Ridge Preservation Comparing a Flap vs. a Flapless Technique When Using a Facial Overlay Contour Graft.
Radmall A, Greenwell H, Hill M, Shumway BS, Fiorica J.
Graduate Periodontics, University of Louisville School of Dentistry, Louisville, Kentucky
Facial overlay grafts in conjunction with ridge preservation tend to improve hard tissue ridge dimensions and the facial soft tissue contour. Traditionally these are performed using a flap technique. The primary aim of this study was to determine if a less invasive flapless technique could be used to achieve similar results to the flap technique.
AIM: The primary aim of this randomized, controlled, blinded clinical trial was to compare a flap to a flapless technique in terms of ridge width and ridge height outcome. Also % vital bone was compared between treatments.
METHODS: 22 patients, 11 per group, were randomly assigned to receive a cortico-cancellous particulate allograft in the socket and a bovine xenograft as a buccal overlay. Both groups had an acellular dermis membrane to cover the grafts. The primary outcome variables were: 1) Clinical ridge width and height change; and 2) Histologic amounts of vital and non-vital bone, and trabecular space at 4 months.
CONCLUSIONS: 1) Both treatments had a similar loss of ridge width and minimal loss of ridge height. This means that in this study the use of a mimimally invasive flap technique worked as well as a flap approach. 2) The flapless group healed with a significantly higher percentage of vital bone (p < 0.05) when compared to the flap group, probably due to less disruption of the blood supply.