Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis

Abstract

ObjectivesThe present paper reports data of a randomized study aimed to analyse and compare the histologic and histomorphometric aspects of bone healing in extraction sites covered with collagen membrane alone or associated with porcine-derived bone graft.Material and MethodsThirty patients, with single extraction sockets without severe bone wall defects in the premolar/molar region, were included. Ten extraction sockets were grafted with porcine-derived bone and covered with collagen membrane (group 1), 10 sites were covered with collagen membrane alone (group 2), and 10 sites healed spontaneously (group 3). After 4 months of healing, 26 (8 in group 1, 9 in group 2, and 9 in group 3) bone core specimens were harvested for histologic evaluation, then dental implants were placed.ResultsSites in the group 1 and in the group 2 showed similar histologic and histomorphometric results without significantly differences in the percentage of vital bone (57.43% [SD 4.8] vs. 60.01% [SD 3.2]), and non-mineralized connective tissue 22.99% (SD 5.3) vs. 18.53% (SD 6.2). In group 1 a 16.57% (SD 3.8) of residual material was found. ConclusionsResults showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process compared to that of extraction sites spontaneously healed. Moreover, histomorphometric data related to bone quality, indicated that extraction sites without severe walls defects and with a vestibular bone thickness > 1.5 mm, treated with a low resorbtion rate collagen membrane alone, do not need more than 4 months for dental implant insertion.

Ridge preservation following tooth extraction using bovine xenograft compared with porcine xenograft: A randomized controlled clinical trial

“…For the porcine group, vital bone formation of 31.3% in the current study was similar to previously reported results for ridge preservation using cortical and collagenated cortico‐cancellous porcine xenograft showing vital bone formation of 36.8% and 41.4%, respectively, after 3 months of healing . Conversely, the ridge preservation study of Guarnieri et al . showed a greater percentage of new bone formation (57.4%) at 4 months of healing than the current study.…”

Barrier membranes: More than the barrier effect?

“…This increase was attributed to the inhibition of osteoclast numbers and activity as well as a reduction in coupling between osteoblasts and osteoclasts, which was not shown in the presence of deproteinized bovine bone and stoichiometric HA (Elgali et al., ). Furthermore, the experimental finding that the collagen membrane alone was sufficient to promote bone formation without the addition of deproteinized bovine bone agrees with clinical data showing similar clinical and histological findings using collagen membrane alone or collagen membrane in combination with anorganic porcine‐derived bone mineral matrix (Guarnieri, Stefanelli et al., ; Guarnieri, Testarelli et al., ).…”

“…On the one hand, synergistic effects have been suggested in several experimental (Bernabe et al., ; Hammerle, Chiantella, Karring, & Lang, ; Jung et al., ; Kohal et al., ; Martinez, Balboa, Gasamans, Otero‐Cepeda, & Guitian, ; Park et al., ; Sverzut et al., ) and clinical (De Angelis et al., ; Luczyszyn et al., ) studies. On the other hand, other reports have not demonstrated significant beneficial effect of combining bone substitutes with membranes in either experimental (Becker et al., ; Buser et al., ; Cho et al., ; Dupoirieux, Neves, & Pourquier, ; Stavropoulos, Kostopoulos, Mardas, Nyengaard, & Karring, ) or clinical (Dies, Etienne, Abboud, & Ouhayoun, ; Guarnieri, Stefanelli et al., ; Guarnieri, Testarelli et al., ; Mattout, Nowzari, & Mattout, ) contexts. The differences between the results of different studies might be attributed to differences in the experimental animal species and model; study design; defect site, size and configuration; and evaluation time.…”

Effectiveness of Xenograft and Porcine-Derived Resorbable Membrane in Augmentation of Posterior Extraction Sockets with a Severe Wall Defect. A Radiographic/Tomographic Evaluation

“…In the present study, the healing process of grafted extraction sockets was not evaluated histologically. However, a previous histological and histomorphometric study [23] on extraction sites without severe wall defects, treated with the same biomaterial used in the present study, reported a mean percentage of newly formed bone of 57.43 (4.8)%, and a mean percentage of residual graft particles of 16.57 (2.8)% after 6 months. To date, controversy remains whether residual xenogenic graft particles present in biopsy samples harvested from regenerated extraction sockets may influence or interfere with the osseointegration process of dental implants, and bone-to-implant contact [39].…”