Ridge preservation combined with open barrier membrane technique in case of post-extractive oro-antral communication:...

After dental extraction a physiological phenomenon of reabsorption of the dentoalveolar process is triggered, especially if periradicular lesions are present, which can sometimes be associated with oro-antral communication in the upper posterior maxilla. With the aim of proposing a minimally invasive approach, 19 patients undergoing tooth extraction in the postero-superior maxilla were recruited. All cases presented an oroantral communication with a diameter of 2-5 mm after tooth extraction and the alveolar process, in some cases, with a partial defect of one or more bony walls. In these cases, a single surgical procedure was used to preserve the alveolar ridge with an open barrier technique with exposed d-PTFE membrane. The bottom of the extraction socket was filled with a collagen fleece and the residual bone process reconstructed using a bio-material based on carbonate-apatite derived from porcine cancellous bone. After 6 months all patients were recalled and subjected to radiographic control associated to an implant-prosthetic rehabilitation plan. Data relating to the sinus health status and the average height and thickness of the regenerated bone were collected. Radiographic evaluation verified the integrity of the maxillary sinus floor with new bone formation, detecting a vertical bone dimension between 3.1mm and 7.4mm (average 5.13mm ± 1.15) and a horizontal thickness between 4.2mm and 9.6mm (average 6.86mm ± 1.55). The goal of this study was to highlight the advantage of managing an oro-antral communication and, at the same time, to obtain the preservation and regeneration of the alveolar bone crest. The open barrier technique appears to be effective for the minimally invasive management of the oro-antral communication up to 5mm in diameter in post-extraction sites, with a good regeneration of hard and soft tissue.