Hormônio do crescimento no processo de osseointegração de implantes de titânio: estudo experimental e revisão de literatura

Abstract

In order to accelerate and improve the quality of the osseointegration process has recently been given emphasis to growth factors. Thus, this thesis was aimed to evaluate the use of growth hormone (GH) on osseointegration of titanium implants. This thesis is composed of two papers, the first chapter is a review of literature on the use of growth factors, and, in particular GH in the process of bone repair. The second chapter is an experimental study to evaluate the topical use of rhGH in the osseointegration of nanotexturized titanium implants inserted in the tibia of rabbits. We used 14 animals randomly divided into rhGH-treated group and control group. In the rhGH-treated group was administered 1 IU of rhGH in surgical defect immediately before the placement of each implant. In the control group was not used rhGH. Each animal received two implants in the left tibia. The animals were sacrificed at 14 and 42 days after surgery. The peri-implant regions were avaluated by transmission and reflection on optical microscopy (OM), to pull out biomechanical testing of implants and scanning electron microscopy (SEM). In all analyzes the rhGH-treated groups showed better performance than the control groups, especially at 14 days. MO at 14 days in the rhGH-treated group have histological characteristics of proliferative repair phase with new bone formation and also marked cortical reaction from the endosteum and periosteum and at 42 days, the bone tissue has a lamellar appearance. The control group at 14 days also has characteristics of the inflammatory and moderate proliferative new bone formation, and with 42 days the new bone does not have lamellar characteristics. In the pull-out testing of the rhGH-treated group showed tension of 59.26N/cm2 and 29.69 N/cm2 at 14 and 42 days respectively. The control group showed tension of 33.88 N/cm2 and 25.99 N/cm2 respectively. The implants analyzed in the SEM showed in the rhGH-treated group at 14 days greater amount of bone attached, but at 42 days there were no differences between groups. The findings in this experiment corroborate the literature, which observed that rhGH increases the speed and amount of newly peri-implanted bone, especially in the early stages of bone repair. Thus, this thesis concludes that topical application of rhGH in the region peri-implant area induces new bone formation.