Bone regeneration with calcium sulfate: evidence for increased angiogenesis in rabbits.
Autologous bone is the preferred bone graft material because it carries proteins as bone-enhancing substrates, minerals, and vital bone cells. Calcium sulfate (CS) is a well-tolerated, biodegradable, osteoconductive bone graft substitute and is a reasonable alternative to autogenous bone graft. Blood vessels are an important component of bone formation and maintenance. The process of vascular induction is called angiogenesis, and it plays a key role in all regenerative processes. Bone tissue differentiation is related to the local presence of blood vessels. One method to evaluate the presence of blood vessels in a tissue is to count the microvessels to evaluate microvessel density (MVD). The aim of the present study was to conduct a comparative evaluation of microvessel density in sites treated with CS and autologous bone in rabbits, with or without e-PTFE nonresorbable membranes (Gore-Tex, Flagstaff, Ariz). Nine New Zealand rabbits, each weighing about 2.5 kg, were used in this experiment. Three 6-mm wide defects were created in each tibial metaphysis. The defects were filled in a random way. The defects of group 1 (3 rabbits) were filled with CS granules (Surgiplaster, Classimplant, Rome, Italy) and covered with e-PTFE membranes. The defects in group 2 (3 rabbits) were filled with CS granules (Surgiplaster). The defects in group 3 (3 rabbits) were filled with autologous bone. A total of 54 defects were filled (18 with CS and e-PTFE membranes, 18 with CS alone, and 18 with autologous bone). No postoperative deaths or complications occurred. All nine animals were sacrificed at 4 weeks. MVD results were as follows: in the first group, 9.88 +/- 4.613; in the second group, 7.92 +/- 1.998; and in the third group, 5.56 +/- 1.895. P = .000 was highly significant. Statistically significant differences were found between groups 1 and 3, 1 and 2, and 2 and 3. The presence of more blood vessels in the sites treated with CS could help to explain the good results reported in the literature with the use of CS.
Strocchi
Rita
R
Dental School of the University of Chieti, Italy.
Orsini
Giovanna
G
Iezzi
Giovanna
G
Scarano
Antonio
A
Rubini
Corrado
C
Pecora
Gabriele
G
Piattelli
Adriano
A
D000704:Analysis of Variance; D000818:Animals; D001557:Benzenesulfonates; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects* / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000473:pathology; D001842:Bone and Bones / Q000098:blood supply*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D004396:Coloring Agents; D007091:Image Processing, Computer-Assisted; D008567:Membranes, Artificial; D008833:Microcirculation / Q000187:drug effects / Q000473:pathology; D018919:Neovascularization, Physiologic / Q000187:drug effects* / Q000502:physiology; D011138:Polytetrafluoroethylene; D011817:Rabbits; D011897:Random Allocation; D013223:Statistics as Topic; D013977:Tibia / Q000098:blood supply / Q000601:surgery; D014048:Tolonium Chloride; D014182:Transplantation, Autologous; D014743:Videotape Recording
D001557:Benzenesulfonates; D001672:Biocompatible Materials; D018786:Bone Substitutes; D004396:Coloring Agents; D008567:Membranes, Artificial; D014048:Tolonium Chloride; C086337:acid fuchsin; D011138:Polytetrafluoroethylene; D002133:Calcium Sulfate