https://pubmed.ncbi.nlm.nih.gov/39382763/
Kloss FR, Kau T, Heimes D, Kämmerer PW, Kloss-Brandstätter A. Int J Implant Dent. 2024;10(1):42. doi:10.1186/s40729-024-00559-6

Original title: Enhanced alveolar ridge preservation with hyaluronic acid-enriched allografts: a comparative study of granular allografts with and without hyaluronic acid addition

This study by Dr. Frank Kloss and colleagues is the first clinical investigation to compare allogeneic bone substitutes with and without hyaluronic acid for alveolar ridge preservation. The results indicate that the addition of hyaluronate to the allogeneic bone grafting material significantly enhances clinical outcomes in the preservation of compromised extraction sockets. Improvements were observed in terms of graft stability, reduced resorption, and increased bone density.

PURPOSE

Ridge preservation is essential to restore alveolar ridge volume and to enhance esthetic and functional outcomes for dental implants. The addition of hyaluronic acid to allogeneic bone substitute materials might enhance these outcomes. This clinical study evaluated the efficacy of ridge preservation after tooth extraction using granular allografts with and without hyaluronic acid addition.

METHODS

In this retrospective study, 40 patients with compromised extraction sockets were enrolled. Among them, 19 received particulate allogeneic bone substitutes (maxgraft^®), 21 received allogeneic bone substitutes with hyaluronic acid (maxgraft^® +HyA). Vertical and horizontal graft stability, graft shrinkage rate, and bone mineral density were assessed using radiographic measurements on CBCT scans conducted before tooth extraction, directly after ridge preservation and after four months. Patients were followed up 12 months post-implantation.

RESULTS

Vertical height loss after 4 months was significantly greater in the maxgraft^® group (-0.82 ± 0.95 mm) compared to the maxgraft^® +HyA group (-0.19 ± 0.51 mm; p = 0.011). Graft shrinkage rate was 16.9 ± 11.5% (maxgraft^®) and 10.3 ± 7.7% (maxgraft^® +HyA) (p = 0.038). After four months, average bone density was significantly higher in the maxgraft^® +HyA compared to the maxgraft^® group (p = 0.004). Nearly all implants (39 out of 40) were classified as “Success” according to the ICOI scheme, with no differences in implant quality between the two study groups.

CONCLUSION

Improved graft stability, reduced resorption, and increased bone density were observed in hyaluronic acid-enriched allografts compared to pure allografts. Adding hyaluronic acid to allogeneic bone grafts significantly enhanced outcomes in ridge preservation.