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Oneida A. Arosarena, MD; Wesley L. Collins

Arch Otolaryngol Head Neck Surg. 2003;129:1125-1130.

Objective  To compare the osteogenic abilities of 2 growth factors (bone morphogenic protein 5 [BMP-5] and prostaglandin E₁ [PGE₁]) and 2 carriers (collagen/polylactic acid [PLA] and collagen/calcium hydroxyapatite cement [HAC]) in the repair of a rat mandibular body defect.

Design  Prospective controlled trial.

Subjects  Twenty-nine Sprague-Dawley rats.

Interventions  Critical size defects were created in the bilateral mandibular bodies of the rats. Each hemimandible was assigned to an experimental group. The defects were filled with PLA (group 1), PLA with BMP-5 (group 2), PLA with PGE₁ (group 3), HAC (group 4), HAC with BMP-5 (group 5), or HAC with PGE₁ (group 6). The control group (group 7) had unfilled defects. The animals were killed after 12 weeks, and the nondemineralized specimens were processed histologically. Stereologic techniques were used to determine the volume fractions of new bone, osteoid, marrow, remaining implant, and fibrous tissue in each defect.

Results  The HAC/BMP-5 group (group 5) contained significantly more new bone than the PLA/BMP-5 group (group 2) (P = .02), the HAC and HAC/PGE₁ groups (groups 4 and 6) (P = .002), and the control group (group 7) (P<.01). The HAC/BMP-5 group also had less fibrous tissue than the HAC group and the HAC/PGE₁ group (P<.001). Groups 5 and 6 had less fibrous tissue than group 7 (P<.01). The groups containing PGE₁ demonstrated significantly more osteoid development than the other experimental groups (P<.001).

Conclusions  Inclusion of BMP-5 in an implant with calcium hydroxyapatite cement resulted in the formation of significantly larger fractions of new bone and less fibrous tissue ingrowth than occurred in the other experimental groups. The presence of PGE₁ resulted in larger amounts of osteoid deposition, suggesting the potential for delayed bone healing.

From the Division of Otolaryngology, Department of Surgery, University of Kentucky Medical Center, Lexington. The authors have no relevant financial interest in this article.

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