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Table of Contents
REVIEW ARTICLE
Year : 2021  |  Volume : 8  |  Issue : 1  |  Page : 24-26

Radiographic evaluation of bone healing in postextraction sockets following bone grafting using autogenous dentin and beta-tricalcium phosphate: A review


1 Assistant Professor, Department of Oral and Maxillofacial Surgery, Dental College, JNIMS (Jawaharlal Nehru Dental College, Imphal, Manipur, India
2 Consultant, Department of Periodontics, Sri Siddhartha Dental College and Hospital, Imphal, Manipur, India
3 Consultant, Sri Siddhartha Dental College and Hospital, Imphal, Manipur, India
4 Consultant, Vyas Dental College and Hospital Rajasthan University of Health and Sciences, Imphal, Manipur, India
5 Dental College, RIMS (Regional Institude of Dental Sciences), Government Manipur Health Services, Imphal, Manipur, India
6 Sr. Lecturer, Department of Periodontics, Rungta College of Dental Science’s and Research, Bhilai, Chhattisgarh, India

Date of Submission12-Feb-2021
Date of Acceptance15-Feb-2021
Date of Web Publication27-Mar-2021

Correspondence Address:
Dr. Nikesh Thounaojam
consultant, Department of Periodontics Sri Siddhartha Dental College and Hospital, Imphal, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpcdr.ijpcdr_7_21

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  Abstract 


Evidence-based study shows that auto-tooth bone graft material supports excellent bone regeneration by its osteoinduction and osteoconduction capacity. It consists of 5% organic and 4% inorganic substances. In inorganic substances, hydroxyapatite has the property of combining and dissociating calcium and phosphate as those of bone. Organic substances also contain bone morphogenetic protein and protein with osteoinduction capacity and Type I collagen. This review was conducted for the evaluation of density of bone formation after the placement of autogenous dentin and beta-tricalcium phosphate radiographically using grayscale analysis. Thus, we can conclude that autogenous dentin bone graft can be used as an alternative bone graft for socket preservation as it is readily available and it also heals faster.

Keywords: Autogenous, beta-tricalcium phosphate, bone graft


How to cite this article:
Sanjenbam N, Thounaojam N, Shalini P, Sanjenbam DD, Geeta R, Jha R. Radiographic evaluation of bone healing in postextraction sockets following bone grafting using autogenous dentin and beta-tricalcium phosphate: A review. Int J Prev Clin Dent Res 2021;8:24-6

How to cite this URL:
Sanjenbam N, Thounaojam N, Shalini P, Sanjenbam DD, Geeta R, Jha R. Radiographic evaluation of bone healing in postextraction sockets following bone grafting using autogenous dentin and beta-tricalcium phosphate: A review. Int J Prev Clin Dent Res [serial online] 2021 [cited 2021 Apr 19];8:24-6. Available from: https://www.ijpcdr.org/text.asp?2021/8/1/24/312238




  Introduction Top


Extraction of a tooth due to caries, trauma, or advanced periodontal disease is a procedure that often results in immediate destruction and loss of alveolar bone and surrounding soft tissues. Post extraction, the portion of the jaw bone that anchors the teeth will not receive the necessary stimulation and it will begin to breakdown. This leads to alveolar bone resorption.[1],[2] Remodeling of the alveolar bone that occurs after tooth loss leads to diminished alveolar ridge dimensions in both the vertical and horizontal planes, up to 40% to 60% bone loss height and width, as early as 3 months.[2],[3],[4] Postoperative extraction tooth socket deformities can be prevented by a procedure called socket preservation. Socket preservation is an indispensable procedure needed to prevent bone loss after tooth extraction. It helps in the maintenance of the socket.[3] There are various graft materials used for socket preservation such as autograft, allografts, and alloplastic materials, all of these materials show varying degrees of success in bone healing after tooth extraction.[5] Beta-tricalcium phosphate is one of the popular alternatives to autogenous bone graft. It is a crystalline, synthetic ceramic substitute that has been widely used to repair bony defects because of its osteoconductive capacity and has no organic components, therefore no chances of antigenicity or allergic reactions. Moreover, no cytotoxic compounds are released during the breakdown and resorption of this graft material.[6] Evidence-based study shows that auto-tooth bone graft material supports excellent bone regeneration by its osteoinduction and osteoconduction capacity. It consists of 5% organic and 4% inorganic substances. In inorganic substances, hydroxyapatite has the property of combining and dissociating calcium and phosphate as those of bone. Organic substances also contain bone morphogenetic protein and protein with osteoinduction capacity and Type I collagen.[7] This review was conducted for the evaluation of density of bone formation after the placement of autogenous dentin and beta-tricalcium phosphate radiographically using grayscale analysis.


  Alveolar Bone Remodeling Top


Extraction of a tooth is one of the most commonly performed procedures in dentistry. There are different indications for the extraction of teeth. It may be necessary because of pain, infection, bone loss, or fracture of the tooth. Tooth extraction whether due to caries, trauma, or advanced periodontal disease is a traumatic procedure that will often lead to immediate destruction and loss of alveolar bone along with the surrounding soft tissues.[3],[4],[5] Post extraction, the alveolar bone that anchors the teeth will no longer receive the necessary stimulation which will eventually lead to breakdown and bone resorption. Alveolar bone remodeling that occurs after tooth extraction will lead to diminished alveolar ridge dimensions both in the vertical as well as horizontal planes up to 40% to 60% bone loss height and weight as early as 3 months. The grafted extracted site had been reported with a loss of width <2 mm and a loss of height <0.5 mm as compared to the nongrafted extraction sites that had been reported with a loss of width from 2 to 6 mm and ridge height of 1 mm with great variations.[8] All osteoplastic materials can be divided into four groups by origin as autogenous bone graft, allogenic bone graft, xenogenic bone graft, and alloplastic bone graft or synthetic bone substitutes.[4] Among these various types of bone graft materials, autogenous bones are the most ideal. They are capable of osteogenesis, osteoinduction, and osteoconduction. The main advantage is rapid healing time without immune rejection.[8]


  Autogenous Bone/Dentin Top


Autogenous bone is an ideal material for the preservation of socket defect as it promotes osteogenesis, osteointegration, osteoconduction, and rapid healing. It also does not induce immune rejection. The disadvantage of autogenous bone as a grafting material includes limited harvested volume and a second defect may be induced in the donor area.[9],[10]


  Beta-Tricalcium Phosphate Top


In over to overcome these limitations, allogenic bone, xenogenic bone, and synthetic bone have been used in clinical practice.[6] Beta-tricalcium phosphate is a synthetic bone graft and is also one of the popular alternatives to autogenous bone. Beta-tricalcium phosphate is known to be osteoconductive as it lacks growth factors and cellular components, it has no osteoinductive properties. Beta-tricalcium phosphate has also been shown to be resorbable and simultaneously capable of supporting new bone formation.[9] A study done in Manipur[8] observed that autogenous dentin and beta-tricalcium phosphate were well accepted within the extracted socket. A collagen membrane barrier was placed over the grated site, which helps in confining the grafted material within the extracted socket and is also resorbable, so secondary surgery is not needed. There was no incidence of allergic reaction and infection during the postoperative follow-up. The mean valve obtained after grayscale analysis for beta-tricalcium phosphate graft was 110.325 preoperatively and 131.461 postoperatively. For autogenous dentin, the mean value obtained was 107.893 preoperatively and 115.990 postoperatively. The difference between the two bone grafts in density analysis was found to be statistically significant during the 12th month follow-up. The statistical analysis was done using a Student t-test and it was observed that autogenous dentin bone graft can be used as an ideal bone graft for socket preservation and also it is easily available for most of the grafting procedures.[5],[6],[7],[8],[9],[10]


  Conclusion Top


It is observed that autogenous dentin bone graft and beta-tricalcium phosphate graft are well accepted on the postextraction grafted site with no infection and allergic reactions when radiographically using grayscale analysis using Adobe Photoshop Software Version 7. Thus, we can conclude that autogenous dentin bone graft can be used as an alternative bone graft for socket preservation as it is readily available and it also heals faster.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Schropp L, Wenzel A, Kostopoulos L, Karring T. Bone healing and soft tissue contour changes following single tooth extraction: A clinical and radiographic 12 months prospective study. Int J Periodontics Restorative Dent 2003;23:313-23.  Back to cited text no. 1
    
2.
Caplanis N, Lozada LJ, Kan JY. Extraction defect assessment, classification, and management. J Calif Dent Assoc 2005;33:853-63.  Back to cited text no. 2
    
3.
Irinakis T. Rationale for socket preservation after extraction of a single-rooted tooth when planning for future implant placement. J Can Dent Assoc 2006;72:917-22.  Back to cited text no. 3
    
4.
Gomes MF, Abreu PP, Morosolli AR, Araújo MM, Goulart MD. Densitometric analysis of the autogenous demineralized dentin matrix on the dental socket wound healing process in humans. Braz Oral Res 2006;20:324-30.  Back to cited text no. 4
    
5.
Allegrini S Jr., Koening B Jr., Allegrini MR, Yoshimoto M, Gedrange T, Fanghaenel J, et al. Alveolar ridge sockets preservation with bone grafting – Review. Ann Acad Med Stetin 2008;54:70-81.  Back to cited text no. 5
    
6.
Horowitz RA, Mazor Z, Miller RJ, Krauser J, Prasad HS, Rohrer MD. Clinical evaluation alveolar ridge preservation with a beta-tricalcium phosphate socket graft. Compend Contin Educ Dent 2009;30:588-90, 592, 594.  Back to cited text no. 6
    
7.
Kim YK, Kim SG, Byeon JH, Lee HJ, Um IU, Lim SC, et al. Development of a novel bone grafting material using autogenous teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:496-503.  Back to cited text no. 7
    
8.
Nelson S. Radiographic evaluation of bone healing in post extraction sockets following bone grafting using autogenous dentin and beta tricalcium phosphate. Int J Dent Health Sci 2020;7:2-16.  Back to cited text no. 8
    
9.
Brkovic BM, Prasad HS, Rohrer MD, Konandreas G, Agrogiannis G, Antunovic D, et al. Beta-tricalcium phosphate/type I collagen cones with or without a barrier membrane in human extraction socket healing: Clinical, histologic, histomorphometric, and immunohistochemical evaluation. Clin Oral Investig 2012;16:581-90.  Back to cited text no. 9
    
10.
Kim YK. Bone graft material using teeth. Korean Assoc Oral Maxillofac Surg 2012;38:134-8.  Back to cited text no. 10
    




 

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