A comparative evaluation of eggshell derived hydroxyapatite and demineralized freeze-dried bone allograft in alveolar ridge preservation - a randomized clinical trial.

Abstract

<h4>Background</h4>Alveolar ridge preservation (ARP) is critical for minimizing post-extraction bone loss and maintaining ridge dimensions essential for prosthetic replacement. Eggshell-derived hydroxyapatite (EHA), owing to its compositional similarity to natural bone and promising biological properties, has emerged as a potential alternative to conventional graft materials such as Demineralized Freeze-Dried Bone Allograft (DFDBA). The aim of the study was to compare the clinical and radiographic outcomes of EHA and DFDBA in ARP.<h4>Materials and methods</h4>This prospective randomized clinical trial involved 20 patients requiring mandibular posterior extractions, which were assigned to two groups: EHA (test) and DFDBA (control). In both groups, bone grafts were combined with injectable Platelet-Rich Fibrin (i-PRF) to form sticky bone and sealed with Advanced Platelet-Rich Fibrin (A-PRF) membranes. Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Width of Keratinized Gingiva (WKG) and radiographic parameters such as Vertical Ridge Height, Horizontal Ridge Width, and Bone Density were evaluated at baseline and Healing Index (HI) was evaluated after 2 weeks.<h4>Results</h4>Both study groups exhibited significant improvements in PI, GI, WKG, vertical ridge height and horizontal ridge width within group with no significant difference between the groups. However, EHA demonstrated less ridge reduction compared to DFDBA with no significant changes in bone density. Wound healing at 2 weeks showed no significant difference between groups.<h4>Conclusions</h4>EHA with platelet-rich fibrin (PRF) is an effective, affordable, and biocompatible option for ARP. EHA demonstrated greater ridge dimensional stability and similar bone density improvements compared to DFDBA, with minimal resorption and favorable healing outcomes.