title: An evaluation and comparison of the efficacy of nanocrystalline calcium sulfate bone grafts (NanoGen) and medical-grade calcium sulfate bone grafts (DentoGen) in human extraction sockets.
abstract: BACKGROUND
  Grafting a fresh extraction socket is essential for successful regeneration of bone and maximizing volume preservation. Various synthetic grafts have been used to simulate bone formation. The purpose of the present study was to evaluate clinical, histomorphometric, and radiographic healing at 1-month, 3-month, and 4-month time points after tooth extraction with placement of calcium sulfate hemihydrate putty bone grafts NanoGen and DentoGen to determine their efficacy in ridge preservation following tooth extraction.
  
  
  METHODS
  Sixty subjects who were in need of extraction were recruited. The subjects were randomly assigned their group based on computer software for both the test groups (NanoGen and DentoGen). DentoGen is a medical-grade calcium sulfate hemihydrate with particle of 30 µm, and NanoGen is a nanocrystalline version of DentoGen with particle size 400 µm to 800 µm. Data were recorded at 1, 3, and 4 months after extraction socket grafting. Bone biopsies were taken at 4 months for histomorphometric analysis.
  
  
  RESULTS
  The mean percentage of bone formed by NanoGen was 51.19 ± 9.53% and by DentoGen 50.67 ± 16.16% after 4 months. No statistically significant difference was noted in the mean bone formation by NanoGen and DentoGen at various time intervals; no bone graft remnants of DentoGen were found at 4 months. The mean percentage of bone graft remnants left after 4 months for NanoGen was 6.83 ± 16% in the maxilla and 7.38 ± 21% in the mandible. The mean percentage of soft tissue formed was significantly higher with DentoGen in mandibular socket sites. On radiographic evaluation the mean percentage of socket fill with DenoGen was found to be 23.1 ± 11.65%, 50 ± 9.6%, and 76.7 ± 11% and with NanoGen was 29.2 ± 12.8%, 52.8 ± 15.6%, and 76.47 ± 12.43% at 1 month, 3 months, and 4 months postoperative intervals, respectively.
  
  
  CONCLUSIONS
  Both the materials investigated in the study showed excellent bone forming capacity, but the nanocrystalline version (NanoGen) of calcium sulfate was found to have clinical and biologic advantages over DentoGen.
authors.affiliation: Senior Resident - Periodontics, CDER, AIIMS (All India Institute for Medical Sciences), Delhi, India.
authors.forename: Bindiya
authors.initials: B
authors.lastname: Kumari
authors.affiliation: Professor and Head, Department of Periodontology, Himachal Dental College, Sundernagar, India.
authors.forename: D K
authors.initials: DK
authors.lastname: Gautam
authors.affiliation: Clinical Assistant Professor, Departments of Implant Dentistry and Periodontics, Oral Surgery, New York University College of Dentistry, New York, New York, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Horowitz
authors.affiliation: Principal, Professor and Head, Department of Periodontology, H.S.J. Institute of Medical Sciences, Panjab University, Chandigarh, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Jain
authors.affiliation: Assistant Professor, Department of Periodontology and Implantology, HP Government Dental College, Shimla, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Mahajan
mesh_terms: D000293:Adolescent; D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods; D001706:Biopsy / Q000379:methods; D018786:Bone Substitutes / Q000627:therapeutic use*; D002133:Calcium Sulfate / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D053758:Nanoparticles / Q000627:therapeutic use*; D010012:Osteogenesis / Q000187:drug effects; D010316:Particle Size; D016300:Radiography, Bitewing; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018786:Bone Substitutes; D002133:Calcium Sulfate