Post-Extraction Socket Preservation With Autogenous Bone Graft and Hyaluronic Acid Followed by Delayed Implant Placement

Abstract

INTRODUCTION:Alveolar ridge atrophy following tooth extraction remains a challenge for future implant placement. Post-extraction socket preservation and implant placement are two methods that are used to prevent significant post-extraction bone loss. OBJECTIVES: The aim of this study was to evaluate the role of hyaluronic acid when mixed with autogenous bone graft in alveolar socket preservation for future implant placement. MATERIALS AND METHODS: A split mouth randomized clinical trial was carried out in 10 patients, 20 mandibular extraction sockets of single rooted teeth with age ranged between 25-55 years, 10 sockets were grafted with autogenous bone graft only using Auto-Max TM bone harvester and the other 10 sockets were grafted with autogenous bone graft mixed with hyaluronic acid (Hyadent TM ). All sockets were evaluated clinically, radiographically, and histologically (after 2 months, core biopsy was taken before implant placement) then histomophometric analysis and delayed implant insertion were done followed by implant stability assessment. After 4 months, final prosthesis was delivered. RESULTS: Histological evaluation revealed rapid thick bone deposition with many well organized osteocytes as well as osteoblast lining of the bone surfaces in the study group and increased mean area percent of formed bone. Radiographic bone density changes were found to be statistically significant between the two studied groups. (P2= <0.001). CONCLUSIONS: The use of autogenous bone graft with hyaluronic acid appears to be more efficient in osteoconduction when compared with autogenous bone graft alone and could be a promising strategy for preservation of alveolar sockets.

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“…Also, in 2018, Alcântara et al (33) evaluated the effects of 1% HA gel on bone repair of human dental sockets and observed a significant difference in bone density between the HA-treated sockets and the control groups after 30 days of extraction. Furthermore, our results were also in agreement with Taman et al (31) revealed statistically significant radiographic bone density changes between the two studied groups after 2 months and concluded that hyaluronic acid was more efficient in osteoconduction when compared with autogenous bone graft alone in post-extraction socket preservation. On the contrast, Alcântara et al revealed that HA has no significant difference between the studied groups at 90 days effect of HA when compared the bone density of the extraction sockets using HA gel only (33).…”

“…As regarding hyaluronic acid, Taman et al (31) evaluated the effect of hyaluronic acid (HyadentTM) when mixed with autogenous bone graft in alveolar socket preservation, and reported that the ISQ intra-operatively and after 2 months did not affect by hyaluronic acid. Vertical bone height gain increased significantly in each group after 1 and 6 months.…”