IADR Abstract Archives
The Effects Of Secondary Healing On Socket Preservation Outcome
Objectives: Primary closure (PCL) is important for healing process of socket preservation (SKP) in preparation for implant placement. However, it is common that the PCL cannot be maintained and ends up with secondary healing. Whether the lack of PCL during healing affects the outcome of SKP is unknown. The purpose of this study therefore was to determine if lack of primary closure affects SKP healing outcome.
Methods: 24 patients, 35-65 y/o, enrolled in this study. SKP was performed by a periodontist 4 weeks (wk) after single tooth extraction of a premolar/molar. Sockets were degranulated, slightly overfilled with allograft and covered with nonabsorbable barrier. All extraction sites had adjacent teeth on each side. Attempts were made to restore the socket bucco-lingual dimension (BLD) to no less than its original size. PCL was obtained for 12 patients (P group) while the other 12 had the wound left open intentionally (NP). Antibiotic and mouthwash were given for 5 days. Post-operative (PO) exams were made 1, 2, 6 wk & 6 months (M) later. All barriers were removed 6 wk after SKP. Gingival index (GI), presence of infection, pain, malodor, Ridge BLD before and 6M after surgery were recorded. Statistics was done with t-test and X2 .
Results: Combined GI for all visits in group P (0.61+0.47, mean+SD) was significantly lower than that of the NP group (1.91+0.88, p<0.05). GI at1, 2 and 6 wk showed the same pattern. However, the difference at 6M was not significant. Group P showed much less PO pain, oral malodor than NP group (X2 , p<0.05). No infection occurred in any patient. There were no significant differences in BLD between groups before (4.43+2.59 vs. 5.01+2.12 ) & after the surgery (4.60+1.98 vs. 5.13+2.04) (NP vs. P). When the barrier was removed in P group, immature new bone was found underneath. In contrast, the NP group wounds often showed a layer of new soft tissue underneath the barrier.
Conclusions: Fail to obtain PCL after SKP demonstrated higher rate of gingival inflammation, PO pain, and malodor in the first 6 weeks of healing compared to those with PCL. However, there was no difference in BLD 6 months after surgery. Whether the presence of soft tissue underneath the barrier found in NP group affects other dimensions of the ridge remains to be investigated.
Methods: 24 patients, 35-65 y/o, enrolled in this study. SKP was performed by a periodontist 4 weeks (wk) after single tooth extraction of a premolar/molar. Sockets were degranulated, slightly overfilled with allograft and covered with nonabsorbable barrier. All extraction sites had adjacent teeth on each side. Attempts were made to restore the socket bucco-lingual dimension (BLD) to no less than its original size. PCL was obtained for 12 patients (P group) while the other 12 had the wound left open intentionally (NP). Antibiotic and mouthwash were given for 5 days. Post-operative (PO) exams were made 1, 2, 6 wk & 6 months (M) later. All barriers were removed 6 wk after SKP. Gingival index (GI), presence of infection, pain, malodor, Ridge BLD before and 6M after surgery were recorded. Statistics was done with t-test and X2 .
Results: Combined GI for all visits in group P (0.61+0.47, mean+SD) was significantly lower than that of the NP group (1.91+0.88, p<0.05). GI at1, 2 and 6 wk showed the same pattern. However, the difference at 6M was not significant. Group P showed much less PO pain, oral malodor than NP group (X2 , p<0.05). No infection occurred in any patient. There were no significant differences in BLD between groups before (4.43+2.59 vs. 5.01+2.12 ) & after the surgery (4.60+1.98 vs. 5.13+2.04) (NP vs. P). When the barrier was removed in P group, immature new bone was found underneath. In contrast, the NP group wounds often showed a layer of new soft tissue underneath the barrier.
Conclusions: Fail to obtain PCL after SKP demonstrated higher rate of gingival inflammation, PO pain, and malodor in the first 6 weeks of healing compared to those with PCL. However, there was no difference in BLD 6 months after surgery. Whether the presence of soft tissue underneath the barrier found in NP group affects other dimensions of the ridge remains to be investigated.