Radiographic Assessment of Bone Regeneration in Alveolar Sockets With PLGA Scaffold
Condition: Preservation of Alveolar Bone Height With PLGA Bioscaffold
Study type: Observational

Summary: 
      After extraction of a tooth, the bony socket heals naturally but due to the absent of the
      tooth and any presence of support in the socket, bone resorption occur both vertically and
      bucco lingually or bucco palataly. This bony resorption ultimately effects a lot of things
      like - the support for the adjacent teeth become weak, the shallow ridge makes it difficult
      for future prosthesis retention, and less bony support for any implant placement in the
      future which is the most popular and effective way of tooth replacement now a days. So now a
      days keeping the integrity and contour of the alveolar bony socket is very important for the
      patients future rehabilitation. The use of scaffold will help to maintain the integrity of
      the alveolar bony socket thus provides a vital support for the adjacent teeth, preserve the
      alveolar crest height, maintain the bony contour, helps to prevent bleeding, and most
      importantly it will help in bone regeneration which is the vital factor for future
      rehabilitation.
    

Detailed description: 
      A case controlled study design is adopted. Patients who will be having extraction of any
      tooth including surgical extraction but not due to any periodontal reasons are selected.
      Consent of the patient will be taken for the procedure and all the effects and possibilities
      will be explained to the patients. Extraction will be done and scaffold material will be
      placed inside the socket. Sockets with the scaffold will be the variable studied and the
      sockets without scaffold placed inside the sockets will be the control group. An OPG x ray
      will be taken with the head position standardized by a positioning device. A second x-ray
      will be taken following the same technique after two months (for assessment of bone healing
      as is practiced normally) and a final x-ray will be taken after 3 months of the first x-ray
      (normally done in clinics for assessment of socket prior to implantation.

      The OPG x ray is taken with the patient biting on a bite plate device fabricated with an
      embedded wire inside which is radiopague. If the distance from the wire line (the occlusal
      plane) to the alveolar bony height is 'a' and if the actual diameter of the metallic ball is
      'b' and radiographic ball diameter is 'c' then the equation ( a×b)/c will give us the
      distance of the alveolar bony crest from the wire line. The measurements taken will determine
      if the distance of the alveolar crest from the wire line remained the same or has increased.
      If it remains the same, it will suggest that the scaffold material had maintained the socket
      and prevented alveolar bone resorption, but if the distance increases that will indicate
      vertical loss of alveolar bone and the extent measured can be compared with sockets without
      the support of an immediate post-extraction scaffold. This study will determine firstly
      whether the scaffold allows for bone regeneration in human alveolar sockets in the normal
      time and secondly whether it would help to preserve alveolar bone height as compared to cases
      without scaffold.

      Consent of the selected patient will be taken for the procedure. Extraction will be done and
      scaffold material will be placed inside the socket. Socket with the scaffold will be our
      cases and the socket without scaffold will be the control group in multiple extraction cases.
      Radiographic assessment will be done to assess bone regeneration at the prescribed
      pre-extraction stage, at the 2 months bone healing stage and at the 3 months (from initial
      extraction) implant planning stage as in usual clinical practice . Assessment of the bony
      height is made with the prescribed formula from the radiographs taken and comparison will be
      made with the control cases. The following are the criteria for selecting the patients.
    

Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Dental clinic patients undergoing teeth extraction
      
Keywords: Alveolar Bone Loss; Alveolar ridge; Alveolar Process