Brief Background and Goal: Dimensional changes following extractions are inevitable. Many
techniques and combinations of materials have been studied and shown to be effective at
minimizing these changes. Although no material has been able to fully preserve the ridge,
xenografts have been shown to be the most effective at maintaining the volume, however,
the use of demineralized freeze-dried bone allograft (DFDBA) results in the most vital
bone when evaluated histologically. These factors are important when planning for a
successful future implant supported prosthesis. A new material that combines xenograft
(deproteinized bovine bone mineral - DBBM) with DFDBA has recently been introduced to the
market. The aim of the study is to compare the dimensional and histological changes
following flapless alveolar ridge preservation (ARP) in the premolar and molar region
with a new material that combines DFDBA and DBBM to a commonly used mineralized
allograft.
Research Question: In patients who require an extraction for future implant placement,
during alveolar ridge preservation, will combining demineralized freeze-dried bone
allograft (DFDBA) and deproteinized bovine bone mineral (DBBM) compared to Tutoplast®
processed mineralized particulate allograft result in less dimensional changes at the
time of implant placement 4 months later.
Specific Aims: The primary goal of the study is to compare the dimensional changes
following alveolar ridge preservation with a new material that combines DFDBA and DBBM to
a commonly used mineralized allograft material. The secondary goal is to assess the
histological composition of the bone after 4 months of healing. The additional goals are
to measure possible confounding factors on the dimensional changes of the alveolar ridge.
Significance: The goal behind the combination of DBBM and DFDBA is to evaluate whether
there could potentially be a synergistic effect between the two materials that would make
it a more desirable material to use for ARP procedures.
Innovation: There is currently no published research that compares the combination of
DFDBA and DBBM to a conventional method inside the extraction site during an alveolar
ridge preservation procedure. This grafting material is new on the market and the first
of its kind.
Research Plan: The randomized clinical trial will be performed at the Nova Southeastern
College of Dental Medicine in the Post-graduate Periodontology Clinic. 30 patients
requiring premolar or molar extraction with future implant placement will be randomly
divided into 2 groups, one test and one control. Following extraction, the patients will
receive either allograft or graft combination of DFDBA and DBBM. The changes in
horizontal and vertical dimensions of the alveolar ridge as well as the histology will be
assessed and compared at 4 months.
Expected Results: When compared to allograft, the graft mixture containing the DFDBA and
DBBM will maintain greater dimensional volume due to the dimensionally stable properties
of DBBM and will contain more vital bone due to the osteoinductive properties of DFDBA.