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BioMed Research International 2023After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation.
MATERIALS AND METHODS
Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups. The control group had spontaneous healing of extraction sockets. The study group had their extraction sockets filled with autogenous dentin biomaterial after processing their extracted retained roots with the KometaBio device. Standardized cone beam computed tomography (CBCT) scans were repeated four months later. A full-thickness mucoperiosteal flap reflection was achieved under local anesthesia to get core biopsies for histomorphometric analysis, and dental implants were placed at the same session.
RESULTS
A total of 32 eligible patients were included in this study ( = 16 in each group). Both groups had significantly higher facial soft tissue thickness after four months than baseline ( < 0.05). However, the study group showed statistically significant lesser dimensional changes than the control group according to the standardized CBCT scans. Furthermore, core biopsies confirmed an excellent remodeling of the autogenous dentin biomaterial in the study group. In comparison, only new thin bone trabeculae-filled sockets were in the control group.
CONCLUSION
Autogenous dentin graft can be safely and successfully used for alveolar ridge preservation. Optimal graft remodeling histologically, better ridge dimensional stability, and uneventful wound healing support its clinical application. This trial is registered with TCTR20220615002.
Topics: Humans; Tooth Socket; Biocompatible Materials; Alveolar Process; Alveolar Bone Loss; Tooth Extraction; Mouth, Edentulous; Dentin; Alveolar Ridge Augmentation
PubMed: 38179035
DOI: 10.1155/2023/7932432 -
Compendium of Continuing Education in... 2022A fairly common treatment modality for anterior and posterior single-rooted teeth, immediate implant placement in molar areas is less prevalent. Technical challenges can...
A fairly common treatment modality for anterior and posterior single-rooted teeth, immediate implant placement in molar areas is less prevalent. Technical challenges can arise when creating an implant osteotomy in a fresh extraction socket of a multi-rooted tooth. Also, the proximity to important anatomic structures and the difficulty in achieving adequate implant stability in wide sockets can also be hindrances. The principles of osseodensification may be utilized as part of a novel, predictable technique for immediate molar replacement with an implant. This article discusses the osseodensification technique, including such key factors as site assessment, radiographic evaluation, minimally traumatic tooth removal, implant positioning, and instrumentation.
Topics: Dental Implantation, Endosseous; Molar; Tooth Extraction; Tooth Root; Tooth Socket
PubMed: 35790481
DOI: No ID Found -
British Dental Journal Oct 2020
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Humans; Tooth Extraction; Tooth Socket
PubMed: 33097888
DOI: 10.1038/s41415-020-2292-1 -
Quintessence International (Berlin,... Dec 2021Healing of postextraction alveolus is a complex process that involves soft and hard tissue regeneration. Pain, swelling, difficulty in opening the mouth, delayed bone... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Healing of postextraction alveolus is a complex process that involves soft and hard tissue regeneration. Pain, swelling, difficulty in opening the mouth, delayed bone tissue healing, alveolitis, and horizontal or vertical resorption of bone tissue are the main problems that impact on consequent treatment. Blood concentrates PRGF (plasma rich in growth factors) and PRF (platelet-rich fibrin), which are rich in growth factors, create better conditions for postextraction alveolus healing, enhance quality of soft tissues and bone regeneration, and decrease pain. The study objective was to compare physiologic healing of the postextraction zone with PRF- and PRGF-induced changes.
METHOD AND MATERIALS
In total, 43 patients were randomly divided into three groups: control group (mandibular molar extraction and filling of postextraction alveolus with hemostatic sponge containing gentamicin), group 2 (postextraction alveolus filled with PRGF), and group 3 (postextraction alveolus filled with PRF). Bone regeneration was evaluated in CBCT scans after 1 month. Pain was evaluated using the visual analog scale (VAS).
RESULTS
After evaluating VAS results 1 day after surgery the lowest pain score was in the PRGF group. Tooth alveolus vertical and diagonal dimensions in the control group were significantly (P = .017) smaller than in the PRGF group. The vertical dimension of the alveolar ridge did not change significantly (P = .859) in the PRGF group; however, it was significantly reduced (P = .04) in the PRF group. One month after surgery the age of the control group was inversely proportionally correlated with the height and diagonal dimension of callus.
CONCLUSION
Both blood concentrates had great anti-inflammatory properties, but PRGF had better osteoblastic properties and resulted in lower postoperative pain.
Topics: Alveolar Process; Humans; Platelet-Rich Fibrin; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 34076381
DOI: 10.3290/j.qi.b1492237 -
Journal of Biological Regulators and... 2019Socket preservation is a surgical procedure whose aim is to limit the physiological resorption of the alveolar ridge that occurs after a dental extraction, in order to...
Socket preservation is a surgical procedure whose aim is to limit the physiological resorption of the alveolar ridge that occurs after a dental extraction, in order to have sufficient bone to perform an implant placement. 16 articles regarding socket preservation procedures were identified through scientific archives and analysed. The biological rationale, the graft materials and the predictive factors are identified to help the clinicians in their practice. Socket preservation is an effective treatment to prevent bone resorption if performed after an atraumatic extraction with the use of biomaterials and membranes. It is also important not to forget local and systemic predictive factors.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Humans; Tooth Extraction; Tooth Socket
PubMed: 30966733
DOI: No ID Found -
Clinical Implant Dentistry and Related... Jan 2015Traditionally, before placing dental implants, the compromised teeth are removed and the extraction sockets are left to heal for several months. To preserve the alveolar... (Review)
Review
BACKGROUND
Traditionally, before placing dental implants, the compromised teeth are removed and the extraction sockets are left to heal for several months. To preserve the alveolar bone level from the collapse caused by healing and to reduce treatment time in situations in which tooth extraction precedes implant placement, some clinicians began to install the implant immediately into the postextraction socket without waiting for the site to heal.
PURPOSE
The purpose of this study was to review the literature regarding treatment outcomes of immediate implant placement into sites exhibiting pathology after clinical procedures to perform the decontamination of the implant's site. The following questions were raised: Does the presence of periodontal or endodontic infection affect immediate implant placement success? What is suggested to address the infection in the socket prior to immediate placement?
MATERIALS AND METHODS
An electronic search in PubMed (U.S. National Library of Medicine, Bethesda, MD, USA) was undertaken in March 2013. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included both animal and human studies, and excluded any review and case reports articles. The publication's intervention had to have been implant placement into a site classified as having an infection (periapical, endodontic, perioendodontic, and periodontal).
RESULTS
The search strategy initially yielded 706 references. Thirty-two studies were identified within the selection criteria, from which nine were case reports and review articles and were excluded. Additional hand-searching of the reference lists of selected studies yielded five additional papers.
CONCLUSIONS
The high survival rate obtained in several studies supports the hypothesis that implants may be successfully osseointegrated when placed immediately after extraction of teeth presenting endodontic and periodontal lesions, provided that appropriate clinical procedures are performed before the implant surgical procedure such as meticulous cleaning, socket curettage/debridement, and chlorhexidine 0.12% rinse. However, more randomized controlled clinical trials with a longer follow-up are required to confirm this procedure as a safe treatment. Moreover, the outcome measures were not related to the type of infection; the classification of infection was often vague and varied among the studies. The benefits of antibiotic solution irrigation and systemic antibiotic administration in such conditions are not yet proved and remain unclear.
Topics: Anti-Bacterial Agents; Bacterial Infections; Debridement; Dental Restoration Failure; Humans; Immediate Dental Implant Loading; Mouth Diseases; Osseointegration; Periodontitis; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 23815434
DOI: 10.1111/cid.12098 -
The Journal of Prosthetic Dentistry Jan 2021This article describes a technique for surgically extruding severely compromised roots needing prosthetic rehabilitation. Unlike previously described approaches, the...
This article describes a technique for surgically extruding severely compromised roots needing prosthetic rehabilitation. Unlike previously described approaches, the technique does not require advanced clinical skills or equipment, may reduce the risk of tooth or bone fracture during the luxation maneuvers, and does not seem to interfere with the alveolar socket healing process.
Topics: Alveolar Process; Tooth Extraction; Tooth Socket
PubMed: 32067754
DOI: 10.1016/j.prosdent.2019.12.002 -
Frontiers in Endocrinology 2023The aim of this clinical trial was to assess the impact of autologous concentrated growth factor (CGF) as a socket-filling material and its ridge preservation properties... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
The aim of this clinical trial was to assess the impact of autologous concentrated growth factor (CGF) as a socket-filling material and its ridge preservation properties following the lower third molar extraction.
MATERIALS AND METHODS
A total of 60 sides of 30 participants who had completely symmetrical bilateral impacted lower third molars were enrolled. The primary outcome variables of the study were bone height and width, bone density, and socket surface area in the coronal section. Cone beam computed tomography images were obtained immediately after surgery and three months after surgery as a temporal measure. Follow-up data were compared to the baseline using paired and unpaired -tests.
RESULTS
CGF sites had higher values in height and width when compared to control sites (Buccal wall 32.9 ± 3.5 vs 29.4 ± 4.3 mm, Lingual wall 25.4 ± 3.5 vs 23.1 ± 4 mm, and Alveolar bone width 21.07 ± 1.55vs19.53 ± 1.90 mm, respectively). Bone density showed significantly higher values in CGF sites than in control sites (Coronal half 200 ± 127.3 vs -84.1 ± 121.3 and Apical half 406.5 ± 103 vs 64.2 ± 158.6, respectively). There was a significant difference between both sites in the reduction of the periodontal pockets.
CONCLUSION
CGF application following surgical extraction provides an easy, low-cost, and efficient option for alveolar ridge preservation. Thus, the use of CGF by dentists during dental extractions may be encouraged, particularly when alveolar ridge preservation is required.
CLINICAL TRIAL REGISTRATION
TCTR identification, TCTR20221028003.
Topics: Humans; Cone-Beam Computed Tomography; Tooth Extraction; Tooth Socket
PubMed: 37265705
DOI: 10.3389/fendo.2023.1163696 -
Journal of Periodontal Research Aug 2015Peri-implantitis has a prevalence of 11-47%, involves destruction of peri-implant bone and may lead to implant loss. A detailed understanding of the pathogenesis of... (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVE
Peri-implantitis has a prevalence of 11-47%, involves destruction of peri-implant bone and may lead to implant loss. A detailed understanding of the pathogenesis of peri-implantitis is lacking. The objective of this study was to develop a murine model of experimental peri-implantitis.
MATERIAL AND METHODS
Machined, smooth-surface, screw-shaped titanium implants were placed in the healed alveolar bone of the left maxillary molars of C57BL/6J male mice, 8 wk after tooth extraction. Peri-implantitis was induced by securing silk ligatures around the head of the implant fixtures. Implant survival and peri-implant bone levels were analyzed by micro-computed tomography (micro-CT) scans and histology, 12 wk after ligature placement.
RESULTS
Implant survival was 60% (six of 10) for implants with ligatures and 100% (eight of eight) for controls. Micro-CT revealed significantly greater bone loss around the implants that received ligatures and that survived, compared with controls. The radiographic findings were confirmed via histology and toluidine blue staining.
CONCLUSION
This study describes a murine model of experimental peri-implantitis around screw-shaped titanium implants placed in the edentulous alveolar bone. This model should be a useful tool to dissect pathogenic mechanisms of peri-implantitis and evaluate potential treatment interventions.
Topics: Alloys; Alveolar Process; Animals; Coloring Agents; Dental Alloys; Dental Implants; Dental Prosthesis Design; Disease Models, Animal; Male; Maxilla; Mice; Mice, Inbred C57BL; Mice, Inbred Strains; Peri-Implantitis; Survival Analysis; Time Factors; Titanium; Tolonium Chloride; Tooth Socket; X-Ray Microtomography
PubMed: 25244403
DOI: 10.1111/jre.12234 -
The International Journal of Esthetic... 2020The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate...
The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate after tooth extraction and avoiding tissue collapse. Therefore, it could be considered a valid option in the immediate implant scenario. A careful shield preparation and handling are paramount for the success of the treatment and to minimize complications. Raising a flap can improve visibility and simplify the procedure. This article reports on a case in which a small crestal approach is used to visualize the root and the buccal plate, combined with a buccal semilunar flap, to gain access to the apical area. This surgical management is especially indicated when long roots are involved, in order to determine the correct axis for cutting and sectioning the root and to remove the apex if conventional drills are not long enough. Possible esthetic complications of raising a flap are also discussed.
Topics: Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Extraction; Tooth Socket
PubMed: 33089256
DOI: No ID Found