Clinical And Histological Evaluation Of Two Techniques In Ridge Preservation

Objectives: To compare hard and soft tissue changes between the closed membrane technique (CMT) and opened membrane technique (OMT) for extraction and ridge preservation.

Methods: This is a study of 70 patients that underwent extraction and site preservation with parallel / bilateral split mouth design in the Department of Periodontology at Tufts University School of Dental Medicine. The two different techniques, OMT and CMT, were performed utilizing demineralized bone allograft (DFDBA) material with cancellous chips and a resorbable extracellular matrix (ECM) through clinical and histomorphometric analysis. A surgical stent and electric caliper were used to measure soft and hard tissue at the time of tooth removal and before implant placement. Bone core samples were obtained at 6 months to determine histologic comparison of the two techniques. n-Query advisor 7.0, alpha at 0.05, was used for statistical analysis.

Results: The preliminary results of this study found that the amount of keratinized mucosa could be preserved much better on the facial aspect of the OMT group, and the patient’s experienced less discomfort. It allows to preserve the gingival esthetic contours significantly better reducing the necessity of a 2nd stage grafting procedure. Hard tissue level analysis failed to show a significant differences between the two groups. (alveolar bone height and width) Descriptive histologic analysis confirmed comparable bone regeneration and turn-over rate for the two surgical techniques.

Conclusions: Socket preservation using DFDBA and ECM presented predictable surgical outcomes without significant complications for the two surgical techniques. Opened membrane technique can be suggested for the better esthetics and patient comfort.