Conventional extraction vs. enucleation in anterior maxillary sites: a pilot study in humans

Abstract

Abstract: Background: Surgical extraction of ankylosed roots may cause severe defects of the alveolar crest. The aim of the present study was to determine the effects of flapless enucleation on the frequency of osteotomy and the maintenance of the alveolar crest width. Method: Ten patients (3 m, 7 f) requiring extractions in the anterior maxil- lary zone were included and randomly treated with conventional extraction and flapless microsurgical enucleation; osteotomy served as rescue technique in both groups. Socket preservation was performed using in situ hardening TCP bone substitute. Results: In the extraction group, 4/10 patients required osteotomy, in the enucleation group 0/10 (P<0.05, chi-square test). The alveolar widths 3 mm below the gingiva before surgery, at 3 and 6 months were 11.50, 8.98, and 9.50 mm in the extraction group and 12.25, 11.35, and 11.25 mm in the enucleation group, re- spectively. Two of 10 control sites and 0 of 10 test sites required augmentation for implant placement. Conclusion: Flapless enucleation combined with socket preservation appears to provide adequate maintenance of alveolar structures for implant placement and may be an alternative for surgical extraction in ankylosed anterior maxillary sites.