| dc.description.abstract | Purpose of the Research: Loss of teeth is commonly associated with a loss of the alveolar bone surrounding the functional tooth, resulting in an undesirably narrow bone ridge for subsequent implant placement. In our quest for alternatives to freeze-dried bovine bone, allografts, alloplasts, or RhBMP-2 we identified the kidney derived growth factor erythropoietin (EPO) as a candidate molecule for alveolar ridge augmentation in combination with suitable scaffolds. Currently, EPO overall safety in patients is established by current approval for Erythropoietin and biosimilars by the US Food and Drug Administration for the treatment of anemia caused by chronic kidney disease, chemotherapy, or use of zidovudine in patients with HIV infection. The aim of the present study is to evaluate the efficacy of erythropoietin’s angiogenic and osteogenic potential compared to two popular ridge preservation techniques; anorganic bovine bone mineral (Bio-Oss®) with non-cross-linked collagen membrane (Bio-Gide®), and collagen membrane alone.
Methods and Materials: Rats underwent bilateral maxillary first molar extraction, and uniform extraction defects were made. Rats were randomly assigned to groups that were to receive an erythropoietin-soaked collagen pellet (Test Group), an anorganic bovine bone group (Bio-Oss® Geistlich Biomaterials) treatment group or no material (Control). Defects were then covered with Bio-Gide collagen membrane and secured with purified cyanoacrylate (Periacryl, Salvin®). The rats were then randomly assigned for sacrifice via CO2 overdose after four or eight weeks. The following analyses were performed; reverse transcriptase polymerase chain reaction (RT-PCR), radiographs, paraffin sections with Masson’s trichrome staining. Ground sections were subjected to Von Kossa staining.
Results: X-ray, and Von-Kossa stain comparison demonstrated comparable bone fill and radiopacity in the extraction sockets of EPO and of anorganic bovine bone treated rats. The extracellular matrix of erythropoietin treated groups appeared to show an organized, sheath-like matrix compared to the control and anorganic bovine bone groups. RT-PCR data showed statistically significant increases in crucial genes for osteoblast regulation, and new blood vessel formation.
Discussion: Our data indicate that EPO acts as a potent factor in combination with a collagen sponge, promoting both new bone and angiogenesis.
Conclusions: Our study suggests that EPO or biosimilars might serve as an alternative to established procedures for alveolar ridge augmentation. | |
