Soft Tissue Dimensions Following Tooth Extraction in the Posterior Maxilla: A Randomized Clinical Trial Comparing Alveolar Ridge Preservation to Spontaneous Healing.

Young Woo Song,Daniel S Thoma,Sung-Wook Yoon,Ui-Won Jung,Jae-Kook Cha,Ronald E Jung

doi:10.3390/jcm9082583

Young Woo Song, Daniel S Thoma + Show 4 more

Open Access

https://doi.org/10.3390/jcm9082583

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Abstract

Background: To assess the soft tissue dimension following tooth extraction and alveolar ridge preservation in the posterior maxilla compared to spontaneous healing. Methods: Thirty-five patients randomly assigned to alveolar ridge preservation (ARP) and spontaneous healing (SH) after maxillary molar extraction. The crestal, buccal, and palatal gingival thickness at 6 months was measured around virtually placed implant fixtures using superimposed cone-beam computed tomography and intraoral scan taken at 6 months. Buccal mucogingival junction (MGJ) level change over 6 months was estimated using intraoral scans obtained at suture-removal and 6 months. Results: The crestal gingiva was significantly thinner in group ARP (−1.16 mm) compared to group SH (p < 0.05). The buccal and palatal gingiva was significantly thinner at the implant shoulder (IS) level in group ARP (buccal: −0.75 mm; palatal: −0.85 mm) compared to group SH (p < 0.05). The thickness at 2 mm below the IS of both sides and the buccal MGJ level change were similar in both groups (p > 0.05). Conclusions: ARP in the posterior maxilla resulted in a thinner soft tissue on top of and at the prospective level of the implant shoulder at 6 months. The buccal MGJ level changed minimal for 6 months in both groups.

Highlights

Alveolar ridge preservation (ARP) following tooth extraction is a well-documented clinical procedure with a number of reported benefits including: limiting morphologic changes of the ridge contour, preserving the integrity of hard and soft tissues [1], optimizing the ridge contour in extraction sites with a loss of the buccal bone plate [2,3], preventing shrinkage of the keratinized tissue [4], and resisting maxillary sinus floor pneumatization in case of extractions in the posterior maxilla [5,6]
Every subject who was included for the evaluation in the present study received a single molar extraction, and 35 molars were assessed
Fourteen first molars and 5 s molars in group alveolar ridge preservation (ARP) and 7 first molars and 9 s molars in group spontaneous healing (SH) were included in the analyses

Summary

Introduction

Alveolar ridge preservation (ARP) following tooth extraction is a well-documented clinical procedure with a number of reported benefits including: limiting morphologic changes of the ridge contour, preserving the integrity of hard and soft tissues [1], optimizing the ridge contour in extraction sites with a loss of the buccal bone plate [2,3], preventing shrinkage of the keratinized tissue [4], and resisting maxillary sinus floor pneumatization in case of extractions in the posterior maxilla [5,6]. Based on the previous studies, the soft tissue thickness can be significantly influenced by the underlying hard tissue dimension following single tooth extraction in the anterior area [10,11]. These results obtained by three-dimensional analyses suggested that the soft tissue thickness increased. To assess the soft tissue dimension following tooth extraction and alveolar ridge preservation in the posterior maxilla compared to spontaneous healing. Conclusions: ARP in the posterior maxilla resulted in a thinner soft tissue on top of and at the prospective level of the implant shoulder at 6 months. The buccal MGJ level changed minimal for 6 months in both groups

Results

Discussion

Conclusion