J Periodontol. 2011 Mar;82(3):377-87. doi: 10.1902/jop.2010.090342. Epub 2010 Nov 2.
The aim of this single-masked, randomized controlled clinical trial is to compare hard and soft tissue changes after ridge preservation performed with (control, RPc) and without (test, RPe) primary soft tissue closure in a split-mouth design.
Eleven patients completed this 6-month trial. Extraction and ridge preservation were performed using a composite bone graft of inorganic bovine-derived hydroxyapatite matrix and cell binding peptide P-15 (ABM/P-15), demineralized freeze-dried bone allograft, and a copolymer bioabsorbable membrane. Primary wound closure was achieved on the control sites (RPc), whereas test sites (RPe) left the membrane exposed. Pocket probing depth on adjacent teeth, repositioning of the mucogingival junction, bone width, bone fill, and postoperative discomfort were assessed. Bone cores were obtained for histological examination.
Intragroup analyses for both groups demonstrated statistically significant mean reductions in probing depth (RPc: 0.42 mm, P = 0.012; RPe: 0.25 mm, P = 0.012) and bone width (RPc: 3 mm, P = 0.002; RPe: 3.42 mm, P <0.001). However, intergroup analysis did not find these parameters to be statistically different at 6 months. The test group showed statistically significant mean change in bone fill (7.21 mm; P <0.001). Compared to the control group, the test group showed statistically significant lower mean postoperative discomfort (RPc 4 versus RPe 2; P = 0.002). Histomorphometric analysis showed presence of 0% to 40% of ABM/P-15 and 5% to 20% of new bone formation in both groups. Comparison of clinical variables between the two groups at 6 months revealed that the mucogingival junction was statistically significantly more coronally displaced in the control group than in the test group, with a mean of 3.83 mm versus 1.21 mm (P = 0.002).
Ridge preservation without flap advancement preserves more keratinized tissue and has less postoperative discomfort and swelling. Although ridge preservation is performed with either method, ≈27% to 30% of bone width is lost.
本单盲、随机对照临床试验旨在比较在分瓣设计中使用（对照组，RPc）和不使用（实验组，RPe）原发性软组织关闭进行牙槽嵴保存后的硬组织和软组织变化。
11 名患者完成了这项 6 个月的试验。使用无机牛源羟磷灰石基质和细胞结合肽 P-15（ABM/P-15）、脱矿冻干骨同种异体移植物和共聚物生物可吸收膜的复合骨移植进行拔牙和牙槽嵴保存。在对照组（RPc）上实现了原发性伤口闭合，而实验组（RPe）则使膜暴露在外。评估相邻牙齿的牙周袋探诊深度、龈乳头位置、骨宽度、骨填充和术后不适。获取骨芯进行组织学检查。
两组的组内分析均显示探诊深度（RPc：0.42mm，P=0.012；RPe：0.25mm，P=0.012）和骨宽度（RPc：3mm，P=0.002；RPe：3.42mm，P<0.001）的均值均有统计学显著降低。然而，组间分析在 6 个月时并未发现这些参数存在统计学差异。实验组的骨填充均值变化具有统计学意义（7.21mm；P<0.001）。与对照组相比，实验组术后不适的均值显著较低（RPc 为 4，RPe 为 2；P=0.002）。组织形态计量学分析显示，两组均有 0%至 40%的 ABM/P-15 和 5%至 20%的新骨形成。6 个月时两组临床变量的比较显示，对照组龈乳头位置明显更向冠方移位，平均为 3.83mm，而实验组为 1.21mm（P=0.002）。
不进行瓣推进的牙槽嵴保存可保留更多的角化组织，且术后不适和肿胀程度较轻。尽管使用任一种方法进行牙槽嵴保存，但仍有约 27%至 30%的骨宽度丢失。
