Alveolar ridge preservation using xenogeneic collagen matrix and bone allograft.

Andreas O Parashis,Konstantinos Tosios,Dimitris N Tatakis,Charalampos J Kalaitzakis

doi:10.1155/2014/172854

Abstract

Alveolar ridge preservation (ARP) has been shown to prevent postextraction bone loss. The aim of this report is to highlight the clinical, radiographic, and histological outcomes following use of a bilayer xenogeneic collagen matrix (XCM) in combination with freeze-dried bone allograft (FDBA) for ARP. Nine patients were treated after extraction of 18 teeth. Following minimal flap elevation and atraumatic extraction, sockets were filled with FDBA. The XCM was adapted to cover the defect and 2-3 mm of adjacent bone and flaps were repositioned. Healing was uneventful in all cases, the XCM remained in place, and any matrix exposure was devoid of further complications. Exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2-3 months. Radiographic and clinical assessment indicated adequate volume of bone for implant placement, with all planned implants placed in acceptable positions. When fixed partial dentures were placed, restorations fulfilled aesthetic demands without requiring further augmentation procedures. Histological and immunohistochemical analysis from 9 sites (4 patients) indicated normal mucosa with complete incorporation of the matrix and absence of inflammatory response. The XCM + FDBA combination resulted in minimal complications and desirable soft and hard tissue therapeutic outcomes, suggesting the feasibility of this approach for ARP.

Highlights

Remodeling after tooth extraction results in substantial horizontal (3-4 mm) and vertical (1-2 mm) alveolar bone loss [1,2,3]
Several studies have been conducted to evaluate the effectiveness of different Alveolar ridge preservation (ARP) surgical techniques and materials, and several approaches have proven successful to varying degrees [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16]
The clinical and radiographic results indicated that the xenogeneic collagen matrix (XCM)-freeze-dried bone allograft (FDBA) combination resulted in successful ARP outcomes, with minimal complications or patient discomfort and pain

Summary

Introduction

Remodeling after tooth extraction results in substantial horizontal (3-4 mm) and vertical (1-2 mm) alveolar bone loss [1,2,3]. This postextraction alveolar bone loss can compromise or prevent subsequent implant placement, while loss of crestal support compromises the position and appearance of the soft tissues in aesthetic areas [2]. In an effort to minimize postextraction alveolar bone remodeling and prevent its undesirable sequelae, alveolar ridge preservation (ARP, a form of guided bone regeneration, GBR) was developed as a therapeutic modality. A high incidence of membrane exposure (potentially leading to infection), early membrane degradation with inadequate barrier function, postoperative discomfort with coronal flap movement, and loss of width and thickness of keratinized tissue in the alveolar ridge are among the reported complications [2, 6, 8, 17]

Objectives

Results

Conclusion