Histologic evaluation of socket augmentation with mineralized human allograft

Socket augmentation performed at the time of tooth extraction has been recommended by many authors, since successful socket augmentation may reduce or eliminate the need for future ridge grafts. An augmentation procedure is described here, along with histologic and histomorphometric findings. Five patients (three men, two women; mean age 56 years) were recruited for this pilot study, and seven sites were treated. Solvent-preserved mineralized cancellous allograft was used to fill each socket up to the bone crest (2 mm below soft tissue surface), and sites were covered with a bioabsorbable collagen wound dressing. Core biopsies were taken from the center of extraction sockets 5 to 6 months after augmentation. Histologic evaluation of the prepared biopsies showed formation and remodeling of trabecular bone in areas of mineralized cancellous allografts and no signs of inflammation. Histomorphometric analysis of the samples showed an average of 68.5% vital bone, 3.8% residual graft particles, and 27.7% of connective tissue/bone marrow. In addition, vital bone and connective tissues were seen in close contact with the remaining allograft. These data suggest that this combination of human mineralized bone and absorbable collagen wound dressing is a suitable technique for socket augmentation. Nevertheless, future controlled clinical trials with larger sample sizes are recommended to validate the findings of the current technique.