Postextraction socket preservation using epithelial connective tissue graft vs porcine collagen matrix. 1-year results of a randomised controlled trial.
OBJECTIVE
To compare epithelial connective tissue graft vs porcine collagen matrix for sealing postextraction sockets grafted with deproteinised bovine bone.


METHODS
A total of 30 patients, who needed a maxillary tooth to be extracted between their premolars and required a delayed, fixed, single implant-supported restoration, had their teeth atraumatically extracted and their sockets grafted with deproteinised bovine bone. Patients were randomised according to a parallel group design into two arms: socket sealing with epithelial connective tissue graft (group A) vs porcine collagen matrix (group B). Outcome measures were: implant success and survival rate, complications, horizontal and vertical alveolar bone dimensional changes measured on Cone Beam computed tomography (CBCT) scans at three levels localised 1, 3, and 5 mm below the most coronal aspect of the bone crest (levels A, B, and C); and between the palatal and buccal wall peaks (level D); and peri-implant marginal bone level changes measured on periapical radiographs.


RESULTS
15 patients were randomised to group A and 15 to group B. No patients dropped out. No failed implants or complications were reported 1 year after implant placement. Five months after tooth extraction there were no statistically significant differences between the 2 groups for both horizontal and vertical alveolar bone dimensional changes. At level A the difference was 0.13 ± 0.18; 95% CI 0.04 to 0.26 mm (P = 0.34), at level B it was 0.08 ± 0.23; 95% CI -0.14 to 0.14 (P = 0.61), at level C it was 0.05 ± 0.25; 95% CI -0.01 to 0.31 mm (P = 0.55) and at level D it was 0.13 ± 0.27; 95% CI -0.02 to 0.32 mm (P = 0.67). One year after implant placement there were no statistically significant differences between the 2 groups for peri-implant marginal bone level changes (difference: 0.07 ± 0.11 mm; 95% CI -0.02 to 0.16; P = 0.41).


CONCLUSIONS
When teeth extractions were performed atraumatically and sockets were filled with deproteinised bovine bone, sealing the socket with a porcine collagen matrix or a epithelial connective tissue graft showed similar outcomes. The use of porcine collagen matrix allowed simplification of treatment because no palatal donor site was involved.
Silvio Mario
SM
Meloni
Marco
M
Tallarico
Francesco Maria
FM
Lolli
Alessandro
A
Deledda
Milena
M
Pisano
Sascha A
SA
Jovanovic
D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000000981:diagnostic imaging; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D064592:Autografts / Q000637:transplantation; D016025:Bone Transplantation / Q000379:methods; D002417:Cattle; D003094:Collagen / Q000627:therapeutic use*; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003238:Connective Tissue / Q000637:transplantation; D003758:Dental Implantation, Endosseous / Q000379:methods; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D004848:Epithelium / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000637:transplantation*; D064593:Heterografts / Q000637:transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D016300:Radiography, Bitewing; D013552:Swine; D020390:Tooth Socket / Q000601:surgery*; D016896:Treatment Outcome
C077540:Bio-Oss; D008903:Minerals; D003094:Collagen