This article reviews the normal and pathological healing processes that take place after tooth extraction in orthodontic cases, and their associated complications within the mucosa or alveolar socket, such as gingival clefts or bone defects. The general and local factors that are involved in such deficient healing cases are detailed, in parallel to surgical procedure to enhance ridge preservation or to 'regenerate' tissues. The relationships between the orthodontist and periodontist are underlined, because both praticioners assess patient's risk factors and follow him during this treatment stage.

Bone substitutes alone or supplemented with platelet-derived concentrates are widely used to promote bone regeneration but their potency remains controversial. The aim of this study was, therefore, to compare the regenerative potential of preparations containing autologous platelet lysate (APL) and particles of either deproteinized bovine bone mineral (DBBM) or biphasic calcium phosphate (BCP), two bone substitutes with different resorption patterns. Rabbit APL was prepared by freeze-thawing a platelet suspension. Critical-size defects in rabbit femoral condyle were filled with DBBM or DBBM+APL and BCP or BCP+APL. Rabbits were sacrificed after six weeks and newly formed bone and residual implanted material were evaluated using nondemineralized histology and histomorphometry. New bone was observed around particles of all fillers tested. In the defects filled with BCP, the newly formed bone area was greater (70%; P < 0.001) while the residual material area was lower (60%; P < 0.001) than that observed in those filled with DBBM. New bone and residual material area of defects filled with either APL+DBBM or APL+BCP were similar to those observed in those filled with the material alone. In summary, osteoconductivity and resorption of BCP were greater than those of DBBM, while APL associated with either DBBM or BCP did not have an additional benefit.

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