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Utilizing Intrasocket Reactive Tissue for Alveolar Ridge Preservation: Case Reports
Background: Alveolar ridge preservation (ARP) has been practiced for decades using various techniques and materials. Intrasocket reactive tissue (ISRT) is a novel approach that may improve primary closure during ARP. These case reports aim to compare the clinical outcomes of ARP using ISRT as a socket sealing material with and without primary closure.
Materials and Methods: Two systemically healthy periodontitis patients, each with a hopeless mandibular molar, were included. Following initial periodontitis treatment, atraumatic extraction and ARP were performed by reflecting ISRT from the socket base to incorporate into the flap design. The socket was filled sequentially with: hemostatic gauze, collagen plug (CollaPlug®), bone graft (Puros® Cortical Particulate Allograft), and covered with a titanium-reinforced d-PTFE membrane (Cytoplast™ Ti-150). Finally, ISRT was utilized as part of the flap to cover the membrane.
Case Reports:
Case 1 (Control): Managed without primary closure due to limited tissue volume. Healing proceeded via secondary intention with membrane exposure.
Case 2 (Test): Achieved primary closure using the reflected ISRT pedicle. The wound healed uneventfully with a complete soft tissue seal.
Results: Clinical outcomes and CBCT scans were evaluated 4 months post-treatment.
Case 2 (Primary Closure with ISRT): Showed superior results with +4.0 mm vertical bone gain and stable horizontal ridge width (+0.2 mm).
Case 1 (No Primary Closure): Showed less vertical gain (+1.6 mm) and significant horizontal resorption (-5.0 mm).
Conclusion: Incorporating ISRT in ARP procedures may facilitate primary closure and contribute to improved dimensional stability of the alveolar ridge.