Following tooth extraction, ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption, and provide a stable base for implant placement. The purpose of this study is to histologically evaluate and compare bone regeneration in extraction sockets grafted with either a putty alloplastic bone substitute or particulate anorganic bovine xenograft utilizing the socket-plug technique. Nineteen patients underwent 20 tooth extractions and ridge preservation following a standardized protocol. Ten sites were grafted with calcium phosphosilicate putty (CPS group) and the remaining 10 with anorganic bovine bone substitute (BO group). Patients were recalled after 4-6 months to evaluate the bone regeneration and to proceed with implant placement. A bone core was obtained during the implant procedure from each site and was used for histologic analysis. Histomorphometry revealed that residual graft values were significantly higher in the BO group (25.60% ± 5.89%) compared to the CPS group (17.40% ± 9.39%) (P < .05). The amount of new bone regenerated was also statistically significant higher in the alloplast group (47.15% ± 8.5%) as compared to the xenograft group (22.2% ± 3.5%) (P < .05). Results suggest that ridge preservation using a putty calcium phosphosilicate alloplastic bone substitute demonstrates more timely graft substitution and increased bone regeneration when compared to an anorganic bovine bone xenograft.
A variety of surgical techniques and materials have been developed to increase the vertical bone height in the posterior maxilla. Minimally invasive crestal approaches for the elevation of the floor of the sinus using a crestal approach have been recently reported to minimize adverse events associated with the use of the osteotome technique for indirect sinus lift. The aim of this study is to report a surgical improvisation that minimizes risks associated with sinus floor elevation using a crestal approach and simplifies the clinical procedure. The technique is based on the use of a viscoelastic calcium phosphosilicate alloplastic putty (CPS putty) bone substitute that can be delivered utilizing a unique cartridge delivery system. CPS putty not only acts as a 'protective cushion' thanks to its physical properties, but also provides hydraulic pressure to lift the Schneiderian membrane when used in conjunction with the cartridge system. This approach minimizes risks of benign paroxysmal positional vertigo or mechanical perforations of the Schneiderian membrane associated with the traditional osteotome technique.
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