Alveolar ridge preservation with a collagen material: a randomized controlled trial

Abstract

PurposeResorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli.MethodsIn this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (±1)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography.ResultsBoth the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (P=0.03).ConclusionsThe proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.

Alveolar ridge preservation with a collagen cone: Histological, histochemical, and immunohistochemical results of a randomized controlled clinical trial

“…However, with the methods employed in the present study, it can be concluded that the combination material has no proven influence or clinical relevance on the formation of new bone, neither can a possible influence be disproved. However, the clinical evaluation according to ARP showed a significant volume preservation in the buccal aspect of the alveolus with the collagen material used (Schnutenhaus, Doering, Dreyhaupt, Rudolph, & Luthardt, ). A potential advantage of delayed implant placement after a healing period of more than 3 months when performing ARP needs to be assessed in further investigations.…”

An Overview of the Use of Equine Collagen as Emerging Material for Biomedical Applications

“…As regards dental care, equine tendon collagen products effectively reduce bone resorption after teeth removal and induce bone regeneration with a bone structure similar to natural [ 167 ]. To this, a high number of equine tendon collagen products (t-Barrier ® , Biocollagen ® , Xenomatrix ® , Bio-gen ® , Bioart ® , Kollagen ® , Parasorb ® ) are actually clinically used for the treatment of periodontitis [ 121 , 126 ], alveolar ridge preservation after tooth extraction [ 77 , 168 ], edentulism [ 125 ], maxillary sinus lift [ 119 ], intraoral donor sites regeneration [ 164 ], root perforation [ 163 ] and radicular cyst [ 120 ].…”

“…In periodontitis, collagen sheets are successfully applied on the bone root to increase the amount of periodontal connective tissue attachment, with new cementum and new bone formation, in order to decrease the pocket depth and restore the gingival recession [ 121 , 126 ]. After tooth extraction, bone resorption is avoided by improving alveolar bone regeneration by mean of an equine tendon collagen sponge that, by the formation on a stable blood clot, gives a natural support for osteoid differentiation and the subsequent calcification [ 119 , 168 ], besides guides epithelial and connective cells important for the post-extraction soft-tissues healing [ 125 ]. The enhancement of the bone strength in sockets or bone gaps by collagen may be due to its intrinsic angioconductivity and osteoconductivity [ 77 , 119 ].…”

Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge Preservation with a Collagen Cone

“…Furthermore, the storage of the collagen had no negative effects on the histological level. On the other hand, significant preservation of the alveolar ridge was demonstrated in the area of the maxillary anterior teeth [ 24 ].…”