Limits...
Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results.

Ghanaati S, Barbeck M, Lorenz J, Stuebinger S, Seitz O, Landes C, Kovács AF, Kirkpatrick CJ, Sader RA - Ann Maxillofac Surg (2013)

Bottom Line: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells.No significant difference was observed in the extent of new bone formation between both groups.The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group.

View Article: PubMed Central - PubMed

Affiliation: Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany ; REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.

ABSTRACT

Background: The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity.

Materials and methods: Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement.

Results: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group.

Conclusions: Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer.

No MeSH data available.


Related in: MedlinePlus

The tissue reaction to the two analyzed bone substitute materials. Within the NB-implantation bed the material-tissue interface that was not covered by bone was almost completely populated by multi-nucleated giant cells (arrow heads) (a1-a3); (a1: H and E staining, ×100 magnification, scale bar = 100 μm); (a2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (a3: Fast garnet GBC staining, ×600 magnification, scale bar = 10 μm). The granules of BioOss® (BO) were integrated within connective tissue and showed a comparable less expressed granulation tissue (b1). Granule surfaces were mainly covered by BT and only small surface areas were bordered by connective tissue (b1 and b2). Within these areas, the material-tissue interfaces contained mostly mononuclear cells and only a few multi-nucleated giant cells (arrow heads) were detected (b1 and b2). Signs of osteogenesis were often visible at the surfaces of the material, where active osteoblasts were located (green arrow heads) (b3). (b1: H and E staining, ×200 magnification, scale bar = 100 μm) (b2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (b3: Fast Garnet GBC staining, ×600 magnification, scale bar = 10 μm)®
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3814660&req=5

Figure 2: The tissue reaction to the two analyzed bone substitute materials. Within the NB-implantation bed the material-tissue interface that was not covered by bone was almost completely populated by multi-nucleated giant cells (arrow heads) (a1-a3); (a1: H and E staining, ×100 magnification, scale bar = 100 μm); (a2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (a3: Fast garnet GBC staining, ×600 magnification, scale bar = 10 μm). The granules of BioOss® (BO) were integrated within connective tissue and showed a comparable less expressed granulation tissue (b1). Granule surfaces were mainly covered by BT and only small surface areas were bordered by connective tissue (b1 and b2). Within these areas, the material-tissue interfaces contained mostly mononuclear cells and only a few multi-nucleated giant cells (arrow heads) were detected (b1 and b2). Signs of osteogenesis were often visible at the surfaces of the material, where active osteoblasts were located (green arrow heads) (b3). (b1: H and E staining, ×200 magnification, scale bar = 100 μm) (b2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (b3: Fast Garnet GBC staining, ×600 magnification, scale bar = 10 μm)®

Mentions: Six months after augmentation of the sinus cavity, the nanocrystalline bone substitute NB was well-integrated within the surrounding tissue covered by newly generated trabecular bone tissue (BT) [Figure 2:a1 and 2:a2]. The intergranular spaces were filled by cellular granulation tissue with fibroblasts, lymphocytes, monocytes and macrophages as well as a high number of blood vessels [Figure 2:a1]. Parts of the surface area that were not covered by bone were encased by multi-nucleated giant cells [Figure 2:a1, 2:a2 and 2:a3]. Analysis of the multi-nucleated giant cells through histochemical TRAP staining revealed that these cells could be divided into osteoclast-like TRAP-positive cells and TRAP-negative multi-nucleated giant cells [Figure 3:a1]. The TRAP-positive multi-nucleated giant cells were visibly dominant and covered almost the entire surface of the NB granules throughout the total implantation bed. In addition, immunohistochemical TRAP5 enzyme detection revealed TRAP-5-positive multi-nucleated giant cells on the surface of granules that were not covered by new bone [Figure 3:a2].


Synthetic bone substitute material comparable with xenogeneic material for bone tissue regeneration in oral cancer patients: First and preliminary histological, histomorphometrical and clinical results.

Ghanaati S, Barbeck M, Lorenz J, Stuebinger S, Seitz O, Landes C, Kovács AF, Kirkpatrick CJ, Sader RA - Ann Maxillofac Surg (2013)

The tissue reaction to the two analyzed bone substitute materials. Within the NB-implantation bed the material-tissue interface that was not covered by bone was almost completely populated by multi-nucleated giant cells (arrow heads) (a1-a3); (a1: H and E staining, ×100 magnification, scale bar = 100 μm); (a2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (a3: Fast garnet GBC staining, ×600 magnification, scale bar = 10 μm). The granules of BioOss® (BO) were integrated within connective tissue and showed a comparable less expressed granulation tissue (b1). Granule surfaces were mainly covered by BT and only small surface areas were bordered by connective tissue (b1 and b2). Within these areas, the material-tissue interfaces contained mostly mononuclear cells and only a few multi-nucleated giant cells (arrow heads) were detected (b1 and b2). Signs of osteogenesis were often visible at the surfaces of the material, where active osteoblasts were located (green arrow heads) (b3). (b1: H and E staining, ×200 magnification, scale bar = 100 μm) (b2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (b3: Fast Garnet GBC staining, ×600 magnification, scale bar = 10 μm)®
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814660&req=5

Figure 2: The tissue reaction to the two analyzed bone substitute materials. Within the NB-implantation bed the material-tissue interface that was not covered by bone was almost completely populated by multi-nucleated giant cells (arrow heads) (a1-a3); (a1: H and E staining, ×100 magnification, scale bar = 100 μm); (a2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (a3: Fast garnet GBC staining, ×600 magnification, scale bar = 10 μm). The granules of BioOss® (BO) were integrated within connective tissue and showed a comparable less expressed granulation tissue (b1). Granule surfaces were mainly covered by BT and only small surface areas were bordered by connective tissue (b1 and b2). Within these areas, the material-tissue interfaces contained mostly mononuclear cells and only a few multi-nucleated giant cells (arrow heads) were detected (b1 and b2). Signs of osteogenesis were often visible at the surfaces of the material, where active osteoblasts were located (green arrow heads) (b3). (b1: H and E staining, ×200 magnification, scale bar = 100 μm) (b2: Masson-Goldner staining, ×400 magnification, scale bar = 10 μm); (b3: Fast Garnet GBC staining, ×600 magnification, scale bar = 10 μm)®
Mentions: Six months after augmentation of the sinus cavity, the nanocrystalline bone substitute NB was well-integrated within the surrounding tissue covered by newly generated trabecular bone tissue (BT) [Figure 2:a1 and 2:a2]. The intergranular spaces were filled by cellular granulation tissue with fibroblasts, lymphocytes, monocytes and macrophages as well as a high number of blood vessels [Figure 2:a1]. Parts of the surface area that were not covered by bone were encased by multi-nucleated giant cells [Figure 2:a1, 2:a2 and 2:a3]. Analysis of the multi-nucleated giant cells through histochemical TRAP staining revealed that these cells could be divided into osteoclast-like TRAP-positive cells and TRAP-negative multi-nucleated giant cells [Figure 3:a1]. The TRAP-positive multi-nucleated giant cells were visibly dominant and covered almost the entire surface of the NB granules throughout the total implantation bed. In addition, immunohistochemical TRAP5 enzyme detection revealed TRAP-5-positive multi-nucleated giant cells on the surface of granules that were not covered by new bone [Figure 3:a2].

Bottom Line: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells.No significant difference was observed in the extent of new bone formation between both groups.The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group.

View Article: PubMed Central - PubMed

Affiliation: Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany ; REPAIR-Lab, Institute of Pathology, University Medical Center, Johannes Gutenberg University, Mainz, Germany.

ABSTRACT

Background: The present study was first to evaluate the material-specific cellular tissue response of patients with head and neck cancer to a nanocrystalline hydroxyapatite bone substitute NanoBone (NB) in comparison with a deproteinized bovine bone matrix Bio-Oss (BO) after implantation into the sinus cavity.

Materials and methods: Eight patients with tumor resection for oral cancer and severely resorbed maxillary bone received materials according to a split mouth design for 6 months. Bone cores were harvested prior to implantation and analyzed histologically and histomorphometrically. Implant survival was followed-up to 2 years after placement.

Results: Histologically, NB underwent a higher vascularization and induced significantly more tartrate-resistant acid phosphatase-positive (TRAP-positive) multinucleated giant cells when compared with BO, which induced mainly mononuclear cells. No significant difference was observed in the extent of new bone formation between both groups. The clinical follow-up showed undisturbed healing of all implants in the BO-group, whereas the loss of one implant was observed in the NB-group.

Conclusions: Within its limits, the present study showed for the first time that both material classes evaluated, despite their induction of different cellular tissue reactions, may be useful as augmentation materials for dental and maxillofacial surgical applications, particularly in patients who previously had oral cancer.

No MeSH data available.


Related in: MedlinePlus