Alveolar Ridge Preservation
Conditions
Keywords
Partial extraction therapy, Pontic shield, Mineralized plasmatic matrix (MPM), Socket preservation, Wound healing index
Brief summary
This study is testing new methods to preserve the jawbone and gum tissue after removing a damaged front tooth. Normally, when a tooth is taken out, the bone and gums in that area shrink, which can make future dental treatment more difficult and affect appearance. A technique called Partial Extraction Therapy (Pontic Shield Technique) keeps part of the tooth root in place to help maintain the natural shape of the bone and gums. Another method, called Mineralized Plasmatic Matrix (MPM), uses a patient's own blood mixed with bone particles to support healing. In this randomized clinical trial, 56 patients were assigned to one of four groups: Group I: Tooth extraction only Group II: Tooth extraction with MPM grafting Group III: Pontic shield technique alone Group IV: Pontic shield technique with MPM grafting The main outcome measured was the amount of bone width preserved, using 3D X-rays (CBCT). Other outcomes included bone height and soft-tissue healing over 4 months. This research will help determine whether the pontic shield technique, with or without MPM, provides better preservation of bone and gum tissue compared to tooth extraction alone.
Interventions
PROCEDURETooth Extraction only
Conventional atraumatic extraction of the non-restorable maxillary tooth in the esthetic zone without socket preservation procedures.
PROCEDUREExtraction + MPM
Tooth extraction followed by socket grafting using MPM, prepared from autologous blood combined with xenograft bone particles.
PROCEDUREPontic Shield Only
Partial extraction therapy using the pontic shield technique, in which the buccal root fragment is preserved to maintain ridge contour, without additional grafting.
PROCEDUREPontic Shield + MPM
Pontic shield technique combined with grafting using mineralized plasmatic matrix (MPM) for enhanced ridge preservation and healing.
Sponsors
Soaad Tolba Mohammed Tolba Badawi
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Intervention model description
Participants were randomized to one of four groups: extraction alone, extraction with MPM, pontic shield alone, or pontic shield with MPM.
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Adults (≥18 years). * Classified as ASA I (healthy) according to the American Society of Anesthesiologists Physical Status Classification. * Presence of Type 1 extraction sockets (intact buccal bone and soft tissues). * Adequate oral hygiene. * Sufficient inter-arch space for prosthetic rehabilitation. * Willingness to comply with study protocol and follow-up schedule.
Exclusion criteria
* Systemic conditions affecting bone metabolism or wound healing (e.g., uncontrolled diabetes, osteoporosis, immunosuppression). * History of head and neck radiotherapy or bisphosphonate therapy. * Acute infection or suppuration at the extraction site. * Severe periodontal disease. * Root caries or tooth mobility. * Buccal bone plate loss due to vertical/horizontal root fractures or advanced periodontitis.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Alveolar Ridge Width Change | Baseline (pre- or immediate post-extraction) to 4 months. | Mean changes in alveolar ridge width measured at standardized reference points on cone-beam computed tomography (CBCT) Unit of Measure: millimeters (mm) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Buccal and Palatal Bone Height Change | Baseline to 4 months. | Change in buccal and palatal bone heights measured on CBCT from baseline to 4 months. Unit of Measure: mm |
| Soft-Tissue Healing (Wound Healing Index, WHI) | 1 week and 4 months post-extraction. | Clinical soft-tissue healing evaluated using the WHI. Unit of Measure: score on 5-point scale with higher values indicating more favorable wound healing. |
Countries
Egypt
Outcome results
None listed