Clinical Study for Silk Mat Application into Extraction Socket: A Split-Mouth, Randomized Clinical Trial

Abstract

Silk mat originates from the cocoon of the silkworm and is prepared by a simple method. The material has been used for guided bone regeneration (GBR) in animal models. In this study, the silk mat used for a clinical application was compared with a commercially available membrane for GBR. A prospective split-mouth, randomized clinical trial was conducted with 25 patients who had bilaterally impacted lower third molars. High-density polytetrafluoroethylene (dPTFE) membrane or silk mat was applied in the extraction socket randomly. Probing depth (PD), clinical attachment level (CAL), and bone gain (BG) were measured at the time of extraction (T0) and then at three months (T1) and six months after extraction (T2). There was no missing case. GBR with silk mat was non-inferior to GBR with dPTFE for PD reduction at T1 and T2 (pnon-inferiority < 0.001). PD and CAL were significantly decreased at T1 and T2 when compared with those at T0 in both membrane groups (p < 0.001). BG at T2 was 3.61 ± 3.33 mm and 3.56 ± 3.30 mm in the silk mat group and dPTFE group, respectively. There was no significant complication from the use of silk mat for the patients. The results for patients undergoing GBR with silk mat for third-molar surgery were non-inferior to GBR with dPTFE for PD reduction.

Antibiotic Prophylaxis on Third Molar Extraction: Systematic Review of Recent Data

“…It is necessary to go to the distal bone peak at the lower second molar and allow a correct closure of the flaps when possible, limiting the risk of infection, dehiscence, or even bone exposure. When the tooth is regularly positioned in the jaws and therefore is not an impacted wisdom tooth, the surgical site can have second intention healing, using only hemostatic maneuvers and possibly sutures to contain the clot [27]. Bone remodeling has a good potential for growth as the distal bone peak is represented by the branch of the mandible.…”

Relevant Properties and Potential Applications of Sericin in Bone Regeneration

“…Furthermore, clinical trials evaluating silk mat as a bone graft material have shown promising results. In a split mouth model, the bone regeneration achieved with silk mat was comparable to that of high-density PTFE [ 54 ]. Additionally, when compared to a control group without any graft, the silk mat group exhibited significantly higher levels of bone regeneration [ 55 ].…”

Silk Sericin: A Promising Sustainable Biomaterial for Biomedical and Pharmaceutical Applications

“…In another clinical study, a sericin-based cream improved hydration and reduced pruritus after 6 weeks in hemodialysis patients with uremic pruritus compared to a cream without sericin [124]. For bone regeneration purposes, to the best of our knowledge, only silk (and not sericin isolated) from the cocoon of the silkworm was investigated in a clinical trial [128].…”