Three-dimensional assessment of the extraction sockets, augmented with platelet-rich fibrin and calcium sulfate: A clinical pilot study

Tipu Sultan; Chia Wei Cheah; Norliza Binti Ibrahim; Muhammad Khan Asif; Rathna Devi Vaithilingam

doi:10.1016/j.jdent.2020.103455

Three-dimensional assessment of the extraction sockets, augmented with platelet-rich fibrin and calcium sulfate: A clinical pilot study

J Dent. 2020 Oct:101:103455. doi: 10.1016/j.jdent.2020.103455. Epub 2020 Aug 21.

Authors

Tipu Sultan¹, Chia Wei Cheah², Norliza Binti Ibrahim³, Muhammad Khan Asif³, Rathna Devi Vaithilingam⁴

Affiliations

¹ Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia. Electronic address: dr.tipusultan23@gmail.com.
² Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia. Electronic address: chiawei@um.edu.my.
³ Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
⁴ Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.

PMID: 32828845
DOI: 10.1016/j.jdent.2020.103455

Abstract

Objectives: This clinical study assessed and compared the linear and volumetric changes of extraction sockets grafted with a combination of Platelet-Rich Fibrin (PRF) and Calcium Sulfate (CS) (PRF-CS), and extraction sockets grafted with a combination of PRF and xenograft (X) (PRF-X).

Methods: Five single maxillary premolar extraction sockets received PRF-CS grafts and five single maxillary premolar sockets received PRF-X grafts. Linear (horizontal and vertical) measurements were accomplished using Cone Beam Computed Tomography (CBCT) images and volumetric changes were assessed using MIMICS software. Soft tissue level changes were measured using Stonecast models. All measurements were recorded at baseline (before extraction) and at 5-months post-extraction.

Results: Significant reduction in vertical and horizontal dimensions were observed in both groups except for distal bone height (D_BH = 0.44 ± 0.45 mm, p = 0.09) and palatal bone height (P_BH = 0.39 ± 0.34 mm, p = 0.06) in PRF-X group. PRF-CS group demonstrated mean horizontal shrinkage of 1.27 ± 0.82 mm (p = 0.02), when compared with PRF-X group (1.40 ± 0.85 mm, p = 0.02). Vertical resorption for mesial bone height (M_BH = 0.56 ± 0.25 mm, p = 0.008), buccal bone height (B_BH = 1.62 ± 0.91 mm, p = 0.01) and palatal bone height (P_BH = 1.39 ± 0.87 mm, p = 0.02) in PRF-CS group was more than resorption in PRF-X group (M_BH = 0.28 ± 0.14 mm, p = 0.01, B_BH = 0.63 ± 0.39 mm, p = 0.02 and P_BH = 0.39 ± 0.34 mm, p = 0.06). Volumetric bone resorption was significant within both groups (PRF-CS = 168.33 ± 63.68 mm³, p = 0.004; PRF-X = 102.88 ± 32.93 mm³, p = 0.002), though not significant (p = 0.08) when compared between groups. In PRF-X group, the distal soft tissue level (D_SH = 1.00 ± 0.50 mm, p = 0.03) demonstrated almost 2 times more reduction when compared with PRF-CS group (D_SH = 1.00 ± 1.00 mm, 0.08). The reduction of the buccal soft tissue level was pronounced in PRF-CS group (B_SH = 2.00 ± 2.00 mm, p = 0.06) when compared with PRF-X group (B_SH = 1.00 ± 1.50 mm, p = 0.05).

Conclusions: PRF-CS grafted sites showed no significant difference with PRF-X grafted sites in linear and volumetric dimensional changes and might show clinical benefits for socket augmentation. The study is officially registered with ClinicalTrials.gov Registration (NCT03851289).

Keywords: Calcium sulfate; Extraction socket; Platelet-rich fibrin; Ridge preservation; Socket augmentation; Xenograft.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alveolar Bone Loss* / diagnostic imaging
Calcium Sulfate
Humans
Pilot Projects
Platelet-Rich Fibrin*
Tooth Extraction
Tooth Socket / diagnostic imaging
Tooth Socket / surgery

Substances

Calcium Sulfate

Associated data

ClinicalTrials.gov/NCT03851289