الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 136 |  |  |
| | | from | 136 | | |
Abstract
The present study was performed to compare clinical, radiographic, and histological effect of bihybrid composite bone graft in preservation of alveolar bone of extraction socket in the maxillary esthetic zone versus without it.
Twenty patients were included in this study, with their age ranging from 21 to 50.
The patients were divided into two groups. Ten patients has undergone extraction of the non-restorable tooth and insertion of bihybrid composite bone graft in the socket covered by absorbable sponge and sutured by 3/0 polypropylene sutures (Study group).
The other ten patients have undergone the same steps of the study group but without bone graft placement. (Control group)
All patients were nonsmokers and free from any systemic disease or sever infection that may affect the healing process postoperatively. All patients had non restorable maxillary anterior teeth indicated for extraction.
Surgical treatment was based on atraumatic extraction using periotome by cutting the periodontal ligaments which allow easier removal of the tooth. this could avoid possible soft and hard tissue injury which might caused by extraction force and movement.
Postoperative antibiotic and non-steroidal anti-inflammatory medications were prescribed to all patients in order to control potential pain and infection, cold fomentation application to control the possible postoperative edema, and sutures were removed after one week.
Clinical evaluation was performed daily for the first week and monthly in the following six months.
Radiographic analysis was performed using CBCT imaging immediately after extraction and after six months to evaluate vertical and horizontal dimensional changes as well as the bone density.
Bone biopsy was collected by trephine bur with inner diameter of 2 millimeters and outer diameter of 3 millimeter for Histological analysis after six months from the site of healed bone where the future implant would be inserted.
Clinically, inspection of complete healing in all patients. No signs of infection or swelling in all patients.
The radiographic evaluation revealed significant differences in socket dimensions preservation between both groups, and the study group showed better ridge horizontal and vertical dimensional stability and better bone density, which will facilitate implant surgery and improve its outcome.
Histological Study revealed more new bone formation and more bone proteins expression in the study group after six months.
Socket preservation using bihybrid composite bone graft (Smart bone) has significantly reduced alveolar bone resorption after six months follow up period. No infection, swelling or healing failure was shown in both groups. However, radiograpic information revealed minimal height and width reduction in grafted sockets while in sockets left without graft, significant reduction in these dimensions was shown.
The radiograph data showed that this smart bone has led to more preservation of bone vertical and horizontal dimensions and contributes to higher density in the healed bone, while sockets without graft has a remarkable reduction in both bone volume and density. Histological evidence indicated that by using bihybrid composite graft, the amount of newly formed bone will be higher and bone proteins release which associated with bone formation has shown to be greater.