A methodological approach to assessing alveolar ridge preservation procedures in humans: hard tissue profile.
OBJECTIVE
Multiple surgical protocols using biomaterials have been proposed to limit the typical post-extraction bone resorption. However, because of the heterogeneity of the studies, particularly the differences in assessment methods, it is difficult to determine the superiority of one technique over another. The objective of this study was to describe a new radiographic method to draw a map of alveolar bone remodelling after alveolar ridge preservation procedures to compare different surgical techniques more accurately. The newly developed measuring method was applied to a case series describing a specific preservation technique.


METHODS
Fourteen extraction sites (in 14 patients) located in the upper anterior maxilla were treated with bovine hydroxyapatite (0.25- to 1-mm particles) and a saddled connective tissue graft. A radiographic three-dimensional assessment of the hard tissues was performed at baseline and 3 months after the procedure. Standardized horizontal measurements were taken at three corono-apical levels (-2, -5 and -9 mm) and at three mesio-distal levels (mesial, centre and distal) in the buccal and palatal aspects. Vertical measurements were also recorded in nine regions superior to the alveolar crest. The measurements were performed by two independent observers and intra- and inter-observer effects were evaluated.


RESULTS
No inter- and intra-observer effects were found when analysing the measurements from these two observers. The horizontal dimension of the crest decreased by 1.6 mm (20%) in the cervical regions (-2 mm level), decreased moderately, by 1 mm (12%), at the -5 mm level and decreased very little, 0.5 mm (6%), at the apical (-8 mm) level. The losses were always significantly higher in the buccal than in the palatal aspect. Buccally, the maximal bone remodelling at the cervical level remained below 1 mm. Vertical bone resorption was homogeneous and<1 mm in the nine measured regions.


CONCLUSIONS
The radiographic measuring methodology proved to be reproducible. It can be applied in other clinical settings. It successfully assessed the alveolar ridge preservation technique (BHA+saddle connective tissue graft).
Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liege, Belgium. france.lambert@chu.ulg.ac.be
France
F
Lambert
Kim
K
Vincent
Vanessa
V
Vanhoutte
Laurence
L
Seidel
Geoffrey
G
Lecloux
Eric
E
Rompen
D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control; D000539:Alveolar Process / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods; D000818:Animals; D018786:Bone Substitutes / Q000627:therapeutic use*; D002417:Cattle; D002508:Cephalometry / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D016348:Osseointegration; D017063:Outcome Assessment, Health Care / Q000379:methods; D011859:Radiography; D015203:Reproducibility of Results; D014081:Tooth Extraction / Q000009:adverse effects*; D020390:Tooth Socket / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery
C077540:Bio-Oss; D018786:Bone Substitutes; D008903:Minerals