Comparative Evaluation of the Efficacy of Calcium Sulfate Bone Grafts in Crystalline and Nano-Crystalline Forms in Fresh Extraction Socket Sites: A Radiographic and Histological Pilot Study

Abstract

Aim: Extraction site reconstruction is essential for alveolar ridge preservation, keeping in mind future placement of implants. In an attempt to preserve the alveolar bone and to avoid ridge augmentation prior to implant placement, numerous biocompatible regenerative materials have been used immediately following tooth extraction to fill the socket.Methodology: This article is a pilot trial presenting early trends of the comparative use of two forms of calcium sulfate, i.e. medical grade (Dentogen) ® and nano-crystalline (Nanogen) ® as bone graft materials in immediate extraction sockets of three cases, based on histological and radiological assessments.Results: At the end of 4 months following grafting, the extraction sites in all the three cases revealed no significant difference between the two materials. Radiographic assessment revealed an almost complete graft resorption and replacement with spongy bone with bone density comparable to the surrounding bone. Histopathological assessment revealed that 100% of the bone was vital with 52% trabecular bone and 48% bone marrow. Conclusion:Calcium sulfate both medical grade and nanocrystalline form hold a valid premise for use as regenerative materials in extraction sockets with no significant differences seen between them in this pilot trial.

Main properties of nanocrystalline hydroxyapatite as a bone graft material in treatment of periodontal defects. A review of literature

“…A large amount of proteins on n-HA films compared to hydroxyapatite particle films were found by Zhou et al [39]. Furthermore, Jain and co-workers [40] indicated that degradation of calcium sulphate particles which decreases local pH can result in demineralization of defects walls and release of growth factors, such as BMP-2, BMP-7, TGF-ß, and PDGF-BB. The results of a study by Pezzatini et al [41] showed that n-HA increased upregulation of FGF-2, and stimulated endothelial cells proliferation.…”

“…Therefore, it is appropriate for post-extraction socket preservation and minimizing the very small amount of remnant graft material around dental implants [42]. The evaluation of the efficacy of two forms of calcium sulphate, crystalline and nanocrystalline, in fresh extraction socket by Jain et al [40] revealed that both materials can be considered as an appropriate regenerative graft material with density compared to the surrounding bone. Canullo et al [43] conducted an assessment of fresh post-extraction sockets grafted with Mg-enriched n-HA.…”

“…These results could be compared with each other. Furthermore, Jain and co-workers [40] compared n-HA and ß-tricalcium phosphate (ß-TCP) in the treatment of human periodontal defects. It was found that both materials were beneficial in the pocket reduction, CAL gain, and radiographic bone fill at 3 and 6 months follow-up.…”

Calcium sulfate bone scaffolds with controllable porous structure by selective laser sintering

“…The results in this study also indicated that CaSO 4 scaffolds fabricated by SLS possessed a good biocompatibility. Compressive strength (MPa) 5 Laser power (W) 6 7 8 …”

“…When CaSO 4 is implanted in vivo, it can degrade and offer the main mineral constituent of bone tissue. So it has long been used to fill bone fractures [5][6][7]. The calcium sulfate demonstrates firmer supporting for bone defect site after solidification than calcium phosphate [8].…”