Abstract
Many biomaterials have been proposed for ridge preservation techniques to counteract fresh extraction socket resorption. The primary aim of this prospective single cohort study was to evaluate the histomorphometric outcomes of a synthetic biphasic calcium phosphate (60% HA/40% β-TCP) and a synthetic poly-lactic acid membrane, used to graft fresh extraction socket sites with a full or partial (>5mm) resorption of the buccal bone plate. Patients recruited were treated at one esthetic site with a ridge preservation procedure to receive an implant-supported prosthesis. After 6 months of healing, a bone biopsy was harvested. Outcome evaluations were: biological complications, histomorphometrical analysis, and alveolar horizontal and vertical bone loss (ΔAHB, ΔAVB). Thirteen subjects were included in this study. Two cases of biological complication were recorded. All 13 patients received implant insertion. From histomorphometric analysis, a mean of 48.9 ± 11.9%, 29.0 ± 9.3%, and 22.0 ± 9.7% was recorded for soft tissues, new bone, and residual graft particles, respectively. From clinical analysis, a mean of 0.5 ± 1.0 mm (p-value < 0.05) and 0.9 ± 1.3 mm (p-value < 0.05) was recorded for alveolar horizontal and vertical bone loss, respectively. In conclusion, this prospective cohort study showed encouraging results in preserving alveolar ridge dimension. A moderate percentage of new bone and an acceptable alveolar ridge loss were achieved at a 6 month follow-up.
Highlights
The treatment of fresh extractions sockets is a common challenge in dental practice
Each patient was treated at one site in the esthetic upper or lower jaw with a ridge preservation procedure; after healing, each patient received an implant-supported prosthesis
None of the sites had acute infection, but most of the sites had a mild amount of granulation tissue, which did not contraindicate the application of this synthetic biphasic calcium phosphates grafting material
Summary
The treatment of fresh extractions sockets is a common challenge in dental practice. Following tooth extraction, the soft and hard alveolar tissues show dimensional, structural, and volumetricAppl. Sci. 2020, 10, 3034 changes [1] These changes to the alveolar ridge consist in the highest amount of horizontal bone loss with a concomitant vertical ridge height loss, which has been recorded to be more prominent at the vestibular site. Multiple key factors seem to be involved in this tissue shrinkage, and the most important role seems to be played by bundle bone resorption and blood clot stabilization [2,3,4]. These three-dimensional tissue changes can result in difficulties in performing a prosthetically-driven implant placement leading to prosthetic compromises. In-depth knowledge of post-extraction healing patterns and contour changes can be essential for a correct implant treatment planning
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