Clinical outcomes of implants placed in ridge‐preserved versus nonpreserved sites: A 4‐year randomized clinical trial

Abstract

Background Consistent bone changes occur after tooth removal, often compromising the success of implants placed within the socket left to natural healing The long‐term effect of ridge preservation on implant outcomes is still unclear. Purpose The aim of the study was to assess success and survival rates of implants placed in extraction sockets, with spontaneous healing, or grafted with cortical porcine bone, or collagenated corticocancellous porcine bone. Materials and methods Ninety patients in need for a single premolar/molar tooth extraction and an implant treatment were selected for the present study. Patients were randomly distributed among 3 groups: sites that healed naturally (ctrl), or sites that received ridge preservation with either cortical (cort) or collagenated corticocancellous porcine bone (coll). Three months after, all the experimental sites were reentered to insert implants. Marginal bone levels were recorded; soft tissues were analyzed and summarized with the Pink Esthetic Score (PES). Forty‐two patients out of 90 (initial cohort study) completed the entire follow‐up of 4 years. Results Cumulative survival and success rates for all implants were 100% at a 4‐year evaluation. Mean marginal bone loss (MBL) was 1.14 ± 0.23 mm in the cort group, 1.13 ± 0.29 mm in the coll group, and 1.92 ± 0.07 mm in the ctrl group. There were no significant differences between the 2 grafting materials but MBL was significantly greater in the nongrafted sites (P value < .001). The PES resulted significantly better (9.42 ± 0.75) for the cort group than for the coll group (8.53 ± 1.18) and ctrl group (6.07 ± 1.89) at 4‐year evaluation. Conclusions Ridge preservation was more effective than natural healing in preserving marginal bone and in achieving better esthetic outcomes around implants 4 years after placement. The cortical porcine bone showed better clinical outcomes than collagenated corticocancellous porcine bone.

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

“…All implants in the present study exhibited stable marginal bone levels (<0.5 mm of bone remodelling during 1 year of loading). Such results concur with previous studies demonstrating no significant differences in the marginal bone levels between ARP-received and naturally healed sites in longer follow-up periods (Apostolopoulos & Darby, 2017;Marconcini et al, 2018;Roccuzzo et al, 2014).…”

Evaluation of the mechanical properties and clinical efficacy of biphasic calcium phosphate-added collagen membrane in ridge preservation

“…In this clinical study, ridge preservation with bone grafting and collagen membranes led to reductions in the vertical and horizontal dimensions of the ridge. This finding could be explained in light of the results of previous studies [ 31 32 ]. Neither of the membranes could completely prevent resorption of the alveolar bone after extraction of the tooth.…”

Dental Implant Outcomes in Grafted Sockets: a Systematic Review and Meta-Analysis

“…Smokers were included in 4 of the studies [30,32-34]. Smoking habit was an exclusion criteria in one investigation [27] and patient smoking status was not reported in two of the studies [29,31]. In 5 of the 7 studies, untreated periodontitis [27,32-34] or a history of periodontitis [29] was an exclusion criteria.…”

“…In 5 of the 7 studies, untreated periodontitis [27,32-34] or a history of periodontitis [29] was an exclusion criteria. Patients’ periodontal status was not reported in two studies [30,31] (Table 2).…”