Comparative Analysis of Ridge Preservation Following Endodontic Microsurgery and Socket Grafting in Implant Placement for Post-Cancer Patients
DOI:
https://doi.org/10.64149/J.Carcinog.24.4s.880-888Keywords:
Alveolar ridge preservation, Dental implants, Endodontic microsurgery, Post-cancer patients, Socket graftingAbstract
Background: Ridge preservation plays a critical role in the success of dental implants, particularly in post-cancer patients where prior oncologic therapy can compromise bone quality and healing potential. Endodontic microsurgery (EMS) and socket grafting (SG) represent two distinct strategies for maintaining alveolar ridge dimensions. However, limited evidence exists directly comparing these modalities in patients with a history of cancer.
Aim: This study aimed to compare the outcomes of ridge preservation following EMS and SG in post-cancer patients undergoing delayed implant placement.
Methods: A prospective randomised controlled trial was conducted with 60 post-cancer patients equally allocated into two groups. Group I (n=30) underwent EMS for salvageable teeth, while Group II (n=30) received atraumatic extractions followed by SG with bone graft and collagen membrane. Implants were placed after 6–9 months, and patients were followed for 12 months post-loading. Outcomes included ridge dimensional changes (CBCT), implant stability (insertion torque and ISQ), clinical healing parameters, implant success and survival rates, and patient-reported satisfaction. Statistical analysis was performed with significance set at p < 0.05.
Results: EMS resulted in significantly lower vertical ridge loss compared to SG (0.9 mm vs. 1.4 mm, p=0.02) and higher implant stability at placement (insertion torque: 38.5 Ncm vs. 34.7 Ncm, p=0.01; ISQ: 72.1 vs. 68.4, p=0.03). Clinical peri-implant health and overall survival rates were comparable, with survival ranging from 96.7–100%. Patient-reported outcomes favoured EMS, with higher esthetic (p=0.04) and functional scores (p=0.03).
Conclusion: Both EMS and SG were effective ridge preservation strategies in post-cancer patients, with high implant survival and favourable clinical outcomes. EMS offered superior vertical ridge preservation, implant stability, and patient satisfaction. SG remained valuable when extraction was unavoidable, although vertical bone loss was more pronounced.
