Ridge Preservation Using Composite Alloplastic Materials: A Randomized Control Clinical and Histological Study in Humans

Abstract

Aim: To evaluate (clinically, histologically, and histo-morphometrically) the use of composite materials (Biphasic calcium sulphate [BCS] with β Tri-Calcium Phosphate (β-TCP) and Hydroxyapatite [HA]) in extraction socket sites and compare it to un-disturbed natural healing.

Material and methods: Prospective clinical trial of 36 patients (40 extraction sockets) were randomly assigned to either test or control group. Alveolar ridge horizontal dimension was measured in the middle of the socket at crest and 3 and 6 mm subcrestally. Crestal vertical height was measured at baseline surgery and at 4 month re-entry, at which time bone core biopsies were harvested from the center of the edentulous ridge. Histo-morphometric evaluation of the samples was performed using hematoxylin & eosin stains and morphometric software.

Results: The change in horizontal ridge width was higher in the control compared to the experimental group: 2.28 ± 2.36 mm versus 0.03 ± 2.32 mm (p = .007) at -3 mm and 2.28 ± 2.43 versus 0.035 ± 3.05 (p = .02) at -6 mm, for the experimental and control sites, respectively. The vertical distance form bone crest to neighboring horizontal line interconnecting the neighboring teeth was minimal in both groups (0.307 ± 2.01 mm versus 0.14 ± 2.03 mm [p = 0.41]). Residual scaffolds occupied 15.99 ± 11.4% of the volume in the grafted (test) sites while bone area fraction was not statistically different among the groups (47.7 ± 10.6% versus 52.6 ± 11.6%, test versus control, respectively p = .39). The percentage of connective tissue in the control group was significantly higher that test group (36.3 ± 19.4% versus 46.7 ± 10.6% test versus control, respectively, p = .013).

Conclusion: Ridge preservation technique using a combination of two synthetic bone grafts β-TCP and HA with BCS resulted in greater stability in the horizontal dimension after 4 months.

Keywords: alloplast; beta TCP; bi phasic calcium sulphate; bone regeneration; bone resorption; socket preservation.