Dental implants placed in extraction sites grafted with different bone substitutes: radiographic evaluation at 24 months.
BACKGROUND
Reduction of alveolar height and width after tooth extraction may provide some problems in implant placement, especially in the anterior maxilla for esthetic reasons. Different graft materials have been advocated to prevent bone-volume reduction. The aim of this study was to evaluate radiographic parameters of implants positioned in grafted alveoli with three different biomaterials: magnesium-enriched hydroxyapatite (MHA), calcium sulfate (CS), and heterologous porcine bone (PB).


METHODS
In 15 patients, 45 fresh extraction sockets with three bone walls were selected. Fifteen sockets received MHA, 15 sockets received CS, and 15 sockets received corticocancellous PB as a graft material. Three months after bone filling, titanium dental implants were placed in grafted sites. Three months after implant placement, temporary restoration was performed. Follow-up examinations were conducted, and intraoral digital radiographs were taken at baseline and 12 and 24 months after implant placement to evaluate the marginal bone level in each patient. Comparisons for marginal bone loss over time between groups were performed by the Student two-tailed t test.


RESULTS
At the 24-month follow-up, a survival rate of 100% was reported for all implants. For the MHA group, a mean mesial bone loss of -0.21 +/- 0.08 mm and a mean distal bone loss of -0.22 +/- 0.09 mm (mean bone loss: 0.21 +/- 0.09 mm) were reported; for the CS group, a mesial bone loss of -0.14 +/- 0.07 mm and a distal bone loss of -0.12 +/- 0.11 mm (mean bone loss: -0.13 +/- 0.09 mm) were measured; for the PB group, a mean mesial bone loss of -0.15 +/- 0.10 mm and a mean distal bone loss of -0.16 +/- 0.06 mm (mean bone loss: -0.16 +/- 0.08 mm) were reported. No statistically significant differences were reported among groups (P >0.05).


CONCLUSIONS
At the 24-month follow-up, the present study showed that placement of implants in grafted sockets was not influenced by the three different biomaterials because they did not negatively impact the clinical outcome.
Department of Dentistry, Vita Salute University, San Raffaele Hospital, Milan, Italy. robcresp@libero.it
Roberto
R
Crespi
Paolo
P
Capparè
Enrico
E
Gherlone
D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000543:Alveoloplasty / Q000379:methods*; D001672:Biocompatible Materials / Q000627:therapeutic use*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000000981:diagnostic imaging / Q000379:methods; D002133:Calcium Sulfate / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D003764:Dental Materials; D003794:Dental Restoration, Temporary; D017886:Durapatite / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019252:Radiography, Dental, Digital; D016019:Survival Analysis; D014025:Titanium; D014081:Tooth Extraction; D020390:Tooth Socket / Q000000981:diagnostic imaging / Q000601:surgery*; D014183:Transplantation, Heterologous; D016896:Treatment Outcome
D001672:Biocompatible Materials; D018786:Bone Substitutes; D015921:Dental Implants; D003764:Dental Materials; D017886:Durapatite; D014025:Titanium; D008274:Magnesium; D002133:Calcium Sulfate