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Vital Bone Formation After Grafting of
Autogenous Bone and Biphasic Calcium
Phosphate Bioceramic in Extraction
Sockets of Rats: Histological,
Histometric, and
Immunohistochemical Evaluation
Rander Moreira Macedo, PhD,* Suzie Aparecida Lacerda, PhD,† Roberta Okamoto, PhD,‡ Shakeel Shahdad, PhD,§
and Luiz Guilherme Brentegani, PhD¶
T
he healing process after dental
extraction initiates a series of
cellular and tissue-related events
with an objective to restore the homeo-
stasis of the area.
1
After tooth extrac-
tion, the body aims to fill the cavity
(alveolar socket) with new bone and
the repair is completed when the alve-
olar bone trabeculae is thick, the mar-
row spaces tiny and alveolar crest is
completely remodeled.
2
After the loss of a natural tooth, 3-
dimensional reduction of the height and
width of the alveolar bone
3
inevitably
occurs in the first 6 months,
4
primarily at
the expense of the buccal bone wall.
5
In
some cases, this may not only compro-
mise the aesthetic outcome but also pros-
thodontic treatment in the posterior areas.
Various treatment protocols have
been described for maintenance and
reconstruction of alveolar bone after
extraction, using different biomaterials
as well as the use of resorbable and
nonresorbable membranes to cover the
socket site.
6
Human and animals stud-
ies have shown better bone quality and
quantity after grafting the alveolar
socket with autogenous,
7
allogenic,
8
xenogenic,
9–11
and synthetic bone sub-
stitutes.
10,12,13
Araứjo et al
9
demon-
strated that sockets grafted with
BioOss Collagen (Geistlich), a deprotei-
nized bovine bone mineral, markedly
*Associate Professor, Department of Dentistry, Positivo
University, Curitiba, PR, Brazil.
†Associate Professor, Department of Stomatology, Public
Health and Forensic Dentistry, School of Dentistry of Ribeirão
Preto, USPdUniversity of São Paulo, Ribeirão Preto, SP, Brazil.
‡Associate Professor, Department of Basic Sciences, School of
Dentistry of Aracatuba, UNESP, Universidade Estadual Paulista,
Araçatuba, SP, Brazil.
§Consultant at The Royal London Dental Hospital, Department
of Restorative Dentistry, Barts and The London NHS Trust;
Honorary Senior Clinical Lecturer at Queen Mary University of
London, Barts and The London School of Medicine and
Dentistry; Chairman of the International Team for Implantology
(ITI) UK & Ireland Section.
¶Professor, Department of Stomatology, Public Health and
Forensic Dentistry, School of Dentistry of Ribeirão Preto,
USPdUniversity of São Paulo, Ribeirão Preto, SP, Brazil.
Reprint requests and correspondence to: Rander
Moreira Macedo, PhD, Departamento de Odontologia,
Universidade Positivo, Av. Prof. Pedro Viriato Parigot
de Souza, 5300, Curitiba, PR, CEP 81280-330, Brazil,
Phone: +55-41-3317-3180, Fax: +55-41-3317-3082,
E-mail: mmrander@hotmail.com
ISSN 1056-6163/18/02706-615
Implant Dentistry
Volume 27 Number 6
Copyright © 2018 Wolters Kluwer Health, Inc. All rights
reserved.
DOI: 10.1097/ID.0000000000000815
Purpose: The study aimed to
investigate through histology, his-
tometry, and immunohistochemis-
try the vital bone formation after
grafting of biphasic calcium
phosphate bioceramic (BC) in
combination with calvarial autog-
enous bone into the dental sockets
of rats.
Materials and Methods: Forty-
five male rats were submitted to
upper right incisor extraction and
divided according to the grafted
material in: control, bioceramic
(BC), and bioceramic + autoge-
nous bone (BC + AB). The animals
were killed 7, 21, and 42 days after
surgery for histological, histomet-
ric, and immunohistochemistry
analysis.
Results: Histomorphometric re-
sults demonstrated, for BC + AB
group, formation of trabecular bone
between the particles of BCs and
autogenous bone, connecting them,
as well as higher percentage of vital
bone in comparison with BC. Immu-
nohistochemical reactions showed
intense labeling for Runx2-positive
cells in the group BC + AB.
Conclusions: Autogenous bone
was able to stimulate bone turn-
over enabling a larger amount of
vital bone synthesis and can be
recommended as a viable grafting
material in combination with syn-
thetic biphasic BC. (Implant Dent
2018;27:615–622)
Key Words: extraction socket, bone
graft, bone substitutes, animal study
MACEDO ET AL IMPLANT DENTISTRY /VOLUME 27, NUMBER 6 2018 615
Copyright Ó 201 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 8