Sequential healing of open extraction sockets. An experimental study in monkeys

AimTo describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made.Material and methodsThe third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90 and 180days was morphometrically studied.ResultsAfter 4days of healing, a blood clot mainly occupied the extraction sockets, with the presence of an inflammatory cells' infiltrate. A void was confined in the central zones of the coronal and middle regions, in continuity with the entrance of the alveoli. At 10days, the alveolus was occupied by a provisional matrix, with new bone formation lining the socket bony walls. At 20days, the amount of woven bone was sensibly increasing. At 30days, the alveolar socket was mainly occupied by mineralized immature bone at different stages of healing. At 90 and 180days, the amount of mineralized bone decreased and substituted by trabecular bone and bone marrow. Bundle bone decreased from 95.5% at 4days to 7.6% at 180days, of the whole length of the inner alveolar surface.ConclusionsModeling processes start from the lateral and apical walls of the alveolus, leading to the closure of the socket with newly formed bone within a month from extraction. Remodeling processes will follow the previous stages, resulting in trabecular and bone marrow formation and in a corticalization of the socket access.