Histological Evaluation of Bone Regeneration Using the Subperiosteal Peri-implant Augmented Layer (SPAL) Technique Combined with Deproteinized Bovine Bone Mineral: A Case Report.

Abstract

Background: SPAL technique in combination with a xenograft has been successfully used to correct a peri-implant bone dehiscence (PIBD) and increase peri-implant buccal tissue thickness. The purpose of the present study was to determine the histological nature of the newly formed tissue at sites treated using SPAL in association with particulate deproteinized bovine bone mineral (pDBBM).

Methods: 6 patients were consecutively selected for treatment with the SPAL technique combined with pDBBM. At 6-month re-entry, samples were harvested from the areas included in the bone augmentation procedure for histological qualitative and quantitative analysis.

Results: Well organized newly formed bone was present in close contact with the residual graft in all patients. However, a variability in the percentage of new bone was found among patients, ranging from 35.54% to 65.68%. Medullary spaces were populated by osteoblast-like cells and blood vessels running close to the residual graft and newly formed bone. No signs of pathological inflammatory infiltrate were observed.

Conclusion: The histological analysis indicated that the SPAL technique leads to a variable amount of newly formed bone which showed a well-organized and mature architecture, even within a relatively short healing period, in close contact to the residual DBBM particles.