Clinical, tomographic, and histological analysis of post-extraction dental sockets filled with particulate dentin or blood clot: pilot study of a randomized clinical trial.

Abstract

Objective: This preliminary study aims to compare the clinical, radiological, and histological outcomes of third molar socket repairs after dental extraction with and without the use of particulate dentin graft.

Materials and methods: Ten patients requiring bilateral surgical extraction of impacted lower third molars were selected. One side received a blood clot (control side) and the other an autologous particulate dentin graft (experimental side). Postoperative evaluations at 7 and 21 days assessed pain, edema, trismus, suture dehiscence, and wound edge coaptation. At 120 days, CBCT was used to evaluate bone density, and a biopsy was performed for histological analysis. Data were analyzed using IBM SPSS software with descriptive statistics and paired t-test at a 5% significance level.

Results: At 21 days, only one case of suture dehiscence occurred on the experimental side, compared to three on the control side. No differences in pain, edema, or trismus were observed between groups. Tomographic analysis showed no significant difference in the distance from the alveolar bone crest to the CEJ, but the experimental group had significantly higher bone density (p = 0.002). Histologically, the experimental side exhibited thicker, denser connective tissue with higher cellularity, collagen production, and multinucleated giant cells, while the control side showed typical connective tissue with fewer multinucleated cells.

Conclusion: Particulate dentin grafting showed benefits in bone density and clinical stability, with a more advanced histological healing stage.

Clinical relevance: Improve post-extraction socket healing, offering a promising alternative to traditional methods, particularly in terms of enhancing bone regeneration and clinical outcomes.