Mastoid obliteration using 3D PCL scaffold in combination with alginate and rhBMP-2

Various materials, both biological and alloplastic, have been used for mastoid obliteration after canal wall-down mastoidectomy in chronic otitis media. The purpose of this study is to investigate the osteoinductive potential of PCL scaffolds in mastoid obliteration, and to test that osteoinductivity can be enhanced by coating PCL with alginate and rhBMP-2. The in vitro biocompatibilities of the scaffolds were examined using osteoblast-like cells (MG63). Cell-morphology and calcium deposition were assessed. Based on scanning electron microscope (SEM) images, the cells grew sporadically on the surfaces of the struts in the PCL scaffold, while the entire struts of the PCL/alginate/BMP-2 scaffold was covered with the cells. Furthermore, the PCL/alginate/BMP-2 scaffold showed significantly higher calcium deposition than the PCL/alginate scaffold. Micro-CT showed osteogenesis in the pores of the 3D PCL scaffold in the experimental group, compared to the control group. Confocal microscopic findings showed that the honeycomb appearance of the PCL structure remained in the control group (pure PCL), but significant amount of bone remodeling in the experimental group (PCL/alginate/BMP-2). Histomorphometric analysis showed that the experimental group demonstrated a significantly higher amount (p=0.014) of new bone formation with 50.2 ± 6.5% (mean ± SD), compared to 10.2 ± 3.5% for the control group. Based on these in vitro and in vivo results, the use of the PCL/alginate/BMP-2 scaffold seemed to be a promising technique for the mastoid obliteration.