الفهرس 
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Abstract
The present study was performed to evaluate the biocompatibility of a new bone filling material ”Tigran” and the healing potentiality of the osseous defects with the use of Porous titanium granules, after periapical surgery.
Animal study:
Twenty male albino rats weighing between 250-300 gm were chosen and classified equally into two main groups. In group (A) rats were examined and sacrificed one week after the operation, while in group (B) they were examined and sacrificed four weeks after the operation.
All Rats were prepared, anesthetized and incised to expose the two femur bones. Bony defects were created in the right and left femur by using a sterile bur with a low speed hand piece, in which the right femur was filled with ”Tigran” and the left one was free from ”Tigran”, Then suturing was done followed by swabbing the operating area using betadine to avoid surface contamination.
Histopathological assessment :
-Assessment of foreign body reaction:
The ”inflammatory cell count” was measured via an image analyser by using slides stained with H&E.
-Bone deposition Assessment :
Contrast between the collagen fibers in the newly formed woven bone and old bone was demonstrated in the defect area by using slides stained with Masson Trichrome stain.
Human study:
Twenty systemically healthy patients were selected and classified into two groups. Group (one), included ten patients who were treated by using ”Tigran” after periapical surgery .While group (two), included ten patients who were treated by periapical surgery without ”Tigran”.
Proper root canal treatment was done for all cases prior to the surgery. Following the aseptic conditions, patient preparation, administration of local anesthesia was done ,followed by choosing adequate flap design, incision, flap elevation and retraction, removal of the buccal bone of the offending tooth if present, excavation, curettage of the bony defect, apicectomy, and implantation of ”Tigran” in the bony defects of group (one) while leaving it ”Tigran-free” in group (two) followed by flap adaptation, repositioning, suturing and post operative patient instructions and medications to avoid infection..
Patients were asked for clinical and radiographic follow up at different time intervals. Seven days, three, six, nine, twelve months after the operation.
Results:
Animal study:
Histopathological assessment :
-Assessment of foreign body reaction:
The quantitative evaluation showed presence of inflammatory cells in relation to the defect area in both samples (Tigran-filled and Tigran-free) through the different time intervals. After one week there was no statistically significant difference between the two groups, while after four weeks ”Tigran filled samples” demonstrated statistically significantly higher mean inflammatory cell counts than ”Tigran-free sample”.
-Bone deposition Assessment :
In the qualitative evaluation after one week postoperatively, ”Tigran-free samples” showed granulation tissue with absence of new bone formation in the defect area, while ”Tigran-filled samples” revealed presence of new bone formation in the defect area, within the marrow cavity integrated with the PTG and covering the outer bony surfaces. Four weeks postoperatively ”Tigran-free samples” showed granulation tissue, scattered minute areas of woven bone bordering the defect but failed to communicate. In the ”Tigran-filled samples” the PTG were seen intermingled with newly formed bone in the defect area and the defect edges.
Human study:
Radiographic evaluation:
In ”Tigran- filled samples” through the whole study periods (7 days to 12 months), there was a statistically significant increase in mean bone density. While in ”Tigran-free samples” there was no statistically significant change in mean bone density through all periods.