Features of tooth extraction in patients with thin gum biotype for planning subsequent orthopedic treatment on dental implants

The aim of this study was to evaluate the impact of different post-extraction socket management techniques in patients with a thin gingival biotype on vertical alveolar ridge resorption and soft-tissue thickness prior to planned implant placement. The study included 36 patients aged 27–43 years with a thin gingival biotype and a diagnosis of chronic apical periodontitis. Extractions were performed atraumatically under local anesthesia, after which patients were allocated to the main group (n = 20) and the control group (n = 16). In the main group, the extraction socket was filled with the collagen-based osteoplastic material Bioplast-Dent and covered with a subepithelial connective tissue graft; in the control group, the socket was managed with L-PRF and a collagen membrane. Vertical alveolar ridge resorption was assessed using dental cone-beam computed tomography 6 months after extraction, and measurements were performed in Xelis Dental Viewer 3D. Statistical analysis was carried out using the Welch t-test. Mean vertical resorption in the main group was 1.37 ± 0.36 mm (10.3 ± 1.2%), compared with 2.07 ± 0.33 mm (14.4 ± 1.4%) in the control group. Analysis taking bone density type into account showed lower vertical resorption in the main group for both D2 and D3 biotypes, with the D3 biotype exhibiting a tendency toward greater resorption. The thickness of keratinized attached gingiva did not change significantly; however, soft-tissue thickness above the planned implant site was greater in the main group (4.37 ± 0.22 mm) than in the control group (3.28 ± 0.35 mm). The findings indicate that atraumatic extraction combined with socket filling using a collagen osteoplastic material and coverage with a subepithelial connective tissue graft supports the preservation of vertical alveolar ridge dimensions and creates favorable conditions for gingival cuff formation, while minimizing the influence of bone biotype on resorption.

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