| Title |
Delaying Implant Placement Up to 12 Months After Ridge Preservation Does not Compromise Alveolar Ridge Dimension on CBCT Analysis |
| Clinical Question |
In adult patients undergoing alveolar ridge preservation, is there any difference in ridge dimension at 4-month healing versus 1-year healing? |
| Clinical Bottom Line |
Delaying implant placement up to 12 months after ridge preservation does not have a negative impact on alveolar ridge dimension according to CBCT analysis. |
| Best Evidence |
|
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| 35044692 | Allen / 2022 | 43 healthy adults needing ridge preservation and implant placement | Randomized Controlled Trial | | Key results | No significant differences were detected in radiographic ridge width as determined on CBCT 4 months and 12 months following alveolar ridge preservation using 70%/30% FDBA/DFDBA. Percent ridge width change calculated from baseline to either 4 months or 12 months post operatively had no significant difference at 3, 5, 7 mm apical to the crest (p = 0.29, 0.55, and 0.41 respectively). | | 32052432 | Nelson / 2020 | 38 healthy adults needing ridge preservation and implant placement | Randomized Controlled Trial | | Key results | No significant clinical differences in ridge width were detected following ridge preservation using 70%/30% FDBA/DFDBA in 8- to 10-week healing group vs. 18- to 20-week healing group (mean loss of 1.0 mm and 1.3 mm respectively, p=0.42). The primary outcome of the study was histological healing, for which they did report a significantly greater amount of vital bone present in the 18- to 20-week group compared to the 8- to 10-week group (p<0.0001). | | 27133791 | Whetman / 2016 | 43 healthy adults needing ridge preservation and implant placement | Randomized Controlled Trial | | Key results | No significant changes in ridge width, buccal crest height, or lingual crest height following ridge preservation with DFDBA in 8- to 10-week healing group vs. 18- to 20-week healing group (p = 0.21, p = 0.29, p>0.99 respectively). The primary outcomes in this study were histological, where the short-term group had 32.63% vital bone at 8-10 weeks, while the long-term group had 47.41% vital bone (p=0.01). There was no significant difference between the two groups regarding amount of residual graft. | |
| Evidence Search |
“Ridge preservation AND ridge dimension AND long-term healing AND short-term healing”
“Ridge preservation AND ridge dimension AND long-term healing AND 12 months”
|
Comments on
The Evidence |
The study by Allen et al. most adequately answers the clinical question posed, as it was the only randomized controlled trial assessing ridge dimension 1 year following ridge preservation before implant placement. However, in the study there was significant variation in baseline ridge width between the short term (4 months) and long-term groups (12 months). This was addressed by statistical adjustment for baseline ridge width and by reporting data as “percent change.” The other two articles offer valuable data but are of limited importance regarding the clinical question because their “long term healing group” was only defined as 18-20 weeks. All studies offer high levels of evidence, minimizing the effect of confounding variables by utilizing a single donor for all allograft materials, randomization techniques, strict inclusion/exclusion criteria, and enrolled adequate subjects as verified by power analysis. All studies achieved at least 80% follow up. |
| Applicability |
Clinicians can confidently assure patients that delaying implant placement for up to 12 months following ridge preservation will not negatively affect alveolar bone dimension. This is important for patients that may not have adequate finances, insurance coverage, or other scheduling conflicts. More research is needed to further evaluate ridge dimension outcomes at long-term follow up (12 months or longer). |
| Specialty |
(General Dentistry) (Oral Surgery) (Periodontics) |
| Keywords |
Ridge preservation, implant placement, alveolar ridge dimension, long-term healing
|
| ID# |
3495 |
| Date of submission |
11/19/2022 |
| E-mail |
fosterj1@uthscsa.edu |
| Author |
Dr. Joelle Foster |
| Co-author(s) |
Dr. Matthew Czernick |
| Co-author(s) e-mail |
czernick@livemail.uthscsa.edu |
| Faculty mentor |
Dr. Brian Mealey |
| Faculty mentor e-mail |
mealey@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?) |
| None available | |
 |
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
| None available | |