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

• An H
• Lee JT
• Oh SE
• Park KM
• Hu KS
• Kim S
• Chung MK

• KMID: 2440173
• DOI: http://doi.org/10.5051/jpis.2019.49.1.2

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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