Ridge Preservation With and Without Primary Wound Closure: A Case Series.
AUTHOR
-- By Kim D, Angelis ND, Camelo M, Nevins ML, Schupbach P, Nevins M.
The purpose of this study was to determine the clinical and histologic
efficacy of the combination of alloplastic biphasic calcium phosphate composed
of 30% hydroxyapatite and 70% Î’-tricalcium phosphate (Osteon II) and a
cross-linked collagen membrane used to reconstruct an extraction socket with
new bone formation. Twelve patients, from two private dental practices,
requiring extraction of maxillary and mandibular nonmolar teeth (n = 30)
received both Osteon II (0.5- to 1.0-mm particle size) and the collagen
membrane.
The primary healing intention group (group A, n = 12) received
primary flap closure over the membrane, while in the secondary healing
intention group (group B, n = 18), the membrane was left exposed. Early wound
healing seemed to be slower in group B when compared to group A, but the
difference was not noticeable after 4 weeks. Clinical reentry revealed that the
dimensions of the ridge appeared to be maintained in both groups, and internal
socket bone fill was evident.
The grafted area appeared to be well
vascularized, but clinically visible graft particles were noted in some cases.
Light microscopic analysis revealed the formation of new bone directly apposing
the surfaces of graft particles and bridging the space between them, indicating
that the graft material behaved as an osteoconductive scaffold. The mean amount
of vital bone in group A was 40.3% ± 7.8%, while the remaining graft was 6.0% ±
4.0%. The mean amount of vital bone in group B was 47.3% ± 11.3%, while the
remaining graft was 18.0% ± 20.0%. The absence of primary flap closure did not
affect the percentage of vital bone formation or residual graft.
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