Badly Decayed Upper Anterior Teeth Clinical Trial
Official title:
Assessment of Collagen Plug Versus Free Gingival Graft for Alveolar Socket Sealing With Simultaneous Implant Placement in Maxillary Esthetic Zone
Following tooth extraction alveolar ridge will undergo dimensional changes and soft tissue
may collapse. These changes may complicate the subsequent restorative procedure especially in
the esthetic zone.
It was observed that socket-healing process may be divided into three sequential, and
frequently over-lapping phases: inflammatory, proliferative and modeling/remodeling.
Implants placed in fresh extraction sockets alone wasn't found to prevent the resorption of
the alveolar bone.
Alveolar socket preservation using primary flap closure technique utilizing free gingival
graft in conjunction with bone substitutes didn't produce the desired effect on ridge
preservation compared with bone substitutes alone. A clinical trial showed that achieving
primary closure didn't present additional beneficial effect on preserving ridge width,
however, the mucosa was significantly thicker and more coronally positioned.
Also soft tissue graft has its limitations on covering graft material and socket preservation
due to the higher morbidity given that the soft tissue graft has to be harvested from a donor
site of the patient.
Another options for socket seal are coronal advancement of buccal flap or rotating grafts
from tissue adjacent to cover the defect but they have limitations such as altering the
mucogingival line and creating a shallow vestibule.
Lekovic et al. investigated the use of a non-resorbable polytetrafluroethylene membrane but
it was found also to have its limitations as 30% of the membranes became exposed and as a
result loss of bone height and width occurred.
Also studies have found that using bone substitutes together with collagen membrane with
primary closure of the socket has shown clear effects on preserving alveolar ridge height as
well as ridge width, however, its limitation are flap dehiscence and subsequent membrane
exposure and the increased cost.
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