Socket Preservation During Preimplantation Period: Effi cacy of Osteoplastic Material Application Using Cone Beam Computed Tomography

Aim. To analyse the effi ciency of osteoplastic material application in order to reduce the resorption level after tooth extraction in the preimplantation period according to the data of cone beam computed tomography.

Materials and methods. The study involved 80 patients who were divided into 4 equal groups depending on the preservation material used. The fi rst group was treated with Cerabone (Botiss, Germany) xenomaterial based on natural bovine bone. Plasma enriched with PRGF growth factors obtained by the BTI Endoret (Spain) technology was used for the patients of the second group. The third group consisted of patients who underwent a socket preservation of the extracted tooth with a powdered autologous dentin matrix (ADM) obtained from their own tooth. In the fourth group, bone-plastic material based on hydroxyapatite with Collapan-L lincomycin hydrochloride (Intermedapatit, Russia) was used to prevent socket resorption. All patients had a cone beam computed tomography of the maxillofacial region before the extraction and 3 months after the preservation in order to evaluate the level of bone resorption. After the installation of dental implants, a comparative assessment of the bone resorption level in the vertical and horizontal directions before tooth extraction and in the preimplantation period was carried out.

Results. The smallest level of vertical bone resorption after socket preservation was observed in group 1 (Cerabone) and group 3 (ADM). The median value of the socket resorption level in group 1 was 0.7 mm (8.54 %) in the vertical direction and 0.5 mm (9.45 %) in horizontal measurement as compared to the level of bone tissue before tooth extraction. Similar indicators were observed in the group using an autologous dentin matrix. The vertical decrease in the socket bone tissue was 0.61 mm (7.75 %), horizontal — 0.51 mm (6.2 %). The level of bone resorption was signifi cantly higher using two other materials.

Conclusions. The use of three-dimensional radiation research methods allows a comprehensive assessment of the bone tissue volume to be carried out, which in turn determines the choice of the dental implant size, the need for further bone-plastic surgery to increase the width/height of the alveolar ridge. The use of cone beam computed tomography showed that the most optimal results can be obtained by introducing Cerabone material into the socket of the extracted tooth, as well as using the innovative method of preservation with the patient’s own powdered tooth (ADM).

1. Beniashvili R.M., Gurin A.N., Kulakov A.A. Gingival and bone grafting in dental implantology. Kurdyukova I.V., editor. Moscow: GEOTAR-Media; 2017. 240 р. (In Russ.).

2. Yanushevich O.O., Maksimovskii Yu.M., Maksimovskaya L.N., Orekhova L.Yu. Preventive dentistry: a tutorial. 3rd edition, recycled, augmented. Moscow: GEOTAR-Media; 2016. 760 р. (In Russ.).

3. Redko A.N., Zobenko A.V. Costs of treatment of the infl ammatory pathology of the maxillofacial area in a hospital among the population of the Krasnodar territory. Sovremennye Problemy Nauki i Obrazovaniya. 2017; 5: 40 (In Russ., English abstract).

4. Dmitrieva L.A., Toibakhtina A.A., Mazurova V.N., Yashkova V.V. The role of computed tomography in the diagnosis and treatment endodontically lesions. Endodontiya Today. 2015; 1: 58–61 (In Russ., English abstract).

5. Panin A.M., Zueva A.O., Chuvilkina E.I. Prevention of infectious complications with the use of ring-shaped bone autotransplants and dental implantation. Rossiiskaya Stomatologiya. 2016; 9(2): 51–52 (In Russ.).

6. Gallone M., Robiony M., Bordonali D., Bruno G., De Stefani A., Gracco A. Multidisciplinary treatment with a customized lingual appliance for an adult patient with severe Class III malocclusion and multiple missing teeth. Am. J. Orthod. Dentofacial Orthop. 2019; 156(3): 401–411. DOI: 10.1016/j.ajodo.2019.05.004

7. Zaderenko I.A., Drobyshev A.Yu., Alieva S.B., Tsiklauri V.T., Amaev A.K., Shekiev R.Z. The use of PEEK implants in patients with oral cancer with defects of the dental system. Siberian Journal of Oncology. 2016; 15(1): 88–89 (In Russ.).

8. Tan W.L., Wong T.L., Wong M.C., Lang N.P. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin. Oral. Implants Res. 2012; 23(Suppl 5):1–21. DOI: 10.5353/th_b4839545

9. Araujo M.G., 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

10. Anitua E., Murias-Freijo A., Alkhraisat M.H., Orive G. Clinical, radiographical, and histological outcomes of plasma rich in growth factors in extraction socket: a randomized controlled clinical trial. Clin. Oral. Investig. 2015; 19(3): 589–600. DOI: 10.1007/s00784-014-1278-2

11. Jung R.E., Ioannidis A., Hämmerle C.H.F., Thoma D.S. Alveolar ridge preservation in the esthetic zone. Periodontol. 2000. 2018; 77(1): 165–175. DOI: 10.1111/prd.12209

12. Faria-Almeida R., Astramskaite-Januseviciene I., Puisys A. Correia F. Extraction socket preservation with or without membranes, soft tissue infl uence on post extraction alveolar ridge preservation: a systematic review. J. Oral Maxillofac. Resh. 2019; 10(3): e5. DOI: 10.5037/jomr.2019.10305

13. Lim H.C., Shin H.S., Cho I.W., Koo K.T., Park J.C. Ridge preservation in molar extraction sites with an open-healing approach: A randomized controlled clinical trial. J. Clin. Periodontol. 2019; 46(11): 1144–1154. DOI: 10.1111/jcpe.13184