Is ridge preservation effective in the extraction sockets of periodontally compromised teeth? A randomized controlled trial

• Published in: Journal of clinical periodontology Vol. 48; no. 3; pp. 464 - 477
• Main Authors: Ben Amara, Heithem, Kim, Jung‐Ju, Kim, Hae‐Young, Lee, Jungwon, Song, Hyun‐Young, Koo, Ki‐Tae
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2021
• Subjects: Alveolar Bone Loss - diagnostic imaging; Alveolar Bone Loss - surgery; Alveolar Process - diagnostic imaging; Alveolar Process - surgery; Alveolar Ridge Augmentation; Animals; Biopsy; Bone growth; Bone healing; Bone loss; Cattle; Collagen; compromised socket; Computed tomography; Gum disease; Osteogenesis; Periodontitis; ridge dimension; ridge preservation; Root resorption; Statistical analysis; Teeth; Tooth Extraction; Tooth extractions; Tooth Socket - diagnostic imaging; Tooth Socket - surgery; ridge dimension; compromised socket; ridge preservation; tooth extraction; periodontitis
• ISSN: 0303-6979; 1600-051X; 1600-051X
• DOI: 10.1111/jcpe.13412

Objective To verify whether ridge preservation is effective in the reduction of dimensional loss and in bone formation compared to spontaneous healing in extraction sockets of periodontally compromised teeth. Methods Twenty‐six subjects requiring tooth extraction for stage III/IV periodontitis were randomly assigned to one of two interventions: alveolar ridge preservation using collagenated bovine bone mineral and a resorbable collagen membrane (test, RP) or spontaneous healing (control, SH). Six months later, postoperative cone‐beam computed tomography (CBCT) was performed to measure the linear and volumetric changes of the sockets compared to baseline scans. Biopsies were retrieved at the implant site for histomorphometric calculations. Nonparametric tests were applied for statistical analysis. Results Significantly less shrinkage occurred in RP compared to SH, mainly in the crestal zone. The width loss difference between groups was 3.3 mm and 2.2 mm at 1 mm and 3 mm below the crest, respectively (p < .05). RP yielded a gain in socket height of 0.25 mm, whereas a loss of −0.39 mm was observed in SH (p < .05). The percentage of volume loss recorded in RP was also less than that recorded in SH (−26.53% vs −50.34, p < .05). Significantly less bone proportion was detected in biopsies from RP (30.1%) compared with SH (53.9%). A positive association between baseline bone loss and ridge shrinkage was found in SH but not in RP. Conclusion Ridge preservation in extraction sockets of periodontally compromised teeth was effective in reducing the amount of ridge resorption.