Socket preservation using maxgraft® cortico-cancellous granules together with collprotect® membrane – case series with clinical and histological outcomes  Barone A et al. Int J Periodontics Restorative Dent. 2024 Jan 4;0(0):1-20. Online ahead of print.

Original Title: Alveolar ridge preservation procedures performed with a freeze-dried bone allograft: clinical and histological outcomes in a case series: part II

In this case series the histological outcomes of socket preservation using maxgraft® cortico-cancellous granules and collprotect® membrane were evaluated in 25 patients. The analyzed biopsies were taken 3 months after the augmentation procedure at the time of implant placement. Additionally, the implants placed in the grafted sites were clinically evaluated at 1- and 2-years follow-up periods in terms of survival rate and marginal bone levels.

The histological analysis showed the incorporation of the maxgraft® granules with newly formed bone. Mean values from the histomorphometric analysis were reported as 25.94 % ± 9.46 % newly formed bone, 14.12 % ± 8.47 % residual particles, and 59.94 % ± 13.1 % marrow spaces. Clinically, the fast healing of maxgraft® granules allowed the placement of the implant with sufficient torque (35.58 ± 11.94 Ncm) after only 3 months. The marginal bone levels did not change significantly between the 1-year and 2-years follow-up periods, and the survival rate of the implants was 100 %.


Tooth extractions can result in alveolar bone dimensional changes, necessitating additional bone grafting for implant placement. Alveolar Ridge Preservation (ARP) aims to counteract post-extraction changes. This study evaluates the bone regenerative properties of a freeze-dried bone allograft (FDBA) and the clinical outcomes of implants in grafted extraction sites.


This case series enrolled 33 patients undergoing single/multiple tooth extractions followed by ARP. Biopsies were harvested during implant placement for histologic and histomorphometric analysis. Clinical outcomes included marginal bone loss and Pink Esthetic Score (PES).


25 patients completed the study. FDBA augmented sockets exhibited new bone formation adjacent to graft particles. Implants (n=25) showed 100% survival and success rates at 1 and 2 years. PES improved significantly over time (p<.001), while marginal bone loss did not significantly differ at 1 and 2 years (p=.096). Specimens showed trabecular bone, residual FDBA particles, and marrow spaces. High magnification revealed immature bone and woven bone bridges around graft particles. No inflammatory cells were observed.


The case series provides valuable insights into ARP performed with FDBA; implants were placed after 3 months of healing without any additional bone augmentation, the histological outcomes were favorable, and implants were successful after a 2-year period of follow-up.