Histologic Evaluation of Human Extraction Sockets Treated With Demineralized Freeze‐Dried Bone Allograft (DFDBA) and Cell Occlusive Membrane

Abstract

This study evaluated new bone formation in human extraction sockets treated with demineralized freeze-dried bone allografts (DFDBA) and celloc occlusive membranes. Hard tissue biopsies of 7 sites in 6 patients were obtained 14 weeks to 13 months following extraction and grafting. Histologic analysis revealed that individual particles of DFDBA were discernible up to 13 months in situ. In all samples, all particles of DFDBA were well incorporated within new bone, which exhibited osteocyte-containing lacunae. Distinct cement lines clearly demarcated the DFDBA particles from the surrounding, intimately-apposed woven and lamellar bone. The marrow demonstrated a mild degree of fibrosis without signs of inflammatory reaction. There was also a notable lack of fibrous encapsulation of the allograft, and little osteoclasis was observed. Our findings demonstrate that commercially available DFDBA has the potential to function physically as a nidus for appositional new bone growth in alveolar sockets following tooth extraction. Further investigations of the biological activity of DFDBA in situ are warranted.

Bone Substitutes and Validation

“…However, a more recent study (Feuille et al 2003) showed positive result with the use of DFDBA and a cell occlusive membrane. Incorporation of the DFDBA particles was observed in new bone that contained lacunae with osteocytes (Brugnami et al 1996). The use of FDBA in this study instead of DFDBA might have yielded a more favorable outcome in terms of new bone regeneration.…”

“…The use of DFDBA as a graft material continues to be questioned because of various reports showing that it is unpredictable in regenerating new bone. In one study in humans, for example, the DFDBA particles were found to be surrounded by uninflammed connective tissue (Brugnami et al 1996). However, a more recent study (Feuille et al 2003) showed positive result with the use of DFDBA and a cell occlusive membrane.…”

Immediate Dental Implants and Bone Graft

“…The advantages of autograft bone material is that it maintains bone structures such as minerals, collagen and viable osteoblasts and bone morphogenic proteins (BMPs), while the main disadvantage is the morbidity of a second surgical site (Hoextor, 2002). Authors such as Brugnami et al, 1996 andDealemans et al, 1997 recommended the use of autografts instead of allografts, due to the absence of immune reactions associated with the former. In this sense, the general impression appears to be that autologous grafts are the best choice for osseoinductive purposes.…”

Ridge preservation comparing the clinical and histologic healing of a mineralized particulate allograft with a nonporous PTFE membrane vs. mineralized particulate xenograft with a collagen plug membrane.

“…Histologic examination reveals that ridge preservation utilizing DFDBA has residual graft particles surrounded by intimately apposed woven and lamellar bone with distinct cement lines and a lack of fibrous encapsulation. Osteoblasts lined endosteal spaces and the new bone marrow exhibited a mild degree of fibrosis without signs of an inflammatory reaction (Brugnami et al 1996, Smukler et al 1999 (Smukler et al 1999, Froum et al 2002. Becker et al (1996Becker et al ( , 1998 reported more residual graft particles and fibrous encapsulation, which may be due to their failure to use an occlusive barrier membrane.…”