Simultaneous inferior alveolar nerve regeneration and osseointegration with a nerve growth factor-supplying implant: a preliminary study

J Oral Maxillofac Surg. 2015 Mar;73(3):410-23. doi: 10.1016/j.joms.2014.07.009. Epub 2014 Jul 18.

Abstract

Purpose: Although nerve growth factor (NGF) has been proved to enhance inferior alveolar nerve (IAN) regeneration, its clinical application remains a challenging issue. This study investigated the functional regeneration of IAN injury by supplying NGF using an NGF-supplying implant and its effect on the osseointegration.

Materials and methods: In canine IAN transection-and-repair models (n = 9), NGF-supplying implants connected to osmotic pumps were installed just above the transection site. In the right IAN, NGF 300 μg in phosphate buffered saline (PBS) 2 mL was loaded in the pump and pure PBS 2 mL was loaded in the left IAN. The gross clinical finding was evaluated by wound healing, inflammation, implant exposure, and loss of fixture. To evaluate IAN regeneration, electrophysiologic (amplitude, latency, conduction velocity, and peak voltage) and histomorphometric (axon count and density, myelin thickness, and ratio of axon diameter to fiber diameter) analyses were performed. Implant stability quotient, bone-to-implant contact ratio, and new bone area were measured to assess the osseointegration of the NGF-supplying implant.

Results: The conduction velocity (2.675 m/second) and peak voltage (1.940 μV) of the NGF group at 6 weeks were considerably higher than those of the PBS group (1.892 m/second and 1.300 μV, respectively). The same results were observed for axon count (NGF vs PBS, 4,576.107 ± 270.413 vs 3,606.972 ± 242.876), axon density (10,707.458 ± 638.835 vs 7,899.781 ± 1,063.625/mm(2)), and myelin thickness (1.670 ± 0.555 vs 1.173 ± 0.388 μm). There were no meaningful differences for the other parameters.

Conclusions: Supplying NGF with specially designed dental implants can be a new therapeutic approach to enable IAN regeneration and osseointegration simultaneously.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials / drug effects
  • Animals
  • Axons / drug effects
  • Dental Implants*
  • Dental Prosthesis Design
  • Dogs
  • Drug Delivery Systems*
  • Infusion Pumps, Implantable
  • Male
  • Mandible / pathology
  • Mandibular Nerve / drug effects*
  • Myelin Sheath / drug effects
  • Nerve Fibers / drug effects
  • Nerve Growth Factor / administration & dosage*
  • Nerve Regeneration / drug effects*
  • Neural Conduction / drug effects
  • Neuritis / drug therapy
  • Osseointegration / drug effects*
  • Osteogenesis / drug effects
  • Reaction Time / drug effects
  • Time Factors
  • Trigeminal Nerve Injuries / drug therapy
  • Wound Healing / drug effects

Substances

  • Dental Implants
  • Nerve Growth Factor