Effects of a Putty‐Form Hydroxyapatite Matrix Combined With the Synthetic Cell‐Binding Peptide P‐15 on Alveolar Ridge Preservation

Abstract

Various grafting materials have been used for preservation of the dimensions of the residual alveolar ridge following tooth extraction. The purpose of this study was to evaluate clinical, histomorphometric, and radiographic healing 4 months after tooth extraction with or without placement of a putty-form anorganic bovine-derived hydroxyapatite matrix combined with a synthetic cell-binding peptide P-15 (Putty P15) to determine the effect on alveolar ridge preservation following exodontia. Twenty-four consecutive subjects in need of extraction of maxillary premolars were recruited. Recruited subjects were randomly assigned to the test (Putty P15 and bioabsorbable collagen wound dressing material) or control (bioabsorbable collagen wound dressing material only) group. Data were recorded at 1, 2, 4, 8, and 16 weeks after ridge preservation procedures. At 16 weeks, a reentry surgery was performed, clinical measurements were repeated, and bone core biopsies were obtained for histomorphometric analysis prior to dental implant placement. The control group had a mean reduction in ridge height of -0.56 +/- 1.04 mm, whereas alveolar ridge height appeared to remain unchanged in the test group (0.15 +/- 1.76). The test group showed a mean reduction in ridge width of -1.31 +/- 0.96 mm, whereas the mean value for the control group was -1.43 +/- 1.05 mm. No statistical significance was observed between the groups. Mean bone density was significantly superior in the test group (2.08 +/- 0.65 versus 3.33 +/- 0.65). Histomorphometric analyses revealed similar percentages of bone vitality (test: 29.92% +/- 8.46%; control: 36.54% +/- 7.73%). Comparable percentages of bone marrow and fibrous tissue also were observed (test: 65.25% +/- 6.41%; control: 62.67% +/- 7.41%). Only 6.25% of the Putty P15 particles remained at 4 months in the analyzed biopsies. A favorable response was observed when Putty P15 was applied to extraction sockets, suggesting that it may be useful for alveolar ridge preservation prior to dental implant placement.