The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  25 (2024)
Volume  24 (2023)
Volume  23 (2022)
Volume  22 (2021)
Volume  21 (2020)
Volume  20 (2019)
Volume  19 (2018)
Volume  18 (2017)
Volume  17 (2016)
Volume  16 (2015)
Volume  15 (2014)
Volume  14 (2013)
Volume  13 (2012)
Volume  12 (2011)
Volume  11 (2010)
Volume  10 (2009)
Volume  9 (2008)
Volume  8 (2007)
Volume  7 (2006)
Volume  6 (2005)
Volume  5 (2004)
Volume  4 (2003)
Volume  3 (2002)
Volume  2 (2001)
Volume  1 (1999)
Related articles

VOLUME 22 , ISSUE 3 ( March, 2021 ) > List of Articles

ORIGINAL RESEARCH

Alveolar Ridge Preservation in the Esthetic Maxillary Zone: Tuberosity Punch Technique of Gingiva and Bone: A Pilot Study

Mustapha Houmani, Nabih Nader, Ziad Salameh, Antoine Berberi

Keywords : Alveolar bone, Gingiva, Ridge preservation, Tuberosity

Citation Information : Houmani M, Nader N, Salameh Z, Berberi A. Alveolar Ridge Preservation in the Esthetic Maxillary Zone: Tuberosity Punch Technique of Gingiva and Bone: A Pilot Study. J Contemp Dent Pract 2021; 22 (3):290-297.

DOI: 10.5005/jp-journals-10024-3049

License: CC BY-NC 4.0

Published Online: 27-01-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: This paper aims to present an alveolar ridge preservation technique, using an autologous punch formed of hard and soft tissues harvested from the tuberosity area. Materials and methods: Ten residual sockets in the anterior maxilla were filled with a punch of hard and soft tissues harvested from the tuberosity area. Clinical and radiographical data were collected at the surgical extraction time 0 (T0) and 5 months during implant placement (T1), from clinical and radiological measurements using cone-beam computed tomography scans and periapical radiographs. Core biopsy was harvested during implant placement for histological and histomorphometrical analysis. Results: Clinically, the alveolar ridge presented a mean width of 10.3 mm before extraction which decreased to 8.85 mm at T1, where the mean horizontal loss is 1.45 mm (standard deviation [SD] 1.03 mm). The initial ridge mean height was 11.25 mm and increased to 12.85 mm after 5 months, where the mean vertical gain is 1.6 mm (SD 0.65 mm). The radiological evaluation shows a reduction in the horizontal dimension with a mean of 1 mm; however, the sockets show stability in the vertical dimensions. Histology showed a new lamellar bone formation with some areas of woven bone. Histomorphometric analysis showed that the percentage of new bone formed was 42.44 ± 5.54% and 48.62 ± 8.66% of the connective tissue and 8.94 ± 5.28% of the residual autogenous bone. Conclusion: At T1, the extraction sockets showed significantly lower vertical and horizontal bone changes, compared to T0. The described preservation punch technique resulted in greater stability in the horizontal and vertical dimensions after 5 months. Clinical significance: Clinical and radiological results show that the punch of hard and soft tissue graft reduces hard and soft tissue dimensional alteration after tooth extraction. In addition, using autogenous bone showed histological new bone formation.

HTML PDF Share
  1. Schropp L, Wenzel A, Kostopoulos L, et al. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 2003;23(4):313–323.
  2. Van der Weijden F, Dell Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol 2009;36(12):1048–1058. DOI: 10.1111/j.1600- 051X.2009.01482.x.
  3. Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations. Int J Oral Maxillofac Implants 2004:19(Suppl.):43–61.
  4. Stig H, Anders H. Alveolar ridge resorption after tooth extraction: a consequence of a fundamental principle of bone physiology. J Dent Biomech 2012;3:1758736012456543. Published online 2012 Aug 16. DOI: 10.1177/1758736012456543.
  5. Goh BT, Teh LY, Tan DBP, et al. Novel 3D polycaprolactone scaffold for ridge preservation – a pilot randomised controlled clinical trial. Clin Oral Implants Res 2015;26(3):271–277. DOI: 10.1111/clr.12486.
  6. Araujo MG, Silva CO, Misawa M, et al. Alveolar socket healing: what can we learn? Periodontol 2000;2015:68(1):122–134. DOI: 10.1111/prd.12082.
  7. The periodontium. In: Oksche A, Vollrath L, editors. Handbook of microscopic anatomy. Berlin: Springer; 1986. p. 233–246.
  8. Lekovic V, Camargo PM, Klokkevold PR. Preservation of alveolar bone in extraction sockets using bioabsorbable membranes. J Periodontol 1998;69(9):1044–1049. DOI: 10.1902/jop.1998.69.9.1044.
  9. Scala A, Lang NP, Schweikert MT, et al. Sequential healing of open extraction sockets. An experimental study in monkeys. Clin Oral Implants Res 2014;25(3):288–295. DOI: 10.1111/clr.12148.
  10. Januario AL, Duarte WR, Barriviera M, et al. Dimension of the facial bone wall in the anterior maxilla: a cone-beam computed tomography study. Clin Oral Implants Res 2011;22(10):1168–1171. DOI: 10.1111/j.1600-0501.2010.02086.x.
  11. Morjaria KR, Wilson R, Palmer RM. Bone healing after tooth extraction with or without an intervention: a systematic review of randomized controlled trials. Clin Implant Dent Relat Res 2012;16(1):1–20. DOI: 10.1111/j.1708-8208.2012.00450.x.
  12. El Chaar E, Oshman S, Fallah AP. Single-rooted extraction sockets: classification and treatment protocol. Compend Contin Educ Dent 2016;37(8):537–541.
  13. Mardas N, Trullenque-Eriksson A, MacBeth N, et al. Does ridge preservation following tooth extraction improve implant treatment outcomes: a systematic review: Group 4: Therapeutic concepts and methods. Clin Oral Implants Res 2015 Sep;26(Suppl. 11):180–201. DOI: 10.1111/clr.12639.
  14. Masaki C, Nakamoto T, Mukaibo T, et al. Strategies for alveolar ridge reconstruction and preservation for implant therapy. J Prosthodont Res 2015 Oct;59(4):220–228. DOI: 10.1016/j.jpor.2015.04.005.
  15. Sanz M, Cecchinato D, Ferrus J, et al. A prospective, randomized, controlled clinical trial to evaluate bone preservation using implants with different geometry placed into extraction sockets in the maxilla. Clin Oral Implants Res 2010;21(1):13–21. DOI: 10.1111/j.1600-0501.2009.01824.x.
  16. Ferrus J, Cecchinato D, Pjetursson BE, et al. Factors influencing ridge alterations following immediate implant placement into extraction sockets. Clin Oral Implants Res 2010;21(1):22–29. DOI: 10.1111/j.1600-0501.2009.01825.x.
  17. Jambhekar S, Kernen F, Bidra AS. Clinical and histologic outcomes of socket grafting after flapless tooth extraction: a systematic review of randomized controlled clinical trials. J Prosthet Dent 2015 May;113(5):371–382. DOI: 10.1016/j.prosdent.2014.12.009.
  18. Schnutenhaus S, Doering I, Dreyhaupt J, et al. Alveolar ridge preservation with a collagen material: a randomized controlled trial. J Periodontal Implant Sci 2018;48(4):236–250. DOI: 10.5051/jpis.2018.48.4.236.
  19. Araujo MG, Silva JCC, Mendonca AF, et al. Ridge alterations following grafting of fresh extraction sockets in man. A randomized clinical trial. Clin Oral Implants Res 2015;25(4):407–412. DOI: 10:1111/clr.12366.
  20. Hjrting-Hansen E. Bone grafting to the jaws with special reference to reconstructive preprosthetic surgery. A historical review. Mund Kiefer Gesichtschir 2002;6(1):6–14. DOI: 10.1007/s10006-001-0343-6.
  21. Araujo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog. J Clin Periodontol 2005;32(2):212–218. DOI: 10.1111/j.1600-051X.2005.00642.x.
  22. Maiorana C, Poli PP, Deflorian M, et al. Alveolar socket preservation with demineralised bovine bone mineral and a collagen matrix. J Periodontal Implant Sci 2017;47(4):194–210. DOI: 10.5051/jpis.2017.47.4.194.
  23. Das S, Jhingran R, Bains VK, et al. Socket preservation by beta-tri-calcium phosphate with collagen compared to platelet-rich fibrin: a clinico-radiographic study. Eur J Dent 2016;10(2):264–276. DOI: 10.4103/1305-7456.178298.
  24. Osburn, RC. Preservation of the alveolar ridge: a simplified technique for retaining teeth beneath removable appliances. J Indiana State Dent Assoc 1974:53(1):8–11.
  25. Barone A, Aldini N, Fini M, et al. Xenograft versus extraction alone for ridge preservation after tooth removal. A clinical and histomorphometric study. J Periodontol 2008;79(8):1370–1377. DOI: 10.1902/jop.2008.070628.
  26. Iasella JM, Greenwell H, Miller RL, et al. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol 2003;74(7):990–999. DOI: 10.1902/jop.2003.74.7.990.
  27. Hammerle CH, Araujo MG, Simion M. Evidence-based knowledge on the biology and treatment of extraction sockets. Clin Oral Implants Res 2012;23(Suppl. 5):80–82. DOI: 10.1111/j.1600-0501.2011.02370.x.
  28. Chappuis V, Engel O, Reyes M, et al. Ridge alterations post-extraction in the esthetic zone: a 3D analysis with CBCT. J Dent Res 2013;92(12 Suppl):195s–201s. DOI: 10.1177/0022034513506713.
  29. Araujo MG, Lindhe J. Ridge alterations following tooth extraction with and without flap elevation. An experimental study in the dog. Clin Oral Implants Res 2009;20(6):545–549. DOI: 10.1111/j.1600-0501.2008.01703.x.
  30. Chan HL, Lin GH, Fu JH, et al. Alterations in bone quality after socket preservation with grafting materials: a systematic review. Int J Oral Maxillofac Implants 2013;28(3):710–720. DOI: 10.11607/jomi.2913.
  31. Avila-Ortiz G, Chambrone L, Vignoletti F. Effect of alveolar ridge preservation interventions following tooth extraction: a systematic review and meta-analysis. J Clin Periodontol 2019;46(Suppl. 21):195–223. DOI: 10.1111/jcpe.13057.
  32. Araujo M, Linder E, Lindhe J. Effect of a xenograft on early bone formation in extraction sockets: an experimental study in dog. Clin Oral Implants Res 2009;20(1):1–6. DOI: 10.1111/j.1600-0501.2008.01606.x.
  33. Sugg K, Rosenthal A, Ozaki W, et al. Quantitative comparison of volume maintenance between inlay and onlay bone grafts in the craniofacial skeleton. Plast Reconstruct Surg 2013;131(5):1014–1021. DOI: 10.1097/PRS.0b013e31828e217a.
  34. Oppenheimer AJ, Tong L, Buchman SR. Craniofacialbonegrafting: Wolff's law revisited. Craniomaxillofac Trauma Reconstr 2008;1(1):49–61. DOI: 10.1055/s-0028-1098963.
  35. Thalmair T, Fickl S, Schneider D, et al. Dimensional alterations of extraction sites after different alveolar ridge preservation techniques – a volumetric study. J Clin Periodontol 2013;40(7):721–727. DOI: 10.1111/jcpe.12111.
  36. Chappuis V, Engel O, Shahim K, et al. Soft tissue alterations in esthetic postextraction sites: a 3-dimensional analysis. J Dent Res 2015;94(9 Suppl):187S–193S. DOI: 10.1177/0022034515592869.
  37. Amin PN, Bissada NF, Ricchetti PA, et al. Tuberosity versus palatal donor sites for soft tissue grafting: a split-mouth clinical study. Quintessence Int 2018;49(7):589–598. DOI: 10.3290/j.qi.a40510.
  38. Harris RJ. Histologic evaluation of connective tissue grafts in humans. Int J Periodontics Restorative Dent 2003;23(6):575–583.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.