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Postextraction tissue management: a soft tissue punch technique
Ronald E Jung1, David W Siegenthaler, Christoph H F Hämmerle
1Department of Fixed and Removable Prosthodontics and Dental Material Science, Dental School, University of Zürich, Switzerland. jung@zzmk.unizh.ch
Summary
This study shows that a soft tissue punch technique using deproteinized bovine bone mineral and a collagen matrix promotes excellent graft integration and esthetics after tooth extraction. The technique achieved high graft survival and a natural color match within six weeks.
Area of Science:
- Oral Surgery
- Periodontology
- Regenerative Medicine
Background:
- Soft tissue healing after tooth extraction is crucial for successful implant placement.
- Grafting techniques aim to improve both the biological and esthetic outcomes of socket preservation.
- Limited data exists on early graft integration using specific biomaterials and a punch technique.
Purpose of the Study:
- To evaluate the efficacy of a novel soft tissue punch technique for graft-enhanced healing following tooth extraction.
- To analyze the initial phases of graft integration and soft tissue regeneration.
- To assess the esthetic outcome, specifically color match, of the grafted site.
Main Methods:
- A prospective clinical study involving 20 patients undergoing tooth extraction and immediate implant replacement.
- Socket preservation using deproteinized bovine bone mineral in a collagen matrix.
- Harvesting a free gingival graft from the palate using a biopsy punch and suturing it to the socket margins.
- Histological and colorimetric analysis at 1 week, 3 weeks, and 6 weeks post-surgery.
Main Results:
- High graft integration rates: 64.3% at 1 week, increasing to 99.7% by 6 weeks.
- Minimal graft surface showed fibrinoid (35.6% at 1 week) or necrotic (0.1% at 1 week) areas, resolving by 6 weeks.
- Excellent color match between graft and adjacent tissue (deltaE = 2.91), below the threshold for visibility.
- Successful wound closure achieved in 99.7% of cases by 6 weeks.
Conclusions:
- The soft tissue punch technique, combined with deproteinized bovine bone mineral and collagen matrix, facilitates rapid and complete graft integration.
- This method provides predictable biologic and esthetic results for soft tissue healing after tooth extraction.
- The technique offers a viable option for socket preservation, enhancing outcomes for dental implant procedures.