Effect of two methods of soft tissue augmentation for socket closure on soft tissue landmarks and ridge dimensions- Results from software-based analysis of clinical data

PurposeThe aim of this study was to evaluate the effect of connective tissue grafts (CTG) and pediculated connective tissue grafts (P-CTG) for extraction socket closure on soft tissue landmarks and ridge dimensions. Methods45 subjects were randomized into two groups, where the soft tissue closure of extraction sockets was done by pediculated connective tissue grafts (P-CTG group) and connective tissue grafts (CTG group). On photographs taken at different time-points, four markers corresponding to marginal gingiva (MG), mucogingival junction (MGJ), mesial papilla (MP) and distal papilla (DP) were placed. After image alignment and stacking, the markers were tracked through five photographs taken during the course of the therapy. The displacement, total displacement (TD), divergence and angle of maximum divergence (AMD) for each marker were recorded. Buccolingual and mesiodistal dimensions of edentulous sites were measured, and the difference from the baseline to 6-months in both the dimensions was calculated and was described as buccolingual gain (BL gain) and mesiodistal gain (ML gain) respectively. ResultsIntergroup comparison of displacement and divergence of markers across both the groups showed varying levels of significance. P-CTG resulted in higher buccolingual dimensions at 3 months (P=0.001) and 6 months (P=0.002) when compared to the CTG group. From baseline to 6-months, the BL and MD gains were 2.82{+/-}1.29mm & 1.68{+/-}1.12mm and 1.27{+/-}0.65mm & 1.48{+/-}0.67mm in P-CTG and CTG group respectively. In the P-CTG group, TD (r=0.4; P=0.001) & AMD (r=0.5; P=0.05) of MG and TD (r=0.2; P=0.005) of MGJ resulted in BL gains. In the CTG group, TD (r=0.7; P=0.004) and AMD (r=0.3; P=0.004) of MP and AMD of MGJ was associated with a significant BL gain. ConclusionsP-CTG and CTG had significant effects on displacement and divergence of soft tissue landmarks respectively. The relocation of these landmarks, seem to result in an improvement in the buccolingual dimensions of the post-extraction ridge.