Abstract
Background: The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss. Methods: In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01. Results: significant reductions of anatomical features were observed four months later in all the groups (p-values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm3 for atraumatic extractions and 0.66 ± 0.19 cm3 for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = −0.30 ± 0.10 cm3 and ΔV% = −22.3 ± 8.4%) compared to the conventional extractions (ΔV = −0.59 ± 0.10 cm3 and ΔV% = −44.3 ± 5.8%) with p-values < 0.0001. Conclusions: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.
Highlights
The remodeling of hard and soft tissues could be affected by many different factors, such as the anatomical features of the extraction sites, all the other treatments following the extraction surgery, and obviously, any surgical procedure or tooth extraction technique as well [4,5,6,7]
Conventional extraction surgery consisted in using the elevators and forceps, which could damage the coronal aspect of the buccal and palatal/lingual cortical bone of the alveolar crest; this occurred if shattered root fragments had to be removed with the reflection of a mucoperiosteal flap, with the removal of bone to retrieve roots, and by utilizing tooth movement in a horizontal direction or by rotating it till to root(s) luxation [9,10]
The present study suggested that alveolar ridges of less traumatic extraction group reported at the four-month survey significantly (p-value = 0.0001) lower volume loss (31.3%) versus those treated with conventional traumatic extraction procedures with forceps and luxators (46.2%)
Summary
Conventional extraction surgery consisted in using the elevators and forceps, which could damage the coronal aspect of the buccal and palatal/lingual cortical bone of the alveolar crest; this occurred if shattered root fragments had to be removed with the reflection of a mucoperiosteal flap, with the removal of bone to retrieve roots, and by utilizing tooth movement in a horizontal direction or by rotating it till to root(s) luxation [9,10] In this respect, elevators could pull out the tooth from a socket by using adjacent bone margins acting as fulcra [11]. Conclusions: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques
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