Orthodontic space closure in combination with membrane supported healing of extraction sockets (MHE) a pilot study

In periodontology and implantology the guided bone regeneration (GBR) technique represents a well established and successful method for augmentation of alveolar bone. The aim of the present study was to evaluate what advantages, if any, are offered for orthodontic space closure by membrane supported healing of extraction sockets (MHE) (criteria: rate of movement, incidence of gingival clefts, atrophy of the alveolar bone).

Within the scope of orthodontic therapy with a complete fixed appliance, three girls aged 11-14 years with indication for extraction of the first premolars were unilaterally augmented with an e-PTFE membrane (Gore-Tex((R)), W. L. Gore & Associates, Flagstaff, AZ, USA) immediately after premolar extraction. The study was performed in the split-mouth technique. An atraumatic extraction without digital compression was performed on the control side. The membranes were fixed with a Frios((R)) fixation set (Friadent, GmbH, Mannheim, Germany) and removed after 6 to 8 weeks. 1 week after membrane removal, space closure was started simultaneously with passive rectangular segmented archwires using Sentalloy((R)) closed coil springs (GAC International, Inc., Gräfelfing, Germany) at a constant force of 200 cN. The transversal and vertical dimensions of the alveolar bone the rate of space closure were determined clinically and radiographically.

Complications were not observed in any patient. The MHE-treated alveolar region showed pronounced stability of the transversal dimension. Space closure was performed in all cases without gingival clefts being induced. The control side showed distinct atrophy as well as gingival clefts. No differences were recorded in the rate of space closure.

The MHE technique seems to be a suitable means of creating favorable periodontal conditions for tooth movement, especially in cases of alveolar bone loss after extraction or trauma.