Influence of healing time on the outcomes of alveolar ridge preservation using a collagenated bovine bone xenograft: A randomized clinical trial

J Clin Periodontol. 2023 Feb;50(2):132-146. doi: 10.1111/jcpe.13744. Epub 2022 Nov 18.

Abstract

Aim: To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time.

Materials and methods: Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A-3 months; B-6 months; C-9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes.

Results: A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups.

Conclusions: Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617).

Keywords: alveolar ridge preservation; bone resorption; dental implants; digital image processing; tooth extraction.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alveolar Bone Loss* / drug therapy
  • Alveolar Bone Loss* / surgery
  • Alveolar Process / surgery
  • Alveolar Ridge Augmentation* / methods
  • Animals
  • Cattle
  • Collagen / therapeutic use
  • Heterografts
  • Humans
  • Swine
  • Tooth Extraction
  • Tooth Socket / surgery
  • Wound Healing

Substances

  • Collagen
  • bone meal

Associated data

  • ClinicalTrials.gov/NCT03659617