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case report _ ridge preservation and GTR I I 17implants3_2011 Fig. 13_Implant placement. Figs. 14 & 15_All samples show new bone formation with the newly formed bone strongly adherent to the bone graft particles. Table I_Histological and histo-mor- phometric evaluation of the xenograft as an alveolar bone graft material. Surgicaltreatment Followingadministrationoflocalanaesthesia(4% articaine and 0.001% epinephrine), the tooth was el- evated and an atraumatic extraction was performed. A full-thickness mucoperiosteal flap was elevated to expose both the labial and the lingual aspects of the alveolarridge.Theextractionsocketwasthencuretted to remove all the soft tissue. A combined two- and three-walled bony defect of 6 and 5 mm and a fenes- tration of the buccal plate were observed (Figs. 3 & 4). Aridgepreservationtechniquewasperformedusinga xenograft material (a blend of granules of depro- teinized bovine bone [90%] and porcine collagen fi- bres [10%]; Bio-Oss collagen, Geistlich) and a double layer of resorbable collagen membrane (BioGide, Geistlich;Figs.5&6).Theflapswerereplacedandwere sutured with GORE-TEX without obtaining complete socket coverage. Thus, the membrane remained ex- posed (Fig. 7). Post-operativecare Thepatientwasgiven600mgibuprofeneveryeight hours for the first four days and 500 mg amoxicillin everyeighthoursforthefirstsevendaysand10ml0.20 %chlorhexidinegluconaterinsesfor30secondstwice aday(1-0-1)fromthedayoftheoperationuntilday14 after surgery was prescribed. A toothbrush with extra softbristleswasrecommendedfromthesecondweek. Thepatientwasadvisedtoavoidchewingontheoper- ated side, and refrain from consuming hot food and drinks for two weeks. A follow-up visit was scheduled for seven days post-treatment, and the sutures were removedafter14days. Surgicalre-entryforimplantplacement (atsixmonthsfollowingridgepreservation,Figs.8&9) Following local anaesthesia as described above, a crestalincisionwasdoneandafull-thicknessflapwas raisedinpreparationforimplantplacement(Fig.10).A bonebiopsyspecimenwasharvestedintheareaprevi- ously regenerated using a bone trephine drill. Follow- ing the biopsy, the planned implant was placed (Figs. 11–13). The specimen was fixed in a solution of 10% neutral buffered formalin, then dehydrated in ethanol and embedded in methyl-methacrylate resin. Finally, the section was stained with basic fuchsine and tolui- dineblue,andwasobservedwithanopticalmicroscope at200xand400xmagnification. Clinicalandhistologicalanalysis(Figs.14&15) Clinically, xenograft particles were well integrated into the alveolus, and the regenerated area was easily distinguishable from the original bone tissue. The new bone formed was firmly attached to the particles of xenograft. The histological analysis revealed no in- flammatory response or fibrous encapsulation of par- Fig. 12 Fig. 13 Fig. 14 Fig. 15 Evaluation time (months) Membrane New bone (%) Residual particles (%) Connective tissue (%) Inflamma- tory response Artzi,2000 9 No 46,3 30,8 22,9 Minimum Vence,2004 4 Collagen 26 16 – 25% sites Barone, 2008 7 Collagen 35 29 36 No Cardaropoli, 2008 4 Collagen – 24,5 – No Lee,2009 4–6 Collagen 23,6 25,4 34,1 Occasional Table I