A Comparison of Demineralized Freeze‐Dried Bone and Autologous Bone to Induce Bone Formation in Human Extraction Sockets

Abstract

The purpose of this study was to test the bone-forming capacity of demineralized freeze-dried bone (DFDBA) and autologous bone grafts in extraction sockets. Seven paired sites were grafted with either DFDBA or autologous bone. The sites were reentered between 3 and 13 months for the purposes of obtaining biopsies of the grafted sites and to place endosseous implants. Biopsies from 6 of the 7 grafted sites were evaluated for new bone formation. DFDBA sites revealed the presence of dead particles of DFDBA with no evidence of bone formation on the surfaces of the implanted particles and no evidence of osteoclastic resorption of the bone particles. Biopsies from the 6 autologous sites revealed vascular channels with woven and lamellar bone. Some specimens had retained cortical, non-vital bone chips. These bone chips were undergoing active osteoclastic resorption. The results of this study questions the use of DFDBA as a bone inductive graft material.

Diferentes alternativas de rellenos óseos

“…Las desventajas se relacionan con la calidad del tejido óseo regenerado, que no siempre es previsible. Necesitan un procesado para eliminar su capacidad antigénica (22,23).…”

Maxillary Sinus Floor Lifting Using Freeze-Dried Homologous Bone And Tibia Autologous Bone: Report On Radiographic And Histological Results

“…40,41 Su principal problema es la disponibilidad. La necesidad de un segundo sitio quirúrgico ha motivado la búsqueda de diferentes materiales sustitutos.…”

Ridge preservation comparing a flap vs. a flapless technique using a demineralized bone matrix allograft plus mineralized particulate allograft and covered with a calcium sulfate barrier.

“…Histologic results from autogenous bone grafts have consisted of vital (osteocytes within the lacunae) bone, non-vital bone, vascular channels, osteoblasts and secondary osteon formation. Cement lines usually surround the non-vital bone, which joins the immature new bone with the non-vital bone chips (Becker et al 1994(Becker et al , 1996(Becker et al , 1998.…”

“…Several studies have found that DFDBA particles are still present in biopsy cores resulting in non-vital DFDBA particles (Smukler et al 1999, Froum et al 2002, Vance et al 2003. It has been reported that DFDBA has osteoinductive properties and should induce bone growth, but in several histologic samples the DFDBA particles are encapsulated in fibrous connective tissue with no evidence of either osteoblastic or osteoclastic activity (Becker et al 1994(Becker et al , 1996(Becker et al , 1998. If DFDBA particles do not provide any osteoinductive properties, it is believed they might interfere with normal bone formation and may weaken the bone at the grafted site (Becker et al 1994).…”

“…It has been reported that DFDBA has osteoinductive properties and should induce bone growth, but in several histologic samples the DFDBA particles are encapsulated in fibrous connective tissue with no evidence of either osteoblastic or osteoclastic activity (Becker et al 1994(Becker et al , 1996(Becker et al , 1998. If DFDBA particles do not provide any osteoinductive properties, it is believed they might interfere with normal bone formation and may weaken the bone at the grafted site (Becker et al 1994). The amount of non-vital bone graft particles remaining compared to the amount of vital bone may be an important factor.…”