Comparison of a New Kind of Calcium Phosphate Formula Versus Conventional Calciumphosphate Matrices in Treating Bone Defects – A Long-Term Investigation in Pigs

Abstract:

In clinical practice arises an increasing need for bone substitute materials. The main inorganic part of bone is the hydroxyapatite (HA). A new hydroxyapatite formula was created by a sol-gel-process at low temperature level [4]. The aim of this investigation was to test the biodegradation and the induction of bone formation by this new material and to compare these versus conventional fabricated HA and ß-TCP. 30 one-year-old Goettingen minipigs were divided into five groups. Critical size defect (>5 m3) in the mandible was treated differently in all 5 groups:-group I- filling with pure HA, which was fabricated by sol-gel-technique, group II- control, only gelatinous material was given, group III- conventional ß-TCP [Cerasorb®], in group IV- conventional HA [Endobone®] and in group V [Targobone®], a non denatureted bovine collagen matrix was used. Macroscopical and microscopical investigations of the former defects were made eight months postoperatively. The bone formation was superior in the sol-gel-HA-group (group I) in comparison with the control groups (group II) and the conventional fabricated ceramics groups (III and IV). In the sol-gel-HA group, the biodegradation of this new biomaterial was considered to very good with a resorption rate of more than 98%; eight months postoperatively. In this group complete bone formation was seen in former defects. In the control group, only an incomplete bone formation with 48.4% of the defect area was noted. This difference was significant (p<0,001). A less bone formation was also observed in group III and IV with 57.6% and 56.9%. The bovine non-denaturated collagen matrix (group V) leads to only 20% of new formed bone. The new calcium phosphate formula made by a sol-gel method seems to be superior and suitable for filling bone defects.