Alveolar Bone (Socket) Preservation After Tooth Extraction in Anterior Regions

Objectives: Resorption of the alveolar bone is an unavoidable consequence of tooth extraction. To minimize it, different alveolar ridge preservation (ARP) measures have been taken with different materials: autografs, allografs, bone substitutes (bovine, porcine bone, hydroxiapatit or Ca sulphate), collagen membranes, and recently plasma rich with GF(growth factors) or fibrin rich with GF. Some materials considerably increase cost and/or morbidity of surgical procedure. The objective of this trial was to test dimensional changes in the alveolar bone after tooth extraction by using affordable materials for socket preservation in sites of anterior teeth to preserve the bone for at least narrow implant placement.
Methods: Three groups (3x10) of patients participated, scheduled for extraction of anterior teeth. One group received BondBone MIS (mixture of Ca sulphate dihydrate and semihydrate) in the extraction socket, another group received A-PRF (Choukroun's procedure-centrifugated autologus blood-plasma rich fibrin section) and one group represented the controls (atraumatic extractions only). Alveolar ridge width was measured prior extraction and 3 month after (both, directly and on casts). CBCT scans were also obtained after 3-month and the bone width, as well as bone density (HU units) were measured. Ridge width prior tooth extraction represented baseline data..
Results: Both groups (MIS Bondbone and a PRF) retained more bone volume than the control group (p<.01). Although there was no significant differences (p>.05) between the A-PRF and the Bonebond groups, the PRF group seemd to have better bone quality for implantation.
Conclusions: It seems that the A-PRF is unexpencive and efficent procedure for socket preservation to avoid alveolar bone loss after tooth extraction..
Acknowledgment: Croatian Science foundation for grant No. 1218