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, 33 (6), 2169-2179

Comparison of Material-mediated Bone Regeneration Capacities of Sintered and Non-sintered Xenogeneic Bone Substitutes via 2D and 3D Data

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Comparison of Material-mediated Bone Regeneration Capacities of Sintered and Non-sintered Xenogeneic Bone Substitutes via 2D and 3D Data

Eleni Kapogianni et al. In Vivo.

Abstract

Background/aim: The aim of this study was the development of a new osteoconductivity index to determine the bone healing capacities of bone substitute materials (BSM) on the basis of 3D microcomputed tomographic (μ-CT) data.

Materials and methods: Sinus biopsies were used for the comparative analysis of the integration behavior of two xenogeneic BSM (cerabone® and Bio-Oss®). 3D μ-CT and data sets from histomorphometrical measurements based on 2D histological slices were used to measure the bone-material-contact and the tissue distribution within the biopsies. The tissue reactions to both BSM were microscopically analyzed.

Results: The 3D and 2D results of the osteoconductivity measurements showed comparable material-bone contacts for both BSM, but the 2D data were significantly lower. The same results were found when tissue distribution was measured in both groups. The histopathological analysis showed comparative tissue reactions in both BSM.

Conclusion: Osteoconductivity index is a reliable measurement parameter for determining the healing capacities of BSM. The observed differences between both measurement methods could be assigned to the resolution capacity of μ-CT data that did not allow for a precise interface distinction between both BSM and bone tissue. Histomorphometrical data based on histological slides still allow for a more exact evaluation.

Keywords: Osteoconductivity index; bone regeneration; histomorphometry; micro-CT; tissue response; xenogeneic bone substitute.

Conflict of interest statement

The Authors declare no conflicts of interest regarding this study.

Figures

Figure 1
Figure 1. Exemplary images of one level from the image stacks of the μ-CT data of a respective biopsy of (A) cerabone® or (B) Bio-Oss®. Purple stars in A and red stars in B=BSM; yellow stars=newly formed bone tissue, green stars=connective tissue.
Figure 2
Figure 2. Exemplary reconstruction of a biopsy including the BSM cerabone®. (A) 2D overview of the biopsy. (B) and (C) 3D reconstruction of the biopsy. Green double arrows: implantation area; yellow double arrows: residual bone; purple stars: xenogeneic BSM; yellow stars: newly formed bone, green stars: connective tissue.
Figure 3
Figure 3. Exemplary images of one level of a μ-CT image stack showing the implantation site of cerabone® with different regions of interest (ROI). (A) ROI of the contact surface between the BSM granules and the newly formed bone tissue. (B) ROI of the BSM granules. (C) ROI of the total implantation area (each marked by a yellow line).
Figure 4
Figure 4. Histopathology and histomorphometric measurements. (A) Exemplary total scan of a sinus biopsy before histomorphometry. (B) Histomorphometrical measurement of the area of the remaining BSM (red lines) (both images: toluidine blue staining, “total scans”, ×100 magnification, scale bars=500 μm).
Figure 5
Figure 5. Results of the histomorphometrical analyses of the BSM-bone contact areas as basis of the newly developed osteoconductivity index in the groups of the BSM cerabone® and Bio-Oss® assessed through μ-CT and histological slide analysis.
Figure 6
Figure 6. Results of the histomorphometrical analyses of the tissue distribution in the groups of the BSM cerabone® and Bio-Oss® assessed through μ-CT and histological slide analysis.
Figure 7
Figure 7. Tissue integration and cellular responses to the two BSM. A, C, E: Cerabone® (CB) and B, D, F: Bio-Oss® (BO). BT: Bone tissue; CT: connective tissue; black stars: areas of active bone formation with signs of active osteoblasts; red arrows: blood vessels; green arrows: walled osteocytes surrounded by pre-calcified bone matrix; red stars: bone matrix margins on the granule surfaces; black arrows: mononuclear cells on the material surface; black arrowheads: material-associated multinucleated giant cells. (A: Movat’s pentachrome staining, B: toluidine staining, A and B: ×200-magnification, scale bar=50 μm, C-E: toluidine staining, F: Movat’s pentachrome staining, ×400-magnification, scale bars=20 μm).

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