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Effect of chitosan on bone restoration in nasal bone defect: An experimental study




The aim of this work was to study the effect of chitosan in restoration of bone defect (an experimental study).

Materials and methods

The study included 54 male guinea pigs. Nasal bone defect was done. The experimental animals were divided into a control group (group A), calcium sulfate group (group B), and chitosan-coated calcium sulfate group (group C). Three-dimensional computed tomography and histological examination were carried out at intervals of 1, 2, and 3 months for measuring the change in the size of the bone defect and confirmation of bone formation, respectively.


The decrease in the size of the bone defect was significant in group C than in groups A and B. Also, histological results showed formation of woven bone after 1 month in groups B and C and formation of lamellar bone in group C in the second month, whereas the lamellar bone was formed in group B in the third month.


Radiological and histological studies showed that the new bone formation on defected nasal bone was more in group C. These findings suggest that chitosan is very effective in early bone formation.


  1. 1

    Kim I-S, Park JW, Kwon IC, Baik BS, Cho BC. Role of BMP, αig-h3, and chitosan in early bony consolidation in distraction osteogenesis in a dog model. Plast Reconstr Surg 2002; 109: 1966–1977.

    Article  Google Scholar 

  2. 2

    Turner TM, Urban RM, Gitelis S, Kuo KN, Andersson GBJ. Radiographic and histologic assessment of calcium sulfate in experimental animal models and clinical use as a resorbable bone-graft substitute, a bone-graft expander, and a method for local antibiotic delivery. One institution’s experience. J Bone Joint Surg A 2001; 83: 8–18.

    Article  Google Scholar 

  3. 3

    Alexander DI, Manson NA, Mitchell MJ. Efficacy of calcium sulfate plus decompression bone in lumbar and lumbosacral spinal fusion: preliminary results in 40 patients. Can J Surg 2001; 44: 262–266.

    PubMed  PubMed Central  CAS  Google Scholar 

  4. 4

    Cui X, Zhang B, Wang Y, Gao Y. Effects of chitosan-coated pressed calcium sulfate pellet combined with recombinant human bone morphogenetic protein 2 on restoration of segmental bone defect. J Craniofacial Surg 2008; 19: 459–465.

    Article  Google Scholar 

  5. 5

    Kind GM, Bines SD, Staren ED, Templeton AJ, Economou SG. Chitosan: evaluation of a new hemostatic agent. Curr Surg 1990; 47: 37–39.

    PubMed  CAS  Google Scholar 

  6. 6

    Hauschks PV. In: Hall BK, (editor). Growth factor effect in bone. Bone. London: CRC Press; 1990. 103–113.

    Google Scholar 

  7. 7

    Cunningham NS, Paralkar V, Reddi AH. Osteogenin and recombinant bone morphogenetic protein 2B are chemotactic for human monocytes and stimulate transforming growth factor α1 mRNA expression. Proc Natl Acad Sci USA 1992; 89: 11740–11744.

    Article  CAS  Google Scholar 

  8. 8

    Muzzarelli RAA, Mattioli-Belmonte M, Tietz C, Biagini R, Ferioli G, Brunelli MA, et al. Stimulatory effect on bone formation exerted by a modified chitosan. Biomaterials 1994; 15: 1075–1081.

    Article  CAS  Google Scholar 

  9. 9

    Klokkevold PR, Vandemark L, Kenney EB, Bernard GW. Osteogenesis enhanced by chitosan (poly-N-acetyl glucosaminoglycan) in vitro. J Periodontol 1996; 67: 1170–1175.

    Article  CAS  Google Scholar 

  10. 10

    Heppenstall, RB, Fracture healing, in fracture treatment and healing (R. B. Heppenstall, ed.) WB. Saunders, company, Philadelphia, 1980;97–112.

  11. 11

    Buck BE, Malinin TI, Brown MD. Bone transplantation and human immunodeficiency virus: an estimate of risk of acquired immunodeficiency syndrome (AIDS). Clin Orthop Relat Res 1989; 240:129–136.

    Google Scholar 

  12. 12

    Binderman I, Fin N. In: T Yamamuro, L Hench, J Wilson (editors). Bone substitutes — organic, inorganic and polymeric; cell material interactions. CRC handbook of bioactive ceramics. Boca Raton: CRC Press; 1990. 45–51.

    Google Scholar 

  13. 13

    Ripamonti U. In: T Yamamuro, LL Hench, J Wilson (editors). Inductive bone matrix and porous hydroxyapatite composites in rodents and non-human primates. CRC handbook of bioactive ceramics. Boca Raton: CRC Press; 1990. 245–253.

    Google Scholar 

  14. 14

    Damien CJ, Parsons JR. Bone graft and bone graft substitutes: a review of current technology and applications. J Appl Biomater 1991; 2:187–208.

    Article  CAS  Google Scholar 

  15. 15

    Ricci JL, Blumenthal NC, Spivak JM, Alexander H. Evaluation of a low-temperature calcium phosphate particulate implant material: physical-chemical properties and in vivo bone response. J Oral Maxillofac Surg 1992; 50:969–978.

    Article  CAS  Google Scholar 

  16. 16

    De Groot, K. In: DF Williams, (editor). Degradable ceramics. Biocompatibility of clinical implants materials, vol. I. Boca Raton, FL: CRC Press; 1981. 19:9–224.

    Google Scholar 

  17. 17

    Peltier LF, Jones RH. Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. J Bone Joint Surg A 1978; 60A:820–822.

    Article  Google Scholar 

  18. 18

    Tay Vikas BKB, Patel V, Bradford DS. Calcium sulfate- and calcium phosphate-based bone substitutes mimicry of the mineral phase of bone. Orthop Clin North Am 1999; 30:615–623.

    Article  Google Scholar 

  19. 19

    Cho BC, Park JW, Baik BS, Kim IS. Clinical application of injectable calcium sulfate on early bony consolidation in distraction osteogenesis for the treatment of craniofacial microsomia. J Craniofacial Surg 2002; 13:465–475.

    Article  Google Scholar 

  20. 20

    Amano K, Ito E. The action of lysozyme on partially deacetylated chitin. Eur J Biochem 1978; 85:97–104.

    Article  CAS  Google Scholar 

  21. 21

    Pangburn SH, Trescony PV, Heller J. Lysozyme degradation of partially deacetylated chitin, its films and hydrogels. Biomaterials 1982; 3:105–108.

    Article  CAS  Google Scholar 

  22. 22

    Shigemasa Y, Saito K, Sashiwa H, Saimoto H. Enzymatic degradation of chitins and partially deacetylated chitins. Int J Biol Macromol 1994; 16:43–49.

    Article  CAS  Google Scholar 

  23. 23

    Malette WG, Quigley HJ, Adickes ED. Chitosan effect in nature and technology. New York: Plenum Press; 1986; 435–457.

    Google Scholar 

  24. 24

    Canter HI, Vargel I, Korkusuz P, Oner F, Gungorduk DB, Cil B, et al. Effect of use of slow release of bone morphogenetic protein-2 and transforming growth factor-beta-2 in a chitosan gel matrix on cranial bone graft survival in experimental cranial critical size defect model. Ann Plast Surg 2010; 64:342–350.

    Article  CAS  Google Scholar 

  25. 25

    Rao SB, Sharma CP. Use of chitosan as a biomaterial: studies on its safety and hemostatic potential. J Biomed Mater Res 1997; 34:21–28.

    Article  CAS  Google Scholar 

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Corresponding author

Correspondence to Yasser M. Haroon MD.

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Conflicts of interest

None declared.

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Elsisy, M., Elhamshary, A., Haroon, Y.M. et al. Effect of chitosan on bone restoration in nasal bone defect: An experimental study. Egypt J Otolaryngol 30, 94–101 (2014).

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  • bone formation
  • chitosan
  • guinea pigs