Effect Of Heterogeneous Acellular Dermal Matrix And Decalcified Bone Matrix On The Healing Of Dental Sockets

Alveolar resorption after tooth extraction might make it difficult for artificial dental rehabilitation or implantation. So how to improve the healing of dental socket and avoid alveolar resorption becomes one of the most important theses for oral and maxillofacial surgeons. There have been some productions for this purpose, but their clinical applications are limited by various problems. To find a simple and effective method, we compared the effect of acellular dermal matrix (ADM) and decalcified bone matrix (DBM) on the healing of dental sockets in dogs.ADM is derived from split-thickness skin from which the cellular components have been extracted. It primarily consists of extracellular matrix proteins and collagen, and the basic dermal architecture of collagen bundles in a loose meshwork remains unaltered. It's of good biocompatibility, absorbability, bone conduction ability and ability to induce formation of blood clot with high quality. Further more, three dimensional collagen structure helps cells migrate and multiply. DBM is a nontoxic and nonirritant biomaterial without pyrogen and immunocompetence. It's of good bone conduction and induction ability. DBM resorption and new bone formation take place simultaneously, and DBM is substituted by new bone gradually. The features of these two materials suggest that ADM and DBM promote healing procedure of dental sockets. Following experiments were performed to comfirm this.Bilateral mandibular second, mandibular fourth and maxilla second premolars of eighteen dogs were extracted. The left mandibular second sockets were filled with ADM while the contralateral sites left untreated as control. The left mandibular fourth sockets were filled with DBM while the contralateral sites left untreated as control. The left maxilla second sockets were filled with ADM while the contralateral sites were filled with DBM. Every 6 dogs were sacrificed at the end of the 4th,12th and 24th weeks, heads were scanned by spiral CT. CT value of socket and height of alveolar resorption were measured by multiplane reconstruction technique. Tissue in sockets was sectioned for histological examination.Results:â‘ At all time points, CT values of the ADM group were significantly higher than those of the control (P<0.01). Heights of alveolar resorption of the ADM group were significantly less than those of the control (P<0.05). There was no significant difference between the two groups in histological appearance.â‘¡At all time points, CT values of the DBM group were significantly higher than those of the control (P<0.05). At the end of the 4th week, height of alveolar resorption of the DBM group was less than that of the control, but the difference between the two groups had no statistical significance (P>0.05). At the end of the 12th and 24th weeks, heights of alveolar resorption of the DBM group were significantly less than those of the control (P<0.05). At the end of the 4th and 12th weeks, new bone formation in the DBM group was better than that in the control, but at the end of the 24th week, no significant difference between the two groups was obsercved.â‘¢At all time points, CT values of the DBM group were higher than those of the ADM group, but the difference between the two groups had no statistical significance (P>0.05). There was no significant difference in height of alveolar resorption between the two groups(P>0.05). At the end of the 4th and 12th weeks, new bone formation in the DBM group was better, but at the end of the 24th week, no significant difference between the two groups were observed.To conclude, both heterogeneous ADM and DBM can promote healing of dental sockets and preserve height of alveolar bone, consequently benefit for later dental implant and prosthetic rehabilitation. There is no significant difference between their effects on preserving height of alveolar bone, but DBM is better than ADM for early healing of dental sockets and remodeling of alveolar bone.