Estudio de un nuevo material en regeneración y preservación ósea de cavidades alveolares post-extracción

Abstract

Alveolar bone resorption after tooth extraction is well documented in dental literature. Filling the fresh alveolar socket with a bone substitute is a common practice to preserve bone ridge resorption to facilitate subsequent prosthetic or implant rehabilitation. This work is aimed to evaluate the efficacy and safety of a new novel synthetic bone substitute (Sil-Oss®, Azurebio s.l., Spain) for preserving post-extraction alveolar bone. Thirty-three patients, carrying at least one hopeless maxillary premolar tooth and prescribed with extraction and posterior implant rehabilitation, were randomized to receive either Sil-Oss® (n=20, test group) or Bio-Oss® (n=19, control group) in postextraction alveolar sockets, according to a parallel group design at the Dental Clinic of the University of Salamanca, Spain. The implanted sites were followed-up for 26 week by means of periodical clinical exams (8-10 day, 3, 12, 16-20 week) measurement of height and width of the alveolar crest (intraoperatively and 26 week), tomographic radiodensity (8-10 day and 26 week) and histological exam (26 week) of filled sockets. No significant differences were observed during the entire follow-up period between both groups with regard to safety outcomes, i.e., pain, inflammation, edema, suppuration, loss of material, healing and membrane exposure. Alveolar bone experienced small reduction in width (-0.9±1.3 mm Sil-Oss® vs. -0.6±1.5 mm Bio-Oss®) and height (-0.1±0.9 mm Sil-Oss® vs. -0.3±0.7 mm Bio-Oss®) in both experimental groups, however, no significant difference between groups was found. The radiodensity of sockets filled with Sil-Oss® was significantly lower than those ones filled with Bio-Oss® at the endpoints of 8-10 day and 26 week. Radiodensity of implanted sites apparently increased with time for both groups, however, the increments were not found statistically significant. According to the results Sil-Oss® was as safe and effective as Bio-Oss® for preserving alveolar ridge dimensions. The tomographic density of the sites implanted with Sil-Oss® was significantly lower than those corresponding to Bio-Oss®. However, the histologic results showed that osteoid matrix and remodeling new bone was more abundant in sites implanted with Sil-Oss® than in those corresponding to Bio-Oss®.