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Minimally invasive mandibular bone augmentation using injectable hydrogels.

Elena Martínez-Sanz1, Oommen P Varghese, Marta Kisiel

  • 1Departamento de Anatomía y Embriología Humana I, Facultad de Medicina, Universidad Complutense de Madrid, Spain.

Journal of Tissue Engineering and Regenerative Medicine
|September 4, 2012
PubMed
Summary
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Injectable hyaluronic acid hydrogels with nanohydroxyapatite and bone morphogenetic protein-2 (BMP-2) successfully regenerated mandibular bone in rats. This minimally invasive technique offers a promising alternative for oral implantology.

Area of Science:

  • Biomaterials Science
  • Regenerative Medicine
  • Craniofacial Surgery

Background:

  • Hyaluronic acid hydrogels are biocompatible carriers for bone morphogenetic protein-2 (BMP-2).
  • Previous studies show promise for craniofacial bone regeneration using these materials, with or without nanohydroxyapatite.
  • Minimally invasive delivery methods are sought for bone augmentation procedures.

Purpose of the Study:

  • To investigate mandibular bone augmentation using injectable hyaluronic acid-based hydrogels with nanohydroxyapatite and varying BMP-2 concentrations (0, 5, 150 µg/ml).
  • To evaluate the efficacy of subperiosteal injection into the mandibular diastema in rats as a model for resorbed mandibles.

Main Methods:

  • Subperiosteal injection of novel hydrogels into the mandibular diastema of 28 rats.

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  • Evaluation using peripheral quantitative computed tomography (pQCT), micro-computed tomography (μCT), histology, immunohistochemistry, and fluorochrome labeling after 8 weeks.

    • Main Results:

    • Engineered bone formation was observed in all treated mandibles.
    • A statistically significant increase in mandibular bone volume was directly correlated with BMP-2 concentration.
    • The procedure was performed without incisions, flaps, or sutures.

    Conclusions:

    • Minimally invasive mandibular bone augmentation is achievable via injection of appropriate injectable scaffolds.
    • Hyaluronic acid-based hydrogels containing nanohydroxyapatite and BMP-2 are effective for bone regeneration.
    • This technique presents a viable clinical option for patients requiring mandibular reconstruction in oral implantology.