The effect of different soft-tissue management techniques for alveolar ridge preservation: a randomized controlled clinical trial

Christopher Büsch,Christian Mertens,Martin Keweloh,Colline Papace,Oliver Ristow,Jürgen Hoffmann

doi:10.1186/s40729-021-00390-3

Abstract

PurposeFor alveolar ridge preservation, various treatment protocols have been described. While most studies focus on the effect of the bone graft material, the aim of this study was to analyze the influence of different soft-tissue management techniques on the soft and hard tissue.MethodsA total of 20 maxillary extraction sockets were grafted with an anorganic xenogenic bone graft and then randomly treated with either a combined epithelialized-subepithelial connective tissue graft (CECG) or a porcine collagen matrix (CM) placed in labial and palatal tunnels. Measurements of soft-tissue thickness were performed at tooth extraction (T0), implant insertion (T1) and second stage surgery (T2).ResultsIn the CECG group, gingival thickness was 1.18 ± 0.56 mm (T0), 1.29 ± 0.26 mm (T1) and 1.2 ± 0.32 mm (T3). In the CM group, the measurements were 1.24 ± 0.50 mm (T0), 1.6 ± 0.6 mm (T1) and 1.7 ± 1.06 mm. Thus, there was an overall increase in gingival thickness from T0 to T2 of 0.02 ± 0.66 mm (CECG) compared to 0.46 ± 0.89 mm (CM). The thickness of keratinized soft-tissue was 3.91 ± 1.11 mm (CECG) and 4.76 ± 1.48 mm (CM) before extraction and 3.93 ± 1.17 mm (CECG) and 4.22 mm ± 1.26 mm (CM) at implant follow-up. Mean peri-implant probing depths were 3.15 ± 1.39 mm (CECG) and 3.41 ± 0.99 mm (CM).ConclusionsAfter ridge preservation, comparable soft-tissue parameters were observed in both groups, whether treated with a collagen matrix or a combined autologous connective tissue graft.

Highlights

Numerous clinical and preclinical studies have shown that bone remodeling after tooth extraction leads to resorption of the alveolar ridge [1, 2]
Vanhoutte et al analyzed alveolar ridge preservation, where a xenogenic anorganic bone graft was covered with a connective tissue graft that was inserted into a buccal and palatal pouch [4]
As most studies analyzing alveolar ridge preservation procedures focus on the type of graft material used to augment the extraction socket [3], this study investigated the influence of soft-tissue management as the influencing factor

Summary

Introduction

Numerous clinical and preclinical studies have shown that bone remodeling after tooth extraction leads to resorption of the alveolar ridge [1, 2]. Vanhoutte et al analyzed alveolar ridge preservation, where a xenogenic anorganic bone graft was covered with a connective tissue graft that was inserted into a buccal and palatal pouch [4]. They documented a stable soft-tissue contour after performing the described technique. Stimmelmayr et al described a technique of a combined epithelized-subepithelial connective tissue graft to achieve primary wound closure of the extraction socket and, aimed to increase the soft-tissue thickness [5, 6]. In their study on 39 patients, the authors focused on the hard tissue stability of the grafted areas, not on the soft-tissue [6]

Objectives

Methods

Results

Discussion

Conclusion