J Periodontal Implant Sci.  2019 Feb;49(1):2-13. 10.5051/jpis.2019.49.1.2.

Adjunctive hyperbaric oxygen therapy for irradiated rat calvarial defects

Affiliations
  • 1Department of Prosthodontics, Yonsei University College of Dentistry, Seoul, Korea.
  • 2Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea. kst72@snu.ac.kr
  • 3Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.
  • 4Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Korea.
  • 5Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea.

Abstract

PURPOSE
The aim of this study was to conduct a histologic evaluation of irradiated calvarial defects in rats 4 weeks after applying fibroblast growth factor-2 (FGF-2) with hyaluronan or biphasic calcium phosphate (BCP) block in the presence or absence of adjunctive hyperbaric oxygen (HBO) therapy.
METHODS
Twenty rats were divided into HBO and non-HBO (NHBO) groups, each of which was divided into FGF-2 and BCP-block subgroups according to the grafted material. Localized radiation with a single 12-Gy dose was applied to the calvaria of rats to simulate radiotherapy. Four weeks after applying this radiation, 2 symmetrical circular defects with a diameter of 6 mm were created in the parietal bones of each animal. The right-side defect was filled with the materials mentioned above and the left-side defect was not filled (as a control). All defects were covered with a resorbable barrier membrane. During 4 weeks of healing, 1 hour of HBO therapy was applied to the rats in the HBO groups 5 times a week. The rats were then killed, and the calvarial specimens were harvested for radiographic and histologic analyses.
RESULTS
New bone formation was greatest in the FGF-2 subgroup, and improvement was not found in the BCP subgroup. HBO seemed to have a minimal effect on new bone formation. There was tendency for more angiogenesis in the HBO groups than the NHBO groups, but the group with HBO and FGF-2 did not show significantly better outcomes than the HBO-only group or the NHBO group with FGF-2.
CONCLUSIONS
HBO exerted beneficial effects on angiogenesis in calvarial defects of irradiated rats over a 4-week healing period, but it appeared to have minimal effects on bone regeneration. FGF-2 seemed to enhance new bone formation and angiogenesis, but its efficacy appeared to be reduced when HBO was applied.

Keyword

Biphasic calcium phosphate; Fibroblast growth factor-2; Hyperbaric oxygen therapy; Radiotherapy

MeSH Terms

Animals
Bone Regeneration
Calcium
Fibroblast Growth Factor 2
Hyaluronic Acid
Hyperbaric Oxygenation*
Membranes
Osteogenesis
Oxygen
Parietal Bone
Radiotherapy
Rats*
Skull
Transplants
Calcium
Fibroblast Growth Factor 2
Hyaluronic Acid
Oxygen

Figure

  • Figure 1 Method of measuring new bone area (A) and length (B) (hematoxylin and eosin).

  • Figure 2 Method of counting blood vessels (diaminobenzidine) – arrowheads.

  • Figure 3 Micro-computed tomography images. (A) NHBO-control group, (B) NHBO-BCP group, (C) NHBO-FGF-2 group, (D) HBO-control group, (E) HBO-BCP group, (F) HBO-FGF-2 group. NHBO: without adjunctive hyperbaric oxygen treatment, BCP: biphasic calcium phosphate, FGF-2: fibroblast growth factor-2, HBO: adjunctive hyperbaric oxygen treatment.

  • Figure 4 Histological images (hematoxylin and eosin). (A) NHBO-control group, (B) HBO-control group, (C) NHBO-BCP group, (D) HBO-BCP group, (E) NHBO-FGF-2 group, (F) HBO-FGF-2 group. NHBO: without adjunctive hyperbaric oxygen treatment, HBO: adjunctive hyperbaric oxygen treatment, BCP: biphasic calcium phosphate, FGF-2: fibroblast growth factor-2.

  • Figure 5 Histological images (hematoxylin and eosin). (A) NHBO-control group, (B) HBO-control group, (C) NHBO-BCP group, (D) HBO-BCP group, (E) NHBO-FGF-2 group, (F) HBO-FGF-2 group. NHBO: without adjunctive hyperbaric oxygen treatment, HBO: adjunctive hyperbaric oxygen treatment, BCP: biphasic calcium phosphate, FGF-2: fibroblast growth factor-2.


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