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Prosthetically Driven Alveolar Reconstructions: A Retrospective Study.

Guaracilei Maciel Vidigal Junior1, Luiz Roberto Figueiredo Dantas2, Luis Carlos de Moraes E Silva Junior3

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The prosthetically-driven alveolar reconstruction (PDAR) technique effectively regenerated alveolar bone after tooth extraction, showing significant bone gain without flaps or grafts. This method offers a low-morbidity approach for alveolar ridge preservation.

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Area of Science:

  • Dental Implantology
  • Periodontology
  • Oral Surgery

Background:

  • Loss of the buccal bone plate in the anterior maxilla post-extraction presents a challenge for alveolar ridge preservation.
  • Maintaining clot stability and preventing gingival collapse are critical for successful bone regeneration.

Purpose of the Study:

  • To evaluate the efficacy of the prosthetically-driven alveolar reconstruction (PDAR) technique for post-extraction alveolar bone reconstruction.
  • To assess bone formation and gingival margin stability following PDAR treatment.

Main Methods:

  • PDAR technique utilizing a partial fixed provisional prosthesis (PFPP) with a specialized pontic to stabilize the clot.
  • Evaluation of gingival recession over a 6-month healing period.
  • Cone beam computed tomography (CBCT) and panoramic imaging for bone measurements before and after treatment.

Main Results:

  • Significant bone formation observed in all 12 patients, with a mean vertical gain of 7.1±3.7 mm and horizontal gain of 4.5±1.4 mm in the alveolar bone crest.
  • High reliability of CBCT measurements (intraclass correlation coefficient = 0.999).
  • No clinically significant gingival recession (>1 mm) was noted post-treatment.

Conclusions:

  • PDAR promotes alveolar bone formation effectively without the need for flaps, grafts, or membranes.
  • The technique offers a lower-morbidity alternative for alveolar ridge regeneration and preservation.
  • The specialized pontic design contributes to clot stability and prevents gingival margin collapse.