Histologic healing following tooth extraction with socket grafting using demineralised freeze-dried bone allograft (DFDBA), compared to undisturbed normal healing in humans: a randomised controlled clinical trial

Abstract

Aim: With dental implant treatment having evolved into a very regularly applied treatment modality, post-extraction grafting of extraction sockets with DFDBA in an effort to anticipate and pre-empt post-extraction bone loss has become common practice – clinically known as ridge preservation procedures. The aim of this study was however to histologically determine the quality of bone available for implant placement using DFDBA as grafting material in combination with a resorbable collagen membrane, compared to bone in extraction sockets that were left to heal naturally.

Method: Twenty sites were identified from eight patients requiring replacement of two or more extracted teeth by means of dental implant supported structures, on contralateral sides of the same jaw. They received DFDBA grafting of the socket on one side and no grafting on the contralateral side at the time of extraction. When implants were placed 16 – 20 weeks later, core samples of bone from these sites were first harvested by means of a trephine drill and those samples were processed and examined histologically to determine which of these sites displayed better quality of bone.

Results: One patient’s samples could not be utilised. Comparing the samples of the remaining nine non-grafted to nine grafted extraction sites, the difference in the calculated percentages of trabecular bone and collagen as well as the numbers of osteocytes, inflammatory cells and blood vessels were statistically insignificant.

Conclusion: The results of the study indicate that statistically there are no significant histological differences between DFDBA-grafted and non-grafted sockets.