Bone Formation Potential of Pomegranate Peel Extract when Used With ImplantableBbone Substitutes: An Animal Study

Abstract

Pomegranate fruit and its components have been used in Ayurveda for a long time in India in the treatment of osteoporosis. A combination of Calcium sulphate, Titanium dioxide and Pomegranate fruit peel extract has not been tried in the treatment of bony defects. The objective of the study was to compare the bone augmentation potential of two bone substitute materials viz. 1. Calcium sulphate -Titanium dioxide nanocomposite 2. Pomegranate peel extract mediated Calcium sulphate -Titanium dioxide nanocomposite. Twelve rabbits were selected of which six served as controls and the other six as experimental. Titanium dioxide-calcium sulphate nanocomposite was implanted in the control group and Pomegranate peel extract mediated Calcium sulphate- Titanium dioxide- nanocomposite was implanted in the experimental group. Hematologic and Alkaline phosphatase evaluation was done at 0,2,4 and 12^th week. At the end of 4^th week, three control and three experimental groups of animals were euthanised and bone specimens were collected for histologic observations. In the 12^th week, the remaining rabbits were euthanised and specimens were obtained. Osteoblasts and Osteocytes were counted at the 4^th and 12^th week. The results were statistically analysed. Blood cell counts and Haemoglobin levels showed changes at the selected time intervals. Alkaline phosphatase level responded significantly in the experimental group which can be attributed to the bone augmentation potential of pomegranate peel extract. The mean osteoblast cell count in the 4^th week of observation was 55 ± 10.49% for the control group and 89.50 ± 8.29% for the experimental group. In the 12^th week, the osteoblast cell count was 6.67±2.58% for the control group and 11.67±2.58 % for the experimental group. The study concluded that Pomegranate peel extract has a definite stimulatory effect on osteoblasts and enhances bone formation when implanted along with Calcium Sulphate-Titanium dioxide nanocomposite. Assessment of serum Alkaline Phosphatase can be used as a bone turnover marker and can be used to evaluate the bone stimulatory and formation potential of implanted materials when they are newly introduced. Osteoblast cell count observed at different time intervals of the experiment validates the bone formation potential assessed through the determination of ALP levels.