The Effect of Demineralized Bone Matrix on the Healing of Intramembranous Bone Grafts in Rabbit Skull Defects

Abstract

A clinical dilemma exists regarding the type of bone that should be used to replace diseased or traumatized osseous tissue. Oral, plastic, and orthopedic surgeons normally implant viable mineralized endochondral (EC) autografts or demineralized EC allografts. A few clinicians have recognized the disadvantages of using EC bone in craniofacial surgery and advocated the replacement of intramembranous (IM) bone with healthy IM bone. However, controversy and uncertainty surround our understanding of these matrices to induce bone formation. Recent studies have advocated the use of other materials with osteoinductive properties, such as demineralized bone matrix (DBM). The proposed delivery system used in this study included IM bone grafts, DBM, and fixation of the IM bone graft. The purpose of this work was to gain further insights into the mechanism of healing of IM bone, in both the presence and the absence of DBM, and to compare the healing of IM bone grafts with that of DBM alone. Critical-sized (10 x 5 mm), full-thickness bony defects in rabbit parietal bone, devoid of periosteum, were filled with IM bone graft (mandible) alone, demineralized cortical bone matrix (DBM) alone, or combined DBM-IM bone graft, or were left unfilled. Histologic changes were examined 14 days later. The IM bone graft healed through IM ossification with no intermediate cartilage stage. DBM and composite DBM-IM healed through an EC ossification with an intermediate cartilage stage. It is hypothesized that the role of the IM graft is to induce neovascularization into the defect site, and that the undifferentiated mesenchymal cells in the perivascular region of the new blood vessels are induced by the bone morphogenetic protein(s) in the DBM into bone-forming cells.

Accelerated repair of cortical bone defects using a synthetic extracellular matrix to deliver human demineralized bone matrix

“…10 There is a growing interest in using DBM to treat a variety of skeletal defects. Thus, DBM has been used in animal models to heal critical-sized calvarial and long bone defects 1,[11][12][13][14][15] and in posterolateral spinal fusion and hip implants. [16][17][18][19] In clinical contexts such as revision arthroplasty, spinal fusion, nonunion fractures, or dental augmentation, the use of DBM as a graft substitute or extender has already proven to be successful.…”

Effect of naringin collagen graft on bone formation

“…To develop materials to replace lost bone, osteogenic matrices such as demineralized bone matrix (DBM) have been extensively studied [1][2][3][4] since they were reported by Urist [5]. Our laboratory has shown that DBM derived from intramembranous bone has extremely good osteogenic properties and greatly improved the integration of autogenous bone grafts in rabbit skulls [6].…”

Molars extraction for bone graft study in rabbits

“…Although a wide variety of bone grafts and implants have been evaluated in various species of experimental animals, there has been little consistency among investigators in the choice of an appropriate animal model [5][6][7] . Some researchers are already using tooth socket as a model including the use of dog, rat and rabbit incisors for these studies [8][9][10][11][12] .…”