• Beta-tricalcium phosphate
• X-ray
• bone tissue restoration
• lower third molar removal
• plasma
• platelet-rich

• Humans
• Alveolar Process
• Tooth Socket/diagnostic imaging
• Tooth Socket/surgery
• Pilot Projects
• Prospective Studies
• Bone Resorption/pathology
• Tooth Extraction/adverse effects

• Alveolar ridge preservation
• Chitosan
• Cone-beam computed tomography
• Nanofibrous scaffold
• Randomized controlled trial
• Tissue engineering

• Male
• Female
• Humans
• Young Adult
• Adult
• Chitosan
• Polyvinyl Alcohol/therapeutic use
• Tooth Socket/diagnostic imaging
• Tooth Socket/surgery
• Alveolar Ridge Augmentation/methods
• Nanofibers/therapeutic use
• Alveolar Process/diagnostic imaging
• Alveolar Process/surgery
• Alveolar Bone Loss/diagnostic imaging
• Alveolar Bone Loss/prevention & control
• Alveolar Bone Loss/surgery
• Tooth Extraction

• absorbable alternative materials
• bone grafting materials
• immediate implant placement
• open membrane technique
• soft tissue grafting
• wound healing

• Core outcomes
• Implant prosthodontics
• Meta-research
• Randomized controlled trials

• Humans
• Dental Implants
• Prosthodontics
• Comparative Effectiveness Research
• Randomized Controlled Trials as Topic

• alveolar ridge preservation
• bone graft materials
• demineralized dentin matrix
• gingival healing
• orthodontics

• Humans
• Alcian Blue
• Alveolar Process/surgery
• Alveolar Process/pathology
• Alveolar Ridge Augmentation/methods
• Bicuspid/surgery
• Gingiva/surgery
• Pain
• Tooth Socket/surgery
• Tooth Socket/pathology
• Prospective Studies

• Humans
• Alveolar Ridge Augmentation/methods
• Dental Implantation, Endosseous/adverse effects
• Quality of Life
• Bone Transplantation/methods
• Alveolar Process
• Bone Substitutes/therapeutic use
• Biocompatible Materials
• Tooth Extraction/adverse effects
• Tooth Socket/surgery
• Dental Implants

• Beta-tricalcium phosphate
• Bone graft
• Odontogenic cyst
• Sinus bone graft
• Socket preservation

• alveolar process
• alveolar ridge preservation
• cost analysis
• evidence-based dentistry
• tooth extraction

• Humans
• Alveolar Process
• Tooth Socket/surgery
• Cost-Benefit Analysis
• Tooth Extraction/adverse effects
• Tooth Extraction/methods
• Alveolar Ridge Augmentation/methods
• Bone Transplantation/methods
• Alveolar Bone Loss/prevention & control

• bone graft
• chlorhexidine
• dehiscence
• exposure
• titanium mesh

• Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

• alveolar ridge preservation
• esthetics
• immediate implant placement
• minimally invasive surgery
• morbidity
• patient reported outcome measures
• wound healing

• alveolar ridge augmentation
• alveolar ridge preservation
• bone graft
• open healing
• socket seal

Ridge resorption after tooth extraction may result in inadequate bone volume and unfavorable ridge architecture for ideal implant placement. The use of bone substitutes has been advocated to fill extraction sites and to enhance primary implant stability. This study was made to evaluate the clinical efficacy of novel 3D printed nano-porous hydroxyapatite (3DP HA, test group) in comparison to nano-crystalline bone graft (NanoBone®, control group) in alveolar ridge preservation prior to implant placement.

Thirty patients were randomized into two groups following tooth extraction. All extracted sockets were filled with 3DP HA or NanoBone® and covered with a non-resorbable membrane. After four months, cone-beam computed tomography (CBCT) and intraoral scanner were used to measure dimensional changes of bone and soft tissue surface. Bone core specimens were harvested for histological analysis during implant osteotomy. Implant stability was assessed using a modified damping capacity analysis.

At four months postoperatively, dimensional changes in soft tissue surface resorption were less in the test group than in the control group; however, alveolar bone resorption was the same in both groups. Histological analysis revealed new bone formation, residual graft and fibrous connective tissue in both groups. The average primary implant stability (IST) value for both groups was approximately 70. There was no statistically significant difference in all parameters between two groups (p > 0.05).

3DP HA could potentially be used as an alternative bone graft material for alveolar ridge preservation.

• 3D printing
• Alveolar ridge preservation
• Bone graft
• Dimensional analysis
• Hydroxyapatite

The purpose of this study was to evaluate and compare the healing patterns of 2-mm and 4-mm proximal infrabony defects adjacent to dental implants in canine mandibles.

Four male beagles were used. Two groups were created: a 2-mm group (n=4) and a 4-mm group (n=4) depending on the horizontal dimension of proximal infrabony defects adjacent to implants. Bone healing patterns between the 2 groups were evaluated and compared at 8 and 16 weeks using radiographic, histological, histomorphometric, and fluorescent labelling analyses.

According to microcomputed tomography, the median bone volume fraction, bone mineral density, and the percentage of radiographic distance from the defect bottom to the most coronal bone-to-implant contact (radio-mcBIC) were 32.9%, 0.6 g/cm³, and 73.7% (8 weeks) and 45.7%, 0.7 g/cm³, and 76.0% (16 weeks) in the 2-mm group and 57.7%, 0.8 g/cm³, and 75.7% (8 weeks) and 50.9%, 0.8 g/cm³, and 74.7% (16 weeks) in the 4-mm group, respectively. According to histomorphometry, the median bone area fraction, mcBIC and the percentage of BIC amounted to 36.7%, 3.4 mm, and 58.4% (8 weeks) and 49.2%, 3.4 mm, and 70.2% (16 weeks) in the 2-mm group and 50.0%, 3.0 mm, and 64.8% (8 weeks) and 55.7%, 3.0 mm, and 69.6% (16 weeks) in the 4-mm group, respectively. No statistically significant differences were found between the groups for any variables (P>0.05).

The proximal defects that measured 2 mm and 4 mm showed similar healing patterns at 8 and 16 weeks, and the top of bone formation in the defects was substantially limited to a maximum of 1.6 mm below the implant shoulder in both groups.

The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation.

Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups.

Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group.

The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction.

Clinicaltrials.gov, NCT02714829, Registered 22 March 2016

• Alveolar ridge preservation
• Clinical trial
• Socket preservation
• rhBMP-2; β-TCP

To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two‐wall (both buccal and lingual)‐damaged extraction sockets.

Distal roots of three mandibular premolars in six beagle dogs were extracted, and the whole buccal and lingual bony walls were surgically removed. Three treatment protocols were then applied according to the following group allocation: no graft (None), grafting DPBM (BG), and grafting DPBM with coverage by a collagen membrane (BG + M). Two observational periods (2 and 8 weeks) were used with the split‐mouth design, and quantitative and qualitative analyses were performed by microcomputed tomography and histology.

The dimensions of the alveolar ridge at both grafted sites (BG and BG + M) remained similar to those of the pristine ridge in the histologic and radiographic analyses, whereas the ungrafted sites (None) collapsed both vertically and horizontally. Both grafting protocols produced substantial bony regeneration, but the addition of a covering membrane enhanced the proportion of mineralized tissue within the augmented area, and the BG + M group also showed a significantly larger area of regenerated ridge than the None group (p < .05).

Bone grafting with collagen membrane can maintain the alveolar ridge dimensions with substantial bone regeneration in a two‐wall‐damaged extraction socket.

• alveolar ridge augmentation
• bone regeneration
• collagen membrane
• damaged extraction socket
• tooth extraction

• Adult
• Alveolar Process
• Alveolar Ridge Augmentation
• Bias
• Biocompatible Materials/administration & dosage
• Bone Regeneration
• Bone Remodeling
• Confidence Intervals
• Dental Implantation, Endosseous
• Heterografts
• Humans
• Middle Aged
• Organ Sparing Treatments/methods
• Randomized Controlled Trials as Topic
• Time Factors
• Tooth Extraction/adverse effects
• Tooth Extraction/methods
• Tooth Socket
• Treatment Outcome

We previously reported similar efficacies of alveolar ridge preservation (ARP) on single extraction socket with two different E. coli derived recombinant human bone morphogenetic protein-2 (rhBMP-2) delivery systems (Cowell BMP, Cowell medi Co, Busan, Korea; β-tricalcium phosphate and hydroxyapatite particle & O-BMP, Osstem Implant Co, Busan, Korea; absorbable collagen sponge). After the trial, we completed implant therapy and observed over an average of 3 years. This follow-up study was performed retrospectively to compare result of implant treatment at the preserved alveolar ridge site.

Patients who underwent extraction of single tooth and received ARP with one of two rhBMP-2 delivery systems from October 2015 to October 2016 were enrolled. Twenty-eight patients (Group 1: Cowell BMP 14; Group 2: O-BMP 14) who underwent implant therapy and prosthetic treatment were included in study. Stability and marginal bone loss (MBL) of each implant were collected from medical charts and radiographs, and analyzed. The survival and success rates of implants were calculated.

The primary implant stability represented by implant stability quotient (ISQ) for Groups 1 and 2 was 69.71 and 72.86, respectively. The secondary implant stability for Groups 1 and 2 was 78.86 and 81.64, respectively. Primary and secondary stabilities were not statistically different (P = 0.316 and 0.185, respectively). MBL at the latest follow-up was 0.014 mm in Group 1 over 33.76 ± 14.31 months and 0.021 mm in Group 2 over 40.20 ± 9.64 months, with no significant difference (P = 0.670). In addition, the success rate of implants was 100% (14/14) in Group 1 and 92.9% (13/14) in Group 2, with survival rate of 100% (14/14) in Group 1 and 92.9% (13/14) in Group 2.

We confirmed good prognosis in both groups as a result of implant therapy after ARP with each of two rhBMP-2 carriers.

• Alveolar bone loss
• Alveolar process
• Bone substitutes
• Dental implants
• Survival rate
• rhBMP-2 protein

• A PRF Plus
• Esthetics
• Extraction socket
• Implant
• Osseous bone graft
• Ridge preservation
• Socket preservation

• alveolar ridge preservation
• bone regeneration
• collagen
• extraction sockets
• histochemistry
• immunohistochemistry

• Adult
• Aged
• Alveolar Bone Loss/surgery
• Alveolar Process/surgery
• Alveolar Ridge Augmentation/methods
• Bone Regeneration
• Collagen/chemistry
• Female
• Humans
• Male
• Middle Aged
• Organ Sparing Treatments/methods
• Prospective Studies
• Tooth Extraction/methods
• Tooth Socket/physiology
• Young Adult

• bone grafting
• cell viability
• osseointegrated dental implantation

• alveolar bone loss
• alveolar process
• bone substitutes
• meta-analysis
• tooth extraction
• tooth socket

The purpose of this systematic review was to assess quantitatively and qualitatively the influence of two different factors: membranes and soft tissue graft influence for the extraction socket preservation.

A wide-ranging electronic search was performed in six databases up to 30 of November 2018 in order to identify all the clinical and randomized clinical trials performed in humans published with no data restriction. The inclusion criteria were extraction socket preservation with and without membranes or a soft tissue graft in a intact socket with at least six months of follow-up, have more than 12 patients or treat more than 12 sites per group and evaluated at least one of the primary outcomes measures (radiographic measures histological assessment, clinical measures).

From an initial search of 1524 studies only 6 papers fulfil the inclusion and exclusion criterions. All the six selected papers, presented a wide heterogeneity of treatments used, evaluated variables and observation period that made impossible to recommend any specific techniques and/or material to achieve better results. The limited data found suggest that the used of membrane reveals to achieve better results. It wasn’t possible to observe in any clinical trial that compares the used of soft tissue graft.

New trials need to be performed in order to identify what specific techniques and/or materials are better to decrease the reabsorption of the socket after tooth extraction. Clinical trials designed to understand when/how the soft tissues grafts influence at the socket preservation is needed.

• alveolar bone loss
• bone remodeling
• systematic review
• tooth socket

The aim of this study was to evaluate clinical and radiographic changes and the survival rate after periodontal surgery using deproteinized bovine bone mineral (DBBM) with 10% collagen or DBBM with a collagen membrane in endo-periodontal lesions.

A total of 52 cases (41 patients) with at least 5 years of follow-up were included in this study. After scaling and root planing with or without endodontic treatment, periodontal regenerative procedures with DBBM with 10% collagen alone or DBBM with a collagen membrane were performed, yielding the DBBM + 10% collagen and DBBM + collagen membrane groups, respectively. Changes in clinical parameters including the plaque index, bleeding on probing, probing pocket depth, gingival recession, relative clinical attachment level, mobility, and radiographic bone gains were evaluated immediately before periodontal surgical procedures and at a 12-month follow-up.

At the 12-month follow-up after regenerative procedures, improvements in clinical parameters and radiographic bone gains were observed in both treatment groups. The DBBM + 10% collagen group showed greater probing pocket depth reduction (4.52±1.06 mm) than the DBBM + collagen membrane group (4.04±0.82 mm). However, there were no significant differences between the groups. Additionally, the radiographic bone gain in the DBBM + 10% collagen group (5.15±1.54 mm) was comparable to that of the DBBM + collagen membrane group (5.35±1.84 mm). The 5-year survival rate of the teeth with endo-periodontal lesions after periodontal regenerative procedures was 92.31%.

This study showed that regenerative procedures using DBBM with 10% collagen alone improved the clinical attachment level and radiographic bone level in endo-periodontal lesions. Successful maintenance of the results after regenerative procedures in endo-periodontal lesions can be obtained by repeated oral hygiene education within strict supportive periodontal treatment.

• Guided tissue regeneration
• Oral hygiene
• Periapical periodontitis
• Periodontitis
• Regenerative endodontics

• beta triphasic calcium phosphate (β-TCP)
• platelet-rich fibrin (PRF-L)
• post-extraction socket
• ridge augmentation

• CTS-138 Junta de Andalucía
• CTS-1028 Junta de Andalucía

• bone regeneration
• immediate implant placement
• molar tooth
• platelet-rich fibrin

• Adult
• Bone Regeneration/drug effects
• Dental Implantation, Endosseous/methods
• Dental Implants/adverse effects
• Female
• Humans
• Male
• Mandible/surgery
• Molar/surgery
• Osseointegration/drug effects
• Platelet-Rich Fibrin/drug effects
• Tooth Extraction

Serum albumin has been identified as an endogenous protein that is integral to early bone regeneration. We hypothesized that albumin addition to allografts may result in better bone remodeling than what can be achieved with anorganic xenografts. Sinus elevations were performed at 32 sites of 18 patients with the lateral window technique. Sites either received filling with an anorganic bovine bone mineral (ABBM, BioOss, Geistlich, CH) or albumin impregnated allograft (BoneAlbumin, OrthoSera, AT). After 6-months patients received dental implants and 16 bone core biopsy samples were obtained from the ABBM filled, and 16 from the BoneAlbumin augmented sites. The biopsies were examined by histomorphometry and µCT. Percentage of the residual graft in the BoneAlbumin group was 0–12.7%, median 5.4% vs. ABBM 6.3–35.9%, median 16.9%, p < 0.05. Results of the µCT analysis showed that the microarchitecture of the augmented bone in the BoneAlbumin group resembles that of the native maxilla in morphometric parameters Trabecular Pattern Factor and Connectivity. Our data show that while ABBM successfully integrates into the newly formed bone tissue as persisting particles, BoneAlbumin is underway towards complete remodeling with new bone closely resembling that of the intact maxilla.

• allograft
• bone graft material
• histology
• histomorphometry
• maxillary sinus floor augmentation
• x-ray microtomography
• xenograft

• bone repair
• bone substitutes
• low-level laser therapy
• pre-clinical study

• BMP2
• BMP9
• GBR
• bone formation
• guided bone regeneration
• osteoinductive

• Alveolar Process
• Bone Remodeling
• Humans
• Regeneration
• Tooth Extraction/adverse effects
• Tooth Socket/physiology
• Tooth Socket/surgery
• Wound Healing/physiology

• Absorbable collagen sponge
• Bone regeneration
• Enamel matrix derivative
• Enamel matrix proteins
• Growth factor
• Regenerative therapy
• Tooth extraction
• Tooth loss

Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

We sought to evaluate the effectiveness of bone substitutes in circumferential peri-implant defects created in the rabbit tibia.

Thirty rabbits received 45 implants in their left and right tibia. A circumferential bone defect (6.1 mm in diameter/4 mm depth) was created in each rabbit tibia using a trephine bur. A dental implant (4.1 mm × 8.5 mm) was installed after the creation of the defect, providing a 2-mm gap. The bone defect gaps between the implant and the bone were randomly filled according to the following groups: blood clot (CO), particulate Bio-Oss^® (BI), and Bio-Oss^® Collagen (BC). Ten animals were euthanized after periods of 15, 30, and 60 days. Biomechanical analysis by means of the removal torque of the implants, as well as histologic and immunohistochemical analyses for protein expression of osteocalcin (OC), Runx2, OPG, RANKL, and TRAP were evaluated.

For biomechanics, BC showed a better biological response (61.00±15.28 Ncm) than CO (31.60±14.38 Ncm) at 30 days. Immunohistochemical analysis showed significantly different OC expression in CO and BC at 15 days, and also between the CO and BI groups, and between the CO and BC groups at 60 days. After 15 days, Runx2 expression was significantly different in the BI group compared to the CO and BC groups. RANKL expression was significantly different in the BI and CO groups and between the BI and BC groups at 15 days, and also between the BI and CO groups at 60 days. OPG expression was significantly higher at 60 days postoperatively in the BI group than the CO group.

Collectively, our data indicate that, compared to CO and BI, BC offered better bone healing, which was characterized by greater RUNX2, OC, and OPG immunolabeling, and required greater reversal torque for implant removal. Indeed, along with BI, BC presents promising biomechanical and biological properties supporting its possible use in osteoconductive grafts for filling peri-implant gaps.

• Bone substitutes
• Bone transplantation
• Dental implantation
• Osseointegration
• Rabbits

• Bio-Gide
• Bio-Oss
• chronic disease
• osteogenesis
• socket graft
• tooth socket

This study was primarily designed to determine the clinico-radiographic efficacy of platelet-rich fibrin (PRF) and beta-tri-calcium phosphate with collagen (β-TCP-Cl) in preserving extraction sockets.

For Group I (PRF), residual sockets (n = 15) were filled with autologous PRF obtained from patients' blood; and for Group II (β-TCP-Cl), residual sockets (n = 15) were filled with β-TCP-Cl. For the sockets randomly selected for Group II (β-TCP-Cl), the reshaped Resorbable Tissue Replacement cone was inserted into the socket.

Clinically, there was a significantly greater decrease in relative socket depth, but apposition in midcrestal height in Group II (β-TCP-Cl) as compared to Group I (PRF), whereas more decrease in buccolingual width of Group I (PRF) than Group II (β-TCP-Cl) after 6 months. Radiographically, the mean difference in socket height, residual ridge, and width (coronal, middle, and apical third of socket) after 6 months was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). The mean density (in Hounsfield Units) at coronal, middle, and apical third of socket was higher in Group I (PRF) as compared to Group II (β-TCP-Cl). There were statistically significant apposition and resorption for Group I (PRF) whereas nonsignificant resorption and significant apposition for Group II (β-TCP-Cl) in buccal and lingual/palatal cortical plate, respectively, at 6 months on computerized tomography scan.

The use of either autologous PRF or β-TCP-Cl was effective in socket preservation. Results obtained from PRF were almost similar to β-TCP-Cl; therefore being autologous, nonimmune, cost-effective, easily procurable regenerative biomaterial, PRF proves to be an insight into the future biofuel for regeneration.

• Beta-tricalcium phosphate
• extraction socket
• platelet-rich fibrin
• type I collagen

Cone-beam computerized tomography (CBCT) is an effective technique for assessment of changes to the alveolar ridge (AR). However, its accuracy and reliability could be improved by standardization of imaging positions to remain unchanged during measurements. In this study, an alveolar ridge preservation procedure was performed on a left third molar (38) socket by filling it with a radiotransparent synthetic bone graft, mineralized collagen (MC). Photographic, X-ray and CBCT images were captured before and 3, 6 and 12 months after surgery. A new method was developed to standardize CBCT for quantitative evaluation. Obtained CBCT images showed good comparability. The post-extraction alveolar width and height were both over 95% of the original values, but some resorption of the lingual bone wall (>50%) and inter-crestal bone (>30%). It is concluded that an effective positional standardization method was developed for CBCT assessment of AR dimensional changes in the posterior mandible. The use of MC in combination with a collagen membrane improved dimensional preservation of the AR.

• CBCT
• alveolar ridge preservation
• quantitative evaluation

• Biphasic calcium phosphate (BCP)
• Collagen
• Hydroxyapatite (HA)
• Tricalcium phosphate (TCP)