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

Abstract

Objectives To compare success rates between the sub‐periosteal prepared (SPP) muco‐periosteal flap and the epi‐periosteal (EPP) prepared 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 EPP group. The primary outcome was treatment failure 8 weeks after surgery. To assess the feasibility of alveoplasty, necrotic bone changes at the timepoint of tooth extraction were evaluated. Results 160 patients were randomized to the SSP (n=82) or the EPP (n=78) group. 157 patients met the primary endpoint 8 weeks after surgery with 5 treatment failures for the SPP group (6.3%) and 18 (23.4%) for the EPP group (p=0.004). A significant relationship (p<0.0001) 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.