Background Use of various bone graft substitutes are advised to prevent bone loss, periodontal problems, and enhance bone formation after surgical removal of the mandibular third molar. Choice of graft substitute depends on biological properties and the cost of the material. So, a preliminary study was planned to evaluate and compare the effectiveness of eggshell-derived nano-hydroxyapatite as an emerging graft substitute for the enhancement of bone regeneration. Materials and methods Twelve patients (out of 20 enrolled) were finally assessed for bone healing after surgical removal of bilateral mandibular third molars in a split-mouth randomized controlled clinical study. All of them were assessed and compared at baseline, first, third, and sixth month. Clinically wound healing and probing depth were assessed. Radiographically the changes in density, bone formation characteristics, and bone level were evaluated. The observers were blinded for the surgical procedure and follow-up duration. The study protocol was approved by Institutional Ethics Committee and registered with National clinical trial registry. Results Wound healing was uneventful in all 24 extraction sites of 12 patients. Trabecular bone pattern with increased bone density was observed indicating complete bone healing in the graft group at third month. Probing depth was gradually decreased over a follow-up period and remained within normal limits during the third-month follow-up. These changes in the graft group were significant compared to the control group. The grafting with eggshell-derived nano-hydroxyapatite showed better bone regeneration properties without any infection or undue reactions. Conclusion Eggshell-derived nano-hydroxyapatite showed enhancement of bone regeneration compared to the control group. Grafting maintained bone height and prevented periodontal problem emergence. Eggshell-derived nano-hydroxyapatite is a safe synthetic graft substitute because it is derived from eggshell without any diseases transfer risks, unlike allografts. The process of preparation is environment-friendly. The beneficial effects of eggshell-derived nano-hydroxyapatite may be extrapolated to develop an ideal economic graft substitute.

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Thus, the study highlights the role of oral physicians in detecting oral mucosal lesions and screening high-risk patients on a regular basis and also reaffrms the importance of public education, stressing the risk factors for oral cancers.

SUMMARYWe present a rare case of concurrent bilateral coronoid hypoplasia and complex odontoma in the mandible, with replacement of missing posterior teeth in both sides of the lower jaw. A 20-year-old woman was diagnosed with bilateral occurrence of coronoid hypoplasia and unerupted complex odontoma after radiographic and histopathological examination. The patient was surgically treated with complete removal of the unerupted complex odontoma and prosthetic replacement of the missing teeth. BACKGROUND