Clinical, Radiographic, Histological and Histomorphometric Analysis of Socket Preservation, Comparing Autogenous dentin graft and Xenograft following an Open Membrane Technique A Randomized Controlled Clinical Trial.

A total of thirty-six patients were chosen and divided into two groups. Every patient who satisfies the requirements for inclusion will be progressively included to the experiment. Using an envelope system and a computer-generated table, each participant will be randomly assigned to receive either the TEST-I (Dentin graft) or TEST-II (DBBM-Collagen Geistlich Bio-Oss®). To assess the percentage of new bone formation by histological and histomorphometric analysis, to assess the dimensional changes of hard and soft tissues, to assess wound healing assessment using the Early Wound Healing Index (Watchel 2003) & Wound Healing Index (Landry et al., 1988), and to assess patient-centered outcomes in terms of pain and patient satisfaction, the surgical procedures for the assigned patients will be performed in the Department of Periodontology. Every patient that took part will be assesseed pain and patient satisfaction as measures of patient-centered outcomes. Prior to surgery, all study participants underwent a comprehensive diagnostic evaluation that comprised a radiograph of the afflicted area, study casts, intraoral photos, and routine blood parameter checks (FBS/PPBS, Bleeding Time (BT), Clotting Time (CT), International Normalized Ratio (INR), and platelet count). A comprehensive oral prophylaxis was then carried out. The Modified Plaque Index (Silness and Loe, 1964), the Gingival Index (Loe and Sillness, 1967), and the Modified Sulcus Bleeding Index (Mombelli et al., 1987) will be done to quantify oral hygiene at baseline for all patients prior to oral prophylaxis. Using the UNC-15 probe, the clinical width of keratinized gingiva will be assessed. The measurement of buccal bone thickness and horizontal ridge width will be based on baseline CBCT. Atraumatic tooth extraction under local anesthesia must be carried out using periotome and peizotome without opening a mucoperiosteal flap. After the socket has been completely curetted, it must be irrigated with sterile saline and examined for the presence of fenestration, dehiscence, or perforations. In the first test group, the entire socket is filled with 300–1200 μm of dentin graft. The extracted tooth will be put in the dentin crusher (KometaBio grinding device) in order to prepare the dentin graft. After being gathered and let to sit at room temperature for five minutes, the crushed dentin particles will be dehydrated using sterile gauze. In order to obtain an autogenous dentin bone graft, phosphate buffered solution (PBS) will be added to the dish containing the dentin particles in order to equalize the pH. This process will be repeated. (Size: 300–1200 μm) In test group II, all of the (DBBM-Collagen Geistlich Bio-Oss®) particles (250–1,000 μm) are entirely packed into the socket. Collagen membrane (Geistlich Bio-Gide®) is used to cover the extraction socket in both groups, and it is sutured.