Histological comparison of healing extraction sockets implanted with bioactive glass or demineralized freeze-dried bone allograft: a pilot study.
BACKGROUND
Various materials have been used immediately following tooth extraction to fill and/or cover the socket in an attempt to limit or prevent ridge resorption. The purpose of the present pilot study was to establish a reliable model to investigate the effect of various bone graft and bone replacement materials on extraction socket healing. This study also compared healing extraction sockets 6 to 8 months postimplantation of a bioactive glass (BG) or demineralized freeze-dried bone allograft (DFDBA) to an unfilled socket control (C).


METHODS
Following tooth extraction, a total of 30 sockets in 19 patients were randomly divided into 3 treatment groups: 10 sockets received BG, 10 sockets DFDBA, and 10 sockets served as unfilled controls. Primary coverage was achieved by flap advancement over each socket. Six to 8 months postextraction at time of implant placement, histological cores of the treatment sites were obtained. These cores were processed, undecalcified sections prepared and stained with Stevenel blue/van Gieson's picric fuchsin, and histomorphometrically analyzed. Vital bone, connective tissue and marrow, and residual graft particles were reported as a percentage of the total core.


RESULTS
A model system was described in humans and used to evaluate the healing response in the 3 treatment groups. Results concluded that mean vital bone present was 59.5% for BG-, 34.7% for DFDBA-, and 32.4% for C-treated sites. These differences were not statistically significant. However, the residual implant material was significantly higher in DFDBA-treated (13.5%) versus BG-treated sockets (5.5%).


CONCLUSIONS
Although the differences in percent vital bone were not statistically significant among the 3 treatment groups in this pilot study, BG material was observed to act as an osteoconductive material which had a positive effect on socket healing at 6 to 8 months postextraction. Further research following implant placement in treated and control sockets is warranted to determine if bone implant contact is improved in BG-filled versus unfilled sockets.
Froum
Stuart
S
Ashman Department of Implant Dentistry, New York University, Kriser Dental Center, New York, USA. dr.froum@verizon.net
Cho
Sang-Choon
SC
Rosenberg
Edwin
E
Rohrer
Michael
M
Tarnow
Dennis
D
D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology / Q000503:physiopathology; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001853:Bone Marrow / Q000473:pathology; D001862:Bone Resorption / Q000517:prevention & control; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods* / Q000473:pathology; D004396:Coloring Agents; D003238:Connective Tissue / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005612:Freeze Drying; D005898:Glass; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D010865:Pilot Projects; D013223:Statistics as Topic; D013524:Surgical Flaps; D014021:Tissue Preservation; D014081:Tooth Extraction; D020390:Tooth Socket / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D014184:Transplantation, Homologous; D014945:Wound Healing
D001672:Biocompatible Materials; C073544:Biogran; D018786:Bone Substitutes; D004396:Coloring Agents