Experimental transplantation of hydroxylapatite-bone composite grafts.

PURPOSE This study was undertaken to determine if autogenous bone can be cultivated in vivo in a porous hydroxylapatite (HA) matrix by ingrowth from underlying bone and if this autogenous HA-bone composite graft can then be transplanted. PATIENTS AND METHODS Five Göttingen minipigs received subperiosteal implantation of one HA block each (40 x 10 x 10 mm), covered by a polylactic membrane, on the ascending ramus of the mandible. After 5 months, half of each implant was harvested and transplanted as an onlay graft to the horizontal ramus of the mandible with simultaneous insertion of a titanium implant. Polychrome fluorescence labeling was done 1, 2, 4, and 8 weeks postoperatively. After 3 months, the vascular system of the animals was filled with BaSO4 for microangiographic examination, and all blocks were retrieved. RESULTS Fluorescence microscopy showed that there was a significant decrease in deposition of the label in the grafted blocks at 1 week when compared with later labels. After the second week, there were no significant changes. A 20% to 30% decrease in the frequency of fluorochrome staining was noted in the upper third of each block. In this region, microangiography demonstrated highly vascularized tissue and limited bone resorption. CONCLUSION It was concluded that cultivation of mandibular bone in a porous matrix under guided bone regeneration is possible and that this autogenous HA-bone composite graft can be transplanted at a later date.

[1]  L. Whitaker,et al.  Membranous vs endochondral bone autografts: implications for craniofacial reconstruction. , 1979, Surgical forum.

[2]  P. Mercier,et al.  A comparative study of the efficacy and morbidity of five techniques for ridge augmentation of the mandible. , 1992, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[3]  H. Schliephake,et al.  Experimental study by fluorescence microscopy and microangiography of remodeling and regeneration of bone inside alloplastic contour augmentations. , 1994, International journal of oral and maxillofacial surgery.

[4]  L. Whitaker,et al.  The Early Revascularization of Membranous Bone , 1985, Plastic and reconstructive surgery.

[5]  W. Hiatt,et al.  Restoration of mandibular continuity defects using combinations of hydroxylapatite and autogenous bone: microscopic observations. , 1990, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[6]  M. McFarland,et al.  The Biologic Behavior of Hydroxyapatite Implanted into the Maxillofacial Skeleton , 1990, Plastic and reconstructive surgery.

[7]  T Rooney,et al.  Evaluation of porous block hydroxylapatite for augmentation of alveolar ridges. , 1988, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[8]  M. Sharawy,et al.  Osteogenesis in composite grafts of allogenic demineralized bone powder and porous hydroxylapatite. , 1989, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  J. Piecuch,et al.  Long-term evaluation of porous hydroxyapatite blocks for alveolar ridge augmentation. , 1990, International journal of oral and maxillofacial surgery.

[10]  R. Holmes,et al.  Porous hydroxyapatite as a bone graft substitute in maxillary augmentation. An histometric study. , 1988, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[11]  J. Hupp,et al.  Use of porous hydroxylapatite blocks for augmentation of atrophic mandibles. , 1988, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[12]  F W Neukam,et al.  Bone replacement with porous hydroxyapatite blocks and titanium screw implants: an experimental study. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  D. Lew,et al.  The effect of electrical stimulation on bone formation around hydroxyapatite implants placed on the rabbit mandible. , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[14]  K. Vig,et al.  Allogeneic bone for secondary alveolar cleft osteoplasty. , 1990, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[15]  U. Ripamonti The induction of bone in osteogenic composites of bone matrix and porous hydroxyapatite replicas: an experimental study on the baboon (Papio ursinus). , 1991, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[16]  S. Parel,et al.  Tissue-integrated prosthesis. , 1986, The Journal of oral implantology.

[17]  J. Marsh,et al.  Craniofacial Onlay Bone Grafting: A Prospective Evaluation of Graft Morphology, Orientation, and Embryonic Origin , 1990, Plastic and Reconstructive Surgery.

[18]  H. Schliephake,et al.  Enhancement of bone ingrowth into a porous hydroxylapatite-matrix using a resorbable polylactic membrane: an experimental pilot study. , 1994, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[19]  C. Hall,et al.  Porous hydroxyapatite as an onlay bone-graft substitute for maxillofacial surgery. , 1989, Plastic and reconstructive surgery.

[20]  M. Nimni,et al.  Osteogenesis in bone defects in rats: the effects of hydroxyapatite and demineralized bone matrix. , 1989, The American journal of the medical sciences.

[21]  J. Glowacki,et al.  Treatment of jaw defects with demineralized bone implants. , 1982, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[22]  W. Sullivan,et al.  Revascularization of Cranial versus Iliac Crest Bone Grafts in the Rat , 1991, Plastic and reconstructive surgery.

[23]  J. McCarthy,et al.  The role of rigid skeletal fixation in bone-graft augmentation of the craniofacial skeleton. , 1989, Plastic and reconstructive surgery.

[24]  J. Mellonig,et al.  Comparison of decalcified freeze-dried bone allograft and porous particulate hydroxyapatite in human periodontal osseous defects. , 1989, Journal of periodontology.