Following tooth extraction, the alveolar bone within the socket (the space formerly occupied by the tooth root) undergoes resorption and dimensional reduction, particularly on the buccal surface and in overall volume. Socket preservation aims to maintain alveolar bone dimensions to optimise subsequent implant placement or prosthetic rehabilitation. One promising approach involves the use of collagen-based scaffolds, modified and combined with biological materials such as injectable platelet-rich fibrin (i-PRF), to support alveolar bone regeneration.
A study conducted by a student of the Faculty of Dentistry, Universitas Gadjah Mada (FKG UGM), Kent Sidharta, under the supervision of drg. Kwartarini M., Sp.Perio(K), Ph.D., and Prof. drg. Suryono, S.H., M.M., Ph.D., entitled “Pengaruh Kombinasi Hidrogel Kolagen–Kitosan dan i-PRF Terhadap Perubahan Dimensi Tulang Alveolar pada Soket Pasca Ekstraksi Gigi Tikus Wistar,” demonstrated that a collagen–chitosan scaffold combined with i-PRF was able to preserve buccal bone height and increase alveolar bone volume more effectively than control groups or conventional bone grafts.
Principles of Collagen Scaffold Design
To function effectively in alveolar bone regeneration, the design of a collagen scaffold should consider the following aspects:
- Porosity and three-dimensional structure
The scaffold must possess sufficiently large and interconnected pores to allow the infiltration of osteogenic cells, blood vessels, and nutrients, thereby supporting tissue regeneration. - Mechanical stability and controlled degradation
The scaffold should provide adequate stability to prevent collapse during the early regenerative phase, while gradually degrading to be replaced by newly formed bone tissue. - Biological binding and growth factor release
An ideal scaffold should enable the sustained release of growth factors to stimulate bone cell proliferation and differentiation. - Cellular compatibility (biocompatibility)
The scaffold must support the survival, migration, and differentiation of osteoblasts and progenitor cells without inducing toxicity. - Material modification for synergistic effects
The incorporation of additional materials such as chitosan, hydrogels, or i-PRF can enhance scaffold properties, including mechanical stability, growth factor delivery, and bioactivity.
UGM Research Findings as a Basis for Scaffold Design
Based on this research:
- Rats treated with a collagen–chitosan hydrogel scaffold combined with i-PRF showed no significant reduction in buccal bone height up to day 42, whereas bone loss was observed in the bone graft and control groups.
- Total alveolar bone volume in this group increased between days 21 and 42, while the control and conventional graft groups did not demonstrate a significant increase.
- These results indicate that the collagen–chitosan + i-PRF scaffold is effective in preserving buccal bone dimensions and enhancing alveolar bone volume regeneration compared with conventional methods.
These findings underscore that scaffold design should aim to:
- prevent dimensional loss of alveolar bone, particularly on the buccal aspect; and
- support new bone formation throughout the entire socket volume.
Recommended Collagen Scaffold Design for Alveolar Bone
Based on the outlined principles and research findings, the following features are recommended for an ideal collagen scaffold for alveolar bone regeneration:
| Component / Feature | Design Objective / Function |
|---|---|
| Pure collagen or collagen composite | Biocompatible scaffold base that mimics the extracellular matrix |
| Addition of chitosan | Enhances mechanical strength and slows collagen degradation |
| Three-dimensional hydrogel structure | Facilitates nutrient exchange and cellular infiltration |
| Inclusion of i-PRF | Provides local delivery of autologous growth factors |
| Interconnected porosity with optimal pore size | Supports cell penetration, vascularisation, and regeneration |
| Controlled degradation | Allows scaffold resorption in parallel with new bone formation |
| Micro- or nanoscale surface features | Promotes osteogenic cell adhesion and bone integration |
References
Kent Sidharta, drg. Kwartarini M., Sp.Perio(K), Ph.D; Prof. drg. Suryono, S.H, M.M, Ph.D., Pengaruh Kombinasi Hidrogel Kolagen – Kitosan dan Injectable Platelet-Rich Fibrin Terhadap Perubahan Dimensi Tulang Alveolar pada Soket Pasca Ekstraksi Gigi Tikus Wistar (Kajian pada Tinggi Tulang Bukal dan Lingual serta Volume Tulang Alveolar), https://etd.repository.ugm.ac.id/penelitian/detail/247956
Author: Rizky B. Hendrawan | Photo: Freepik
