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Dent Mater. 2018 Jul;34(7):1024-1035. doi: 10.1016/j.dental.2018.03.021. Epub 2018 Apr 7.

In-vitro and in-vivo design and validation of an injectable polysaccharide-hydroxyapatite composite material for sinus floor augmentation.

Author information

1
Inserm U1026, University of Bordeaux, Tissue Bioengineering, U1026, F-33076 Bordeaux, France; CHU Bordeaux, Dentistry and Oral Health Department, F-33076 Bordeaux, France.
2
Inserm U1148, LVTS, X. Bichat Hospital, University Paris Diderot F-75018 Paris & Institut Galilée, University Paris 13, 93430 Villetaneuse, France.
3
Inserm U1026, University of Bordeaux, Tissue Bioengineering, U1026, F-33076 Bordeaux, France.
4
CIC 14.01 Inserm, University Hospital of Bordeaux, Bordeaux, France.
5
Inserm U1148, LVTS, X. Bichat Hospital, University Paris Diderot F-75018 Paris & Institut Galilée, University Paris 13, 93430 Villetaneuse, France; SILTISS SA, Zac de la Nau, F-19240 Saint-Viance, France.
6
Inserm U1026, University of Bordeaux, Tissue Bioengineering, U1026, F-33076 Bordeaux, France. Electronic address: joelle.amedee@inserm.fr.
7
Inserm U1026, University of Bordeaux, Tissue Bioengineering, U1026, F-33076 Bordeaux, France; CHU Bordeaux, Dentistry and Oral Health Department, F-33076 Bordeaux, France. Electronic address: sylvain.catros@u-bordeaux.fr.

Abstract

OBJECTIVE:

Polysaccharide-based composite matrices consisting of natural polysaccharides, pullulan and dextran supplemented with hydroxyapatite (Matrix-HA) have recently been developed. The principal objective of this study was to evaluate the capacities of this composite material to promote new bone formation in a sinus lift model in the sheep. Secondary objectives were to evaluate in vitro properties of the material regarding cell adhesion and proliferation.

METHODS:

In this report, once such composite matrix was prepared as injectable beads after dispersion in a physiological buffer, and evaluated using a large animal model (sheep) for a sinus lift procedure.

RESULTS:

In vitro studies revealed that these microbeads (250-550μm in diameter) allow vascular cell adhesion and proliferation of Endothelial Cells (EC) after 1 and 7 days of culture. In vivo studies were performed in 12 adult sheep, and newly formed tissue was analyzed by Cone Beam Computed Tomography (CBCT scanning electron microscopy (SEM) and by histology 3 and 6 months post-implantation. CBCT analyses at the implantation time revealed the radiolucent properties of these matrices. Quantitative analysis showed an increase of a dense mineralized tissue in the Matrix-HA group up to 3 months of implantation. The mineralized volume over total volume after 6 months reached comparable values to those obtained for Bio-Oss® used as positive control. Histological examination confirmed that the Matrix-HA did not induce any long term inflammatory events, and promoted direct contact between the osteoid tissue and lamellar bone structures and beads. After 6 months, we observed a dense network of osteocytes surrounding both biomaterials as well as a newly vascularized formed tissue in close contact to the biomaterials.

SIGNIFICANCE:

In conclusion, the absence of animal components in Matrix-HA, the osteoconductive property of Matrix-HA in sheep, resulting in a dense bone and vascularized tissue, and the initial radiolucent property to follow graft integration offer great promises of this composite material for clinical use.

KEYWORDS:

Bone regeneration; Injectable bone substitute; Polysaccharide composites; Sheep model; Sinus floor augmentation

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