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

Kattimani VS, Prathigudupu RS, Jairaj A, Khader MA, Rajeev K, Khader AA

J Contemp Dent Pract, 2019 Aug 01;20(8):987-993.
PMID: 31797859

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.

Matched MeSH terms: Alveolar Ridge Augmentation*
Interim prosthesis design and socket preservation for a non-salvageable traumatic injury in a young adult: a minimalistic approach to traumatic injuries in children

Kaur K

BMJ Case Rep, 2023 Feb 14;16(2).
PMID: 36787931 DOI: 10.1136/bcr-2022-251154

Long-term prognosis of complicated traumatic injuries depends on precise treatment planning. Establishing a balance between a patient's age, prognosis, financial hurdles, and treatment needs is challenging. This case highlights the need for meticulous and realistic treatment planning to achieve long-term favourable outcomes in traumatic injuries in young adults.A young child sustained a traumatic injury that caused avulsion of #21 and intrusion along with palatal luxation of #11. The child reported to the dental clinic with intraoral swelling and pain a week after the injury. Socket preservation was done so that uniform bone contour could be achieved for implant placement at a later stage. We modified a 'Hollywood appliance' as an interim prosthesis to ensure that the ridge was not immediately loaded where socket preservation was done.After a follow-up of 3 years, there is significant bone deposition and the child is satisfied with aesthetics.

Matched MeSH terms: Alveolar Ridge Augmentation*
Efficacy of guided bone regeneration using composite bone graft and resorbable collagen membrane in Seibert's Class I ridge defects: radiological evaluation

Saravanan P, Ramakrishnan T, Ambalavanan N, Emmadi P, John TL

J Oral Implantol, 2013 Aug;39(4):455-62.
PMID: 23964779 DOI: 10.1563/AAID-JOI-D-10-00211

The purpose of the study was to evaluate radiologically the efficacy of guided bone regeneration using composite bone graft (autogenous bone graft and anorganic bovine bone graft [Bio-Oss]) along with resorbable collagen membrane (BioMend Extend) in the augmentation of Seibert's class I ridge defects in maxilla. Bone width was evaluated using computerized tomography at day 0 and at day 180 at 2 mm, 4 mm, and 6 mm from the crest. There was a statistically significant increase in bone width between day 0 and day 180 at 2 mm, 4 mm, and 6 mm from the crest. The results of the study demonstrated an increase in bone width of Seibert's class I ridge defects in the maxilla of the study patients.

Matched MeSH terms: Alveolar Ridge Augmentation/methods*
Three-Dimensional Radiological Assessment of Alveolar Bone Volume Preservation Using Bovine Bone Xenograft

Al Qabbani A, Al Kawas S, A Razak NH, Al Bayatti SW, Enezei HH, Samsudin AR, et al.

J Craniofac Surg, 2018 Mar;29(2):e203-e209.
PMID: 29303859 DOI: 10.1097/SCS.0000000000004263

INTRODUCTION: Alveolar bone is critical in supporting natural teeth, dental implants as well as a removable and fixed prosthesis. Alveolar bone volume diminishes when its associated natural tooth is lost.
OBJECTIVE: The aim of this study is to evaluate the effectiveness of bovine bone granules on alveolar bone socket augmentation for ridge preservation following atraumatic tooth extraction.
MATERIALS AND METHODS: Twenty medically fit patients (12 males and 8 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of 1 mandibular premolar tooth were divided randomly and equally into 2 groups. In control group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In group II, the empty extraction socket wound was filled with lyophilized bovine bone xenograft granules 0.25 to 1 mm of size, 1 mL/vial. A resorbable pericardium membrane was placed to cover the defect. Clinical and 3-dimensional radiological assessments were performed at day 0, 3 months, and 9 months postoperative.
RESULTS: There were no clinical differences in general wound healing between the groups. Comparisons within the groups showed a significant difference of bone resorption of 1.49 mm (95% confidence interval, 0.63-2.35) at 3 months, and further resorption of 1.84 mm (P ≤ 0.05) at 9 months in the control group. No significant changes of bone resorption were observed in group II during the same time interval. Comparison between groups showed a significant difference of bone resorption at 3 and 9 months (2.40 and 2.88 mm, respectively).
CONCLUSION: The use of lyophilized demineralized bovine bone granules in socket preservation to fill in the extraction socket seems essential in preserving the alveolar bone dimension as it showed excellent soft and hard tissue healing. This study concludes that the alveolar bone socket exhibited a dynamic process of resorption from the first day of tooth extraction. Evidence shows the possibility of using bovine bone granules routinely in socket volume preservation techniques following tooth extraction.

Matched MeSH terms: Alveolar Ridge Augmentation/methods*
Tissue-engineered bone applied for alveolar ridge augmentation with simultaneous implant

Ueda M

Med J Malaysia, 2004 May;59 Suppl B:29.
PMID: 15468803
Matched MeSH terms: Alveolar Ridge Augmentation*
Edentulous arch treatment with a CAD/CAM screw-retained framework and cemented crowns: a clinical case report

Baig MR, Rajan G, Rajan M

J Oral Implantol, 2009;35(6):295-9.
PMID: 20017646 DOI: 10.1563/AAID-JOI-D-09-00012R1.1

This article describes the rehabilitation of a completely edentulous patient using a milled titanium implant framework and cemented crowns. This combined approach significantly offsets unsuitable implant position, alignment, or angulation, while ensuring the easy retrievability, repair, and maintenance of the prosthesis. Hence, the dual advantage of cemented-retained crowns reproducing appropriate esthetics and function, irrespective of where the screw access openings are located in the substructure, can be obtained, along with the splinting effect and management of soft and hard tissue deficits achievable with a screw-retained framework.

Matched MeSH terms: Alveolar Ridge Augmentation/methods