Role of Synthetic Hydroxyapatite—In Socket Preservation: A Systematic Review and Meta-analysis

Abstract

Since a long time, the preservation of the socket is emphasized for various reasons. Many studies have suggested the ridge preservation through socket grafting using various bone graft substitute materials (GSMs). But none of the studies suggested the material of choice for the grafting. So, the systematic review was planned to analyze the outcomes of synthetic hydroxyapatite (SHA) graft material for socket preservation. The review was aimed to determine the existing evidence for the use of SHA GSM for grafting and its usefulness. Materials and methods: The literature search was performed for the studies published in the English language independently by all four authors (search team) in the Medline database through the PubMed search engine for the past 5 years. The study involved predetermined inclusion and exclusion criteria for the search. The final lists of clinical trials were analyzed to determine the existing evidence and suggested the mechanism of action. Review results: The search resulted in 117 titles. After application of inclusion and exclusion criteria, a total of seven studies were found eligible for this systematic review. Out of seven, two studies were found eligible for meta-analysis whereas remaining included for the systematic review. Conclusion:The meta-analysis favors socket grafting compared to control in terms of preservation of existing bone height and width. The SHA grafting showed successful bone regeneration with less connective tissue component. The histomorphometric evaluation showed a good bone regeneration associated with SHA than xenograft. Within the limitations of this meta-analysis, the synthetic GSM can be used for socket grafting. Clinical significance: In the wake of increasing graft materials in the market and different origin raw material sources for the preparation of graft materials, clinicians are in dilemma for selection and its use. The success of grafting depends on the selection of appropriate material with a suitable calcium/phosphate (Ca/P) ratio. The review provided available evidence for the use of SHA.

Osseointegration evaluation of an experimental bone graft material based on hydroxyapatite, reinforced with titanium-based particles

“…HAp is a material that shows a slow resorption in the biological environment [32], which according to some authors may represent a greater susceptibility to infections [33]. In our study, although we encountered residual particles of HAp in all samples, no signs of local infection were identified.…”

“…Although initially it was believed that osteoinduction is determined only by the concentration of bone growth factors in the circulating blood [ 30 ], more recent research has shown that the geometric structure of HAp and its microporosity also may determine the transformation of stem cells into osteoblasts [ 31 ]. HAp is a material that shows a slow resorption in the biological environment [ 32 ], which according to some authors may represent a greater susceptibility to infections [ 33 ]. In our study, although we encountered residual particles of HAp in all samples, no signs of local infection were identified.…”

Biphasic Calcium Phosphate in the Extraction Socket Preservation: A Systematic Review

“…[ 18 19 20 21 22 23 ] that cannot be standardized to provide conclusive remarks. [ 11 ] As a result, this review focused on the specific review question on the use of the biphasic calcium phosphate for socket preservation over xenografts and other alloplastic materials.…”

“…As have documented that the nature, physio-chemical properties have profound effect in the bone regeneration. [ 11 ]…”

“…[ 9 ] Despite the fact that the available literature has demonstrated the use of various synthetic substitute materials for socket grafting, none of these have prescribed a single material as an ideal substitute, despite presence of various systematic reviews. [ 10 11 ]…”