Extraction socket preservation graft before implant placement with calcium sulfate hemihydrate and platelet-rich plasma: A clinical and histomorphometric study in humans

Background: The aim of this investigation is to evaluate clinical and histologic outcome of using medical-grade calcium sulfate hemihydrate (MGCSH) mixed with platelet-rich plasma (PRP) for extraction socket preservation graft before implant placement. Methods: This study is a single-site, randomized and controlled investigation. Sixteen patients with a non-restorable tooth requiring extraction followed by implant placement were enrolled in this study. After extraction of a tooth, eight selected patients randomly received MGCSH mixed with PRP in the extraction sockets (test group), and eight selected patients randomly received collagen resorbable plug dressing material (control group). At the time of extraction and 3 months later (at implant placement surgery), vertical and horizontal socket dimensions were measured. Bone core samples were retrieved from the center of the healed socket before implant placement for histomorphometric analysis. Results: There was a statistically significant difference between the two groups based on histomorphometric analysis (P < 0.05). New vital bone percentage regenerated after 3 months of healing was 66.5% ± 10.4% in sockets grafted with MGCSH mixed with PRP compared to 38.3% ± 9.3% collagen resorbable plug. There was no statistically significant difference in the amount of vertical and horizontal bone resorption (P > 0.05) between groups. In all cases but two in the control group, implants were placed with primary stability. Conclusion: MGCSH mixed with PRP showed greater vital bone volume at 3 months with rapid enhancement of bone healing compared to PRP-free collagen resorbable graft.