Comparative assessment of anterior maxillary alveolar ridge preservation with and without adjunctive use of enamel matrix derivative: A randomized clinical trial.

Abstract

The aim of this randomized, controlled, parallel-arm study was to evaluate the (a) radiographic bone dimensional changes, (b) postoperative discomfort, and (c) early soft tissue wound healing outcomes, following extraction of maxillary anterior teeth (central and lateral incisors) and treatment with alveolar ridge preservation (ARP) with and without the adjunctive use of enamel matrix derivative (EMD). Thirty extraction sockets were randomly assigned to two groups: deproteinized bovine bone mineral with 10% collagen covered with collagen membrane with the adjunctive use of EMD (test group) and without EMD (control group). Bone dimensional changes were measured using cone beam computed tomography at 3 and 5months after ARP. The severity and duration of pain and swelling were evaluated using self-reported questionnaires, and soft tissue wound healing outcomes were assessed clinically. Chi-square tests and t tests were conducted to compare differences between the two groups. Radiographic and clinical analyses showed no significant differences in horizontal and vertical bone dimensional changes and soft tissue wound healing outcomes (including spontaneous bleeding, persistent swelling, and ulceration) between the two groups. There were no significant differences in the severity of pain and swelling between the two groups, but the durations of pain (difference [df]=1.20, 95% CI=0.33-2.06; p=.008) and swelling (df=1.06, 95% CI=0.11-2.01; p=.029) were significantly reduced in the test group. Alveolar ridge preservation with the adjunctive use of EMD reduced the durations of postoperative pain and swelling following maxillary anterior teeth extraction.