A Retrospective Study to Investigate the Clinical Effectiveness of Ridge Preservation in the Anterior Maxilla

Clinical Problem:

Current literature shows that there are benefits in ridge preservation with less resorption of bone width and height after extraction. However, there are no known studies investigating the clinical effectiveness of ridge preservation in the anterior maxillary esthetic zone.

Aim:

The primary aim of this study is to investigate if ridge preservation done at extraction will preserve at least 6 mm of alveolar ridge width in the anterior maxillary esthetic zone and obviate the need for secondary bone augmentation during implant insertion.

Materials and Methods:

This is a retrospective comparative study investigating the clinical effectiveness of alveolar ridge preservation in maxillary anterior esthetic zone. The outpatient records of patients who had implant treatment in National Dental Centre Singapore between 1 Jan 2012 and 31 Dec 2014 were reviewed.

60 patients with single implant placed in the anterior maxillary esthetic zone were identified via the electronic records and were classified into 2 groups. 40 had ridge preservation during extraction, while the other 20 did not. The records were studied to investigate if the patients underwent additional secondary bone augmentation during the implant insertion. The pre-implant CBCT was also analysed to investigate if there were at least 6 mm of alveolar ridge width prior to implant insertion.

Results:

The mean age of the 60 subjects is 48.37 years old (range 23 to 86 years old). The treatment group that received ridge preservation during extraction had significantly higher odds of having more than 6 mm in the pre-implant alveolar ridge width as compared to the group that did not have ridge preservation (p<0.001), the odd ratio with 95% confidence internal is 8.77 (2.56 to 30.30). The treatment group also had lesser need for further augmentation (67.5%) than that of the control group (85.0%). The difference is 17.5% but it did not reach statistical significance (p=0.218). Data analysis was performed using Fisher's Exact test.

Conclusion:

Ridge preservation during tooth extraction is effective in preserving alveolar ridge width in the anterior maxillary aesthetic zone. Ridge preservation also reduces the need for further bony augmentation during implant insertion but the effect is not statistically significant.

References:

1. Vignoletti, F, et al: Surgical protocols for ridge preservation after tooth extraction. A systematic review. Clin Oral Implants Res, 23 Suppl 5: p. 22-38, 2012.

2. Horvath, A, et al: Alveolar ridge preservation. A systematic review. Clin Oral Investig, 17(2): p. 341-63, 2013.