Abstract
The aim of this randomized, controlled animal exploratory trial was to investigate the influence of local application of aminobisphosphonate pamidronate during the socket preservation procedure. Mandibular premolars were extracted in five Göttingen minipigs. Two animals underwent socket preservation using BEGO OSS (n = 8 sockets) and three animals using BEGO OSS + Pamifos (15 mg) (n = 12 sockets). After jaw impression, cast models (baseline, eight weeks postoperative) were digitized using an inLab X5 scanner (Dentsply Sirona) and the generated STL data were superimposed and analyzed with GOM Inspect 2018 (GOM, Braunschweig). After 16 weeks, the lower jaws were prepared and examined using standard histological methods. In the test group (BEGO OSS + pamidronate), buccooral dimensional loss was significantly lower, both vestibulary (−0.80 ± 0.57 mm vs. −1.92 ± 0.63 mm; p = 0.00298) and lingually (−1.36 ± 0.58 mm vs. −2.56 ± 0.65 mm; p = 0.00104) compared with the control group (BEGO OSS). The test group showed a significant difference between vestibular and lingual dimensional loss (p = 0.04036). Histology showed cortical and cancellous bone in the alveolar sockets without signs of local inflammation. Adjuvant application of pamidronate during socket preservation reduces alveolar dimensional loss significantly. Further investigations with regard to dose–response relationships, volume effects, side effects, and a verification of the suitability in combination with other bone substitute materials (BSMs) are necessary.
Highlights
The osseous volume of the alveolar ridge can be lost as a result of various causes such as tooth extraction, periodontal disease, pathological bone changes, or physiological age-related atrophy processes, and may be present in the form of single- or multi-walled horizontal, vertical, or combined defects [1,2]
It could be shown that the strongest changes of the alveolar process occur within three to six months after tooth extraction and manifest primarily at the buccal alveolar wall [5]
In addition to autologous bone, which remains as the gold standard owing to its osteoinductive characteristics, various bone substitute materials (BSMs) are used to stabilize the alveolar socket after tooth extraction, whereby basically human donor materials, animal, and synthetic substitutes are differentiated [12]
Summary
The osseous volume of the alveolar ridge can be lost as a result of various causes such as tooth extraction, periodontal disease, pathological bone changes, or physiological age-related atrophy processes, and may be present in the form of single- or multi-walled horizontal, vertical, or combined defects [1,2]. As a possible cause for the buccal pronounced resorption processes, the bundle bone predominantly occurring in the crestal area of the alveolar ridge is discussed [6,7]. The atrophy and remodeling processes result in a loss of volume, and in a displacement of the alveolar ridge towards the lingual or palatinal side, which results in both aesthetic and, with regard to masticatory rehabilitation, functional deficits In this context, socket preservation was born as a procedure to prevent or, more properly, limit the alteration of the post-extraction bone crest as a function of an optimal implant–prosthetic rehabilitation.
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