J Korean Assoc Oral Maxillofac Surg.  2019 Dec;45(6):332-342. 10.5125/jkaoms.2019.45.6.332.

Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique

Affiliations
  • 1Department of Oral and Maxillofacia Surgery, Sibar Institute of Dental Sciences, Guntur, India. drvivekanandsk@gmail.com
  • 2Department of Physics, Periyar University Salem, Salem, India.
  • 3Department of Oral and Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, India.

Abstract


OBJECTIVES
Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation.
MATERIALS AND METHODS
This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee.
RESULTS
All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissue re-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae.
CONCLUSION
Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.

Keyword

Bone; Tooth extraction; Socket grafting; Wound healing; Bone regeneration

MeSH Terms

Bone Density
Bone Regeneration
Bone Resorption
Chickens
Ethics Committees
Fibrin*
Humans
Membranes*
Mucous Membrane
Osteogenesis
Pilot Projects
Prospective Studies
Tooth Extraction
Transplants
Wound Healing
Fibrin
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