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Alveolar ridge regeneration in two-wall-damaged extraction sockets of an in vivo experimental model.Clinical Oral Implants Research Aug 2021To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two-wall (both buccal...
AIM
To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two-wall (both buccal and lingual)-damaged extraction sockets.
MATERIALS AND METHODS
Distal roots of three mandibular premolars in six beagle dogs were extracted, and the whole buccal and lingual bony walls were surgically removed. Three treatment protocols were then applied according to the following group allocation: no graft (None), grafting DPBM (BG), and grafting DPBM with coverage by a collagen membrane (BG + M). Two observational periods (2 and 8 weeks) were used with the split-mouth design, and quantitative and qualitative analyses were performed by microcomputed tomography and histology.
RESULTS
The dimensions of the alveolar ridge at both grafted sites (BG and BG + M) remained similar to those of the pristine ridge in the histologic and radiographic analyses, whereas the ungrafted sites (None) collapsed both vertically and horizontally. Both grafting protocols produced substantial bony regeneration, but the addition of a covering membrane enhanced the proportion of mineralized tissue within the augmented area, and the BG + M group also showed a significantly larger area of regenerated ridge than the None group (p < .05).
CONCLUSIONS
Bone grafting with collagen membrane can maintain the alveolar ridge dimensions with substantial bone regeneration in a two-wall-damaged extraction socket.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Dogs; Models, Theoretical; Swine; Tooth Extraction; Tooth Socket; X-Ray Microtomography
PubMed: 34101908
DOI: 10.1111/clr.13791 -
Journal of Applied Oral Science :... 2022Characterizations of rat mandibular second molar extraction socket with significantly different buccal and lingual alveolar ridge width remain unclear.
BACKGROUND
Characterizations of rat mandibular second molar extraction socket with significantly different buccal and lingual alveolar ridge width remain unclear.
OBJECTIVE
To observe alterations in the alveolar ridge after extraction of mandibular second molars, and to examine processes of alveolar socket healing in an experimental model of alveolar ridge absorption and preservation.
METHODOLOGY
Eighteen Wistar rats were included and divided into six groups regarding healing time in the study. Bilateral mandibular second molars were extracted. The rats with tooth extraction sockets took 0, 1.5, 2, 3, 4 and 8 weeks of healing. Histological observation, tartrate-resistant acidic phosphatase (TRAP) staining, Masson's trichrome staining, immunohistochemical staining and micro-computed tomography (micro-CT) were applied to estimate alterations in the alveolar ridge.
RESULTS
Different buccal and lingual alveolar ridge width led to different height loss. Lingual wall height (LH) decreased significantly two weeks after tooth extraction. Buccal wall height rarely reduced its higher ridge width. From two to eight weeks after extraction, bone volume (BV/TV), density (BMD), and trabecular thickness (Tb.Th) progressively increased in the alveolar socket, which gradually decreased in Tb.Sp and Tb.N. LH showed no significant change during the same period. Osteogenic marker OCN and OPN increased during bone repair from two to eight weeks. The reduced height of the lingual wall of the tooth extraction socket was rarely repaired in the later repair stage. Osteoclast activity led to absorption of the alveolar ridge of the alveolar bone wall within two weeks after operation. We observed positive expression of EMMPRIN and MMP-9 in osteoclasts that participated in the absorption of the spire region.
CONCLUSION
Extraction of rat mandibular second molars may help the study of alveolar ridge absorption and preservation. The EMMPRIN-MMP-9 pathway may be a candidate for further study on attenuating bone resorption after tooth extraction.
Topics: Alveolar Bone Loss; Alveolar Ridge Augmentation; Animals; Basigin; Matrix Metalloproteinase 9; Molar; Rats; Rats, Wistar; Tooth Extraction; Tooth Socket; X-Ray Microtomography
PubMed: 35830122
DOI: 10.1590/1678-7757-2022-0010 -
BMC Oral Health Jun 2020The aim of this prospective clinical study was to investigate differences between virtually planned and clinically achieved implant positions in completely... (Clinical Trial)
Clinical Trial
BACKGROUND
The aim of this prospective clinical study was to investigate differences between virtually planned and clinically achieved implant positions in completely template-guided implant placements as a function of the tooth area, the use of alveolar ridge preservation, the implant length and diameter, and the primary implant stability.
METHODS
The accuracy of 48 implants was analyzed. The implants were placed in a completely template-guided manner. The data of the planned implant positions were superimposed on the actual clinical implant positions, followed by measurements of the 3D deviations in terms of the coronal (dc) and apical distance (da), height (h), angulation (ang), and statistical analysis.
RESULTS
The mean dc was 0.7 mm (SD: 0.3), the mean da was 1.4 mm (SD: 0.6), the mean h was 0.3 mm (SD: 0.3), and the mean ang was 4.1° (SD: 2.1). The tooth area and the use of alveolar ridge preservation had no significant effect on the results in terms of the implant positions. The implant length had a significant influence on da (p = 0.02). The implant diameter had a significant influence on ang (p = 0.04), and the primary stability had a significant influence on h (p = 0.02).
CONCLUSION
Template-guided implant placement offers a high degree of accuracy independent of the tooth area, the use of measures for alveolar ridge preservation or the implant configuration. A clinical benefit is therefore present, especially from a prosthetic point of view.
TRIAL REGISTRATION
German Clinical Trial Register and the International Clinical Trials Registry Platform of the WHO: DRKS00005978 ; date of registration: 11/09/2015.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Female; Humans; Male; Prospective Studies; Tooth; Treatment Outcome
PubMed: 32600405
DOI: 10.1186/s12903-020-01155-x -
Clinical Implant Dentistry and Related... Jun 2022To assess the horizontal and vertical dimensional changes of the alveolar ridge when using a collagen matrix in combination with collagen embedded xenogenic bone... (Randomized Controlled Trial)
Randomized Controlled Trial
Histological and dimensional changes of the alveolar ridge following tooth extraction when using collagen matrix and collagen-embedded xenogenic bone substitute: A randomized clinical trial.
AIM
To assess the horizontal and vertical dimensional changes of the alveolar ridge when using a collagen matrix in combination with collagen embedded xenogenic bone substitute, in comparison with natural healing after tooth extraction.
METHODS
Patients that required extraction in non-molars areas were included. Test group-15 sockets were treated with deproteinized bovine bone mineral containing 10% collagen (DBBM-C), covered by a procaine collagen membrane (CMXs). Control group-15 sockets left for spontaneous healing. We used a custom-made acrylic stent as a reference for alveolar ridge measurements. Six-month postoperative, a single implant was placed in the experimental site. A core biopsy was taken from the site, using a trephine bur. Histomorphometric analysis assessed bone area, connective tissue, bone marrow, and residual bone graft.
RESULTS
Six months later, horizontal ridge width at -3 mm showed a significant (p < 0.05) reduction in both groups albeit smaller in the test group 1.19 ± 1.55 mm, compared with the control 2.27 ± 1.52 (p = 0.087). At -5 mm sub-crestally, statistically non-significant reduction was noted in both groups, 1.61 ± 1.53 and 1.96 ± 1.52 mm for the test and control groups, respectively (p = 0.542). Vertical changes were smaller in the test group (0.14 ± 1.84 mm) compared with control (0.98 ± 1.49 mm). Keratinized tissue (KT) width was 7.3 ± 2.13 and 7.5 ± 3.49 mm in the test and control groups, respectively. Newly formed bone occupied 33.79 ± 17.37% and 51.14 ± 23.04% in the test and control groups, respectively, (p = 0.11). Connective tissue volume was 33.74 ± 13.81% and 30.12 ± 18.32% in the test and control groups, respectively (p = 0.65). Bone marrow occupied 19.57 ± 10.26% and 18.74 ± 17.15% in the test and control groups, respectively (p = 0.91). Residual graft occupied 12.9 ± 9.88% in the test group.
CONCLUSION
Alveolar ridge preservation using DBBM-C resulted in reductions of the vertical and horizontal dimensions albeit not reaching statistical significance. The larger than anticipated standard deviation and smaller inter-group differences might account for this phenomenon.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Bone Substitutes; Cattle; Collagen; Humans; Tooth Extraction; Tooth Socket
PubMed: 35298865
DOI: 10.1111/cid.13085 -
Clinical Oral Implants Research Sep 2023The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of...
Group 1 ITI Consensus Report: The role of bone dimensions and soft tissue augmentation procedures on the stability of clinical, radiographic, and patient-reported outcomes of implant treatment.
OBJECTIVES
The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of biologic and aesthetic complications, and (ii) of soft tissue augmentation (STA) on the stability of clinical, radiographic, and patient-related outcomes of implant treatments.
MATERIALS AND METHODS
Two systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, recommendations for future research, and reflections on patient perspectives were based on structured group discussions until consensus was reached among the entire group of experts. The statements were then presented and accepted following further discussion and modifications as required by the plenary.
RESULTS
Dimensional changes of the alveolar ridge occurred after implant placement in healed sites, and a reduction in buccal bone wall thickness (BBW) of 0.3 to 1.8 mm was observed. In healed sites with a BBW of <1.5 mm after implant placement, increased vertical bone loss, and less favorable clinical and radiographic outcomes were demonstrated. Implants with buccal dehiscence defects undergoing simultaneous guided bone regeneration, showed less vertical bone loss, and more favorable clinical and radiographic outcomes, compared to non-augmented dehiscence defects during initial healing. At healthy single implant sites, probing depths, bleeding and plaque scores, and interproximal bone levels evaluated at 1 year, remained stable for up to 5 years, with or without STA. When single implant sites were augmented with connective tissue grafts, either for soft tissue phenotype modification or buccal soft tissue dehiscence, stable levels of the soft tissue margin, and stable or even increased soft tissue thickness and/or width of keratinized mucosa could be observed from 1 to 5 years. In contrast, non-augmented sites were more prone to show apical migration of the soft tissue margin in the long-term. Favorable aesthetic and patient-reported outcomes after STA were documented to be stable from 1 to 5 years.
CONCLUSIONS
It is concluded that dimensional changes of the alveolar ridge occur after implant placement in healed sites and that sites with a thin BBW after implant placement are prone to exhibit less favorable clinical and radiographic outcomes. In addition, it is concluded that STA can provide stable clinical, radiographic, aesthetic, and patient-reported outcomes in the medium and long-term.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Alveolar Process; Mucous Membrane; Patient Reported Outcome Measures; Alveolar Ridge Augmentation; Treatment Outcome
PubMed: 37750519
DOI: 10.1111/clr.14154 -
Journal of Dental Research Jul 2020Tooth extraction results in alveolar bone resorption and is accompanied by postoperative swelling and pain. Maresin 1 (MaR1) is a proresolving lipid mediator produced by...
Tooth extraction results in alveolar bone resorption and is accompanied by postoperative swelling and pain. Maresin 1 (MaR1) is a proresolving lipid mediator produced by macrophages during the resolution phase of inflammation, bridging healing and tissue regeneration. The aim of this study was to examine the effects of MaR1 on tooth extraction socket wound healing in a preclinical rat model. The maxillary right first molars of Sprague-Dawley rats were extracted, and gelatin scaffolds were placed into the sockets with or without MaR1. Topical application was also given twice a week until complete socket wound closure up to 14 d. Immediate postoperative pain was assessed by 3 scores. Histology and microcomputed tomography were used to assess socket bone fill and alveolar ridge dimensional changes at selected dates. The assessments of coded specimens were performed by masked, calibrated examiners. Local application of MaR1 potently accelerated extraction socket healing. Macroscopic and histologic analysis revealed a reduced soft tissue wound opening and more rapid re-epithelialization with MaR1 delivery versus vehicle on socket healing. Under micro-computed tomography analysis, MaR1 (especially at 0.05 μg/μL) stimulated greater socket bone fill at day 10 as compared with the vehicle-treated animals, resulting in less buccal plate resorption and a wider alveolar ridge by day 21. Interestingly, an increased ratio of CD206:CD68 macrophages was identified in the sockets with MaR1 application under immunohistochemistry and immunofluorescence analysis. As compared with the vehicle therapy, local delivery of MaR1 reduced immediate postoperative surrogate pain score panels. In summary, MaR1 accelerated extraction wound healing, promoted socket bone fill, preserved alveolar ridge bone, and reduced postoperative pain in vivo with a rodent preclinical model. Local administration of MaR1 offers clinical potential to accelerate extraction socket wound healing for more predictable dental implant reconstruction.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Bone Regeneration; Docosahexaenoic Acids; Male; Rats; Rats, Sprague-Dawley; Tooth Extraction; Tooth Socket; Wound Healing; X-Ray Microtomography
PubMed: 32384864
DOI: 10.1177/0022034520917903 -
PeerJ 2023Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called...
PURPOSE
Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called alveolar antral artery. It can complicate lateral sinus lift procedure by bleeding and hemosinus formation or bone graft wash out. The artery can also go in soft tissues where is not visible on cone beam computed tomography. In previous studies, the relation of this artery to sinus floor or alveolar process was measured. These structures are highly unstable during lifetime and after tooth loss. The aim of this study is to study presence and relations of bony canal in the lateral maxillary wall, to characterize the group of patients which is more likely to have bone canal in the lateral maxilla. The aim and the novelty of this study is the describing of the relationship of the bony canal to the more stable structure of hard palate and describing the relation of presence of bony canal on width of maxillary sinus, and to facilitate the prediction of presence of the alveolar antral artery.
MATERIALS
The cone beam computed tomography scans of the patients (251 in number) of the university hospital were examined for presence of alveolar antral artery (148 was fulfilled inclusion criteria), patient were characterized by gender, age, and sinus type (wide, average, narrow). The diameter of the bony canal and its relation to the level of sinus floor and hard palate were measured.
RESULTS
The cone beam computed tomography scans of 148 patients, out of it 55 man (37,2%) and 93 women (62,8%). Bony canal containing alveolar anastomosis was found in 69 cases (57,0%). Presence of the bony canal in the lateral wall of maxillae showed statistical probability depending on age with = 0, 064 according to Mann-Whitney test. The older patients have more likely the bony canal. The presence of the alveolar antral artery was found more likely in the wide sinuses. The hard palate level can serve as a prediction point of alveolar antral artery only in first molar and second premolar region. In accordance with previous studies the width of bony canal is significantly higher in group of man ( = 0, 015). There was found a correlation between smaller distance of bony canal from sinus floor in the presence of teeth ( = 0, 067). After tooth loss the distance between sinus floor and bony canal increases, but the distance of bony canal to hard palate level stays constant. This can be explained hypothetically so that periodontal ligaments and root surface acts as a barrier for sinus pneumatization.
CONCLUSION
Lateral sinus lifting in some cases can be unenviable, the knowledge about alveolar antral artery anatomy can reduce the risk of arterial bleeding. The cone-beam computed tomography is a routine examination prior to augmentation surgery and therefore the data obtained from it has an impact on clinical practice.
Topics: Male; Humans; Female; Sinus Floor Augmentation; Tooth Loss; Cone-Beam Computed Tomography; Arteries; Alveolar Process
PubMed: 38050605
DOI: 10.7717/peerj.16439 -
International Journal of Environmental... Feb 2021Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions... (Review)
Review
Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician's choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Prostheses and Implants; Surgery, Computer-Assisted; Tooth
PubMed: 33673563
DOI: 10.3390/ijerph18052341 -
Advances in Clinical and Experimental... 2014Gingival recession (GR) is a common clinical situation observed in patient populations regardless of their age and ethnicity. It has been estimated that over 60% of the... (Review)
Review
Gingival recession (GR) is a common clinical situation observed in patient populations regardless of their age and ethnicity. It has been estimated that over 60% of the human population has gingival recession. It is the final effect of the interaction of multiple etiological factors. Identification and definition of the range of influence is often not possible, with the result that new methods for testing and elimination of potential etiological factors are still being sought. The aim of this study is to present the etiopathogenesis of gingival recessions with regard to the analysis of morphological and functional factors. For the assessment of the bone factors, we will describe the new cephalometric method for measuring sagital width of the bone in the central incisors area, places when GR are most commonly observed. Also, a review will be presented of modern methods of treatment; in particular classes recessions; usage substitute of autogenous tissue will be emphasized--collagen matrix, and primary culture fibroblasts on collagen net.
Topics: Alveolar Process; Cephalometry; Gingival Recession; Humans; Mandible; Maxilla; Predictive Value of Tests; Prevalence; Radiography; Risk Factors
PubMed: 25618109
DOI: 10.17219/acem/27907 -
European Review For Medical and... Jul 2022Understanding the labial alveolar bone thickness (ABT) and buccolingual teeth angulation may reduce the complication that might arise during or post-operative treatment....
OBJECTIVE
Understanding the labial alveolar bone thickness (ABT) and buccolingual teeth angulation may reduce the complication that might arise during or post-operative treatment. The operator could determine the precise method to ensure long-term treatment success. This study aimed to evaluate the ABT with buccolingual upper incisor teeth angulation based on the maxillary plane by using the cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
A total of 371 CBCT radiographs were initially assessed and 100 CBCT radiographs were included. On the maxillary incisors, the labial alveolar bone thickness is evaluated at three points (Point A: Four mm below from CEJ, Point B: Midpoint from the labial alveolar-palatal alveolar crest plane and root apex. Point C: Root Apex of the tooth). The distance from these points to labial alveolar bone was measured for the ABT. Moreover, buccolingual angulation of the tooth was measured by the angle formed by the maxillary plane and the long axis of the tooth.
RESULTS
There is no significant difference observed between genders in the labial alveolar bone thickness. The labial alveolar bone thickness grew gradually from the cementoenamel junction (CEJ) level to the apical level. Moreover, there was a statistically significant positive correlation observed between labial alveolar bone thickness at the apical level (Point C) and angulation (p<0.05).
CONCLUSIONS
The labial bone thickness was less than 2 mm in the majority of cases at the three points among maxillary incisors. In addition, there is a correlation between buccolingual angulation of the maxillary incisors and labial alveolar bone thickness.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Female; Humans; Incisor; Male; Maxilla; Spiral Cone-Beam Computed Tomography
PubMed: 35856352
DOI: 10.26355/eurrev_202207_29184