Growth Factors in Grafting Extraction Sockets: Soft, Hard Tissue Healing

Objectives: A number of growth factors have been used in grafting the extraction sockets to minimize the dimensional changes and to shorten the healing period between extraction and implant placement. This randomized controlled clinical trial aims to evaluate the efficacy of novel application of amniotic tissue allograft in extraction sockets, by measuring the soft tissue wound contraction and histomorphometric analysis.
Methods: 20 participants who needed extraction of maxillary anterior tooth or maxillary or mandibular premolar and replacement with an implant were enrolled and randomized to either: (Group 1/Control) - extraction and grafting with mineralized bone allograft or (Group 2/Test) - extraction and grafting with mineralized bone allograft and amniotic tissue allograft. The soft tissue wound contraction and epithelial migration between two groups was measured from the standardized 1:1 clinical photographs using image analysis software at day of extraction, and at 1, 2, 4, and 7 weeks. Hard tissue healing was evaluated by performing histomorphometric analysis using Bioquant Image Analysis Software on bone core biopsies obtained at 8 weeks post – op from the extractions sites. Statistical analysis consisted of repeated measures analysis of variance (rANOVA) and Fisher’s exact test.
Results: There was no statistically significant difference (p = 0.71) noted in the mean wound surface area at 7 week healing between group 1(1.78 mm²) and group 2 (0.87 mm²). The percent change in mean wound surface area in group 1 was 94.40% and in group 2 was 96.50% by week 7. Though more new bone formation was observed in the test group (35.82%) vs. control group (31.76%), but it lacked statistical significance (p = 0.74).
Conclusions: There may be clinical advantage to the inclusion of amniotic tissue allograft in healing of extraction sockets, however, future large-scale studies are needed to compare its effect with other growth factors and to assess its generalizability.