Efficacy of socket grafting for alveolar ridge preservation

Abstract

Tooth extraction initiates a cascade of events that often leads to local anatomic changes in the alveolar ridge. Ridge preservation is a surgical approach aimed at minimizing hard and soft tissue volume loss. There have been contradicting reports on the efficacy of socket grafting for alveolar ridge preservation. Interestingly, there is a paucity of adequately powered randomized controlled clinical trials. The purpose of this study was to assess the effect of the application of a socket grafting technique on alveolar ridge dimensional changes following tooth extraction. Methods: Healthy patients requiring the extraction of one single-rooted tooth on either arch, from second premolar to second premolar, excluding mandibular incisors, and who met the eligibility criteria were recruited. Patients were then randomly assigned to either the control group, consisting of tooth extraction alone, or the experimental group, which consisted of extraction and simultaneous ridge preservation using an allograft bone material to fill the socket and a dense polytetrafluoroethylene membrane (dPTFE) to seal it. Cone beam computed tomography (CBCT) was obtained immediately prior to extraction (baseline) and at 14 weeks. Linear measurements with the use of a toothsupported stent were obtained immediately after extraction (baseline) and at 14 weeks. Linear and volumetric measurements were made using data obtained from the CBCTs. Masked, calibrated examiners performed all radiographic measurements. Measurements obtained included buccal keratinized tissue width, buccal and lingual plate height and width, alveolar ridge horizontal width (CBCT); and alveolar ridge volume changes.

Tomographic Evaluation of Alveolar Ridge Preservation Using Bone Substitutes and Collagen Membranes—A Retrospective Pilot Study

“…This poses complications for adequate tooth replacement, both aesthetically and functionally. For functional implant placement to occur, a maintained alveolar ridge is required [ 3 ]. Even though no ARP technique will completely prevent dimensional changes from occurring, the extent of these changes can be reduced [ 4 ].…”

“…Following tooth extraction, substantial alterations to the width and height of the alveolar ridge occur [ 1 , 2 , 3 ]. In the interest of achieving long-term esthetically acceptable implant support, rehabilitation efforts have been made to maintain and or decrease the inevitable modelling and remodelling process of the alveolar ridge following tooth extraction [ 3 ]. The bundle bone contains investing periodontal ligament fibres, which act to anchor teeth into the jaw.…”

Periodontal phenotype and supracrestal soft tissue dimensions – clinical correlations and their impact on post-extraction volumetric changes

“…Sample size calculations were completed with the aim to provide adequate power for the primary outcome of interest -percentage change in ridge (hard and soft tissues) from baseline to 14 weeks following single tooth extraction. Based upon the findings of a previous study conducted within the Department of Periodontics at the University of Iowa College of Dentistry, a 10-20% reduction in the volume must be detectable (Gubler 2015).…”