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Graziani U. et al.
CT Figure 3. Photomicrograph illustrating a specimen of extraction sockets healed with MGCSH. Coronal section showing lamellar bone and bone marrow. No presence of organized connective tissue and foreign graft material. (original magnification X 5, Fast Green Stain)
Figure 4. Higher magnification of Figure. 1 showing absence of organized connective tissue .
CT Figure 5. Photomicrograph illustrating a specimen of spontaneously healed extraction socket. Coronal section showing lamellar bone and bone marrow. Great presence of organized connective tissue (CT).Original magnification X 5 Fast Green Stain
Journal of Osteology and Biomaterials
Figure 6. Higher magnification of Figure 3 showing presence of organized connective tissue (CT).
new trabecular design, while in the control group, the new trabecular design was reported only in 4 patients. The right quantity and quality of new bone allowing fixture placement was reported in each patient scheduled for implant treatment. HISTOLOGIGAL RESULTS (Tab. 1) Grafted sites (Figures. 3,4). In the coronal sections the average trabeculal bone fraction area was 59,2%, in medium size sections it was 56,6% and in the apical sections it was 58.3%. In all the grafted sections we did not report the presence of organized connettive tissue nor foreign material. Non grafted sites (Figures. 5,6). In the coronal sections, the averege trabecular bone fraction area was 25,8%, whereas in the medium size section was 42.5%, and in the apical sections was 57,2%. In all the coronal sections we found a percentage of connective tissue totalling 38.5%, while in the middle and apical sections we did not report the presence of organized connective tissue.
DISCUSSION Formation of 100% living bone within the extraction socket using MGCSH was evidenced at histologic examinations in all the specimens examined in our study. This agrees with other studies supporting calcium sulfate as a bone substitute23,24,25,26,27. The complete absence of grafting material remnants indicate that MGCSH has undergone complete resorption, therefore leading to the formation of new bone. In order to determine the healing process of newly formed tissue in relation to the presence of grafting material and to evaluate the influence of extraction sockets depth on the healing process, cross-sections along tissue cores from the socket sites were executed and examined histomorphometrically. No statistically significant differences emerged comparing the most superficial with the deepest section cuts in the trabecular area. The presence of a great amount of connective tissue reported within the coronal sections of spontaneously healed sockets confirmed the data reported by other histological studies regarding natural healing of extraction sockets in humans; these extraction sockets showing very little osteogenic activity in the superficial bone fraction area where only occasionally osteoblasts were present34. The consistent presence of connective tissue in the coronal aspect seems to be related to tissues competition in the healing process of conventional non-grafted sockets, which heal by secondary intention. The presence of MGCSH during the healing process in the most superficial portion of the socket seems to promote osteogenic activity; no percentage variations of trabeculal bone within the coronal and apical sections were reported in