Antonio Barone1, Paolo Toti2,3, Giovan-Battista Menchini-Fabris2,3, Giacomo Derchi2,3, Simone Marconcini2,3, Ugo Covani2,3. 1. Unit of Oral Surgery and Implantology, Department of Surgery, University of Geneva, Genève, Switzerland. 2. Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy. 3. Tuscan Dental Institute, Fortis Dental Center, Forte dei Marmi, Italy.
Abstract
BACKGROUND: Incorporation of bone substitute material into the extraction socket could minimize the edentulous ridge volume loss or maximize the bone formation within the healing area. PURPOSE: The aim of the study was to test the effectiveness in maintaining the volumetric contour of fresh extraction sockets grafted with or without 2 types of porcine biomaterials and covered with a resorbable barrier. MATERIALS AND METHODS: In the present multi-center single-blind randomized control trial, 55 patients underwent 1-tooth extraction, were surveyed, and randomly allocated to control- (25 sites, nat-group) or test groups (15 sites grafted with pre-hydrated collagenated cortico-cancellous porcine bone, coll-group, and 15 with cortical porcine bone, cort-group). Before extraction, and then 4 months later, contours of the sockets were acquired through a laser scanner, voxelized, and ghosts of each patient were superimposed with a matrix laboratory. Volumetric and area evaluations of the virtual superimposed models were performed with dentascan tools to create a volume of interest extending between the 2 residual teeth. Intra- and inter-group comparisons of the outcomes were performed. Non-parametric tests were applied with a level of significance set at P < .05. RESULTS: Intergroup analysis at 4 months' survey revealed that percentage loss of alveolar ridge volume of the coll-group (28.8% ± 8.8%) and of the cort-group (30.2% ± 7.1%) was significantly lower (P < .0001) than that of the naturally-healing group (46.4% ± 4.1%). No statistically-significant differences in outcomes were observed between the 2 test groups at any of the observation periods. Moreover, tooth position (bicuspids vs molars) seemed to affect neither volume loss nor basal shrinkage. CONCLUSION: At the 4-month analysis both test groups showed reduced bone loss when compared to naturally healing sockets. However, the 2 grafting materials were not able to preserve the alveolar crest, and a reduction close to 30% in the estimates was registered after healing.
RCT Entities:
BACKGROUND: Incorporation of bone substitute material into the extraction socket could minimize the edentulous ridge volume loss or maximize the bone formation within the healing area. PURPOSE: The aim of the study was to test the effectiveness in maintaining the volumetric contour of fresh extraction sockets grafted with or without 2 types of porcine biomaterials and covered with a resorbable barrier. MATERIALS AND METHODS: In the present multi-center single-blind randomized control trial, 55 patients underwent 1-tooth extraction, were surveyed, and randomly allocated to control- (25 sites, nat-group) or test groups (15 sites grafted with pre-hydrated collagenated cortico-cancellous porcine bone, coll-group, and 15 with cortical porcine bone, cort-group). Before extraction, and then 4 months later, contours of the sockets were acquired through a laser scanner, voxelized, and ghosts of each patient were superimposed with a matrix laboratory. Volumetric and area evaluations of the virtual superimposed models were performed with dentascan tools to create a volume of interest extending between the 2 residual teeth. Intra- and inter-group comparisons of the outcomes were performed. Non-parametric tests were applied with a level of significance set at P < .05. RESULTS: Intergroup analysis at 4 months' survey revealed that percentage loss of alveolar ridge volume of the coll-group (28.8% ± 8.8%) and of the cort-group (30.2% ± 7.1%) was significantly lower (P < .0001) than that of the naturally-healing group (46.4% ± 4.1%). No statistically-significant differences in outcomes were observed between the 2 test groups at any of the observation periods. Moreover, tooth position (bicuspids vs molars) seemed to affect neither volume loss nor basal shrinkage. CONCLUSION: At the 4-month analysis both test groups showed reduced bone loss when compared to naturally healing sockets. However, the 2 grafting materials were not able to preserve the alveolar crest, and a reduction close to 30% in the estimates was registered after healing.