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Comparing Two Ridge Preservation Techniques: With And Without Soft Tissue Primary Closure

  • Author(s): Pham, Anh Nguyen Quynh
  • Advisor(s): Xenoudi, Pinelopi
  • et al.
Abstract

Objective: The goal was to compare two surgical approaches for extraction and ridge preservation: primary soft tissue closure and secondary healing intention. Data from one center is presented.

Materials and methods: UCSF IRB approved. Prospective split mouth study design was used. Each patient (n=7) obtained CBCTs before and 3.5 months after extractions. Two teeth with intact sockets (premolars/anteriors) in each patient were randomized to one of the two techniques for extractions and ridge preservation using allograft and collagen membrane. Control group had buccal mucoperiosteal flap to obtain primary soft tissue closure and test group had secondary healing intention. Patients reported post-operative discomfort at 1,3,5,7 days using visual analog scale. At 4.5 months after extractions, during implant placement or ridge augmentation, soft tissue thickness in the grafted area was measured and bone cores were harvested. Cores were sent to University of Minnesota for histologic and histomorphormetric analyses using a non-decalcified technique. A superimposition of CBCTs were performed to compare the changes in alveolar bone.

Outcome variables were the level of post-operative discomfort, percentage of vital bone, residual allograft and marrow spaces/fibrous tissue, changes in vertical and horizontal dimensions of alveolar process, and resultant differences in soft tissue thickness.

Results: pain scale analyses showed no significant differences between two groups at any time point (1,3,5,7 days). Analyses of the resultant soft tissue thickness revealed no significant differences between two techniques. CBCTs revealed no significant differences between two groups for the buccal plate thickness. In addition, there were no differences in alveolar bone changes between two techniques. There were significant differences in changes in width and height of alveolar bone within each group pre-operatively and post-operatively (p<=0.05). Histomorphometric analyses revealed no significant differences between two groups. Mean percentage of newly formed bone was 38.55% versus 39.62%; residual graft was 10.17% versus 9.24%; and marrow spaces/fibrous tissue was 51.28% versus 51.14% for primary soft tissue closure versus secondary healing intention, respectively.

Conclusion: No significant differences were observed in post-operative discomfort, soft tissue thickness, and alveolar bone changes when comparing between two surgical approaches.

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