Teeth height preservation by means of reverse tooth retention method

Tooth loss due to trauma or periodontal disease is often associated with atrophy of the alveolar ridges. Due to atrophy the final volume of bone tissue and height of bone ridges are insufficient for dental implants placement. The preservation of alveolar ridge dimensions and bone characteristics could be more effective than any augmentation methods. Augmentative bone treatment may result in extensive surgical interventions and increased treatment costs. Attempts to reduce alveolar bone resorption include the placement of natural roots, root analogues and immediate implantations into the extraction socket, sometimes in combination with membrane or graft techniques and other restore techniques. The aim of this study was to evaluate the effectiveness of reverse tooth retention methods in alveolar bone volume preservation. Materials and methods: The study included 65 consecutive patients presenting beaked teeth or their roots after trauma or periodontal disease with atrophy beginning. The own method of reverse teeth retention (Ukraine patent for invention U200612) was performed in all cases. According to this method the treated roots or remains of processing dental crown were covered with gum flap sometimes in combination with membrane. The place was treat with red rays laser. The height of the alveolar bone ridges, the height required for insertion of the appropriate implants were calculated in each patient after X-ray or CT evaluation. Results: Stable marginal bone conditions can be preserved after 1-8 years following reverse tooth retention. Laser illuminations during several days after operation prevent some acute complications. Follow up observation of patients show a mean marginal bone loss of 1.2 mm (SD 0.8 mm) during the period. The vertical resorption in frontal area was 1,4±0,5 mm in molar area the horizontal resorption was absent during 3 years, during 5 years it was 1,7±0,7 mm and during 8 years 1,6±0,9 mm. The absence of any alveolar ridge atrophy in retromolar area was registered in 8 patients during 5 years of observation. The degree of atrophy measured by teeth height correlates with intensive smoking habits (r=-0,54, p0,05), daily use of alcohol (r=-0,39, p0,05), low calcium diet (r=-0,36, p0,05). In 17 cases of root preservation and in 45 cases of teeth crown preparation with reverse retention were provided and the standard implantation procedure was conducted based on sufficient alveolar ridge size (width 6,3±1,7 mm, height 12,0±0,8 mm). In retromolar area the volume of alveolar plate in 3 cases there was insufficient bone's volume and the artificial grafts were used. So the results of this study suggest that method of reverse teeth retention could be successfully used before implantation procedures or another prosthetic technique. Keywords: reverse retention, atrophy of alveolar ridge, bone augmentation, implant