All ETDs from UAB

Advisory Committee Chair

Ramzi Abou-Arraj

Advisory Committee Members

Maria Geisinger

Nicolaas Geurs

Amjad Javed

Maninder Kaur

Document Type

Thesis

Date of Award

2018

Degree Name by School

Master of Science (MS) School of Dentistry

Abstract

Alveolar ridge preservation at the time of tooth extraction is a commonly performed procedure as it significantly minimizes ridge resorption and allows for more optimal implant placement. The amount of new vital bone has been shown to vary with the use of different types of bone replacement grafts, however, the effect of bone graft particle size on the outcomes following ridge preservation has not been elucidated in the scientific literature. The present randomized clinical trial compared clinically, radiographically and histomorphometrically the use of small- (0.25-1.0mm) versus large- (1.0- 2.0mm) sized particle mineralized cortico-cancellous bone freeze-dried bone allografts (FDBAs) in ridge preservation procedures. Nineteen patients (22 sites) were initially enrolled and randomized to receive either small- or large-sized particle FDBA. Flapless extractions were performed, and sockets grafted with the corresponding allograft. A CBCT scan was taken immediately following the ridge preservation procedure. After an average of 16 weeks of healing, a second CBCT scan, as well as bone core biopsy and implant placement were performed. Vertical and horizontal dimensional changes were assessed clinically by direct measurements, a novel CBCT superimposition technique was used for radiographic measurements and bone cores were analyzed by histomorphometric analysis. Two-sample t-tests were conducted to compare the outcomes in the two groups. The small-sized particle group had an average of 17.3% ± 12.8% new vital bone, 43.0% ± 11.7% residual graft particles and 39.7% ± 12.8% soft tissue. The large-sized particle group had a mean of 25.9% ± 9.5% new vital bone, 37.6% ± 13.8% residual graft particles and 36.5% ± 7.8% soft tissue. The difference between the two groups lacked statistical significance for any of the tissue types. Similarly, no statistically significant variation was found between the two groups in clinical and radiographic dimensional changes. These findings suggest that both types of graft material can be used in a clinical setting with similar outcomes.

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