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Bone substitute as an on-lay graft on rat tibia
Malmö högskola, Faculty of Odontology (OD).
Department of Orthopedics, Lund University Hospital, Lund, Sweden.
Malmö högskola, Faculty of Odontology (OD).ORCID iD: 0000-0002-8143-9554
Department of Oral and Maxillofacial Surgery, Malmö University Hospital, Malmö, Sweden.
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2010 (English)In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 4, p. 424-429Article in journal (Refereed) Published
Abstract [en]

Objectives: To investigate the capacity of Cerament ® , an injectable bone substitute, to guide bone generation from a cortical surface.

Materials and method: Cerament ® was applied to the cortical surface of rat tibiae and investigated histologically after 3, 6 and 12 weeks, using a procedure similar to that performed in sham‐operated rats.

Results: In both groups, the thickness of the bone cortex increased significantly from 473±58 μm (mean±SD) at day 0 to 1193±255 μm (Cerament ® ) and 942±323 μm (sham) after 3 weeks. In the Cerament ® group, the new bone thickness remained constant (1258±288 μm) until the end of the experiment at 12 weeks, while the sham group demonstrated a return to initial cortical thickness (591±73 μm) at 12 weeks. The newly formed bone in the Cerament ® group was highly trabecular after 3 weeks but attained a normal trabecular structure of the cortex after 12 weeks.

Conclusion: Cerament ® may guide bone generation from an intact cortical bone surface. Although bone remodeling speed may differ between rats and humans, our study indicates that Cerament ® may become a useful alternative to autologous bone, both to fill defects and to increase bone volume by cortical augmentation.

To cite this article: 
Truedsson A, Wang J‐S, Lindberg P, Gordh M, Sunzel B, Warfvinge G. Bone substitute as an on‐lay graft on rat tibia. Clin. Oral Impl. Res . 21 , 2010; 424–429.
doi: 10.1111/j.1600‐0501.2009.01875.x

Place, publisher, year, edition, pages
Blackwell Munksgaard, 2010. Vol. 21, no 4, p. 424-429
Keywords [en]
Cerament, Rat
National Category
Dentistry
Identifiers
URN: urn:nbn:se:mau:diva-6108DOI: 10.1111/j.1600-0501.2009.01875.xISI: 000275443500010PubMedID: 20443795Scopus ID: 2-s2.0-77951596837Local ID: 11423OAI: oai:DiVA.org:mau-6108DiVA, id: diva2:1402996
Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2025-06-04Bibliographically approved
In thesis
1. An injectable biphasic bone substitute in sinus augmentation
Open this publication in new window or tab >>An injectable biphasic bone substitute in sinus augmentation
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis concerns a new synthetic, injectable bone substitute, Cerament™, primarily developed for treatment of vertebral fractures. The purpose of the thesis was to investigate the properties of the newbone substitute, that is, whether it can contribute to the generation of new bone formation needed for placement of future dental implants. When the amount of bone in the upper jaw is insufficient, primary stability of dental implants cannot be achieved. Sinus augmentationis a well-established method for increasing the bone volume. This technique can be performed with autologous bone graft and/or bone substitute. Autologous bone graft can be harvested either from a local source in the oral cavity or from an extra oral source. The iliac crest is a common donor site for bone grafts when large quantities are needed, but bone harvesting from the iliac crest require surgery under general anesthesia resulting in an increased morbidity and higher costs.The thesis is based on study I-IV, both animal experimental studies and clinical applications. The question is what gains can be achievedwith the use of a bone substitute. Therefore, to start with, study I analyzed and compared the costs of local bone grafts from the oral cavity and extra-oral bone grafts from the iliac crest. In addition, post-operative health parameters were analyzed for those patients who underwent sinus augmentation, performed under general anesthesia, with bone graft from the iliac crest. Finally, the total cost of sinus augmentation, performed under general anesthesia, with iliac bone graft was calculated and analyzed with respect to the cost of surgery, anesthesia, hospitalization and sick leave. To achieve a broader understanding of the properties of the bone substitute study II and III were performed. Firstly, an animal experimental study in rats, with the intention to investigate if and to what extent Cerament™ onlay is able to stimulate new bone growth on a cortical bone surface. Secondly, an animal experimental rat study that analyzed and estimated to what extent Cerament™, in an onlay application, adds strength to the osseointegration of a titanium screw, measured as removal torque resistance. Further, to investigate the effect of a titanium screw without any bone substitute on a corticalbone surface analyzed with regard to bone remodeling. Finally, as a clinical application (study IV), sinus augmentation with Cerament™ was performed in four patients. The patients received either pure Cerament™ or Cerament™ mixed with autologous bone chips. The studies resulted in the following: Costs for sinus augmentation with iliac graft are several times larger than those for policlinic procedures. Most patients, who received iliac graft surgery, had recovered after 14 days. LoP (loss of production) constituted 41% of the total cost for sinus augmentation with iliac bone graft. Cerament™ guided bone generation from a cortical surface on rats’ tibia. The second animal study displayed no difference in torque resistance between screws embedded in Cerament™ and controls. Sinus augmentation in a mixture of bone chips and 50-75% Cerament™ rendered new bone formation after 6-11 months. Conclusion: There are gains to be made, in both economic and morbidity terms, by using Cerament™. When applied as an onlay, Cerament™ is capable of guiding and generating new bone formationon rats’ tibia. In sinus augmentation, Cerament™ has been proven to generate new bone without any adverse reactions. Future research should clarify how the clinical findings made in this thesis can be applied in the orofacial environment.

Place, publisher, year, edition, pages
Malmö University, Faculty of Odontology, 2014. p. 84
Series
Doctoral Dissertation in Odontology
Keywords
Dentala implantat, Dental Implants, Bone transplantation, Bone substitutes
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-7706 (URN)17698 (Local ID)9789171043993 (ISBN)9789171044006 (ISBN)17698 (Archive number)17698 (OAI)
Note

Note: The papers are not included in the fulltext online.

Paper III in dissertation as manuscript.

Available from: 2020-02-28 Created: 2020-02-28 Last updated: 2024-03-14Bibliographically approved

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Truedsson, AnnaLindberg, PiaSunzel, BoWarfvinge, Gunnar

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