title: Reactive Soft Tissue Preservation in Maxillary Large Bone Defects.
abstract: OBJECTIVE
  Granulation tissue containing reactive soft tissue with potential multipotent stem cells can help socket healing following extraction. The aim of this study was to assess bone healing of maxillary large bone defects while maintaining reactive soft tissue.
  
  
  METHODS
  A total of 32 patients presenting large bone defects were selected for this prospective study. Eight patients (Group A) presented with large bone defects but an intact buccal cortical plate, while 24 patients (Group B) presented with large bone defects lacking a buccal cortical plate. Teeth were extracted, and reactive soft tissue was left in the defects. Bone volume was assessed through cone beam computed tomography (CBCT) both before tooth extraction and at 4 months. A histomorphometric evaluation was performed.
  
  
  RESULTS
  CBCT and cylinder bone cores were obtained for histology and histomorphometry analysis. At 4 months after tooth extraction, CBCT showed bone volume preservation and bone formation and no statistically significant difference in bone volume before and after tooth extraction in group A. However, in group B, over the same time period, a statistically significant increase (P < .01) of vertical bone volume was reported. Biopsy specimens showed the presence of vital bone in the defects 4 months later.
  
  
  CONCLUSIONS
  Reactive soft tissue left in large bone defects after tooth extraction may support a significant bone volume gain and vital bone formation.
authors.forename: Roberto
authors.initials: R
authors.lastname: Crespi
authors.forename: Paolo
authors.initials: P
authors.lastname: Capparé
authors.forename: Patrizio
authors.initials: P
authors.lastname: Bollero
authors.forename: Renato
authors.initials: R
authors.lastname: Pagani
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gastaldi
authors.forename: Enrico F
authors.initials: EF
authors.lastname: Gherlone
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000517:prevention & control*; D000539:Alveolar Process / Q000000981:diagnostic imaging / Q000502:physiology; D054893:Cone-Beam Computed Tomography; D005260:Female; D006097:Granulation Tissue / Q000166:cytology / Q000502:physiology*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D008875:Middle Aged; D010012:Osteogenesis; D011446:Prospective Studies; D013997:Time Factors; D014081:Tooth Extraction; D020390:Tooth Socket / Q000166:cytology / Q000502:physiology*; D014945:Wound Healing / Q000502:physiology