The Effectiveness of Different Grafting Strategies in Alveolar Ridge Preservation: A Retrospective Study of 2D and 3D Radiographic Analysis.

PURPOSE: To evaluate the effectiveness of different alveolar ridge preservation (ARP) techniques by means of 2D and 3D radiographic analysis.

MATERIALS AND

METHODS

The retrospective study included three different ARP approaches: (1) half-grafted technique covered with a collagen membrane (TestC, n = 6); (2) half-grafted technique covered with a nonresorbable dense polytetrafluoroethylene (dPTFE) membrane (TestD, n = 8); and (3) full-grafted technique covered with a collagen membrane (Control, n = 13). The radiographic evaluation included linear, area, and volume changes at multiple time points throughout the 12-month follow-up: before tooth extraction, 6 months after ARP, during implant surgery, and 6 months after loading. The correlation between baseline socket conditions and radiographic outcomes was also investigated.

RESULTS

Among the different ARP strategies, significantly more horizontal reduction (change in horizontal ridge width, ΔHRW) was observed in the half-grafted groups (men of both groups) 6 months after ARP (ΔHRW1-half-grafted: -2.45 ± 0.96 mm; full-grafted: -1.21 ± 0.98 mm, P = .002; ΔHRW3-half-grafted: -1.49 ± 1.34 mm; full-grafted: -0.27 ± 0.68 mm, P = .002; ΔHRW5-half-grafted: -0.46 ± 0.27 mm; full-grafted: -0.16 ± 0.41 mm, P = .033). Following the removal of poorly attached graft material at implant surgery, the half-grafted groups showed significantly more area reduction (ΔA%) (half-grafted: -11.53% ± 12.56%; full-grafted: -6.11% ± 4.73%, P = .022). However, there was no intergroup difference in volume change (ΔVo%) (P = .892). All implants presented stable peri-implant health without the presence of peri-implant disease or progressive bone loss, regardless of the ARP technique used. The type of destruction affecting the tooth and the reasons for extraction were not relevant to ridge alteration, while a thin buccal plate was associated with greater reductions in height (P = .02) and area (P = .047).

CONCLUSIONS

Both the half-grafted and full-grafted techniques showed comparable results in volume analysis and peri-implant health at all time points, but the half-grafted strategy could present more area reduction after graft removal during implant surgery. Additionally, sockets with a buccal plate thinner than 1 mm may experience a compromised effect on ridge preservation.