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Tooth extraction triggers a cascade of biological events mediated by the local inflammatory response following surgical intervention and by the loss of masticatory stimulation to the periodontium. These factors disrupt the homeostasis and structural integrity of the periodontal tissues. Following tooth loss, bone remodeling is initiated and continues for several months, with the majority of dimensional and morphological changes occurring within the first three months. This early alveolar bone resorption may compromise future implant placement and prosthetic rehabilitation.
Previous studies by Schmidt-Schultz and Schultz have demonstrated that biologically intact growth factors can be preserved within the collagenous extracellular matrix of ancient human bone and teeth. These findings suggest that stored dentin may retain biologically active growth factors and provide regenerative benefits comparable to those of freshly prepared dentin, while eliminating the need for simultaneous multiple surgical interventions. Moreover, the volume of particulate dentin exceeds twice the original root volume, allowing for the acquisition of sufficient graft material for clinical application.
Based on these biological and volumetric advantages, the use of autogenous stored mineralized dentin grafts (ASMDG) has emerged as a promising approach for alveolar socket preservation. ASMDG may contribute to limiting post-extraction alveolar ridge resorption and maintaining ridge dimensions during the critical early healing period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Group | Dentin graft socket preservation | ||
| Control Group | Spontaneous healing |
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| Measure | Description | Time Frame |
|---|---|---|
| Mean change in horizontal alveolar ridge width (mm) from baseline to 4 months (CBCT) | Horizontal alveolar ridge width will be measured in millimeters using cone-beam computed tomography (CBCT) at baseline (immediately after tooth extraction) and at 4 months postoperatively prior to implant placement. The primary outcome will be defined as the mean change in ridge width (Δ width = width at 4 months - width at baseline), expressed in millimeters. | Baseline (immediately after tooth extraction) and 4 months postoperatively (prior to implant placement) |
| Measure | Description | Time Frame |
|---|---|---|
| Mean change in vertical alveolar ridge height (mm) from baseline to 4 months (CBCT) | Vertical alveolar ridge height will be measured in millimeters using cone-beam computed tomography (CBCT) at baseline (immediately after tooth extraction) and at 4 months postoperatively prior to implant placement. The secondary outcome will be defined as the mean change in ridge height (Δ height = height at 4 months - height at baseline), expressed in millimeters. |
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Inclusion Criteria:
Exclusion Criteria:
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Adult, systemically healthy patients indicated for the extraction of at least two posterior teeth with a hopeless prognosis due to periodontal disease, root caries, or root fractures, and who are candidates for implant-supported posterior rehabilitation. Eligible participants will present with intact alveolar socket walls after extraction, have no systemic or local contraindications affecting bone healing, and will provide written informed consent and comply with follow-up visits.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Health Sciences University | Istanbul | Uskudar | 34668 | Turkey (Türkiye) |
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| Baseline (immediately after tooth extraction) and 4 months postoperatively (prior to implant placement) |
| ID | Term |
|---|---|
| D016301 | Alveolar Bone Loss |
| D010510 | Periodontal Diseases |
| D055093 | Periodontal Atrophy |
| D001847 | Bone Diseases |
| D001862 | Bone Resorption |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
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