Alveolar ridge preservation in sockets with severe periodontal destruction using autogenous partially demineralized dentin matrix: A randomized controlled clinical trial

Abstract

BackgroundThe preservation and reconstruction of alveolar ridge volume in extraction sockets of molars affected by severe periodontitis is a critical challenge that requires clinical attention.PurposeThis randomized controlled clinical trial was designed to evaluate the efficiency of autogenous partially demineralized dentin matrix (APDDM) for alveolar ridge preservation (ARP) in severely periodontally compromised sockets compared to spontaneous healing (SH) on radiographic and histomorphometric outcomes.Materials and MethodsThirty‐two patients with 32 periodontally compromised molars were randomized into either the test group, which received ARP using APDDM covered with a collagen sponge, or the control group, which underwent SH. Linear and volumetric changes were assessed using superimposed cone‐beam computed tomography (CBCT) acquired pre‐extraction and after a 4‐month healing time. Histomorphometric evaluation was performed on trephine cores harvested during implant placement.ResultsAll sites healed uneventfully. The ridge width at 1 mm apical to the bone crest increased by 5.03, 4.50, and 5.20 mm in the mesial, middle, distal area in the APDDM group, while decreasing by −1.98, −2.19, and −1.98 mm in the SH group, respectively (p < 0.05). The height increase of the central bone was significantly higher in the APDDM group than in the SH group (p < 0.05). The height decrease of the buccal (mesial, middle, distal) bone plate was lower in the APDDM group than in the SH group (p < 0.05). After a 4‐month healing time, bone volume increased by 37.07% in the APDDM group and by only 2.33% in the SH group (p < 0.05). Histomorphometric analysis revealed that APDDM particles were surrounded by newly formed bone, with partially absorbed residual APDDM materials observed. New bone, APDDM remnants, and connective tissue occupied 39.67 ± 8.28%, 23.66 ± 9.22%, and 36.67 ± 17.05% of the areas in the APDDM group, respectively.ConclusionsARP using APDDM was effective, resulting in a significant increase in both linear and volumetric changes in severely periodontally compromised extraction sockets compared to SH. These findings suggest that APDDM may serve as a promising new clinical option for the reconstruction of alveolar ridge dimensions.

Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis

“…Of the 6 included articles, 2 articles [ 37 , 38 ] originated from the same research group and reported different outcomes separately in the 2 articles for the same cohort, resulting in a total number of 5 included studies in this review. Among the 6 included articles, 2 were RCT [ 2 , 39 ] and 4 were non-RCT [ 33 , 37 , 38 , 40 ].…”

“…The studies included were between 2010 and 2023. All studies were conducted in China [ 33 , 37 , 38 , 39 , 40 ] except for one that was conducted in Europe [ 2 ]. A total of 130 participants with 135 extraction sites were included, taking note that the 3 articles were under the same clinical trial registration [ 37 , 38 , 40 ].…”

“…A total of 130 participants with 135 extraction sites were included, taking note that the 3 articles were under the same clinical trial registration [ 37 , 38 , 40 ]. All teeth were extracted for advanced periodontal destruction and presented with at least 2 socket walls [ 2 , 33 , 37 , 38 , 39 , 40 ] with a bone height of at least 3 mm [ 33 , 37 , 38 , 39 , 40 ]. ARP was conducted at 68 sites, while the other 67 sites were allowed to heal naturally after extraction without intervention.…”

“…ARP was conducted at 68 sites, while the other 67 sites were allowed to heal naturally after extraction without intervention. Four studies reported healing results at 6 months [ 2 , 33 , 37 , 40 ], and one study reported healing results at 4 months [ 39 ]. Four studies reported on the need for additional sinus procedures or bone augmentation during implant placement [ 2 , 38 , 39 , 40 ].…”

“…Four studies reported healing results at 6 months [ 2 , 33 , 37 , 40 ], and one study reported healing results at 4 months [ 39 ]. Four studies reported on the need for additional sinus procedures or bone augmentation during implant placement [ 2 , 38 , 39 , 40 ]. One study reported implant survival and success up to 36 months [ 38 ].…”