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Histological Evaluation of Bone Repair with Hydroxyapatite: A Systematic Review

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Abstract

The aim of this study was to evaluate the morphological bone response in animal experiments by applying hydroxyapatite grafts in critical and non-critical size bone defects. Current report followed the guidelines established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Animal experiments were selected by assessing repair of bone defects with hydroxyapatite as bone graft and with blood clot only as control. Eight articles were identified in specialized literature and included in the meta-analysis. Statistical analysis was carried out with a random-effect model (p = 0.05). Subgroup analyses were further performed to investigate bone repair in critical and non-critical bone defects. Comprehensive analysis of bone repair outcome showed a statistically significant difference between hydroxyapatite and blood clot control (p < 0.05). Subgroup analyses showed statistically significant difference for critical bone defects (p < 0.05). No statistically significant difference was reported in non-critical bone defects (p > 0.05). Although animal studies revealed a high risk of bias and results should be interpreted with caution, the literature suggests that non-critical bone defects may heal spontaneously and without the need of a bone graft. Conversely, when critical-size defects are present, the use of hydroxyapatite bone graft improves the bone repair process.

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Acknowledgements

CECS wants to thank PRODEP/México for the scholarship.

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Authors and Affiliations

  1. Biomaterials Development and Control Center, School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457. Centro, Pelotas, RS, CEP: 96015‐560, Brazil

    Héllen L. Oliveira, Wellington L. O. Da Rosa, Carlos E. Cuevas-Suárez, Adriana F. da Silva & Evandro Piva

  2. Graduate Program Science and Materials Engineering, Technology Development Center, Federal University of Pelotas, Rua R. Gomes Carneiro, 1. Centro, Pelotas, RS, CEP: 96010-610, Brazil

    Neftali L. V. Carreño

  3. Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of the State of Hidalgo, Circuito Ex Hacienda La Concepción S/N Carretera Pachuca Actopan, C.P. 42160, San Agustín Tlaxiaca, Hidalgo, Mexico

    Carlos E. Cuevas-Suárez

  4. Veterinary Clinic Hospital, Veterinary School, Federal University of Pelotas, Avenida Eliseu Maciel S/N-Jardim América, Capão do Leão, RS, CEP: 96010-610, Brazil

    Thomas N. Guim

  5. Technology Development Center, Postgraduate Program in Biotechnology, Federal University of Pelotas, Campus Universitário, s/n. Campus Capão do Leão, Capão do Leão, RS, CEP: 96010-610, Brazil

    Odir A. Dellagostin

  6. Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves 457, Pelotas, RS, ZIP 96020630, Brazil

    Evandro Piva

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Contributions

HLO, WLOR and EP designed the study. HLO and CECS prepared the first draft of the paper. NLVC, AFS, TNG and OAD contributed to the experimental work. WLOR was responsible for statistical analysis of the data. HLO, CECS, WLOR and EP prepared the final draft of the manuscript. All authors revised the paper critically for intellectual content and approved the final version. All authors agree to be accountable for the work and to ensure that any questions relating to the accuracy and integrity of the paper are investigated and properly resolved.

Funding

This study was financed by Coordination for the Improvement of Higher Education Personnel, CAPES/MEC-Brazil.

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Correspondence to Evandro Piva.

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Authors Héllen L. Oliveira, Wellington L. O. Rosa, Carlos E. Cuevas-Suárez, Neftali L. V. Carreño, Adriana F. Silva, Thomas N. Guim, Odir A. Dellagostin and Evandro Piva declare that they have no conflict of interest.

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Oliveira, H.L., Da Rosa, W.L.O., Cuevas-Suárez, C.E. et al. Histological Evaluation of Bone Repair with Hydroxyapatite: A Systematic Review. Calcif Tissue Int 101, 341–354 (2017). https://doi.org/10.1007/s00223-017-0294-z

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