Aug 2026· The Journal of Periodontology· 0 citations· 16 references
Medicine
TL;DR
Maton's Trichrome staining may improve discrimination between osteoid/collagen matrix and mineralized tissue interfaces during histomorphometric analysis during histomorphometric analysis.
Abstract
Background
The primary aim of this study was to evaluate histologic wound healing of demineralized freeze-dried bone allograft (DFDBA), in particulate (P) or fiber (F) form, in combination with deproteinized bovine bone mineral (DBBM) for maxillary sinus floor augmentation. Two stains were used to evaluate whether the type of stain had an effect on histologic analysis.
Methods
This two-arm, parallel, randomized controlled trial included 29 patients with maxillary posterior edentulism requiring maxillary sinus augmentation to facilitate implant placement. Patients were blindly randomized into one of two groups: DBBM+F or DBBM+P. After 6 months of healing, bone cores were collected for histologic evaluation of vital bone, residual allograft, residual xenograft, and connective tissue (CT)/other using two stains (hematoxylin and eosin [H&E] and Masson's trichrome).
Results
No statistically significant differences were observed between the DBBM+F and DBBM+P groups for percent vital bone formation, residual graft, or CT/other on mixed linear model analysis (all p > 0.05). Paired analysis demonstrated no statistically significant differences between H&E and trichrome staining for percent vital bone formation, residual allograft, or residual xenograft (all p > 0.05). However, a statistically significant difference was observed for CT/other, with trichrome staining yielding lower mean values than H&E (mean paired difference -8.03%, p = 0.0146).
Conclusion
Both graft combinations demonstrated comparable histomorphometric outcomes within the limits of this study. Masson's Trichrome staining may improve discrimination between osteoid/collagen matrix and mineralized tissue interfaces during histomorphometric analysis.
In edentulous maxilla with insufficient bone width, both the association of i-PRF+DBBM and DBBM alone were effective in providing bone width gain for implant placement, and the association of DBBM with i-PRF showed similar outcomes compared with DBBM alone for the studied parameters.
Gabriel Rodrigues Oliveira, Vínicius Fabris, Alfonso Sánchez-Ayala et al.· Clinical Oral Investigations· 0 citations
Introduction: Alveolar ridge resorption is initiated rapidly within weeks following tooth extraction, therefore successful implant outcomes depend upon preservation of alveolar ridge. Techniques like atraumatic extraction and socket grafting helps in reduction of bone loss. Demineralised Freeze-dried Bone Allograft (DFDBA) is a commonly used due to its osteoinductive properties which are enhanced when combined with Advanced Platelet Rich Fibrin (A-PRF). A-PRF enhances healing and regeneration of both soft and hard-tissues. Autologous Dentin Graft (ADG), derived from extracted teeth, mimics natural bone and offers osteoinductive and osteoconductive benefits. Radiographic and histological analysis along with clinical evaluation are reliable methods to assess outcomes.
Need of the study: The ADG eliminates the need for a second surgical site and reduces patient morbidity. Furthermore, the combined effect of ADG with A-PRF has not yet been evaluated, highlighting the need for this study.
Aim: To assess and compare the effectiveness of DFDBA with A-PRF and ADG with A-PRF in socket preservation using clinical, radiographical, and histological analysis.
Materials and Methods: This randomised controlled clinical trial compares DFDBA with A-PRF and ADG with A-PRF in socket preservation. The trial will be conducted at the Department of Periodontics, Sharad Pawar Dental College, Sawangi (Meghe), Wardha, from May 2025 to June 2026, which will involve 10 participants in each group. Participants will be randomly assigned to one of two groups: (a) Socket preservation performed using DFDBA with A-PRF; (b) Socket preservation performed using ADG with A-PRF. Cone Beam Computed Tomography (CBCT) will be performed postoperatively and at four months, along with clinical evaluation and implant placement. Bone biopsies obtained during implant placement will be analysed histomorphometrically in a blinded manner. Statistical analysis will be performed using paired and unpaired Student’s t-tests, with a p-value <0.05 will be considered statistically significant.
Mahima Kothekar, Pavan Bajaj, Sneha Dare et al.· Journal of Clinical and Diag...· 0 citations
BACKGROUND
Demineralized freeze-dried bone allograft (DFDBA) is widely utilized in alveolar ridge preservation (ARP). However, limited human histologic evidence exists characterizing early healing associated with aseptically processed large-particle DFDBA. Both graft processing methodology and particle size may influence regenerative healing dynamics, graft integration, and tissue maturation.
METHODS
Three systemically healthy patients underwent ARP following tooth extraction using aseptically processed large-particle DFDBA (850-2000 µm) and dense polytetrafluoroethylene (d-PTFE) membrane coverage. Core biopsies were harvested at implant placement after 13-17 weeks of healing. Histologic and histomorphometric analyses were performed to evaluate graft integration, newly formed bone, residual graft particles, connective tissue, cellular repopulation, and tissue mineralization patterns.
RESULTS
All specimens demonstrated active bone formation, graft integration, and cellular repopulation of residual DFDBA particles. Newly formed bone was observed in close apposition to graft particles, consistent with ongoing remodeling and incorporation at the graft-host interface. Mean vital bone formation was approximately 34%, while mean mineralization approached 90%. Residual graft particles remained present at all sites and demonstrated varying degrees of integration into newly formed tissue. Cone beam computed tomography (CBCT) evaluation demonstrated regions of reduced radiopacity suggestive of incomplete mineralization; however, histologic and histomorphometric analyses demonstrated highly mineralized regenerated tissue, highlighting differences between radiographic appearance and tissue maturity during early healing.
CONCLUSION
Within the limitations of this exploratory case series, aseptically processed large-particle DFDBA demonstrated early healing characterized by graft integration, cellular repopulation of graft particles, vital bone formation, mineralized tissue development, and progressive remodeling following alveolar ridge preservation. Histologic and histomorphometric findings obtained at 13-17 weeks provide direct human evidence regarding early healing patterns associated with a graft configuration defined by both aseptic processing methodology and large particle size. Mean vital bone formation of approximately 35% and mean 90% mineralization were observed during this early healing interval, and all sites demonstrated sufficient clinical development to permit subsequent implant placement.
PLAIN LANGUAGE SUMMARY
When a tooth is removed, the surrounding bone naturally shrinks during healing, which can make future dental implant placement more difficult. One way to reduce this bone loss is alveolar ridge preservation, in which a bone graft is placed into the extraction socket. This study evaluated early healing following ridge preservation using an aseptically processed human donor bone graft composed of relatively large particles. Three healthy patients received the graft after tooth extraction. Approximately 13-17 weeks later, small bone samples were collected during routine implant site preparation and examined microscopically. In all cases, new bone formation was observed, and the graft particles showed evidence of integration with the surrounding tissue. Many particles were repopulated with living bone cells, indicating active remodeling. Although radiographs suggested that healing was still ongoing, microscopic analysis demonstrated a high degree of mineralization within the regenerated tissue. Within the limitations of this small case series, these findings provide insight into early healing patterns associated with this graft material and support further investigation in larger clinical studies.
N. Soldatos, A. M. Sreeramadas, Hongseok An et al.· The Journal of Periodontolog...· 0 citations
ARP using OCP/Col resulted in increased buccal bone height and enhanced bone maturation at the alveolar crest compared with atelocollagen alone, and may facilitate minimally invasive, prosthetically driven implant therapy.
Takahiro Miyazawa, K. Takeshita, Hiroto Sano et al.· Clinical Oral Investigations· 0 citations
Objective
To evaluate the clinical and radiographic outcomes of membrane-free guided tissue regeneration (GTR) using enamel matrix derivative (EMD) with bone grafts in dogs with vertical infrabony periodontal defects.
Methods
This retrospective study reviewed cases of client-owned dogs that underwent membrane-free GTR using EMD in combination with bone grafts between August 1, 2023, and September 30, 2025. Outcomes were assessed from records and cone-beam computed tomography (CBCT) datasets using 2-D measurements of clinical attachment loss (CAL) and vertical bone defect ratio (VBDR) and 3-D volumetric analysis. Success was defined as CAL improvement (≥ 1 mm) and VBDR reduction (> 10%). Volumetric analysis was used to quantify infrabony defect fill.
Results
20 periodontal defects in 16 dogs were included (allograft, n = 10; xenograft, 10). Median follow-up was 7 months (range, 6 to 14 months). All defects met the success criteria. Median CAL decreased from 5.0 mm (range, 3.0 to 8.0 mm) to 2.0 mm (range, 1.0 to 3.0 mm), and median VBDR decreased from 0.42 (range, 0.16 to 0.78) to 0.18 (range, 0.04 to 0.46). Volumetric analysis revealed a median infrabony defect fill of 98.49% (range, 71.86% to 100.00%).
Conclusions
Membrane-free GTR with EMD was associated with clinically meaningful periodontal improvement and substantial infrabony defect fill in appropriately selected canine patients with vertical infrabony defects. Prospective, controlled studies are warranted to further evaluate its efficacy and indications.
Clinical Relevance
This membrane-free regenerative approach may provide a practical tooth-preserving treatment option for selected small-breed dogs when conventional barrier-membrane placement is technically challenging.
Daehyun Kwon, Y. Jang, Gyumin Kim· American Journal of Veterina...· 0 citations
Within the limitations of this study, intentionally exposing the xenogeneic collagen matrix seal yielded comparable outcomes in non-contained and contained sockets, which may reflect the material's ability to reduce the adverse effects of socket-wall resorption.
Xinyi Zhou, Yuping Hong, Yang Yang et al.· Journal of Periodontal & Imp...· 0 citations