Hyperbaric oxygen ceramic and resorbable liquid membrane on bone repair

Background: Autogenous bone remains the gold standard for reconstruction of craniofacial defects, yet limitations of autogenous bone have led to the development of novel bone substitutes. Improved bone graft healing has also been demonstrated with hyperbaric oxygen therapy (HBOT).

Objective: The purpose of this study is to evaluate whether HBOT can potentially increase the amount of bone regenerated within defects grafted with bone ceramic or autologous bone when liquid resorbable membranes (RLM) are employed.

Methods: Thirty male rabbits were randomly divided into 3 groups. Bilateral critical sized defects were made in the parietal bones of each animal. Group 1 had unfilled defects, group 2 had defects filled with autogenous bone (ABG), and group 3 had defects filled with bone ceramic. One calvarial defect was protected with a RLM in each. Five animals from each group underwent HBOT. Micro-CT and histomorphometric analysis was performed.

Results: Analysis of the microCT data by 3-way ANOVA indicated that HBO, graft type and RLM all significantly influenced the volume of bone and the bone mineral content of the defects (P<0.05). Histomorphometric analysis demonstrated that graft type and presence of RLM significantly affected the amount of bone and of regenerative tissue (RT; new bone+marrow) present in the defect (P<0.01), while HBO did not.

Conclusions: A greater amount of bone and regenerative tissue was found in defects where the RLM was not applied. The bone volume fraction was greatest in the ABG treated defects, followed by the bone ceramic filled defects and least in the unfilled defects. While HBO appeared to have a positive effect based on microCT analysis, histomorphometry was unable to confirm this.

Grants: NORTH (Network for Oral Research Training and Health), C.A.O.M.S. Foundation and Straumann®.