Ridge preservation procedures revisited: A randomized controlled trial to evaluate dimensional changes with two different surgical protocols

Hong, Heather; Chen, Chia‐Yu; Kim, David M.; Machtei, Eli E.

doi:10.1002/jper.18-0041

Cited by 28 publications

(39 citation statements)

References 27 publications

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“…This “soft tissue invasion” phenomenon can be explained by the different healing dynamics of soft tissue and bone and may be notably dramatic in ridges that undergo a process of unassisted healing in which ≥1 bony walls are rapidly resorbed after tooth extraction (e.g., very thin buccal bone) or in sites that exhibit an alveolar bone defect (i.e., fenestration or dehiscence) prior to or as a consequence of the surgical intervention. Several RCTs have evaluated the effect of ARP on the basis of bone volumetric reduction (Pang et al 2014; Barone et al 2016; Barone et al 2017) or soft tissue contour changes (El Shazley et al 2016; Zadeh et al 2016; Sbordone et al 2017; Hong et al 2019). To the best of our knowledge, this is the first study that reports soft and hard tissue volumetric outcomes.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

et al. 2020

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Alveolar ridge preservation (ARP) therapy is indicated to attenuate the physiologic resorptive events that occur as a consequence of tooth extraction with the purpose of facilitating tooth replacement therapy. This randomized controlled trial was primarily aimed at testing the efficacy of ARP as compared with unassisted socket healing. A secondary objective was to evaluate the effect that local phenotypic factors play in the volumetric reduction of the alveolar bone. A total of 53 subjects completed the study. Subjects were randomized into either the control group, which involved only tooth extraction (EXT n = 27), or the experimental group, which received ARP using a combination of socket grafting with a particulate bone allograft and socket sealing with a nonabsorbable membrane (dPTFE) following tooth extraction (ARP n = 26). A set of clinical, linear, volumetric, implant-related, and patient-reported outcomes were assessed during a 14-wk healing period. All linear bone assessments (horizontal, midbuccal, and midlingual reduction) revealed that ARP is superior to EXT. Likewise, volumetric bone resorption was significantly higher in the control group (mean ± SD: EXT = −15.83% ± 4.48%, ARP = −8.36% ± 3.81%, P < 0.0001). Linear regression analyses revealed that baseline buccal bone thickness is a strong predictor of alveolar bone resorption in both groups. Interestingly, no significant differences in terms of soft tissue contour change were observed between groups. Additional bone augmentation to facilitate implant placement in a prosthetically acceptable position was deemed necessary in 48.1% of the EXT sites and only 11.5% of the ARP sites ( P < 0.004). Assessment of perceived postoperative discomfort at each follow-up visit revealed a progressive decrease over time, which was comparable between groups. Although some extent of alveolar ridge remodeling occurred in both groups, ARP therapy was superior to EXT as it was more efficacious in the maintenance of alveolar bone and reduced the estimated need for additional bone augmentation at the time of implant placement (ClinicalTrials.gov NCT01794806).

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Section: Discussionmentioning

confidence: 99%

Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

et al. 2020

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“…Linear measurements of the augmented bone were performed rather than a volumetric analysis based on the available software. Although linear radiographic measurements provide valuable information regarding alveolar bone width gain, and have been used in similar studies (Hong, Chen, Kim, & Machtei, 2019), these measurements provide only a two‐dimensional assessment compared to a volumetric analysis achieved by superimposition of three‐dimensional images (Koerich, Weissheimer, Koerich, Luz, & Deeb, 2018).…”

Section: Discussionmentioning

confidence: 99%

Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study

Deeb

Reichert²,

Carrico

et al. 2020

Clinical & Exp Dental Res

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Purpose The purpose of this study was to investigate if the addition of biologic agents to a particulate bone graft enhances horizontal ridge augmentation outcomes in terms of bone dimensions, bone density, and successful implant placement. Materials and Methods A retrospective chart review was done to assess the clinical and radiographic outcomes in 52 horizontal ridge augmentation sites in 43 patients. Information was gathered regarding surgical technique, type of graft material, biologic agents used (PRP or rhPDGF‐BB), method of space maintenance, and achieved alveolar ridge width and bone density changes as quantified on CBCT scans. Results The use of tenting screws, a resorbable membrane, and a combination of particulate allogenic and xenogenic bone graft material provided an average horizontal bone gain of 3.6 mm in the 52 augmented sites. There was no statistically significant difference observed in the amount of horizontal bone gain between sites treated with the addition of biologic agents (n = 21), or with a particulate bone graft alone (n = 31). A marginally statistically significant difference was found in the density of the grafted bone with the addition of biologics (p value = .0653). Conclusion The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.

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“…Of these, four were excluded from quantitative analyses because they did not report SD, three were excluded because they did not report numerical data, and three others were excluded because they used the same membrane in both the test and control groups. Ultimately, 11 articles were included in the quantitative NMA (Table 3 ) [ 24 – 26 , 29 , 31 , 33 , 38 – 41 , 43 ]. Seventeen studies had a parallel design, and five had a split-mouth design.…”

Section: Resultsmentioning

confidence: 99%

“…Overall, it was impossible to assess the impact of healing type (primary/secondary intention) on soft tissue dimensional changes, as this variable was heterogeneously distributed and could not be evaluated. Of the studies in the NMA, eight included smoking patients (24,26,29,33,38,39,41,43), of which 4 (24,26,39,43) were only light smokers and 2 (33,38) were also heavy smokers. Two studies (31,40) do not report the smoking status and one (25) considers strictly non-smoking patients.…”

Section: Risk Of Bias Analysismentioning

confidence: 99%

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Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis

Canullo

Pesce

Antonacci³

et al. 2021

Clin Oral Invest

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Background Alveolar ridge preservation (ARP) is a proactive treatment option aiming at attenuating post-extraction hard and soft tissue dimensional changes. A high number of different types of biomaterials have been utilized during ARP to seal the socket, but their effectiveness in terms of soft tissue outcomes has rarely been investigated and compared in the literature. Objective To evaluate the efficacy of different types of membranes and graft materials in terms of soft tissue outcomes (keratinized tissue width changes, vertical buccal height, and horizontal changes) after ARP, and to assign relative rankings based on their performance. Materials and methods The manuscript represents the proceedings of a consensus conference of the Italian Society of Osseointegration (IAO). PUBMED (Medline), SCOPUS, Embase, and Cochrane Oral Health’s Information Specialist were utilized to conduct the search up to 06 April 2021. English language restrictions were placed and no limitations were set on publication date. Randomized controlled trials that report ARP procedures using different sealing materials, assessing soft tissue as a primary or secondary outcome, with at least 6-week follow‐up were included. Network meta-analysis (NMA) was performed using mean, standard deviation, sample size, bias, and follow-up duration for all included studies. Network geometry, contribution plots, inconsistency plots, predictive and confidence interval plots, SUCRA (surface under the cumulative ranking curve) rankings, and multidimensional (MDS) ranking plots were constructed. Results A total of 11 studies were included for NMA. Overall, the level of bias for included studies was moderate. Crosslinked collagen membranes (SUCRA rank 81.8%) performed best in vertical buccal height (VBH), autogenous soft tissue grafts (SUCRA rank 89.1%) in horizontal width change (HWch), and control (SUCRA rank 85.8%) in keratinized mucosa thickness (KMT). Conclusions NMA confirmed that the use of crosslinked collagen membranes and autogenous soft tissue grafts represented the best choices for sealing sockets during ARP in terms of minimizing post-extraction soft tissue dimensional shrinkage. Clinical relevance Grafting materials demonstrated statistically significantly better performances in terms of soft tissue thickness and vertical buccal height changes, when covered with crosslinked collagen membranes. Instead, soft tissue grafts performed better in horizontal width changes. Non-crosslinked membranes and other materials or combinations presented slightly inferior outcomes.

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Ridge preservation procedures revisited: A randomized controlled trial to evaluate dimensional changes with two different surgical protocols

Cited by 28 publications

References 27 publications

Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study

Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis

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