Autogenous Mineralized Dentin versus Xenograft granules in Ridge Preservation for Delayed Implantation in Post‐extraction Sites: A Randomized controlled clinical trial with an 18 months follow‐up

Abstract

Objectives To test primary stability of delayed implants placed in post‐extraction ridges preserved with autogenous mineralized dentin matrix (MDM) versus xenograft granules. Clinical, histological and pain experience outcomes were further assessed. Material and Methods From March 2018 to July 2020, patients requiring ridge preservation in preparation for delayed implant placement in post‐extraction sites were included. Participants were randomly allocated to either the test (MDM) or control group (xenograft granules) prior to ridge preservation. Visual analogue scale and analgesic consumption were measured every day for a week. Six months after preservation, trephine cores were harvested for histomorphometry prior to implant placement. Implants were then placed, and implant stability was measured immediately as well as two months after placement. Marginal bone loss and presence of mucositis/peri‐implantitis were registered up to 18 months after prosthetic loading. Results Fifty‐two patients (66 implants) completed the study. MDM and xenograft groups presented similar primary (77.1 ± 6.9 versus. 77.0 versus. 5.9) and secondary (81.8 ± 5.1 versus. 80.1 ± 3.8) implant stabilities. The percentage of newly formed bone in MDM (47.3%) was significantly higher than xenograft (34.9%) (p < .001), and the proportion of residual graft was significantly lower (12.2% in MDM and 22.1% in xenograft) (p < .001). No significant differences were found as far as clinical, radiographic and patient‐related outcomes. Conclusions Implants placed in sites preserved with MDM had similar primary stability in comparison to xenograft granules. MDM showed a significantly higher quantity of newly formed bone and lower amount of residual graft in histomorphometry results and equal clinical and patient‐related outcomes.

Histological and dimensional changes of the alveolar ridge following tooth extraction when using collagen matrix and collagen‐embedded xenogenic bone substitute: A randomized clinical trial

“…30 A study which examined the insertion torque of dental implants in the anterior maxilla 4 months after ARP reported that they achieved insertion torque over 35 N/cm 2 in 75% of the cases. 31 In a recent study by Santos et al, 32 delayed implant placement, 6 months after ridge preservation using DBBM or autogenous mineralized dentin, yielded high initial stability, with a mean ISQ of 77 in both experimental groups. In a study comparing ridge preservation sites grafted with enamel matrix derivatives (EMD) or DBBM-C, in RFA measurements conducted 3 months of healing mean ISQ of 66 was found in the EMD sites and 65 in the DBBM-C sites.…”

A Histologic, Histomorphometric, and Immunohistochemical Evaluation of Anorganic Bovine Bone and Injectable Biphasic Calcium Phosphate in Humans: A Randomized Clinical Trial

“…Conversely, some human studies have shown that alveolar ridge defects grafted with Bio-Oss ® resulted in different percentages of newly formed bone, residual BSB, and soft tissue structures from the above results, such as the studies by Froum et al [ 81 ], Schmitt et al [ 82 ], Lorenz et al [ 83 ], Fienitz et al [ 84 ], etc. Moreover, studies performed in recent years indicate different proportions of the variables already mentioned, as in the studies by Sivolella et al [ 85 ], Pignaton et al [ 86 ], and Santos et al [ 87 ]. Such results can be explained by different initial morphology of the defect, type of wound closure, elevation of the flap, use of different membranes, location of the biopsy, and different follow-up periods.…”

Bio-Morphological Reaction of Human Periodontal Ligament Fibroblasts to Different Types of Dentinal Derivates: In Vitro Study

“…Santos et al [34] conducted a clinical trial comparing the integration of mineralized dentin and xenograft in post-extractive sites for ridge preservation and implant placements. The histological analysis revealed a quantity of newly formed bone in the sites filled with the dentin and no differences in the implant therapy outcomes [34].…”