Sari Tuusa

A Review of Two Animal Studies Dealing with Biological Responses to Glass-Fibre-Reinforced Composite Implants in Critical Size Calvarial Bone Defects in Rabbits

In these studies, E-glass-fibre-reinforced composite (FRC) implants with photopolymerisable resin systems and bioactive glass granules (BAG) were evaluated as a reconstructive material in the critical size bone defects made to rabbits’ calvarial bones. In the first study, a new experimental resin system, DD1/MMA/BDDMA, was used to impregnate the doubleveil FRC-implants, while in the second study, a commercial resin system composed of BisGMA/MMA/PMMA was used in impregnation. These double-veil FRC-implants were coated with bioactive glass granules (BAG, 315-500 0m). In the second study, an experimental FRC consisting of two laminates of woven fibres, was also tested as an implant material. These implants were filled with BAG-granules and pure fused quartz fibers (Quartzel wool). In the first study, implantation time was 4 or 12 weeks, while in the second study, it was 12 weeks for both the implant types. Results: In the first study, the healing of the defects had started in the form of new bone growth from the defect margins, as well as small islands of woven bone in the middle of the defect, at 4 weeks postoperatively. Ingrowth of dense connective tissue into the pores of the implant was widely seen. At 12 weeks postoperatively, more bony islands were seen as compared to the animals studied at 4 weeks. Part of the newly formed bone had an appearance of lamellar structure. The porous structures of the implant were deeply filled with fibroconnective tissue. Ingrowth of maturing bone to the implant structures was occasionally seen. The inflammatory reaction was moderate, and was mostly found inside the upper part of the implant. In the second study, inflammatory reactions caused by both types of the FRC implants were very slight. Small amount of new bone had started to grow from the defect margins in doulble-veil implanted defects. No ingrowth of connective tissues or new bone formation was seen inside these implants. Instead, both the connective tissues and newly formed, mineralizing bone were seen inside the experimental double-laminate implants. SiO2-fibres seemed to cause moderate inflammatory reaction inside the implants, while BAG granules did not. In both the study groups, the brain tissue was oedemic, but no obvious serious damage was found. Conclusions: The structural properties of the FRC-implants had an influence on the healing process of the bone defect. BAG, as a constituent of the FRCimplants, enhanced the bone formation process. After some modifications to the properties of the FRC, this type of implant has possibilities to become one material alternative in clinical bone defect reconstruction at the craniofacial area in the future.