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Full text release has been delayed at the author's request until August 04, 2026

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Alveolar Socket Preservation Clinical Outcomes: Comparison of Two Surgical Approaches

Kang, Yeram
http://rave.ohiolink.edu/etdc/view?acc_num=osu1719840864480142

Abstract Details

2024, Master of Science, Ohio State University, Dentistry.
Background and objective: Socket preservation is a bone regeneration procedure indicated immediately following tooth extraction to preserve existing alveolar ridge height and to control alveolar ridge width. Primary wound closure following socket preservation is not indicated since it is a flapless procedure and wound edges cannot be proximated to close the bone graft through suturing. Instead, a collagen plug and/or a resorbable membrane is generally used to stabilize bone graft and seal the orifice of the socket. The purpose of this approach is to allocate time for soft tissue granulation and complete epithelization. To our knowledge the indications for these two types of biomaterials are not well-established and there are no clinical studies in the literature comparing clinical outcomes in relation to the use of these wound management approaches. Thus, the purpose of this study was to evaluate and compare the early clinical outcomes following socket preservation procedures performed by using collagen plug (CP) or collagen membrane (CM) as a sealing material. In addition, soft tissue phenotype was evaluated as a variable possibly affecting clinical healing outcomes. Material and Methods: Patients who need single tooth extraction (surrounded with mesial and distal intact teeth) and socket preservation procedures for a future implant placement procedure were recruited (IRB protocol #2022H0277). Impressions (digital) were obtained prior to surgery and at 3-6 months to study ridge dimensional changes. Soft tissue phenotype was determined prior to extraction by probing and buccal tissue thickness was determined by using a surgical caliper. Buccal bone integrity was determined by probing immediately after extraction. FDBA was used as bone graft material. Decision to use a collagen plug or collagen membrane was clinician’s choice based on the case and site anatomy. The membrane and plug were stabilized via simple interrupted and cross matrix suture using a resorbable suture. Post-operative care included antibiotic, analgesic and chlorhexidine rinse as routine clinical protocol. Patient was seen at 10-14 days, 4-6 weeks and 3-6 months period for follow-up. Specific indices were used to evaluate soft tissue wound healing in addition to regular clinical parameters. Sites were also photographically documented. At the time of implant placement, bone quality was determined by interviewing the surgeon and by measuring implant stability through resonance frequency analysis and/or torque values. In addition, a soft tissue sample from crest was removed and fixed in formalin for future histological and immunohistochemistry analysis for inflammatory infiltrates. Results: Thirty-six patients were recruited and 20 completed the study (mean 60+/-11 yrs, 7 female, 10 CP). 16 patients were excluded at different time points during 6 months follow-up due to changes in treatment plan, not following study protocol or not continuing with the recommended treatment plan. Surgery time and healing time was longer in CM (p>0.05). Surgeon preference of CM compared to CP was dependent on post-extraction buccal bone thickness/stability of bone graft. Clinical wound healing, evaluated by 3 different scoring methods, was eventful for both groups. Time dependent changes in alveolar ridge width were not statistically significant in the CP group compared to the CM group, although more dimensional variation were noted within CP (p>0.05). Time dependent phenotype changes were minimal in both groups. The main determinant in ridge dimensional changes for both groups was buccal bone thickness compared to soft tissue thickness (p=0.04, r=0.417). Primary implant stability, a secondary parameter to evaluate regenerated bone quality, was not statistically different between groups (p>0.05). Conclusion: Within the limitations of this study, the clinical outcomes following CP and CM are similar and independent of the factors influencing the surgeon’s decision making. When considering baseline tissue phenotype, post-extraction residual buccal bone thickness may be more important determinant of alveolar bone ridge dimensions following SP than soft tissue thickness and the width of keratinized tissue. The results of this study may help clinicians to make evidence-based decisions during routine surgical procedures. In addition, the results can be beneficial in choosing cost-effective approaches in dental practice.
Binnaz Leblebicioglu (Advisor)
Guo-Liang Cheng (Committee Member)
Hanin Hammoudeh (Committee Member)
Luiz Meirelles (Committee Member)
57 p.
Dentistry
Socket preservation; collagen plug; collagen membrane; alveolar ridge width

Recommended Citations

Citations

  • Kang, Y. (2024). Alveolar Socket Preservation Clinical Outcomes: Comparison of Two Surgical Approaches [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1719840864480142

    APA Style (7th edition)

  • Kang, Yeram. Alveolar Socket Preservation Clinical Outcomes: Comparison of Two Surgical Approaches . 2024. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1719840864480142.

    MLA Style (8th edition)

  • Kang, Yeram. "Alveolar Socket Preservation Clinical Outcomes: Comparison of Two Surgical Approaches ." Master's thesis, Ohio State University, 2024. http://rave.ohiolink.edu/etdc/view?acc_num=osu1719840864480142

    Chicago Manual of Style (17th edition)

osu1719840864480142
© 2024, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.