Alveolar ridge preservation in the posterior maxilla reduces vertical dimensional change: A randomized controlled clinical trial

Abstract

Objectives:To test whether or not alveolar ridge preservation reduces vertical changes in the posterior maxilla compared to spontaneous healing following tooth extraction. Materials and methods:Forty subjects requiring extraction of maxillary posterior teeth with root apices protruding into the maxillary sinus floor were consecutively enrolled. Patients were randomly assigned to either one of two surgical interventions: an alveolar ridge preservation procedure using collagenated bovine bone mineral and a resorbable collagen membrane (test) or no grafting (control). Cone-beam computed tomographies were taken immediately and at 6 months after surgery, prior to dental implant placement.Results: Based on radiographic data, the level of the sinus floor remained stable over time (baseline to 6 months) in the test group (−0.14 mm [−0.31, −0.02]). In the control group, the sinus floor level shifted more coronally (−1.16 mm [−1.73, −0.61]) than the test group (p < 0.05). The test group demonstrated a significantly larger residual bone height than the control group at 6 months (7.30 mm [6.36, 8.20] vs. 4.83 mm [3.94, 5.76], respectively, p < 0.05). Implant placement without any additional sinus augmentation procedure was performed in 42.9% of test group cases, whereas in all of the subjects in the control group an additional augmentation procedure was needed (100% of the cases).Conclusion: Alveolar ridge preservation in the posterior maxilla maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to spontaneous healing. K E Y W O R D Salveolar ridge preservation, cone-beam CT, maxillary sinus, pneumatization, sinus augmentation, superimposition, vertical dimension

Ridge preservation in molar extraction sites with an open‐healing approach: A randomized controlled clinical trial

“…However, such exposure appears to receive less attention in the current era of resorbable membranes, which might be due to the tissue‐friendly nature of resorbable membranes (Kim et al, ) or the rapid vascularization and integration of tissue into a resorbable collagen membrane (Rothamel et al, ). With regard to ARP, the planned partial exposure of resorbable membranes was found not to harm clinical healing, nor did it lead to complications (Cardaropoli et al, ; Cha et al, ; Cho et al, ; Engler‐Hamm, Cheung, Yen, Stark, & Griffin, ), in line with our findings.…”

“…Several studies, including the present study, have demonstrated the effect of ARP specifically in molar areas (Cha et al, ; Lombardi et al, ; Walker et al, ; Zhao, Xu, Hu, & Chung, ). All of these studies favoured ARP over natural healing in terms of maintaining ridge dimension, but high heterogeneity among studies should be considered (Cha et al, ; Lombardi et al, ; Walker et al, ; Zhao et al, ), such as jaw and socket morphology, biomaterial, surgical technique (flap reflection and primary flap closure), healing period, and measurement (reference line and measurement level). Concerns over such heterogeneity were also stated well in recent systematic reviews (Avila‐Ortiz et al, ; Bassir et al, ; Troiano et al, ).…”

“…However, such exposure appears to receive less attention in the current era of resorbable membranes, which might be due to the tissuefriendly nature of resorbable membranes (Kim et al, 2009) or the rapid vascularization and integration of tissue into a resorbable collagen membrane (Rothamel et al, 2005). With regard to ARP, the planned partial exposure of resorbable membranes was found not to harm clinical healing, nor did it lead to complications (Cardaropoli et al, 2012;Cha et al, 2019; Engler (Cardaropoli et al, 2012;Scheyer et al, 2016). Comparable soft tissue thickness and minimal fibrous tissue ingrowth into the hard tissue area in both groups also underlines the advantages of DBBM-C, despite disoriented collagen fibres and some scattered DBBM particles observed in the soft tissue area of test group 2.…”

Clinical benefits of ridge preservation for implant placement compared to natural healing in maxillary teeth: A retrospective study

“…The volume maintenance achieved by RP can reduce the need for additional augmentation procedures during implant surgery, thereby, minimizing the invasiveness and reducing the possible incidence of complications (Barone, Ricci, Tonelli, Santini, & Covani, ; Mardas, Trullenque‐Eriksson, MacBeth, Petrie, & Donos, ). Particularly in the posterior maxilla, RP may reduce sinus pneumatization as well as minimize crestal bone resorption and therefore reduce the need of performing sinus augmentation (Cha et al, ; Rasperini, Canullo, Dellavia, Pellegrini, & Simion, ). Similarly, RP in the anterior maxilla may allow implant placement with improved soft and hard tissue conditions and a minimal risk of aesthetic complications (Jung, Ioannidis, Hammerle, & Thoma, ; Lee & Poon, ).…”

Soft Tissue Dimensions Following Tooth Extraction in the Posterior Maxilla: A Randomized Clinical Trial Comparing Alveolar Ridge Preservation to Spontaneous Healing

“…Alveolar ridge preservation (ARP) following tooth extraction is a well-documented clinical procedure with a number of reported benefits including: limiting morphologic changes of the ridge contour, preserving the integrity of hard and soft tissues [ 1 ], optimizing the ridge contour in extraction sites with a loss of the buccal bone plate [ 2 , 3 ], preventing shrinkage of the keratinized tissue [ 4 ], and resisting maxillary sinus floor pneumatization in case of extractions in the posterior maxilla [ 5 , 6 ]. Moreover, ARP can compensate for alveolar bone resorption and changes of the soft tissue contour that spontaneously occur following tooth extraction [ 7 , 8 , 9 ].…”