Effect of hyperbaric oxygen on demineralized bone matrix and biphasic calcium phosphate bone substitutes

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jan;109(1):59-66. doi: 10.1016/j.tripleo.2009.07.036. Epub 2009 Oct 20.


Objectives: The aim of this study was to assess the possible effect of hyperbaric oxygen (HBO) on the healing of critical-sized defects that were grafted with demineralized bone matrix (DBM) combined with Pluronic F127 (F127) to form a gel or putty, or a commercially available biphasic calcium phosphate (BCP), mixed either with blood or F127 to form a putty.

Study design: Twenty New Zealand White rabbits were randomly divided into 2 groups of 10 animals each. Bilateral 15-mm calvarial defects were created in the parietal bones of each animal, resulting in 40 critical-sized defects. Group I defects were grafted with either DBM putty or DBM gel. Group II defects were grafted with either BCP or BCP putty. Five animals from each group received HBO treatment (100% oxygen, at 2.4 ATA) for 90 minutes per day 5 days a week for 4 weeks. The other 5 animals in each group served as a normobaric (NBO) controls, breathing only room air. All animals were humanely killed at 6 weeks. The calvariae were removed and analyzed by micro computed tomography (mCT) and histomorphometry.

Results: mCT analysis indicated a higher bone mineral content (BMC, P < .05), bone volume fraction (BVF; P < .001), and bone mineral density (BMD; P < .001) of the defects grafted with BCP rather than DBM. Furthermore, the voxels that were counted as bone had a higher tissue mineral density (TMD) in the BCP- than in the DBM-filled defects (P < .001). Histologically complete bony union over the defects was observed in all specimens. Histomorphometric analysis showed that DBM-filled defects had more new bone (P < .007) and marrow (P < .001), and reduced fibrous tissue compared with the BCP defects (P < .001) under NBO conditions. HBO treatment reduced the amount of fibrous tissue in BCP filled defects (P < .05), approaching levels similar to that in matching DBM-filled defects. HBO also resulted in a small but significant increase in new bone in DBM-grafted defects (P < .05).

Conclusion: Use of DBM or BCP promoted healing in these critical-sized defects. Hyperbaric oxygen therapy resulted in a slight increase in new bone in DBM-grafted defects and much larger reduction in fibrous tissue and matching increases in marrow in BCP-grafted defects, possibly through increased promotion of angiogenesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analysis of Variance
  • Animals
  • Bone Density
  • Bone Matrix / physiology
  • Bone Matrix / transplantation*
  • Bone Regeneration / physiology*
  • Bone Substitutes*
  • Bone Transplantation* / physiology
  • Calcium Phosphates
  • Decalcification Technique
  • Hyperbaric Oxygenation*
  • Male
  • Neovascularization, Physiologic
  • Parietal Bone / diagnostic imaging
  • Parietal Bone / surgery
  • Poloxamer
  • Rabbits
  • Random Allocation
  • X-Ray Microtomography


  • Bone Substitutes
  • Calcium Phosphates
  • Poloxamer