Efficacy of calcium sulfate dihydrate as a bone graft substitute in odontogenic cystic defects of jaws following enucleation: A clinical study.

Abstract

Background: The treatment of osseous bone defects created following enucleation of a cyst is an arduous challenge. Autogenous bone grafts despite being the gold standard have various drawbacks such as donor site morbidity, limited availability of bone graft, and increased operative time. Hence, there are various bone grafts which are being investigated which could overcome the limitations of autografts. Thus, this study was conducted to evaluate the efficacy of calcium sulfate (CS), a bone graft substitute, for spontaneous bone regeneration of cystic defects.

Objectives: The purpose of this study is to evaluate bone formation in odontogenic cystic defects following enucleation and reconstruction with bone graft substitute by three-dimensional radiographic and clinical evaluation.

Methodology: A total of twenty patients diagnosed with odontogenic cysts were randomly divided into two groups, out of which the study group had undergone enucleation with bone grafting (tobramycin-impregnated CS dihydrate) and the control group had undergone enucleation without bone grafting. The patients were evaluated clinically and radiographically at the 1^st, 3^rd, 6^th, and 12^th months postoperatively.

Results: There was no bone formation observed at 1 month postoperative in both the groups. There was a statistically significant higher bone defect reduction observed radiologically on orthopantomogram and computed tomography scan in the study group than the control group at the 3^rd, 6^th, and 12^th months postoperative. The rate of reduction in cystic volume of the study group at the 12^th month was 94.4% and in the control group was 37.16%.

Conclusion: Immediate grafting of cystic cavity can avoid complications such as pathological fracture due to less bone support, delayed healing, etc., The utilization of a graft with a property of inducing rapid bone formation should be taken into consideration. The use of CS as a grafting material accelerated the rate of bone regeneration in the cystic defects, with minimal complications.