Histological and Histomorphometric Evaluation of Post-Extractive Sites Filled with a New Bone Substitute with or without Autologous Plate Concentrates: One-Year Randomized Controlled Trial

Abstract

The purpose of the present study was to evaluate the histological and histomorphometric characteristics of post-extraction sites grafted with decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin after four months of healing. This study was designed as a randomized controlled trial of parallel groups. Patients in need of a single, implant-supported restoration to replace a hopeless tooth were recruited for tooth extraction and implant placement four months after socket preservation procedure. After tooth extraction, patients were randomly allocated to receive decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin. After four months of healing, tapered implants were inserted with an insertion torque between 35 and 45 Ncm. Two months later, implants were loaded with screw-retained definitive crowns. Outcome measures were implant (ISR) and prosthesis (PSR) survival rates, complications, histological and histomorphometric analyses, radiographic marginal bone-level changes, and patients’ satisfaction. Clinical data were collected up to one year after tooth extraction and socket preservation procedures. Thirty patients were consecutively enrolled in the trial (15 in each group). Unfortunately, due to the COVID-19 pandemic, bone samples were collected only in 19 patients. Two implants failed before definitive prosthesis delivery (ISR 93.3%). No prosthesis failed (PSR 100%). Three complications were experienced in the control group. The mean bone percentage was 40.64 ± 18.76 in the test group and 33.40 ± 22.38 in the control group. The difference was not statistically significant (p = 0.4846). The mean soft tissue percentage was 32.55 ± 19.45 in the test group and 55.23 ± 17.64 in the control group. The difference was statistically significant (p = 0.0235). The mean residual graft was 24.59 ± 18.39 in the test group and 11.37 ± 12.12 in the control group. The difference was not statistically significant (p = 0.0992). Mean marginal bone loss, as well as patient satisfaction, showed no differences between groups. With the limitations of the present study, socket preservation with L-PRF mixed with decellularized bovine compact bone demonstrated favorable results, comparing with decellularized bovine compact bone from bovine femur alone. Further studies with larger sample size and longer follow-up are needed to confirm these preliminary results.

Feasibility and Preliminary Efficacy of α–Calcium Sulfate Hemihydrate in Socket Preservation: Protocol for a Pilot Randomized Controlled Trial

“…In dentistry, bone grafts and substitute materials are commonly used to regenerate missing hard tissue structures [ 24 , 25 ]. In recent years, there has been a growing interest in the use of bone graft substitutes, driven by concerns over potential immune reactions associated with allografts [ 1 , 2 , 18 ]. Challenges remain, particularly regarding graft versus host responses associated with nonautograft-derived materials [ 24 , 26 ].…”

“…Bone resorption is an ongoing and irreversible process that leads to changes in both hard and soft tissue dimensions, particularly occurring immediately after tooth extraction [ 1 , 2 ]. Various factors, such as chronic periodontitis, alveolar cleft, prolonged edentulous state, and tooth morphology, can contribute to alveolar bone resorption [ 3 , 4 ].…”

“…In recent years, there has been a growing emphasis on developing techniques to preserve alveolar bone volume following tooth extraction [ 2 , 6 , 8 ]. Socket preservation procedures are recommended when tooth extraction significantly impacts the height of the buccal bone [ 9 , 10 ].…”

Application of Fibrin Associated with Photobiomodulation as a Promising Strategy to Improve Regeneration in Tissue Engineering: A Systematic Review

“…The three-dimensional structure of fibrin allows for a series of cellular interactions and provides a temporary matrix in which cells can proliferate, organize, and perform their functions, especially at injured or inflamed sites. Thus, fibrin has been used with the aim of accelerating healing and regeneration in several surgical procedures, especially in medicine in the areas of orthopedics [ 5 , 6 ], neurology [ 7 , 8 , 9 ], and plastic surgery [ 10 , 11 ], as well as in dentistry in the areas of periodontics [ 12 , 13 ], implantology [ 14 , 15 ], and oral and maxillofacial surgery [ 16 , 17 ].…”