Effect of Alveolar Ridge Preservation after Tooth Extraction

Abstract

Alveolar ridge preservation strategies are indicated to minimize the loss of ridge volume that typically follows tooth extraction. The aim of this systematic review was to determine the effect that socket filling with a bone grafting material has on the prevention of postextraction alveolar ridge volume loss as compared with tooth extraction alone in nonmolar teeth. Five electronic databases were searched to identify randomized clinical trials that fulfilled the eligibility criteria. Literature screening and article selection were conducted by 3 independent reviewers, while data extraction was performed by 2 independent reviewers. Outcome measures were mean horizontal ridge changes (buccolingual) and vertical ridge changes (midbuccal, midlingual, mesial, and distal). The influence of several variables of interest (i.e., flap elevation, membrane usage, and type of bone substitute employed) on the outcomes of ridge preservation therapy was explored via subgroup analyses. We found that alveolar ridge preservation is effective in limiting physiologic ridge reduction as compared with tooth extraction alone. The clinical magnitude of the effect was 1.89 mm (95% confidence interval [CI]: 1.41, 2.36; p < .001) in terms of buccolingual width, 2.07 mm (95% CI: 1.03, 3.12; p < .001) for midbuccal height, 1.18 mm (95% CI: 0.17, 2.19; p = .022) for midlingual height, 0.48 mm (95% CI: 0.18, 0.79; p = .002) for mesial height, and 0.24 mm (95% CI: -0.05, 0.53; p = .102) for distal height changes. Subgroup analyses revealed that flap elevation, the usage of a membrane, and the application of a xenograft or an allograft are associated with superior outcomes, particularly on midbuccal and midlingual height preservation.

Alveolar ridge regeneration of damaged extraction sockets using deproteinized porcine versus bovine bone minerals: A randomized clinical trial

“…These were in agreement with a recent multicenter clinical study of grafting at buccal‐bone‐deficient extraction sockets18 showing significantly larger dimensional alterations and a much larger standard deviation (2–4 mm) than previous results for intact socket grafting. Previous clinical studies19 of alveolar ridge preservation in intact extraction sockets have found minimal changes in the horizontal and vertical dimensions by grafting xenogenous and allogenous bone substitutes, with small ranges for each value (around 1 mm in most of these studies). Another single‐cohort clinical study5 of grafting at damaged extraction sockets found minimal changes in dimensions along with small variations, which was comparable to the results obtained for intact extraction sockets.…”

Hounsfield unit comparison of grafted versus non-grafted extraction sockets

“…The magnitude of ridge alterations after tooth extraction with/without socket preservation varies both between and within subjects (23). Several factors affect the ridge resorption and socket-healing patterns, among which are: presence and the number of neighboring teeth, socket morphology, and patient compliance.…”

Tissue Dimensional Changes Following Alveolar Ridge Preservation with Different Xenografts Associated with a Collagen Membrane. Results at the 4-Month Re-Entry Surgery

“…Some investigations reported that an extractive flapless approach is associated with significantly more horizontal and vertical bone reduction [23,24]. In addition, less RW changes have been observed when primary closure was achieved [23].…”