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Randomized Controlled Trial
. 2021 Apr;27(3):532-546.
doi: 10.1111/odi.13556. Epub 2020 Aug 10.

Wound closure and alveoplasty after preventive tooth extractions in patients with antiresorptive intake-A randomized pilot trial

Oliver Ristow  1 , Thomas Rückschloß  1 , Julius Moratin  1 , Michael Müller  1 , Reinald Kühle  1 , Horn Dominik  2 , Maximilian Pilz  3 , Veronika Shavlokhova  1 , Sven Otto  4 , Jürgen Hoffmann  1 , Christian Freudlsperger  1
Affiliations
Randomized Controlled Trial

Wound closure and alveoplasty after preventive tooth extractions in patients with antiresorptive intake-A randomized pilot trial

Oliver Ristow et al. Oral Dis. 2021 Apr.

Abstract

Objectives: To compare success rates between the sub-periosteal prepared (SPP) muco-periosteal flap and the epi-periosteal prepared (EPP) mucosa flap and the feasibility of alveoplasty after surgical tooth extractions in patients undergoing/after antiresorptive treatment.

Subjects: Patients with an indication for preventive tooth extraction undergoing/after antiresorptive treatment were enrolled over a 24-month period in a parallel-group randomized clinical pilot trial and randomly assigned for primary wound closure to either the SPP or the EPP group. The primary outcome was treatment failure 8 weeks after surgery. To assess the feasibility of alveoplasty, necrotic bone changes at the time point of tooth extraction were evaluated.

Results: One hundred and sixty patients were randomized to the SSP (n = 82) or the EPP (n = 78) group. One hundred and fifty-seven patients met the primary endpoint 8 weeks after surgery with five treatment failures for the SPP group (6.3%) and 18 (23.4%) for the EPP group (p = .004). A significant relationship (p < .0001) was observed between symptomatic teeth and non-vital bone found in 54.8% of all biopsies.

Conclusions: The strong superiority of the muco-periosteal flap as primary wound closure revealed the feasibility and effectiveness of the study. The large number of necrotic biopsies emphasizes the importance of alveoplasty as a preventive measure.

Keywords: BRONJ; MRONJ; alveoplasty; medication-related osteonecrosis of the jaw; prevention; tooth extraction; wound closure.

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References

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