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Randomized Controlled Trial
. 2021 Jun;23(3):309-316.
doi: 10.1111/cid.12991. Epub 2021 Mar 8.

The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial

Aleksandra Križaj Dumić  1 , Franja Pajk  2 , Giovanni Olivi  3   4
Affiliations
Randomized Controlled Trial

The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial

Aleksandra Križaj Dumić et al. Clin Implant Dent Relat Res. 2021 Jun.

Abstract

Background: Post-extraction bone resorption may affect the outcome of ensuing restorations.

Purpose: This study aimed to evaluate a comprehensive laser post-extraction protocol by comparing resulting alveolar bone regeneration with that obtained after standard extraction procedure.

Materials and methods: About 53 simple extractions were randomized to either laser or control group. In the laser group, erbium (Er:YAG; 2940 nm) and neodymium (Nd:YAG; 1064 nm) lasers were used for degranulation, disinfection, de-epithelialization of the surrounding gingiva, clot stabilization, and photobiomodulation. The primary outcome measure was change in bone density in the extraction area between day 1 and 4 months after extraction. Patients were monitored for potential side effects.

Results: Increase in bone density at the follow-up CBCT was significantly higher in laser than in control group (p < 0.001). No post-operative pain, bleeding, or swelling was present in the laser group. In the control group, one patient had bleeding 3-5 days after extraction, two patients had swelling and three patients reported post-operative pain rated 3-5 on a 0-10 pain scale up to 3 days after extraction.

Conclusions: The proposed laser post-extraction procedure is a safe and effective method to improve post-extraction bone healing.

Keywords: CBCT; alveolar preservation; bone density; laser post-extraction procedure.

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Conflict of interest statement

Dr. Pajk has nothing to disclose. Dr. Križaj Dumić has nothing to disclose. Prof. Dr. Olivi has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Laser post‐extraction procedure: (A) Er:YAG degranulation, (B) Nd:YAG disinfection, (C) Er:YAG de‐epithelialization, and (D) Nd:YAG clot stabilization
FIGURE 2
FIGURE 2
Nd:YAG photobiomodulation with intra‐oral angular adapter; oral (A) and vestibular (B)
FIGURE 3
FIGURE 3
Trial flow‐chart. Three patients with multiple extractions had teeth in both groups
FIGURE 4
FIGURE 4
Female, 56 years old, extraction of 45 and 47 due to chronic periodontitis. Laser post‐extraction procedure was used. CBCT scan 1 day after extraction (A) and at for month follow up (B)
FIGURE 5
FIGURE 5
Same patient as Figure 4, extraction of 18 due to chronic periodontitis. Standard extraction procedure was used. CBCT scan 1 day after extraction (A) and at for month follow up (B)
FIGURE 6
FIGURE 6
A, Change in gray scale values (GSV) between CBCT 1 day after extraction and at 4 months follow‐up. Individual observations are represented by symbols. The dotted line with error bar represents mean and standard deviation. B, Relationship between GSV of initial (CBCT1) and follow‐up CBCT scan (CBCT2). C, Relationship between change in GSV and patient age. While bone healing appears to decrease with age in the control group (dotted line) it remains constant in the laser group (solid line). D, Change in GSV according to indication for extraction; chronical periodontitis (Perio), apical granuloma (Gran), vertical or horizontal root fracture or radix relicta (Root), or caries profunda (Caries). Symbols as in (A)
See this image and copyright information in PMC

References

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