Randomized Controlled Clinical Trial of Nanostructured Carbonated Hydroxyapatite for Alveolar Bone Repair

Abstract

The properties of the biodegradation of bone substitutes in the dental socket after extraction is one of the goals of regenerative medicine. This double-blind, randomized, controlled clinical trial aimed to compare the effects of a new bioabsorbable nanostructured carbonated hydroxyapatite (CHA) with a commercially available bovine xenograft (Bio-Oss®) and clot (control group) in alveolar preservation. Thirty participants who required tooth extraction and implant placement were enrolled in this study. After 90 days, a sample of the grafted area was obtained for histological and histomorphometric evaluation and an implant was installed at the site. All surgical procedures were successfully carried out without complications and none of the patients were excluded. The samples revealed a statistically significant increase of new bone formation (NFB) in the CHA group compared with Bio-Oss® after 90 days from surgery (p < 0.05). However, the clot group presented no differences of NFB compared to CHA and Bio-Oss®. The CHA group presented less amount of reminiscent biomaterial compared to Bio-Oss®. Both biomaterials were considered osteoconductors, easy to handle, biocompatible, and suitable for alveolar filling. Nanostructured carbonated hydroxyapatite spheres promoted a higher biodegradation rate and is a promising biomaterial for alveolar socket preservation before implant treatment.

Histomorphometric evaluation of human extraction sockets treated with autologous fibrin, sticky bone or biphasic calcium phosphate

“…For maintaining and potentially repairing alveolar bone structure, minimally invasive surgery is recommended that could provide a total flap to preserve periosteal vascularization and avoid reduction in the volume of the alveolus, the height of the bone crest and the keratinized gingival margin [16][17][18] . However, in the present study, a mucoperiosteal flap was performed for better surgical access in the use of PRF, and no negative influence on the clinical parameters was observed after 8 months.…”

Evaluation of the In Vivo Biocompatibility of Amorphous Calcium Phosphate-Containing Metals

“…In this study, we used carbonated hydroxyapatite synthesized at 37 °C, the same temperature used in a previous study [ 4 , 5 , 32 ]. Patel et al showed that HA synthesized by lower temperature exhibited a more considerable inflammatory cell and fibroblastic proliferation, with a higher concentration of Ca 2+ in the ECM, and a difference between them in physical parameters: porosity and crystal morphology [ 35 ].…”

“…Hydroxyapatite (HA) is a naturally occurring mineral, a component of bone and teeth, and a synthesized material with wide application in medicine for the healing of bones. Due to its biocompatibility and bioactivity [ 1 , 2 , 3 ] HA has been used in dentistry as a bone substitute for alveolar ridge preservation [ 4 ], sinus lift elevation [ 5 ], and as a drug carrier to prevent and control inflammatory processes, chronic infections, and to enhance the endogenous healing capacity of bone defects, which ultimately result in the significant improvement of bone regeneration [ 6 , 7 , 8 , 9 ]. Although, the main limitation of HA ceramics is their high crystallinity, low adsorption capacity for drugs, and poor in vivo bioabsorbability.…”

Nanostructured Carbonated Hydroxyapatite Associated to rhBMP-2 Improves Bone Repair in Rat Calvaria

“…Our study evaluated the nanostructured carbonated hydroxyapatite (nCHA), which was presented in previous pre-clinical and clinical studies, biocompatibility, and better rates of bioabsorption, characteristics that contribute to bone repair [ 7 , 10 , 35 ]. The microspheres were synthesized at 37 °C and were not sintered, and its physicochemical characterization was previously [ 11 , 35 ] evaluated with scanning electron microscopy, that showed its morphological characteristics, the Fourier transform infrared (FTIR) spectroscopy, which presented intense water bands, phosphate ions, and carbonate ions, confirming that the replacements occurred as expected, and the X-ray diffractogram showed peaks corresponding to standard hydroxyapatite. Habibovic et al [ 5 ] also observed these results, describing that carbonated HA produces more favorable biological responses because carbonates in the apatite network structure increase the chemical reactivity, facilitating the resorption of bone tissue.…”