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J Clin Periodontol. 2016 Dec;43(12):1188-1199. doi: 10.1111/jcpe.12623. Epub 2016 Oct 21.

A randomized, controlled, multicentre clinical trial of post-extraction alveolar ridge preservation.

Author information

1
The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.
2
Private Practice, Houston, TX, USA.
3
Private Practice, Victoria, TX, USA.
4
Private Practice, Tacoma, WA, USA.
5
Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA.
6
Private Practice, Oakbrook Terrace, IL, USA.
7
Department of Graduate Periodontics, College of Dentistry, University of Illinois, Chicago, IL, USA.
8
Private Practice, Boston, MA, USA.
9
Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA, USA.
10
Private Practice, San Mateo, CA, USA.
11
Private Practice, Richmond, VA, USA.
12
Department of Graduate Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA.
13
Private Practice, New London, CT, USA.
14
Private Practice, Fenton, MI, USA.
15
University of Michigan School of Dentistry, Ann Arbor, MI, USA.
16
Institute for Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany.

Abstract

AIM:

To compare the effectiveness of two-ridge preservation treatments.

MATERIALS AND METHODS:

Forty subjects with extraction sockets exhibiting substantial buccal dehiscences were enrolled and randomized across 10 standardized centres. Treatments were demineralized allograft plus reconstituted and cross-linked collagen membrane (DFDBA + RECXC) or deproteinized bovine bone mineral with collagen plus native, bilayer collagen membrane (DBBMC + NBCM). Socket dimensions were recorded at baseline and 6 months. Wound closure and soft tissue inflammation were followed post-operatively, and biopsies were retrieved for histomorphometric analysis at 6 months.

RESULTS:

Primary endpoint: at 6 months, extraction socket horizontal measures were significantly greater for DBBMC + NBCM (average 1.76 mm greater, p = 0.0256). Secondary and Exploratory endpoints: (1) lingual and buccal vertical bone changes were not significantly different between the two treatment modalities, (2) histomorphometric % new bone and % new bone + graft were not significantly different, but significantly more graft remnants remained for DBBMC; (3) at 1 month, incision line gaps were significantly greater and more incision lines remained open for DFDBA + RECXC; (4) higher inflammation at 1 week tended to correlate with lower ridge preservation results; and (5) deeper socket morphologies with thinner bony walls correlated with better ridge preservation. Thirty-seven of 40 sites had sufficient ridge dimension for implant placement at 6 months; the remainder were DFDBA + RECXC sites.

CONCLUSION:

DBBMC + NBCM provided better soft tissue healing and ridge preservation for implant placement. Deeper extraction sockets with higher and more intact bony walls responded more favourably to ridge preservation therapy.

KEYWORDS:

collagen membrane; demineralized allograft; extraction; guided bone regeneration; private practice; randomized controlled trial; ridge preservation; xenogeneic graft

PMID:
27617409
PMCID:
PMC5132058
DOI:
10.1111/jcpe.12623
[Indexed for MEDLINE]
Free PMC Article

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