All ETDs from UAB

Advisory Committee Chair

Nicolaas Geurs

Advisory Committee Members

Michael S Reddy

Amjad Javed

Jack Lemons

Document Type

Thesis

Date of Award

2013

Degree Name by School

Master of Dentistry (MDent) School of Dentistry

Abstract

Ridge preservation protocols reduce crestal remodeling after tooth extraction. Limited evidence supports the potential of different grafting materials to preserve the alveolar ridge. There is limited evidence to indicate advantage of bone replacement grafting in combination with platelet rich plasma (PRP), compared to grafting alone. A combination of recombinant human platelet derived growth factor (rhPDGF-BB) with beta tricalcium phosphate (ß-TCP) has recently been approved to aid wound healing. Aim: To evaluate early healing of grafted and non-grafted extraction sockets in the es-thetic zone, with or without PRP and rhPDGF-BB. Materials and Methods: Population consisted of 41 healthy adult patients whose treat-ment plan included extraction of anterior teeth and replacement by dental implants. Participants were randomized into four groups. One site per subject was selected to re-ceive trephine sampling. Teeth were extracted and following groups were formed: Group 1: Saline irrigation (Control). Group 2: Freeze-dried bone allograft (FDBA)/TCP/collagen plug. Group 3: FDBA/TCP/PRP/collagen plug and Group 4: FDBA/TCP/ rhPDGF-BB /collagen plug. At 8 weeks, a core was harvested from the cen-ter of 41 sockets. Cores were processed and histomorphometric analysis took place. Differences were ana-lyzed using one-way analysis of variance (ANOVA) or chi-square tests for continuous and categorical data. If significant difference was determined, pairwise comparisons were tested using least squares means (LS-means). Spearman correlation coefficients were used to evaluate the relationship of bone growth with potential confounders. A p-value <0.05 was considered statistically significant. Results: Analysis of variance did not indicate statistical significance in age gender, smok-ing, ethnicity or race distribution among groups. Significant differences in tissue distribu-tion were identified between groups as well as between different thirds of harvested core. Overall, more new bone as well as soft tissue formation was noted in group 1 comparing to the groups where bone graft was used. Where growth factors were used, the amount of residual particles was less than group 2. Conclusion: a)Inclusion of bone replacement graft suppressed new bone formation during early healing and b) Inclusion of PRP and rh-PDGFbb produced less residual bone graft particles, indicating more rapid turnover of bone graft but failed to induce signifi-cantly more new bone formation overall.

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