Histomorphometric and Clinical Analysis of Ridge Preservation Procedures in Extraction Sockets with Buccal Bone Defects (>5mm) Using an In Situ Hardening Biphasic Calcium Phosphate (HA/β-TCP) Graft and a Bioresorbable Matrix: A Human Study at 6 Months

Abstract

Many biomaterials have been proposed for ridge preservation techniques to counteract fresh extraction socket resorption. The primary aim of this prospective single cohort study was to evaluate the histomorphometric outcomes of a synthetic biphasic calcium phosphate (60% HA/40% β-TCP) and a synthetic poly-lactic acid membrane, used to graft fresh extraction socket sites with a full or partial (>5mm) resorption of the buccal bone plate. Patients recruited were treated at one esthetic site with a ridge preservation procedure to receive an implant-supported prosthesis. After 6 months of healing, a bone biopsy was harvested. Outcome evaluations were: biological complications, histomorphometrical analysis, and alveolar horizontal and vertical bone loss (∆AHB, ∆AVB). Thirteen subjects were included in this study. Two cases of biological complication were recorded. All 13 patients received implant insertion. From histomorphometric analysis, a mean of 48.9 ± 11.9%, 29.0 ± 9.3%, and 22.0 ± 9.7% was recorded for soft tissues, new bone, and residual graft particles, respectively. From clinical analysis, a mean of 0.5 ± 1.0 mm (p-value < 0.05) and 0.9 ± 1.3 mm (p-value < 0.05) was recorded for alveolar horizontal and vertical bone loss, respectively. In conclusion, this prospective cohort study showed encouraging results in preserving alveolar ridge dimension. A moderate percentage of new bone and an acceptable alveolar ridge loss were achieved at a 6 month follow-up.