Int J Stomatol

Int J Stomatol ›› 2021, Vol. 48 ›› Issue (3): 249-259.doi: 10.7518/gjkq.2021059

• Expert Forum •     Next Articles

Related problems in clinical practice of alveolar ridge preservation

Hu Wenjie()   

  1. Dept. of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2021-01-15 Revised:2021-02-20 Online:2021-05-01 Published:2021-05-14
  • Contact: Wenjie Hu E-mail:huwenjie@pkuss.bjmu.edu.cn;huwenjie@pkuss.bjmu.edu.cn
  • Supported by:
    Capital Foundation for Clinical Characteristics and Application Research of Beijing Municipal Science & Technology Commission(Z161100000516042);Peking University Clinical Scientist Program(BMU2019LCKXJ010)

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Abstract:

Good soft and hard tissue conditions are important for the successful placement of dental implants.However, following tooth extraction, the alveolar ridge undergoes physiological remodeling that results in vertical and horizontal bone reduction, which affects prosthetically driven implant restoration. Alveolar ridge preservation can effectively preserve and reconstruct the volume of alveolar bone. Alveolar ridge preservation with minimally invasive extraction and minimally flap at molar extraction sites with severe periodontitis is strategically recommended to clinicians. This article discusses the changes in soft and hard tissues after natural healing of tooth extraction sockets, the influencing factors of successful alveolar ridge preservation, and the characteristics of alveolar ridge preservation at tooth extraction sites with severe periodontitis.

Key words: extraction socket healing, alveolar ridge preservation, atraumatic extraction, severe periodontitis, implant therapy

CLC Number: 

  • R782.1

TrendMD: 

Fig 1

Clinical photo (left) and sagittal view of cone-beam CT image (right) on natural healing site after tooth extraction"

Fig 2

Sagittal views of cone-beam CT images obtained immediately and after 6-month period healing of natual socket healing"

Fig 3

Sagittal views of cone-beam CT images obtained immediately and after 6-month period healing after the alveolar ridge preservation"

Fig 4

Atraumatic extraction and minimal flap ridge preservation produces in #17 with severe periodontitis"

Fig 5

Radiographic examination performed immediately (above) and after 6-month period healing (below) after traumatic extraction and minimal flap ridge preservation in #17 with severe periodontitis"

[1] Araújo MG, Silva CO, Misawa M, et al. Alveolar so-cket healing: what can we learn[J]. Periodontol 2000, 2015,68(1):122-134.
doi: 10.1111/prd.12082
[2] Tan WL, Wong TL, Wong MC, et al. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans[J]. Clin Oral Implants Res, 2012,23(Suppl 5):1-21.
[3] Avila-Ortiz G, Chambrone L, Vignoletti F. Effect of alveolar ridge preservation interventions following tooth extraction: a systematic review and meta-ana-lysis[J]. J Clin Periodontol, 2019,46(Suppl 21):195-223.
doi: 10.1111/jcpe.13057
[4] Cha JK, Song YW, Park SH, et al. Alveolar ridge preservation in the posterior maxilla reduces vertical dimensional change: a randomized controlled cli-nical trial[J]. Clin Oral Implants Res, 2019,30(6):515-523.
doi: 10.1111/clr.v30.s19
[5] Vignoletti F, Matesanz P, Rodrigo D, et al. Surgical protocols for ridge preservation after tooth extraction. A systematic review[J]. Clin Oral Impl Res, 2012,23:22-38.
[6] Marks SC Jr. The basic and applied biology of tooth eruption[J]. Connect Tissue Res, 1995,32(1/2/3/4):149-157.
doi: 10.3109/03008209509013718
[7] Pietrokovski J, Massler M. Alveolar ridge resorption following tooth extraction[J]. J Prosthet Dent, 1967,17(1):21-27.
pmid: 5224784
[8] Araújo MG, Wennström JL, Lindhe J. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation[J]. Clin Oral Implants Res, 2006,17(6):606-614.
doi: 10.1111/clr.2006.17.issue-6
[9] Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in the dog[J]. J Clin Periodontol, 2005,32(2):212-218.
doi: 10.1111/cpe.2005.32.issue-2
[10] van der Weijden F, Dell’Acqua F, Slot DE. Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review[J]. J Clin Periodontol, 2009,36(12):1048-1058.
doi: 10.1111/cpe.2009.36.issue-12
[11] Chappuis V, Araújo MG, Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites[J]. Periodontol 2000, 2017,73(1):73-83.
doi: 10.1111/prd.12167
[12] Chappuis V, Engel O, Shahim K, et al. Soft tissue alterations in esthetic postextraction sites: a 3-dimensional analysis[J]. J Dent Res, 2015,94(9 Suppl):187S-193S.
doi: 10.1177/0022034515592869
[13] López-Martínez F, Gómez Moreno G, Olivares-Pon-ce P, et al. Implants failures related to endodontic treatment. An observational retrospective study[J]. Clin Oral Implants Res, 2015,26(9):992-995.
doi: 10.1111/clr.12415 pmid: 24860973
[14] Ahn JJ, Shin HI. Bone tissue formation in extraction sockets from sites with advanced periodontal disease: a histomorphometric study in humans[J]. Int J Oral Maxillofac Implants, 2008,23(6):1133-1138.
[15] Lindhe J, Cecchinato D, Bressan EA, et al. The al-veolar process of the edentulous maxilla in periodontitis and non-periodontitis subjects[J]. Clin Oral Implants Res, 2012,23(1):5-11.
doi: 10.1111/j.1600-0501.2011.02205.x pmid: 21635557
[16] Zhao LP, Wei YP, Xu T, et al. Changes in alveolar process dimensions following extraction of molars with advanced periodontal disease: a clinical pilot study[J]. Clin Oral Implants Res, 2019,30(4):324-335.
[17] Zhang Z, Shi D, Meng HX, et al. Influence of vertical soft tissue thickness on occurrence of peri-implantitis in patients with periodontitis: a prospective cohort study[J]. Clin Implant Dent Relat Res, 2020,22(3):292-300.
doi: 10.1111/cid.2020.v22.3
[18] Wang Q, Tang ZH, Han J, et al. The width of keratinized mucosa around dental implants and its in-fluencing factors[J]. Clin Implant Dent Relat Res, 2020,22(3):359-365.
doi: 10.1111/cid.12914 pmid: 32378806
[19] Hämmerle CHF, Araújo MG, Simion M, et al. Evidence-based knowledge on the biology and treatment of extraction sockets[J]. Clin Oral Implant Res, 2011,23:80-82.
doi: 10.1111/clr.2011.23.issue-s5
[20] MacBeth N, Trullenque-Eriksson A, Donos N, et al. Hard and soft tissue changes following alveolar ridge preservation: a systematic review[J]. Clin Oral Imp-lants Res, 2017,28(8):982-1004.
[21] Aimetti M, Manavella V, Corano L, et al. Three-dimensional analysis of bone remodeling following ridge augmentation of compromised extraction soc-kets in periodontitis patients: a randomized controlled study[J]. Clin Oral Implants Res, 2018,29(2):202-214.
doi: 10.1111/clr.13099 pmid: 29148597
[22] 詹雅琳, 胡文杰, 甄敏, 等. 去蛋白牛骨基质与可吸收胶原膜的磨牙拔牙位点保存效果影像学评价[J]. 北京大学学报(医学版), 2015,47(1):19-26.
Zhan YL, Hu WJ, Zhen M, et al. Radiographic eva-luation of ridge preservation after molar tooth extra-ction: a controlled clinical trial[J]. J Peking Univ (Heal Sci), 2015,47(1):19-26.
[23] Vera C, de Kok IJ, Reinhold D, et al. Evaluation of buccal alveolar bone dimension of maxillary ante-rior and premolar teeth: a cone beam computed tomography investigation[J]. Int J Oral Maxillofac Implants, 2012,27(6):1514-1519.
[24] Zhao LP, Xu T, Hu WJ, et al. Preservation and augmentation of molar extraction sites affected by severe bone defect due to advanced periodontitis: a prospective clinical trial[J]. Clin Implant Dent Relat Res, 2018,20(3):333-344.
doi: 10.1111/cid.2018.20.issue-3
[25] Lombardi T, Bernardello F, Berton F, et al. Efficacy of alveolar ridge preservation after maxillary molar extraction in reducing crestal bone resorption and sinus pneumatization: a multicenter prospective case-control study[J]. Biomed Res Int, 2018,2018:9352-130.
[26] Cosyn J, Cleymaet R, De Bruyn H. Predictors of alveolar process remodeling following ridge preservation in high-risk patients[J]. Clin Implant Dent Relat Res, 2016,18(2):226-233.
doi: 10.1111/cid.12249 pmid: 25041378
[27] Barone A, Toti P, Quaranta A, et al. Clinical and Histological changes after ridge preservation with two xenografts: preliminary results from a multicentre randomized controlled clinical trial[J]. J Clin Perio-dontol, 2017,44(2):204-214.
[28] Spinato S, Galindo-Moreno P, Zaffe D, et al. Is soc-ket healing conditioned by buccal plate thickness? A clinical and histologic study 4 months after minera-lized human bone allografting[J]. Clin Oral Implants Res, 2014,25(2):e120-e126.
doi: 10.1111/clr.2014.25.issue-2
[29] Engler-Hamm D, Cheung WS, Yen A, et al. Ridge pre-servation using a composite bone graft and a bioabsorbable membrane with and without primary wound closure: a comparative clinical trial[J]. J Periodontol, 2011,82(3):377-387.
doi: 10.1902/jop.2010.090342
[30] Cardaropoli D, Tamagnone L, Roffredo A, et al. Relationship between the buccal bone plate thickness and the healing of postextraction sockets with/without ridge preservation[J]. Int J Periodontics Resto-rative Dent, 2014,34(2):211-217.
[31] Walker CJ, Prihoda TJ, Mealey BL, et al. Evaluation of healing at molar extraction sites with and without ridge preservation: a randomized controlled clinical trial[J]. J Periodontol, 2017,88(3):241-249.
doi: 10.1902/jop.2016.160445
[32] Nart J, Barallat L, Jimenez D, et al. Radiographic and histological evaluation of deproteinized bovine bone mineral vs. deproteinized bovine bone mineral with 10% collagen in ridge preservation. A randomized controlled clinical trial[J]. Clin Oral Implants Res, 2017,28(7):840-848.
doi: 10.1111/clr.2017.28.issue-7
[33] Renton T, Hankins M, Sproate C, et al. A randomi-sed controlled clinical trial to compare the incidence of injury to the inferior alveolar nerve as a result of coronectomy and removal of mandibular third molars[J]. Br J Oral Maxillofac Surg, 2005,43(1):7-12.
doi: 10.1016/j.bjoms.2004.09.002
[34] Avila-Ortiz G, Rodriguez JC, Rudek I, et al. Effectiveness of three different alveolar ridge preservation techniques: a pilot randomized controlled trial[J]. Int J Periodontics Restorative Dent, 2014,34(4):509-521.
doi: 10.11607/prd.1838 pmid: 25006768
[35] Lee J, Lee JB, Koo KT, et al. Flap management in alveolar ridge preservation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018,33(3):613-621.
[36] Barone A, Borgia V, Covani U, et al. Flap versus flapless procedure for ridge preservation in alveolar extraction sockets: a histological evaluation in a randomized clinical trial[J]. Clin Oral Implants Res, 2015,26(7):806-813.
doi: 10.1111/clr.2015.26.issue-7
[37] Wang RE, Lang NP. Ridge preservation after tooth extraction[J]. Clin Oral Implants Res, 2012,23(Suppl 6):147-156.
doi: 10.1111/clr.2012.23.issue-s6
[38] Araújo M, Linder E, Lindhe J. Effect of a xenograft on early bone formation in extraction sockets: an experimental study in dog[J]. Clin Oral Implants Res, 2009,20(1):1-6.
doi: 10.1111/j.1600-0501.2008.01606.x pmid: 19126101
[39] 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]. J Prosthet Dent, 2015,113(5):371-382.
doi: 10.1016/j.prosdent.2014.12.009 pmid: 25749077
[40] Levi I, Halperin-Sternfeld M, Horwitz J, et al. Dimensional changes of the maxillary sinus following tooth extraction in the posterior maxilla with and without socket preservation[J]. Clin Implant Dent Relat Res, 2017,19(5):952-958.
doi: 10.1111/cid.2017.19.issue-5
[41] Lim G, Lin GH, Monje A, et al. Wound healing complications following guided bone regeneration for ridge augmentation: a systematic review and meta-analysis[J]. Int J Oral Maxillofac Implants, 2018,33(1):41-50.
[42] 徐涛, 胡文杰, 毕小成, 等. 针对罹患重度牙周病变磨牙实施微创拔牙和位点保存术的初步探索(附1例报告)[J]. 中国实用口腔科杂志, 2018,11(1):37-43.
Xu T, Hu WJ, Bi XC, et al. A minimally invasive extraction and site preservation for molars with severe periodontal lesions: a case analysis[J]. Chin J Pract Stomatol, 2018,11(1):37-43.
[43] Kotsakis G, Chrepa V, Marcou N, et al. Flapless alveolar ridge preservation utilizing the “socket-plug” technique: clinical technique and review of the lite-rature[J]. J Oral Implantol, 2014,40(6):690-698.
doi: 10.1563/AAID-JOI-D-12-00028
[44] 李丽曼, 赵丽萍, 徐涛, 等. 罹患重度牙周病变磨牙采取微创拔牙和微翻瓣位点保存术后种植修复效果观察(附1例3年随访报告)[J]. 中国实用口腔科杂志, 2020,13(3):139-145.
Li LM, Zhao LP, Xu T, et al. Evaluation of dental implants following ridge preservation in molar extrac-tion sockets affected by advanced periodontitis: a 3-year follow-up of one case[J]. Chin J Pract Stomatol, 2020,13(3):139-145.
[45] Tonetti MS, Jung RE, Avila-Ortiz G, et al. Management of the extraction socket and timing of implant placement: consensus report and clinical recommendations of group 3 of the XV European Workshop in Periodontology[J]. J Clin Periodontol, 2019,46(Suppl 21):183-194.
doi: 10.1111/jcpe.13131
[46] Kalsi AS, Kalsi JS, Bassi S. Alveolar ridge preser-vation: why, when and how[J]. Br Dent J, 2019,227(4):264-274.
doi: 10.1038/s41415-019-0647-2
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[2] ZHANG Yong, LI Yun-sheng.. Research progress on reduction of bone resorption through alveolar ridge preservation after tooth extraction [J]. Inter J Stomatol, 2011, 38(3): 288-291.
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