Socket Preservation Using a Biomimetic Nanostructured Matrix and Atraumatic Surgical Extraction Technique.
OBJECTIVE
The aim of the present study was to evaluate the efficacy of biomimetic composite bone substitute composed of equine collagen I and Mg-hydroxyapatite in improving socket preservation after tooth extraction in humans.


METHODS
Thirty-two patients were subjected to a single tooth extraction, performed without elevation of the full-thickness flap. In each patient, socket was grafted with the bone substitute and specimens were retrieved 2 months after surgery and processed for histological observations. The clinical outcome variables were healing index, visual analog score for pain, postsurgery complications, and patient satisfaction evaluated through a questionnaire.


RESULTS
No adverse reaction or infection occurred, in which healing index averaged 5.8 (range 4-7). Pain scores were lower. The patients' questionnaire outcomes were unanimously in favor of the test treatment. At low-power magnification, it was possible to see a portion of native bone with small marrow spaces and many areas of bone remodeling. At high-power magnification, it could be observed that small newly formed trabeculae originated from the preexisting bone and bone spicules in the middle of the defect.


CONCLUSIONS
Grafting the postextraction socket with composite bone substitute may improve the healing process by accelerating socket closure and tissue maturation. Such a product demonstrated excellent biocompatibility as no inflammatory reaction could be detected histologically and was well accepted by patients.
*SIOM Oral Surgery and Implantology Center, Torino †Science Department, Department of Health Sciences "A. Avogadro," University of Eastern Piedmont, Novara ‡Department of Medical, Oral and Biotechnological Sciences, University "G. d'Annunzio," Chieti, Italy.
Marco
M
Mozzati
Giorgia
G
Gallesio
Giorgio
G
Staiti
Giovanna
G
Iezzi
Adriano
A
Piattelli
Carmen
C
Mortellaro
D000328:Adult; D000368:Aged; D000818:Animals; D040761:Biomimetic Materials / Q000627:therapeutic use*; D016723:Bone Remodeling; D018786:Bone Substitutes / Q000627:therapeutic use*; D003094:Collagen / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use*; D005260:Female; D006736:Horses; D006801:Humans; D008297:Male; D008875:Middle Aged; D013524:Surgical Flaps; D014081:Tooth Extraction; D020390:Tooth Socket / Q000601:surgery*; D014945:Wound Healing
D018786:Bone Substitutes; D003094:Collagen; D017886:Durapatite