Alveolar Ridge Preservation In Extraction Sockets With Severe Periodontitis Using Autogenous Partially Demineralized Dentin Matrix:A Randomized Controlled Clinical Trial

Objective:To explore alveolar bone changes after ridge preservation using autogenous partially dentin matrix on extraction sockets with severe periodontitis,compared to natural healing,and to assess the application value of APDDM in sites with severe periodontitis.Material and Methods:Twenty patients with a total of 20 molars which needed to be removed due to severe periodontitis were enrolled in this study,and the subjects were randomly assigned to the test group（alveolar ridge preservation procedure with APDDM）or to the control group（natural healing）.All patients were follow-up by telephone or video within 3days after the operation.Cone-beam computed tomography scans were performed before or immediately after operation as well as 4 months later,while radiological analyses were used to assess vertical and horizontal bone changes.Bone specimens of some patients in the test group were collected for histological observation during implant placement.Results:No postoperative infection or immune rejection occurred in all patients.After 4months healing,the height of mesial buccal and middle buccal bone plates increased by 0.15 mm and 0.81 mm in the test group while decreased by 2.24 mm and 2.79 mm in the control group,respectively（P < 0.05）.The height of central bone increased by7.57 to 8.80 mm in the test group and increased by 4.02 to 5.15 mm in the control group（P < 0.05）.At the same time,the ridge width at 1 mm apical from the crest increased by 5.45 to 5.59 mm in test group,whereas decreased by 0.53 to 1.94 mm in the control group（P < 0.05）.There were no significant difference of the ridge width changes at 3 mm apical from the crest（middle coronal plane and distal coronal plane）between the test group and the control group（P >0.05）.No statistically significant difference between groups were observed in height of lingual or palate bone changes and the ridge width changes at 5 mm apical from the crest（P >0.05）.Moreover,no inflammatory cells were found in histological specimens,and all showed active bone regeneration.Conclusion:It can be concluded that APDDM can be used as a safe and effective bone graft for alveolar ridge preservation in severe periodontitis.Compared with nature healing,ridge preservation using APDDM can significantly increase the height and the width of alveolar bone after tooth extraction.