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Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone

Taschieri, Silvio, MD, DDS*,†; Del Fabbro, Massimo, MSc, PhD*,†; Panda, Sourav, DDS, MDS*,‡; Goker, Funda, DMD, PhD*; Babina, Ksenia S., DDS§; Tampieri, Anna, MChem, PhD||; Mortellaro, Carmen, MD, DDS

Journal of Craniofacial Surgery: June 2019 - Volume 30 - Issue 4 - p 1089–1094
doi: 10.1097/SCS.0000000000005416
Clinical Studies

Purpose: This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation.

Materials: Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons.

Results: Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33–50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group.

Conclusion: The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.

*Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano

Dental Clinic, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy

Department of Periodontics and Oral Implantology, Institute of Dental Science and SUM Hospital, Siksha O Anusandhan, Bhubaneswar, India

§Department of Therapeutic Dentistry, Institute of Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia

||Institute of Ceramic Materials Science and Technology (ISTEC), National Research Council and President of Finceramica Faenza SpA, Faenza

Department of Medical Science, Oral Surgery Unit, University of Eastern Piedmont, Novara, Italy.

Address correspondence and reprint requests to Massimo Del Fabbro, MSc, PhD, Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161 Milano, Italy; E-mail:

Received 17 December, 2018

Accepted 17 January, 2019

The authors report no conflicts of interest.

© 2019 by Mutaz B. Habal, MD.