Guided Bone Regeneration Using Cyanoacrylate-Combined Calcium Phosphate in a Dehiscence Defect: A Histologic Study in Dogs Jung-Seok Lee, MD, Seung-Hee.

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Guided Bone Regeneration Using Cyanoacrylate-Combined Calcium Phosphate in a Dehiscence Defect: A Histologic Study in Dogs Jung-Seok Lee, MD, Seung-Hee Ko, MD, Young-Taek Kim, PhD, Ui-Won Jung, PhD, Seong-Ho Choi, PhD Journal of Oral and Maxillofacial Surgery Volume 70, Issue 9, Pages 2070-2079 (September 2012) DOI: 10.1016/j.joms.2012.04.044 Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 1 A, Surgically created, standardized dehiscence defects at the buccal side of the installed implants. B, Each defect was treated with 1 graft material (ie, biphasic calcium phosphate or cyanoacrylate-combined calcium phosphate), with a barrier membrane alone, with a barrier membrane plus biphasic calcium phosphate or cyanoacrylate-combined calcium phosphate, or left untreated (control). Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 2 Illustrations of the A, experimental defect and B, parameters for histometric analysis. Bone regeneration height (BH) is the distance from the base of the defect to the most coronal extension of the newly formed bone along the implant surface. The bone regeneration area (dark yellow) is depicted. Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 3 Representative photomicrographs (original magnification, ×40; Goldner trichrome stain) from A, control, B, biphasic calcium phosphate, and C, cyanoacrylate-combined calcium phosphate sites. A, The control site shows slight but mature bone formation in the defect area, whereas extensive newly formed bone in an immature state is observed in the B, biphasic calcium phosphate and C, cyanoacrylate-combined calcium phosphate sites. B, Especially in the biphasic calcium phosphate site, the surgically created defect line (arrowheads) is distinguished between the mature native bone and the newly formed woven bone, and residual biomaterials (stars) are observed all around the defect area. Residual biomaterials in the upper area of the defect are capsulated with connective tissues. Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 4 Representative photomicrographs (original magnification, ×40; Goldner trichrome stain) from the A, barrier membrane only, B, biphasic calcium phosphate plus barrier membrane, and C, cyanoacrylate-combined calcium phosphate plus barrier membrane sites. A, The barrier membrane site shows partial defect resolution with mature newly formed bone. In contrast, the B, biphasic calcium phosphate plus barrier membrane and C, cyanoacrylate-combined calcium phosphate plus barrier membrane sites show extensive bone formation within the defect and over the top of the implant. C, The cyanoacrylate-combined calcium phosphate plus barrier membrane site shows homogeneous bone formation without residual biomaterials, B, whereas residual biomaterials (stars) appear interspersed in the newly formed woven bone at the biphasic calcium phosphate plus barrier membrane site. Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 5 Higher-magnification photomicrographs (original magnification, ×100) of the outlined areas in Fig 4. B, D, Polarized views of A, C, respectively. A, B, Biphasic calcium phosphate plus barrier membrane site shows a clearly distinguishable defect line (arrowheads) between the newly formed and the native bone, and B, lamellar structures are observed only in the native bone area in a polarized view. A, Some areas show no bone formation around the residual biomaterials (stars). D, The polarized view of the cyanoacrylate-combined calcium phosphate plus barrier membrane site shows lamellar structures in the native and newly formed bone areas. C, The base of the dehiscence defect is displayed (arrow). Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions

Figure 6 Higher-magnification photomicrographs (original magnification, ×200) of the 2 top outlined areas in Fig 4B. A, Newly formed bone is observed contacting the residual biomaterials all around the defect area. B, In some areas, the residual biomaterials are encapsulated by loose connective tissue, within which debris from the biomaterials is scattered extensively. Lee et al. Cyanoacrylate-Calcium phosphate in GBR. J Oral Maxillofac Surg 2012. Journal of Oral and Maxillofacial Surgery 2012 70, 2070-2079DOI: (10.1016/j.joms.2012.04.044) Copyright © 2012 American Association of Oral and Maxillofacial Surgeons Terms and Conditions