Socket Preservation Using Autogenous Dentin

The study evaluates four different approaches to alveolar ridge preservation after tooth extraction. Eligible patients aged 18-70 years will undergo minimally traumatic extraction. Four treatment modalities will be compared: 1) Spontaneous healing secured with a stitch (control group), 2) Application of collagen sponge (Parasorb Cone, Resorba, Germany) secured with a stitch, 3) Application of a tricalcium phosphate xenograft (Poresorb TCP, Lasak, Czech Republic) covered with a collagen sponge (Parasorb Cone) and secured with a stitch. 4) Application of autogenous dentin, covered with a collagen sponge (Parasorb Cone) and secured with a stitch. Alveolar ridge dimensions will be measured on CBCT before extraction and again after six months. Primary outcomes include the absolute and relative change in ridge width and height at 1 mm, 3 mm, and 5 mm below the highest point of the alveolar bone as per Del Canto-Díaz, 2019. Patient factors (periodontal biotype, soft tissue phenotype, and vestibular thickness of the alveolar bone) will be recorded to allow subgroup analysis.

• Tooth extraction left to heal spontaneously (Procedure): Wound after the tooth extraction will be secured with a stitch without addition of any augmentation material.
• Tooth extraction plus collagen sponge (Procedure): Wound after the tooth extraction will be filled with a collagen sponge (Parasorb Cone, Resorba, Germany) and secured with a stitch.
• Tooth extraction plus tricalcium phosphate (Procedure): Wound after the tooth extraction will be filled with tricalcium phosphate xenograft (Poresorb TCP, Lasak, Czech Republic), covered with a collagen sponge (Parasorb Cone, Resorba, Germany), and secured with a stitch.
• Tooth extraction plus autogenous dentin (Procedure): Wound after the tooth extraction will be filled with grounded autogenous dentin, covered with a collagen sponge (Parasorb Cone, Resorba, Germany), and secured with a stitch.

Primary outcomes

• Alveolar bone width [6 months]: Absolute and relative change in the alveolar bone width at 1 mm, 3 mm, and 5 mm below the alveolar crest measured from CBCT imagery.

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* 18-70 years
* no active periodontitis
* signed informed consent with participation in the study
* need for extraction of teeth other than third molars
* patients requesting only standard/reimbursed care

Exclusion Criteria:

* drug or alcohol abuse
* ongoing chemotherapy
* ongoing radiotherapy
* pregnancy
* ongoing treatment of osteoporosis or other biological treatment with MRONJ risk
* low compliance
* patients asking for premium care

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• Martin Starosta, Assoc. Prof., Study chair, University of Ostrava