Combined Use of Hyaluronic Acid with Nano-bioactive Glass Enhanced BiocementBased Silicate Stimulated Bone Regenerative Capacity in Tibial Bone Defects of Rabbits: In-Vivo Study

Background: An ideal biomaterial for bone regeneration is a longstanding quest nowadays. Thisstudy aimed to evaluate the osteogenic potentiality of nano-bioactive glass (NanoBG) enhanced biocement based silicate with or without hyaluronic acid(HA) seeded in rabbits' tibial bone defects. Methodology: 24 male rabbits were divided into three equal groups. All rabbit's tibia had two defects 5mm in diameter (1 defect per tibia). Group 1(control): bone defects were left untreated. Group 2: defects received nanoBG enhanced biocement based silicate cement. Group 3: defects received NanoBG cement mixed with HA. Animals in each group were divided equally for euthanization after 3 weeks and after 6 weeks. At each duration, the bone specimens were processed and examined histologically with histomorphometrically analysis of new bone area percentage. Results: Thebone defects in group 3 showed significant improved osseous healing as compared to group 1&2 along the two durations. Upon long duration healing, the histological examination of the bone defects of group 3 showed almost filled defects with mature compact bone, however both groups 1&2 revealed less mature bone with more bone marrow spaces inbetween. The morphometric analysis revealed a significant increase in the new bone area percentage in group 3 in comparison to group 1 and 2 (P < 0.05). Conclusions: The present study concluded that bone defects and fractures could be treated with NanoBG and HA cement. Nano BG alone was capable of bone regeneration. Yet, the regenerative capacity of their combination was more significant.