Management of Multiple Adjacent Extraction Sockets
Management of Compromised Adjacent Extraction Sockets Via Vestibular Socket Therapy Versus Early Contour Augmentation a Randomized Controlled Clinical Trial
British University In Egypt
32 participants
Jul 14, 2025
INTERVENTIONAL
Conditions
Summary
While early implant placement with guided bone regeneration (GBR) offers advantages, the desire for reduced treatment time and fewer surgical steps continues to drive the exploration of alternative approaches. In this context, the recent introduction of vestibular socket therapy (VST) presents an intriguing option. VST utilizes a minimally invasive tunnel access technique through the vestibular area to perform socket augmentation for immediate implant placement in compromised extraction sockets .
Eligibility
Inclusion Criteria2
- \- patients with two adjacent hopeless maxillary teeth or remaining roots in the esthetic region missing coronal tooth structure, type II socket (deficient labial plate of bone and intact overlying soft tissues), adequate palatal bone, ≥ 3 mm apical bone to engage the immediately placed implants, thereby achieving optimum primary stability (a minimum of 30 Ncm insertion torque) following teeth extraction.
- acceptable compliance and oral hygiene.
Exclusion Criteria2
- medically compromised patients. (Systemic diseases). general contraindication for implant placement. (Untreated periodontitis, severe bruxism , immunosuppression , uncontrolled diabetes , smokers , patients under radiation therapy, patients on bisphosphonate medications).
- \-
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Interventions
atraumatic extraction to the hopeless teeth will be performed using periotomes followed by conventional forceps under local anesthesia.A small incision (1 cm) is made on (vestibular area) near the base of the extracted teeth, extending slightly towards neighboring teeth.Using special instruments from the VST kit, the gum tissue is carefully dissected to expose the underlying bone and an immediate implant is placed using a surgical guide. the augmentation is done using A mixture of bone chips harvested from the surgical site (autogenous bone) and a bone-grafting material (deproteinized bovine bone mineral) is used to fill any gaps and support the implant, especially in the labial bone wall (labial plate). A special 0.6 mm thick membrane is inserted through the access incision. the vestibular incision is then sutured and the provisional is inserted.
Teeth extraction : minimally invasive adjacent teeth extraction under anesthesia using periotome and forceps. the empty sockets will be filled with a special collagen material (BioPlug) to aid healing for 4 to 8 weeks. flap elevation : a full-thickness flap will be carefully raised using a crestal incision extended one tooth mesial and distal to the extraction location, then connected with two vertical incisions extended through the sulcus forming a trapezoid flap. Implants Insertion: The two implant is then placed into the prepared sockets using surgical guide. Bone Grafting: Any bone deficiencies are addressed by grafting. This involves placing a layer of (autogenous bone) directly on the two implants' surface, followed by a layer of a bone-grafting material (Demineralized Bone Matrix). Membrane Placement: A double-layered collagen membrane is used to cover the grafted area. Flap Closure: The previously lifted flap is repositioned and sutured back in place.
Locations(1)
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NCT07063836