Effects of osteopromotive and anti-infective membranes on bone regeneration: an experimental study in rat mandibular defects.
OBJECTIVE
Reconstructive surgical treatment with osteopromotive membranes has become an integral part of implant dentistry. Nevertheless, there are still instances in which this technique alone is of limited or no benefit. The aim of the present study was to determine whether a combination of titanium membranes coated with transforming growth factor beta1 (TGF-beta1) and insulin-like growth factor I (IGF-I) is of value in the regeneration of so-called critical-size defects in the rat model. An analysis was made of whether or not locally administered antibiotics are deleterious to bone regeneration.


METHODS
A total of 24 rats were included in the study and were divided into 4 groups, each with 6 animals. Critical-size defects were created bilaterally and covered by titanium membranes coated with (1) polylactide, (2) polylactide and clindamycin, (3) polylactide and growth factors, or (4) polylactide, clindamycin, and growth factors. All 24 contralateral defects were covered by titanium membranes without any substrate (controls). Four weeks after treatment the animals were sacrificed.


RESULTS
In groups 3 and 4, most defects showed thin but almost complete bridging of the defects with new bone formation. In particular, clindamycin had no inhibitory effect on the regeneration of bone. Nevertheless, after 28 days, there was no significant difference between the individual groups (including controls) with respect to the total amount of newly formed bone.


CONCLUSIONS
These results support the hypothesis that coating titanium membranes with TGF-beta1/IGF-I leads to almost complete bony bridging of critical-size defects without voluminous carrier materials. Moreover, simultaneous administration of clindamycin seems possible.
Deppe
Herbert
H
Oral Surgeon, Department of Oral and Maxillofacial Surgery, Technical University, Munich, Germany. herbert.deppe@lrz.tu-muenchen.de
Stemberger
Axel
A
Hillemanns
Marija
M
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000187:drug effects*; D002981:Clindamycin / Q000008:administration & dosage / Q000627:therapeutic use; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D005260:Female; D007091:Image Processing, Computer-Assisted; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage / Q000627:therapeutic use; D008336:Mandibular Diseases / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D010012:Osteogenesis / Q000187:drug effects*; D011091:Polyesters / Q000627:therapeutic use; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D014025:Titanium / Q000737:chemistry; D016212:Transforming Growth Factor beta / Q000008:administration & dosage / Q000627:therapeutic use; D053773:Transforming Growth Factor beta1; D014945:Wound Healing / Q000187:drug effects
D000900:Anti-Bacterial Agents; D001672:Biocompatible Materials; D020099:Coated Materials, Biocompatible; D008567:Membranes, Artificial; D011091:Polyesters; C508962:Tgfb1 protein, rat; D016212:Transforming Growth Factor beta; D053773:Transforming Growth Factor beta1; D002981:Clindamycin; C033616:poly(lactide); D007334:Insulin-Like Growth Factor I; D014025:Titanium