title: A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots.
abstract: The objective of this investigation was to determine the fate of thin buccal bone encasing the prominent roots of maxillary anterior teeth following extraction. Resorption of the buccal plate compromises the morphology of the localized edentulous ridge and makes it challenging to place an implant in the optimal position for prosthetic restoration. In addition, the use of Bio-Oss as a bone filler to maintain the form of the edentulous ridge was evaluated. Nine patients were selected for the extraction of 36 maxillary anterior teeth. Nineteen extraction sockets received Bio-Oss, and seventeen sockets received no osteogenic material. All sites were completely covered with soft tissue at the conclusion of surgery. Computerized tomographic scans were made immediately following extraction and then at 30 to 90 days after healing so as to assess the fate of the buccal plates and resultant form of the edentulous sites. The results were assessed by an independent radiologist, with a crest width of 6 mm regarded as sufficient to place an implant. Those sockets treated with Bio-Oss demonstrated a loss of less than 20% of the buccal plate in 15 of 19 test sites (79%). In contrast, 12 of 17 control sockets (71%) demonstrated a loss of more than 20% of the buccal plate. In conclusion, the Bio-Oss test sites outperformed the control sites by a significant margin. No investigator was able to predict which site would be successful without the grafting material even though all were experienced clinicians. This leads to the conclusion that a patient has a significant benefit from receiving grafting materials at the time of extraction.
authors.affiliation: Department of Periodontology, Harvard University School of Dental Medicine, Boston, Massachusetts, USA.
authors.forename: Myron
authors.initials: M
authors.lastname: Nevins
authors.forename: Marcelo
authors.initials: M
authors.lastname: Camelo
authors.forename: Sergio
authors.initials: S
authors.lastname: De Paoli
authors.forename: Bernard
authors.initials: B
authors.lastname: Friedland
authors.forename: Robert K
authors.initials: RK
authors.lastname: Schenk
authors.forename: Stefano
authors.initials: S
authors.lastname: Parma-Benfenati
authors.forename: Massimo
authors.initials: M
authors.lastname: Simion
authors.forename: Carlo
authors.initials: C
authors.lastname: Tinti
authors.forename: Barry
authors.initials: B
authors.lastname: Wagenberg
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000517:prevention & control; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000543:Alveoloplasty; D015519:Bone Density / Q000502:physiology; D001857:Bone Matrix / Q000637:transplantation; D018786:Bone Substitutes / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008437:Maxilla; D008903:Minerals / Q000627:therapeutic use; D010510:Periodontal Diseases / Q000628:therapy; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction; D014092:Tooth Root / Q000473:pathology*; D020390:Tooth Socket / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D014945:Wound Healing / Q000502:physiology
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D008903:Minerals