THE HARD AND SOFT TISSUE DIMENSIONAL CHANGES FOLLOWING EXTRACTION AND RIDGE PRESERVATION WITH DIFFERENT MEMBRANES – A PILOT STUDY
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Introduction: Following tooth extraction, bone resorption can be expected, especially on the buccal wall. An alveolar ridge preservation procedure (ARP) is commonly performed to maintain appropriate ridge volume for future implant placement. Various materials and methods can be utilized during ARP, however, there is no consensus on the membrane selection when the intact buccal plate is present after tooth extraction. The objective of this study is to investigate the dimension changes of the hard and soft tissue followed by alveolar ridge preservation with different membranes used.Materials and Methods: This prospective randomized clinical trial aims to enroll 50 subjects divided into 5 groups of 10. Each group underwent RP with mixing allograft and xenograft(1:1 ratio) and received 1 of 5 membranes: absorbable collagen dressing (ACD), non-resorbable d-polytetrafluoroethylene (d-PTFE), cross-linked collagen membrane (CLCM), non-crosslinked ECM membrane (N-CLCM), or dehydrated human de-epithelialized amnion-chorion membrane (DHDA-C). An intraoral scan was obtained before the extraction. Immediately following the extraction, a Cone Beam CT was taken to evaluate the extraction socket (Initial-CT). 4 months after ARP, a second CBCT(Post-CT) and an intraoral scan were obtained. Measurements were performed using implant planning software. Intraoral scan files were superimposed on Initial and Post-CT. A region of interest (ROI) guide was utilized to provide an accurate slice for measurement and a horizontal reference line at 1 mm interval from the bone crest. Following the ROI guide, horizontal measurements were taken at 0-9 mm level for hard tissue and 0-3 mm level for soft tissue. Results: A total of 35 patients were enrolled in the randomized clinical trial when the report was written. After removing insufficient data, only 29 patients’ data were included in bone measurement and 21 for soft tissue measurements. ANOVA test was used for analyzing the results. The results showed no statistically significant differences in dimensional changes in hard tissue (p=0.3) and soft tissue volume (p=0.7) among different kinds of membranes used in the intact defects. Conclusion: There were no significant differences in the dimensional changes of hard and soft tissue between the membrane groups, suggesting that the membranes are equally effective in intact sockets. The rationale of the material selection is mostly a clinician’s choice. A larger sample size is needed to confirm these findings.