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Ridge Preservation Procedures After Tooth Extractions. A Systematic Review and Decision Tree
Thursday, March 1 / 12:50-1:00pm / Monitor 4

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Introduction: Disruption to the oral environment by tooth extraction can compromise the integrated tissue morphology, inducing healing mechanisms similar to those of new tissue formation. Schropp et al, determined that major changes of an extraction site are occurring within 12 months, during which time a 50% (5-7mm) reduction of alveolar ridge width can be observed, with two thirds of this reduction occurring within the first three months. The purpose of this systematic review was to accurately assess the procedural success of ridge preservation through the application of strict inclusion and exclusion criteria. Method: Two electronic databases were methodically searched by two independent researchers (GB and NS) for applicable articles, in the English language. Selected key words “ridge preservation”, “alveolar ridge preservation,” and “socket preservation” were applied and results were individually screened in a follow up greater than twelve months, between January 1980 and December 2016. Articles were further filtered to include randomized controlled trials, comparing ridge preservation treatment with a non-grafting control, and the use of CBCT before and after rendered treatment. Results: The literature search of both databases provided a total of 2411 articles. Through the manual search, 5 supplementary articles were added. After the duplicates were removed, 1876 papers were available for screening. Only 2 articles met the inclusion criteria for qualitative data analysis. Both studies were evaluated for risk of bias. Pang et al, showed higher risk of bias. Finally, a decision tree was created for ridge preservation procedures based on different clinical parameters.The authors were unable to conduct a meta-analysis as the two selected studies were dissimilar and were deemed unsuitable for combined extension of the data. Conclusion: The use of deproteinized bovine bone in a collagen sponge (DBB/CS) prevented the vertical crestal bone resorption while the leucocyte platelet rich fibrin (L-PRF) prevented both the horizontal and vertical crestal bone resorption. Every clinical case should be addressed individually based on the specific clinical parameters. More randomized controlled clinical trials with strict inclusion criteria, are needed to eliminate all the confounding factors that bias the outcome of ridge preservation techniques.

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