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Annals of African Medicine 2019The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss...
BACKGROUND
The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss around the implants determines the success rate of treatment. Platform switching (PLS) concept preserves the crestal bone loss, and this approach should be applied clinically for the overall success of dental implants.
PURPOSE
The purpose of this study is to discuss the literature dealing with the concept of PLS concept and preservation of marginal bone, the mechanism by which it contributes to maintenance of marginal bone, its clinical applications, advantages, and disadvantages, to assess its survival rates.
MATERIALS AND METHODS
PubMed and Google Scholar search was done to find out the studies involving PLS concept from 2005 to 2017. Data were analyzed using SPSS statistical software.
RESULTS
Literature search revealed studies involving concepts of PLS, comparison of platform-switched and nonplatform-switched implants, case reports on PLS, and studies with histological and finite element analyses regarding PLS.
CONCLUSION
PLS helps preserve crestal bone around the implants, and this concept should be followed when clinical situations in implant placement permit.
Topics: Adult; Alveolar Bone Loss; Alveolar Process; Bone Density; Dental Abutments; Dental Implant-Abutment Design; Dental Implantation; Dental Implants; Dental Prosthesis Design; Humans; Prosthesis Fitting
PubMed: 30729925
DOI: 10.4103/aam.aam_15_18 -
Periodontology 2000 Oct 2023Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth... (Review)
Review
Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth extraction/loss results in alveolar ridge deficiencies. Although RAP-related surgical techniques and biomaterials have been in practice for several decades, outcomes are not always predictable. Post-surgical complications experienced during the early or late wound healing phases may jeopardize the targeted ideal ridge dimensions, required for implant fixture placement, and may have other consequences, such as negatively impacting the patient's quality of life. This review describes reported post-surgical complications following RAP under the following subtitles: complications by tissue type, complications in function and aesthetics, complications by healing time, complications by biomaterial type, and complications by surgical protocol modalities. Specifically, RAP performed by using particulate bone graft substitutes and related complications are explored. Modalities developed to prevent/manage these complications are also discussed.
Topics: Humans; Alveolar Ridge Augmentation; Dental Implantation, Endosseous; Quality of Life; Bone Transplantation; Alveolar Process; Bone Substitutes; Biocompatible Materials; Tooth Extraction; Tooth Socket; Dental Implants
PubMed: 37489632
DOI: 10.1111/prd.12509 -
The Angle Orthodontist Jan 2022To evaluate incisor position and its relationship to alveolar bone in untreated optimal occlusions and in untreated Class II malocclusions.
OBJECTIVES
To evaluate incisor position and its relationship to alveolar bone in untreated optimal occlusions and in untreated Class II malocclusions.
MATERIALS AND METHODS
Fifty-seven lateral cephalograms of individuals with naturally occurring optimal occlusions (mean age = 23 years) were used to assess positions of central incisors and their relationships to alveolar bone. Data were compared to a sample of 57 individuals with untreated Class II malocclusions with concurrent anterior-posterior (AP) skeletal discrepancies (mean age = 16.9 years).
RESULTS
Significant intergroup differences were found for AP jaw relationship, maxillary alveolar bone thickness, mandibular incisor inclination, maxillary incisor root distance to labial surface of alveolar bone, and mandibular incisor root apex distance to labial surface of alveolar bone. Small differences between females and males existed for several variables. In both samples, maxillary incisor roots were located closer to the labial surface of alveolar process than to the palatal surface by roughly a 2:1 ratio. Mandibular incisor root apices were generally equidistant from the labial and lingual surfaces of the alveolus in the optimal sample but closer to the lingual surface in the Class II sample.
CONCLUSIONS
Maxillary incisors tend to occupy the anterior one-third of the alveolus in untreated individuals, regardless of AP interarch dental relationships or AP jaw relationships. Mandibular incisor root apices tend to be centered within the alveolus in untreated optimal occlusions but are more positively inclined, and their root apices are more posterior in untreated Class II malocclusions.
Topics: Adolescent; Adult; Alveolar Process; Cone-Beam Computed Tomography; Female; Humans; Incisor; Male; Mandible; Maxilla; Young Adult
PubMed: 34383019
DOI: 10.2319/022320-122.1 -
Frontiers of Oral Biology 2016The periodontal ligament (PDL) and alveolar bone are two critical tissues for understanding orthodontic tooth movement. The current literature is replete with... (Review)
Review
The periodontal ligament (PDL) and alveolar bone are two critical tissues for understanding orthodontic tooth movement. The current literature is replete with descriptive studies of multiple cell types and their matrices in the PDL and alveolar bone, but is deficient with how stem/progenitor cells differentiate into PDL and alveolar bone cells. Can one type of orthodontic force with a specific magnitude and frequency activate osteoblasts, whereas another force type activates osteoclasts? This chapter will discuss the biology of not only mature cells and their matrices in the periodontal ligament and alveolar bone, but also stem/progenitor cells that differentiate into fibroblasts, osteoblasts and osteoclasts. Key advances in tooth movement rely on further understanding of osteoblast and fibroblast differentiation from mesenchymal stem/progenitor cells, and osteoclastogenesis from the hematopoietic/monocyte lineage.
Topics: Adaptation, Physiological; Alveolar Process; Cell Differentiation; Cell Lineage; Fibroblasts; Humans; Mesenchymal Stem Cells; Osteoblasts; Osteoclasts; Periodontal Ligament; Tooth Movement Techniques
PubMed: 26599112
DOI: 10.1159/000351894 -
Journal of Biomechanics May 2020Mobility is a fundamental characteristic of mammalian teeth, and has been widely used to determine individual tooth prognosis. However, the direction and extent of tooth...
Mobility is a fundamental characteristic of mammalian teeth, and has been widely used to determine individual tooth prognosis. However, the direction and extent of tooth movement under functional loads are unknown. This study investigated maxillary molar mobility, alveolar bending, and periodontal space (PDL) fluid pressure during mastication and masseter muscle contraction in young pigs, along with PDL space measurements. Twelve three-month-old farm pigs were instrumented with some or all of the following: (1) ultrasonic crystals, one implanted into the pulp chamber of a deciduous maxillary molar and additional crystals glued onto its buccal and palatal alveolar plates; (2) rosette strain gauges affixed to the buccal and palatal of alveolar ridges; (3) a pressure transducer inserted into palatal alveolar bone facing the PDL. Tooth mobility, alveolar bending, and fluid pressure were simultaneously recorded during unrestrained feeding and subsequent masseter muscle stimulation. The PDL widths were measured using micro-CT. The results indicate that during the power stroke of mastication, (1) the molar displaced buccally and apically (192 ± 95 µm) regardless of the side of chewing; (2) compressive bone strain was greater on the buccal than on the palatal alveolar plate; and (3) PDL pressure increased during the power strok (3.63 ± 0.80 kPa). Masseter contraction produced similar results but with generally lower values. The PDL widths were larger than the range of tooth mobility, and showed no correlation with the mobility. Thus occlusal function causes buccal tipping and intrusion of maxillary molars with concomitant compression of the buccal alveolar plate and raised pressure within the PDL space.
Topics: Alveolar Process; Animals; Periodontal Ligament; Swine; Tooth; Tooth Mobility; Tooth Movement Techniques
PubMed: 32173029
DOI: 10.1016/j.jbiomech.2020.109716 -
Clinical Implant Dentistry and Related... Aug 2022An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties...
BACKGROUND
An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties also could have an impact on the results. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested and in the past years, a growing interest in teeth material has been observed as a valuable alternative to synthetic biomaterials.
AIM
The aim of the study was to explore the histomorphometric outcomes of tooth derivative materials as used as bone substitute material in socket preservation procedure.
METHODS
After alveolar socket preservation (ASP) procedures using autologous demineralized tooth as graft material prepared by means of an innovative device, was evaluated. A total of 101 histological samples, from 96 subjects, were analyzed by evaluating the total amount of bone (BV), residual tooth material (residual graft, TT), and vital bone (VB). The section from each sample was then split in nine subsections, resulting in 909 subsections, to allow statistical comparison between the different areas.
RESULTS
It was not noticed a statistically significant difference between maxillary and mandibular sites, being the amount of VB in upper jaw sites 37.9 ± 21.9% and 38.0 ± 22.0% in lower jaw sites and the amount of TT was 7.7 ± 12.2% in maxilla and 7.0 ± 11.1% in mandibles. None of the other considered parameters, including defect type and section position, were statistically correlated to the results of the histomorphometric analysis.
CONCLUSIONS
ASP procedure using demineralized autologous tooth-derived biomaterial may be a predictable procedure to produce new vital bone potentially capable to support dental implant rehabilitation.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Bone Substitutes; Bone Transplantation; Humans; Tooth Extraction; Tooth Socket
PubMed: 35507503
DOI: 10.1111/cid.13097 -
International Dental Journal Oct 2022The aim of this study was to investigate the alveolar bone density and thickness in Chinese participants with and without periodontitis.
OBJECTIVE
The aim of this study was to investigate the alveolar bone density and thickness in Chinese participants with and without periodontitis.
METHODOLOGY
This study was retrospective and cross-sectional in nature and used cone-beam computed tomography (CBCT) to evaluate alveolar bone loss, bone density, and bone thickness around 668 mandibular molars (344 periodontally healthy teeth and 324 teeth with periodontitis). Comparative statistical tests were done related to the age, sex, tooth type, tooth side, and degree of bone loss. The significance level was set to be P < .05.
RESULTS
The alveolar bone density significantly differed between the healthy and periodontitis groups (mean difference = 24.4 Hounsfield units; P = .007). Similarly, the alveolar bone thickness of the healthy group was significantly higher than that of the periodontitis group (4.6 ± 1.8 mm compared to 4.2 ± 1.1 mm). Teeth in females demonstrated a significantly (P ˂ .001) higher bone density compared with males in both healthy and compromised groups. However, males showed a significantly (P ˂ .05) thicker bone of the teeth than females in relation to the healthy group. The alveolar bone density and thickness in both healthy and periodontitis groups significantly differed between the first and the second molars (P < .001). The alveolar bone thickness had a highly significant difference (P < .001) between the different degrees of bone loss.
CONCLUSIONS
Alveolar bone thickness and density were reduced at periodontally diseased teeth.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Cross-Sectional Studies; Female; Humans; Male; Periodontitis; Retrospective Studies
PubMed: 35760735
DOI: 10.1016/j.identj.2022.03.003 -
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 -
BMC Oral Health Nov 2023To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate.
MATERIALS AND METHODS
Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0.
RESULTS
24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants' survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction.
CONCLUSION
Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality.
CLINICAL RELEVANCE
The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Alveolar Ridge Augmentation; Alveolar Process; Bone Transplantation; Randomized Controlled Trials as Topic
PubMed: 37986181
DOI: 10.1186/s12903-023-03643-2 -
International Journal of Environmental... Dec 2022Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis...
Traumatic injuries to the permanent dentition are most common in children. In severe dentoalveolar injuries, especially avulsion and intrusion, dentoalveolar ankylosis is a common complication, leading to adverse effects on the developing alveolar bone and interfering with the eruption of the adjacent teeth. The decoronation procedure was suggested in 1984 to reduce these side effects related to ankylosis. The objective of the current publication is to describe a minimally invasive, flapless decoronation procedure aimed to minimize and simplify the surgical procedure of decoronation, and ease its clinical acceptance, particularly in young children. The technique is described in a detailed protocol and demonstrated in two cases. Under local anesthesia, the dental crown is removed, and the root is reduced by 1.5-2.0 mm apically to the marginal bone crest. The root canal content is then removed, allowing it to fill with blood. The socket is coronally sealed with a porcine-derived collagen matrix (PDCM) sutured using the "parachute" technique over the resected root, allowing close adaptation to the surrounding soft tissue. In conclusion, the presented technique of flapless decoronation is a modification of the classic decoronation procedure, which can be used as a minimally invasive technique to simplify the surgical procedure and the post-operative process.
Topics: Humans; Tooth Ankylosis; Tooth Crown; Alveolar Process; Tooth; Tooth Avulsion
PubMed: 36612921
DOI: 10.3390/ijerph20010603