Closure of critical sized defects with allogenic and alloplastic bone substitutes.
OBJECTIVE
This study evaluates bone regeneration of critical sized cranial vault defects in New Zealand white rabbits using four commercially available bone substitutes: OsteoSet (calcium sulphate pellets), DynaGraft Putty (demineralized bone matrix delivered in a poloxmer excipient), Norian CRS, and Bone Source (two commercially available calcium phosphate cements).


METHODS
Critical sized defects 15 mm in diameter were created bilaterally in the parietal bones of 30 adult male New Zealand White rabbits. They were divided into three groups with ten animals in each. Bone healing was assessed clinically, radiographically, and histomorphometrically. Group 1 had calcium sulfate bioimplant on one side of the calvarium and an unfilled defect on the contralateral side. Group 2 had DBM putty on one side and Poloxamer gel on the contralateral side. Group 3, the Calcium phosphate cements (CPC), had Norian CRS on one side and Bone Source on the contralateral side. Five animals in each group were killed at 6 weeks and 12 weeks post operatively.


RESULTS
All unfilled defects healed with fibrous scar, as did the Plaster of Paris and the poloxamer gel defects. Defects reconstructed with the demineralized bone matrix putty healed with bone throughout the entire defect. This was obvious clinically and radiographically where the defects appeared completely filled with a dense radiopaque tissue. The six-week group displayed new bone formation (87.1%) surrounding the remaining allogeneic particles. Resorption was evidenced by the presence of osteoclastic activity and by the significant decrease in the size of the demineralized bone particles. By 12 weeks, the demineralized bone putty bioimplant was almost completely replaced by new bone (95.5%). Both calcium phosphate cement groups (Norian CRS and Bone Source) had identical patterns of healing. They clinically were visible and firm and uniformly radiopaque with little evidence of new bone formation. Histologically the cement remained unresorbed with little new bone with in the defect at 12 weeks.


CONCLUSIONS
The utilization of a demineralized bone matrix putty appeared to allow for complete closure of critical sized calvarial defects in New Zealand white rabbits with viable new bone at 12 weeks.
Clokie
Cameron M L
CM
Department of Oral and Maxillofacial Surgery, University of Toronto, 124 Edward Street, Toronto, Ontario, Canada M5B 1G6. cameron.clokie@utoronto.ca
Moghadam
Hassan
H
Jackson
Michael T
MT
Sandor
George K B
GK
D000704:Analysis of Variance; D000818:Animals; D001843:Bone Cements; D001857:Bone Matrix / Q000637:transplantation; D001861:Bone Regeneration; D018786:Bone Substitutes; D016025:Bone Transplantation; D002130:Calcium Phosphates; D002133:Calcium Sulfate; D020007:Implants, Experimental; D008297:Male; D020442:Poloxamer; D011817:Rabbits; D012886:Skull / Q000601:surgery*; D018709:Statistics, Nonparametric
D001843:Bone Cements; D018786:Bone Substitutes; D002130:Calcium Phosphates; C485828:alpha-tricalcium phosphate; C485830:tetracalcium phosphate; D020442:Poloxamer; C485838:calcium phosphate, monobasic, anhydrous; C020243:calcium phosphate; C485829:calcium phosphate, dibasic, anhydrous; D002133:Calcium Sulfate