Scintigraphic and histopathologic evaluation of combined bone grafts.
OBJECTIVE
We aimed to assess various bone grafts on bone formation using bone scintigraphy and histology, especially the first study that evaluated the demineralized bone matrix (DBM) + tricalcium phosphate (TCP) + hyaluronic acid (HA) combination.


METHODS
A total of 44 pieces in groups of autogenous bone graft, TCP, DBM, DBM + TCP combination, and DBM + TCP + HA combination were applied to parietal bones of 24 New Zealand rabbits. Bone scintigraphies of the rabbits were performed at 2, 6, and 12 weeks. The uptake ratios were compared for the different types of grafts. In addition, in 2, 6, and 12 weeks, the graft areas were taken from the sacrificed rabbits and examined histologically.


RESULTS
In the 2-week evaluation, DBM + TCP combination and DBM + TCP + HA combination had more osteoblastic activity accumulation than the TCP and DBM groups. These findings supported that the DBM + TCP combination group showed new bone formation earlier in the histopathological evaluation. The DBM + TCP + HA combination had more uptake than the TCP and DBM groups on bone scintigraphy at 2 weeks, and this uptake ratio decreased in the following weeks. It was thought that the increased uptake in DBM + TCP + HA combination at 2 weeks was due to severe inflammation seen in the histopathological evaluation.


CONCLUSIONS
The DBM + TCP + HA combination should not be used for graft repair, although it was thought to be a good combination in the early weeks.
From the *Ministry of Health Kahramanmaras Necip Fazil City Hospital, Division of Nuclear Medicine, Kahramanmaras; †Ministry of Health Ankara Training and Research Hospital, Department of Nuclear Medicine; ‡Ministry of Health Ankara Training and Research Hospital, Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara; §Duzce University Faculty of Medicine, Department of Pathology, Duzce; and ∥Ankara University Faculty of Medicine, Department of Pathology, Ankara, Turkey.
Hasan Ikbal
HI
Atilgan
Koray
K
Demirel
Yuksel
Y
Kankaya
Murat
M
Oktay
Cem
C
Sahiner
Meliha
M
Korkmaz
Gökhan
G
Koca
Ugur
U
Kocer
Duygu
D
Kankaya
D000818:Animals; D001672:Biocompatible Materials; D001857:Bone Matrix; D018786:Bone Substitutes; D016025:Bone Transplantation; D002130:Calcium Phosphates; D006820:Hyaluronic Acid; D010012:Osteogenesis / Q000502:physiology*; D010294:Parietal Bone / Q000473:pathology / Q000601:surgery; D011817:Rabbits; D011877:Radionuclide Imaging
D001672:Biocompatible Materials; D018786:Bone Substitutes; D002130:Calcium Phosphates; D006820:Hyaluronic Acid; C018392:tricalcium phosphate