127 Dental Journal (Majalah Kedokteran Gigi) 2023 June; 56(2): 127–131 Original article Post-tooth extraction induction effect of Moringa oleifera leaf extract and demineralized freeze-dried bovine bone xenograft treatment on alveolar bone trabecula area Utari Kresnoadi 1 , Najla Salsabila 2 , Primanda Nur Rahmania 1 , Phara Aster Chandra Adventia 2 , Bima Subiakto Rahmani 2 , Nobuhiro Yoda 3 1 Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia 2 Undergraduate Student, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia 3 Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan ABSTRACT Background: After tooth extraction, alveolar bone resorption occurs naturally, followed by alveolar bone remodeling. Alveolar bone formation is characterized by an increase in density and expansion of the trabecular bone. Socket preservation using a combination of Moringa oleifera leaf extract and demineralized freeze-dried bovine bone xenograft (DFDBBX) is expected to increase the area of the alveolar bone trabeculae and thus accelerate the process of alveolar bone formation. Purpose: This study aimed to determine if a combination of Moringa oleifera leaf extract and DFDBBX could increase the area of the alveolar bone trabeculae in tooth extraction sockets. Methods: With their lower left incisors extracted, the 56 Cavia cobayas were divided into eight treatment groups according to the material given: polyethylene glycol (PEG), DFDBBX and PEG, Moringa oleifera leaf extract and PEG, and a combination of Moringa oleifera leaf extract, DFDBBX, and PEG. On the seventh and thirtieth days, the Cavia cobayas were sacrificed and examined. Histopathological samples were stained with Hematoxylin-Eosin (HE) to evaluate the trabecula area, and data were analyzed using one-way ANOVA and Tukey HSD. Results: On the thirtieth day, the group that received a combination of Moringa oleifera leaf extract and DFDBBX had the greatest area of alveolar bone trabeculae. Conclusion: A combination of Moringa oleifera leaf extract and DFDBBX induced in the tooth extraction socket can increase the area of the alveolar bone trabeculae. Keywords: alveolar bone; DFDBBX; Moringa oleifera leaf extract; socket preservation; trabecular area Article history: Received 29 November 2021; Revised 21 November 2022; Accepted 12 December 2022 Correspondence: Utari Kresnoadi, Department of Prosthodontics, Faculty of Dental Medicine, Universitas Airlangga. Jl. Mayjen. Prof. Dr. Moestopo 47, Surabaya 60132, Indonesia. Email: utari-k@fkg.unair.ac.id INTRODUCTION Tooth extraction will result in the formation of a socket. In the post-extraction socket, bleeding will occur as an early marker of the socket healing process, followed by coagulation, inflammation, proliferation, and remodeling. 1 After tooth extraction, alveolar bone resorption happens, causing changes in the morphology and dimensions of the alveolar bone. After six months, the alveolar bone will resorb by 29–63% in the horizontal plane and 11–22% in the vertical plane. 2 The bone remodeling process will involve concurrent bone resorption and deposition. The balance of osteoclasts and osteoblasts influences this process. Preosteoclasts will differentiate into osteoclasts, causing increased bone resorption. The activation of osteoclasts stimulates the differentiation and maturation of osteoblast precursor cells, resulting in bone matrix mineralization, which is an indicator of the bone formation process and osteoclast apoptosis. 3 On the seventh day after tooth extraction, bone regeneration will begin at the periphery and extend to the socket’s middle area toward the bone trabeculae. On the twelfth day, woven bone trabeculae have formed at the socket’s periphery and are surrounded by preosteoblasts, osteoblasts, and osteoprogenitor cells. 4 By the fourteenth day, trabecular bone is actively forming and will cover most of the bone graft’s surface. On the twenty-eighth day, the trabecular bone will fill most of the alveolar sockets. 5 An increase in trabecular bone density and expansion also indicates the formation of new alveolar bone. 6 Copyright © 2023 Dental Journal (Majalah Kedokteran Gigi) p-ISSN: 1978-3728; e-ISSN: 2442-9740. Accredited No. 158/E/KPT/2021. Open access under CC-BY-SA license. Available at https://e-journal.unair.ac.id/MKG/index DOI: 10.20473/j.djmkg.v56.i2.p127–131