Influence of bone morphogenetic protein and proportion of hydroxyapatite on new bone formation in biphasic calcium phosphate graft: Two pilot studies in animal bony defect model

Purpose: The purpose of these two pilot studies using animal bony defect models was to evaluate the influence of bone morphogenetic protein (BMP) and proportion of hydroxyapatite (HA)/beta-tricalcium phosphate (beta-TCP) in biphasic calcium phosphate (BCP) graft on new bone formation. Methods: In this study, four kinds of synthetic osteoconductive bone materials known for bone growth scaffold, OSTEON (TM) II(HA:beta-TCP 30:70), OSTEON (TM) III (HA:beta-TCP 20:80), OSTEON (TM) II Collagen, and OSTEON (TM) III Collagen, were prepared as BCP graft materials. In pilot study 1, three BCP materials (OSTEON (TM) II, OSTEON (TM) III, and OSTEON (TM) II Collagen) were grafted in rabbit calvarial defects after impregnating in rhBMP-2. OSTEON (TM) II without the rhBMP-2 impregnation was included in the study as the control. The amount of new bone was examined and measured histologically at 2, 4, and 8 weeks. In pilot study 2, four BCP materials (OSTEON (TM) II, OSTEON (TM) III, OSTEON (TM) II Collagen, and OSTEON (TM) III Collagen) were grafted in beagle dog mandibular defects after soaking in the rhBMP-2. The amount of total bone and new bone were measured three-dimensionally using microCT and healing process was examined histologically at 2, 4, and 8 weeks. Results: In pilot study 1, rhBMP-2 impregnated groups showed more new bone formation than the rhBMP-2 free group. In pilot study 2, increased new bone formation was observed in time-dependent manner after graft of BCP and BCP-collagen (OSTEON (TM) II, OSTEON (TM) III, OSTEON (TM) II Collagen, and OSTEON (TM) III Collagen) impregnated with rhBMP-2. Also, BCP with a higher proportion of HA (30% HA) showed more favorable result in new bone formation and space maintenance, especially at the 8 weeks. Conclusion: From the results of the pilot studies, rhBMP-2 played positive roles in new bone formation and BCP could become a scaffold candidate for rhBMP-2 impregnation to induce new bone formation. Moreover, BCP with a higher proportion of HA (30% HA) could be considered more appropriate for rhBMP-2 carrier. (C) 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.