Effects of calcium phosphate ceramic bone graft materials on permanent teeth eruption in beagles

Objective: The aim of this study was to evaluate the use of calcium phosphate ceramic (CPC) materials as a potential alternative to autogenous secondary alveolar bone grafting in cleft lip and palate patients who are in mixed dentition. Sample: Four 12-week-old beagles and one 15-week-old beagle were used as subjects. Interventions: In each experimental beagle, the third and fourth deciduous premolars were extracted. The sockets were filled with four different CPC materials and sutured. Main Outcome Measure: The beagles were fed a soft diet for the following 8 weeks and then sacrificed for clinical, radiological, histological, transmission electron microscope (TEM), and infrared (IR) absorption analysis. Results: All four experimental graft materials allowed normal development and eruption of permanent premolars. In histological sections, small particles of biphasic calcium phosphate (BCP) and carbonate apatite (CO₃-AP) were resorbed, and large particulate forms served as bone frames in cortical bones. Polymer coated with carbonate apatite (Poly/CO₃-AP) did not cause inflammation but was pushed away to the soft tissue by erupting teeth. Alginate coated with carbonate apatite (alginate/CO₃-AP) caused a severe inflammatory reaction to the point of destroying a part of the dental follicle and cortical bone. In TEM, resorption activity by phagocytic cells was observed only in CO₃-AP. Direct bonding of CO₃-AP to the bone was observed as the electron-dense interface between bone and CO₃-AP. Conclusion: BCP and CO₃-AP proved to be suitable as alveolar bone graft materials in areas where tooth eruption occurs. Of the four materials tested, CO₃-AP produced the best results.