A clinico-radiographic and histomorphometric analysis of alveolar ridge preservation using calcium phosphosilicate, PRF, and collagen plug

Background

Tooth extraction commonly leads to loss of residual alveolar ridge, thus compromising the room available for the implant placement. To combat the post-extraction alveolar loss, alveolar ridge preservation is practiced, with the advent of the biomaterial available. The purpose of this study was to assess the efficiency of calcium phosphosilicate biomaterial in alveolar ridge preservation. Twenty patients indicated for extraction were selected followed by socket grafting using calcium phosphosilicate. Implant placement was done 6 months postoperatively during which a core was harvested from the preserved sockets. Clinico-radiographic measurements of hard and soft tissues were taken at baseline and 6 months post-grafting.

Results

There were no significant changes in the radiographic and soft tissue parameters while significant changes in hard tissue parameters with 1.9 mm (p = 0.013) gain in mid-buccal aspect and 1.1 mm (p = 0.019) loss in horizontal bone width were observed. The histomorphometric evaluation depicted the vital bone volume of 54.5 ± 16.76%, non-mineralized tissue 43.50 ± 15.80%, and residual material 2.00 ± 3.37%.

Conclusion

The implants placed in these preserved ridges presented 100% success rate with acceptable stability after a 1-year follow-up, concluding calcium phosphosilicate is a predictable biomaterial in alveolar ridge preservation.

A randomized controlled clinical trial to evaluate a new xenograft for alveolar socket preservation

OBJECTIVE

The aim of this clinical trial was to compare the effect of Bio-Oss(®) and a new bovine xenograft (Osseus(®) ) in alveolar sockets after a 24-week healing period.

MATERIALS AND METHODS

A total of 20 adult volunteers ages 30-60 were subjected to single tooth extraction. A tooth extraction was performed at the baseline. All sites were randomly allocated to two test groups (TG1: grafted using a new bovine xenograft, Osseus(®) , and TG2: grafted using commercially available bovine xenograft-Bio-Oss(®) ). Six months later, a sample of the grafted area was obtained and implants were inserted in the same site. Histological sections were examined focusing on the presence of fibrous connective tissue (CT), and newly formed bone in direct contact with the graft. The HE-stained sections were subjected to histomorphometrical evaluation using Image Pro-Plus(®) software (Release 7.0). The definitive crown was placed 3 months later.

RESULTS

Upon completion of the study, no patients were removed from the study and all inserted implants (10 in each group) were eventually integrated. After 6 months, in the TG1, the mean value of new bone formation was 33.7 (± 7.1), for CT was 32.3 (± 8.9) and for the remaining biomaterial was 10.7 (± 16.2). In the TG2, the mean value of new bone formation was 19.3 (± 22.6), of the CT was 49.9 (± 14.1) and of the remaining biomaterial was 22.6 (± 7.9).

CONCLUSIONS

No statistically significant difference was observed between TG1 and TG2 after 6 months (P > 0.05), and both biomaterials afforded a more favorable implant position.

Socket preservation with alloplast: discussion and a descriptive case

Soon after tooth extraction the bone resorption takes place reducing the height and width of alveolar ridge. This produces an altered morphology of the bone unfavorable for implant placement and implant placement becomes impossible without surgical correction. Socket grafting maintains and preserves ridge for implant placement.