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Clinical Oral Implants Research Jul 2021To investigate the effect of a bone substitute material combined with fibroblast growth factor-2 (FGF-2) loaded barrier membrane on the preservation of alveolar ridge...
OBJECTIVE
To investigate the effect of a bone substitute material combined with fibroblast growth factor-2 (FGF-2) loaded barrier membrane on the preservation of alveolar ridge after tooth extraction.
MATERIAL AND METHODS
Four dogs were included. Six extraction sockets of each animal received the 3 treatments and were randomly divided into three groups. Group A: negative control; Group B: bovine xenografts + membrane; and Group C: bovine xenografts + FGF-2-loaded membrane. CBCT and histological analysis were performed to evaluate changes in the width and height of alveolar ridges and extraction socket bone healing 8 weeks post-extraction.
RESULTS
CBCT showed that the alveolar bone in Group A was significantly thinner than that in Group B and Group C at 1 and 3 mm apically from the alveolar crest. The alveolar width at 1 mm in Group C (60.99 ± 15.36%) was significantly thicker than that in Group B (39.75 ± 30.18%). Histomorphmetrical measurements showed that the buccal alveolar width at 1 mm was significantly thicker in Groups B and C than in Group A. Additionally, buccal bone height and lingual bone width at 1 mm in Group C (87.06 ± 10.34%, 89.09 ± 10.56%) were significantly greater than in Group A (53.48 ± 23.94%, 82.72 ± 12.59%).
CONCLUSION
The present findings indicate that application of bovine bone combined with barrier membrane with or without FGF-2 over tooth sockets can effectively reduce ridge absorption, especially in terms of ridge width and FGF-2 modified membrane seems to improve the outcomes obtained with membrane alone.
Topics: Acellular Dermis; Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Cattle; Fibroblast Growth Factor 2; Heterografts; Tooth Extraction; Tooth Socket
PubMed: 33756026
DOI: 10.1111/clr.13749 -
The Journal of Contemporary Dental... Mar 2021This paper aims to present an alveolar ridge preservation technique, using an autologous punch formed of hard and soft tissues harvested from the tuberosity area.
AIM
This paper aims to present an alveolar ridge preservation technique, using an autologous punch formed of hard and soft tissues harvested from the tuberosity area.
MATERIALS AND METHODS
Ten residual sockets in the anterior maxilla were filled with a punch of hard and soft tissues harvested from the tuberosity area. Clinical and radiographical data were collected at the surgical extraction time 0 (T0) and 5 months during implant placement (T1), from clinical and radiological measurements using cone-beam computed tomography scans and periapical radiographs. Core biopsy was harvested during implant placement for histological and histomorphometrical analysis.
RESULTS
Clinically, the alveolar ridge presented a mean width of 10.3 mm before extraction which decreased to 8.85 mm at T1, where the mean horizontal loss is 1.45 mm (standard deviation [SD] 1.03 mm). The initial ridge mean height was 11.25 mm and increased to 12.85 mm after 5 months, where the mean vertical gain is 1.6 mm (SD 0.65 mm). The radiological evaluation shows a reduction in the horizontal dimension with a mean of 1 mm; however, the sockets show stability in the vertical dimensions. Histology showed a new lamellar bone formation with some areas of woven bone. Histomorphometric analysis showed that the percentage of new bone formed was 42.44 ± 5.54% and 48.62 ± 8.66% of the connective tissue and 8.94 ± 5.28% of the residual autogenous bone.
CONCLUSION
At T1, the extraction sockets showed significantly lower vertical and horizontal bone changes, compared to T0. The described preservation punch technique resulted in greater stability in the horizontal and vertical dimensions after 5 months.
CLINICAL SIGNIFICANCE
Clinical and radiological results show that the punch of hard and soft tissue graft reduces hard and soft tissue dimensional alteration after tooth extraction. In addition, using autogenous bone showed histological new bone formation.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Esthetics, Dental; Gingiva; Humans; Pilot Projects; Tooth Extraction; Tooth Socket
PubMed: 34210931
DOI: No ID Found -
Scientific Reports Jun 2022Current rat alveolar ridge preservation models have not been well standardized. In this study, we proposed decoronation-induced infected alveolar socket model of rat....
Current rat alveolar ridge preservation models have not been well standardized. In this study, we proposed decoronation-induced infected alveolar socket model of rat. The bilateral maxillary first molars (M1) of twenty-four rats were decoronized or extracted. After 2, 6, 10, and 14 weeks, bone and soft tissue changes at M1 and periodontal conditions of maxillary second (M2) and third molars (M3) were evaluated by micro-computed tomography and histological analysis. Additional eighteen rats with standardized size defects were grafted with Bio-Oss Collagen to compare with unmanipulated contralateral side. Decoronation preserved greater bone and soft tissue dimensions at M1, provided larger three-dimensional (3D) bone contour volume, but also promoted periodontal breakdown of M2 Histological results showed intense inflammatory cell infiltrations and severe bone resorption within M1 socket and at mesial aspect of M2. The critical dimensions to accommodate largest standardized defect at M1 were 2.2-2.3 mm at vertical bone height and 2.8-3.2 mm at alveolar crestal width. Bio-Oss Collagen could not fully preserve buccal or palatal bone height but could be beneficial in preserving ridge width in large alveolar defects. Collectively, if periodontally-involved alveolar bone defect is preferred, we suggest extracting M1 roots 6 weeks after decoronation to allow periodontitis to occur at M2. If standardized critical dimension defect is preferred, we suggest extracting M1 roots 2 weeks after decoronation, and creating defect in the middle of M1 site with size no larger than 2.7 mm diameter to its full depth.
Topics: Alveolar Bone Loss; Alveolar Process; Animals; Collagen; Minerals; Periodontal Ligament; Rats; Tooth Extraction; Tooth Socket; X-Ray Microtomography
PubMed: 35705614
DOI: 10.1038/s41598-022-14064-6 -
The International Journal of Oral &... Dec 2023Alveolar ridge split (ARS) is ridge augmentation to mitigate ridge width loss that typically follows tooth extraction. This study aimed to determine the efficacy of ARS... (Meta-Analysis)
Meta-Analysis
PURPOSE
Alveolar ridge split (ARS) is ridge augmentation to mitigate ridge width loss that typically follows tooth extraction. This study aimed to determine the efficacy of ARS on alveolar ridge horizontal dimensional changes and the survival rates of implants placed into the same sites.
MATERIALS AND METHODS
An electronic and manual search was conducted for English articles published up to January 1, 2021. The PICO (problem, intervention, comparison, outcome) model for quantitative studies was established to address the following two focused questions: (1) What are the effects of the ARS technique on increasing alveolar width and implant survival?; and (2) what are the factors that influence the efficacy of the ARS technique? The outcome measures in this systematic review and meta-analysis were mean alveolar ridge gain-horizontal (buccolingual) in millimeters from baseline (initial presentation) to final assessment (minimum of 12 weeks after ARS), implant survival rate, and patient-reported complication rate. The risk of bias was evaluated using the ROBINS-I assessment tool for non-randomized interventional studies. Weighted means were calculated, and pooled effects and 95% confidence intervals (95% CI) were depicted on forest plots. Publication bias was assessed by funnel plot and Rosenthal Statistics. A sensitivity analysis was undertaken to assess the primary outcome.
RESULTS
Overall, 35 studies met the inclusion criteria and were included in the systematic review. The mean alveolar ridge gain for ARS was 3.06 mm (95% CI: 3.01 to 3.12 mm). A mean gain of 2.99 mm (95% CI: 2.93 to 3.04 mm) was found after sensitivity analysis, excluding one article with a high risk of bias. There were no significant differences in ridge width in the group with bone graft (mean difference [95% CI] of 2.97 mm [2.91 to 3.03 mm]) and in the group without bone graft (mean difference [95% CI] of 3.06 mm [2.92 to 3.20 mm]). The ARS technique demonstrated a 98.17% implant survival rate in 4,446 implants, 4,103 of which were placed at the time of ARS with a 97.72% implant survival rate, and 343 placed in a delayed approach with a 99.14% implant survival rate. The risk of bias was low in 14.2%, low to moderate in 68.5%, moderate in 11.4%, and severe/moderate in 5.7% of the included studies.
CONCLUSIONS
ARS shows a high implant survival rate in narrow alveolar ridges, adequate horizontal alveolar ridge dimensional gain regardless of adding grafting material, and minimal patient-reported complications.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Alveolar Ridge Augmentation; Alveolar Process; Bone Transplantation
PubMed: 38085739
DOI: 10.11607/jomi.9972 -
Journal of Periodontology Feb 2023The aim of this randomized clinical trial was to compare a flapless technique of alveolar ridge preservation (ARP) to a flap technique to determine if preserving the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The aim of this randomized clinical trial was to compare a flapless technique of alveolar ridge preservation (ARP) to a flap technique to determine if preserving the periosteal blood supply would limit loss of crestal ridge width and height.
METHODS
Twenty-four patients were randomly assigned to receive ARP using either a flapless or flap technique. Sockets were grafted with demineralized bone matrix and mineralized particulate allograft then covered with a barrier in both groups. Re-entry was performed at 4 months to obtain samples for histological analysis and subsequent implant placement.
RESULTS
Ridge width of the flapless group at the crest decreased from 8.3 ± 1.3 mm to 7.0 ± 1.9 mm for a mean loss of 1.3 ± 0.9 mm (p < 0.05), whereas the flap group decreased from 8.5 ± 1.5 mm to 7.5 ± 1.5 mm for a mean loss of 1.0 ± 1.1 mm (p < 0.05). The mean midbuccal vertical change for the flap group was a loss of 0.9 ± 1.3 mm (p < 0.05) versus 0.5 ± 0.9 mm (p < 0.05) for the flapless group. There was no statistically significant difference between the groups. Histologically, flapless ARP revealed more vital mineralized tissue (44 ± 10%) compared to the flap group (p>0.05). In the flapless group, the occlusal soft tissue was significantly thicker than in the flap group at the 4-month re-entry (p< 0.05).
CONCLUSIONS
Crestal ridge width, height, and percentage of vital mineralized bone following treatment with a flapless ARP technique, was not significantly different from a flap technique.
Topics: Humans; Alveolar Process; Tooth Socket; Surgical Flaps; Tooth Extraction; Alveolar Ridge Augmentation; Alveolar Bone Loss
PubMed: 35924603
DOI: 10.1002/JPER.22-0213 -
Clinical Oral Investigations Aug 2021The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP)... (Meta-Analysis)
Meta-Analysis Review
AIM
The aim of this systematic review was to evaluate the efficacy of immediate implant placement (IIP) compared to implants placed after alveolar ridge preservation (ARP) in terms of clinical, esthetic, and patient-reported outcomes.
METHODS
A manual and electronic search (National Library of Medicine) was performed for controlled clinical trials, with at least 12 months of follow-up. Primary outcome variable was implant survival and secondary outcomes were marginal bone level (MBL) (change), pink esthetic score (PES), mid-facial mucosal level (change), papilla index score, complications, and patient-reported outcomes.
RESULTS
A total of 10 publications were included (7 randomized clinical trials and 3 controlled clinical trials). The results from the meta-analyses showed that survival rate was significantly lower in the IIP group compared to ARP group [RR = 0.33; 95% CI (0.14; 0.78); p = 0.01]. No significant differences between the two groups were observed regarding radiographic MBL, PES scores, or mid-facial mucosal level (p > 0.05).
CONCLUSION
The results from this systematic review and meta-analysis showed that IIP had lower survival rates and similar esthetic results when compared to ARP.
CLINICAL RELEVANCE
Clinicians should weigh the benefits and disadvantages of each intervention to select the optimal timing of implant placement.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Dental Implants; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 34100157
DOI: 10.1007/s00784-021-03986-6 -
Journal of Clinical Periodontology Jul 2022To evaluate the efficacy of different techniques to seal the alveolus (flap advancement [FA], open healing with barrier [OHB], and open healing without barrier [OHNB])... (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the efficacy of different techniques to seal the alveolus (flap advancement [FA], open healing with barrier [OHB], and open healing without barrier [OHNB]) during alveolar ridge preservation (ARP) in terms of horizontal ridge width resorption.
MATERIALS AND METHODS
Randomized trials of at least 2 months duration comparing at least two techniques to seal the alveolus against each other or against spontaneous healing (SH) were eligible. Searches were conducted in MEDLINE via PubMed, EMBASE, Scopus, and Cochrane Central. Conventional meta-analysis, meta-regression, and network meta-analysis (NMA) were conducted, with clinical and tomographic ridge width changes as outcomes. Predictive intervals (95% PI) were reported.
RESULTS
Twenty-two studies were included, accounting for 52 study arms. Meta-regression identified that the socket sealing technique and publication year explained the observed heterogeneity. NMA showed that FA and OHB led to significantly lower ridge resorption than SH, resulting in 1.18 mm (95% PI 0.21-2.13) and 1.10 mm (95% PI 0.49-1.69) wide alveolar ridges, respectively. No significant difference between OHNB and SH was found (0.46 mm, 95% PI -0.70 to 1.64). The treatment with the largest probability for ARP was FA (52.7%), followed by OHB (39.1%) and OHNB (8.2%).
CONCLUSIONS
FA and OHB are efficacious techniques to seal the alveolus during ARP.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Humans; Network Meta-Analysis; Tooth Extraction; Tooth Socket
PubMed: 35451071
DOI: 10.1111/jcpe.13628 -
Journal of Oral and Maxillofacial... Feb 2023The purpose of this study was to compare different materials' effects on alveolar ridge preservation of postextraction sockets in anterior maxilla. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The purpose of this study was to compare different materials' effects on alveolar ridge preservation of postextraction sockets in anterior maxilla.
MATERIALS AND METHOD
In this prospective, single center, randomized, controlled clinical trial, healthy patients who needed one single anterior maxillary tooth extraction (including bicuspids) were selected. After a minimally traumatic extraction without complications, 44 patients were randomly allocated into 4 groups: 1) natural socket healing (blood clot), 2) xenograft and gingival free graft, 3) dense polytetrafluoroethylene membrane, and 4) platelet rich fibrin plugs. Alveolar ridge height and width loss were evaluated in cone beam computed tomography (CBCT) and in dental casts at 3 moments: 1) preoperative (T1), 2) 7 days postoperative (T2), and 3) 120 days postoperative (T3). Height and width alveolar ridge loss detected in CBCT and in dental casts were compared among the groups (two-way analysis of variance [ANOVA]; P < .05).
RESULTS
Forty patients (24 women and 16 men) ranging from 25 to 70 years old (mean of 42 years old) participated in this study. Group 2 showed the least alveolar ridge height loss results in CBCT (9.8 ± 1.9% at T3) and dental cast analysis (1.0 ± 0.2 mm). Groups 2 (12.7 ± 4.7% at T3) and 3 (15.4 ± 2.7% at T3) showed the least alveolar ridge width loss measured in CBCT compared with groups 1 and 4, but the difference between groups 2 and 3 were not statistically significant (P = .968). Group 3 (0.9 ± 0.2 mm) and group 2 (1.0 ± 0.2 mm) showed the least width loss compared with groups 1 and 4 in dental cast analysis. Again, the difference between groups 3 and 2 was not statistically significant (P = 1.000).
CONCLUSION
In postextraction sockets of the anterior maxilla and bicuspid region, group 2 (xenogenous bone graft with free gingival graft) and group 3 (dense polytetrafluoroethylene) obtained the best results in alveolar preservation, with group 2 being more indicated when the vertical alveolar ridge preservation is mandatory.
Topics: Male; Humans; Female; Adult; Middle Aged; Aged; Tooth Socket; Alveolar Bone Loss; Prospective Studies; Alveolar Process; Tooth Extraction; Polytetrafluoroethylene; Alveolar Ridge Augmentation
PubMed: 36400157
DOI: 10.1016/j.joms.2022.10.008 -
The Journal of Craniofacial Surgery Sep 2014To evaluate clinically and radiographically an alveolar ridge, preservation technique with deproteinized bovine bone graft and absorbable collagen membrane and then... (Comparative Study)
Comparative Study Randomized Controlled Trial
To evaluate clinically and radiographically an alveolar ridge, preservation technique with deproteinized bovine bone graft and absorbable collagen membrane and then restoration with delayed implants were done. The study included 30 patients. The trial group's sockets were filled with deproteinized bovine bone graft (Bio-Oss) and covered with absorbable collagen membrane (Bio-Gide). The control group's sockets healed without any treatment. Panoramic radiograph and computed tomography were taken immediately after graft and 3 and 6 months later to evaluate the height, width, and volume change of the alveolar ridge bone. Dental implants were inserted in all sockets at 6 months, and osseointegration condition was evaluated in the following 12 months. All sockets healed uneventfully. In the trial group, the mean (SD) height reduction of the alveolar ridge bone was 1.05 (0.24) mm at 3 months and 1.54 (0.25) mm at 6 months. The width reduction was 1.11 (0.13) mm at 3 months and 1.84 (0.35) mm at 6 months. Bone volume reduction was 193.79 (21.47) mm at 3 months and 262.06 (33.08) mm at 6 months. At the same trend, in the control group, the bone height reduction was 2.12 (0.15) mm at 3 months and 3.26 (0.29) mm at 6 months. The width reduction was 2.72 (0.19) mm at 3 months and 3.56 (0.28) mm at 6 months. Bone volume reduction was 252.19 (37.21) mm at 3 months and 342.32 (36.41) mm at 6 months. There was a significant difference in alveolar ridge bone height, width, and volume reduction in the 2 groups. The osseointegration condition had no significant difference between the 2 groups. This study suggested that the deproteinized bovine bone graft and absorbable collagen membrane were beneficial to preserve the alveolar ridge bone and had no influence on the osseointegration of delayed implant.
Topics: Absorbable Implants; Adult; Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Bone Substitutes; Cattle; Collagen; Dental Implantation, Endosseous; Dental Implants; Female; Follow-Up Studies; Humans; Male; Membranes, Artificial; Middle Aged; Minerals; Osseointegration; Radiography; Tooth Socket; Young Adult
PubMed: 25148644
DOI: 10.1097/SCS.0000000000000887 -
International Journal of Implant... Dec 2022The remodeling process following tooth extraction can be observed as horizontal and vertical bone reduction of the alveolar ridge. Preservation procedures such as...
PURPOSE
The remodeling process following tooth extraction can be observed as horizontal and vertical bone reduction of the alveolar ridge. Preservation procedures such as alveolar ridge preservation (ARP) aim to maintain the 3D volume of the extraction site. This retrospective study analyzed differences in the hard and soft tissue changes in patients treated with either spontaneous healing or ARP.
METHODS
After tooth extraction, the patients were treated either by spontaneous socket healing (SH group) or with ARP using a xenograft and a resorbable membrane (ARP group). One week before and 6 months after extraction, the patients underwent cone beam computed tomography. A volumetric analysis was performed by superimposing the digital models of the two time points. Intraoral radiography was performed after implant placement, upon prosthesis delivery, and at 1-year post-treatment. An esthetic assessment was conducted using the Pink Esthetic Score (PES). The patients' overall satisfaction with the implant restoration was investigated at 12 months.
RESULTS
Intragroup comparisons revealed significant differences between baseline and the 6-month follow-up in both groups at the measured locations (1 mm, 3 mm, and 5 mm below the most coronal aspect of the alveolar ridge) showing a reduction of the horizontal width (P < 0.05). Additionally, after treatment, the horizontal width at 1 mm was significantly different in the SH and ARP groups (P < 0.001), with mean changes of 2.03 ± 0.54 mm and 0.86 ± 0.49 mm, respectively. ARP was associated with an increased PES (11.6 ± 2.2) and a reduction in patients requiring additional grafting procedures in subsequent treatment phases (9% vs 26%; P = 0.11).
CONCLUSIONS
In both groups, significant horizontal and vertical bone loss was observed after the extraction. ARP can reduce linear and volumetric shrinkage of the alveolar ridge, leading to improved outcomes. It can also simplify implant restoration.
Topics: Humans; Retrospective Studies; Alveolar Process
PubMed: 36480055
DOI: 10.1186/s40729-022-00456-w