Abstract
Background Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian’s Classification, in socket grafting materials upon volumetric changes in width and height. Material and Methods An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group. Results The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height. Conclusions Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect. Key words:Alveolar ridge preservation, buccal wall defect, volumetric changes, bone loss, meta-analysis.
Highlights
Tooth extraction is one of the most widely performed dental procedures
In 2005, Araújo and Lindhe conducted an experimental study in dogs to assess the dimensional alterations of the alveolar ridge occurring after tooth extraction, as well as the bone modeling and remodeling processes associated with such changes
Alveolar ridge preservation significantly reduced the loss of bone width by 2.37 mm compared with the control group
Summary
Tooth extraction is one of the most widely performed dental procedures. Studies have demonstrated that there are marked dimensional changes of the alveolar ridge in the first 2-3 months post-extraction, and that the bone changes are more pronounced on the buccal part [1]. The blood supply from the periodontal ligament is disrupted, and this leads to significant osteoclastic activity In this context, as a greater proportion of the buccal plate is composed of bundle bone compared with the lingual plate, it is quickly reabsorbed [4]. The present study offers a systematic review of the scientific evidence on the influence of type II buccal bone defects, according to Elian’s classification [9], in socket grafting materials upon volumetric changes in width and height, compared to sockets with spontaneous healing. - Study selection criteria The inclusion criteria were as follows: 1) no language restriction; 2) randomized controlled trials (RCTs); 3) controlled clinical trials (CCTs); 4) studies describing sockets with buccal wall loss; 5) studies describing the use of biomaterials and/or barriers; 6) studies with test groups involving graft-based alveolar ridge preservation (ARP); and 7) studies with controls involving spontaneous healing (SH) or placement of a collagen membrane (CM). Radiological at baseline (from the extraction tooth) and 1-3mo: CBCT measure at 6 mm Control: J.Fiorellini et al 2005
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