Donos N. The effect of diabetes mellitus on osseous healing.
Clin. Oral Impl. Res. 21 , 2010; 673–681.
doi: 10.1111/j.1600‐0501.2010.01923.x     

Tissue regeneration in bone defects adjacent to endosseous implants: an experimental pilot study

Extraction socket defects or alveolar ridge defects may limit or restrict placement of implants. The present study assessed the efficacy of inducing bone formation with demineralized freeze-dried bone (DFDB), osteoinduction with hydroxyapatite (HA), and guided bone regeneration with expanded polytetrafluoroethylene (e-PTFE) in bone defects adjacent to endosseous implants in an animal model. Twenty-four implants were placed in the long bones of 3 pigs. After preparation of 24 cylindric acute defects adjacent to the coronal 5 mm of each implant, 18 of the defects were treated by DFDB, HA, or e-PTFE. The 6 remaining defects healed spontaneously with no treatment (controls). In each pig, one tibia received 4 commercially pure titanium screw implants (3.75 mm x 15 mm), while the contralateral tibia received 4 HA-coated cylindric implants (3.25 mm x 15 mm). Bone formation in response to the 3 treatments and control cases was evaluated using computer-assisted densitometric image analysis. The results showed that a higher density of tissue formed under e-PTFE membranes. A significantly greater increase in bone density was noticed in bone defects treated with an e-PTFE membrane vs DFDB (P = 0.04), in e-PTFE vs control sites (P = 0.04), and in defects treated with HA vs DFDB (P = 0.04) in HA-coated implants. In titanium implants the differences observed were not significant. It was also observed that bone regeneration in defects treated with HA differs with the type of implant used (titanium vs HA-coated implants), but such differences were not significant.     

Guided bone regeneration of cranial defects, using biodegradable barriers: an experimental pilot study in the rabbit.

The aim of this study was to test if a biodegradable barrier could be used to achieve proper bone healing of full-thickness trephine skull defects, applying the biological principle of guided tissue regeneration (GTR). Two New Zealand white rabbits were used. In each animal, 2 circular through-and-through bone defects with a diameter of 8 mm were created in the midline of the frontal and parietal bones of the calvarium. One defect was covered with the mucoperiosteal flaps without placement of an intervening membrane barrier (control). One test defect (test 1) was covered by a biodegradable, non-porous polylactic acid membrane on the outer (supra-calvarial) side of the defect, and 2 test defects (tests 2 and 3) were covered by similar membranes on both the outer and the inner aspects of the defects, prior to flap closure. 6 weeks postsurgically, the animals were sacrificed and the defect areas including surrounding tissues were harvested for histological preparation. The control defect was essentially occupied by supra-calvarial soft tissue, located in direct contact with the dural tissue. In the test cavities, there was a continuous bridge of regenerated bone extending from one edge of the defect to the other, although in test 1 not attaining the same thickness as the bone bordering the defect. In the 2 other test defects, the regenerated bone had reached a thickness almost corresponding to that of the surrounding bone. The bone regeneration was achieved without recourse to adjunctive bone graft materials.(ABSTRACT TRUNCATED AT 250 WORDS)     

Histomorphometric analysis of a half hydroxyapatite-coated implant in humans: a pilot study.

The aim of this study was to compare the characteristics of the bone-to-implant interface of hydroxyapatite-coated and non-coated commercially pure titanium threaded implants after different periods of healing in humans. To eliminate possible variations of the results from differences in bone quality and in surgical techniques used in the different test and control sites, only one half of each implant was coated with hydroxyapatite. The coated portions of the implants showed a tendency toward a higher percentage of direct bone-to-implant contact at each period of healing that was observed, although the small number of specimens does not allow definitive conclusions to be made.     

Guided bone regeneration (GBR) on healing bone defects: a histological study in rabbits

In this study, the effects of guided bone regeneration (GBR) on the healing of bone defects were evaluated. Resorbable membranes were placed in experimentally formed cavities in the right posterior tibia of 30 rabbits. Decalcified histological sections were evaluated using optical microscopy at 10, 20, and 30 days after GBR. Osteocondrial bone union, active bone formation and spongiosal bone formation values of the GBR group are higher than the control group. It was found that GBR technique had a positive and accelerating influence in all phases of bone healing.     

Histomorphometric evaluation of guided bone regeneration around implants with SLA surface: an experimental study in beagle dogs

The aim of this study was to evaluate the efficacy of collagen membranes, either alone or combined with a human demineralized freeze-dried bone allograft (DFDBA) or natural bovine bone graft, in bone defects around dental implants with an SLA (sand-blasted, large grit, acid-etched) surface. The experiments were carried out in three beagle dogs using a split-mouth design. On one side of the jaw, three implants were placed and intra-bony defects were created and covered with a collagen membrane, randomly combined in two of the defects with human DFDBA or inorganic bovine bone graft. A control implant, without membrane covering or defect filling, was also placed. On the other side of the jaw, three implants were placed and the bone defects were treated in a similar fashion, but without membrane covering. The studied variables were the percentage of bone-to-implant contact within the limits of the initial bony defect and percentage of the original bony defect occupied by bone tissue. Although no statistically significant differences were found in this study between the membrane and nonmembrane groups, bone defects augmented with anorganic bovine bone and membranes showed the most promising results from a histological and histomorphometric perspective.     

Platelet concentration and its effect on bone formation in calvarial defects: an experimental study in rabbits.

STATEMENT OF PROBLEM: The use of the platelet concentration technique is widespread in dental implant surgery. However, its effect or mechanism is not clearly understood. PURPOSE: This study introduced an animal model for the platelet concentration technique and evaluated its effect on bone formation with natural cancellous bovine bone mineral. MATERIAL AND METHODS: Adult New Zealand white rabbits were used as the animal model. A density gradient medium was used to obtain a constant platelet count for the preparation of platelet concentrates. In the experimental group, natural cancellous bovine bone mineral with added platelet concentrates was grafted onto critically sized bony defects of the rabbit calvarium. Bone formation in the tissue sections was evaluated with soft x-ray imaging and computer tomography. RESULTS: The average platelet count of the rabbit platelet concentrates was 1487 x 10(3)/microL (287% concentrated). In all the tested parameters, greater bone densities were obtained in grafts that were combined with platelet concentrates. CONCLUSION: This study showed that the rabbit is a useful animal model for studying the platelet concentration technique. When combined with grafts of natural cancellous bovine bone mineral, the technique increased bone formation.     

The effect of pentosan polysulphate on bone healing of rat cranial defects.

The purpose of the study was to determine the efficacy of pentosan polysulphate, used in combination with guided bone regeneration on rat skull defects. The study was conducted on 45 adult Wistar rats. On each animal two symmetrical 6 mm wide, full-thickness, skull defects were created in the parietal regions. The right defect was chosen as the experimental site and the left one was left empty to provide a control. Each experimental site was covered by an inner and outer polytetrafluoroethylene membrane. The 45 rats were divided into 3 groups: in group I (n = 15), carboxymethyl cellulose, used as a delivery vehicle, was injected between the two membranes; in group II (n = 15), 1 mg of pentosan polysulfate was added to the carboxymethyl cellulose vehicle; in group III (n = 15), purified micronized eggshell powder was added to the mixture of pentosan polysulfate and carboxymethyl cellulose between the two membranes. In each group, the animals were sacrificed at 42 days. The harvested specimens were processed for contact radiography and standard histological examination. The results were assessed by a Fisher's exact test. All animals, except one, healed uneventfully. In group I, partial bone healing was observed in 14 out of 15 animals. In group II, partial bone healing was observed in 13 out of 15 animals, and complete bone healing in 1 out of 15 cases. In group III, partial resorption of the eggshell implant was observed with a partial bone healing in only 2 cases (P < 0.001). In conclusion, significant bone regeneration was observed with the membranes alone. The use of pentosane polysulphate did not result in additional bone gain. The use of particulate material as a space maintainer is also questionable.