J Korean Assoc Oral Maxillofac Surg 2019; 45(6): 332~342
Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique
Vivekanand Sabanna Kattimani1, Krishna Prasad Lingamaneni1, Girija Easwaradas Kreedapathi2, Kiran Kumar Kattappagari3
Departments of 1Oral and Maxillofacial Surgery and 3Oral and Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, 2Department of Physics, Periyar University Salem, Salem, India
Vivekanand Sabanna Kattimani
Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Takkellapadu, Guntur, Andra Pradesh 522509, India
TEL: +91-863-2292249 FAX: +91-863-2292139
E-mail: drvivekanandsk@gmail.com
ORCID: https://orcid.org/0000-0002-9812-7207
Received December 15, 2018; Revised May 1, 2019; Accepted May 12, 2019.; Published online December 31, 2019.
© The Korean Association of Oral and Maxillofacial Surgeons.. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Objectives: Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation.
Materials and Methods: This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee.
Results: All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissue re-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae.
Conclusion: Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshellderived nHA and PRF membrane from the patient’s own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.
Keywords: Bone, Tooth extraction, Socket grafting, Wound healing, Bone regeneration


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31 December 2019
Vol. 45
No. 6 pp. 301~378

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