Influence of Healing Time on the Outcomes of Alveolar Ridge Preservation in Periodontally Compromised Extraction Sockets

Linear dimensional alterations of the alveolar ridge from the time of tooth extraction to the time of implant placement (3 months)

Clinical and radiographic (via CBCT) assessment. The buccal-lingual ridge width at the time of the extraction will be measured clinically using a periodontal probe (UNC-15) and prior to implant placement (3-months). The same measurements will be performed radiographically through the CBCTs taken prior to tooth extraction and prior to implant placement, utilizing a CBCT viewer software. The linear vertical alterations will be used utilizing the same methods, using fiduciary anatomical landmarks. Superimposition of the digital files obtained from the intra-oral scanner will be utilized to verify these changes clinically.

Time frame: 3 months

Linear dimensional alterations of the alveolar ridge from the time of tooth extraction to the time of implant placement (6 months)

Clinical and radiographic (via CBCT) assessment. The buccal-lingual ridge width at the time of the extraction will be measured clinically using a periodontal probe (UNC-15) and prior to implant placement (6-months). The same measurements will be performed radiographically through the CBCTs taken prior to tooth extraction and prior to implant placement, utilizing a CBCT viewer software. The linear vertical alterations will be used utilizing the same methods, using fiduciary anatomical landmarks. Superimposition of the digital files obtained from the intra-oral scanner will be utilized to verify these changes clinically.

Time frame: 6 months

Assessment of the mucosal healing of the extraction sites at 2 weeks using a wound healing index (1-3 scale rating)

Wound Healing Index.1-3 scale rating: 1) Uneventful Healing, 2) Normal healing with moderate soft tissue inflammation, erythema but no suppuration and 3) poor wound healing with significant signs of clinical inflammation and/or suppuration

Time frame: 2 weeks following tooth extraction and alveolar ridge preservation

Assessment of the mucosal healing after implant placement at 2 weeks using a wound healing index (1-3 scale rating)

Wound Healing Index.1-3 scale rating: 1) Uneventful Healing, 2) Normal healing with moderate soft tissue inflammation, erythema but no suppuration and 3) poor wound healing with significant signs of clinical inflammation and/or suppuration

Time frame: 2 weeks after dental implant placement

Patient reported outcomes (number of days of total or partially impaired activity) following tooth extraction

Number of days of total or partially impaired activity

Time frame: At the time of implant placement (3 or 6 months)

Patient reported outcomes (number of days of total or partially impaired activity) following implant placement

Number of days of total or partially impaired activity

Time frame: 4 months post implant placement

Patient reported outcomes (pain) 2 weeks following tooth extraction, using a Visual Analog Score for pain (0-100)

Visual Analog Score for pain (0-100, with 0 representing no pain, and 100 very severe pain, described as "worse pain imaginable").

Time frame: 2 weeks following tooth extraction and alveolar ridge preservation

Patient reported outcomes (pain) 3 months following tooth extraction, using a Visual Analog Score for pain (0-100)

Visual Analog Score for pain (0-100, with 0 representing no pain, and 100 very severe pain, described as "worse pain imaginable").

Time frame: 3 months following tooth extraction and alveolar ridge preservation

Patient reported outcomes (pain) 6 months following tooth extraction, using a Visual Analog Score for pain (0-100)

Visual Analog Score for pain (0-100, with 0 representing no pain, and 100 very severe pain, described as "worse pain imaginable").

Time frame: 6 months following tooth extraction and alveolar ridge preservation

Patient reported outcomes (patient satisfaction), using a Visual Analog Scale (0-100)

Patients will be asked to rate their satisfaction in terms of function, comfort and esthetics, using a Visual Analog Scale (0-100, with 0 meaning "not at satisfied at all" and 100 corresponding to "perfectly satisfied").

Time frame: Up to 30 days post implant crown delivery

Implant survival rate

Percentage of implants still in the mouth

Time frame: 1 year post implant loading

Marginal bone level changes

Measured in millimeters using standardized parallel technique intraoral radiographs

Time frame: 1 year post implant loading