Butyl-cyanoacrylate Adhesives for Fixation of Autologous Bone Graft. Study in Rabbits

Butyl-cyanoacrylate adhesives for fixation of autologous bone graft. Study in rabbits.

            In oral and maxillofacial surgery the autografts ("gold standard"), are the most widely used materials for the reconstruction of the cranio-maxillo-facial skeleton, since they have no immune response, besides having three properties: osteogenic, osteoconductive and osteoinductive favoring a faster integration of the graft to the bed in relation to other types of grafts and alloplastic materials.

            Therefore, the graft fixation technique currently used are plates and screws, this method allows proper positioning and dimensional stability of bone grafts, as well as providing excellent clinical predictability. However, the internal fixation of bone grafts by this method has some disadvantages that are related to various complications such as, for example, inserting screws in places of difficult access and extrusion of them. In some cases are necessary a second surgical procedure to remove the plates and screws. Furthermore, these materials interfere with radiotherapy, computed tomography and magnetic resonance imaging and can cause allergies and hypersensitivity to cold.

            This study compared the fixation of autologous bone graft with titanium screw and adhesives based on butyl cyanoacrylate, Tissuacyl and Histacryl. Twenty adult rabbits had three ostectomies in parietal bones of each animal, using a trephine. In group I, the bone graft was fixed with 1.5 mm x 4 mm screw (Synthes, Switzerland), in group II, the bone graft was fixed with surgical glue Tissuacryl ® (biomaterials Center of the University of Havana, Cuba) and group III, the graft was fixed with Histoacryl ® (B. Braun, Germany). The animals were sacrificed at 7, 15, 30, 60 and 120 days postoperatively. Histological analysis to compare the biocompatibility of the adhesive, and histomorphometric analysis to quantify the maintenance area of the grafts were performed. Inflammatory reaction was observed in all groups during the period of 7 days and declined steadily over the subsequent periods in groups II and III. At 15 days, group I showed no inflammatory reaction. At 30 days, there was new bone formation in group I and 60 days in groups II and III. After 120 days, the grafts were completely incorporated in group I and partially in a specimen from group II and group III two specimens. In this study the butyl-cyanoacrylate adhesives (Histoacryl and Tissuacryl), were compatible when in contact with bone structures. Until the last proposed period of analysis, the adhesives were effective in fixing bone grafts, but further studies are needed to evaluate their behavior in a longer postoperative period.

References

1 - Saska, S, E. Hochuli-Vieira, A. Minarelli Gaspar, M. Gabrielli, M. Capela, M.Gabrielli. Fixation of autogenous bone graft with ethyl-cyanoacrylate glue or titanium screws in the calvaria of rabbits. International journal of Oral and Maxillofacial surgery 2009; 38: 180-6.

2 - Pérez, M.C., Fernández I, Márquez D, Guerra R.M. “Use of n-butyl cyanoacrylate in oral surgery. Biological and clinical evaluation”, Artificial Organs, 2000; 24(3): 241-3