Socket Preservation Using Socket-plug Technique with Alloplastic Putty Bone Versus Ice Cream Cone Technique in Extraction Socket with Buccal Dehiscence: A Randomized Controlled Clinical Trial.
Single or double rooted teeth indicated for extraction.
Systemically free patient
Presence of small buccal dehiscence not exceeding 1/3 of the root.
Maxillary and Mandibular Arches
Systemic conditions/disease that contraindicate surgical procedure.
Patients with presence or history of osteonecrosis of the jaws, with use of bisphosphonates, exposure to head and neck radiation, chemotherapy.
Extraction socket with intact walls with no buccal dehiscence
Patients with large distinct pre-apical pathology
Parallel
socket-plug technique with putty bone
Procedure/Surgery* Atraumatic extractions after careful surgical preparation of the soft and hard tissues using periotomes sulcular incision may be done with the aid of number 15c scalpel to dissect the crestal fibers and avoid trauma to soft tissue, care should be taken not to raise the flap. * Careful curettage and debridement of the socket is performed with hand instruments to remove granulation tissue. * The socket walls are then inspected for the presence of buccal defects. * putty bone is injected into the socket up to the crest of the bone. * Collagen plug or sponge is adapted over the graft to occlude the socket * The plug is then stabilized with absorbable suture material.
Ice cream cone technique
Procedure/Surgery* Atraumatic extractions after careful surgical preparation of the soft and hard tissues using periotomes sulcular incision may be done with the aid of number 15c scalpel to dissect the crestal fibers and avoid trauma to soft tissue, care should be taken not to raise the flap. * Careful curettage and debridement of the socket is performed with hand instruments to remove granulation tissue. * The socket walls are then inspected for the presence of buccal defects. * A Collagen barrier membrane is then shaped as an ice-cream cone and placed in the extraction socket lining the buccal tissues. * The socket is then filled with particulate bone graft. * The upper part of the membrane is then used to cover the socket. * Absorbable suture is then used to close the socket and stabilize the barrier membrane
Quantitative volumetric changes
Bone volumetric changes will be measured in millimeter by super-imposition of 3D scans using volume analysis software.
Horizontal alveolar ridge width
Buccolingual alveolar ridge width will be measured in millimeter 1, 3, 5 mm bellow alveolar crest in both groups.
Vertical alveolar ridge height
Vertical alveolar ridge height will be measured in millimeter from the end of the socket to the alveolar crest in both groups.
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