Histologic Evaluation of Wound Healing After Ridge Preservation With Cortical, Cancellous, and Combined Cortico-Cancellous Freeze-Dried Bone Allograft: A Randomized Controlled Clinical Trial

J Periodontol. 2017 Sep;88(9):860-868. doi: 10.1902/jop.2017.170155. Epub 2017 Apr 28.

Abstract

Background: Cortical and cancellous mineralized freeze-dried bone allografts (FDBA) are available for use in alveolar ridge preservation after tooth extraction. There are currently no data regarding use of a combination 50%/50% cortico-cancellous FDBA compared with a 100% cortical or 100% cancellous FDBA in ridge preservation. The primary objective of this study is to dimensionally and histologically evaluate healing after ridge preservation in non-molar sites using 50%/50% cortico-cancellous FDBA versus 100% cortical and 100% cancellous FDBA.

Methods: Sixty-six patients requiring extraction of a non-molar tooth were enrolled and randomized into three groups to receive ridge preservation with the following: 1) 100% cortical FDBA; 2) 100% cancellous FDBA; or 3) 50%/50% cortico-cancellous FDBA. After 18 to 20 weeks of healing, a biopsy was harvested, and an implant was placed. The alveolar ridge was measured pre- and postoperatively to evaluate change in ridge height and width. Percentages of vital bone, residual graft, and connective tissue (CT)/other were determined via histomorphometric analysis.

Results: Histomorphometric analysis revealed no significant differences among groups regarding percentage of vital bone or CT/other. The 100% cortical FDBA group had significantly greater residual graft material (P = 0.04). Dimensional analysis revealed no significant between-group differences in any parameter measured.

Conclusion: To the best knowledge of the authors, this study offers the first histologic evidence demonstrating no significant difference in vital bone formation or dimensional changes among 50%/50% cortico-cancellous FDBA, 100% cortical FDBA, and 100% cancellous FDBA when used in ridge preservation of non-molar tooth sites.

Trial registration: ClinicalTrials.gov NCT02275767.

Keywords: Alveolar bone grafting; alveolar bone loss; bone resorption; bone transplantation; dental implants; tooth extraction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Allografts
  • Alveolar Ridge Augmentation / methods*
  • Bone Transplantation / methods*
  • Female
  • Freeze Drying
  • Humans
  • Male
  • Middle Aged
  • Texas
  • Tooth Extraction
  • Tooth Socket / surgery*
  • Wound Healing / physiology*

Associated data

  • ClinicalTrials.gov/NCT02275767