A comparative evaluation of decalcified freeze dried bone allograft, hydroxyapatite and their combination in osseous defects of the jaws

Abstract

Objectives: To evaluate decalcified freeze dried allograft or hydroxyapatite and a combination of both as bone autograft substitutes in the healing of osseous jaw defects.

Materials and methods: 24 patients participated in the study which involved the filling of osseous defects in the maxilla/mandible with decalcified freeze dried bone allograft (DFDBA) or hydroxyapatite (HA) or a combined graft composed of these two in equal proportions.

Results: Bone formation occurred as early as 4 weeks in the DFDBA and combination groups and 12 weeks in the HA group which was verified by radiographs, Dentascans (DentaScan® Software Program, General Electric, USA) and bone scintigraphy.

Conclusion: Both these materials can be used as bone graft substitutes in smaller defects although their suitability in large defects is yet to be studied.

Keywords: Bone; Demineralised; Freeze dried; Grafts; Hydroxyapatite.

Fig. 1

Preoperative radiograph showing periapical pathology in 22 region

Fig. 2

Enucleation of cyst followed by obliteration of the defect with the graft (DFDBA and HA)

Fig. 3

24 weeks postoperative radiograph showing healed osseous defect with residual hydroxyapatite granules

Fig. 4

Dentascan done 4 weeks postoperatively showing no evidence of bone formation and radioopaque HA granules

Fig. 5

Scintigraphy done at 4 weeks after surgery showing increased uptake of ^m99Tc at surgical site representing new bone formation at grafted site