Comparative Micro-CT evaluation of Ankaferd Blood Stopper, xenogeneic grafts, and their combination in bone healing: An experimental study

Abstract

Background Augmentation of bone resorbed by trauma, infection, systemic or local causes is one of the most difficult tasks of modern surgery. Many academicians conduct research on the successful repair of bone defects in line with the opportuni ties provided by the developing technology. In the reconstruction of bone defects, more successful results have been tried to be obtained by using many synthetic and natural biomaterials in combination with grafts as well as bone graft materials. This study aimed to evaluate the effects of combining Ankaferd Blood Stopper (ABS) with xenogeneic bone grafts on bone regeneration in critical-sized calvarial defects, using micro-computed tomography (micro-CT) for quantitative analysis. Methods Forty Sprague Dawley rats were assigned to four groups: (1) Control, (2) ABS application, (3) xenogeneic graft, and (4) combined ABS and graft. Bilateral 5-mm calvarial defects were created in each rat. Animals were euthanized on days 7 and 28 post-operation. Bone healing was assessed using micro-CT to measure bone mineral density (BMD), bone volume (BV), bone volume fraction (BV/TV), bone surface (BS), and bone surface-to-bone volume ratio (BS/BV). Results On day 7, the graft-only group exhibited higher increases in BV and BS compared to the ABS and combined groups. ABS alone showed modest improvements without statistical significance. By day 28, BMD increased only in the ABS group, while BV and BS remained higher in the graft-only group. The combination of ABS with graft did not enhance bone regen eration beyond graft application alone. Conclusion ABS demonstrated limited benefits in early bone healing, likely due to its anti-inflammatory properties. How ever, its combination with xenogeneic grafts did not improve long-term bone regeneration compared to grafts alone. Further studies incorporating histological analyses are recommended to elucidate the regenerative potential of ABS.