Volumetric and Linear Analysis of Soft Tissue Changes After Tooth Extraction and Socket Grafting

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  • March 22, 2019
Creator
  • Lopez, Brenda
    • Affiliation: School of Dentistry, Department of Periodontology
Abstract
  • Introduction: The success and survival of dental implants are dependent on proper three- dimensional positioning in the bone, the anatomical shape of the prosthetic restoration1, the quantity and quality of the soft tissue,2 and the presence of a balanced occlusion.3 Adequate preservation of the alveolar bone dimension is of great importance to adequately place dental implants. Various methods have been utilized with the aim of preserving the alveolar ridge and soft tissue contours post tooth extraction due to the importance that it has on prosthetic and esthetic outcomes when replacing missing teeth. Purpose: To evaluate the linear and volumetric changes in soft tissue following site preservation/socket grafting with a xenograft bone mineral that was covered with either a collagen sponge or a 3D-collagen matrix at the 1 month, 3 month and 6-month post extraction time points. Methods: This clinical trial included twenty-four subjects who required tooth extraction, site preservation and implant placement. All patients received extraction and grafting with xenograft + 10% collagen (Geistlich Bio-Oss Collagen®) and were randomly assigned to a test or control group for closure of the extraction site. The control group received socket closure with a collagen dressing/sponge/plug (HeliPlug®) and test group with a 3D-collagen matrix (Geistlich Mucograft® Seal). Linear and volumetric soft tissue analysis were performed using Standard Tessellation Language (STL) files, obtained with an intra-oral scanner and were analyzed via a non-contact reverse engineering system to compare the facial linear and volumetric soft tissue changes between the control and test group. Results: The linear measurement analysis revealed less linear soft tissue loss with the collagen matrix. The difference between groups was not statistically significant. The volumetric analysis demonstrated a longitudinal decreased loss of soft tissue volume when a 3-D collagen matrix was used compared to a collagen sponge from month 1 to month 6. The longitudinal difference in volume was statistically significant between the two groups. Conclusion: This human investigation provides early evidence of the volumetric soft tissue changes after tooth extraction and socket grafting. The linear soft tissue analysis at the 1, 3 and 6-month time points did not show a statistical difference between the use of a collagen sponge and a 3-D collagen matrix. The results from the volumetric analysis demonstrated a reduced volume loss when a 3-D collagen matrix was used compared to a collagen dressing. The data provides early evidence in regards to decreased amount of volume loss using a 3-D collagen matrix. This finding may positively benefit clinicians when managing soft tissue contours around implants in the esthetic zone.
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Advisor
  • Moriarty, John
  • Cook, Ryan
  • Morelli, Thiago
Degree
  • Master of Science
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2018
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