Alveolar Ridge Reconstruction Using Autogenous Tooth Roots vs Ice Cream Cone Technique: Clinical and Histomorphometric Outcomes from a Randomized Clinical Trial.

OBJECTIVES

This randomized controlled clinical trial aims to compare clinical and histomorphometric outcomes of autogenous tooth roots (TR) versus ice cream cone technique (IC) for alveolar ridge reconstruction.

MATERIAL AND

METHODS

Patients presenting a hopeless single tooth with type II extraction socket according to Elian classification were randomly allocated to two groups. In the TR group, autogenous root fragments from the extracted tooth were cleansed, shaped and fixed with osteosynthesis screws to reconstruct the buccal wall. In IC group, ridge reconstruction was performed using xenogeneic granules and a resorbable collagen membrane. Digital impressions were obtained before surgery (T0) and after 26 weeks of healing (T1) and analyzed using 3D metrology software. Bone biopsies were collected at implant site preparation for histomorphometric analysis. Data distribution was assessed by using Shapiro-Wilk test and, due to the normality of data, independent sample t-test was performed for inter-group comparisons.

RESULTS

Twenty-four patients were included (TR=12; IC=12). Mean total horizontal contour reduction was 3.76 ± 0.57 mm in the TR group and 3.72 ± 0.59 mm in the IC group (mean difference: 0.04 mm; 95% CI: -0.45 to 0.53; p = .87). Mean vertical contour reduction was not significantly different between the two procedures in all the measured points. Histomorphometry showed vital bone percentages of 54.2±9.1 (TR) and 33.4±13.1 (IC) (𝑝 = 0.002), whilst marrow spaces percentages were 45.8±9.1 (TR) and 56.6±4.9 (IC) (𝑝 = 0.01). Residual graft percentage was 10.1±9.0 in IC group, whereas no graft was present in TR.

CONCLUSION

Both TR and IC showed positive clinical outcomes and may represent suitable approaches for alveolar ridge reconstruction of type II extraction sockets in order to allow delayed implant placement.