Ridge preservation comparing a flap vs. a flapless technique using a demineralized bone matrix allograft plus mineralized particulate allograft and covered with a calcium sulfate barrier.
Date on Master's Thesis/Doctoral Dissertation
Aims . The primary aim of this study is to compare the clinical and histologic results of a flap vs. a flapless technique of ridge preservation after 4 months of healing. Both groups received an intrasocket graft of demineralized bone matrix mixed with mineralized particulate allograft that was covered with a calcium sulfate barrier. Methods . Twelve test patients received ridge preservation using the flapless technique while 12 positive control patients were treated with a flap technique. All sockets were grafted with a mixture of demineralized bone matrix and a mineralized particulate allograft. Following tooth extraction horizontal ridge dimensions were measured with a digital caliper and vertical ridge dimensions were measured from a stent. Each site was re-entered for implant placement at about 4 months. Prior to implant placement a 2 X 6 mm trephine core was obtained and preserved in formalin for histologic analysis. Results . The horizontal ridge width of the flapless group at the crest decreased from 8.3 ± 1.3 mm to 7.0 ± 1.9 mm for a mean loss of 1.3 ± 0.9 mm (p < 0.05) while the flap group decreased from 8.5 ± 1.5 mm to 7.5 ± 1.5 mm for a mean loss of 1.0 ± 1.1 mm (p <; 0.05). There were no statistically significance differences between the two groups (p > 0.05). The mean mid-buccal vertical change for the flap group was a loss of 0.9 ± 1.3 mm (p < 0.05) vs. a loss of 0.5 ± 0.9 mm (p < 0.05) for the flap group. There were no statistically significant differences between groups for vertical change (p > 0.05). Histologic analysis revealed 44 ± 10% vital bone for the flapless group and 35 ± 15% for the flap group. Non-vital bone was 17 ±13% for the flapless group and 19 ± 12% for the flap group. Conclusions . Crestal ridge width following treatment with a flapless ridge preservation procedure using a demineralized bone matrix plug allograft and a calcium sulfate barrier was not significantly different than a flap ridge preservation technique using the same materials. There was a trend toward less loss of ridge height when the flapless procedure was used, although the difference was not statistically significant (p > 0.05).
Siu, Trever L., "Ridge preservation comparing a flap vs. a flapless technique using a demineralized bone matrix allograft plus mineralized particulate allograft and covered with a calcium sulfate barrier." (2007). Electronic Theses and Dissertations. Paper 1335.