The investigation of effectiveness of systemic teriparatide administration on guided bone regeneration

Aim: In the study, we aimed to search the efficacy of hydroxyapatide beta tricalcium phosphate (HA/βTCP) and osteoanabolic effective teriparatide together with titanium barrier on guided bone regeneration. Method: In this research 24 adult male New Zealand rabbit were used. The study included four groups, one of which was a control group. Two barriers were placed to the skulls of rabbits, each on the right and left parietal bone. In the research, a bleeding area was constituted by decortications and HA/βTCP (Straumann® Bone Ceramic) as a synthetic graft material was used under titanium barriers placed to the left side. As for the right side, no material was placed under titanium barriers but a bleeding area was constituted by decortication. Half of the animals were applied 10 µg/kg teriparatide (Forsteo) in subcutaneous dorsal region 3 times in a week. Medicine application was conducted from the date of operation until the day of sacrification. Half of the animals were sacrificed after one month; the other half was sacrificed after three months. Results: Histomorphometric values in terms of the amount of new bone formation were found to be higher in graft under barrier groups at the third month than at the first month (p<0.05). There was statistically significant difference in between control group and other three groups at first and third months (p<0.05). Also there was statistically significant difference in between graft+teriparatide group and other three groups at third month (p<0.01). When the new bone percentages were compared between the first and third months, the increase in the new bone percentages at the third month was observed to be statistically significant in all groups (p< 0.05). There was statistically significant difference in between control group and other groups at first and third months (p<0.05). Also the increase in the new bone percentage at the third month was found to be statistically significant between graft+teriparatide and teriparatide groups (p<0.05). Conclusions: When the accession of fibrous structure into titanium barriers is inhibited and a roof is constituted, new bone formation out of skeletal borders could be obtained even by only with decortication. It is understood that HA/βTCP graft material used with titanium barriers and teriparatide promotes new bone formation.