Clinical Effect Of Alveolar Ridge Preservation With Different Height Of Labial Bone Plate Defect In Aesthetic Area Of Anterior Teeth

Objective:Clinical effect of alveolar ridge preservation with different height of labial bone plate defect in aesthetic area of anterior teeth.Methods:In this study,30 patients who were admitted to Stomatological Hospital of Shanxi Medical University from January 2021 to January 2022 were selected and divided into two groups according to the degree of defect of labial bone plate height,the degree of defect in group A > 50%,and the degree of defect in group B < 50%.There were 15 patients in group A,which covered 6 males and 9 females,their average age was30.13±7.14,there were 15 patients in group B,which included 10 males and 5 females,their average age was 28.60±6.00.For all patients,performing ARP at the affected tooth site.After minimally invasive extraction of the affected tooth,collagen and PRF were implanted into the extracted tooth socket,and the wound was closed with collagen membrane and PRF membrane.Finally,absorbable suture was used to fix the barrier membrane.CBCT was taken for each subject before and 4 months after surgery,and they were imported into Pro Plan CMF3.0 software for 3D model reconstruction,and the two3 D models were matched to measure the changes in the bone height of the labillary bone plate in the mesial,distal and middle,the changes of alveolar bone width at 25%,50%and 75% of palatal plate height,and recording the changes of labial keratinized gingival width before tooth extraction and 4 months after ARP,and postoperative pain index.Results:Before operation,the average height of the labial plates in the mesial,distal and middle was 2.30±1.71 mm,2.53±1.93 mm,2.25±1.67 mm in group A,4.78±1.56 mm,4.37±1.92 mm,3.93±1.83 mm in group B,respectively.Mean labial bone height increased in both groups at 4 months postoperatively.In group A,the mean bone height of the mesial,distal and middle was increased by 3.55±3.28 mm,4.85±3.35 mm,3.49±2.71 mm,respectively,group B increased by 0.81±0.72 mm,0.47±2.08 mm,0.52±0.36 mm,respectively.Comparison before and after operation within the group showed statistical difference except labial distal in group B(P < 0.05).In group A,preoperative mean width of alveolar bone at 25%,50% and 75% levels of palatal plate was 9.70±2.07 mm,10.55±1.35 mm and 10.32±1.93 mm,respectively,while that in group B was10.67±2.12 mm,10.41±2.83 mm,11.04±2.01 mm,there was no statistical difference between the two groups(P > 0.05).The alveolar bone width of group A and B was absorbed to certain extent at the palatal bone plate height of 25%,50% and 75% four months after surgery,with statistical differences compared with the preoperative level(P< 0.05).The average absorption in group A was-2.23±0.13 mm,-1.09±0.06 mm,-0.39±0.05 mm,and that in group B was-2.17±0.11 mm,-1.12±0.04 mm,-0.37±0.04 mm,respectively.In both group A and group B,the absorption of alveolar bone width showed decreasing trend from 25%,50% to 75% levels,but the loss of alveolar bone width was basically similar in group A and B at the same level.Postoperative keratinized gingival width was decreased to certain extent in both groups A and B compared with preoperative width,with an average decrease of-0.06±0.03 mm in group A and-0.18±0.02 mm in group B.There was no statistical difference in preoperative and postoperative keratinized gingival width in group A(P > 0.05),while there was statistical difference in group B(P < 0.05).With the extension of healing time,the pain index decreased in both groups.On the 1st postoperative day,the average pain index was 1 in group A and 2 in group B;on the 3rd postoperative day,the average pain index was 0 and2 in group A and B;and on the 5th postoperative day,the average pain index was 0.Conclusion:In the aesthetic area of anterior teeth,the extracted fossa with a defect of more than50% of the labial bone plate height was more preserved after ARP than the extracted fossa with a defect of less than 50% of the labial bone plate height.However,the width of alveolar bone was reduced at 25%,50% and 75% of the palatal bone plate height in the two kinds of extracted fossa,the absorption of alveolar bone width increased gradually,and the former preserved more for keratinized gingival width.