Clinical Study for Silk Mat Application into Extraction Socket: A Split-Mouth, Randomized Clinical Trial

Ju-Won Kim,Ji-Hyeon Oh,Jwa-Young Kim,You-Young Jo,Seong-Gon Kim,Byoung-Eun Yang

doi:10.3390/app9061208

Abstract

Silk mat originates from the cocoon of the silkworm and is prepared by a simple method. The material has been used for guided bone regeneration (GBR) in animal models. In this study, the silk mat used for a clinical application was compared with a commercially available membrane for GBR. A prospective split-mouth, randomized clinical trial was conducted with 25 patients who had bilaterally impacted lower third molars. High-density polytetrafluoroethylene (dPTFE) membrane or silk mat was applied in the extraction socket randomly. Probing depth (PD), clinical attachment level (CAL), and bone gain (BG) were measured at the time of extraction (T0) and then at three months (T1) and six months after extraction (T2). There was no missing case. GBR with silk mat was non-inferior to GBR with dPTFE for PD reduction at T1 and T2 (pnon-inferiority < 0.001). PD and CAL were significantly decreased at T1 and T2 when compared with those at T0 in both membrane groups (p < 0.001). BG at T2 was 3.61 ± 3.33 mm and 3.56 ± 3.30 mm in the silk mat group and dPTFE group, respectively. There was no significant complication from the use of silk mat for the patients. The results for patients undergoing GBR with silk mat for third-molar surgery were non-inferior to GBR with dPTFE for PD reduction.

Highlights

The presence of a third molar is common in human populations; third molars in the mandible are often impacted in the bone [1]
The extraction socket is generally healed by bone formation, but the level of bony healing is dependent on many clinical variables [6,7]
The split-mouth, randomized clinical trial study demonstrated that there was no significant difference in probing depth (PD), clinical attachment level (CAL), and bone gain (BG) between the density polytetrafluoroethylene (dPTFE) group and the silk mat group at T1 and T2 (Tables 1 and 2; p > 0.05)

Summary

Introduction

The presence of a third molar is common in human populations; third molars in the mandible are often impacted in the bone [1]. Many oral and maxillofacial surgeons have recommended surgical removal as a preventive measure [2,5]. The extraction socket is generally healed by bone formation, but the level of bony healing is dependent on many clinical variables [6,7]. The most important factor is the age of the patient at the time of extraction [8]. Removal of the third molar is advised because younger patients have a higher probability of uneventful healing after extraction [9]

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Methods

Discussion

Conclusion