Sequential healing of open extraction sockets. An experimental study in monkeys

Authors

  • Alessandro Scala,

    1. ARDEC, Ariminum Odontologica, Rimini, Italy
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  • Niklaus P. Lang,

    1. The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China
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  • Michael T. Schweikert,

    1. Faculty of Dentistry, University of Medical Science, La Habana, Cuba
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  • José Américo de Oliveira,

    1. Faculdade de Odontologia de Araçatuba, UNESP – Universidade Estadual Paulista, Araçatuba, SP, Brasil
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  • Idelmo Rangel-Garcia Jr,

    1. Faculdade de Odontologia de Araçatuba, UNESP – Universidade Estadual Paulista, Araçatuba, SP, Brasil
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  • Daniele Botticelli

    Corresponding author
    1. ARDEC, Ariminum Odontologica, Rimini, Italy
    2. The University of Hong Kong, Prince Philip Dental Hospital, Hong Kong SAR, China
    3. Faculdade de Odontologia de Araçatuba, UNESP – Universidade Estadual Paulista, Araçatuba, SP, Brasil
    • Corresponding author:

      Daniele Botticelli

      Universidade Estadual Paulista “Júlio de Mesquita Filho”,

      UNESP – Campus de Araçatuba,

      Rua José Bonifácio 1193

      16015-050 Araçatuba, SP

      Brasil

      Tel.: +55 02118 3636 3209

      Fax: +55 02118 3636 3340

      e-mail: daniele.botticelli@ardec.it

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Abstract

Aim

To describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made.

Material and methods

The third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180 days was morphometrically studied.

Results

After 4 days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10 days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20 days, the amount of woven bone was sensibly increasing. At 30 days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180 days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4 days to 7.6% at 180 days, of the whole length of the inner alveolar surface.

Conclusions

Modeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access.

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