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With the goal of providing optimal care to patients, student-centered active learning and the development of clinical competency have become vital components of the education of future physicians capable of sustainably coping with future challenges. However, the shape of future medicine is dramatically changing based on advances in information and communication technology, and the current classroom model seems to have difficulties in fully preparing students for the future of medicine. New trends in teaching and assessment methods include computer-aided instruction, virtual patients, augmented reality, human patient simulations, and virtual reality for the assessment of students’ competency. The digital technologies introduced in medical and dental education include Google Forms to collect students’ answers, YouTube livestreaming, Google Art & Culture (an online art museum), and choose-your-own-adventure as a story-telling technique. Innovations in digital technology will lead the way toward a revolution in medical and dental education, allowing learning to be individualized, interactive, and efficient.
ABSTRACT
With the goal of providing optimal care to patients, student-centered active learning and the development of clinical competency have become vital components of the education of future physicians capable of sustainably coping with future challenges. However, the shape of future medicine is dramatically changing based on advances in information and communication technology, and the current classroom model seems to have difficulties in fully preparing students for the future of medicine. New trends in teaching and assessment methods include computer-aided instruction, virtual patients, augmented reality, human patient simulations, and virtual reality for the assessment of students’ competency. The digital technologies introduced in medical and dental education include Google Forms to collect students’ answers, YouTube livestreaming, Google Art & Culture (an online art museum), and choose-your-own-adventure as a story-telling technique. Innovations in digital technology will lead the way toward a revolution in medical and dental education, allowing learning to be individualized, interactive, and efficient.
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Purpose@#The various suture techniques can be utilized in order to maximize the keratinized tissue healing around dental implants. The aim of this study is to compare the soft tissue healing pattern between two different suture techniques after implant placement. @*Materials and Methods@#15 patients with 18 implants were enrolled in this study. Simple implant placement without any additional bone graft was performed. Two different suture techniques were used to tug in the mobilized flap near the healing abutment after paramarginal flap design. Digital intraoral scan was performed at baseline, post-operation, stitch out, and 3 months after operation. The scan data were aligned using multiple points such as cusp, fossa of adjacent teeth, and/or healing abutment. After subtracting scan data at baseline with other time-point results, closed space indicating volume increment of peri-implant mucosa was selected. The volume of the close space was measured in mm 3 . The volume between two suture techniques at three time-points was compared using nonparametric rank-based analysis. @*Results@#Healing was uneventful in both groups. Both suture technique groups showed increased soft tissue volume immediately after surgery. The amount of volume increment significantly decreased after 3 months (P 0.05). @*Conclusion@#After paramarginal flap reflection, the raised flaps stabilized by flap folding suture showed relatively higher volume maintenance after 3-month healing period. However, further studies are warranted.
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BACKGROUND/OBJECTIVES: The nutrition of the elderly depends on various factors. Oral health, especially oral dryness, can be an important risk factor. In this study, we attempted to determine whether dry mouth is associated with compromised nutrient intakes.SUBJECTS/METHODS: A total of 120 participants aged 65–86 yrs (mean age: 69 ± 1 y) were included in this study. Demographic and health-related characteristics, living status, meals, number of medications, medical conditions, chewing ability, and quality of life, the Oral Health Impact Profile (the OHIP-14) were assessed. We performed one day 24-hr recall assessment for nutrient analyses. The differences of the means between the dry-mouth and non-dry-mouth groups were analyzed. Elderly subjects with xerostomia-induced dry mouth were classified as those who reported at least one dryness symptom on a questionnaire.RESULTS: A significant difference in population distribution was observed among the elderly who took medications for hypertension, diabetes and osteoporosis and was significantly higher in the dry-mouth group (70.2%) than in the non-dry-mouth group (44.4%) (P = 0.005). Compared with the non-dry-mouth group (50.8%), a significantly higher proportion (73.7%) of participants in the dry-mouth group took multiple medicines (≥ 4 medications) (P = 0.019). The intakes of vegetable fat, vitamin E, folate and water in the dry-mouth group were lower than in the non-dry-mouth group. The intakes of fluoride and ω-3 fatty acids were significantly lower in the dry-mouth group than in the non-dry-mouth group.CONCLUSION: The participants in the dry-mouth group exhibited low nutrient and water intakes. It is recommended that the elderly with dry mouth should drink sufficient water and receive targeted and specific nutritional guidance to prevent malnutrition.
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Purpose@#After periodontal surgery, studies have found that the use of periodontal wound dressing reduces the risk of wound infection and increases healing. The purpose of this study is to evaluate the effect of attachable periodontal wound dressing on the healing and patient satisfaction after periodontal flap surgery. @*Materials and Methods@#Twenty-eight patients requiring periodontal surgery underwent periodontal flap surgery on both quadrants of maxilla or mandible. Postoperative pain, bleeding, dietary discomfort and hypersensitivity in relation to attachable periodontal wound dressing was assessed using Visual Analogue Scale (VAS). Additional survey on frequency of burning sensation and overall satisfaction rates were assessed. @*Results@#VAS mean values for pain, bleeding, and dietary discomfort depending on the presence and absence of attachable wound dressing were; pain: 2.82, 3.96 (P = 0.002), bleeding: 1.61, 2.54 (P = 0.008), dietary discomfort: 2.82, 4.18 (P < 0.001), respectively. Test groups with attachable wound dressing reported significantly lower rates of discomfort. No significant difference was observed in burning sensation and hypersensitivity related with wound dressing. Satisfaction was higher in 75% of patients who received wound dressing. @*Conclusion@#According to the results of this study, patients who received attachable periodontal wound dressing reported less postoperative pain, bleeding, and dietary discomfort. There was no statistical significance related to the use of wound dressing with burning sensation and hypersensitivity.
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Purpose@#This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. @*Methods@#Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. @*Results@#In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation.Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. @*Conclusions@#Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
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Purpose@#The aim of this study was to determine the impact of different compressive forces on deproteinized bovine bone mineral (DBBM) particles covered by native bilayer collagen membrane (NBCM) during alveolar ridge preservation (ARP) in the molar area, and to identify any histomorphometric and clinical differences according to the compressive force applied. @*Methods@#Sockets were filled with DBBM after tooth extraction, and different compressive forces (30 N and 5 N, respectively) were applied to the graft material in the test (30 N) and control (5 N) groups. The DBBM in both groups was covered with NBCM in a double-layered fashion. A crossed horizontal mattress suture (hidden X) was then made. A core biopsy was performed using a trephine bur without flap elevation at the implant placement site for histomorphometric evaluations after 4 months. The change of the marginal bone level was measured using radiography. @*Results@#Twelve patients completed the study. The histomorphometric analysis demonstrated that the mean ratios of the areas of new bone, residual graft material, and soft tissue and the implant stability quotient did not differ significantly between the groups (P>0.05). However, the mean size of the residual graft material showed a significant intergroup difference (P<0.05). @*Conclusions@#The application of 2 compressive forces (5 N, 30 N) on particulate DBBM grafts during open-healing ARP in the posterior area led to comparable new bone formation, implant feasibility and peri-implant bone level.
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Purpose@#After periodontal surgery, studies have found that the use of periodontal wound dressing reduces the risk of wound infection and increases healing. The purpose of this study is to evaluate the effect of attachable periodontal wound dressing on the healing and patient satisfaction after periodontal flap surgery. @*Materials and Methods@#Twenty-eight patients requiring periodontal surgery underwent periodontal flap surgery on both quadrants of maxilla or mandible. Postoperative pain, bleeding, dietary discomfort and hypersensitivity in relation to attachable periodontal wound dressing was assessed using Visual Analogue Scale (VAS). Additional survey on frequency of burning sensation and overall satisfaction rates were assessed. @*Results@#VAS mean values for pain, bleeding, and dietary discomfort depending on the presence and absence of attachable wound dressing were; pain: 2.82, 3.96 (P = 0.002), bleeding: 1.61, 2.54 (P = 0.008), dietary discomfort: 2.82, 4.18 (P < 0.001), respectively. Test groups with attachable wound dressing reported significantly lower rates of discomfort. No significant difference was observed in burning sensation and hypersensitivity related with wound dressing. Satisfaction was higher in 75% of patients who received wound dressing. @*Conclusion@#According to the results of this study, patients who received attachable periodontal wound dressing reported less postoperative pain, bleeding, and dietary discomfort. There was no statistical significance related to the use of wound dressing with burning sensation and hypersensitivity.
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Purpose@#This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. @*Methods@#Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. @*Results@#In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation.Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. @*Conclusions@#Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
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Osseointegration has been reported to be a dynamic process in which the alveolar bone comes in direct contact with the implant. Various methods were tried to evaluate degree of osseointegration and the measurement of bone-implant contact (BIC) have been commonly used among them. To properly assess the BIC, only histologic analysis is available. However, few studies evaluated BIC of successfully osseointegrated implants in humans. Thus, this is a unique opportunity when implants should be explanted due to inappropriate positioning of implant, presence of pain or sensory disturbance, or broken screw or fixture. This report presents a case of the implant underwent 3-year functional load and a histologic analysis after the fixture fracture. The histomorphometric analysis revealed 53.1% of BIC measured along the whole implant and 70.9% measured only in subcrestal area, respectively. In the present study, although the implant was fractured, a high degree of BIC was observed.
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PURPOSE: The aim of this retrospective study was to determine the prevalence of early implant failure using a single implant system and to identify the factors contributing to early implant failure. METHODS: Patients who received implant treatment with a single implant system (Luna®, Shinhung, Seoul, Korea) at Dankook University Dental Hospital from 2015 to 2017 were enrolled. The following data were collected for analysis: sex and age of the patient, seniority of the surgeon, diameter and length of the implant, position in the dental arch, access approach for sinus-floor elevation, and type of guided bone regeneration (GBR) procedure. The effect of each predictor was evaluated using the crude hazard ratio and the adjusted hazard ratio (aHR) in univariate and multivariate Cox regression analyses, respectively. RESULTS: This study analyzed 1,031 implants in 409 patients, who comprised 169 females and 240 males with a median age of 54 years (interquartile range [IQR], 47–61 years) and were followed up for a median of 7.2 months (IQR, 5.6–9.9 months) after implant placement. Thirty-five implants were removed prior to final prosthesis delivery, and the cumulative survival rate in the early phase at the implant level was 95.6%. Multivariate regression analysis revealed that seniority of the surgeon (residents: aHR=2.86; 95% confidence interval [CI], 1.37–5.94) and the jaw in which the implant was placed (mandible: aHR=2.31; 95% CI, 1.12–4.76) exerted statistically significant effects on early implant failure after adjusting for sex, age, dimensions of the implant, and type of GBR procedure (preoperative and/or simultaneous) (P<0.05). CONCLUSIONS: Prospective studies are warranted to further elucidate the factors contributing to early implant failure. In the meantime, surgeons should receive appropriate training and carefully select the bone bed in order to minimize the risk of early implant failure.
Subject(s)
Female , Humans , Male , Bone Regeneration , Dental Arch , Dental Implants , Jaw , Osseointegration , Prevalence , Prospective Studies , Prostheses and Implants , Retrospective Studies , Risk Factors , Seoul , Surgeons , Surgical Procedures, Operative , Survival RateABSTRACT
PURPOSE: The purpose of present study was to retrospectively analyze the survival rate of narrow diameter implant less than 3.6 mm by initial stability and radiographic measurements. MATERIALS AND METHODS: In total, 24 patients who received 38 narrow diameter implants (≤ 3.6 mm in diameter, ≥ 7 mm in length) were enrolled in this retrospective study. The cumulative survival rate was calculated and various factors were investigated according to the implant platform diameter, body diameter, length, position, concomitant use of guided bone regeneration in implant placement and final prosthesis type. Initial stability was investigated with implant stability quotient (ISQ) value. The mesial and distal marginal bone level (MBL) change was calculated with radiography. RESULTS: The overall survival rate was 92.11%. Mean ISQ value and MBL change of survival implants was 66.26 and 0.14 ± 0.31 mm, respectively. None of the implants with platform diameters larger than the body diameter failed. CONCLUSION: In conclusion, the findings of present study suggest that narrow diameter implant could be predictable treatment in narrow alveolar ridge.
Subject(s)
Humans , Alveolar Process , Bone Regeneration , Prospective Studies , Prostheses and Implants , Radiography , Retrospective Studies , Survival RateABSTRACT
PURPOSE@#The aim of this study was to confirm the applicability of YouTube as a delivery platform of lecture videos for dental students and to assess their learning attitudes towards the flipped classroom model.@*METHODS@#Learning experiences after using the YouTube platform to deliver preliminary video lectures in a flipped classroom were assessed by 69 second-year students (52 males, 17 females) at Dankook University College of Dentistry, Korea, who attended periodontology lectures during 2 consecutive semesters of the 2016 academic year. The instructor uploaded the lecture videos to YouTube before each class. At the end of the second semester, the students were surveyed using a questionnaire devised by the authors.@*RESULTS@#Of the students, 53 (76.8%) always watched the lecture before the class, 48 (69.6%) used their smartphones, and 66 (95.7%) stated that they watched the lectures at home. The majority of the students replied that the video lectures were easier to understand than face to face lectures (82.6%) and that they would like to view the videos again after graduation (73.9%).@*CONCLUSION@#Our results indicate that YouTube is an applicable platform to deliver video lectures and to expose students to increased learning opportunities.
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PURPOSE: The aim of this study was to confirm the applicability of YouTube as a delivery platform of lecture videos for dental students and to assess their learning attitudes towards the flipped classroom model. METHODS: Learning experiences after using the YouTube platform to deliver preliminary video lectures in a flipped classroom were assessed by 69 second-year students (52 males, 17 females) at Dankook University College of Dentistry, Korea, who attended periodontology lectures during 2 consecutive semesters of the 2016 academic year. The instructor uploaded the lecture videos to YouTube before each class. At the end of the second semester, the students were surveyed using a questionnaire devised by the authors. RESULTS: Of the students, 53 (76.8%) always watched the lecture before the class, 48 (69.6%) used their smartphones, and 66 (95.7%) stated that they watched the lectures at home. The majority of the students replied that the video lectures were easier to understand than face to face lectures (82.6%) and that they would like to view the videos again after graduation (73.9%). CONCLUSION: Our results indicate that YouTube is an applicable platform to deliver video lectures and to expose students to increased learning opportunities.
Subject(s)
Humans , Male , Dentistry , Education, Dental , Educational Technology , Korea , Learning , Lecture , Republic of Korea , Smartphone , Students, DentalABSTRACT
PURPOSE: Nonsteroidal anti-inflammatory drugs that prohibit biosynthesis of arachidonic acid metabolites have been considered potent host modulation agents. The aim of this review was to determine the effect of nonsteroidal anti-inflammatory drugs adjunctive with nonsurgical periodontal treatment in patients with periodontal disease. MATERIALS AND METHODS: Three electronic databases were searched to identify relevant studies. The methodological quality and mean differences of the change in clinical attachment level and probing depth were analyzed according to Cochrane review methods. RESULTS: Twelve studies were included in the methodological assessment and nine studies were suitable for inclusion in the meta-analysis. The mean difference in the clinical attachment level gain did not differ significantly between the nonsteroidal anti-inflammatory drugs and control groups at any observation time. The highest mean difference in clinical attachment level gain was 0.30 mm at 4 weeks (95% confidence interval = -0.37 to 0.97). There was a significant mean difference in the probing depth reduction, of 0.34 mm (95% confidence interval = 0.29 to 0.40) at 6 weeks. CONCLUSION: Therefore, nonsteroidal anti-inflammatory drugs have additional therapeutic effect when administrated with nonsurgical periodontal treatment.
Subject(s)
Humans , Anti-Inflammatory Agents , Arachidonic Acid , Drug Therapy , Periodontal Diseases , ProstaglandinsABSTRACT
PURPOSE: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. METHODS: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. RESULTS: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were −1.7±0.5 mm in the SL group and −1.8±0.4 mm in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. CONCLUSIONS: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.
Subject(s)
Humans , Alveolar Process , Bone Regeneration , Collagen , Cone-Beam Computed Tomography , Dental Implants , Membranes , Miners , Molar , Pilot Projects , Prospective Studies , Tooth , Tooth Extraction , Transplants , Vertical DimensionABSTRACT
Patient management is considered an important factor in dental field. The aim of this review is to analyze the efficacy of hypnosis to treat fear, anxiety, pain, stress of dental patients, and see how it can be adopted in dentistry for improving patient satisfaction. Medline research was carried out to find the use of hypnosis in dentistry and other aspects of hypnosis in medical area. It can help patient more comfortable, relax, and accordingly reduce patient's negative feelings such as fear, anxiety, pain, stress during dental treatment. Also, it affects patient recovery after surgery by accelerating healing speed and reinforce immune system. When hypnosis is used with other anesthetic method, it can reduce the use of main medication, leading to reduce possibility of side effect. Therefore, using Hypnosis can give patients more comfortable dental experience, both mentally and physically, ultimately making patients more satisfied with the dental treatment.
Subject(s)
Humans , Anxiety , Dentistry , Hypnosis , Immune System , Methods , Patient SatisfactionABSTRACT
PURPOSE: Following tooth extraction, alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. Although previous studies have demonstrated the effects of ARP, few if any studies have investigated the compressive force applied during grafting. The aim of this study was to determine the effects of different compressive forces on the graft materials during ARP. METHODS: After tooth extraction, sockets were filled with deproteinized bovine bone mineral with 10% porcine collagen and covered by a resorbable collagen membrane in a double-layered fashion. The graft materials were compressed using a force of 5 N in the test group (n=12) and a force of 30 N in the control group (n=12). A hidden X suture was performed to secure the graft without primary closure. Cone-beam computed tomography (CBCT) was performed immediately after grafting and 4 months later, just before implant surgery. Tissue samples were retrieved using a trephine bur from the grafted sites during implant surgery for histologic and histomorphometric evaluations. Periotest values (PTVs) were measured to assess the initial stability of the dental implants. RESULTS: Four patients dropped out from the control group and 20 patients finished the study. Both groups healed without any complications. The CBCT measurements showed that the ridge volume was comparably preserved vertically and horizontally in both groups (P>0.05). Histomorphometric analysis demonstrated that the ratio of new bone formation was significantly greater in the test group (P0.05). CONCLUSIONS: The application of a greater compressive force on biomaterials during ARP significantly enhanced new bone formation while preserving the horizontal and vertical dimensions of the alveolar ridge. Further studies are required to identity the optimal compressive force for ARP.
Subject(s)
Humans , Alveolar Bone Grafting , Alveolar Process , Alveolar Ridge Augmentation , Biocompatible Materials , Collagen , Cone-Beam Computed Tomography , Dental Implants , Membranes , Miners , Osteogenesis , Sutures , Tooth Extraction , Transplants , Vertical DimensionABSTRACT
PURPOSE: The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. METHODS: The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. RESULTS: During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. CONCLUSIONS: Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing.
Subject(s)
Adult , Animals , Dogs , Humans , Bicuspid , Bone Marrow , Connective Tissue , Debridement , Fibrin , Granulation Tissue , Ligation , Microscopy, Electron, Scanning , Models, Biological , Osteogenesis , Pathology , Periodontal Ligament , Radiography , Tooth , Wound Healing , Wounds and InjuriesABSTRACT
PURPOSE: The present study investigated the impact of 2 different suture techniques, the conventional crossed mattress suture (X suture) and the novel hidden X suture, for alveolar ridge preservation (ARP) with an open healing approach. METHODS: This study was a prospective randomized controlled clinical trial. Fourteen patients requiring extraction of the maxillary or mandibular posterior teeth were enrolled and allocated into 2 groups. After extraction, demineralized bovine bone matrix mixed with 10% collagen (DBBM-C) was grafted and the socket was covered by porcine collagen membrane in a double-layer fashion. No attempt to obtain primary closure was made. The hidden X suture and conventional X suture techniques were performed in the test and control groups, respectively. Cone-beam computed tomographic (CBCT) images were taken immediately after the graft procedure and before implant surgery 4 months later. Additionally, the change in the mucogingival junction (MGJ) position was measured and was compared after extraction, after suturing, and 4 months after the operation. RESULTS: All sites healed without any complications. Clinical evaluations showed that the MGJ line shifted to the lingual side immediately after the application of the X suture by 1.56±0.90 mm in the control group, while the application of the hidden X suture rather pushed the MGJ line slightly to the buccal side by 0.25±0.66 mm. It was demonstrated that the amount of keratinized tissue (KT) preserved on the buccal side was significantly greater in the hidden X suture group 4 months after the procedure (P<0.05). Radiographic analysis showed that the hidden X suture had a significant effect in preserving horizontal width and minimizing vertical reduction in comparison to X suture (P<0.05). CONCLUSIONS: Our study provided clinical and radiographic verification of the efficacy of the hidden X suture in preserving the width of KT and the dimensions of the alveolar ridge after ARP.