The aim of this study was to test the suitability of calcium phosphate cement mixed with poly(lactic-co-glycolic acid) (CPC-PLGA) microparticles into a ring-shaped polymeric space-maintaining device as bone graft material for lateral bone augmentation. Therefore, the bone chambers were installed on the lateral portion of the anterior region of the mandibular body of mini-pigs. Chambers were filled with either CPC-PLGA or BioOss® particles for comparison and left for 4 and 12 weeks. Histology and histomorphometry were used to obtain temporal insight in material degradation and bone formation. Results indicated that between 4 and 12 weeks of implantation, a significant degradation of the CPC-PLGA (from 75.1% to 23.1%), as well as BioOss material, occurred (from 40.6% to 14.4%). Degradation of both materials was associated with the presence of macrophage-like and osteoclast-like cells. Furthermore, a significant increase in bone formation occurred between 4 and 12 weeks for the CPC-PLGA (from 0.1% to 7.2%), as well as BioOss material (from 8.3% to 23.3%). Statistical analysis showed that bone formation had progressed significantly better using BioOss compared to CPC-PLGA (p < 0.05). In conclusion, this mini-pig study showed that CPC-PLGA does not stimulate lateral bone augmentation using a bone chamber device. Both treatments failed to achieve “clinically” meaningful alveolar ridge augmentation.
Impact statement
All procedures applied to augment an atrophic alveolar ridge for the predictable installation of dental implants are associated with complications and morbidity risks for the patient. In view of this, there is clear need to develop ridge augmentation methods with grafting materials that are simpler, less invasive, and risky, which reach a substantial gain in bone dimensions within a short time frame. In this mini-pig study, we investigated the use of ring-shaped polymeric chambers filled with calcium phosphate cement mixed with poly(lactic-co-glycolic acid) as an alternative for lateral bone augmentation.
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