title: A methodological approach to assessing alveolar ridge preservation procedures in humans: soft tissue profile.
abstract: BACKGROUND
  The aesthetic results of implant restoration in the anterior maxilla are particularly related to the soft tissue profile. Although socket preservation techniques appear to reduce bone remodelling after tooth extraction, there is still few investigations assessing the external soft tissue profile after such procedures. The goal of this study was to describe an accurate technique to evaluate soft tissue contour changes after performing socket preservation procedures. The secondary objective was to apply the newly developed measuring method to a specific socket preservation using a "saddled" connective tissue graft combined with the insertion of slowly resorbable biomaterials into the socket.
  
  
  METHODS
  A total of 14 patients needing tooth replacement in the aesthetic region were included to receive a socket preservation procedure using a connective tissue graft. Impressions were taken before the tooth extraction (baseline) and at 2, 4, and 12 weeks after the procedure. The corresponding plaster casts were scanned, and the evolution of the soft tissue profile in relation to the baseline situation was assessed using imaging software.
  
  
  RESULTS
  The measuring technique allowed assessing the soft tissue profiles accurately at different levels of the alveolar process. The insertion of a saddled connective tissue appeared to compensate for the horizontal and vertical bone remodelling after a socket preservation procedure in most regions of the alveolar crest. After 12 weeks, the only significant change was located in the more cervical and central region of the alveolar process and reached a median drop of 0.62 mm from baseline.
  
  
  CONCLUSIONS
  Within the limitations of this study, we found that a saddled connective tissue graft combined with a socket preservation procedure could almost completely counteract the bone remodelling in terms of the external soft tissue profile. The minor changes found in the cervical region might disappear with the emergence profile of the prosthodontic components. The described technique might therefore enhance the aesthetic outcomes when a tooth has to be replaced in the aesthetic zone. The described protocol can be used to further compare the effectiveness of different extraction socket preservation protocols in randomised controlled trials.
authors.affiliation: Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Vanhoutte
authors.affiliation: Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium.
authors.forename: Eric
authors.initials: E
authors.lastname: Rompen
authors.affiliation: Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Lecloux
authors.affiliation: Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Rues
authors.affiliation: Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Schmitter
authors.affiliation: Department of Periodontology and Oral Surgery, Faculty of Medicine, University of Liege, Liège, Belgium.
authors.forename: France
authors.initials: F
authors.lastname: Lambert
mesh_terms: D000293:Adolescent; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000473:pathology* / Q000517:prevention & control*; D000539:Alveolar Process / Q000033:anatomy & histology / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods; D019072:Antibiotic Prophylaxis; D001530:Belgium; D016723:Bone Remodeling; D018786:Bone Substitutes / Q000627:therapeutic use; D019250:Dental Implants, Single-Tooth; D004954:Esthetics; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D003765:Models, Dental; D010511:Periodontal Dressings; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014081:Tooth Extraction / Q000009:adverse effects*; D020390:Tooth Socket / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D008903:Minerals
keywords: alveolar soft tissue volume; assessment method; esthetic dentistry; extraction socket; wound healing