Dental Hygienists' Familiarity, Utilization, and Barriers to Using Advanced Instruments during Non-Surgical Periodontal Therapy.

Purpose Non-surgical periodontal therapy (NSPT) is considered to be fundamental in the treatment of periodontal disease. Advanced area specific instruments were designed to increase the clinician's ability to effectively access root furcation areas during NSPT. The purpose of this study was to explore clinical dental hygienists' familiarity, utilization, and perceived efficacy of advanced instruments in root furcation areas during NSPT.Methods A randomized sample (n=3,500) of licensed dental hygienists in Michigan was invited to participate in a paper-based, mail survey. The 10-item instrument consisted of demographic, multiple choice, Likert scale, and open-ended questions. Descriptive and inferential statistics were used to analyze the data.Results A total of 1,156 surveys were returned; 858 met the inclusion criteria for a response rate of 24.5%. Respondents who graduated between 2010-2020 than those who graduated between 1990-1999 were more likely to utilize advanced instruments and those who graduated in 1989 or earlier (16.0% and 19.9% respectively). Respondents familiar with advanced instruments were more likely to use them in furcation areas during NSPT than those less familiar with the instruments (95% CI [18.1, 29.6], p<0.001). Respondents who perceived advanced instruments to be effective in furcation areas were more likely to utilize them (95% CI [1.0, 8.0], p<0.05) during NSPT. Most respondents indicated that they became familiar with advanced instruments during their dental hygiene education or through continuing education courses.Conclusion Familiarity with advanced instruments and perceived efficacy of these instruments for accessing root furcations increased the likelihood of clinical dental hygienists utilizing them during NSPT. Dental hygiene education and continuing education programs should continue to provide opportunities for students and practicing clinicians to learn NSPT instrumentation techniques utilizing advanced instruments designed for furcation access.

Antibiotic prescription patterns among US general dentists and periodontists.

BACKGROUND: In the absence of a full spectrum of evidence-based guidelines for the appropriate use of antimicrobial agents, dentists, including periodontists, remain a highly frequent antibiotic prescribing group. With the goal of understanding antibiotic prescribing practices, the authors surveyed a convenience sample of dental practitioners and periodontists to identify differences between the 2 cohorts and assess the factors that affect prescribing practices. METHODS: An institutional review board-approved 15-item survey was developed to capture antibiotic prescribing practices addressing the main research question, factors affecting systemic antibiotic prescription patterns, and prescription timing. The authors collaborated with the American Dental Association (ADA) and the American Academy of Periodontology (AAP) for survey dissemination. Responses were summarized using descriptive statistics. Multivariable models were developed to identify antibiotic prescription predictors. RESULTS: Overall, 32.4% of the participants prescribed systemic antibiotics with scaling and root planing. When comparing the 2 groups, the authors found that 46.4% and 18.7% of the AAP and ADA members, respectively, prescribed systemic antibiotics with scaling and root planing (P = .0001). The authors found a significant difference between the AAP and ADA groups in prescription timing (P = .01). The multivariable model revealed that practitioner sex (P = .03), AAP membership (P = .0001), and years of practitioner experience (P = .04) predicted antibiotic prescription practices. The geographic location, practice setting, and occupation type did not predict antibiotic prescription patterns. CONCLUSION: The authors found a lack of clarity related to prescription timing, factors determining prescription patterns, and selection of patient population who would benefit more from antibiotics. PRACTICAL IMPLICATIONS: This study confirmed a lack of clarity related to antibiotic prescription patterns in combination with nonsurgical periodontal treatment.

Vaccines for COVID-19: An Overview.

The advent of the COVID-19 pandemic in the final months of 2019 prompted an extraordinary response on the part of the scientific community, with fundamental research on the biology of the virus and the human immune response, and development of testing, therapeutics, and vaccines occurring on an unprecedentedly short timescale. Within a year after the worldwide outbreak of the disease, more than 40 vaccine candidates had emerged, with 21 candidates in phase 3 trials or already being used on an emergency basis. Many of these vaccines have involved innovative platforms. In this concise review, the authors will summarize the characteristics and performance of the leading vaccines and discuss considerations of virus mutations and asymptomatic spread that may affect the ability of the worldwide community to use these vaccines as a means to defeat the pandemic and restore pre-COVID-19 normality.

Using business intelligence and data visualization to understand the characteristics of failed appointments in dental school clinics.

PURPOSE/OBJECTIVES: Broken appointments are an important cause of waste in health care. Patients who fail to attend incur costs to providers, deny trainees learning opportunities, and impact their own health as well as that of other patients who are waiting for care. METHODS: A total of 410,000 appointment records over 3 years were extracted from our electronic health record. We conducted exploratory data analysis and assessed correlations between appointment no-shows and other attributes of the appointment and the patient. The University of Michigan Medical School's Committee on Human Research reviewed the study and deemed that no Institutional Review Board oversight was necessary for this quality improvement project that was, retrospectively, turned into a study with previously de-identified data. RESULTS: The patient's previous attendance record is the single most significant correlation with attendance. We found that patients who said they are "scared" of dental visits were 62% as likely to attend as someone reporting "no problem." Patients over 65 years of age have better attendance rates. There was a positive association between receiving email/text confirmation and attendance. A total of 94.9% of those emailed a reminder and 92.2% of those who were texted attended their appointment. CONCLUSION(S): We were able to identify relationships of several variables to failed and attended appointments that we were previously unknown to us. This knowledge enabled us to implement interventions to support better attendance at Dental Clinics at the University of Michigan, improving patient health, student training, and efficient use of resources.

Acellular dermal matrix for root coverage procedures: 9-year assessment of treated isolated gingival recessions and their adjacent untreated sites.

BACKGROUND: The long-term outcomes of acellular dermal matrix (ADM) for the treatment of isolated gingival recessions has not yet been evaluated. Thus, the aim of this study was to observe the root coverage outcomes of coronally advanced flap with ADM over time, and compare them with their adjacent untreated sites. METHODS: Twelve patients (from 20) were available at the 9-year recall. Clinical parameters (recession depth, mean root coverage [mRC], keratinized tissue width [KTW], and gingival thickness) were evaluated and compared with the 1-year results, and the ADM-adjacent untreated sites (on mesial and distal) via mixed-modeling regression analyses. RESULTS: From 1 to 9 years, the ADM-treated isolated recessions showed a relapse from 77% to 62% mRC (P <0.05). A similar pattern toward apical shift of the gingival margin was noticed for the ADM-adjacent untreated sites without baseline recession. However, ADM-adjacent untreated sites which had presented with recession at baseline but were not treated showed a significantly more apical shift of the gingival margin (almost two-fold). A significant increase in KTW was noted for all sites. Baseline KTW ≥2 mm was a significant predictor for the stability of the gingival margin at the ADM-treated, and the ADM-adjacent sites with baseline recession. CONCLUSIONS: ADM-treated sites displayed recession relapse from 1 to 9 years. The untreated adjacent sites with a recession at baseline, showed a higher apical displacement of the gingival margin compared with the ADM-treated sites, and ADM-adjacent sites without a recession at baseline.

Increasing Levels of Smoking may Increase the Relative Risk of Dental Implant Failure.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Levels of smoking and dental implants failure: A systematic review and meta-analysis. Naseri R, Yaghini J, Feizi A. J Clin Periodontol. 2020;47(4):518-528. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

Canceling dental procedures due to elevated blood pressure: Is it appropriate?

BACKGROUND: In 1974, the American Dental Association first considered recommending that dental offices measure blood pressure (BP) routinely, and it has been further encouraged since 2006. Investigators in several dental publications have recommended cancellation of dental procedures based solely on BP greater than 180/110 millimeters of mercury for urgent oral health care and greater than 160/100 mm Hg for elective oral health care, in the absence of prior medical consultation. METHODS: The authors reviewed the evidence for cancellation of any dental or surgical procedures by using an Ovid MEDLINE search for the terms dental, elevated blood pressure, and hypertension. In addition, the authors searched resources at ebd.ada.org using the same criteria. The authors collaborated to develop recommendations in view of 2017 guidelines on this subject. RESULTS: To the authors' knowledge, there are no professionally accepted criteria or study evidence indicating a specific BP elevation at which to prohibit oral health care. Researchers of a 2015 review on management of comorbidities in ambulatory anesthesia failed to find increased morbidity from hypertension in the outpatient setting. CONCLUSIONS: To the authors' knowledge, there are no prospective study investigators that have addressed whether or when to cancel dental procedures due to office-measured elevated BP. The authors recommend using current anesthesiology guidelines based on functional status and past BP measurements to prevent unnecessary cancellations. PRACTICAL IMPLICATIONS: It is seldom necessary to cancel dental procedures on the basis of BP measured before a planned procedure for patients under a physician's care.

Stopping Anticoagulation Therapy Before Implant and Bone Grafting Surgery May Not Be Necessary to Prevent Bleeding Events.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Management of anticoagulated patients in implant therapy: a clinical comparative study. Clemm R, Neukam FW, Rusche B, Bauersachs A, Musazada S, Schmitt CM. Clin Oral Implants Res 2016;27(10):1274-82. SOURCE OF FUNDING: Information not available TYPE OF STUDY/DESIGN: Cohort study.

Periodontal health in breast cancer patients on aromatase inhibitors versus postmenopausal controls: a longitudinal analysis.

AIM: This study was conducted to determine periodontal changes in postmenopausal breast cancer (BCa) survivors using aromatase inhibitors (AI) as compared to postmenopausal women without BCa. METHODS: An 18-month prospective examination of periodontal health in postmenopausal women (29 receiving AI therapy; 29 women without BCa) was conducted at University of Michigan. Comprehensive periodontal examinations including alveolar bone height (ABH) were conducted at baseline, 6, 12, and 18 months. Bisphosphonate, vitamin D, and calcium supplementation were collected via chart review. Linear mixed models were utilized to investigate the relationship between AI and periodontal measures. RESULTS: Aromatase inhibitor users had significantly deeper probing depths, more dental plaque and clinical attachment loss as compared to controls at the 6, 12, and 18 month study visits (p < 0.05). ABH loss was seen over time within the AI group. The linear mixed model showed a significant effect of time as well as an interaction between aromatase inhibitor use and calcium supplement status. AI users taking calcium experienced less ABH loss over the study than AI users not taking calcium (p = 0.005). CONCLUSION: Aromatase inhibitor therapy has a negative impact on the periodontal health of postmenopausal BCa patients. Calcium supplementation appears to mitigate ABH loss in women on AI.

Comparison of Freeze-Dried and Solvent-Dehydrated Acellular Dermal Matrix for Root Coverage: A Randomized Controlled Trial.

The prevalence of gingival recession has been estimated at around 22.5% in people aged older than 29 years. Classic treatment approaches include the use of connective tissue grafts in combination with coronally advanced flaps (CAFs). To reduce morbidity and the need for a secondary surgical site, allograft materials are currently being used. Nevertheless, long-term randomized studies testing the efficacy of these materials are lacking. Hence, the aim of the present randomized controlled clinical trial was to compare two acellular dermal matrix (ADM) materials produced by different processing techniques, freeze-dried (FDADM) and solvent-dehydrated ADM (SDADM). At 12 months, both groups showed significant improvement in attachment level, recession depth, and recession width. A mean improvement in attachment level of 2.0 ± 1.08 mm for FDADM and 2.0 ± 0.70 mm for both SDADM was achieved (P = .002). Root coverage after 12 months was 80.66 ± 22.90% for FDADM and 80.97 ± 18.08% for SDADM. Hence, it was concluded that both FDADM and SDADM grafting materials can successfully achieve root coverage in Miller Class I and II recession defects for up to 12 months when used in combination with CAFs.

Systemic Chemotherapeutic Agents as Adjunctive Periodontal Therapy: A Narrative Review and Suggested Clinical Recommendations.

Periodontitis is an inflammatory condition of the periodontium that leads to destruction of the supporting structures of the tooth, including loss of attachment and alveolar bone. A clinician's first line of treatment for periodontitis is traditionally mechanical periodontal therapy, including oral hygiene instructions together with scaling and root planing. How- ever, it has been shown that mechanical therapy may not always be effective in halting disease. Adjunctive chemotherapeutics, such as systemic antibiotics or host-modulating agents, may improve the treatment outcome of periodontitis. Using relevant terms such as "adjunctive antibiotics" and "systemic chemotherapeutics" in a manual search of the PubMed database, the authors have prepared a narrative review of the chemotherapeutics currently used in the field. Results of the search and review show that adjunctive antibiotics may be useful in cases of aggressive periodontitis, refractory periodontitis, and in some patients who are immunocompromised, such as heavy smokers or poorly controlled diabetics. Host-modulating agents are generally recommended only as the last resort and are limited to the use of submicrobial dose doxycycline. Microbial testing may be indicated, particularly in aggressive periodontitis cases or refractory cases. Using these results, a decision tree is provided for clinicians to determine when adjunctive chemotherapeutics may be indicated.

Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft.

INTRODUCTION: This randomized controlled clinical pilot trial compared the efficacy of 2 soft tissue grafting methods for correcting esthetic discrepancies associated with definitively restored implant crowns. METHODS: Thirteen patients presenting with implants displaying recession, thin biotype, concavity defects, or a combination thereof associated with single crowned dental implants randomly received subepithelial connective tissue grafts (SCTG) in the control group (N = 7) or acellular dermal matrix (ADM) allografts in the test group (N = 6), both under coronally positioned flaps. Data regarding soft tissue, hard tissue, esthetics, and quality of life (QoL) parameters were collected over 6 months. RESULTS: Both groups gained tissue thickness (SCTG: 63% and ADM: 105%), reduced concavity measures (SCTG: 82% and ADM: 96%), and improved recessions (SCTG: 40% and ADM: 28%) from baseline to 6 months. Clinicians determined improvement in esthetics for both groups (P = 0.001), unlike patients who did not change their esthetic ratings. No statistical differences were noted for QoL assessment; however, ADM subjects had more eventful wound healing (P = 0.021). CONCLUSIONS: Within the limitations of this study, both SCTG and ADM result in increased mucosal thickness, reduction in concavity dimensions, and have a potential for recession reduction on definitively restored dental implants.

Comparison of two differently processed acellular dermal matrix products for root coverage procedures: a prospective, randomized multicenter study.

BACKGROUND: The purpose of this multicenter randomly controlled clinical trial was to compare two acellular dermal matrix (ADM) materials produced by different processing techniques, freeze-dried (FDADM) and solvent-dehydrated (SDADM) ADM, in their ability to correct Miller Class I and II recession defects. METHODS: Eighty individuals from four study centers, each with a single maxillary anterior Miller Class I or II recession defect were enrolled. Participants were randomly assigned and treated with coronally advanced flap (CAF) + FDADM (n = 42) or CAF + SDADM (n = 38). Gingival thickness, recession depth, recession width, probing depth (PD), clinical attachment level, gingival index, plaque index, patient discomfort, and wound healing index were recorded before surgery (day 0), immediately after surgery (day 1), and 2, 4, 12, 24, and 52 weeks postoperatively. The Student t test, paired t test, and Kruskal-Wallis one-way ANOVA were used to analyze the data. RESULTS: When evaluating the clinical parameters after 1 year, both groups showed significant (P <0.05) improvement for most of the parameters evaluated when compared to baseline (day 0). For example, percentage of root coverage was 77.21% ± 29.10% for CAF + FDADM and 71.01% ± 32.87% for CAF + SDADM. Conversely, no significant differences were observed between the two materials for any clinical parameter tested or for patient satisfaction except PD on the mesial side of the defects (P = 0.03). CONCLUSIONS: Both FDADM and SDADM can be used successfully to correct Miller Class I or II recession defects. There were no statistically significant differences between groups for any of the clinical parameters tested.

Characterization of periodontal structures of enamelin-null mice.

BACKGROUND: Enamelin-null (ENAM(-/-)) mice have no enamel. When characterizing ENAM(-/-) mice, alveolar bone height reduction was observed, and it was hypothesized that enamel defects combined with diet are associated with the periodontal changes of ENAM(-/-)mice. The aim of the present study is to compare the dimension of interradicular bone of ENAM(-/-) (knock-out [KO]) with wild-type (WT) mice, maintained on hard (HC) or soft (SC) chow. METHODS: A total of 100 animals divided into four groups were studied at 3, 8, and 24 weeks of age: 1) KO/HC; 2) KO/SC; 3) WT/HC; and 4) WT/SC. Microcomputed tomography was performed, and the following measurements were made between mandibular first (M1) and second (M2) molars: relative alveolar bone height (RBH), crestal bone width (CBW), bone volume (BV), bone mineral content (BMC), and bone mineral density (BMD). The position of M1 and M2 in relation to the inferior border of the mandible was also determined at 24 weeks. All variables were analyzed by one-way analysis of variance and Dunnett test for pairwise comparisons. Morphologic analyses were conducted on hematoxylin and eosin-stained sections. RESULTS: Radiographically, the enamel layer was absent in ENAM(-/-) mice. Interproximal open contacts were observed exclusively in ENAM(-/-) mice, and the prevalence decreased over time, suggesting that a shifting of tooth position had occurred. Additionally, in the two ENAM(-/-) groups, RBH was significantly lower at 8 and 24 weeks (P <0.02); CBW, BV, and BMC were significantly less (P <0.05) at 24 weeks. No differences in BMD were found among the four groups. The molars migrated to a more coronal position in ENAM(-/-) mice and mice on HC. Histologic findings were consistent with radiographic observations. After eruption, the junctional epithelium was less organized in ENAM(-/-) mice. CONCLUSION: The interdental bone density was not affected in the absence of enamelin, but its volume was, which is likely a consequence of alternations in tooth position.

Combination flap surgery with resin-modified glass ionomer for the treatment of radicular lesions: a long-term follow-up.

This retrospective study evaluated the long-term clinical success of combination therapy using resin-modified glass ionomer (RMGI) with flap surgery in treating subgingival radicular defects. The study population consisted of 142 patients with 188 radicular defects. Clinical parameters (pocket depth, recession, clinical attachment level [CAL], and bleeding on probing) were evaluated. Statistically significant CAL gain was observed from baseline to follow-up in successful cases (4.3 ± 0.1 mm to 4.1 ± 0.1 mm, respectively; P < .01). RMGI with flap surgery demonstrated an overall success rate of 86.7% (77.7% with open flap debridement and 94.4% with coronally advanced flap with or without connective tissue graft), with favorable and stable clinical results over a mean period of 4.2 years (longest follow-up, 13 years).

Systemic Teriparatide Administration Promotes Osseous Regeneration of an Intrabony Defect: A Case Report.

INTRODUCTION: Teriparatide comprises the first 34 amino acids of parathyroid hormone and is a systemic anabolic agent that is Food and Drug Administration approved for the treatment of osteoporosis but not for periodontitis. To our knowledge, this is the first clinical case report to document the treatment of a patient with severe periodontitis using an open-flap debridement procedure in conjunction with teriparatide. CASE PRESENTATION: A 45-year-old female patient was diagnosed with severe chronic periodontitis, including the presence of an intrabony defect on tooth #6. She received open-flap debridement surgery in conjunction with daily systemic administration of 20 µg teriparatide, oral vitamin D, and calcium supplements for 6 weeks. Radiographic, clinical, gingival crevicular fluid (pyridinoline cross-linked carboxy-terminal propeptide of type I procollagen, procollagen type 1 N-propeptide, and osteocalcin), and serum parameters (parathyroid hormone, bone alkaline phosphatase, calcium, and 25-hydroxyvitamin D) were assessed. Treatment outcomes were evaluated over 4 years, with successful radiographic and clinical results throughout the follow-up period. CONCLUSION: Teriparatide administration in conjunction with traditional open-flap debridement surgery offers potential for the treatment of severe intrabony defects resulting from chronic periodontitis.

Evaluating postdoctoral dental candidates: assessing the need and recommendations for a national qualifying examination.

Increasingly, U.S. dental schools report pass/fail grades and do not rank students. In addition, the Joint Commission on National Dental Examinations will report National Board Dental Examination (NBDE) scores as pass/fail after January 1, 2012. This article discusses how these changes will force postdoctoral dental program directors to modify how they assess candidates and how noncognitive evaluations might enhance those assessments. The authors propose developing a national qualifying examination for postdoctoral dental programs that will measure knowledge, decision making, and noncognitive traits including empathy, self-confidence, integrity, and emotional intelligence. Without NBDE scores, class rank, and GPA as a basis for decision making, a single national qualifying examination would assist postdoctoral programs in selecting high-quality candidates based on knowledge, critical thinking skills, and noncognitive traits.

Teriparatide and osseous regeneration in the oral cavity.

BACKGROUND: Intermittent administration of teriparatide, a drug composed of the first 34 amino acids of parathyroid hormone, has anabolic effects on bone. Although teriparatide has been evaluated for the treatment of osteoporosis and for the healing of fractures, clinical trials evaluating it for the treatment of osseous conditions of the oral cavity in humans are lacking. METHODS: A total of 40 patients with severe, chronic periodontitis underwent periodontal surgery and received daily injections of teriparatide (20 µg) or placebo, along with oral calcium (1000 mg) and vitamin D (800 IU) supplementation, for 6 weeks. The patients were followed for 1 year. The primary outcome was a radiographic linear measurement of alveolar bone level. Secondary outcomes included clinical variables, bone turnover markers in serum and oral fluid, systemic bone mineral density, and quality of life. RESULTS: Radiographic linear resolution of osseous defects was significantly greater after teriparatide therapy than after placebo beginning at 6 months, with a mean linear gain in bone at 1 year of 29% as compared with 3% (P<0.001). Clinical improvement was greater in patients taking teriparatide than in those taking placebo, with a reduction in periodontal probing depth of 33% versus 20% (2.42 mm vs. 1.32 mm) and a gain in clinical attachment level of 22% versus 7% (1.58 mm vs. 0.42 mm) in target lesions at 1 year (P = 0.02 for both comparisons). No serious adverse events were reported; however, the number of patients in the study was small. No significant differences were noted with respect to the other variables that were assessed. CONCLUSIONS: Teriparatide, as compared with placebo, was associated with improved clinical outcomes, greater resolution of alveolar bone defects, and accelerated osseous wound healing in the oral cavity. Teriparatide may offer therapeutic potential for localized bone defects in the jaw. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT00277706 .).

Factors associated with the appearance of gingival papillae.

AIM: The purpose of this study was to evaluate factors associated with the fill of inter-dental spaces by gingival papillae. MATERIALS AND METHODS: Ninety-six adult subjects were evaluated. Papilla score (PS), tooth form/shape, interproximal contact length and gingival thickness were recorded for 672 maxillary anterior and first pre-molar interproximal sites. Statistical analyses included a non-parametric chi(2) test, anova, the Mixed Procedure for SAS and Pearson's correlation coefficient (r). RESULTS: Papilla deficiency was more frequent in older subjects (p<0.05), as papilla height decreased 0.012 mm with each year of increasing age (p<0.05). Competent papillae (complete fill inter-dentally) were associated with: (1) crown width: length >or=0.87; (2) proximal contact length >or=2.8 mm; (3) bone crest-contact point or=1.5 mm. Gingival thickness correlated negatively with PS (r=-0.37 to -0.54) and positively with tissue height (r=0.23-0.43). Tooth form (i.e. crown width to length ratio) correlated negatively with PS (r=-0.37 to -0.61). Other parameters failed to show any significant effects. CONCLUSIONS: Gingival papilla appearance was associated significantly with subject age, tooth form/shape, proximal contact length, crestal bone height and interproximal gingival thickness.

Effects of a putty-form hydroxyapatite matrix combined with the synthetic cell-binding peptide P-15 on alveolar ridge preservation.

BACKGROUND: Various grafting materials have been used for preservation of the dimensions of the residual alveolar ridge following tooth extraction. The purpose of this study was to evaluate clinical, histomorphometric, and radiographic healing 4 months after tooth extraction with or without placement of a putty-form anorganic bovine-derived hydroxyapatite matrix combined with a synthetic cell-binding peptide P-15 (Putty P15) to determine the effect on alveolar ridge preservation following exodontia. METHODS: Twenty-four consecutive subjects in need of extraction of maxillary premolars were recruited. Recruited subjects were randomly assigned to the test (Putty P15 and bioabsorbable collagen wound dressing material) or control (bioabsorbable collagen wound dressing material only) group. Data were recorded at 1, 2, 4, 8, and 16 weeks after ridge preservation procedures. At 16 weeks, a reentry surgery was performed, clinical measurements were repeated, and bone core biopsies were obtained for histomorphometric analysis prior to dental implant placement. RESULTS: The control group had a mean reduction in ridge height of -0.56 +/- 1.04 mm, whereas alveolar ridge height appeared to remain unchanged in the test group (0.15 +/- 1.76). The test group showed a mean reduction in ridge width of -1.31 +/- 0.96 mm, whereas the mean value for the control group was -1.43 +/- 1.05 mm. No statistical significance was observed between the groups. Mean bone density was significantly superior in the test group (2.08 +/- 0.65 versus 3.33 +/- 0.65). Histomorphometric analyses revealed similar percentages of bone vitality (test: 29.92% +/- 8.46%; control: 36.54% +/- 7.73%). Comparable percentages of bone marrow and fibrous tissue also were observed (test: 65.25% +/- 6.41%; control: 62.67% +/- 7.41%). Only 6.25% of the Putty P15 particles remained at 4 months in the analyzed biopsies. CONCLUSION: A favorable response was observed when Putty P15 was applied to extraction sockets, suggesting that it may be useful for alveolar ridge preservation prior to dental implant placement.