Ridge Preservation in Maxillary Molar Extraction Sites with Severe Periodontitis: a Prospective Observational Clinical Trial

Objectives: To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing.

Material And Methods: Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets.

Results: Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases.

Conclusions: Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing.

Clinical Relevance: Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.