Comparison of Bone Mineral Density and Primary Implant Stability after Socket Preservation by Calcium Phospho-silicate Putty, Sticky Bone and Natural Bone Healing: A Randomized Controlled Clinical Trial

Socket preservation is a procedure which preserves the hard as well as soft tissues of the alveolar ridge after tooth extraction. 40% bone height reduction and 60% bone width reduction occur after 6 months of extraction. Bone loss occurs more on labial surface rather than lingual or palatal surface.This alveolar ridge resorption makes it difficult or next to impossible for fabrication of implant supported prosthesis. Thakkar et al. conducted a clinical study to evaluate bone healing and soft tissue alterations after removal of teeth. The authors found that after 12 months 50% of buccolingual width of edentulous site was lost. They concluded that preservation of bone in that area is mandatory specifically if osseo-integrated implants are to be planned. Various studies have shown positive impact of using different grafts, membranes and growth factors to preserve the sockets compared to spontaneous healing. Primary implant stability is a prerequisite for a predictable, long term secondary stability (Osseo-integration), the success of secondary stability depends upon the bone quality and quantity at the receptor site. The term ‘‘bone quality’’ is not clearly defined in the literature. This includes physiological and structural aspects and the degree of bone tissue mineralization.

The present study is aimed to investigate bone mineral density (by Lekholm and Zarb classification, 1985), on Cone Beam Computed Tomography [CBCT] and primary implant stability (by Insertion Torque Value [ITV]) after three months of socket preservation with:  Nova bone putty (Group A); Sticky bone (Group B) as compared to spontaneous healing (Group C).