Clinical and Radiographic Evaluation of Zinc Incorporated Bovine Derived- Hydroxyappatite Xenograft in Immediately Placed Implant: A Randomized Clinical Study

Implant dentistry is a prosthetic effort via a surgical procedure. In order to achieve an ideal prosthetic construct, precise plan should be taken into consideration prior to the beginning of treatment. The position of implant requires protected prosthesis. It can be affected by the implant size, volume, and the quantity and quality of bone provided at various sites.

One pitfall of immediate implant use, however, is the inevitable residual space that remains between the implant body and the socket wall, due to a discrepancy in size between the implant and the socket wall. This space, which is located toward the coronal end of the implant, is called the jumping distance. Excessive jumping distance may lead to bone resorption and formation of a bony defect, decreasing the implant stability .

One of the most extensively used methods for restoration of the lost attachment is the use of bone grafts. bone grafting which is one of the methods used to address these issues has experienced an increased level of demand.

The problem of bone defects has also contributed to making bone autograft become the gold standard for treating bone abnormalities, although it has its limitations which are graft quantity and donor site morbidity. Contributory,allografts have become popular for replacing bone defects because the graft size can be easily adjusted but it also has several drawbacks, including disease transfer, rejection reactions, non-union, graft resorption, fracture, and donor restrictions A xenograft is one of the choices used to overcome these limitations since the raw material is plentiful, readily available, and inexpensive. Additionally, several previous studies showed that organic or inorganic matrix derived from bovine bone is biocompatible, but this biomaterial requires proper preparation to avoid risks such as the transmission of zoonoses .

Bovine hydroxyapatite is made up of materials which have biological properties that makes it biocompatible and osteoconductive. These important biological properties allow the apposition of newly formed bone by osteoprogenitor cells and the partial remodeling by osteoclast and osteoblast of the host . Hydroxyapatite is used as scaffolds to support the development of bone tissue from an osteoblast proliferation stage through to extracellular matrix (ECM) deposition and on to cell-mediated early-stage mineralization. The addition of small quantities of hydroxyapatite to the scaffolds considerably increases calcium deposition and has a mild osteogenic impact.