Ridge-Preservation with a ribose-crosslinked porcine collagen membrane
Kauffmann FM1, Fickl S1
1 Department of Periodontology, Julius-Maximilians-University, Würzburg, Germany



Background
After tooth extraction remodelling processes of the extraction socket lead to a deficient bone volume in various cases. If implant placement is planned to reconstruct the edentulous areas, aesthetic problems are frequently seen. Especially in the anterior region these areas present a concave morphology and can lead to second stage surgery. Reducing the bone volume loss at the time of tooth extraction by means of immediate augmentation of the extraction socket (Socket-/Ridge Preservation) could help the surgeon to place the implant in a better position to avoid second stage surgery for the patient.

Aim/Hypothesis
It is known that volume loss after tooth extraction can be successfully reduced by Socket- and Ridge-Preservation techniques using a combination of bone substitutes covered with a punch graft from the palate. To avoid the second operation area, the author uses a slow-resorbing ribose-crosslinked porcine collagen membrane with comparable results.

Materials and Methods
After tooth extraction, the extraction socket was cleaned, filled with a bone substitute and covered with a slow resorbing ribose-crosslinked porcine collagen membrane (OSSIX® PLUS, REGEDENT GmbH, Dettelbach, Germany). No complete wound closure was performed. The membrane was exposed from the beginning. To guarantee a sufficient stabilization of the membrane for the healing period, the membrane was placed slightly underneath the elevated tissue. For suturing monofilament sutures were used (Seralene®, SERAG-WIESSNER GmbH & Co. KG, Naila, Germany). Sutures were removed after 7 days. After 5 months, the implant was placed. The surrounding tissue showed no inflammation or scars. Only a slight resorption was visible.

Results
During the ridge preservation procedure as well as during the implantation there were no complications. The membrane remained intact until full soft tissue closure. At reentry for implantation after 5 months, the texture of the membrane was still visible. This verifies the long resorption time of 4-6 months.

Conclusions
Ribose-Crosslinked porcine collagen membranes can be used for socket- as well as for ridge-preservation techniques. Due to the good clinical results, even after membrane exposure, the author considers the membrane as helpful and easy to use.