A Retrospective Digital Analysis of Contour Changing after Tooth Extraction with or without Using Less Traumatic Surgical Procedures

Giovanni Battista Menchini-Fabris; Paolo Toti; Roberto Crespi; Giovanni Crespi; Saverio Cosola; Ugo Covani

doi:10.3390/jcm11040922

A Retrospective Digital Analysis of Contour Changing after Tooth Extraction with or without Using Less Traumatic Surgical Procedures

J Clin Med. 2022 Feb 10;11(4):922. doi: 10.3390/jcm11040922.

Authors

Giovanni Battista Menchini-Fabris^{1

2

3}, Paolo Toti^{1

4}, Roberto Crespi^{1

2}, Giovanni Crespi¹, Saverio Cosola¹, Ugo Covani^{1

4}

Affiliations

¹ Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Dental Clinic, Research and Continuing Education, 55041 Camaiore, Italy.
² Study Center for Multidisciplinary Regenerative Research, Guglielmo Marconi University, 00100 Rome, Italy.
³ San Rossore Dental Unit, Viale delle Cascine 152, San Rossore, 56122 Pisa, Italy.
⁴ Department of Dentistry, Unicamillus-Saint Camillus International University of Health and Medical Sciences, 00100 Rome, Italy.

Abstract

Background: The present retrospective analysis aimed to compare two different single tooth extraction surgical approaches in both premolar and molar areas: less traumatic magneto-electrical versus conventional tooth extraction in minimizing the edentulous ridge volume loss.

Methods: In the present retrospective control trial, 48 patients who underwent one-tooth extraction, were allocated either to control (28 sites treated with conventional tooth extraction procedures) or test group (20 subjects treated with less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric roots subluxation). Intraoperatively (during tooth extraction surgery just after the subsequent filling of the alveolar socket with the sterile fast re-absorbable gelatin sponge), and then four months later, contours of the sockets were acquired through a laser intra-oral scanner. The digitally superimposed models were converted to dicom (Digital Imaging and Communications in Medicine) format first, then volumetric and area evaluations were performed with a DentaScan tool package. Non-parametric tests were applied with a level of significance set at p < 0.01.

Results: significant reductions of anatomical features were observed four months later in all the groups (p-values < 0.001) with volume losses leading to a final alveolar ridge volume of 0.87 ± 0.34 cm³ for atraumatic extractions and 0.66 ± 0.19 cm³ for conventional extractions. No significant differences were registered for outcomes related to the basal surface variables. When just molar tooth were considered, the outcomes relating to volume loss between baseline and four months (ΔV) and its percentage (ΔV%) showed a better behavior in the less traumatic procedure (ΔV = -0.30 ± 0.10 cm³ and ΔV% = -22.3 ± 8.4%) compared to the conventional extractions (ΔV = -0.59 ± 0.10 cm³ and ΔV% = -44.3 ± 5.8%) with p-values < 0.0001.

Conclusions: at four months, the less traumatic tooth extraction procedures by tooth sectioning and magnetoelectric root subluxation seemed to be able to better preserve the volume of the alveolar crest (reduction close to 22% with less traumatic extraction in molar sites) when compared to subjects treated with the conventional tooth extraction techniques.

Keywords: alveolar remodeling; imaging superimposition; intraoral digital scanning; less traumatic surgery; socket healing; tooth extraction.