Tomographic and Histologic Analysis of Different Socket Sealing Approaches for Alveolar Ridge Preservation: A Randomized Controlled Pilot Clinical Trial.

Abstract

Purpose: To compare different socket sealing approaches for alveolar ridge preservation and assess the dimensional changes and histologic characteristics of soft and hard tissues in a 4- to 6-month period. Material and Methods: A total of 22 patients with indicated single-tooth extraction in the maxillary nonmolar region were eligible for this study. After CBCT scanning and minimally traumatic tooth extraction, the alveolar sockets were filled with demineralized bovine bone mineral with collagen (DBBM-C) in patients from all groups except for those in the control group. Patients were divided into groups for socket sealing as follows: unsealed/spontaneous healing (control; n = 6), collagen matrix (n = 5), collagen membrane (n = 5), and autogenous graft (n = 6). A second CBCT scan was taken 4 to 6 months after extraction, and a trephine biopsy of soft and hard tissues was collected during implant placement. Tomographic dimensional changes were compared between groups. Intragroup tomographic evaluation and histological analysis were also performed. Results: Analysis of dimensional changes did not detect differences between the socket sealing groups (P > .05). In an intragroup evaluation, the height of the buccal bone and cross-sectional area of the alveolar ridge were significantly lower 4 to 6 months after extraction for the control group (P = .031). Histological analysis revealed that the socket sealing approach had no impact on hard and soft tissue formation. Conclusion: The data from the present study suggest that socket sealing with a collagen matrix, a collagen membrane exposed to the oral cavity, or an autogenous punch graft had no difference in the effects on volumetric maintenance and tissue formation in a period of 4 to 6 months.