J Periodontal Implant Sci.  2022 Aug;52(4):312-324. 10.5051/jpis.2104700235.

The effect of hard-type crosslinked hyaluronic acid with particulate bone substitute on bone regeneration: positive or negative?

Affiliations
  • 1Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
  • 2One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Korea

Abstract

Purpose
The role of hard-type crosslinked hyaluronic acid (HA) with particulate bone substitutes in bone regeneration for combined inlay-onlay grafts has not been fully investigated. We aimed to evaluate the effect of hard-type crosslinked HA used with bone substitute in terms of new bone formation and space maintenance.
Methods
A 15-mm-diameter round defect was formed in the calvaria of 30 New Zealand White rabbits. All animals were randomly assigned to 1 of 3 groups: the control group (spontaneous healing without material, n=10), the biphasic calcium phosphate (BCP) graft group (BCP, n=10), and the BCP graft with HA group (BCP/HA, n=10). The animals were evaluated 4 and 12 weeks after surgery. Half of the animals from each group were sacrificed at 4 and 12 weeks after surgery. Samples were evaluated using micro-computed tomography, histology, and histomorphometry.
Results
The BCP group showed higher bone volume/tissue volume (BV/TV) values than the control and BCP/HA groups at both 4 and 12 weeks. The BCP and BCP/HA groups showed higher bone surface/tissue volume (BS/TV) values than the control group at both 4 and 12 weeks. The BCP group showed higher BS/TV values than the control and BCP/HA groups at both 4 and 12 weeks. No statistically significant difference in newly formed bone was found among the 3 groups at 4 weeks. The BCP group showed significantly higher new bone formation than the BCP/HA group at 12 weeks.
Conclusions
Hard-type crosslinked HA did not show a positive effect on new bone formation and space maintenance. The negative effect of hard-type crosslinked HA may be due to the physical properties of HA that impede osteogenic potential.

Keyword

Bone regeneration; Bone substitute; Hyaluronic acid; Osteogenesisv
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