A Comparison between Primary and Secondary Flap Coverage in Ridge Preservation Procedures: A Pilot Randomized Controlled Clinical Trial

Abstract

Aims. To assess the bone dimensional changes after extraction and alveolar ridge preservation (ARP) using primary coverage (closed flap technique, CFT) or healing by secondary intention (open flap technique, OFT). Materials and Methods. Ten patients (split mouth design) were planned for extraction and ARP. All sites received ARP with freeze-dried bone allograft (FDBA) and nonresorbable membrane after extraction. Clinical standardized measurements were used to assess the dimensional alterations of the alveolar ridge. Results. All patients completed the study, and a total of 20 sites were randomized to CFT or OFT group. Center height (mean difference of 8.1 mm, SD =1.9 CFT, and 7.5 mm, SD= 1.8 OFT) and buccal height (mean difference of 0.8 mm, SD =1.0 CFT, and 0.3 mm, SD= 1.1 OFT) were significantly different within the same group. However, there was no statistically significant difference between groups. In the OFT group, the keratinized tissue width was higher and the pain VAS scores at 24 hours were lower compared with the CFT (p = 0.004 and p = 0.006, respectively). Conclusions. Leaving the flap open did not have any effects on the dimensional changes of bone height or width. However, there was a wider band of keratinized tissue and less pain with the CFT compared with the OFT. The study protocol was registered at ClinicalTrials.gov, Identifier NCT03136913.

Omega-3 Fatty Acids Effects on Inflammatory Biomarkers and Lipid Profiles among Diabetic and Cardiovascular Disease Patients: A Systematic Review and Meta-Analysis

“…This approach helps the body return to homeostasis through active and highly regulated “programmed resolution”. These mediators trigger the pathways that signal the physiologic end of the acute inflammatory phase in several diseases 9,11 , 12–18 .…”

Diode Laser Photocoagualtion as a Novel Method for Socket Sealing During Alveolar Socket Preservation

“…For the control group, open healing with the nonresorbable d-PTFE membrane was chosen as a comparable flapless approach due to the small pore size of the membrane and the good tissue compatibility that permit the incomplete wound closure to cover the membrane (21,22). One important clinical difference in the use of d-PTFE membranes than the expanded PTFE (e-PTFE) is the ease of removal.…”

“…Dense polytetrafluoroethylene (d-PTFE) membranes are also widely used in socket preservation procedures due to their small pore size <0.2 μm that resists bacterial invasion into their structure and can be left exposed intraorally with a low risk of infection (21). Therefore, they are effective without complete soft tissue coverage, as flap advancement yields increased postoperative pain and narrower zones of keratinized tissue (22).…”

Comparative evaluation of effectiveness with cutback incision and without cut back incision technique on healing in patients between 18 to 65 years of age for socket preservation cases: A randomized controlled trial

“…Additional advantages of the back cuts in those medicine areas are; improvement of the flap mobilization, minimizing of the scar length and shifting tensions away from the direction of primary defect closure. 17,18 The cutbacks, when they used for the primary closure of the bone-augmented socket may give the same advantages. They increase the mobilization and the sliding of the flap over the open socket wound, lengthen the flap, and enhance the tension free primary closure over the bone.…”