Socket Preservation Using Autogenous Dentin

Официальное название

Socket Preservation After Tooth Extraction Using Autogenous Dentin in Comparison With Other Techniques

Обзор

Tooth extraction leads to a substantial reduction in alveolar bone volume, with up to 25% loss within the first year and up to 40-60% within three years. This prospective randomized clinical study aims to compare four commonly used methods of alveolar ridge preservation, evaluating their effectiveness in maintaining bone volume for later prosthetic or implant rehabilitation. Alveolar dimensions will be measured using calibrated CBCT imaging pre-extraction and at six months post-extraction.

Подробное описание

The study evaluates four different approaches to alveolar ridge preservation after tooth extraction. Eligible patients aged 18-70 years will undergo minimally traumatic extraction. Four treatment modalities will be compared: 1) Spontaneous healing secured with a stitch (control group), 2) Application of collagen sponge (Parasorb Cone, Resorba, Germany) secured with a stitch, 3) Application of a tricalcium phosphate xenograft (Poresorb TCP, Lasak, Czech Republic) covered with a collagen sponge (Parasorb Cone) and secured with a stitch. 4) Application of autogenous dentin, covered with a collagen sponge (Parasorb Cone) and secured with a stitch. Alveolar ridge dimensions will be measured on CBCT before extraction and again after six months. Primary outcomes include the absolute and relative change in ridge width and height at 1 mm, 3 mm, and 5 mm below the highest point of the alveolar bone as per Del Canto-Díaz, 2019. Patient factors (periodontal biotype, soft tissue phenotype, and vestibular thickness of the alveolar bone) will be recorded to allow subgroup analysis.

Вмешательства

• Процедура Tooth extraction left to heal spontaneously
  Wound after the tooth extraction will be secured with a stitch without addition of any augmentation material.
• Процедура Tooth extraction plus collagen sponge
  Wound after the tooth extraction will be filled with a collagen sponge (Parasorb Cone, Resorba, Germany) and secured with a stitch.
• Процедура Tooth extraction plus tricalcium phosphate
  Wound after the tooth extraction will be filled with tricalcium phosphate xenograft (Poresorb TCP, Lasak, Czech Republic), covered with a collagen sponge (Parasorb Cone, Resorba, Germany), and secured with a stitch.
• Процедура Tooth extraction plus autogenous dentin
  Wound after the tooth extraction will be filled with grounded autogenous dentin, covered with a collagen sponge (Parasorb Cone, Resorba, Germany), and secured with a stitch.

Первичные конечные точки

• Alveolar bone width [Срок оценки: 6 months]

Критерии участия

Критерии включения

• 18-70 years
• no active periodontitis
• signed informed consent with participation in the study
• need for extraction of teeth other than third molars
• patients requesting only standard/reimbursed care

Критерии исключения

• drug or alcohol abuse
• ongoing chemotherapy
• ongoing radiotherapy
• pregnancy
• ongoing treatment of osteoporosis or other biological treatment with MRONJ risk
• low compliance
• patients asking for premium care

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Чехия · 1 центр

• University Hospital Ostrava — Ostrava

Публикации

• Yuceer-Cetiner E, Ozkan N, Onger ME. Effect of Autogenous Dentin Graft on New Bone Formation. J Craniofac Surg. 2021 Jun 1;32(4):1354-1360. doi: 10.1097/SCS.0000000000007403. PMID 33405453
• Lopez Sacristan H, Del Canto Pingarron M, Alobera Gracia MA, de Elio Oliveros J, Diaz Pedrero R, Seco-Calvo J. Use of autologous tooth-derived material as a graft in the post-extraction socket. Split-mouth study with radiological and histological analysis. BMC Oral Health. 2024 Jul 23;24(1):832. doi: 10.1186/s12903-024-04576-0. PMID 39044178
• Isola G, Santonocito S, Di Tommasi S, Torrisi S, Iorio-Siciliano V, Caltabiano R, Ramaglia L, Torrisi P. Use of Autogenous Tooth-Derived Mineralized Dentin Matrix in the Alveolar Ridge Preservation Technique: Clinical and Histologic Evaluation. Int J Periodontics Restorative Dent. 2022 Jul-Aug;42(4):497-504. doi: 10.11607/prd.6170. PMID 35830314
• Yang F, Ruan Y, Bai X, Li Q, Tang X, Chen J, Chen Y, Wang L. Alveolar ridge preservation in sockets with severe periodontal destruction using autogenous partially demineralized dentin matrix: A randomized controlled clinical trial. Clin Implant Dent Relat Res. 2023 Dec;25(6):1019-1032. doi: 10.1111/cid.13247. Epub 2023 Jul 16. PMID 37455372
• Hussain AA, Al-Quisi AF, Abdulkareem AA. Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial. Biomed Res Int. 2023 Dec 27;2023:7932432. doi: 10.1155/2023/7932432. eCollection 2023. PMID 38179035
• Del Canto-Diaz A, de Elio-Oliveros J, Del Canto-Diaz M, Alobera-Gracia MA, Del Canto-Pingarron M, Martinez-Gonzalez JM. Use of autologous tooth-derived graft material in the post-extraction dental socket. Pilot study. Med Oral Patol Oral Cir Bucal. 2019 Jan 1;24(1):e53-e60. doi: 10.4317/medoral.22536. PMID 30573707

Идентификаторы

NCT: NCT07608289 · SPAD

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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