COMPARATIVE CLINICAL ANALYSIS OF CALCIUM PHOSPHOSILICATE PUTTY/NOVABONE DENTAL PUTTY VERSUS PLATELET-RICH FIBRIN (PRF) IN ALVEOLAR RIDGE PRESERVATION PRIOR TO IMPLANT: AN ORIGINAL RESEARCH STUDY

Abstract

Aim: This study aims to analyze calcium phosphosilicate putty/novabone dental putty versus platelet-rich fibrin (PRF) in alveolar ridge preservation prior to implant. Materials and Methods: A randomized controlled trial conducted which involved 60 participants aged 35 to 60 with chronic generalized periodontitis, requiring extraction and lacking sufficient jawbone for dental implants. Participants were divided into three groups of 20. Comprehensive clinical assessments measured probing pocket depths and radiographic evaluations at baseline, 3 months, and 6 months post-surgery. The study aimed to compare the effectiveness of calcium phosphosilicate putty (Novabone) and platelet-rich fibrin (PRF) for alveolar ridge preservation. PRF was prepared through centrifugation of blood to create a membrane. The surgical protocol randomized the treatment of defects, with Group A receiving Novabone, Group B receiving PRF, and Group C receiving a combination. Post-surgery follow-ups evaluated healing using the same methods as baseline assessments. The study was to provide insights into materials promoting bone healing before dental implantation. Statistical Analysis and Results:The study involved 60 participants, evenly divided into three groups of 20, with a gender distribution of 27 males and 33 females aged 35 to 60. At baseline, analysis showed no significant differences (P > 0.05) among the groups regarding clinical and radiographic parameters, establishing comparable clinical severity. Over time, significant improvements were observed in all groups (P < 0.01) at the 3-month and 6-month follow-ups. Both Plaque and Gingival Indices declined, with a notable drop in the Gingival Index at 3 months followed by a slight rebound at 6 months, yet still below baseline levels. Probing Pocket Depth (PPD) and Relative Attachment Level (RAL) showed consistent reductions, indicating improved periodontal health. Inter-group comparisons revealed significant differences in improvement: - For Plaque Index, Group C had the most reduction (0.68 ± 0.45), though no significant differences were found at 3 or 6 months. - PPD differences became significant by 6 months (P < 0.05) with Group C at 4.65 ± 0.72 mm, followed by Group B at 4.95 ± 0.88 mm, and Group A at 5.31 ± 0.48 mm. - RAL results showed Group C had a higher mean (9.10 ± 1.25 mm) and greater net gain (2.80 ± 0.65 mm) compared to Group B (1.88 ± 0.50 mm) and Group A (1.50 ± 0.80 mm). While all groups reduced radiographic defect depth significantly (P < 0.01), no differences were noted among them (P > 0.05). This summary reflects the effectiveness of the interventions and highlights the differences in outcomes between groups. Conclusion: This study concluded that combining Novabone and PRF was most effective for long-term periodontal rehabilitation, with better clinical attachment levels and reduced pocket depth at 6 months. However, all groups were similarly effective at reducing bone defects, with no significant differences on radiographic evaluation. Overall, all three interventions effectively managed periodontal issues, resulting in reduced plaque, decreased gingival inflammation, and improved clinical outcomes.