Evaluation of micro crestal flap-alveolar ridge preservation following extraction of mandibular molars with severe periodontitis
10.19723/j.issn.1671-167X.2025.01.006
- VernacularTitle:罹患重度牙周炎下颌磨牙拔牙微翻瓣牙槽嵴保存效果评价
- Author:
Yutong SHI
1
;
Yiping WEI
;
Wenjie HU
;
Tao XU
;
Haoyun ZHANG
Author Information
1. 北京大学口腔医学院·口腔医院牙周科,国家口腔医学中心,国家口腔疾病临床医学研究中心,口腔生物材料和数字诊疗装备国家工程研究中心,北京 100081;北京大学国际医院口腔科,北京 102206
- Publication Type:Journal Article
- Keywords:
Severe periodontitis;
Mandibular molars;
Alveolar ridge preservation;
Dental implant
- From:
Journal of Peking University(Health Sciences)
2025;57(1):33-41
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical and radiographic efficacy of micro crestal flap-alveolar ridge preservation following extraction of mandibular molars with severe periodontitis compared with natu-ral healing,and to preliminarily propose the surgical indication.Methods:A retrospective analysis was conducted on clinical data from patients with mandibular molars with severe periodontitis either receiving micro crestal flap-alveolar ridge preservation(MCF-ARP group)or undergoing natural healing in depart-ment of periodontology,Peking University School and Hospital of Stomatology from September 2013 to June 2021.Cone-beam computed tomography scannings performed before/immediately after extraction(as baseline)and repeated before implantation(after the extraction socket healing)were used to measure the ridge width,height and volumetric changes of the sockets,and the proportion of guided bone regeneration(GBR)during implant therapy were compared between the two groups.Results:Between baseline and healing,significant differences in changes of MCF-ARP group[(8.34±2.81)mm]and natural healing group[(3.82±3.58)mm]in the distances from mandibular canal to center of the tooth socket were recorded(P＜0.001).The ridge width at 1 mm below the most coronal aspect of the crest increased by(3.50±4.88)mm in the MCF-ARP group but decreased by(0.16±5.70)mm in the natural healing group,respectively(P=0.019).After healing,the MCF-ARP group showed the dis-tances from mandibular canal to center of the tooth socket＞8 mm in all the cases,with 97.1％excee-ding 10 mm.Natural healing group displayed 23.1％of the cases with center bone height＜8 mm and 61.5％exceeding 10 mm.Volume changes at the buccal and lingual aspect as well as the total socket were significantly greater in the MCF-ARP group compared with natural healing group(P＜0.001).At the time of implantation,GBR was performed in 5 out of 68 subjects(8.3％)in the MCF-ARP group,whereas 8 out of 26 subjects(30.8％)in the natural healing group required GBR,reflecting significant difference(P=0.003).Conclusion:In the sites of mandibular molars with severe periodontitis,when the distances from mandibular canal to center of the tooth socket was not enough(less than 7 mm),clini-cians could consider performing the micro crestal flap-alveolar ridge preservation to achieve augmentation for alveolar ridge and reduce the proportion of guided bone regeneration during implant therapy to reduce the difficulty and risk of injuries during implant therapy.
