Rotary Versus Manual Degranulation in Alveolar Ridge Preservation
Efficacy of Manual Versus Rotary Degranulation Techniques on Clinical and Radiographic Outcomes of Alveolar Ridge Preservation: Randomized Clinical Trial
Imam Abdulrahman Bin Faisal University
60 participants
Jun 1, 2026
INTERVENTIONAL
Conditions
Summary
After a tooth is taken out, the empty socket needs to heal. Sometimes unhealthy soft tissue (called granulation tissue) is left behind and can slow down healing. This study compares two ways to clean the socket: 1. Manual method: a hand instrument (curette) 2. Rotary method: a small rotating dental bur Both methods are standard in dental practice. The study will see which method is faster, causes less pain, and leads to better bone healing. After cleaning, all patients will receive a routine bone graft to protect the jawbone for a possible future dental implant. The study will measure: * How long (in seconds) it takes to clean the socket * Whether the socket is completely clean, checked with a harmless blue stain (Toluidine Blue) * Changes in the bone at 3 and 6 months, measured by a special three-dimensional X-ray (cone-beam computed tomography, CBCT) * Pain and swelling reported by patients in the first week after the procedure * Any side effects or healing problems Patients are randomly assigned to one of the two cleaning methods (like flipping a coin). The surgeon knows which method is used, but the person analyzing the X-rays does not, to keep the results fair. The study will include 58-60 adult patients who need a tooth removed because of a long-term infection at the root. It is being conducted at the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Eligibility
Inclusion Criteria5
- Patients will be recruited from those attending the outpatient clinics of the College of Dentistry.
- Systemically healthy adults aged 18-65 years who present with teeth indicated for extraction due to chronic periapical pathology (e.g., periapical granuloma or cystic lesion) confirmed clinically and radiographically.
- All cases must be verified with a tooth-specific, limited field-of-view cone-beam computed tomography (CBCT) scan to minimize radiation exposure and to demonstrate the presence of periapical pathology with intact socket walls and sufficient residual alveolar bone to allow for ridge preservation.
- Only teeth with single or multi-rooted lesions indicated for atraumatic extraction without excessive bone removal will be considered.
- Participants must also be capable of providing informed consent, demonstrate adequate oral hygiene, and be willing to return for scheduled follow-up visits.
Exclusion Criteria10
- Acute odontogenic infection at the extraction site.
- Thin buccal bone (< 1mm on CBCT).
- Severe periodontal breakdown with more than 50% bone loss.
- Grade III mobility.
- Root morphology that limits instrument accessibility.
- Uncontrolled systemic diseases (e.g., diabetes, immunocompromised status).
- Pregnant or lactating women.
- Medications known to affect bone metabolism such as long-term corticosteroids or bisphosphonates.
- Self-reported or documented allergy to penicillin or amoxicillin.
- Poor oral hygiene, inability to maintain adequate postoperative care, or unwillingness to attend scheduled follow-up visits.
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Interventions
Degranulation of the extraction socket using a 2.5mm super coarse diamond bur at 1000-1200 RPM, followed by standardized alveolar ridge preservation with allograft and collagen membrane.
Degranulation of the extraction socket using a #85 Lucas surgical curette 2.5mm, followed by standardized alveolar ridge preservation with allograft and collagen membrane.
Locations(1)
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NCT07607314