Effect of Socket Preservation Procedure on Dimensional Changes of the Ridge, and Its Efficacy.
Condition: Alveolar Bone Atrophy
MeSH terms: Alveolar Bone Loss
Study type: Interventional
Phase: Phase 2

Summary: 
      In this study, the investigators will evaluate the dimensional changes of alveolar bone in
      the preserved sites in comparison with extraction only conventional healed sockets, as well.

        1. Dimensional changes of the alveolar ridge contour after socket preservation in
           comparison to conventional tooth extraction.

        2. Evaluation the stability of implants placed at the preserved sockets.

        3. Histological evaluation of newly formed bone at the socket preserved sites in comparison
           with extracted only healed sites.
    

Detailed description: 
      Nineteen systematically healthy patients (10 female and 9 male; mean age 38 years old; range
      19-57) providing 32 hopeless non-molar teeth were selected and divided into 2 treatment
      groups: In the test group, following tooth extraction, for 16 sockets (9sockets from 5 female
      and 7 sockets from 5 male patients) soft and hard tissue measurements include horizontal
      (Bucco-Lingual dimensions at 1mm,3mm and 7mm at the mid portion from the line connecting two
      adjacent CEJs) and vertical ridge dimensions (vertical distance from the line connecting two
      adjacent CEJs at 8 points: Mid-Buccal, Mid-Lingual, Mesial, Distal, Disto-Buccal,
      Disto-Lingual, Mesio-Buccal, Mesio-Lingual around the socket) will be determined using a
      caliper and a template. All sockets will be filled with DFDBA and covered with absorbable
      membrane. Primary coverage will be achieved by full thickness mucosal flap advancement over
      each socket. Then an acid-etch bridge will be applied for the sites, both to avoid the
      movement of adjacent teeth to the empty space & also for patients esthetics. 6 months
      following the procedure, the soft and hard tissue in all the sites will be measured again as
      it was mentioned previously, plus the measurements gained from CBCT radiographs.

      Besides, biopsy will be harvested from some of the preserved sites that has enough width with
      the use of trephine bur no.3 and it was sent for histological evaluation. Subsequently,
      Implants will be installed in the preserved sites and the implant stability will be measured
      with the help of Ostell device. The stability will be measured after 4 month following
      implant insertion with the same device while the implant undergoes the implant exposure
      procedure.

      In control group, 16 sockets (9 sockets from 5 female, and 7 sockets from 4 male patients)
      served as unfilled extraction only group. Following extraction, soft and hard tissue
      measurements (horizontal and vertical ridge dimensions) will be determined with the use of
      caliper and template.

      6month after extraction, CBCT will be taken from the site and at the time of implant
      installation, the soft and hard tissue in all sites will be measured in vertical and
      horizontal dimensions. Furthermore, biopsy from some of the healed sockets with enough width
      will be taken with the use of trephine bur no.3 and it will be sent for histological
      examination.
    

Intervention name(s): socket preservation
Intervention type(s): Procedure
Intervention description(s): sockets will be filled with DFDBA and covered with absorbable membrane. Primary coverage will be achieved by full thickness mucosal flap advancement over each socket
Other intervention name(s): DFDBA
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: socket preservation; alveolar ridge augmentation