Ridge Preservation Using a Novel Freeze-dried Enzymedeantigenic Bone Paste: A Histomorphometric-retrospective Pilot Case Series

Aim and objective: The aim of this study is to provide preliminary retrospective evidence concerning the histologic and histomorphometric outcome of a novel freeze-dried equine-derived bone paste (EDEBEX) for ridge preservation of sockets following tooth extraction. Materials and methods: This pilot retrospective case series describes the histologic and histomorphometric outcome of three patients who received the equine-derived bone paste in post-extractive sockets to allow the preservation of the alveolar ridge. Patients were later rehabilitated with monolithic-zirconia, implant-supported prostheses. Results: All patients healed uneventfully. The collected biopsies showed a prevalence of bone formation at 4 months, compact lamellar bone, with well-defined lamellae surrounding Haversian and Volkmann’s canals at 6 months, and an intermediate degree of maturation in active anabolic phase at 7 months after grafting. The amount of mineralized matrix was 63.3–70.7%, whereas medullar spaces were 26.0–30.7%. Conclusion: Histologic examination showed that the bone paste was fully biocompatible. Bone regeneration occurred within the first 4 months from grafting, with 63.3–70.7% mineralized bone matrix. The residual biomaterial, when present, did not exceed, on average, 2%. Clinical significance: Ridge preservation using bone substitutes as an alternative to autogenous bone is known to be effective. However, available clinical evidence still does not indicate the biomaterial, if any, that should be preferred to carry it out. The equine bone paste used in the present study appears to be a good candidate for further investigation because it is easy to handle in the clinical setting and it displays a good bone formation rate.