Frontal sinus and skull bone defect obliteration with three synthetic bioactive materials. A comparative study

Area of Science:

• Biomaterials Science
• Regenerative Medicine
• Craniofacial Surgery

Background:

• Synthetic bioactive materials are crucial for bone defect repair.
• Bioactive glass (BAG) and hydroxyapatite (HA) are commonly used bone graft substitutes.
• Comparing novel bioactive glasses with established materials is essential for clinical translation.

Purpose of the Study:

• To compare the efficacy of two bioactive glasses (BAG(1), BAG(2)) and hydroxyapatite (HA) in frontal sinus and skull bone defect obliteration.
• To evaluate material resorption, new bone formation, and fibrous tissue development.
• To assess the influence of periosteum flap type on healing outcomes.

Main Methods:

• An experimental model using Elco rabbits with surgically created frontal sinus and skull bone defects.
• Defects were filled with BAG(1), BAG(2), or HA granules.
• Histomorphometry, scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR) were employed for analysis at 1, 3, and 6 months.

Main Results:

• All materials promoted new bone formation, with BAG(1) showing significantly higher bone formation than BAG(2) and HA.
• New bone formation and material resorption were faster with pedicled periosteum flaps compared to free flaps.
• SEM confirmed intimate contact between materials and new bone; FTIR showed bone composition similar to natural bone for BAG(1) and BAG(2).

Conclusions:

• Bioactive glass (BAG(1)) exhibits promising osteogenic potential for skull bone defect repair.
• The type of periosteum flap significantly impacts healing efficiency.
• Bioactive glass (BAG(2)) shows potential for custom implant shapes, warranting further investigation for clinical applications.