Ridge Preservation After Maxillary Third Molar Extraction Using 30% Porosity PLGA/HA/β-TCP Scaffolds With and Without Simvastatin: A Pilot Randomized Controlled Clinical Trial

Implant Dent. 2017 Dec;26(6):832-840. doi: 10.1097/ID.0000000000000655.

Abstract

Objective: To evaluate clinically and radiographically, in humans, the healing of maxillary third molars postextraction sockets after application of different ridge preservation techniques 3 months after tooth extraction.

Materials and methods: Twenty-six sockets (13 patients) were randomly assigned to 4 treatment modalities: deproteinized bovine bone mineral with 10% collagen (DBBM-C), poly(D,L-lactide-co-glycolide) with hydroxyapatite/β-TCP scaffold (PLGA/HA), PLGA/HA/β-TCP with 2.0% simvastatin scaffold (PLGA/HA/S), and spontaneous healing (control). Clinical complications were assessed, and cone-beam computed tomographies were taken in 5 patients 3 months after surgeries. For statistical purposes, the Fisher exact test was used (P < 0.05).

Results: After 3 months, 6 of 9 grafts from the PLGA/HA group were lost (P < 0.05). PLGA/HA/S' loss was only 2 of 8 (P > 0.05), but no loss was observed in the DBBM-C group. Pain was present in 3 of 8 sites that lost the graft (37.5%) (P > 0.05) and infection in 1 of 8 (12.5%) (P > 0.05), with these only occurring in the PLGA/HA group.

Conclusions: Poly (D, L-lactide-co-glycolide) with hydroxyapatite/β-TCP (PLGA/HA/β-TCP) scaffolds, with and without simvastatin, failed to obtain the initial expected results and presented more complications. Scaffolds with simvastatin showed to be superior, with less clinical complications than scaffolds without simvastatin.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Alveolar Ridge Augmentation / methods*
  • Biocompatible Materials / therapeutic use*
  • Bone Substitutes / therapeutic use*
  • Calcium Phosphates / therapeutic use*
  • Collagen / therapeutic use*
  • Cone-Beam Computed Tomography
  • Durapatite / therapeutic use*
  • Female
  • Humans
  • Lactic Acid / therapeutic use*
  • Male
  • Maxilla / surgery*
  • Minerals / therapeutic use*
  • Molar, Third / surgery*
  • Pilot Projects
  • Polyglycolic Acid / therapeutic use*
  • Polylactic Acid-Polyglycolic Acid Copolymer
  • Porosity
  • Prospective Studies
  • Simvastatin / therapeutic use*
  • Tissue Scaffolds*
  • Tooth Extraction*
  • Young Adult

Substances

  • Bio-Oss
  • Biocompatible Materials
  • Bone Substitutes
  • Calcium Phosphates
  • Minerals
  • beta-tricalcium phosphate
  • Polylactic Acid-Polyglycolic Acid Copolymer
  • Polyglycolic Acid
  • Lactic Acid
  • Collagen
  • Durapatite
  • Simvastatin