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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Extraction Only | Active Comparator | Patients receive total tooth extraction in the esthetic maxillary zone without any adjunctive grafting. |
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| Extraction + MPM | Active Comparator | Patients receive total tooth extraction in the esthetic maxillary zone, followed by grafting with MPM. |
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| Pontic Shield Only | Active Comparator | Patients undergo the pontic shield technique, in which a portion of the buccal root is preserved to maintain ridge contour, without grafting. |
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| Pontic Shield + MPM | Active Comparator | Patients undergo the pontic shield technique combined with MPM grafting for ridge preservation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tooth Extraction only | Procedure | Conventional atraumatic extraction of the non-restorable maxillary tooth in the esthetic zone without socket preservation procedures. |
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| Measure | Description | Time Frame |
|---|---|---|
| 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) | Baseline (pre- or immediate post-extraction) to 4 months. |
| Measure | Description | Time Frame |
|---|---|---|
| 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 | Baseline to 4 months. |
| Soft-Tissue Healing (Wound Healing Index, WHI) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Soaad Tolba Badawy, Lecturer, Oral Surgery, MU | Mansoura University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry, Mansoura University | Al Mansurah | Dakahlia Governorate | 35511 | Egypt |
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| ID | Term |
|---|---|
| C083299 | 1-methyl-1-piperidinomethane sulfonate |
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Participants were randomized to one of four groups: extraction alone, extraction with MPM, pontic shield alone, or pontic shield with MPM.
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| Extraction + MPM | Procedure | Tooth extraction followed by socket grafting using MPM, prepared from autologous blood combined with xenograft bone particles. |
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| Pontic Shield Only | Procedure | Partial extraction therapy using the pontic shield technique, in which the buccal root fragment is preserved to maintain ridge contour, without additional grafting. |
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| Pontic Shield + MPM | Procedure | Pontic shield technique combined with grafting using mineralized plasmatic matrix (MPM) for enhanced ridge preservation and healing. |
|
Clinical soft-tissue healing evaluated using the WHI. Unit of Measure: score on 5-point scale with higher values indicating more favorable wound healing.
| 1 week and 4 months post-extraction. |