Innovative Alveolar Socket Preservation Procedure Using Demineralized Tooth Dentin as Graft Biomaterial Covered with Three Reabsorbable Membranes: Human Histological Case Series Evaluation

Background: Extracted tooth material has been seen as a valuable alternative to synthetic biomaterials. Aims: A novel flapless alveolar socket preservation (ASP) procedure with demineralized extracted tooth dentin graft material covered by three reabsorbable membranes was histologically and clinically evaluated 4 months after bone healing. Methods: Ten patients were enrolled and separated into two groups. Five post-extractive sites without buccal and/or palatal bone walls were treated with the flapless ASP procedure with demineralized tooth dentin covered with three reabsorbable membranes (Group A-GA). Five patients were treated with primary wound closure covered only with a reabsorbable membrane (Group B-GB). Bone biopsies were performed for histologic and histomorphometric analyses. Results: In both procedures, all clinical outcomes showed good healing of hard and soft tissue and a good maintenance of maxillary architecture. The histological analysis showed no necrosis or inflammatory areas in either group. The histomorphometric analysis showed higher total bone volume in GA (62.78 +/- 7.97%) compared to GB (48.04 +/- 9.32%), higher vital new bone in GA (57.53 +/- 11.16%) compared to GB (42.41 +/- 13.06%) and similar values for residual graft in GA (5.24 +/- 5.82%) compared to GB (5.29 +/- 4.83%). Conclusions: The data obtained show how this novel technique, mixed with the dentin-derived graft material, seems to promote higher bone regeneration.