Influence of suture technique on ridge dimensions and keratinized tissue after alveolar ridge preservation: a pilot study

Abstract

The alveolar ridge preservation (ARP) procedure was designed to minimize bone loss following tooth extraction to allow for implant placement in the prosthetically-driven position, and reduce the need for subsequent grafting procedures. The aim of this study was to evaluate how two suturing techniques affect the healing morphology of hard and soft tissue following ARP. A randomized controlled pilot study was designed to compare the outcome of ARP using an external crossing horizontal mattress suture (control) versus an internal crossing horizontal mattress suture (test). After at least 15 weeks healing from extraction and ARP, subjects were evaluated clinically for changes alveolar ridge height, width, and extent of keratinized tissue as measured by any shift in the mucogingival junction (MGJ) position. Eleven patients with twelve tooth sites met the inclusion criteria and completed the study. The loss of lingual alveolar width was significantly lower for the test suture group 0.51 ± 0.52 mm than the control suture group 1.58±0.81 mm (p=0.03). The loss of buccal height was significantly lower for the control group 0.07± 0.90 mm than test group 1.90±1.51 mm (p=0.04). In contrast, there was no significant difference between the test and control suture groups when comparing buccal alveolar width or lingual alveolar height. The mean change in MGJ position was -0.20±0.31 mm for the control group and -0.05±0.83 mm for the test group, but the difference was not statistically or clinically different. The results of this pilot study suggest that the choice of suture technique might influence the resultant lingual width and buccal height after ARP. Stronger evidence might be obtained in future studies through a larger scale clinical trial and by measuring alveolar changes by cone beam computed tomography (CBCT).