Socket Preservation Using a Biomimetic Nanostructured Matrix and Atraumatic Surgical Extraction Technique

J Craniofac Surg. 2017 Jun;28(4):1042-1045. doi: 10.1097/SCS.0000000000003496.


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.

Conclusion: 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.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Animals
  • Biomimetic Materials / therapeutic use*
  • Bone Remodeling
  • Bone Substitutes / therapeutic use*
  • Collagen / therapeutic use*
  • Durapatite / therapeutic use*
  • Female
  • Horses
  • Humans
  • Male
  • Middle Aged
  • Surgical Flaps
  • Tooth Extraction*
  • Tooth Socket / surgery*
  • Wound Healing


  • Bone Substitutes
  • Collagen
  • Durapatite