8 March 2015; 7(1) © ARIESDUE
ABSTRACT
Aim The objective of this study was to assess the capacity of beta-
tricalcium phosphate to facilitate bone formation in the socket
and prevent post-extraction alveolar resorption.
Materials and methods After premolar extraction in 16
patients, the sockets were flled with beta-tricalcium phosphate.
Six months later, during the implant placement surgery, a trephine
was used to harvest the bone samples which were processed
for histological and histomorphometrical analyses. Data were
gathered on patient, clinical, histological and histomorphometric
variables at the extraction and implant placement sessions, using
data collection forms and pathological reports.
Results Clinical outcomes were satisfactory, the biomaterial was
radio-opaque on X-ray. Histological study showed: partial flling
with alveolar bone of appropriate maturation and mineralization
for the healing time, osteoblastic activity and bone lacunae
containing osteocytes. The biomaterial was not completely
resorbed at six months.
Conclusion Beta-tricalcium phosphate is a material capable of
achieving preservation of the alveolar bone when it is positioned
in the immediate post-extraction socket followed by suture;
it also helps the formation of new bone in the socket. Further
studies are needed comparing this technique with other available
biomaterials, with growth factors and with sites where no
alveolar preservation techniques are performed.
Post-extraction application of beta-tricalcium phosphate
in alveolar socket
TO CITE THIS ARTICLE
Muñoz-Corcuera M, Bascones-Martínez A, Ripollés-de Ramón J. Post-extraction application
of beta tricalcium phosphate in alveolar socket. J Osseointegr 2015;7(1):8-14.
M. MUñOZ-CORCUERA, A. BASCONES-MARTíNEZ
1
, J. RIPOLLéS-DE RAMóN
INTRODUCTION
In normal conditions, healthy bone is under continuous
remodelling and has an effective self-repair capacity.
Bone remodelling maintains a continuous balance of
bone formation and resorption in a dynamic process
that adapts the bone to local forces (1). Above a critical
defect size, however, bone cannot be repaired by its own
osteogenic activity, and some type of bone grafts must
be used (2).
Jaw bone defects can be caused by surgical resection,
traumatic loss, ossification impairment (in the elderly),
periodontal and peri-implant diseases and congenital
disorders. These defects may complicate the surgical
phase of implant supported rehabilitation treatment
due to insufficient bone volume for an adequate
implantation (3, 4). Jaw bone loss is frequently caused
by post-extraction alveolar resorption, a physiological
phenomenon which leads to a reduction of the original
height and width of the alveolar ridge to a degree that
varies among localizations and patients (5). Alveolar ridge
preservation techniques have been developed to address
the ensuing clinical problem, especially in aesthetic areas
(5). They are conducted during or after extraction and
are designed to minimize external ridge resorption and
maximize bone formation inside the socket (5). Measures
include autologous bone grafts, allografts, bone of
animal origin (xenografts) and synthetic bone substitutes
(alloplastic grafts), as well as the application of growth
factors and gene therapies (3, 4, 6).
Beta-tricalcium phosphate (beta-TCP) is widely used
as a biocompatible, resorbable and osteoconductive
ceramic substitute to repair bone defects. Thanks to its
physicochemical characteristics, it has been successfully
used to fill spaces in multiple settings, including biology,
veterinary medicine, human medicine and dentistry (7-
12). It has also been proposed as a vehicle for growth
factors that stimulate bone formation (12, 13). Various
authors have reported on its capacity as a biomaterial
for bone regeneration in animals and humans (4, 14-21).
The study is aimed at evaluating granular beta-TCP in
post-extraction sockets in order to measure its bone
regenerative potential and its capacity to preserve
the original height and width of the alveolar bone for
subsequent implant placement.
Specifically, the study objectives were the following.
1. To analyze the clinical and radiological results
Department of Oral Medicine and Surgery, School of Dentistry, Madrid Complutense University, Madrid, Spain
1
Professor at Dental School
KEYWORDS Bone graft; Calcium phosphate; Dental implant;
Post-extraction alveolar socket.