Pontic Shield and Mineralized Plasmatic Matrix for Ridge Preservation

Soaad Tolba Mohammed Tolba Badawi56 enrolled

Overview

This study is testing new methods to preserve the jawbone and gum tissue after removing a damaged front tooth. Normally, when a tooth is taken out, the bone and gums in that area shrink, which can make future dental treatment more difficult and affect appearance. A technique called Partial Extraction Therapy (Pontic Shield Technique) keeps part of the tooth root in place to help maintain the natural shape of the bone and gums. Another method, called Mineralized Plasmatic Matrix (MPM), uses a patient's own blood mixed with bone particles to support healing. In this randomized clinical trial, 56 patients were assigned to one of four groups: Group I: Tooth extraction only Group II: Tooth extraction with MPM grafting Group III: Pontic shield technique alone Group IV: Pontic shield technique with MPM grafting The main outcome measured was the amount of bone width preserved, using 3D X-rays (CBCT). Other outcomes included bone height and soft-tissue healing over 4 months. This research will help determine whether the pontic shield technique, with or without MPM, provides better preservation of bone and gum tissue compared to tooth extraction alone.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Alveolar Ridge Preservation

Interventions

Tooth Extraction onlyPROCEDURE

Conventional atraumatic extraction of the non-restorable maxillary tooth in the esthetic zone without socket preservation procedures.

Extraction + MPMPROCEDURE

Tooth extraction followed by socket grafting using MPM, prepared from autologous blood combined with xenograft bone particles.

Pontic Shield OnlyPROCEDURE

Partial extraction therapy using the pontic shield technique, in which the buccal root fragment is preserved to maintain ridge contour, without additional grafting.

Pontic Shield + MPMPROCEDURE

Pontic shield technique combined with grafting using mineralized plasmatic matrix (MPM) for enhanced ridge preservation and healing.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults (≥18 years). * Classified as ASA I (healthy) according to the American Society of Anesthesiologists Physical Status Classification. * Presence of Type 1 extraction sockets (intact buccal bone and soft tissues). * Adequate oral hygiene. * Sufficient inter-arch space for prosthetic rehabilitation. * Willingness to comply with study protocol and follow-up schedule. Exclusion Criteria: * Systemic conditions affecting bone metabolism or wound healing (e.g., uncontrolled diabetes, osteoporosis, immunosuppression). * History of head and neck radiotherapy or bisphosphonate therapy. * Acute infection or suppuration at the extraction site. * Severe periodontal disease. * Root caries or tooth mobility. * Buccal bone plate loss due to vertical/horizontal root fractures or advanced periodontitis.

Outcomes

Primary Outcomes

Alveolar Ridge Width Change

Mean changes in alveolar ridge width measured at standardized reference points on cone-beam computed tomography (CBCT) Unit of Measure: millimeters (mm)

Time frame: Baseline (pre- or immediate post-extraction) to 4 months.

Secondary Outcomes

Buccal and Palatal Bone Height Change

Change in buccal and palatal bone heights measured on CBCT from baseline to 4 months. Unit of Measure: mm

Time frame: Baseline to 4 months.

Soft-Tissue Healing (Wound Healing Index, WHI)

Clinical soft-tissue healing evaluated using the WHI. Unit of Measure: score on 5-point scale with higher values indicating more favorable wound healing.

Time frame: 1 week and 4 months post-extraction.