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Dense Hydroxyapatite Inserted Into Postextraction Sockets: A Histologic and Histomorphometric 20‐Year Case Report
Author(s) -
Mangano Carlo,
Piattelli Adriano,
Perrotti Vittoria,
Iezzi Giovanna
Publication year - 2008
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2008.070245
Subject(s) - premolar , dental alveolus , implant , dentistry , alveolar ridge , histology , osteocyte , bone remodeling , medicine , biomaterial , materials science , biomedical engineering , chemistry , pathology , surgery , molar , osteoblast , biochemistry , in vitro
Background: The biologic behavior, i.e., the degradation of hydroxyapatite (HA) in the human body, is of relevance for clinicians. The present investigation is a long‐term (20‐year) histologic and histomorphometric evaluation of dense HA used in postextraction sockets. Methods: Dense HA particles were used in a patient in postextraction alveolar sockets to maintain the alveolar ridge height. The patient returned after 20 years for implant treatment. A ridge remodeling was necessary during implant insertion surgery, and the HA/bone tissue was harvested with bone‐cutting forceps from the canine and premolar area. The specimen was processed for histology and histomorphometry at the Implant Retrieval Centre, Dental School, University of Chieti‐Pescara. Results: Most of the particles (56%) were surrounded partially by bone, whereas some particles (39%) were surrounded completely. At higher magnification, bone was in close contact with the particles, and neither gaps nor fibrous tissues were present at the bone–biomaterial interface. Microscopically, the particles had a dense appearance. In only a few fields, it was possible to observe that the outer part of some particles had detached from the original particles' surface. Histomorphometry showed that bone represented 25.4% ± 3.2%, marrow spaces represented 41.3% ± 5.2%, and residual HA particles represented 38.1% ± 4.1%. Conclusions: Intimate binding between bone and HA particles was present after a long‐term implantation period (20 years). The fact that HA particles were surrounded closely by bone is very promising for the long‐term stability of the augmentation.