Autogenous masticatory mucosal grafts in extraction socket seal procedures: a comparison between sockets grafted with demineralized freeze-dried boneand deproteinized bovine bone mineral

Successful preservation of the edentulous ridge after extractions may elimi nate or reduce the need for ridge augmentation procedures. It has been clai med that grafting fresh extraction sockets and sealing them with autogenous soft tissue grafts promote ridge preservation after tooth extraction. In t his study, the survival of free autogenous connective tissue grafts sealing extraction sites was evaluated. In 24 healthy patients, 42 maxillary anter ior teeth were extracted. After socket debridement, soft tissue margins of the socket orifice were carefully cut to remove epithelial debris. Sockets were filled with either demineralized freeze-dried bone allografts (DFDBA) or deproteinized natural bovine bone mineral xenograft (DBBMX) to the level of the alveolar bone crest. Circular connective tissue grafts, slightly la rger in diameter than the soft tissue socket orifice, were obtained and pla ced on top of the filler graft material sealing the sockets. Grafts were st abilized and secured by sutures and inspected weekly for the first month. T he grafts were classified into 3 groups according to clinical parameters: v ital, partially vital and non-vital. After 1 week, 18 grafts were vital, 13 partially vital and 11 non-vital. When only 1 sample unit (1 site per pati ent) was compared between DFDBA and DBBMX grafted sockets, no significant d ifference in graft vitality was shown (P=0.34 for vital; P=0.67 for vital p lus partially vital). After 1 month, all socket orifices were sealed with m ucosa. Based on the present observations, it seems that connective tissue g rafts sealing fresh extraction sites are mainly dependent on underlying tis sue vascularization and that sealing grafted fresh extraction sockets fille d with bone substitute allograft or xenograft materials may be beneficial b ut an unpredictable procedure.