Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone

Abstract

Purpose: This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation. Materials: Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons. Results: Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33–50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group. Conclusion: The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.

Osteogenic effects of bioabsorbable magnesium implant in rat mandibles and in vitro

“…In addition, the simultaneously expanded surrounding soft tissue saves the additional need of soft tissue grafting procedures. Although some other Mg based materials have been tested for socket preservation or alveolar bone augmentation in pre‐clinical or clinical studies, none of them were verified to induce subperiosteal bone formation like pure Mg 26–29 . The special characteristics of ultrapure Mg may lead to the positive results in the present research.…”

Research status of biodegradable metals designed for oral and maxillofacial applications: A review

“…MgHA was also applied in combination with collagen scaffolds for alveolar socket preservation. Recently, a double-blinded prospective clinical trial revealed that the effect of the combination of MgHA and collagen scaffolds on alveolar socket preservation was consistent with that of the deproteinized bovine bone matrix [ 159 ]. The MgHA composite scaffold was almost completely replaced by newly formed bone tissue after 6 months of implantation.…”

Calcium Phosphate Modified with Silicon vs. Bovine Hydroxyapatite for Alveolar Ridge Preservation: Densitometric Evaluation, Morphological Changes and Histomorphometric Study

“…Among xenogeneic materials hydroxyapatite of bovine origin (BHA) is the most studied and has been used successfully in several investigations. This material has succeeded in preserving the dimensions of the bone crest after tooth extraction [18][19][20].…”