At the 4 week time period, if the site was not grafted, the socket would be filled with dense collagen and very little bone. When a tooth is extracted and not grafted, it goes through a cycle of clot, granulation tissue, and then collagen before any bone is formed, which takes a month. With Socket Graft™, the clot- granulation tissue-collagen plug is skipped and bone formation begins immediately. With Socket Graft™, bone formation is accelerated by SL Factor and elemental calcium phosphate. Calcium phosphate in its elemental state is known to stimulate bone formation and Socket Graft™ is the only bone graft on the market that contains calcium phosphate in elemental form which contributes to the bone formation shown on these radiographs. Ceramic bone grafts that contain calcium phosphate do not stimulate bone formation because the particles must be encased in bone before osteoclasts can release the calcium phosphate during resorption and therefore it is too late in the process to stimulate bone formation.
Any particulate synthetic bone graft material will proceed through the same process of clot, granulation tissue, and collagen plug during the first month, followed by osteoconduction—just like a socket without graft. The presence of biocompatible but biologically inert granules produces the same amount of bone at the same rate but it will maintain volume due to the presence of the granules.
When using cadaver bone grafts, there is no way to know if bone has formed radiographically. The process of bone formation for cadaver bone grafts is different than normal bone formation as it takes place on the graft particles and not from the surrounding bone. At 4 weeks, no bone formation will have occurred in a socket grafted with a cadaver bone graft.