Pontic Shield and Mineralized Plasmatic Matrix for Ridge Preservation (PONTIC-MPM)

Partial Extraction Therapy for Facial Contour Preservation, "Old is Gold or Time for Change?" A Randomized Clinical Trial

This study is testing new methods to preserve the jawbone and gum tissue after removing a damaged front tooth. Normally, when a tooth is taken out, the bone and gums in that area shrink, which can make future dental treatment more difficult and affect appearance. A technique called Partial Extraction Therapy (Pontic Shield Technique) keeps part of the tooth root in place to help maintain the natural shape of the bone and gums. Another method, called Mineralized Plasmatic Matrix (MPM), uses a patient's own blood mixed with bone particles to support healing.

In this randomized clinical trial, 56 patients were assigned to one of four groups:

Group I: Tooth extraction only Group II: Tooth extraction with MPM grafting Group III: Pontic shield technique alone Group IV: Pontic shield technique with MPM grafting The main outcome measured was the amount of bone width preserved, using 3D X-rays (CBCT). Other outcomes included bone height and soft-tissue healing over 4 months.

This research will help determine whether the pontic shield technique, with or without MPM, provides better preservation of bone and gum tissue compared to tooth extraction alone.

Study Overview

• Status: Completed
• Conditions: Alveolar Ridge Preservation
• Intervention / Treatment: Procedure: Tooth Extraction only; Procedure: Extraction + MPM; Procedure: Pontic Shield Only; Procedure: Pontic Shield + MPM

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Egypt
  • Dakahlia Governorate
    • Al Mansurah, Dakahlia Governorate, Egypt, 35511
      • Faculty of Dentistry, Mansoura University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults (≥18 years).
• Classified as ASA I (healthy) according to the American Society of Anesthesiologists Physical Status Classification.
• Presence of Type 1 extraction sockets (intact buccal bone and soft tissues).
• Adequate oral hygiene.
• Sufficient inter-arch space for prosthetic rehabilitation.
• Willingness to comply with study protocol and follow-up schedule.

Exclusion Criteria:

• Systemic conditions affecting bone metabolism or wound healing (e.g., uncontrolled diabetes, osteoporosis, immunosuppression).
• History of head and neck radiotherapy or bisphosphonate therapy.
• Acute infection or suppuration at the extraction site.
• Severe periodontal disease.
• Root caries or tooth mobility.
• Buccal bone plate loss due to vertical/horizontal root fractures or advanced periodontitis.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Extraction Only; Patients receive total tooth extraction in the esthetic maxillary zone without any adjunctive grafting.	Procedure: Tooth Extraction only; Conventional atraumatic extraction of the non-restorable maxillary tooth in the esthetic zone without socket preservation procedures.
Active Comparator: Extraction + MPM; Patients receive total tooth extraction in the esthetic maxillary zone, followed by grafting with MPM.	Procedure: Extraction + MPM; Tooth extraction followed by socket grafting using MPM, prepared from autologous blood combined with xenograft bone particles.
Active Comparator: Pontic Shield Only; Patients undergo the pontic shield technique, in which a portion of the buccal root is preserved to maintain ridge contour, without grafting.	Procedure: Pontic Shield Only; Partial extraction therapy using the pontic shield technique, in which the buccal root fragment is preserved to maintain ridge contour, without additional grafting.
Active Comparator: Pontic Shield + MPM; Patients undergo the pontic shield technique combined with MPM grafting for ridge preservation.	Procedure: Pontic Shield + MPM; Pontic shield technique combined with grafting using mineralized plasmatic matrix (MPM) for enhanced ridge preservation and healing.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Alveolar Ridge Width Change	Mean changes in alveolar ridge width measured at standardized reference points on cone-beam computed tomography (CBCT) Unit of Measure: millimeters (mm)	Baseline (pre- or immediate post-extraction) to 4 months.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Buccal and Palatal Bone Height Change	Change in buccal and palatal bone heights measured on CBCT from baseline to 4 months. Unit of Measure: mm	Baseline to 4 months.
Soft-Tissue Healing (Wound Healing Index, WHI)	Clinical soft-tissue healing evaluated using the WHI. Unit of Measure: score on 5-point scale with higher values indicating more favorable wound healing.	1 week and 4 months post-extraction.

Collaborators and Investigators

• Sponsor: Soaad Tolba Mohammed Tolba Badawi
• Investigators: Principal Investigator: Soaad Tolba Badawy, Lecturer, Oral Surgery, MU, Mansoura University

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2024
• Primary Completion (Actual): July 1, 2025
• Study Completion (Actual): July 1, 2025

Study Registration Dates

• First Submitted: September 6, 2025
• First Submitted That Met QC Criteria: September 6, 2025
• First Posted (Estimated): September 15, 2025

Study Record Updates

• Last Update Posted (Estimated): September 17, 2025
• Last Update Submitted That Met QC Criteria: September 11, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Socket preservation; Partial extraction therapy; Pontic shield; Mineralized plasmatic matrix (MPM); Wound healing index
• Additional Relevant MeSH Terms: 1-methyl-1-piperidinomethane sulfonate
• Other Study ID Numbers: R.25.09.22

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No