Histological and histomorphometric evaluation of alveolar ridge preservation using an allograft and nonresorbable membrane with and without primary closure: A pilot randomized controlled clinical trial

Majdi A Aladmawy, Zuhair S Natto, Michael Kreitzer, Yumi Ogata, Yong Hur, Majdi A Aladmawy, Zuhair S Natto, Michael Kreitzer, Yumi Ogata, Yong Hur

Abstract

The aim of this article is to assess the formation of new vital bone (VB) using histomorphometric analysis in alveolar ridge preservation (ARP), with and without primary closure. Eight patients needed bilateral tooth extraction and planned for ARP. All patients had a nonresorbable membrane with freeze-dried bone allograft after the extractions. Biopsies were obtained 6 months after ARP and were evaluated using histomorphometric analysis. The study included 6 males and 2 females, with an average age of 54.2 years (standard deviation, 9.7). The teeth requiring extraction included a bilateral canine (1 case), premolars (5 cases), and molars (2 cases). Histomorphometric values of new VB, residual bone (RB) substitute particles, and marrow tissue formation were 71.1 %, 16.2%, and 9.69% for closed flap and 50.9%, 15.3%, and 8.19 for open flap. P values were 0.066, 0.878, and 0.326, respectively. The present findings indicate that leaving the flap without primary closure did not have any effect on new VB, RB particles, and immature bone marrow compared with closed flap. However, the results favored the closed-flap technique.

Trial registration: ClinicalTrials.gov NCT03136913.

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Figures

Figure 1.
Figure 1.
Consolidated Standards of Reporting Trials (CONSORT) flow diagram.
Figure 2.
Figure 2.
Surgical steps. (A) Patient needed bilateral extraction. (B, C) Atraumatic bilateral extraction. (D) Placed bone graft then membrane was exposed in one side and closed in other side. (E) Flap reflection after 6 mo. (F) Implant area was prepared for a biopsy. (G) Core biopsy was obtained.
Figure 3.
Figure 3.
Panoramic histological section of bone core biopsy taken after 6 mo with primary closure.
Figure 4.
Figure 4.
Panoramic histological section of bone core biopsy taken after 6 mo without primary closure.
Figure 5.
Figure 5.
Box plot diagram of the percentage of (A) new vital bone, (B) residual bone of the particle, and (C) immature bone marrow.

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