ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Extraction Socket Preservation Techniques Decrease Post-Operative Bone Loss
Clinical Question In a patient following tooth extraction, does extraction socket preservation compared to extraction alone decrease post-operative bone loss?
Clinical Bottom Line Yes, socket preservation techniques decrease the amount of bone loss after tooth extraction. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 12931761Iasella/200324 patients (10 males and 14 females - age 28 to 76) divided into 2 treatment groups.Randomized Control Trial
Key resultsAlthough both extraction alone and ridge preservation groups lost ridge width, the ridge width loss was more pronounced in the extraction group than in the ridge preservation group (2.7 mm vs 1.2 mm). Moreover, while the ridge preservation group gained ridge height (+ 1.3 mm), the extraction group showed significant vertical ridge loss (- 0.9 mm). The quantity of bone observed on histologic analysis was greater in ridge preservation sites.
#2) 11846205Froum/200219 patients (12 males and 7 females - age 35 to 77) divided into 3 treatment groups.Randomized Control Trial
Key resultsIn 30 extraction sockets treated with bioactive glass (BG), demineralized freeze dried bone (DFDBA), or debridement only (control); bioactive glass-treated sockets yield more vital bone (59.5% vital bone) than freeze dried-treated sockets (34.7%) and control sockets (32.4%) at 6 to 8 months post-extraction. These differences, however, were not statistically significant due to the small number of treated sites.
Evidence Search Limits: Systematic Reviews,Randomized Controlled TrialMeta-Analysis, Limits: Randomized Controlled TrialSearch "Alveolar Bone Loss"[Mesh],"Preservation, Biological"[Mesh],"Tooth Socket"[Mesh], "Tooth Extraction"[Mesh]
Comments on
The Evidence
Both articles are randomized controlled trials where patients were divided into treatment groups and control groups. Even though patients in both articles where treated with different tooth socket preservation techniques following tooth extraction, the techniques were all similar at decreasing post-operative bone loss. Both articles also had control groups to test the treatments given.
Applicability Extraction socket preservation techniques after a tooth extraction can preserve bone in patients receiving post extraction restorations such as implants.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics)
Keywords tooth extraction extraction socket preservation post-operative bone loss
ID# 536
Date of submission: 03/26/2010spacer
E-mail rooks@livemail.uthscsa.edu
Author Melissa Rooks
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Cristina Villar, DDS
Faculty mentor/Co-author e-mail Villar@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
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by Tyler Borg (San Antonio, TX) on 07/07/2012
A systematic review published in 2011 concluded that socket preservation does limit alveolar bone loss. FDBA performed the best in respect to maintenance of alveolar height. It is important to note that despite this procedure, a loss of width was still reported. The systematic review also makes note that data is scarce in this field, which prevents firm conclusions. The bottom line of this CAT is supported, although modified. PubMed ID: 21091540
by Tina Desai (San Antonio, TX) on 04/19/2012
A PubMed search on this topic was complete April 2012. The publications listed in the CAT are the most recent and highest level of evidence.
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