Osseointegração de implantes em defeitos circunferenciais utilizando proteínas angiogênicas purificadas do látex, osso autógeno e regeneração óssea guiada. Estudo comparativo em mandíbulas de cães / Implant osseointegration in circumferential bone defects using latexderived proteins, autogenous bone graft and guided bone regeneration. A comparative study in the dog mandible

Maya Fernanda Manfrin Arnez

The development of biomaterials that can assist osseointegration and implant stability in dissatisfactory anatomical regions has been the goal of several researches in the past years. Despite the array of regenerative therapies to be used, some clinical disadvantages still persist, such as considerable patient morbidity, extended patient recovery periods, substantial cost, risk of paresthesia and residual defects in the donor site. Natural latex biomaterials from Hevea brasiliensis (rubber tree) have shown promising advantages, such as angiogenic properties, significantly high bone repair in dental alveoli, easy acquisition and handling, biocompatibility, reduced cost, dispensability of donor sites and very little chance of morbidity. Considering the well-known benefits of angiogenesis in the bone healing process, the purpose of this study was to evaluate the osteogenic capacity of angiogenic latex proteins in accelerating osseointegration and implant stability, when placed in circumferential bone defects. Ten male dogs were underwent an implant placement in center of the defects after pre-molar extractions. The circumferential gaps around the implant were filled either with coagulum, particulate autogenous bone graft, latex angiogenic proteins mixed in a gel carrier, or with collagen and hyaluronic acid gel carrier without implants. Circumferential defects were covered with a non-absorbable e-PTFE membrane on one side and left uncovered on the other. Half the animals were sacrificed 4 and 12 weeks after implant placement. Implant stability was evaluated using resonance-frequency analysis and bone formation was analyzed by histological, histometric, qualitative and quantitative bone labeling analysis. Data were analyzed statistically using ANOVA and orthogonal contrasts for multiple comparisons. Immature and lamellar bone were observed at 4 and 12 weeks, respectively. Bone labeling analysis showed more bone activity on early period of healing (p≤0.05). The membrane did not show significant effect on bone regeneration and there was not statistical difference among the different biomaterials, considering the different time evaluation periods (p≥0.05). Gel carrier group showed less bone formation than other filling materials, not considering recovery time and membrane (p≤0.05). Latex angiogenic proteins showed bone regeneration similar to coagulum and bone graft at 4 and 12 weeks, respectively (p≥0.05). There was significant bone formation, osseointegration and implant stability of biomaterials during the entire healing period. This research showed that guided bone regeneration technique did not change the histometric results; latex angiogenic proteins promoted bone deposition similar to coagulum and bone graft on alveolar bone defects; osseointegration process and implant stability occurred in all experimental sites, regardless of the treatment performed.

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