Abstract
Objectives:
The objective of the study is to compare xenograft graft material and synthetic bioactive glass allograft in immediate dental implant patients.
Materials and Methods:
Forty patients were grouped as Group A patients (xenograft graft material, BioOss) and Group B (synthetic allograft material, Perio Glas) and immediate implant placement was done. Plaque index, gingival index, probing depth, and bone resorption were compared at different intervals.
Results:
A nonsignificant difference was observed in all parameters at different interval of time (P > 0.05) recorded at mesial, distal, buccal, and lingual side.
Conclusion:
Xenograft (Bio Oss) and synthetic allograft (PerioGlas) found to be effective graft materials treatment choice.
KEYWORDS: Allograft, gingival index, plaque index, xenograft
INTRODUCTION
Immediate dental implant insertion procedure has gained popularity in today's life since the quantity of the alveolar bone is maintained as well as there is no need of projecting the patients to second surgical step. It reduces discomfort to the patients.[1]
The chances of dental implant are high in the area of sufficient bone quantity. In recent extracted cases, dental implant can be inserted with biocompatible material.[2] Graft is placed in the area between dental implant and socket to promote osseointegration. Based on the properties of osteoinductive, osteoconductive, and osteogenic nature, autogenous bone graft is the best among all.[3]
Perio Glas acts as a scaffold for bone formation and it is easily available in market.[4] Bio-Oss is a biocompatible material that has maximum stability with a slow resorption rate and, in turn, helps in new bone formation.[5] The present study compared xenograft graft material and synthetic bioactive glass allograft in immediate dental implant patients.
MATERIALS AND METHODS
After considering the inclusion and exclusion criteria, 40 patients aged 18–50 years of both genders were included for the study with 20 samples in each group. The approval for the study was obtained from review and ethical clearance committee.
Group A patients were those who undergo extraction and use of xenograft graft material (Bio-Oss) along with immediate implant placement and Group B patients were those who underwent extraction and BPP followed by use of synthetic allograft material (PerioGlas) and immediate implant placement.
All selected patients underwent atraumatic extraction followed by cone beam computed tomography scan of the site. After assessing the scan for height, width, and angulation of insertion, an appropriate size dental implant was selected and inserted into the socket.
Assessment of parameters such as gingival index and modified plaque index at buccal, lingual, distal, and mesial side was performed. Probing depth was calculated at both the full mouth site and the immediate implantation site Digital intraoral radiographs were taken postoperatively at 3rd, 6th months, and 1 year. Cases were considered successful when there was no mobility as well as absence of peri-implantitis radiographically.
Data were recorded as mean and statistically evaluated using Statistical Package for Social Sciences version 21.0 for Windows (SPSS Inc., Chicago, IL, USA). A <0.05 was regarded as considerable.
RESULTS
Implant site gingival index measured at 3 months showed value of 0.94 in Group A and 0.85 in Group B, at 6 months was 0.84 in Group A and 0.89 in Group B and at 1 year was 0.80 in group A and 0.84 in Group B. Intergroup comparison revealed nonsignificant difference (P > 0.05) [Table 1]. Intergroup comparison for plaque score revealed nonsignificant difference (P > 0.05) [Table 2].
Table 1.
Comparison of gingival index at different intervals in both groups
| Parameters | Duration | Group A | Group B | P |
|---|---|---|---|---|
| Full mouth gingival index | 3 months | 0.87 | 0.80 | 0.72 |
| 6 months | 0.83 | 0.85 | 0.90 | |
| 1 year | 0.83 | 0.86 | 0.85 | |
| Implant site gingival index | 3 months | 0.94 | 0.85 | 0.72 |
| 6 months | 0.84 | 0.89 | 0.93 | |
| 1 year | 0.80 | 0.84 | 0.81 |
Table 2.
Comparison of plaque index at different intervals in both groups
| Parameters | Duration | Group A | Group B | P |
|---|---|---|---|---|
| Full mouth plaque index | 3 months | 0.66 | 0.65 | 0.91 |
| 6 months | 0.83 | 0.81 | 0.80 | |
| 1 year | 0.69 | 0.71 | 0.62 | |
| Implant site plaque index | 3 months | 0.73 | 0.75 | 0.92 |
| 6 months | 0.79 | 0.77 | 0.82 | |
| 1 year | 0.71 | 0.71 | 0.84 |
Table 3 shows that mean probing depth recorded at 6 months in Group A at mesial, distal, buccal, and lingual side. A nonsignificant variation was seen among two groups (P > 0.05) [Table 3].
Table 3.
Comparison of probing depth in both groups
| Duration | Site | Group A | Group B | P |
|---|---|---|---|---|
| 6 months | Mesial | 2.42 | 2.32 | 0.95 |
| Distal | 2.23 | 2.21 | 0.94 | |
| Buccal | 2.26 | 2.23 | 0.91 | |
| Lingual | 2.32 | 2.28 | 0.73 | |
| 1 year | Mesial | 2.28 | 2.12 | 0.87 |
| Distal | 2.22 | 2.24 | 0.88 | |
| Buccal | 2.20 | 2.22 | 0.90 | |
| Lingual | 2.08 | 2.05 | 0.72 |
A nonsignificant variation was seen in amount of bone resorption at both mesial and distal side in Group A and IB (P > 0.05) [Table 4].
Table 4.
Comparison of bone resorption in both groups
| Duration | Side | Group A | Group B | P |
|---|---|---|---|---|
| 3 months | Mesial | 5.04 | 4.92 | 0.12 |
| Distal | 4.94 | 5.01 | 0.15 | |
| 6 months | Mesial | 3.62 | 3.37 | 0.21 |
| Distal | 3.70 | 3.66 | 0.26 | |
| 1 year | Mesial | 3.12 | 3.26 | 0.72 |
| Distal | 3.25 | 3.11 | 0.17 |
DISCUSSION
A dental implant if it stays for more than 5 years without complications such as mobility is considered to be successful treatment.[6] Immediate dental implants are becoming popular nowadays if used with appropriate grafts. Recent extraction sockets had plenty of periodontal cells and matrix offering rapid healing and decreasing bone resorption.[7]
Daniel et al. found that PerioGlas and Bio-Oss in immediate implant site indicated outstanding osseointegration around the immediate implant site.[8]
Viswambaran et al. found no failures after 3 months in 30 patients inserted with immediate implant using freeze-dried bone allograft and modified hydroxyapatite.[9]
Becker et al. inserted 49 immediate implants using expanded polytetrafluoroethylene membrane and found 4.8 mm bone formation in membrane-retained sites as compared to 4.0 mm in sites where membranes were prematurely removed.[10]
A nonsignificant difference was observed in amount of bone resorption at both mesial and distal side in Group A and B. Bio-Oss is a highly porous structure stimulates more capillaries in the growth, migration, and proliferation of osteoblasts. Perio Glas promotes osteoconduction and their ability to bond to soft and osseous tissues makes it popular in comparison to other alloplastic materials.[11] Further studies are needed to verify the results.
CONCLUSION
Both xenograft (Bio-Oss) and synthetic allograft (PerioGlas) were found to be effective graft materials treatment choice. There was comparable bone formation with both grafts.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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