Tetracalcium phosphate cement and its combination with synthetic hydroxyapatite as graft materials in bone regeneration

BAEZ AN, LUCHETTI CG, AYALA M, LÓPEZ A, CARBONE C, KITRILAKIS A, FANOVICH MA

Viña del Mar

Taller; 3er Taller de Órganos Artificiales, Biomateriales e Ingeniería de Tejidos; 2013

Sociedad de BIomateriales

Typically, when a defect is generated in the bone tissue (as fractures or other defects) spontaneously are initiated bone forming mechanisms, in order to restore the bone tissue at the site of injury. In most cases, the dynamics of bone is sufficient to reconstruct the common defects. However, in cases where the loss bone mass is significant, is necessary to resort to the contribution of bone substitutes for repair.  The best bone substitute is the bone itself, either from the patient (autograft bone) or obtained from a donor (allograft bone). However their use involves additional surgery to take bone graft, usually from the chin, retromolar trigone, maxillary tuberosity, calvaria and iliac crest.  In the field of dentistry, from the development of implantology is increasingly began to perform more studies on this subject, due to the absence in many cases of bone available for implant placement. Therefore, research has been focused on creating new bone where needed. The sizes of the defects may be as large as several centimeters, making them irreparable by normal bone cells.   On the base of their properties, the tetracalcium phosphate based cement (CPC) can easily fill osseous cavities of any geometry, which leads to an optimal tissue-biomaterial contact. The components of the cement react in an aqueous environment to form, as the final product,hydroxyapatite. The combination of setting and biocompatibility properties makes CPC a potentially useful material in a diversity of dental and medical applications.   Our group has evaluated numerous biomaterials for use as bone grafts. During the initial phase of this work we experimented on animals with this new CPC material with very good results.   This study aimed to assess the changes in bone reconstruction on patients treated with dental implants, having reduced loss bone mass.This case report on the initial treatment experiences of 4 patients who received a 4.00 mm wide dental implant placed at the time of the extraction of maxillary or mandibular premolars or molars, utilizing as graft material Tetracalcium phosphate based cement, to fill the gap between the socket and implant to achieve successful outcomes for wider extraction sockets.Tetracalcium phosphate based cement showed very good properties as graft material, enabling the complete healing of a critical bone defect .   Their physical characteristics, ease of manipulation give us an additional benefit in clinical use.  In this preliminary study, neither inflammation nor foreign-body giant cell reaction was observed in the tissue adjacent to the implanted material. Histologic examination showed that osteogenesis occurred directly on the surface of the material. These findings suggest that this CPC is biocompatible and possesses successful osteoconductive behaviour in dental defects.