Date Published: November 25, 2019
Publisher: Sociedade Brasileira para o Desenvolvimento da Pesquisa em
Author(s): Nihat Laçin, Serhat Bozan İzol, Fikret İpek, Mehmet Cudi Tuncer.
Ganoderma lucidum, a kind of mushroom used for its
antioxidant, anti-inflammatory, and immunomodulatory activities, was
investigated in the present study for its possible healing effect on
calvarial defects with bone grafts.
Wistar male rats (n = 30) were divided into 3 groups: 1) the
control (defect) group (n = 10), 2) defect and graft group
(n = 10), and 3) defect, graft, and G.
lucidum treated group (n = 10). The G.
lucidum was administered to the rats at 20 mL/kg per day via
In the defect and graft group, osteonectin positive expression was observed
in osteoblast and osteocyte cells at the periphery of the small bone
trabeculae within the graft area. In the defect, graft, and G.
lucidum treated group, osteonectin expression was positive in
the osteoblast and osteocyte cells and positive osteonectin expression in
new bone trabeculae. The expression of matrix metalloproteinase-9 (MMP-9)
was positive in the inflammatory cells, fibroblast cells, and degenerated
collagen fibril areas within the defect area.
This study shows that, with its antioxidant and anti-inflammatory properties,
G. Lucidum is an important factor in the treatment of
calvarial bone defects.
Bone defects occur as a result of trauma, ageing, congenital anomalies, neoplasms,
and infectious conditions. The treatment of bone defects may be complicated with the
effect of tissue disadvantages, and recovery may be delayed. Several procedures have
been used to stimulate bone regeneration in osseous defects in the craniofacial
area1. To enhance bone regeneration in bone defects, researchers have studied
different types of therapies, such as autogenous bone grafts, allogeneic banked
bone, demineralized matrix pastes, ceramic scaffolds, synthetic materials2, medicinal herb treatment (such as Salvia
miltiorrhiza)3, platelet-rich plasma application4, and, especially in calvarial bone defects, laser and ozone therapy5,6 and Danshen and Ge Gan herbal extract treatment7.
The investigation was conducted in accordance with the Guide for the Care and
Use of Laboratory Animals published by the US National Institutes of
Health (NIH Publication no. 85-23, revised 1996).
The histopathological and immunohistochemical results of the present study were
evaluated under a light microscope. We compared the histopathological findings in
the control and experimental groups (Table
Bone regeneration in calvarial defects in experimental studies is an important model
in implant application and treatment. Various methods, derivatives, and remedies are
being used for regeneration in bone defects4 and for calvarial bone defects7. It was thought that graft applications could be a suitable model for
determining the bone regenerative effects in comparison with other experimental bone
defects. Regeneration of bone, infiltration of granulation tissue, and remodelling
of osteogenic cells with proliferation and healing occurred herein. In our study,
inflammatory cell infiltration, aggregate-forming cells, and osteoclast cells
increased in the defect area. Our histopathological findings included dilatation of
blood vessels, decreased numbers of osteoblast and osteocyte cells, and degeneration
of connective tissue fibres (Fig. 1a).
Different bone graft materials have been used for bone regeneration, closure of
osteotomy openings, and alveolar augmentation by oral and maxillofacial
surgeons34. In our study, an alloplastic graft material consisting of a combination of
350 to 500μm diameter porous biphasic hydroxyapatite granules and β-tricalcium
phosphate granules was used. In the defect and graft group, there was an increase in
mitotic activity in osteoblast cells around the calvarial bone, a decrease in
osteoclast cells, and a decrease in inflammatory cells between the defect and graft
region. The study found osteoblast cells surrounding the immature new bone
trabeculae in the graft area and osteocyte cells embedded in the lacuna (Fig. 1b).
In experimental studies, a large number of different materials, techniques, and
solutions have been studied for the treatment of calvarial bone defects so far.
Despite the results, there are a few limitations. The expression and effect levels
of osteopontin, osteonectin, and MMP-9 proteins at the cell level were determined in
the graft-induced rats with a calvarial defect model.