Accelerated Osteogenesis in Extraction Sockets using a novel Calcium Sulfate-PRF Combination: A Clinico-Histological Study

A pre-requisite for placement of dental implants is availability of sufficient vital bone.Literature reports vertical and horizontal ridge reduction following extraction, primarily in the initial 3 months. Post extraction socket grafting is performed to avoid future complex bone augmentations. The search for an ideal socket graft material is ongoing. Aim: To evaluate and compare (Clinically, Radiographically, Histologically,) the quantity of newly formed bone in naturally healing human extraction sockets to sockets grafted with a combination of Medical-Grade Calcium Sulphate Hemihydrate(MGCSH) and Platelet Rich Fibrin(PRF). Methods: Five patients (both male and females) in the age group of 20-45, who require to undergo multiple extractions in the mandible were selected based on strict inclusion and exclusion criteria. For each patient, one socket received a combination of MGCSH and PRF combination. The other socket was left to heal naturally. Radiographic analysis of the extraction sites were performed pre and post extraction and after 8 weeks, using a standardized radiographic technique. Bone cores were trephined out of the socket after 8-10 weeks. They were decalcified and the amount of new osteoid deposition and trabaculae formation was evaluated under an Image analyser for determining percentage of vital bone formation. Results: 36% new bone formation (mostly lamellar) was seen in the grafted sites and 22% in the control sites. Comparisons between the test and control group was performed using un-paired student-t test. Conclusions and clinical implications: A combination of Calcium sulphate and PRF is highly osteogenic resulting in faster bone formation in extraction sockets. This can be used as a simple, inexpensive, uncomplicated yet effective socket graft material. Its use can yield tooth extraction healing sites ready to receive dental implants at an earlier stage than conventionally healing sockets. Schlagwörter: osteogenesis, PRF, calcium sulphate