Demineralized dentin matrix promotes gingival healing in alveolar ridge preservation：a split-mouth randomized controlled study
Authors: Xu Xiaofeng , Peng Dongsheng , Zhou Bowei , Lin Kaijin , Wang Siyi , Zhao Wei , Zheng Minqian , Yang Jin , Guo Jianbin 
Published: June 2023

Objective
The purpose of this study was to prospectively evaluate the efficacy of demineralized dentin matrix (DDM) in decreasing the initial inflammatory response of gingiva and facilitating the repair and regeneration of soft tissue in alveolar ridge preservation.
Methods
In this clinical study, a split-mouth design was implemented. A total of forty-four sites in fourteen patients were scheduled for extraction and alveolar ridge preservation (ARP). Bilaterally symmetrical extraction surgery was performed on each patient's premolars. The test side was treated with DDM as a graft material, while the control side was left to heal naturally. (1) The day following the surgery, the patients' pain levels were assessed using a visual analog scale (VAS). (2) Gingival state of the operated area was evaluated at 3 and 7 days after operation. (3) At 3 days after the operation, Alcian blue-nuclear fast red staining was performed on the contents of extraction sockets to observe the number of neutrophils in the contents. (4) Comparing the gingival recession between the test group and the control group by measuring the height of the buccal gingival margin of the extraction socket at 3 and 30 days after operation. (5) Evaluate the gingival fullness by measuring the width of the buccal-lingual (palate) soft tissue on the alveolar crest of the extraction socket at 30 days after surgery. (6) The digital measurement technique was used to evaluate the effectiveness of DDM in promoting healing of gingiva.
Results
All patients completed the study. (1) Although there were more painless sites in the experimental group than in the control group at 1 day after operation, the difference was not statistically significant (P＞0.05). (2) After the operation, the gingival state of the operated area was observed on the 3rd and 7th day. Results showed that on the 3rd day, the gingival state of the operated area was significantly better than that of the control group (P＜0.05). However, on the 7th day, no significant difference was observed between the two groups (P＞0.05). (3) The Alcian blue-nuclear fast red staining results in some patients indicated that the test group had a higher number of neutrophils than the control group at 3 days after operation. (4) On the third day following the operation, the test group exhibited a significantly higher buccal gingival margin height (0.696 ± 0.345) compared to the control group (0.384 ± 0.425) (P＜0.05). On the 30th day following the operation, the experimental group exhibited a slightly larger buccal gingival margin height (0.604 ± 0.475) compared to the control group (0.427 ± 0.558). However, statistical analysis revealed no significant difference between the two groups (P＞0.05). (5) After 30 days after operation, the test group demonstrated a greater width of the buccal-lingual (palate) soft tissue of the alveolar ridge crest (7.949 ± 1.460) compared to the control group (6.341 ± 1.257) (P＜0.05). (6) Following the operation, there was no noticeable distinction in the extraction socket area between the control and test groups (P＞0.05). However, at 7, 14, and 30 days after operation, there were statistically significant differences (P＜0.05) in the extraction socket area between the two groups. (7) The healing rate of the soft tissue in the extraction socket of the test group was found to be significantly higher than that of the control group at 7, 14, and 30 days after operation (P＜0.05).
Conclusions
The application of DDM in alveolar ridge preservation had been discovered to reduce the initial inflammation of gingival healing after tooth extraction. Furthermore, it had been demonstrated to promote early healing of the gingival soft tissue and maintain its contour.