Graduation Date

Summer 8-11-2023

Document Type

Thesis

Degree Name

Master of Science (MS)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Amy Killeen, DDS MS

Abstract

The purpose of this prospective cohort pilot study was to determine if initial periodontal inflammation limits healing outcomes after tooth extraction, specifically in terms of reduced periodontal attachment on adjacent teeth and changes in radiographic bone quantity and quality. Additionally, the study sought to explore correlations between patients with high body mass index and post-extraction healing outcomes. The study enrolled nine patients at the University of Nebraska Medical Center College Of Dentistry who required the extraction of a posterior tooth due to advanced periodontal bone loss, non-restorable caries, or root fracture. Prior to extraction, a limited field cone beam CT (CBCT), body mass index (BMI), medical history, baseline periodontal indices including periodontal probing depth (PPD), recession (REC), relative clinical attachment level (CAL), and bleeding on probing (BOP) were recorded on the tooth to be extracted as well as adjacent teeth. Patients were then placed into periodontitis and non-periodontitis groups based on initial clinical indices. Routine atraumatic tooth extraction was performed under local anesthesia. Clinical and radiographic assessments were conducted at baseline and three months after extraction to compare healing outcomes between the groups. Horizontal and vertical residual ridge dimensional changes were assessed using CBCT images. Soft tissue dimensional changes were assessed by evaluating changes in the periodontal indices of adjacent teeth. Residual ridge and soft tissue dimensional changes occurred in both groups of patients, periodontitis and non-periodontitis, following tooth extraction. For residual ridge changes, there were statistically significant differences noted in the horizontal dimension at the apical aspect of the extraction socket nine millimeters from the osseous crest when comparing groups, periodontitis and non-periodontitis, with greater change noted in the non-periodontitis group (p= 0.03). In the coronal aspect of the socket, horizontal residual ridge dimensional changes approached statistical significance one millimeter and six millimeters from the osseous crest, with greater change noted in the non-periodontitis group (p=0.08 and p=0.06, respectively). Radiographic density measurements approached statistical significance in the tangential view (p=0.06), with less radiographic density noted in the periodontitis group. For soft tissue dimensional changes, there were no statistically significant differences noted between the two groups. There were no statistically significant correlations that could be drawn between patients with high pre-operative body mass index and post-extraction healing outcomes. Following tooth extraction, soft tissue, and residual ridge dimensional changes occur during the first three months.

Comments

2023 Copyright, the authors

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