A comparison of demineralized freeze-dried bone and autologous bone to induce bone formation in human extraction sockets
The aim of the study was to compare the ability of demineralized freeze-dried bone (DFDB) and autologous bone (AB) to induce bone formation in extraction sockets. Seven healthy patients volunteered for this project. Patients had a minimum of two periodontally hopeless teeth that were scheduled for extraction. Full-thickness flaps were reflected, teeth were extracted, and pockets were debrided. DFDB was placed in one of the two sites selected by coin flip. The other site received AB harvested from the alveolar crest adjacent to the extraction sites. The flaps were closed by primary intention. The patients were placed on penicillin or erythromycin 1 g for seven days, and the sutures were removed after one week. Between three and 13 months after the graft was placed, a second surgery was performed to place endosseous implants. Biopsies, including hard tissue from the alveolar crest and the extraction sockets, were taken at this time. The sites grafted with DFDB looked similar to the adjacent bone. In one site, after seven months particles were clearly visible on the biopsy. Histologically, the particles of DFDB were surrounded by uninflamed connective tissue. No osteoclastic or osteoblastic activity was seen. The sites grafted with AB looked similar to the adjacent bone. The sites were hard and dense. Histologically, osteocytes, blood vessel, and trabecular and lamellar bone were identified. In conclusion, all the sections that received DFDB displayed non-vital DFDB particles, with no evidence of either osteoblastic or osteoclastic activity. This was regardless of the time waited for biopsies. This material then is considered osteoconductive and is not osteoinductive. [c.c.]
Becker, W., B.E. Becker, and R. Caffesse, J Periodont, 65:1128, 1994