P-68027613-297 - Role of nano-porous-hydroxyapatite derived from eggshell in socket preservation and implant supported restoration

Abstract

Background Ridge preservation using various bone graft substitutes have been performed but none of the studies have recommended the material of choice for grafting. So, the study was aimed to analyze the outcomes of nano-porous-hydroxyapatite (nHA) graft material for socket preservation and implant restoration in the grafted sites using clinical and radiographic& microCT parameters. Methods A total of 20 sockets were preserved using nHA in a flapless extraction technique. The sites were divided randomly into two groups for implant placement at two different time intervals (4th & 6th-month). During implant placement, the trephine biopsy was obtained using a 3x10mm trephine bur. The bone regeneration was assessed using CBCT and microCT, correlated with histomorphometry. Patients were observed for 3 years with 6 month intervals for implant survival. The study was approved by the institutional ethics committee. Results All patients showed a well-preserved ridge and fourteen implants were placed successfully. Histomorphometric and Micro-CT analysis revealed a newly formed bone with interconnecting trabeculae of woven bone. Plenty of cellular osteoid in the form of trabeculae with intervening loose relatively dense cellular fibrous tissue was observed. Radiographic analysis showed increased density with a trabecular pattern in 74% and a ground glass pattern in 24% of the sockets within three months. Conclusion nHA grafting showed successful bone regeneration with less connective tissue components and osseointegration with a successful implant-supported prosthesis at the end of three years of follow-up. nHA restores and improves physical functions and enhances survival and quality of life. So, nHA may emerge as a novel graft substitute. Ridge preservation using various bone graft substitutes have been performed but none of the studies have recommended the material of choice for grafting. So, the study was aimed to analyze the outcomes of nano-porous-hydroxyapatite (nHA) graft material for socket preservation and implant restoration in the grafted sites using clinical and radiographic& microCT parameters. A total of 20 sockets were preserved using nHA in a flapless extraction technique. The sites were divided randomly into two groups for implant placement at two different time intervals (4th & 6th-month). During implant placement, the trephine biopsy was obtained using a 3x10mm trephine bur. The bone regeneration was assessed using CBCT and microCT, correlated with histomorphometry. Patients were observed for 3 years with 6 month intervals for implant survival. The study was approved by the institutional ethics committee. All patients showed a well-preserved ridge and fourteen implants were placed successfully. Histomorphometric and Micro-CT analysis revealed a newly formed bone with interconnecting trabeculae of woven bone. Plenty of cellular osteoid in the form of trabeculae with intervening loose relatively dense cellular fibrous tissue was observed. Radiographic analysis showed increased density with a trabecular pattern in 74% and a ground glass pattern in 24% of the sockets within three months. nHA grafting showed successful bone regeneration with less connective tissue components and osseointegration with a successful implant-supported prosthesis at the end of three years of follow-up. nHA restores and improves physical functions and enhances survival and quality of life. So, nHA may emerge as a novel graft substitute.