Effect of Provisional Restorations with Ovate Pontics on Preservation of the Ridge after Tooth Extraction: Case Series.

OBJECTIVE: To evaluate the effect of provisional restorations using ovate pontics on the hard and soft tissues of the alveolar ridge after tooth extraction. METHODS: Patients with intact buccal bone after extraction of a maxillary incisor underwent a series of treatments. The protocol included tooth extraction and provisional restoration using ovate pontics. The outcomes were assessed 1, 3 and 6 months after the procedure, regarding changes in bone volume and soft tissue dimension. RESULTS: A total of 11 patients (6 female and 5 male) were treated using an ovate pontic provisional restoration after tooth extraction. After 6 months, bone loss at level 1, 3 and 5 mm below the most coronal section of the bone crest was 2.28 ± 0.53 mm, 1.51 ± 0.30 mm and 1.46 ± 0.41 mm, respectively. Changes in bone volume of these three levels were significantly lower (P < 0.01) than changes previously reported in the literature. The mesial and distal papillae recessed 0.47 ± 0.24 mm and 0.88 ± 0.57 mm, respectively, whereas the midfacial shrinkage was 0.86 ± 0.44 mm. The dimension of the ridge contour around the socket reduced mostly at 3 and 5 mm below the coronal section and the gingival mucosa, with values of 1.68 ± 0.48 mm and 1.61 ± 0.48 mm, respectively. CONCLUSION: Using a provisional restoration with ovate pontics after tooth extraction may preserve the alveolar ridge by sustaining the soft tissue, in particular the gingival papilla.

The relation of gingival thickness to dynamics of gingival margin position pre- and post-surgically.

BACKGROUND: To evaluate the gingival margin position (GMP) before and after open flap debridement in different gingival thickness (GT). MATERIALS AND METHODS: Twenty-seven healthy patients with moderate to advanced adult periodontitis were included in a randomized control clinical trial. A calibrated UNC-15 periodontal probe, an occlusal onlay stent was used for clinical measurements recorded at baseline, 3 month, 6 month, and 16 month. The changes in the GMP were studied at midbuccal (Mi-B), mesiobuccal (MB), and distobuccal sites. GT was measured presurgically, transgingivally at Mi-B and interdental sites, divided into 2 groups: Group 1 (thin) and Group 2 (thick). RESULTS: In GT of ≤1 mm group, the statistically significant apical shift of GMP led to gingival recession at all study sites in the early postsurgical period of 1 and 3 months. During 6 and 16 months, the apical shift of GMP coincided with the Chernihiv Airport at Mi-B site (6 months), MB site (16 months). The gingival recession was obvious at Mi-B sites (16 months). In the GT of >1 mm, the statistically significant apical shift of GMP did not cause gingival recession at any sites throughout postsurgical (1, 3, 6, and 16 months) period. CONCLUSION: Thin gingiva showed apical shift of GMP leading to gingival recession as compared to thick gingiva postsurgically.