Alveolar ridge preservation with guided bone regeneration or socket seal technique. A randomised, single‐blind controlled clinical trial. Issue 7 (22nd June 2022)

• Record Type: Journal Article
• Authors: MacBeth, Neil D.; Donos, Nikolaos; Mardas, Nikos
• Is Part Of: Clinical oral implants research. Volume 33:Issue 7(2022)
• Page Start: 681
• Page End: 699
• Publication Date: 2022-06-22
• Subjects: alveolar bone dimensions -- alveolar ridge preservation -- bone healing complications and visual analogue pain scores -- cone beam computerised tomography -- guided bone regeneration -- optical scanning -- randomised controlled trial -- socket seal; Dental implants -- Research -- Periodicals; 617.69
• DOI: 10.1111/clr.13933
• Languages: English
• ISSNs: 0905-7161

Abstract

Abstract: Objectives: To compare radiographic bone changes, following alveolar ridge preservation (ARP) using Guided Bone Regeneration (GBR), a Socket Seal (SS) technique or unassisted socket healing (Control). Material and methods: Patients requiring a single rooted tooth extraction in the anterior maxilla, were randomly allocated into: GBR, SS and Control groups ( n = 14/). Cone Beam Computed Tomography (CBCT) images were recorded post‐extraction and at 4 months, the mid‐buccal and mid‐palatal alveolar ridge heights (BARH/PARH) were measured. The alveolar ridge width, cross‐sectional socket and alveolar‐process area changes, implant placement feasibility, requirement for bone augmentation and post‐surgical complications were also recorded. Results: BARH and PARH was found to increase with the SS (0.65 mm ± 1.1/0.65 mm ± 1.42) techniques, stabilise with GBR (0.07 mm ± 0.83/0.86 mm ±1.37) and decrease in the Control (−0.52 mm ± 0.8/−0.43 mm ± 0.83). Statistically significance was found when comparing the GBR and SS BARH ( p = .04/.005) and GBR PARH ( p = .02) against the Control. GBR recorded the smallest reduction in alveolar ridge width (−2.17 mm ± 0.84), when compared to the Control (−2.3 mm ± 1.11) ( p = .89). A mid‐socket cross‐sectional area reduction of 4% (−2.27 mm 2 ± 11.89), 1% (−0.88 mm 2 ± 15.48) and 13% (−6.93 mm 2 ± 8.22) was found with GBR, SS and Control groups (GBR vs. Control p = .01). The equivalent alveolar process area reduction was 8% (−7.36 mm 2 ± 10.45), 6% (−7 mm 2 ± 18.97) and 11% (−11.32 mm 2 ± 10.92). All groups supported implant placement, with bone dehiscence noted in 57% ( n = 4), 64%( n = 7) and 85%( n = 12) of GBR, SS and Control cases (GBR vs. Control p = .03). GBR had a higher risk of swelling and mucosal colour change, with SS associated with graft sequestration and matrix breakdown. Conclusion: GBR ARP was found to be more effective at reducing radiographic bone dimensional changes following tooth extraction.