Journal of Ear Nose Throat and Head Neck Surgery, vol.31, no.3, pp.145-150, 2023 (Scopus)
Objective: Our aim in this study is to determine if a pretreatment could make bone cement connection stronger and reduce the failure rate. Material and Methods: Twenty-four 6-9 months old female rats were divided into 2 groups as “day 0” and “day 90”. Four different applications were made to the 2x2 cm2 surgical area. Freshly prepared glass ionomer bone cement (GIBC) was applied by removing the periosteum with bipolar in the first ap-plication, by keeping the perichondrium intact in the second application, by removing the periosteum with trichloroacetic acid (TCA) solution in the third application, and by removing the periosteum mechanically in the last application. After these rats were sacrificed on day 0 and day 90, mechanical tests were made to the bone cements and shear strength values were calculated by dividing the maximum measured forces by the apparent contact areas. Results: Although shear forces were higher on day 90 than on day 0 (p=0.007), sub-group analyses revealed that the differences were significant in only the sub-periosteum group (p=0.003). According to the pairwise comparisons, subperiosteal bone cement application yielded significantly higher shear forces on day 90 compared to the others (p<0.003) while the supraperiosteum, TCA, and electrocoagulation groups were similar to each other. Conclusion: GIBC reached its highest shear strength with time after a subperiosteal application. We do not recommend any of the pre-treatments tried in this study over a supra periosteal application before a bone cement ossiculoplasty since no increase in shear strength could be obtained.