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Impact of Bone Particle Size on Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites
Xinbo Yu1, Ziang Wu2, Chaolun Li1
1Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology and National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China.
Large particle deproteinized bovine bone mineral (DBBM) showed a trend toward increased vertical bone height in alveolar ridge preservation (ARP) for periodontally compromised molars. Socket integrity is crucial for optimal outcomes in ARP.
Area of Science:
- Periodontology
- Dental Implantology
- Bone Regeneration
Background:
- Alveolar ridge preservation (ARP) is crucial for maintaining bone volume after tooth extraction.
- Limited evidence exists for ARP in posterior, periodontally compromised sites.
- Guidance on deproteinized bovine bone mineral (DBBM) particle size for ARP in molars is lacking.
Purpose of the Study:
- To compare radiographic outcomes of small particle (SP) vs. large particle (LP) DBBM for ARP in periodontally compromised molar sockets.
- To assess implant placement difficulty (LIPD) based on DBBM particle size.
- To provide clinical decision-making guidance for ARP in challenging molar sites.
Main Methods:
- 96 patients with stage III/IV periodontitis underwent molar extraction and ARP.
- Sites were randomized to receive either SP (0.25-1 mm) or LP (1-2 mm) DBBM.
- Radiographic analysis evaluated dimensional and volumetric changes; multivariable regression adjusted for confounders.
Main Results:
- A non-significant trend for increased vertical central socket height (VC) was observed with LP-DBBM (8.54 ± 2.34 mm) compared to SP-DBBM (7.76 ± 1.93 mm; P = .077).
- No significant differences in other dimensional or volumetric changes between groups.
- Multivariable analysis identified socket integrity (P < .001), jaw (P = .007), and particle size (P = .041) as significant predictors of VC.
Conclusions:
- Larger particle size DBBM demonstrated a trend towards superior vertical bone fill in compromised molar sockets.
- Socket integrity is a critical factor influencing VC in ARP.
- Larger DBBM particle size may enhance predictability for subsequent implant treatment.
