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Pushpanathan KV, Chitrpautirapillay S, Pushparaj R, Kumar P. A Systematic Review and Meta-Analysis to Find Out the Efficacy of Socket Preservation Techniques in Adults in Split-Mouth Randomized Controlled Trials. Cureus 2025; 17:e79873. [PMID: 40166795 PMCID: PMC11956118 DOI: 10.7759/cureus.79873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2025] [Indexed: 04/02/2025] Open
Abstract
Alveolar ridge preservation has been practiced for a long time, yet it is not a standard component of post-extraction care. Post-extraction bone loss is an inevitable consequence, but successful implant treatment planning requires adequate bone and soft tissue coverage. Delayed implant placement and fixed partial dentures may significantly benefit from alveolar ridge preservation. This systematic review aimed to gather evidence on alveolar ridge preservation using split-mouth randomized controlled trials. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration ID number CRD42020177085. A comprehensive literature search was conducted using electronic databases and manual searches, yielding 4,654 results, from which 10 eligible studies were selected. These studies included a total of 101 participants and 202 extraction sockets. Meta-analysis was conducted using the fixed and random effects generic inverse variance method with the RevMan 5.3 software (Cochrane Collaboration, London, UK). The analysis revealed that the mean bone dimensional change in width at three months was 1.99 (0.63, 3.35), while the vertical height changes for the buccal and lingual plates were 1.13 (0.57, 1.70) and 0.46 (-0.06, 0.98), respectively. The pooled mean for differences in width at six months favored alveolar ridge preservation, though the internal vertical height changes at six months provided contradictory results. The findings indicate that socket preservation techniques help reduce alveolar bone loss. However, the conclusions must be interpreted cautiously, as further research with long-term randomized controlled trials is necessary to evaluate outcomes beyond bone loss.
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Affiliation(s)
| | | | | | - Prasana Kumar
- Oral Medicine and Radiology, Adhiparasakthi Dental College and Hospital, Chennai, IND
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Jin Y, Deng C, Yang X, Man Y, Hu C. Immediate Implant Placement in the Esthetic Zone: A Multi-Variate Analysis of Influencing Factors. Clin Implant Dent Relat Res 2025; 27:e13439. [PMID: 39899346 DOI: 10.1111/cid.13439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 12/22/2024] [Accepted: 12/25/2024] [Indexed: 02/04/2025]
Abstract
OBJECTIVES To evaluate the dimensional reduction of the peri-implant hard tissues and esthetic outcome after immediate implant placement (IIP) in the esthetic zone. MATERIAL AND METHODS Patients who received IIP with bone grafts in the esthetic zone, with either immediate or delayed restoration, were included in this retrospective cohort study. The implants were categorized into three groups based on the labial bone thickness (LBT) before implantation: Group 1 (≤ 0.5 mm), Group 2 (0.5-1 mm), Group 3 (≥ 1 mm). The horizontal bone loss (HBL) at 0, 3, 5 mm apical to implant shoulder, peri-implant marginal bone loss (MBL), and Pink Esthetic Score (PES) were used to evaluate the hard and soft tissue after IIP. RESULTS A total of 87 implants in 74 patients met the inclusion criteria. Compared to group 3, there was significant severe bone loss in the HBL-0 mm in groups 1 (p = 0.017); and the implant located in the central incisor position and female may led to increased bone resorption (p = 0.021, p = 0.061, respectively). For HBL-3 mm and HBL-5 mm, the non-immediate restoration may reduce bone resorption (p = 0.013, p = 0.022, respectively). The MBL during short-term follow-up and PES score showed no significant difference among three groups. CONCLUSIONS Despite limitations, our study found that LBT < 0.5 mm significantly affected horizontal bone loss. Meanwhile, immediate restoration, implant position of central incisors and female may also be considered as risk factors for HBL. However, the difference in the labial bone did not significantly affect MBL, or peri-implant soft tissue outcomes. TRIAL REGISTRATION This study was registered in a clinical trial registry (www.chictr.org.cn, No: ChiCTR2400087990).
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Affiliation(s)
- Yixin Jin
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chen Deng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xingmei Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yi Man
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Chen Hu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
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Cinar IC, Zboun M, Saglanmak A, Mijiritsky E. Immediate Implantation with Autologous Mineralized Dentin Graft versus Deproteinized Bovine Bone as Space-Filling Substitute in Maxillary Anterior Zone: Retrospective Radiological and Clinical Study. J Clin Med 2024; 13:5521. [PMID: 39337008 PMCID: PMC11432380 DOI: 10.3390/jcm13185521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2024] [Revised: 09/13/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Background/Objectives: Various bone substitutes have been recommended to augment the horizontal gap following immediate implantation. The purpose of this study was to compare the effectiveness of an autogenous mineralized dentin graft or a deproteinized bovine bone in horizontal gap augmentation following immediate implant placement in the maxillary anterior region. Methods: A total of 110 patients underwent tooth extraction followed by immediate implant placement. The patients were divided into two groups. The first group received an autogenous mineralized dentin graft (the test group) while the second group received a deproteinized bovine bone (the control group) to augment the horizontal gap. Preoperative (T0), immediate postoperative (T1), and 1-year postoperative (T2) cone beam computed tomography scans were taken from all the patients. Linear measurements were recorded 1 mm (R1) and 5 mm (R2) points apical to the implant platform at both T1 and T2 time intervals. Pink Esthetic Scores and prosthetic complications were evaluated as well. Results: There were 57 patients with a mean age of 45.42 ± 9.86 (range 24-63 years) selected as the test group and 53 patients with a mean age of 40.28 ± 11.69 (range 20-63 years) as the control group. The mean reduction in the buccal bone plate at R1 was 6.39 ± 3.78% in the test group and 6.99 ± 5.01% in the control group (p > 0.05). The mean reduction in the buccal bone plate at R2 was 5.46 ± 4.98% in the test group and 6.77 ± 7.60% in the control group (p < 0.05). The PES and prosthetic-related complications were shown to be negligible between the groups (p > 0.05). Conclusions: The efficiency of using an autogenous mineralized dentin graft for horizontal gap augmentation showed similar results in comparison to using a deproteinized bovine bone in relation to buccolingual socket reduction following immediate implantation.
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Affiliation(s)
- Ihsan Caglar Cinar
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Fatih, Istanbul 34093, Türkiye
| | - Mohammed Zboun
- Department of Oral & Maxillofacial Surgery and Periodontology, Faculty of Dentistry, Arab American University, 13 Zababdeh, Jenin 240, Palestine
| | - Alper Saglanmak
- Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Fatih, Istanbul 34093, Türkiye
| | - Eitan Mijiritsky
- Department of Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, School of Medicine, Tel Aviv University, Tel Aviv 64239, Israel
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Qu F, Huang YJ, Wang YY, Cao XM, Shen YY, Wu ZA, Wu YQ, Xu C. Cone-beam CT evaluation of post-extraction alveolar bone changes at the maxillary incisor sites in an East Asian population: A cross-sectional study. Heliyon 2024; 10:e32027. [PMID: 38868037 PMCID: PMC11167353 DOI: 10.1016/j.heliyon.2024.e32027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 04/26/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
Objective Understanding the characteristics of alveolar bone resorption in an East Asian population after maxillary incisor extraction and providing a reference for implant treatment plans. Study design Cone-beam computerized tomography (CBCT) data of 125 East Asian patients with unilateral extraction of maxillary incisors for 3 months were collected. The alveolar bone width and height in the extraction sites were measured and compared with the corresponding contralateral sites. Results The differences in alveolar bone width between the extraction site and contralateral site were as follows: 4.11 mm, 2.68 mm, and 2.09 mm (3 mm, 5 mm, 7 mm apical from CEJ of the contralateral tooth). Data are expressed as the median. The horizontal resorption ratio of alveolar bone was 49.94 %, 31.5 %, and 24.46 %. The difference in alveolar bone height was 0.78 mm. The vertical resorption ratio was 7.78 %. The resorption did not differ significantly between sexes and was not significantly affected by tooth positions. Conclusions In the studied East Asian population, significant horizontal and vertical alveolar bone resorption occurs after natural healing of maxillary incisor extraction for 3 months. The closer to the alveolar ridge crest, the more significant the horizontal resorption, resulting in an "inverted triangle" shape residual alveolar bone.
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Affiliation(s)
- Fang Qu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Yu-Jie Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ying-Ying Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Xi-Meng Cao
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ying-Yi Shen
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Zi-Ang Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ya-Qin Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
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Abundo R, Dellavia CPB, Canciani E, Daniele M, Dioguardi M, Zambelli M, Perelli M, Mastrangelo F. Alveolar Ridge Preservation with a Novel Cross-Linked Collagen Sponge: Histological Findings from a Case Report. J Clin Med 2023; 12:7599. [PMID: 38137668 PMCID: PMC10743811 DOI: 10.3390/jcm12247599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Alveolar ridge preservation (ARP) is a well-documented procedure to maintain bone volume after tooth extraction in order to place implants. However, at the end of the healing process, the residual biomaterial that is not reabsorbed remains embedded in the bone over time. Ribose cross-linked biomaterials demonstrated their ability to promote osteoconduction and complete resorption. The aim of this study was to evaluate the histological healing pattern of a novel ribose cross-linked collagen sponge used as a grafting material left exposed in human sockets at the time of tooth extraction. On a single patient, non-restorable lower first molars were extracted on both sides, and a ribose cross-linked collagen sponge was placed bilaterally in the cavities and left uncovered at the end of the surgery. After six months, core biopsies were taken immediately prior to implant placement; after the sample preparation, a histological analysis was performed. The results are very promising for substitution with newly formed bone and the amount of residual material. Ribose cross-linked collagen sponge could represent a valid alternative to conventional biomaterials for ARP procedures with no need for flap advancement and/or the addition of a membrane to cover the graft, reducing the invasiveness, complexity, and costs of the treatment.
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Affiliation(s)
| | | | - Elena Canciani
- Microscopic Anatomy, University of Milan, 20126 Milan, Italy;
| | - Monica Daniele
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.D.); (M.D.)
| | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.D.); (M.D.)
| | | | | | - Filiberto Mastrangelo
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.D.); (M.D.)
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Al-Madhagy G, Darwich K, Alghoraibi I, Al-Moraissi EA. Radiographic evaluation of alveolar ridge preservation using a chitosan/polyvinyl alcohol nanofibrous matrix: A randomized clinical study. J Craniomaxillofac Surg 2023; 51:772-779. [PMID: 37863731 DOI: 10.1016/j.jcms.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/14/2023] [Accepted: 09/30/2023] [Indexed: 10/22/2023] Open
Abstract
The objective of this randomized clinical trial (RCT) was to assess the effectiveness of electrospun chitosan/polyvinyl alcohol (CS/PVA) nanofibrous scaffolds in preserving the alveolar ridge and enhancing bone remodeling following tooth extraction when compared to a control group. In this split RCT, 24 human alveolar sockets were randomly assigned to two groups, with 12 sockets receiving CS/PVA nanofibrous scaffold grafts (test group) and 12 left to heal by secondary intention as the control group. Cone-beam computed tomography (CBCT) was performed at two different time points: immediately after extraction (T0) and 4 months post-extraction (T4). After 4 months, linear vertical and horizontal radiographic changes and bone density of extraction sockets were assessed in both the test and control groups. The RCT included 12 patients (4 male and 8 female) with a mean age of 24 ± 3.37 years. The test group had a significantly lower mean vertical resorption vs the control group, with a mean difference of 1.1 mm (P < 0.05). Similarly, the control group's mean horizontal bone resorption was -2.01 ± 1.04 mm, while the test group had a significantly lower mean of -0.69 ± 0.41 mm, resulting in a mean difference of 1.35 mm (P < 0.05). Furthermore, the study group exhibited a significant increase in bone density (722.03 ± 131.17 HU) after 4 months compared to the control group (448.73 ± 93.23 HU). In conclusion, we demonstrated within the limitations of this study that CS/PVA nanofibrous scaffold significantly limited alveolar bone resorption horizontally and vertically and enhanced bone density in alveolar sockets after 4 months when compared to results in the control group (TCTR20230526005).
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Affiliation(s)
- Gamil Al-Madhagy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Khaldoun Darwich
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Ibrahim Alghoraibi
- Department of Physics, Faculty of Science, Damascus University, Damascus, Syrian Arab Republic
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Mahardawi B, Kyaw TT, Mattheos N, Pimkhaokham A. The clinical efficacy of autogenous dentin blocks prepared chairside for alveolar ridge augmentation: A systematic review and meta-analysis. Clin Oral Implants Res 2023; 34:1025-1037. [PMID: 37461220 DOI: 10.1111/clr.14131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/06/2023] [Accepted: 07/06/2023] [Indexed: 10/10/2023]
Abstract
OBJECTIVES This systematic review aimed to evaluate the current evidence on the effectiveness of autogenous dentin block graft prepared chairside for alveolar ridge augmentation and compare its clinical outcomes to the main available grafting materials and techniques. MATERIALS AND METHODS Three databases were screened, including prospective clinical studies, utilizing autogenous dentin blocks for ridge augmentation, with at least 3 months of postoperative follow-up. RESULTS Eight articles were included, and four of them were meta-analyzed. Dentin blocks demonstrated similar vertical bone gain and significantly higher width gain, compared to bone blocks (WMD = 0.03, 95% CI -0.51 to 0.57, p = .92 and WMD = 1.34, 95% CI 0.57 to 2.12, p = .0007, respectively). Vertical and horizontal resorption were similar between the two groups (WMD = -0.36, 95% CI -0.91 to 0.18, p = .19, and WMD = -0.47, 95% CI -1.05 to 0.11, p = .11, respectively). Dentin blocks showed more incidences of postoperative complications, however, with no statistical significance (RR = 4.30, 95% CI 0.97 to 18.96, p = .054). The need for additional augmentation upon implant placement was also similar between both grafts (RR = 0.95, 95% CI 0.39 to 2.28, p = .90). Recorded incidences of graft exposure were low (2.27%), and no study stated surgical site infection. CONCLUSION Within its limitations, this study indicates that the autogenous dentin blocks prepared chairside could be a possible alternative to the other established bone augmentation techniques for staged ridge augmentation. Nevertheless, future studies are needed to confirm its efficacy and implant success/survival in sites grafted with this material.
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Affiliation(s)
- Basel Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Thiha Tin Kyaw
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
- Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Barootchi S, Tavelli L, Majzoub J, Stefanini M, Wang HL, Avila-Ortiz G. Alveolar ridge preservation: Complications and cost-effectiveness. Periodontol 2000 2023; 92:235-262. [PMID: 36580417 DOI: 10.1111/prd.12469] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 12/30/2022]
Abstract
Alveolar ridge preservation is routinely indicated in clinical practice with the purpose of attenuating postextraction ridge atrophy. Over the past two decades numerous clinical studies and reviews on this topic have populated the literature. In recent years the focus has primarily been on analyzing efficacy outcomes pertaining to postextraction dimensional changes, whereas other relevant facets of alveolar ridge preservation therapy have remained unexplored. With this premise, we carried out a comprehensive evidence-based assessment of the complications associated with different modalities of alveolar ridge preservation and modeled the cost-effectiveness of different therapeutic modalities as a function of changes in ridge width and height. We conclude that, among allogeneic and xenogeneic bone graft materials, increased expenditure does not translate into increased effectiveness of alveolar ridge preservation therapy. On the other hand, a significant association between expenditure on a barrier membrane and reduced horizontal and vertical ridge resorption was observed, though only to a certain degree, beyond which the return on investment was significantly diminished.
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Affiliation(s)
- Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Ann Arbor, Michigan, USA
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Division of Periodontology, Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Jad Majzoub
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Martina Stefanini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa, College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
- Private Practice, Atelier Dental Madrid, Madrid, Spain
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Efficacy of the autogenous dentin graft for implant placement: a systematic review and meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg 2022; 52:604-612. [PMID: 36328864 DOI: 10.1016/j.ijom.2022.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022]
Abstract
The aim of this study was to determine whether the autogenous dentin graft (ADG) shows comparable results and similar clinical performance to other graft materials when utilized for implant placement. Four databases were searched, and controlled human studies that applied autogenous dentin for implant surgery, comparing it with other bone grafts, were included. Nine articles met the inclusion criteria, five of which were randomized controlled trials and were included in the meta-analysis. ADG showed equivalent primary and secondary implant stability when compared to Bio-Oss (primary: mean difference -0.74, 95% confidence interval (CI) - 3.36 to 1.88, P = 0.58; secondary: mean difference - 1.29, 95% CI - 5.69 to 3.11, P = 0.57). The standardized mean difference (SMD) of marginal bone loss at 6 months and at the final follow-up (18 months) showed the two grafts to be similar (6 months: SMD -0.26, 95% CI -0.64 to 0.12, P = 0.18; final follow-up: SMD -0.12, 95% CI -0.50 to 0.26, P = 0.53), and survival after immediate implant placement was the same in the two groups: 97.37% and 97.30%, respectively. Incidences of complications with the autogenous dentin particles or blocks were in line with those of Bio-Oss or autogenous bone blocks, respectively. This meta-analysis indicates that the autogenous dentin graft is an effective option for bone augmentation around dental implants, with acceptable implant stability, marginal bone loss, and incidences of complications and failure.
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10
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Mahardawi B, Rochanavibhata S, Jiaranuchart S, Arunjaroensuk S, Mattheos N, Pimkhaokham A. Autogenous tooth bone graft material prepared chairside and its clinical applications: a systematic review. Int J Oral Maxillofac Surg 2022; 52:132-141. [PMID: 35618639 DOI: 10.1016/j.ijom.2022.04.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 12/24/2022]
Abstract
This systematic review was conducted to evaluate the available literature on the clinical outcomes of the use of autogenous tooth bone graft prepared chairside, and its current applications. A literature search was done to answer the focused questions "In partially edentulous patients, what are the alveolar ridge volumetric changes, histological findings, and implant survival rates in sites augmented with autogenous tooth bone graft prepared chairside?" Twenty articles were included at the end of the database search. Reported alveolar bone dimension changes after ridge preservation ranged between - 0.64 mm and + 2.26 mm for height, and between - 1.21 mm and + 0.41 mm for width. Augmented sites showed a significant increase in their dimensions in all investigations. The implant survival rate was 98.8% for delayed placement and 97.4% for immediate placement. Additional reports were found on the percentage bone formation following the use of this graft at different postoperative time points, which showed a higher bone volume with time. Currently available studies have included small samples, with short follow-up periods, and most have lacked a control group. Within the limitations of this review, the available evidence suggests that the autogenous tooth bone graft prepared chairside is as effective as other bone grafting materials.
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Affiliation(s)
- B Mahardawi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Rochanavibhata
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Jiaranuchart
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - S Arunjaroensuk
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - N Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - A Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
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11
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Caccianiga G, Rey G, Baldoni M, Caccianiga P, Porcaro G, Baldoni A, Ceraulo S. Laser Decontamination and LED Photobiomodulation Promote Bone Regeneration and Wound Healing by Secondary Intention, in Alveolar Ridge Preservation-Clinical and Radiographic Evaluation: A Pilot Experience. Photobiomodul Photomed Laser Surg 2022; 40:343-354. [PMID: 35255233 DOI: 10.1089/photob.2021.0062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: Tooth loss reduces crestal bone with important resorption of alveolar dimensions, reducing the possibility of placing implants after wounds healing. Objective: The goal of this pilot experience was to consider, in alveolar ridge preservation, the regenerative and decontaminating potential of oxygen high-level laser therapy (OHLLT), a high-frequency and high-power diode laser combined with hydrogen peroxide 10 volumes 3%, and to evaluate wound closure during the 14-21 days after surgery. Methods: For this study we selected 15 patients (age range from 30 to 70 years old) who underwent alveolar ridge preservation (three patients were treated in the anterior maxilla, 12 in the mandibular jaw, with molars and premolars involved). A clinical and radiographic examination was performed at baseline. In this pilot experience, after the extractions, the sockets were treated with photodynamic therapy without dye (OHLLT/SiOxyL+ protocol) to decontaminate the area that was treated, combined with allografts, Osteobiol, granulometry 25, Platelet-Rich Fibrin and collagen membranes, Biogide/Geistlich. Photobiomodulation (PBM) sessions with ATP38 were made for the first 4 months every 2 weeks. Clinical evaluations were performed at 14, 21, 90, and 240 days. Radiographic evaluations with cone beam computed tomography (CBCT) were performed at 240 days, before the second surgery. Two hundred seventy days after the first surgery, a new surgical treatment was made with the same concepts adopted in the first surgery, to place implants. Results: All alveolar ridge preservation surgeries were successful, with minimal bone resorption after 9 months. Closure of gingival tissue healed by secondary intention was achieved after 14 days for all patients, except one, who showed wound closure after 21 days. Conclusions: This pilot experience showed that this technique allowed to obtain new bone and wound healing by secondary intention in treated sites and to place implants in all patients, without other bone augmentation techniques, thanks to extracellular matrix induced by photodynamic laser therapy on grafts materials and to PBM made each 2 weeks for the first 4 months postsurgery. The study was conducted according to the guidelines of the Ethics Committee of the School of Medicine and Surgery at the Milano Bicocca University (protocol n. 11/17), and derived from the approval of Italian National Institute of Health (ISS), protocol 30 July 2007-0040488.
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Affiliation(s)
| | - Gerard Rey
- Dental Surgery Faculty, University of Paris-Diderot, Paris, France
| | - Marco Baldoni
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Paolo Caccianiga
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | - Gianluca Porcaro
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
| | | | - Saverio Ceraulo
- School of Medicine and Surgery, University of Milano-Bicocca, Milano, Italy
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12
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MacBeth N, Donos N, Mardas N. Alveolar Ridge Preservation with Guided Bone Regeneration or Socket Seal Technique. A Randomised, Single-Blind Controlled Clinical Trial. Clin Oral Implants Res 2022; 33:681-699. [PMID: 35488477 PMCID: PMC9541021 DOI: 10.1111/clr.13933] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 03/27/2022] [Accepted: 04/07/2022] [Indexed: 11/27/2022]
Abstract
Objectives To compare radiographic bone changes, following alveolar ridge preservation (ARP) using Guided Bone Regeneration (GBR), a Socket Seal (SS) technique or unassisted socket healing (Control). Material and methods Patients requiring a single rooted tooth extraction in the anterior maxilla, were randomly allocated into: GBR, SS and Control groups (n= 14/). Cone Beam Computed Tomography (CBCT) images were recorded post‐extraction and at 4 months, the mid‐buccal and mid‐palatal alveolar ridge heights (BARH/PARH) were measured. The alveolar ridge width, cross‐sectional socket and alveolar‐process area changes, implant placement feasibility, requirement for bone augmentation and post‐surgical complications were also recorded. Results BARH and PARH was found to increase with the SS (0.65 mm ± 1.1/0.65 mm ± 1.42) techniques, stabilise with GBR (0.07 mm ± 0.83/0.86 mm ±1.37) and decrease in the Control (−0.52 mm ± 0.8/−0.43 mm ± 0.83). Statistically significance was found when comparing the GBR and SS BARH (p = .04/.005) and GBR PARH (p = .02) against the Control. GBR recorded the smallest reduction in alveolar ridge width (−2.17 mm ± 0.84), when compared to the Control (−2.3 mm ± 1.11) (p = .89). A mid‐socket cross‐sectional area reduction of 4% (−2.27 mm2 ± 11.89), 1% (−0.88 mm2 ± 15.48) and 13% (−6.93 mm2 ± 8.22) was found with GBR, SS and Control groups (GBR vs. Control p = .01). The equivalent alveolar process area reduction was 8% (−7.36 mm2 ± 10.45), 6% (−7 mm2 ± 18.97) and 11% (−11.32 mm2 ± 10.92). All groups supported implant placement, with bone dehiscence noted in 57% (n = 4), 64%(n = 7) and 85%(n = 12) of GBR, SS and Control cases (GBR vs. Control p = .03). GBR had a higher risk of swelling and mucosal colour change, with SS associated with graft sequestration and matrix breakdown. Conclusion GBR ARP was found to be more effective at reducing radiographic bone dimensional changes following tooth extraction.
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Affiliation(s)
- Neil MacBeth
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK.,Defence Centre For Rehabilitative Dentistry, Defence Primary Health Care (DPHC), Dental Centre Aldershot, Guilford, Surry, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
| | - Nikos Mardas
- Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London (QMUL), Barts & The London School of Medicine & Dentistry, London, UK
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13
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Kijartorn P, Wongpairojpanich J, Thammarakcharoen F, Suwanprateeb J, Buranawat B. Clinical evaluation of 3D printed nano-porous hydroxyapatite bone graft for alveolar ridge preservation: A randomized controlled trial. J Dent Sci 2022; 17:194-203. [PMID: 35028038 PMCID: PMC8739241 DOI: 10.1016/j.jds.2021.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 02/08/2023] Open
Abstract
Background/purpose 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. Materials and methods 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. Results 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). Conclusion 3DP HA could potentially be used as an alternative bone graft material for alveolar ridge preservation.
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Affiliation(s)
- Pennapa Kijartorn
- Department of Periodontology and Implantology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Jirapa Wongpairojpanich
- Department of Periodontology and Implantology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Faungchat Thammarakcharoen
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Jintamai Suwanprateeb
- Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center, National Science and Technology Development Agency, Pathum Thani, Thailand
| | - Borvornwut Buranawat
- Department of Periodontology and Implantology, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
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14
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Galve-Huertas A, Garcia-Gonzalez S, Molina-López J, Hernández-Alfaro F. Usefulness of the subepithelial connective tissue pedicled palatal flap in alveolar reconstruction: A report of case series. J Indian Soc Periodontol 2022; 26:287-294. [PMID: 35602533 PMCID: PMC9118945 DOI: 10.4103/jisp.jisp_37_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/28/2020] [Indexed: 11/09/2022] Open
Abstract
The purpose of this case series report was to describe the subepithelial connective tissue pedicled palatal flap technique, its indications, and its efficacy in closure of alveolar ridge reconstruction. The present case series consisted of all 11 consecutive subjects who underwent a ridge augmentation with biomaterials or with bone grafts. Furthermore, in other cases were placed immediate or delayed implants. All cases were closed with a subepithelial connective tissue pedicled palatal flap reconstruction in our private dental clinic between 2014 and 2020. The main advantages of this flap are that the donor site remains primarily covered, the soft tissue volume at the recipient site is increased, and there is good integration of the graft because the blood supply of the flap comes directly from the base of the pedicle. All cases exhibited an increase in soft tissue height and width after 6 months and primary closure was successful. This case series suggests that the subepithelial connective tissue pedicled palatal flap may be useful for moderate vertical and horizontal augmentation in the recipient site.
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15
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Canullo L, Del Fabbro M, Khijmatgar S, Panda S, Ravidà A, Tommasato G, Sculean A, Pesce P. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig 2021; 26:141-158. [PMID: 34826029 DOI: 10.1007/s00784-021-04248-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/23/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket? MATERIALS AND METHODS The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials. RESULTS Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation. CONCLUSIONS Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons. CLINICAL RELEVANCE XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last.
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Affiliation(s)
- L Canullo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - M Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - S Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - S Panda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Periodontics and Oral Implantology, Siksha 'O' Anusandhan University, Bhubaneswar, India
| | - A Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - G Tommasato
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - A Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - P Pesce
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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16
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Arioka M, Dawid IM, Cuevas PL, Coyac BR, Leahy B, Wang L, Yuan X, Li Z, Zhang X, Liu B, Helms JA. Accelerating Socket Repair via WNT3A Curtails Alveolar Ridge Resorption. J Dent Res 2021; 101:102-110. [PMID: 34157887 DOI: 10.1177/00220345211019922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Tooth extraction triggers alveolar ridge resorption, and when this resorption is extensive, it can complicate subsequent reconstructive procedures that use dental implants. Clinical data demonstrate that the most significant dimensional changes in the ridge occur soon after tooth extraction. Here, we sought to understand whether a correlation existed between the rate at which an extraction socket heals and the extent of alveolar ridge resorption. Maxillary molars were extracted from young and osteoporotic rodents, and quantitative micro-computed tomographic imaging, histology, and immunohistochemistry were used to simultaneously follow socket repair and alveolar ridge resorption. Extraction sockets rapidly filled with new bone via the proliferation and differentiation of Wnt-responsive osteoprogenitor cells and their progeny. At the same time that new bone was being deposited in the socket, tartrate-resistant acid phosphatase-expressing osteoclasts were resorbing the ridge. Significantly faster socket repair in young animals was associated with significantly more Wnt-responsive osteoprogenitor cells and their progeny as compared with osteoporotic animals. Delivery of WNT3A to the extraction sockets of osteoporotic animals restored the number of Wnt-responsive cells and their progeny back to levels seen in young healthy animals and accelerated socket repair in osteoporotic animals back to rates seen in the young. In cases where the extraction socket was treated with WNT3A, alveolar ridge resorption was significantly reduced. These data demonstrate a causal link between enhancing socket repair via WNT3A and preserving alveolar ridge dimensions following tooth extraction.
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Affiliation(s)
- M Arioka
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,Department of Clinical Pharmacology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - I M Dawid
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - P L Cuevas
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - B R Coyac
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - B Leahy
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - L Wang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - X Yuan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
| | - Z Li
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - X Zhang
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA.,State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - B Liu
- Ankasa Regenerative Therapeutics, South San Francisco, CA, USA
| | - J A Helms
- Division of Plastic and Reconstructive Surgery, Department of Surgery, School of Medicine, Stanford University, Stanford, CA, USA
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17
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Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CMJ, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev 2021; 4:CD010176. [PMID: 33899930 PMCID: PMC8092674 DOI: 10.1002/14651858.cd010176.pub3] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. This is an update of the Cochrane Review first published in 2015. OBJECTIVES To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 19 March 2021), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2021, Issue 2), MEDLINE Ovid (1946 to 19 March 2021), Embase Ovid (1980 to 19 March 2021), Latin American and Caribbean Health Science Information database (1982 to 19 March 2021), Web of Science Conference Proceedings (1990 to 19 March 2021), Scopus (1966 to 19 March 2021), ProQuest Dissertations and Theses (1861 to 19 March 2021), and OpenGrey (to 19 March 2021). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. A number of journals were also handsearched. SELECTION CRITERIA We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. Corresponding authors were contacted to obtain missing information. We estimated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants. We assessed four trials as at overall high risk of bias and the remaining trials at unclear risk of bias. Nine new trials were included in this update with six new trials in the category of comparing ARP to extraction alone and three new trials in the category of comparing different grafting materials. ARP versus extraction: from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width (MD -1.18 mm, 95% CI -1.82 to -0.54; P = 0.0003; 6 studies, 184 participants, 201 extraction sites), and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001; 6 studies, 184 participants, 201 extraction sites) in favour of xenografts, but we found no evidence of a significant difference for the need for additional augmentation (RR 0.68, 95% CI 0.29 to 1.62; P = 0.39; 4 studies, 154 participants, 156 extraction sites; very low-certainty evidence) or in implant failure rate (RR 1.00, 95% CI 0.07 to 14.90; 2 studies, 70 participants/extraction sites; very low-certainty evidence). From the one trial comparing alloplasts versus extraction, there is very low-certainty evidence of a reduction in loss of alveolar ridge height (MD -3.73 mm; 95% CI -4.05 to -3.41; 1 study, 15 participants, 60 extraction sites) in favour of alloplasts. This single trial did not report any other outcomes. Different grafting materials for ARP: three trials (87 participants/extraction sites) compared allograft versus xenograft, two trials (37 participants, 55 extraction sites) compared alloplast versus xenograft, one trial (20 participants/extraction sites) compared alloplast with and without membrane, one trial (18 participants, 36 extraction sites) compared allograft with and without synthetic cell-binding peptide P-15, and one trial (30 participants/extraction sites) compared alloplast with different particle sizes. The evidence was of very low certainty for most comparisons and insufficient to determine whether there are clinically significant differences between different ARP techniques based on changes in alveolar ridge width and height, the need for additional augmentation prior to implant placement, or implant failure. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes for any of the comparisons. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material, and fibrous adhesions at the cervical part of previously preserved sockets, for the comparisons xenografts versus extraction, allografts versus xenografts, alloplasts versus xenografts, and alloplasts with and without membrane. AUTHORS' CONCLUSIONS ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long-term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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Affiliation(s)
- Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Hm Alsabeeha
- RAK Dental Centre, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
| | - Alan Gt Payne
- Private practice, Northland Prosthodontics Ltd, c/o NorthShore Oral and Maxillofacial Surgeons, Auckland, New Zealand
| | - Sara Ali
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | | | - Marco Esposito
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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18
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Radoczy-Drajko Z, Windisch P, Svidro E, Tajti P, Molnar B, Gerber G. Clinical, radiographical and histological evaluation of alveolar ridge preservation with an autogenous tooth derived particulate graft in EDS class 3-4 defects. BMC Oral Health 2021; 21:63. [PMID: 33573644 PMCID: PMC7879529 DOI: 10.1186/s12903-021-01429-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/13/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at implant-prosthetic treatment. BonMaker® ATB is a novel autogenous bone grafting material, produced by the mechanical and chemical processing of natural teeth. This pilot case report aims at providing a clinical, radiographical, and histological evaluation of the safety and efficacy of Bonmaker ATB powder in the treatment of EDS class 3-4 postextraction sockets with alveolar ridge preservation. METHODS A total of 9 teeth were extracted from 5 patients. The extracted teeth were prepared immediately with the Bonmaker® device. The extraction sockets were filled up with ATB powder. Six months after extraction, standardized intraoral x-rays and CBCT scans were performed. Re-entry was performed under local anaesthesia. Core biopsies were harvested for histological analysis and implants were placed. RESULTS Horizontal alveolar dimension loss occurred, even though ARP was performed, but the horizontal shrinkage was moderate. Vertical dimensions did not show loss of volume, but increased defect fill. Core biopsies showed ATB particles surrounded by newly formed bone and connective tissue. According to histomorphometric analysis, the harvested samples contained 56% of newly formed bone on average, and only a mean of 7% of non-remodelled ATB material was observed. CONCLUSION The preliminary clinical, radiographical, and histological results of Bonmaker® autogenous tooth graft therapy indicate that ATB may be safely and successfully used as a grafting material for ARP. Optimal graft incorporation and histologically proven effective remodelling, as well as uneventful wound healing support the clinical application of ATB to minimize post-extraction hard tissue loss. Further research is needed to exploit the full potential of ATB and to evaluate the long-term peri-implant hard and soft tissue stability of ATB-treated post-extraction sites.
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Affiliation(s)
- Zsombor Radoczy-Drajko
- Department of Periodontology, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary.
| | - Peter Windisch
- Department of Periodontology, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| | - Eszter Svidro
- Scientific Students' Associations Student, Semmelweis University, Budapest, Hungary
| | - Peter Tajti
- Scientific Students' Associations Student, Semmelweis University, Budapest, Hungary
| | - Balint Molnar
- Department of Periodontology, Semmelweis University, Szentkirályi street 47., Budapest, 1088, Hungary
| | - Gabor Gerber
- Department of Anatomy, Histology and Embriology, Semmelweis University, Budapest, Hungary
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19
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Kim YK, Ku JK. Extraction socket preservation. J Korean Assoc Oral Maxillofac Surg 2020; 46:435-439. [PMID: 33377470 PMCID: PMC7783174 DOI: 10.5125/jkaoms.2020.46.6.435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/16/2022] Open
Abstract
Extraction socket preservation (ESP) is widely performed after tooth extraction for future implant placement. For successful outcome of implants after extractions, clinicians should be acquainted with the principles and indications of ESP. It is recommended that ESP be actively implemented in cases of esthetic areas, severe bone defects, and delayed implant placement. Dental implant placement is recommended at least 4 months after ESP.
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Affiliation(s)
- Young-Kyun Kim
- Editor-in-Chief of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Dentistry & Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
- Young-Kyun Kim, Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul, National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea, TEL: +82-31-787-7541 FAX: +82-31-787-4068, E-mail: , ORCID: https://orcid.org/0000-0002-7268-3870
| | - Jeong-Kui Ku
- Section Editor of J Korean Assoc Oral Maxillofac Surg, Seongnam, Korea
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Seongnam, Korea
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Stumbras A, Galindo-Moreno P, Januzis G, Juodzbalys G. Three-dimensional analysis of dimensional changes after alveolar ridge preservation with bone substitutes or plasma rich in growth factors: Randomized and controlled clinical trial. Clin Implant Dent Relat Res 2020; 23:96-106. [PMID: 33084205 DOI: 10.1111/cid.12950] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously. MATERIALS AND METHODS Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans. RESULTS The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (-1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (-0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (-0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (-0.26 ± 0.91 mm) and PRGF (-0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group. CONCLUSIONS Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.
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Affiliation(s)
- Arturas Stumbras
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pablo Galindo-Moreno
- Oral Surgery and Implant Dentistry Department, University of Granada, Granada, Andalucía, Spain
| | - Gintaras Januzis
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Functionalized Scaffold and Barrier Membrane with Anti-BMP-2 Monoclonal Antibodies for Alveolar Ridge Preservation in a Canine Model. BIOMED RESEARCH INTERNATIONAL 2020; 2020:6153724. [PMID: 33029518 PMCID: PMC7530509 DOI: 10.1155/2020/6153724] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/04/2020] [Indexed: 01/14/2023]
Abstract
Introduction The aim of this study was to investigate the ability of anti-bone morphogenetic protein 2 monoclonal antibody (anti-BMP-2 mAb) to functionalize scaffolds to mediate bone regeneration in a canine model. Materials and Methods The mandibular right premolar 4 (PM4) was extracted in eight beagle dogs and grafted with anti-BMP-2 mAb+anorganic bovine bone mineral with 10% collagen (ABBM-C) and porcine bilayer native collagen membrane (CM). The ABBM-C and CM were functionalized with either anti-BMP-2 mAb (test group) or an isotype matched control mAb (control group). Animals were euthanized at 12 weeks for radiographic, histologic, and histomorphometric analyses. Outcomes were compared between groups. Results 3D imaging using cone beam computed tomography (CBCT) revealed that sites treated with ABBM-C and CM functionalized with anti-BMP-2 mAb exhibited significantly more remaining bone width near the alveolar crest, as well as buccal bone height, compared with control groups. Histologic and histomorphometric analyses demonstrated that in anti-BMP-2 mAb-treated sites, total tissue volume was significantly higher in the coronal part of the alveolar bone crest compared with control sites. In anti-BMP-2 mAb-treated sites, bone formation was observed under the barrier membrane. Conclusion Functionalization of the ABBM-C scaffold and CM appeared to have led to bone formation within healing alveolar bone sockets.
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Padhye NM, Mehta LK, Yadav N. Buccally displaced flap versus sub-epithelial connective tissue graft for peri-implant soft tissue augmentation: a pilot double-blind randomized controlled trial. Int J Implant Dent 2020; 6:48. [PMID: 32869135 PMCID: PMC7459078 DOI: 10.1186/s40729-020-00244-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 07/08/2020] [Indexed: 11/23/2022] Open
Abstract
Background This article describes a novel surgical technique, the buccally displaced flap, for keratinized mucosa (KM) augmentation during implant uncovering. Furthermore, it clinically compares this technique with sub-epithelial connective tissue graft (SCTG) for peri-implant KM augmentation. Twelve weeks following implant placement, subjects were randomly divided for KM augmentation into group A (buccally displaced flap) and group B (SCTG). The width (WKM) and thickness (TKM) of the KM were assessed prior to the implant uncovering, 4 weeks and 1 year after implant loading. Post-operative pain assessment was performed using the Numeric Rating Scale. Results The study comprised of 20 implants that were uncovered in 20 subjects. For group A, the mean WKM increased from 0.98 (± 0.23 mm) to 3.01 mm (± 0.18 mm), and the mean TKM increased from 1.45 (± 0.13 mm) to 2.21 mm (± 0.16 mm) at 1 year. For group B, the mean WKM increased from 0.93 (± 0.18 mm) to 3.28 mm (± 0.13 mm), and the mean TKM increased from 1.41 (± 0.15 mm) to 2.25 mm (± 0.11 mm) at 1 year. Post-operative pain was significantly higher for group B 4.15 (± 1.35) as compared to group A 2.6 (± 1.22) (p < 0.001). Conclusion The buccally displaced flap increased the WKM and TKM during implant uncovering, with results comparable to SCTG. The main advantages of the technique were lack of sutures, maintenance of blood supply, reducing number of surgical sites, and it was relatively atraumatic with lesser post-operative pain. Trial registration Clinical trials registry—India CTRI/2019/09/021059. Date of registration—September 4, 2019, retrospectively registered.
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Affiliation(s)
| | | | - Naveeta Yadav
- Mahatma Gandhi Postgraduate Institute of Dental Sciences, Pondicherry, India
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Lesclous P, Cloitre A, Catros S, Devoize L, Louvet B, Châtel C, Foissac F, Roux C. Alendronate or Zoledronic acid do not impair wound healing after tooth extraction in postmenopausal women with osteoporosis. Bone 2020; 137:115412. [PMID: 32404281 DOI: 10.1016/j.bone.2020.115412] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/29/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bisphosphonates (BPs) are widely used for the prevention or treatment of osteoporosis. One of the most serious complications associated with BPs is medication-related osteonecrosis of the jaw (MRONJ) but its incidence in patients with osteoporosis is very low ranging from 0.001-0.15%. A major predisposing factor for MRONJ is tooth extraction (TE). Controversies persist about the influence of current BP therapy regarding socket healing after TE. The aims of this study were to investigate prospectively, (i) alveolar bone healing, i.e., filling of the bony socket by new bone and (ii) mucosal healing, i.e., closure of the overlying mucosa, after TE in women receiving current BP therapy for the prevention or the treatment of postmenopausal osteoporosis. METHODS Women with osteoporosis under current treatment with BPs (BP+ group) or other anti-osteoporotic medications (BP- group) undergoing single TE were included in this study. No antibiotic prophylaxis was prescribed solely for the BP therapy, but antibiotic treatment may have been required for local infectious conditions. Chlorohexidine mouthwashes were systematically prescribed in all study patients for one week after TE. New bone height (NBH) and rate of socket filling (RSF) were recorded using intraoral standardized radiographs one month and 3 months after TE (T30 and T90 respectively). The closure of the overlying mucosa was assessed by measuring the wound extent with an electronic caliper at 1 week and at 1 month after TE (T7 and T30 respectively). RESULTS At T30, NBH was not statistically different between the BP+ and BP- groups (p = .76). At T90, more than a two-fold in NBH increase was recorded for both groups with no statistically significant difference between them (p = .76). At T30 and T90, RSF was similar in both groups (p = .58 and p = .32 respectively). More than a two-fold RSF increase was founded between T30 and T90 in both groups. No demographic or BPs-related factors were correlated with the RSF at T90. At T7, the mucosa wound extent was reduced by more than two-fold with no statistically significant difference between both groups (p = .80). At this time, mucosa healing was achieved in 11.9% of the BP+ group and 10% of the BP- group (p = .99). At T30, mucosal healing was achieved in all patients but two, and at T90 it was achieved in all patients. CONCLUSION This study provides new insights into bone and mucosal healing in patients with osteoporosis taking BPs after TE. In this population, TE can be managed successfully with an appropriate surgical protocol and without discontinuation of BP treatment.
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Affiliation(s)
- Philippe Lesclous
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, UFR Odontologie, CHU de Nantes, Unité Fonctionnelle de Chirurgie Orale, PHU4 OTONN, ONIRIS, Nantes F-44042, France.
| | - Alexandra Cloitre
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, UFR Odontologie, CHU de Nantes, Unité Fonctionnelle de Chirurgie Orale, PHU4 OTONN, ONIRIS, Nantes F-44042, France
| | - Sylvain Catros
- Inserm, UMR 1026, BioTis, Tissue Bioengineering, Service de Chirurgie Orale, Université de Bordeaux, UFR Odontologie, CHU de Bordeaux, F-33076, France
| | - Laurent Devoize
- Université Clermont Auvergne, Neuro-Dol BP 10448, Clermont-Ferrand & Inserm U1107, F-63001 Clermont Ferrand, France
| | | | - Cécile Châtel
- Service de Chirurgie Plastique et Maxillo-Faciale, CHU Grenoble, Grenoble F-38000, France
| | | | - Christian Roux
- Inserm UMR 1153 Clinical epidemiology and biostatistics, Université Paris Descartes, PRES Sorbone Paris-Cité Service de Rhumatologie-Hôpital Cochin, AP -HP centre, Université de Paris, Paris, France
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Debel M, Toma S, Vandenberghe B, Brecx MC, Lasserre JF. Alveolar ridge dimensional changes after two socket sealing techniques. A pilot randomized clinical trial. Clin Oral Investig 2020; 25:1235-1243. [PMID: 32591869 DOI: 10.1007/s00784-020-03428-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 06/22/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This pilot study aimed to assess dimensional changes following two different alveolar socket sealing techniques. MATERIAL AND METHODS Twenty-one patients requiring tooth extraction and implant placement were randomly allocated to two different alveolar ridge preservation techniques. In the control group, demineralized bovine bone mineral (DBBM) and a gingival soft tissue punch were used to fill and seal the socket, whereas in the test group, the extraction socket was filled with DBBM and sealed with a hemostatic gelatin sponge. Digitalized impressions were taken before and 6 months after tooth extraction. The comparison was made on horizontal and vertical dimensional changes. RESULTS The mean vertical loss was 0.8 ± 0.6 mm for the control group and 0.7 ± 0.5 mm for the test one. No statistical difference was found between groups for the vertical shrinkage. The horizontal dimensional narrowing of the alveolar socket was respectively 7.1/4.0/2.5 mm at levels 1, 3, and 5 mm from a coronal reference level for the control group. The test group showed dimensional changes of 4.8/2.3/1.3 mm at the three different levels, respectively. A significant difference was found at levels 3 and 5 mm. Referring to a visual analog pain scale, patients reported more severe pain in the control group (5.7/10) when compared with the test group (2.8/10). The difference was statistically highly significant (P ≤ 0.001). CONCLUSIONS A significant difference was found between control and test groups regarding the horizontal dimensional changes and the post-operative pain. CLINICAL RELEVANCE Regarding this primary result, the socket sealing technique with a hemostatic sponge provides an effective and inexpensive protocol with less post-operative pain.
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Affiliation(s)
- M Debel
- Department of Periodontology, Université Catholique de Louvain (UCL)-Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium.
| | - S Toma
- Department of Periodontology, Université Catholique de Louvain (UCL)-Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - B Vandenberghe
- Advimago, Center for Advanced Oral Imaging, Rue Emile Claus 42, 1050, Brussels, Belgium
| | - M C Brecx
- Department of Periodontology, Université Catholique de Louvain (UCL)-Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium
| | - J F Lasserre
- Department of Periodontology, Université Catholique de Louvain (UCL)-Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, 1200, Brussels, Belgium
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Hojo S, Bamba N, Kojima K, Kodama T. Examination of β-TCP/collagen composite in bone defects without periosteum in dogs: a histological and cast model evaluation. Odontology 2020; 108:578-587. [PMID: 32162098 DOI: 10.1007/s10266-020-00506-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 02/24/2020] [Indexed: 10/24/2022]
Abstract
After tooth extraction, the alveolar ridge is absorbed and changes shape. Recently, socket preservation has been proposed to prevent alveolar ridge absorption. However, there are few reports of socket preservation in a model without the periosteum, and alveolar bone regeneration and resorption inhibitory effects in this type of model remain unclear. Therefore, in this study, we conducted socket preservation at the bone defect without the periosteum using a canine model. Ten beagle dogs were extracted. A 5 mm × 7 mm × 4 mm bone defect was created without the periosteum. Defects were filled with beta-tricalcium phosphate (β-TCP)/collagen (Col), β-TCP, collagen, or left intact (Control). The observation periods were 4 and 8 weeks (n = 5 per group). Evaluations were made of the newly formed bone area, residual granular area, horizontal width and vertical dimensional change. The newly formed bone area at 4 weeks after surgery in TCP/Col, Collagen, β-TCP, and Control groups was 21.50%, 17.26%, 18.22%, and 17.47%. Compared to the control group, the TCP/Col group showed a significant difference in bone regeneration and horizontal width. TCP/Col is suggested to be effective for bone regeneration and suppression of alveolar ridge resorption in the bone defect periosteum removal model.
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Affiliation(s)
- Sawako Hojo
- Division of Implantology and Periodontology, Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, 3-31-6, Kanagawa-ku, Yokohama, Kanagawa, 221-0835, Japan.
| | - Noriko Bamba
- Division of Implantology and Periodontology, Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, 3-31-6, Kanagawa-ku, Yokohama, Kanagawa, 221-0835, Japan
| | - Kousuke Kojima
- Division of Implantology and Periodontology, Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, 3-31-6, Kanagawa-ku, Yokohama, Kanagawa, 221-0835, Japan
| | - Toshiro Kodama
- Division of Implantology and Periodontology, Department of Highly Advanced Stomatology, Graduate School of Dentistry, Kanagawa Dental University, 3-31-6, Kanagawa-ku, Yokohama, Kanagawa, 221-0835, Japan
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Kattimani VS, Lingamaneni KP, Kreedapathi GE, Kattappagari KK. Socket preservation using eggshell-derived nanohydroxyapatite with platelet-rich fibrin as a barrier membrane: a new technique. J Korean Assoc Oral Maxillofac Surg 2019; 45:332-342. [PMID: 31966978 PMCID: PMC6955417 DOI: 10.5125/jkaoms.2019.45.6.332] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 05/01/2019] [Accepted: 05/12/2019] [Indexed: 11/07/2022] Open
Abstract
Objectives Socket grafting is vital to prevent bone resorption after tooth extraction. Several techniques to prevent resorption have been described, and various bone graft substitutes have been developed and used with varying success. We conducted this pilot study to evaluate the performance of nanohydroxyapatite (nHA) derived from chicken eggshells in socket preservation. Materials and Methods This was a prospective, single center, outcome assessor-blinded evaluation of 23 sockets (11 patients) grafted with nHA and covered with platelet-rich fibrin (PRF) membrane as a barrier. Bone width and radiographic bone density were measured using digital radiographs at 1, 12, and 24 weeks post-procedure. Postoperative histomorphometric and micro-computed tomography (CT) evaluation were performed. The study protocol was approved by the Institutional Ethics Committee. Results All patients had uneventful wound healing without graft material displacement or leaching despite partial exposure of the grafted socket. Tissue re-epithelialized with thick gingival biotype (>3 mm). Width of the bone was maintained and radiographic density increased significantly with a trabecular pattern (73.91% of sockets) within 12 weeks. Histomorphometric analysis showed 56.52% Grade 3 bone formation and micro-CT analysis revealed newly formed bone with interconnecting trabeculae. Conclusion Use of a PRF membrane with nHA resulted in good bone regeneration in sockets. Use of a PRF membrane prevents periosteal-releasing incisions for primary closure, thereby facilitating the preservation of keratinized mucosa and gingival architecture. This technique, which uses eggshell-derived nHA and PRF membrane from the patient's own blood, is innovative and is free of disease transfer risks. nHA is a promising economic bone graft substitute for bone regeneration and reconstruction because of the abundant availability of eggshell waste as a raw material.
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Affiliation(s)
| | | | | | - Kiran Kumar Kattappagari
- Department of Oral and Maxillofacial Pathology, Sibar Institute of Dental Sciences, Guntur, India
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Prospective Clinical and Histologic Evaluation of Alveolar Socket Healing Following Ridge Preservation Using a Combination of Hydroxyapatite and Collagen Biomimetic Xenograft Versus Demineralized Bovine Bone. J Craniofac Surg 2019; 30:1089-1094. [PMID: 30839465 DOI: 10.1097/scs.0000000000005416] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This prospective study is aimed at investigating clinically and histologically the effectiveness of a biomimetic magnesium-enriched-hydroxyapatite (MgHA)/collagen-based bone substitute for alveolar socket preservation. MATERIALS Patients scheduled for posterior single tooth extraction were included. The alveolar socket was filled either with MgHA or deproteinized bovine bone matrix (DBBM). In DBBM group, a punch of mucosa was taken from the palate and used to cover the graft. Vertical and horizontal dimensional changes of the alveolar process were assessed clinically with a periodontal probe and with 3-dimensional (3D) analysis of a cast model. Postoperative quality of life was assessed through a questionnaire. After 6 months of healing, an alveolar tissue biopsy was taken for histologic and histomorphometric analysis of the newly formed tissue. After checking normality of the distributions, parametric or nonparametric tests were used for statistical comparisons. RESULTS Twenty patients (12 males, 8 females, mean age 42.8 ± 5.1 years, range 33-50 years) were treated. After 6 months, vertical and horizontal alveolar ridge resorption was similar in the 2 groups. The 3D analysis of the models showed a significantly higher resorption at the buccal side than at the palatal/lingual side. Histomorphometric analysis showed similar new bone formation for MgHA group (23.07 ± 10.3%) and DBBM (22.77 ± 6.95%), and a significantly higher residual material% for DBBM (15.77 ± 1.95%) than MgHA (5.01 ± 1.04%). Significantly less pain was reported in the first 3 days after surgery in patients of the MgHA group. CONCLUSION The MgHA was as safe and effective as DBBM and may represent a feasible bone substitute for alveolar socket preservation.
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Hsu PY, Kuo HC, Tuan WH, Shih SJ, Naito M, Lai PL. Manipulation of the degradation behavior of calcium sulfate by the addition of bioglass. Prog Biomater 2019; 8:115-125. [PMID: 31127540 PMCID: PMC6556162 DOI: 10.1007/s40204-019-0116-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/13/2019] [Indexed: 11/30/2022] Open
Abstract
A bioactive calcium sulfate/glass composite was prepared using a sintering technique, and Ca–P–Si glass particles were prepared by spray pyrolysis. The glass exhibited bioactivity in terms of its ability to form apatite in a simulated body fluid. The glass was transformed into two crystallized phases, i.e., calcium phosphate and calcium silicate, respectively, during the heating stage. The presence of the crystallized phases retarded the densification of calcium sulfate. A high sintering temperature of 1200 °C was needed to prepare the composite. The increased addition of glass enhanced the strength and decreases the degradation rate of calcium sulfate. The new composite is not only degradable but also bioactive.
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Affiliation(s)
- Pei-Yi Hsu
- Department of Materials Science and Engineering, National Taiwan University, Taipei, 107, Taiwan
| | - Hsiao-Chun Kuo
- Department of Materials Science and Engineering, National Taiwan University, Taipei, 107, Taiwan
| | - Wei-Hsing Tuan
- Department of Materials Science and Engineering, National Taiwan University, Taipei, 107, Taiwan.
| | - Shao-Ju Shih
- Department of Materials Science and Engineering, National Taiwan University of Science and Technology, Taipei, 107, Taiwan
| | - Makio Naito
- Joining and Welding Research Institute, Osaka University, 11-1, Mihogaoka, Ibaraki, Osaka, 567-0047, Japan
| | - Po-Liang Lai
- Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital at Linkou, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
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Comparative Evaluation of Recombinant Human Bone Morphogenetic Protein-2/Hydroxyapatite and Bovine Bone for New Bone Formation in Alveolar Ridge Preservation. IMPLANT DENT 2019; 27:623-629. [PMID: 30199421 DOI: 10.1097/id.0000000000000814] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Hydroxyapatite treated with recombinant human bone morphogenetic protein-2/Hydroxyapatite (rhBMP-2/HA) or bovine bone was applied on extraction sockets for alveolar ridge preservation, and the results were compared with respect to clinical and histological bone formation. MATERIALS AND METHODS This was a prospective, randomized controlled clinical trial performed on 20 implant placement sites (10 in the experimental and 10 in the control group). rhBMP-2/HA was applied on extraction sockets in the experimental group and bovine bone on those of the control group. The bone at the corresponding sites was biopsied 3 months later, and clinical, histological, and histomorphometric analyses were performed. RESULTS The alveolar bone height was well preserved in both groups with relatively less change in width in the experimental group compared with the control group. The percentage of new bone was 25.37% ± 17.23% in the experimental group and 6.13% ± 4.32% in the control group; the difference was statistically significant. CONCLUSIONS The alveolar ridge was preserved clinically and histologically in both groups. rhBMP-2/HA resulted in greater new bone formation than bovine bone 3 months after the surgery.
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Blanco J, Carral C, Argibay O, Liñares A. Implant placement in fresh extraction sockets. Periodontol 2000 2019; 79:151-167. [DOI: 10.1111/prd.12253] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Juan Blanco
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Cristina Carral
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Olalla Argibay
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
| | - Antonio Liñares
- Unit of Periodontology Department of Estomatology Santiago de Compostela University Santiago de Compostela Spain
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31
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Guarnieri R, Di Nardo D, Gaimari G, Miccoli G, Testarelli L. One-stage laser-microtextured implants immediately placed in the inter-radicular septum of molar fresh extraction sockets associated with GBR technique. A case series study. J Clin Exp Dent 2018; 10:e996-e1002. [PMID: 30386506 PMCID: PMC6203904 DOI: 10.4317/jced.54705] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 07/05/2018] [Indexed: 11/05/2022] Open
Abstract
Background The outcome of one-stage trans-mucosal immediate implants with simultaneous guided bone regeneration (GBR) technique has become highly predictable. Furthermore, when this approach is performed to place one-stage implants into the inter-radicular septum of fresh extraction sockets in the molar region, the risk of incorrect emergence profile and off-angle loading is reduced. The aim of the present study was to clinically evaluate the horizontal hard and soft tissue changes, and radiographically the vertical socket walls remodeling, and the early peri-implant marginal bone loss (EMBL) following the placement of immediate one-stage implants in the inter-radicular septum of molar fresh extraction sockets, associated with a collagen membrane. Material and Methods Twenty patients were selected to receive a one-stage implant with laser-microtextured collar surface into the inter-radicular septum of a fresh molar extraction sockets, associated with a simultaneous placement of a collagen membrane. Intraoral radiographs and model casts were used for the evaluation. Correlation between the amount of the keratinized tissue thickness (KTT) with EMBL was also analyzed. Results After 4 months, the vertical radiographic mesial and distal EMBL around implants was of 0.06 ±0.01 mm and 0.04±0.02 mm, respectively, with no statistically significant difference between T0 and T1 (P >0.05). No statistical differences were found also for each radiographic measure used for the examination of implant sites vertical bone changes (p >0.05). Clinically, horizontal changes of the bucco-lingual central width were found statistically significant (p<0.05), whereas no statistical differences were found for bucco-lingual mesial and distal width changes (p >0.05). In addition, no statistically significant correlation between EMBL and the amount of KTT was found (P >0.05). Conclusions Results suggest that the immediate placement of one-stage laser-microtextured implants could provide advantages in preserving the extraction socket's hard and soft tissue remodeling, and the peri-implant marginal bone level before the prosthetic loading. Key words:One-stage implant, laser-microtextured collar surface, GBR, collagen membrane.
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Affiliation(s)
- Renzo Guarnieri
- MD DDS, Adjunct Professor. Dept. of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Dario Di Nardo
- DDS, PhD. Dept. of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gianfranco Gaimari
- DDS, PhD. Dept. of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Gabriele Miccoli
- DDS, PhD. Dept. of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
| | - Luca Testarelli
- DDS, PhD, Associated Professors. Dept. of Dental and Maxillofacial Sciences, School of Dentistry, University La Sapienza, Rome, Italy
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Pessanha-Andrade M, Sordi MB, Henriques B, Silva FS, Teughels W, Souza JCM. Custom-made root-analogue zirconia implants: A scoping review on mechanical and biological benefits. J Biomed Mater Res B Appl Biomater 2018; 106:2888-2900. [PMID: 30070423 DOI: 10.1002/jbm.b.34147] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/18/2018] [Accepted: 04/09/2018] [Indexed: 12/26/2022]
Abstract
The aim of this study was to conduct a literature review on the potential benefits of custom-made root-analogue zirconia implants. A PubMed and ScienceDirect bibliographical search was carried out from 1969 to 2017. The increased interest in zirconia-based dental structures linked to aesthetic and biological outcomes have been reported in literature. Recent technological advances have focused on novel strategies for modification of zirconia-based surfaces to accelerate osseointegration. However, only a few studies revealed mechanical and biological benefits of custom-made root-analogue zirconia implants and therefore further studies should investigate the influence of different design and surface modification on the performance of such implants. Custom-made root-analogue zirconia implants have become a viable alternative to overcome limitations concerning stress distribution, aesthetics, and peri-implantitis induced by biofilms. However, further in vitro and in vivo studies on surface-bone interactions and mechanical behavior of zirconia should be evaluated to reduce clinical issues regarding mechanical failures and late peri-implant bone loss. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 2888-2900, 2018.
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Affiliation(s)
- Miguel Pessanha-Andrade
- Division of Oral Implantology, School of Dentistry, Universidade Fernando Pessoa (UFP), Porto, Portugal
| | - Mariane B Sordi
- Post-graduate Program in Dentistry (PPGO), Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Bruno Henriques
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Filipe S Silva
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
| | - Wim Teughels
- Department of Oral Health Sciences, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Júlio C M Souza
- Center for Microelectromechanical Systems (CMEMS-UMinho), University of Minho, Campus Azurém, Guimarães, Portugal
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Zeeshan R, Mutahir Z, Iqbal H, Ali M, Iqbal F, Ijaz K, Sharif F, Shah AT, Chaudhry AA, Yar M, Luan S, Khan AF, Ihtesham-ur-Rehman. Hydroxypropylmethyl cellulose (HPMC) crosslinked chitosan (CH) based scaffolds containing bioactive glass (BG) and zinc oxide (ZnO) for alveolar bone repair. Carbohydr Polym 2018; 193:9-18. [DOI: 10.1016/j.carbpol.2018.03.046] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 12/11/2022]
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Girish Kumar N, Chaudhary R, Kumar I, Arora SS, Kumar N, Singh H. To assess the efficacy of socket plug technique using platelet rich fibrin with or without the use of bone substitute in alveolar ridge preservation: a prospective randomised controlled study. Oral Maxillofac Surg 2018; 22:135-142. [PMID: 29411166 DOI: 10.1007/s10006-018-0680-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023]
Abstract
AIM The purpose of this study is to evaluate the efficacy of Platelet Rich Fibrin (PRF) as a socket plug with or without use of Plaster of Paris (POP) as bone substitute to preserve the alveolar ridge post-extraction. MATERIAL AND METHODS A prospective randomised single blind controlled study, was conducted for 18 months from November 2014 to May 2016 on 48 patients requiring extraction. All teeth were extracted atraumatically using periotomes and luxators without raising mucoperiosteal flap. Sockets were randomly allotted to groups A, B and C. Group A sockets were chosen as control, where figure of eight suture was placed. In group B sockets, PRF obtained by centrifugation was used as a socket plug and stabilised with figure of eight suture. Group C sockets were filled with POP and then covered with PRF. The socket was then closed with a figure of eight suture. Patients were informed of need for 6 months follow-up. RESULTS Ninety sockets in 48 patients were subjected to our study. We found that results in the sockets where we have grafted POP showed better ridge preservation and post-operative comfort even though the difference in ridge resorption between the three groups was not statistically significant. Powered by Editorial Manager® and ProduXion Manager® from the Aries Systems Corporation. CONCLUSION Atraumatic extraction may minimise the post-operative pain and discomfort to patient as well as the post-extraction alveolar height and width changes. The use of PRF and/or bone substitute even though clinically contributes to better post-operative healing and minimal loss of alveolar width and height, the values were not statistically significant.
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Affiliation(s)
- N Girish Kumar
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India
| | - Rupanzal Chaudhary
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India
| | - Ish Kumar
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India.
| | - Srimathy S Arora
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India
| | - Nilesh Kumar
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India
| | - Hem Singh
- Department of Oral and Maxillofacial Surgery, Swami Devi Dyal Hospital & Dental College, Barwala, Panchkula, India
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Munhoz EA, Bodanezi A, Cestari Biol TM, Zardin Graeff MS, Junior OF, de Carvalho PSP, Taga R. Impact of Inorganic Xenograft on Bone Healing and Osseointegration: An Experimental Study in Rabbits. IMPLANT DENT 2017; 26:875-881. [PMID: 29095789 DOI: 10.1097/id.0000000000000694] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate if an inorganic graft applied before implant insertion interferes with osseointegration. MATERIALS AND METHODS The bilateral mandibular incisors of 12 rabbits were extracted. One of the sockets was randomly filled with an inorganic xenogenic bone graft, whereas the remaining socket was allowed to heal naturally and served as a control. After 60 days, titanium implants were inserted into healing areas. The animals were killed 60 days after. Bone depositions were marked with fluorochrome oxytetracycline, alizarin, and calcein and evaluated using confocal laser scanning microscopy. Bone-to-implant contact (BIC) and bone area (BA) within the limits of the implant threads were analyzed. Data were compared statically by paired t tests, one-way ANOVA, and Bonferroni post hoc tests (α = 0.05). RESULTS No differences between the control and experimental groups in bone deposition for each marker, in either the BIC or BA analysis were observed. The bone deposition marked by alizarin (14-21 days) was the highest, followed by oxytetracycline (0 and 7 days) and calcein (45 and 52 days) in both groups (P < 0.05). CONCLUSION The bone healing or the course of osseointegration was not impaired by the use of an inorganic xenogenic graft before insertion of a titanium implant.
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Affiliation(s)
- Etiene Andrade Munhoz
- Assistant Professor, Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Augusto Bodanezi
- Assistant Professor, Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Tania Mary Cestari Biol
- Scientific Laboratory Technician, Department of Oral Biology, School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Márcia Sirlene Zardin Graeff
- Scientific Laboratory Technician, Integrated Research Center, Dental School of Bauru, University of São Paulo, São Paulo, Bauru, Brazil
| | - Osny Ferreira Junior
- Associate Professor, Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Paulo Sergio Perry de Carvalho
- Chairman in Oral Surgery, Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Rumio Taga
- Chairman in Oral Biology, Department of Oral Biology, School of Dentistry, University of São Paulo, Bauru, Brazil
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Elgali I, Omar O, Dahlin C, Thomsen P. Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 2017; 125:315-337. [PMID: 28833567 PMCID: PMC5601292 DOI: 10.1111/eos.12364] [Citation(s) in RCA: 468] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Guided bone regeneration (GBR) is commonly used in combination with the installment of titanium implants. The application of a membrane to exclude non‐osteogenic tissues from interfering with bone regeneration is a key principle of GBR. Membrane materials possess a number of properties which are amenable to modification. A large number of membranes have been introduced for experimental and clinical verification. This prompts the need for an update on membrane properties and the biological outcomes, as well as a critical assessment of the biological mechanisms governing bone regeneration in defects covered by membranes. The relevant literature for this narrative review was assessed after a MEDLINE/PubMed database search. Experimental data suggest that different modifications of the physicochemical and mechanical properties of membranes may promote bone regeneration. Nevertheless, the precise role of membrane porosities for the barrier function of GBR membranes still awaits elucidation. Novel experimental findings also suggest an active role of the membrane compartment per se in promoting the regenerative processes in the underlying defect during GBR, instead of being purely a passive barrier. The optimization of membrane materials by systematically addressing both the barrier and the bioactive properties is an important strategy in this field of research.
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Affiliation(s)
- Ibrahim Elgali
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Omar Omar
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden.,Department of Oral Maxillofacial Surgery/ENT, NU-Hospital organisation, Trollhättan, Sweden
| | - Peter Thomsen
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,BIOMATCELL VINN Excellence Center of Biomaterials and Cell Therapy, University of Gothenburg, Gothenburg, Sweden
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Valdec S, Pasic P, Soltermann A, Thoma D, Stadlinger B, Rücker M. Alveolar ridge preservation with autologous particulated dentin-a case series. Int J Implant Dent 2017; 3:12. [PMID: 28361377 PMCID: PMC5374084 DOI: 10.1186/s40729-017-0071-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 03/15/2017] [Indexed: 11/21/2022] Open
Abstract
Introduction Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated dentin. Material and methods The fractured, non-savable mesial incisor of the upper jaw was carefully extracted in axial direction. After the extraction, the tooth was cleared from remaining periodontal tissue. The vital pulp tissue or a root canal filling, enamel and cementum were also removed. Following the particulation of the remaining dentin in a bone mill, the dentin particles were immediately filled orthotope into the alveolar socket. The soft tissue closure was performed with a free gingival graft of the palate. Results After an observation period of 4 months, an implant was placed in the augmented area, which osseointegrated successfully and could be restored prosthodontically in the following. The results of this method showed a functional and aesthetic success. Conclusion The pre-implantological, autologous ridge preservation with dentin could be performed successfully. For the establishment of dentin as augmentation material for jaw augmentation procedures, a prospective, clinical trial is now necessary.
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Affiliation(s)
- Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland.
| | - Pavla Pasic
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Alex Soltermann
- Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Daniel Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
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Ridge Preservation Comparing a Nonresorbable PTFE Membrane to a Resorbable Collagen Membrane: A Clinical and Histologic Study in Humans. IMPLANT DENT 2017; 25:128-34. [PMID: 26655097 DOI: 10.1097/id.0000000000000370] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The primary aim of this randomized, controlled, blinded clinical trial was to compare the effect of a resorbable collagen membrane (CM group) versus a nonresorbable high-density polytetrafluoroethylene membrane (PTFE group) on the clinical and histologic outcomes of a ridge preservation procedure. MATERIALS AND METHODS All 24 sites received an intrasocket cancellous allograft and a buccal overlay bovine derived xenograft. RESULTS The change in horizontal crestal ridge width was -1.4 ± 1.2 mm for the CM group, whereas the PTFE group lost -2.2 ± 1.5 mm, which was not statistically significant between groups (P > 0.05). Vertical ridge height change was -1.2 ± 1.5 for the CM group, whereas the PTFE group lost -0.5 ± 1.6, which was not significantly different between groups (P > 0.05). The percent vital bone was similar and not significantly different between groups. Primary closure was not obtained and the exposed membrane portion over the socket opening healed with keratinized tissue. CONCLUSION The choice of a resorbable versus a nonresorbable barrier membrane did not affect the clinical or the histologic outcome of ridge preservation treatment.
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Araújo MG, Silva CO, Misawa M, Sukekava F. Alveolar socket healing: what can we learn? Periodontol 2000 2017; 68:122-34. [PMID: 25867983 DOI: 10.1111/prd.12082] [Citation(s) in RCA: 255] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2014] [Indexed: 12/16/2022]
Abstract
Tooth extraction induces a series of complex and integrated local changes within the investing hard and soft tissues. These local alterations arise in order to close the socket wound and to restore tissue homeostasis, and are referred to as '"socket healing". The aims of the present report were twofold: first, to describe the socket-healing process; and, second, to discuss what can be learned from the temporal sequence of healing events, in order to improve treatment outcomes. The socket-healing process may be divided into three sequential, and frequently overlapping, phases: inflammatory; proliferative; and modeling/remodeling. Several clinical and experimental studies have demonstrated that the socket-healing process promotes up to 50% reduction of the original ridge width, greater bone resorption at the buccal aspect than at the lingual/palatal counterpart and a larger amount of alveolar bone reduction in the molar region. In conclusion, tooth extraction, once a simple and straightforward surgical procedure, should be performed in the knowledge that ridge reduction will follow and that further clinical steps should be considered to compensate for this, when considering future options for tooth replacement.
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Leonida A, Todeschini G, Lomartire G, Cinci L, Pieri L. Socket Preservation using Enzyme-treated Equine Bone Granules and an Equine Collagen Matrix: A Case Report with Histological and Histomorphometrical Assessment. J Contemp Dent Pract 2016; 17:890-896. [PMID: 27965496 DOI: 10.5005/jp-journals-10024-1949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To histologically assess the effectiveness of a socket-preservation technique using enzyme-treated equine bone granules as a bone-graft material in combination with an equine collagen matrix as a scaffold for soft-tissue regeneration. BACKGROUND Enzyme-treated equine bone granules and equine collagen matrix recently have been developed to help overcome alveolar bone deficiencies that develop in the wake of edentulism. CASE REPORT The patient had one mandibular molar extracted and the socket grafted with equine bone granules. The graft was covered with the equine collagen matrix, placed in a double layer. No flap was prepared, and the gingival margins were stabilized with a single stitch, leaving the matrix partially exposed and the site to heal by secondary intention. The adjacent molar was extracted 1 month later, and that socket was left to heal by secondary intention without any further treatment. Three months after each surgery, an implant was placed and a biopsy was collected. The two biopsies underwent histological processing and qualitative evaluation. Histomorphometric analysis was also performed to calculate the percentage of newly formed bone (NFB) in the two cores. Healing at both sites was uneventful, and no inflammation or other adverse reactions were observed in the samples. Soft-tissue healing by secondary intention appeared to occur faster at the grafted site. The corresponding core showed a marked separation between soft and hard tissue that was not observed in the core from the nongrafted site, where soft-tissue hypertrophy could be observed. Newly formed bone at the grafted and nongrafted sites was not significantly different (27.2 ± 7.1 and 29.4 ± 6.2% respectively, p = 0.45). CONCLUSION The surgical technique employed in this case appeared to facilitate postextraction soft-tissue healing by second intention and simplify soft-tissue management. CLINICAL SIGNIFICANCE Using a collagen-based matrix to cover a postextraction grafted site may facilitate second intention soft-tissue healing and proper soft-tissue growth.
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Affiliation(s)
- Alessandro Leonida
- Department of Dental School, University of Milan-Bicocca, Milan, Italy, Phone: +00390258303922, e-mail:
| | | | | | - Lorenzo Cinci
- Department of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence Italy
| | - Laura Pieri
- Department of Health Sciences, Interdepartmental Forensic Medicine Section, University of Florence, Florence, Italy
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Histologic, histomorphometric, and cone-beam computerized tomography analyses of calcium sulfate and platelet-rich plasma in socket preservation: a pilot study. IMPLANT DENT 2016; 23:593-601. [PMID: 25192162 DOI: 10.1097/id.0000000000000148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To assess dimensional changes and histologic/histomorphometric aspects of grafted sockets using either calcium sulfate-platelet-rich plasma (CS-PRP) or CS alone in socket preservation procedure. STUDY DESIGN Twelve subjects with single nonmolar teeth underwent atraumatic extraction. Six sockets received CS grafts and 6 sockets received CS-PRP grafts. Cone-beam computerized tomography scans taken immediately after extraction and 4 months after surgery were used to measure vertical and horizontal dimensional changes. Histologic and histomorphometric analyses of grafted sites were performed at 4 months after surgery. Intergroup changes were compared using Mann-Whitney U test. RESULTS CS group demonstrated 18.6% horizontal resorption as compared with 9.2% in CS-PRP group. Resorption for buccal height (BH) (14%) and palatal/lingual height (PH) (13.7%) in CS group was nearly 3 times more than resorption in BH (5%) and PH (4.6%) for CS-PRP group. Mineralized bone component in CS-PRP group (11.19% ± 6.59%) was significantly more than CS group (1.51% ± 2.86%) (P = 0.01). CONCLUSION CS-PRP-grafted sites demonstrated higher mineralized bone content than CS-grafted sites.
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MacBeth N, Trullenque-Eriksson A, Donos N, Mardas N. Hard and soft tissue changes following alveolar ridge preservation: a systematic review. Clin Oral Implants Res 2016; 28:982-1004. [PMID: 27458031 DOI: 10.1111/clr.12911] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Two focused questions were addressed within this systematic review. Q1) What is the effect of alveolar ridge preservation on linear and volumetric alveolar site dimensions, keratinised measurements, histological characteristics and patient-based outcomes when compared to unassisted socket healing. Q2) What is the size effect of these outcomes in three different types of intervention (guided bone regeneration, socket grafting and socket seal). MATERIALS AND METHODS An electronic search (MEDLINE, EMBASE, Cochrane Central Register LILACS, Web of Science) and hand-search was conducted up to June 2015. Randomised controlled trials (RCT) and controlled clinical trials (CCT); with unassisted socket healing as controls: were eligible in the analysis for Q1. RCTs, CCTs and large prospective case series with or without an unassisted socket healing as control group were eligible in the analysis for Q2. RESULTS Nine papers (8 RCTs and 1 CCTs) were included in the analysis for Q1 and 37 papers (29 RCTs, 7 CCTs and 1 case series) for Q2. The risk for bias was unclear or high in most of the studies. Q1: the standardised mean difference (SMD) in vertical mid-buccal bone height between ARP and a non-treated site was 0.739 mm (95% CI: 0.332 to 1.147). The SMD when proximal vertical bone height and horizontal bone width was compared was 0.796mm (95% CI: -1.228 to 0.364) and 1.198 mm (95% CI: -0.0374 to 2.433). Examination of ARP sites revealed significant variation in vital and trabecular bone percentages and keratinised tissue width and thickness. Adverse events were routinely reported, with three papers reporting a high level of complications in the test and control groups and two papers reporting greater risks associated with ARP. No studies reported on variables associated with the patient experience in either the test or the control group. Q2: A pooled effect reduction (PER) in mid-buccal alveolar ridge height of -0.467 mm (95% CI: -0.866 to -0.069) was recorded for GBR procedures and -0.157 mm (95% CI: -0.554 to 0.239) for socket grafting. A proximal vertical bone height reduction of -0.356 mm (95% CI: -0.490 to -0.222) was recorded for GBR, with a horizontal dimensional reduction of -1.45 mm (95% CI: -1.892 to -1.008) measured following GBR and -1.613 mm (95% CI: -1.989 to -1.238) for socket grafting procedures. Five papers reported on histological findings after ARP. Two papers indicated an increase in the width of the keratinised tissue following GBR, with two papers reporting a reduction in the thickness of the keratinised tissue following GBR. Histological examination revealed extensive variations in the treatment protocols and biomaterials materials used to evaluate extraction socket healing. GBR studies reported a variation in total bone formation of 47.9 ± 9.1% to 24.67 ± 15.92%. Post-operative complications were reported by 29 papers, with the most common findings soft tissue inflammation and infection. CONCLUSION ARP results in a significant reduction in the vertical bone dimensional change following tooth extraction when compared to unassisted socket healing. The reduction in horizontal alveolar bone dimensional change was found to be variable. No evidence was identified to clearly indicate the superior impact of a type of ARP intervention (GBR, socket filler and socket seal) on bone dimensional preservation, bone formation, keratinised tissue dimensions and patient complications.
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Affiliation(s)
- Neil MacBeth
- Defence Primary Health Care and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Anna Trullenque-Eriksson
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), London, UK
| | - Nikos Mardas
- Center for Adult Health Sciences, Institute of Dentistry, Barts & The London School of Medicine & Dentistry, Queen Mary University of London (QMUL), London, UK
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Chen ST, Darby I. The relationship between facial bone wall defects and dimensional alterations of the ridge following flapless tooth extraction in the anterior maxilla. Clin Oral Implants Res 2016; 28:931-937. [DOI: 10.1111/clr.12899] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Stephen T. Chen
- Periodontics Melbourne Dental School; The University of Melbourne; Parkville Victoria Australia
| | - Ivan Darby
- Periodontics Melbourne Dental School; The University of Melbourne; Parkville Victoria Australia
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Schiegnitz E, Noelken R, Moergel M, Berres M, Wagner W. Survival and tissue maintenance of an implant with a sloped configurated shoulder in the posterior mandible-a prospective multicenter study. Clin Oral Implants Res 2016; 28:721-726. [DOI: 10.1111/clr.12869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E. Schiegnitz
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - R. Noelken
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
- Private Practice; Lindau/Lake Constance; Lindau Germany
| | - M. Moergel
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - M. Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz; RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry; Epidemiology and Informatics; Johannes Gutenberg-University; Remagen Germany
| | - W. Wagner
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
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Bassetti RG, Stähli A, Bassetti MA, Sculean A. Soft tissue augmentation procedures at second-stage surgery: a systematic review. Clin Oral Investig 2016; 20:1369-87. [PMID: 27041111 DOI: 10.1007/s00784-016-1815-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 03/28/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this systematic review was to evaluate the efficacy of different soft tissue augmentation/correction methods in terms of increasing the peri-implant width of keratinized mucosa (KM) and/or gain of soft tissue volume during second-stage surgery. MATERIALS AND METHODS Screening of two databases, MEDLINE (PubMed) and EMBASE (OVID), and hand search of related articles, were performed. Human studies reporting on soft tissue augmentation/correction methods around submucosally osseointegrated implants during second-stage surgery up to July 31, 2015 were considered. Quality assessment of the selected full-text articles was performed according to the Cochrane collaboration's tool to assess the risk of bias. RESULTS Overall, eight prospective studies (risk of bias: high) and two case series (risk of bias: high) were included. Depending on the surgical technique and graft material used, the enlargement of keratinized tissue (KT) ranged between -0.20 and 9.35 mm. An apically positioned partial-thickness flap/vestibuloplasty (APPTF/VP) in combination with a free gingival graft (FGG) or a xenogeneic graft material (XCM) was most effective. Applying a roll envelope flap (REF) or an APPTF in combination with a subepithelial connective tissue graft (SCTG), mean increases in soft tissue volumes of 2.41 and 3.10 mm, respectively, were achieved. Due to the heterogeneity of study designs, no meta-analysis could be performed. CONCLUSIONS Within the limitations of this review, regarding the enlargement of peri-implant KT, the APPTF in the maxilla and the APPTF/VP in combination with FGG or XCM in the lower and upper jaw seem to provide acceptable outcomes. To augment peri-implant soft tissue volume REF in the maxilla or APPTF + SCTG in the lower and upper jaw appear to be reliable treatment options. CLINICAL RELEVANCE The localization in the jaw and the clinical situation are crucial for the decision which second-stage procedure should be applied.
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Affiliation(s)
- Renzo G Bassetti
- Department of Oral and Maxillofacial Surgery, Lucerne Cantonal Hospital, Spitalstrasse, 6000, Lucerne, Switzerland.
| | - Alexandra Stähli
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Mario A Bassetti
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
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Rafael CF, Passoni B, Araúio C, de Araúio MA, Benfatti C, Volpato C. Can Time of Implant Placement influence Bone Remodeling? J Contemp Dent Pract 2016; 17:270-4. [PMID: 27340159 DOI: 10.5005/jp-journals-10024-1840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Since the alveolar process is tissue "dental dependent," after the extraction of the dental element, this process suffers some degree of atrophy during the healing process, which can be reduced with the installation of immediate implants, aiming to maintain the original bone architecture. The aim of this study was to investigate the influence of the time of implant placement on bone formation around them. Seven dogs were selected and randomly divided into two groups: Group 1, where implants were placed immediately after extraction of two lower premolars without flap elevation, and group 2, where implants were delayed by 4 months after extractions. Each group received 14 implants, and 4 months after the second surgery, the samples were processed and analyzed histomorphometrically. A mean average analysis and the Kruskal-Wallis test (p < 0.05) were performed. The buccal bone-implant contact (BIC) mean average was found larger in immediate implants (42.61%) compared with delayed implants (37.69%). Group 1 had statistically higher outcomes in bone formation and BIC on the buccal bone wall. It was concluded that performing immediate implants with the palatal approach technique and leaving a buccal GAP enables a higher or at least equal rate to BIC and bone area around them, when compared with delayed implants. Actually, the patients and dentists want to do a shorter treatment with satisfactory results, but it is necessary to understand whether different times of implant placement can influence the results and longevity of the treatment.
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Affiliation(s)
- Caroline F Rafael
- PhD Student, Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil, Phone: +5527997475867, e-mail:
| | - Bernardo Passoni
- Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Carlos Araúio
- Department of Dentistry, Sao Paulo University, Sao Paulo Brazil
| | | | - César Benfatti
- Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
| | - Claudia Volpato
- Department of Dentistry, Federal University of Santa Catarina, Santa Catarina, Brazil
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Xia Y, Xie L, Zhou Y, Song T, Zhang F, Gu N. A new method to standardize CBCT for quantitative evaluation of alveolar ridge preservation in the mandible: a case report and review of the literature. Regen Biomater 2016; 2:251-60. [PMID: 26816648 PMCID: PMC4676331 DOI: 10.1093/rb/rbv017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 08/21/2015] [Accepted: 08/30/2015] [Indexed: 11/29/2022] Open
Abstract
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.
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Affiliation(s)
- Yang Xia
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China, ; Jiangsu Key Laboratory for Biomaterials and Devices, Southeast University, Nanjing, 210009, China
| | - Lizhe Xie
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China
| | - Yi Zhou
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China
| | - Tianxi Song
- Beijing Allgens Medical Science & Technology Co., Ltd, Beijing, 100176, China
| | - Feimin Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, 210029, China, ; Suzhou Key Laboratory of Biomaterials and Technologies & Collaborative Innovation Center of Suzhou Nano Science and Technology, Suzhou, 215123, China
| | - Ning Gu
- Suzhou Key Laboratory of Biomaterials and Technologies & Collaborative Innovation Center of Suzhou Nano Science and Technology, Suzhou, 215123, China
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Munhoz EDA, Cardoso CL, Bodanezi A, Mello MB, Yaedu RYF, Junior OF. Concepts and challenges of alveolar ridge preservation and augmentation. World J Stomatol 2016; 5:8. [DOI: 10.5321/wjs.v5.i1.8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 10/10/2015] [Accepted: 12/18/2015] [Indexed: 02/06/2023] Open
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Hong CE, Lee JY, Choi J, Joo JY. Prediction of the alveolar bone level after the extraction of maxillary anterior teeth with severe periodontitis. J Periodontal Implant Sci 2015; 45:216-22. [PMID: 26734492 PMCID: PMC4698948 DOI: 10.5051/jpis.2015.45.6.216] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 12/01/2015] [Indexed: 11/15/2022] Open
Abstract
Purpose After extraction, the alveolar bone tends to undergo atrophy in three-dimensions. The amount of alveolar bone loss in the horizontal dimension has been reported to be greater than the amount of bone loss in the vertical dimension, and is most pronounced in the buccal aspect. The aim of this study was to monitor the predictive alveolar bone level following the extraction of anterior teeth seriously involved with advanced chronic periodontitis. Methods This study included 25 patients with advanced chronic periodontitis, whose maxillary anterior teeth had been extracted due to extensive attachment loss more than one year before the study. Periapical radiographs were analyzed to assess the vertical level of alveolar bone surrounding the edentulous area. An imaginary line connecting the mesial and the distal ends of the alveolar crest facing the adjacent tooth was arbitrarily created. Several representative coordinates were established in the horizontal direction, and the vertical distance from the imaginary line to the alveolar crest was measured at each coordinate for each patient using image analysis software. Regression functions predicting the vertical level of the alveolar bone in the maxillary anterior edentulous area were identified for each patient. Results The regression functions demonstrated a tendency to converge to parabolic shapes. The predicted maximum distance between the imaginary line and the alveolar bone calculated using the regression function was 1.43±0.65 mm. No significant differences were found between the expected and actual maximum distances. Likewise, the predicted and actual maximum horizontal distances did not show any significant differences. The distance from the alveolar bone crest to the imaginary lines was not influenced by the mesio-distal spans of the edentulous area. Conclusions After extraction, the vertical level of the alveolar ridge increased to become closer to the reference line connecting the mesial and distal alveolar crests.
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Affiliation(s)
- Chul Eui Hong
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea
| | - Ju-Youn Lee
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.; Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea
| | - Jeomil Choi
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.; Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea
| | - Ji-Young Joo
- Department of Periodontology, Pusan National University School of Dentistry, Yangsan, Korea.; Department of Periodontology, Pusan National University Dental Hospital, Dental Research Institute, Yangsan, Korea
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