Autogenous Demineralized Dentin Graft-Based Strategies With or Without I-PRF and Metronidazole for Ridge Preservation...

Area of Science:

• Dentistry
• Oral Surgery
• Regenerative Medicine

Background:

• Chronic periapical infections in extraction sockets pose challenges for alveolar ridge preservation (ARP).
• Demineralized dentin graft (DDG) and injectable platelet-rich fibrin (I-PRF) are used in regenerative procedures.
• Metronidazole (MTZ) is an antibiotic with potential anti-inflammatory properties.

Purpose of the Study:

• To evaluate the efficacy of DDG combined with I-PRF and MTZ versus DDG with I-PRF and DDG alone in ARP of chronically infected extraction sockets.
• To assess the impact of these combinations on bone dimensions, mineralization, and soft tissue formation.

Main Methods:

• Pilot randomized controlled trial with 54 patients in three groups: DDG alone, DDG + I-PRF, and DDG + I-PRF/MTZ.
• Evaluated vertical and horizontal ridge dimensions using cone-beam CT scans at baseline and 6 months.
• Assessed bone mineralization and soft tissue proportion via histomorphometric analysis of bone biopsies.

Main Results:

• No significant differences in vertical and horizontal ridge dimensional changes were observed across groups.
• The DDG + I-PRF/MTZ group demonstrated the highest percentage of mineralized bone (55.02%).
• The DDG + I-PRF/MTZ group showed the lowest proportion of soft tissue histologically.

Conclusions:

• All evaluated protocols were effective for alveolar ridge preservation in chronically infected extraction sockets.
• The addition of I-PRF with MTZ significantly enhanced bone mineralization compared to DDG alone or DDG with I-PRF.
• The combination of DDG, I-PRF, and MTZ appears promising for improving bone regeneration in ARP.