Travmatologiâ i Ortopediâ Rossii (Apr 2021)
Features of Bone Regeneration of the Jaws Alveolar Ridge Using Hydroxyapatite-Based Material
Abstract
Background. Currently, using of osteointegrated titanium implants has become a key component for restoring lost function in various areas of clinical medicine. The actual issue remains preservation or reconstruction of bone tissue for optimal use of titanium implants in traumatology and orthopedics, as well as in maxillofacial surgery. One of the most common grafts are hydroxyapatite-based material with various inclusions, for example, an antibiotic. The aim of the study is to characterize the regeneration of bone tissue of the jaws alveolar ridge using the hydroxyapatite-based material “Collapan-L” in clinical practice. Material and Methods. The study of the material “Collapan-L” (Intermedapatit, Russia) using involved 30 patients with a diagnosis “chronic periodontitis of the tooth”. Patients underwent complex surgical and orthopedic treatment to restore masticatory function. At the first stage, teeth were removed with the “Collapan-L” material used to preserve the alveolus. 4 months after extraction, dental implantation was performed with simultaneous trephine biopsy from the augmentation zone for histomorphometric analysis. At the stage of implant placement and before prosthetics the stability dynamics was measured. Results. The study involved 42 tissue samples obtained at periods from 9 to 32 weeks after removal. The morphological assessment of bone tissue from the implantation zone determined that after 4 months trabeculae from the newly formed bone, including small fragments of biomaterial, were revealed; at the same time, there were signs of biodegradation of the implanted material fragments, there was no inflammatory infiltrate. After 6 months in a significant part of cases the granules of bone material were not found, which indicates a pronounced osseointegration of the material. In its structure, the formed bone tissue differences barely noticeable from the native one, which allows us to conclude that by the time of 24 weeks, the processes of reparative osteogenesis in the alveolus are completed. Conclusion. Histological examination and assessment of changes in the stability showed that using of bone replacement material after tooth extraction can increase the regenerative potential of bone tissue, avoid additional surgical interventions to increase the volume of bone tissue in the area of future implantation, and the formed bone tissue is close in its structure to the native one.
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