Soft tissue contour and radiographic evaluation of ridge preservation in early implant placement: A randomized controlled clinical trial

S0CCJ ORAL COMMUNICATION CLINICAL RESEARCH – SURGERY

Background: Alveolar ridge preservation (ARP) aims to counteract the magnitude of dimensional changes following tooth extraction thereby simplifying implant placement. Although ARP can be applied in every clinical situation, whether this procedure has an added benefit in early implant placement remains unclear.

Aim/Hypothesis: To compare two ridge preservation techniques and spontaneous healing in terms of soft and hard tissue changes and necessity of additional guided bone regeneration (GBR) at early implant placement.

Materials and Methods: Seventy-five patients were recruited. After single tooth extractions in the incisor/premolar area of the maxilla, patients were randomly allocated to one of the following three groups: 1) ARP with a xenogeneic bone substitute covered with a collagen matrix (CM), 2) ARP with a xenogeneic bone substitute covered with a free palatal graft (PG), 3) spontaneous healing (SH). Eight weeks after tooth extraction, implants were placed. Clinical, profilometric and radiographic evaluations. In addition, the need for further guided bone regeneration (GBR) at implant placement was assessed. The differences between the treatment groups were compared with One-way ANOVA test with the corresponding post hoc analysis. The proportions of the categorical parameters were compared with the Fisher′s exact test.

Results: Seventy-five underwent early implant placement 8 weeks after tooth extraction and were evaluated. The mean changes in soft tissue contour between tooth extraction and implant placement were significant less in patients who underwent ARP (CM; −1.5 ± 0.6 mm; PG;-1.7 ± 0.6) when compared to SH group (−2.3 ± 0.9, P = 0.037). CM and PG group however did not differ in terms of soft tissue changes (P > 0.05). Furthermore, CM (−0.9 ± 0.6 mm) and PG group (1.0 ± 0.8) exhibited less horizontal bone resorption as compared to SH group (3.2 ± 2.1 mm, P < 0.001). Necessity of GBR at implant placement was significantly reduced in CM (32%) and PM group (24%) when compared to the control group (72%, P = 0.001).

Conclusions and Clinical Implications: Both ARP modalities resulted in greater preservation of the soft tissue contour and bone at implant placement simplifying the implant therapy. Therefore, ARP represents a valuable treatment option in early implant placement.

Keywords: alveolar ridge preservation, early implant placement, tooth extraction, necessity of guided bone regeneration, soft tissue contour.