Oral and maxillofacial surgery
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Histologic study of incorporation and resorption of a bone cement–collagen composite: an in vivo study in the minipig

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Objective

Calcium phosphates are clinically established as bone defect fillers. They have the capability of osseoconduction and are characterized by a slow resorption process. The present study evaluated the suitability of a newly developed calcium phosphate cement modified with collagen type I.

Study design

The modified cement paste was inserted in differently designed defects of 10 minipigs. Further, an alveolar ridge augmentation was performed, applying the cement paste. The cement hardened in situ during the operation, forming a hydroxyapatite collagen composite. Animals were sacrificed after 1, 3, 6, 12, and 18 months. The tissue integration and resorption process was then evaluated using nondecalcified microsections. All animals were evaluated for histology.

Results

The implanted material showed osseoconductive characteristics. Resorption started from the edge of the defect zone, and bone substitution followed rapidly. Twelve months after placement of the cement, complete remodeling was observed.

Conclusion

It can be concluded that the applied hydroxyapatite-collagen cement composite shows good resorption and bone integration.

Section snippets

Implant materials

The Biocement D (Calcibon; Biomet Merck Biomaterials, Darmstadt, Germany) used in this study is a hydraulic fast-setting calcium phosphate bone cement. The cement precursor powder consists of tricalcium phosphate (TCP; Ca3(PO4)2), anhydrous dicalcium phosphate (DCPA; CaHPO4), and small amounts of calcium carbonate (CaCO3). After mixing the cement precursor with a defined amount of disodium hydrogen phosphate solution (Na2HPO4 aq, 4% w/w), it is transformed into calcium-deficient carbonated

Results

Following application at operation, the collagen cement composite could be manually molded for about 6-8 min. The material displayed good cohesion and had a high subjective stability after primary setting. It is not necessary for the implant substance to be kept dry during the hardening of the cement. Precise adaptation to the edges of the defect zone was possible (Fig. 2).

After the operation, 1 animal developed transient wound healing complications and received antibiotic treatment and

Discussion

The aim of the present study was to verify bone healing and remodeling of a bone replacement substance, based on calcium phosphate bone cement (Calcibon) modified with collagen type I.

Based on the results, we conclude that the applied hydroxyapatite-collagen cement is resorbable under in vivo conditions and shows good biocompatibility. Resorption can be seen as the combination of cellular macrophage activity and physiologic solubility.

This study confirms the suitability of the material as a

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Biomet Biomaterials, Darmstadt, Germany, supplied the cement powder.

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