Ridge Preservation In Periodontally Compromised Maxillary Molar Sockets

This retrospective clinical study aimed to investigate the effects of micro crestal flap-alveolar ridge preservation (MCF-ARP) following maxillary molar extraction in patients with severe periodontitis. A total of 95 maxillary molars from 80 patients were included, with the teeth extracted and then either left to heal naturally or treated with MCF-ARP before implant placement. Changes in bone height, bone width, and maxillary sinus pneumatization were evaluated using imaging. Additionally, the proportion of patients requiring bone augmentation surgery during implant placement was recorded. After healing, the bone height at the center of the alveolar socket increased by 4.94 mm in the MCF-ARP group and 2.20 mm in the natural healing group. The bone width 1 mm below the crest of the ridge increased by about 4 mm in the MCF-ARP group, while it decreased by about 1 mm in the natural healing group. The maxillary sinus pneumatization was (0.50 ± 0.35) mm in the natural healing group compared to (0.23 ± 0.44) mm in the MCF-ARP group (P=0.003). The proportion of patients requiring bone augmentation during implant placement was 67.6% in the natural healing group compared to 29.5% in the MCF-ARP group. In patients with severe periodontitis, MCF-ARP can improve alveolar bone height and width, as well as reduce maxillary sinus pneumatization. This technique decreases the need for bone augmentation surgery during implant placement, thereby reducing the trauma and complexity of the implant procedure.