May, 2019 | Ridge preservation in molar extraction sites with an open-healing approach: A randomized controlled clinical trial

Ridge preservation in molar extraction sites with an open-healing approach: A randomized controlled clinical trial

Authors: Lim H-C et al.Journal: J Clin Periodontol. 2019DOI: 10.1111/jcpe.13184

🧪 Objective

To evaluate the clinical efficacy of alveolar ridge preservation (ARP) using an open-healing approach (without primary closure) in molar extraction sites, and assess its impact on subsequent implant placement success.

🧱 Methods

Three groups were compared:

• Test Group 1: DBBM-C (Bio-Oss® Collagen) + double-layer collagen membrane (Bio-Gide®)

• Test Group 2: DBBM-C only

• Control: Natural healing without ARP

Implants were placed after 4 months, and CBCT scans as well as histologic analyses were conducted.

🔍 Key Findings

• Significantly less horizontal bone resorption in Test Group 1 than control (e.g., HW1: −1.02 mm vs −4.44 mm, p < 0.05)

• Vertical ridge height at the midcrestal area was better preserved with the membrane (Test 1 vs Test 2: −0.25 mm vs −1.15 mm, p < 0.05)

• Stable marginal bone levels in all groups at 1-year follow-up

• 100% implant survival rate across all groups

• No adverse healing events despite open membrane exposure

🏁 Conclusion

Open-healing ridge preservation, especially when using both DBBM-C and a double-layer collagen membrane, effectively maintains ridge dimensions in molar sites and supports successful implant placement without requiring primary flap closure.

🌟 Clinical Implications for Luna® (Evertis SI) Implant System

The success of open-healing ARP in this study directly supports and enhances the clinical advantages of the Luna® (Evertis SI) implant system in the following ways:

✅ 1. Flapless, Graftless Protocol Compatibility

• This study confirms that ARP without flap closure maintains ridge integrity.

• Luna® implants, designed for minimally invasive flapless procedures, are ideally suited to such conditions, enhancing patient comfort and reducing chair time.

✅ 2. High Initial Stability in Preserved Sites

• Preserved ridges via ARP ensure optimal bone volume and quality for implant placement.

• Luna®'s progressive thread design and self-tapping apex maximize initial stability, especially critical in molar sites with high masticatory loads.

✅ 3. Avoidance of Additional Bone Grafting

• Test groups required no additional bone grafting at implant placement.

• This reflects predictable surgical outcomes when using Luna®, which can be placed safely and accurately in ridge-preserved sites with minimal surgical trauma.

✅ 4. Long-Term Marginal Bone Stability

• All implants, regardless of group, showed <0.5 mm marginal bone loss at 1 year.

• Luna®'s platform-switching and microgroove design are engineered to maintain peri-implant bone health, complementing such results in clinical practice.

✅ 5. Support for Posterior Sites

• The study specifically focused on molar sites, where bone remodeling risk is higher.

• Luna® offers a wide-diameter platform option (Ø4.0–Ø6.0) that supports immediate and delayed placement protocols in molar regions with preserved ridges.

  
  

🦷 Clinical Takeaway

The outcomes of this randomized controlled trial validate a flapless, open-healing approach as a reliable method for alveolar ridge preservation—especially in molar sites. When combined with the Luna® (Evertis SI) implant, clinicians can expect:

• Enhanced patient experience

• Efficient workflow

• Predictable long-term success

This synergy between evidence-based ARP techniques and advanced implant design like Luna® sets a new standard in modern implantology.

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