The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Radiographic results of a randomized controlled clinical trial

Abstract

Aim: To radiographically evaluate the effect of immediate implant placement plus alveolar ridge preservation (ARP) with a deproteneized bovine bone mineral and a collagen matrix (IMPL/DBBM/CM) as compared to ARP (DBBM/CM) or spontaneous healing (SH) on vertical and horizontal bone dimensional changes after 4 months of healing. Materials and methods: Thirty patients requiring extraction of one single-rooted tooth or premolar were randomly assigned to IMPL/DBBM/CM, ARP DBBM/CM or SH. Cone-beam computed tomography (CBCT) scans, performed before tooth extraction and after 4 months, were superimposed in order to assess changes in ridge height at the buccal and lingual aspect and in ridge width at 1 mm, 3 mm and 5 mm apical to the bone crest. Kruskal-Wallis test was applied for comparison of differences between groups. Results:No statistically significant differences between the groups were observed for the vertical bone resorption of the buccal and the lingual side, while significant differences were found between SH group (−3.37 ± 1.55 mm; −43.2 ± 25.1%) and both DBBM/CM (−1.56 ± 0.76 mm; −19.2 ± 9.1%) and IMPL/DBBM/CM (−1.29 ± 0.38 mm; −14.9 ± 4.9%) groups in the horizontal dimension at the most coronal aspect. Conclusion:Ridge preservation techniques using DBBM and CM reduce the horizontal bone morphological changes that occur, mostly in the coronal portion of the buccal bone plate following tooth extraction, when compared to spontaneous healing. This is true regardless of whether immediate implant placement is performed or not. K E Y W O R D S alveolar ridge preservation, CBCT, immediate implant placement, radiographic changes, tooth extraction | 777 CLEMENTINI ET aL.

The effect of immediate implant placement on alveolar ridge preservation compared to spontaneous healing after tooth extraction: Soft tissue findings from a randomized controlled clinical trial

“…Findings from STL analysis do not seem to follow previous radiographic results obtained from the same pool of patients. That study (Clementini et al, 2019) level when recorded in the same group of patients (Jung et al, 2013).…”

“…This report is based on a prospective controlled, randomized, clinical study (Clementini et al, 2019)…”

“…Sample size was calculated in a previous report (Clementini et al, 2019) published by the authors. Ten subjects for each group were included, based on data from Jung et al 2013for the variable HW-1C, respectively, for the spontaneous healing group (−3.3 ± 2) and DBBM-C/CM group (−1.2 ± 0.8).…”

“…Details of the surgical procedures are reported in Clementini et al, 2019. In brief, after the elevation of a full-thickness flap and atraumatic tooth extraction with granulation tissue removal, the integrity of the bone plates was assessed and patients were randomly assigned to:…”

“…The authors reported a 7.5-fold increase in soft tissue thickness after tooth extraction in patients with a thin biotype and concluded that a rapidly resorbing thin buccal plate favoured soft tissue ingrowth and therefore increased soft tissue thickness. Very recently, Clementini et al (2019) investigated the effect of immediate implant placement on alveolar ridge preservation when compared to alveolar ridge preservation alone or spontaneous healing of the socket. Based on radiographic linear measurements from CBCT, the authors demonstrated the effectiveness of the alveolar ridge preservation technique, independently of the insertion of the implant, on the reduction of the hard tissue dimensional changes that occurred after spontaneous healing of a tooth extraction.…”