Experimental transplantation of hydroxylapatite-bone composite grafts

Purpose: This study was undertaken to determine if autogenous bone can be cultivated in vivo in a porous hydroxylapatite (HA) matrix by ingrowth from underlying bone and if this autogenous HA-bone composite graft can then be transplanted. Patients and Methods: Five Göttingen minipigs received subperiosteal implantation of one HA block each (40 × 10 × 10 mm), covered by a polylactic membrane, on the ascending ramus of the mandible. After 5 months, half of each implant was harvested and transplanted as an onlay graft to the horizontal ramus of the mandible with simultaneous insertion of a titanium implant. Polychrome fluorescence labeling was done 1, 2, 4, and 8 weeks postoperatively. After 3 months, the vascular system of the animals was filled with BaSO4 for microangiographic examination, and all blocks were retrieved. Results: Fluorescence microscopy showed that there was a significant decrease in deposition of the label in the grafted blocks at 1 week when compared with later labels. After the second week, there were no significant changes. A 20% to 30% decrease in the frequency of fluorochrome staining was noted in the upper third of each block. In this region, microangiography demonstrated highly vascularized tissue and limited bone resorption. Conclusion: It was concluded that cultivation of mandibular bone in a porous matrix under guided bone regeneration is possible and that this autogenous HA-bone composite graft can be transplanted at a later date.