Influence of Different Rehydration Protocols on Biomechanical Properties of Allogeneic Cortical Bone Plates: A Combined in-vitro/in-vivo Study

Pabst et al. J Invest Surg 2020 May 22;1-7. Online ahead of print.

This study shows that the biomechanical properties of maxgraft® cortico can be significantly improved by 10 min of rehydration in saline solution, resulting in an increased breaking strength and flexibility.

Allogeneic cortical bone plates (CP) are used for alveolar ridge augmentation. Since CP are freeze-dried and dehydrated during processing, the breaking strength (BS) and the flexibility (FX) are reduced, resulting in a relevant risk for plate fractures during insertion. The aim of this study was to evaluate the influence of rehydration time on the biomechanical properties (BS & FX) of CP in-vitro and in vivo.

Material and Methods: 
40 CP were randomly divided into four experimental groups. (A) untreated control (n = 10), rehydration for 10 (B), 30 (C) and 60 (D) minutes in 0.9% saline solution (n = 10 each). BS [Newton, N] and FX [mm] (force till fracture and distance of deflection to the breaking point) were analyzed. Besides, architectural features of all CP groups were visualized and examined by scanning electron microscopy (SEM). In addition, the frequency of CP fractures of rehydrated- vs. non-rehydrated CP was retrospectively analyzed in 6 patients.

Compared to the control group, significantly increased BS and FX were demonstrated after 10, 30 and 60 minutes of rehydration (p each ≤ 0.035). After a rehydration time of 10 minutes, no additional increase of BS and FX was seen when compared to 30 and 60 minutes (p each = 1.0). SEM scans demonstrated that the CP fracture characteristics were influenced by the different rehydration protocols. The frequency of CP fractures was reduced in patients by CP rehydration.

The biomechanical properties of CP can be significantly improved by 10 min of rehydration, resulting in an increased BS and FX, that might be clinically relevant.

Dr. Andreas Pabst, Dr. Peer Kämmerer

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