Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study

Abstract

ObjectivesThe aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing.Material and MethodsThirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement.ResultsThe vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm) and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm) were found significantly lower (P < 0.001), when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm).In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material.ConclusionsAt the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.

Bone Healing in Extraction Sockets Covered With Collagen Membrane Alone or Associated With Porcine-Derived Bone Graft: a Comparative Histological and Histomorphometric Analysis

“…Therefore, the present histological study aimed to compare histologically and histomorphometrically the effectiveness of socket preservation techniques using a slow resorption porcine-derived collagen membrane alone, or associated with porcine-derived bone. Clinical results of the present randomized study were previously reported by the same authors [16]. …”

“…These outcomes are in agreement with data reported by other studies [17,18], and confirm that porcine-derived bone and reabsorbable membrane are effective in maintaining the post-extractive ridge volume, compared to spontaneously healed extraction sites. As previously reported [16] the comparative clinical results between the three experimental groups, showed that at 4 months re-entry surgery, extraction sockets without severe walls deficiencies and with vestibular bone thickness ≥ 1.5 mm, grafted with porcine-derived bone and/or covered by collagen membrane have significantly lower vertical and horizontal bone changes compared to extraction sockets left to heal spontaneously. In addition, in type 1 premolar extraction sockets, based on Juodzbalys et al classification [19], with vestibular bone thickness ≥ 1.5 mm, the use of collagen membrane alone showed similar clinical results to the use of collagen membrane combined with bone graft.…”

“…The present study complements the previously published clinical study [16] on extraction socket preservation techniques by reporting on the histologic and histomorphometric outcomes. Results showed that the use of collagen membrane alone or associated to porcine-derived bone improves the healing bone process, compared to that of extraction sites spontaneously healed.…”

“…For further details regarding study population, recruitment, materials and methods, surgical procedures and assessed clinical parameters, see Guarneri et al [16]. Patients were divided into three groups of 10 subjects each: …”

Effect of alveolar ridge preservation interventions following tooth extraction: A systematic review and meta‐analysis

“…The list of excluded articles and the reasons for exclusion are available in Appendix . The final selection consisted of 25 articles, for a total of 22 studies (Aimetti, Romano, Griga, & Godio, ; Alissa, Esposito, Horner, & Oliver, ; Araujo, da Silva, de Mendonca, & Lindhe, ; Barone, Ricci, Tonelli, Santini, & Covani, ; Barone, Toti, Menchini‐Fabris, et al., ; Barone, Toti, Quaranta, et al., ; Cardaropoli, Tamagnone, Roffredo, & Gaveglio, , ; Cardaropoli, Tamagnone, Roffredo, Gaveglio, & Cardaropoli, ; Festa, Addabbo, Laino, Femiano, & Rullo, ; Fiorellini et al., ; Guarnieri et al., ; Iasella et al., ; Iorio‐Siciliano et al., ; Jung et al., ; Karaca, Er, Gulsahi, & Koseoglu, ; Kotsakis, Salama, Chrepa, Hinrichs, & Gaillard, ; Madan et al., ; Pang et al., ; Pelegrine, da Costa, Correa, & Marques, ; Rasperini, Canullo, Dellavia, Pellegrini, & Simion, ; Schneider et al., ; Spinato, Galindo‐Moreno, Zaffe, Bernardello, & Soardi, ; Temmerman et al., ; Thalmair, Fickl, Schneider, Hinze, & Wachtel, ). A flow chart that depicts this selection process is displayed in Figure .…”