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International Journal of Dentistry
Volume 2016 (2016), Article ID 5406736, 12 pages
Research Article

Minimally Invasive Alveolar Ridge Preservation Utilizing an In Situ Hardening β-Tricalcium Phosphate Bone Substitute: A Multicenter Case Series

1Department of Oral and Maxillofacial Surgery, Dental School, University of Athens, 2 Thivon Street, Goudi, 115 27 Athens, Greece
2Department of Periodontology and Implant Dentistry, School of Dentistry, University of Detroit Mercy, 2700 Martin Luther King Jr Boulevard, Detroit, MI 48208, USA
3Dental College, Yenepoya University, University Road, Mangalore, Karnataka 575018, India
4Medical School, University of Athens, 75 M. Assias Street, 115 27 Athens, Greece
5PhD and DrPH Public Health Programs, College of Health Sciences, Walden University, 100 S Washington Avenue No. 900, Minneapolis, MN 55401, USA
6Department of Prosthodontics, Preclinical Education and Materials Science, University of Bonn, Regina-Pacis-Weg 3, 53113 Bonn, Germany
7Departments of Periodontics, Implant Dentistry, and Oral Surgery, New York University College of Dentistry, 345 E. 24th Street, New York, NY 10010, USA
8Department for Oral and Maxillofacial Surgery, Cell Tissue Analysis (CTA), Medical Center, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany
9Institute for Clinical Chemistry and Laboratory Medicine, Medical Center, University of Freiburg, Hugstetter Street 55, 79106 Freiburg, Germany

Received 9 December 2015; Revised 25 January 2016; Accepted 3 February 2016

Academic Editor: Andreas Stavropoulos

Copyright © 2016 Minas D. Leventis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone) in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material) while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques.