Preliminary evaluation of hydroxyapatite cement as an augmentation device in the edentulous atrophic canine mandible.
OBJECTIVE
The purpose of this study was to answer the following two questions: (1) Can hydroxyapatite cement in combination with demineralized freeze dried bone feasibly augment the dimension of an atrophic edentulous canine mandible? (2) What is the histologic fate of an augmentation graft composed of hydroxyapatite cement and demineralized freeze dried bone placed on the surface of an atrophic edentulous canine mandible?


METHODS
Each of four mixed-breed canines (weighing 50 to 60 pounds) underwent bilateral mandibular dental extraction (canine to second molar) and radical alveolectomy. After 4 months of healing, a bilateral subperiosteal mandibular augmentation graft was put into place, with hydroxyapatite cement/demineralized freeze dried bone on the surface of one hemimandible and porous granular hydroxyapatite and demineralized freeze dried bone on the surface of the other hemimandible. The animals were killed after functioning on a soft diet for 9 months, and the grafted hemimandibles were harvested.


RESULTS
Both hydroxyapatite cement and granular hydroxyapatite grafts appeared to augment the edentulous atrophic canine mandible. On histologic exam, the hydroxyapatite cement grafts showed osteoconduction and subperiosteal and endosteal osteonal bone formation, whereas the granular hydroxyapatite grafts showed only osteoconduction. Neither graft material showed chronic or acute inflammation.


CONCLUSIONS
Hydroxyapatite cement can function feasibly as a mandibular augmentation device. The histologic fate of hydroxyapatite cement is different from that of granular hydroxyapatite. It has a fate comparable to autograft or allograft cortical bone grafts.
Bifano
C A
CA
Department of Oral/Maxillofacial Surgery, Keesler Medical Center, Keesler Air Force Base, Miss 39534-2567, USA.
Edgin
W A
WA
Colleton
C
C
Bifano
S L
SL
Constantino
P D
PD
D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000541:Alveolectomy; D000818:Animals; D001284:Atrophy; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001843:Bone Cements / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods / Q000473:pathology; D003648:Decalcification Technique; D004285:Dogs; D017886:Durapatite / Q000627:therapeutic use*; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005612:Freeze Drying; D006253:Haversian System / Q000473:pathology / Q000502:physiology; D007575:Jaw, Edentulous / Q000473:pathology / Q000601:surgery*; D008334:Mandible / Q000473:pathology / Q000601:surgery*; D010012:Osteogenesis / Q000502:physiology; D010521:Periosteum / Q000473:pathology / Q000502:physiology; D016062:Porosity; D014021:Tissue Preservation
D001672:Biocompatible Materials; D001843:Bone Cements; D017886:Durapatite