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Journal of Oral Science & Rehabilitation Issue 01/2016

28 Volume 2 | Issue 1/2016 Journal of Oral Science & Rehabilitation Fla ples s s oc ket pres ervati o n pro ce du re 0.2 ± 0.8 mmfordistalsitesand0.9 ± 0.9 mmfor palatal/lingual sites. The dimensional changes were statistically significant for all of the sites (Table 2). The histological analysis performed on the retrieved bone cores found that the granules of graftedbonewerestillpresent,eventhoughnew trabecular bone could be observed in all of the specimens. Osteocytic lacunae could be seen on the particles’ surfaces, and newly formed bone was observed inside some of the resorption ar- eas of the biomaterial. Vascular growth close to the newlyformed bone was also evident, and no inflammatory cells or foreign body reaction around the biomaterial granules was observed (Fig. 13). Discussion Ridge preservation techniques have been pro- posedinordertoreducethebonevolumeshrink- agethat follows atooth extraction, since several studies have reported resorption ofbothvertical and horizontal dimensions.1, 6, 7, 23 The use ofvar- ious biomaterials and techniques has been pro- posed over time, but there is still no evidence to indicate the best choice. In the present study, 37 single-tooth extractions and the subsequent flaplessridgepreservationprocedureswereper- formed. Cortico-cancellous porcine bone and a resorbable collagen membrane were used in all of the cases, and several clinical parameters were measured at the tooth extraction and after four months, including width of keratinized gin- giva, thickness of the buccal bone wall, and changes to the vertical and horizontal dimen- sions. A minimally invasive tooth extraction tech- nique,with preservation ofthe socketwalls dur- ing the surgery, helps to maintain the architec- tureofthealveolarcrest,1,4 evenifboneremodel- ing is not completely avoidable.9 A flapless surgical technique was chosen in our study be- cause, even though some studies have not re- ported any significant differences between a flapped and aflapless surgicaltechnique,5, 24 Van der Weijden et al. assert that the elevation of a full-thicknessflapisbelievedtocompromisethe bloodsupply,limitingthefutureregenerativepo- tential.23 Furthermore,theuseofaflaplesstech- nique has been demonstrated to be less trau- maticforbothhardtissue—avoidinginterruption of the blood flow—and soft tissue—preserving the keratinized gingiva.25, 15, 26 The exposure of the collagen membrane and the soft-tissue clo- sure bysecondaryintention seemed not to jeop- ardize the bone healing, and 100% of the ridge preservation procedures were successful. The width of the keratinized gingiva gained 1.8 ± 0.7 mm after four months. These results correspond to those of other studies that used a similarsurgicalprotocol.14 The evaluation of the clinical parameters in this study confirmed the efficacy ofthis surgical procedure in counteracting the soft- and hard- Fig. 13 Newly formed bone around the grafting material. No inflammatory cells or foreign body reaction was observed.

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