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The Pan African Medical Journal 2022
Topics: Infant; Humans; Cleft Lip; Pulmonary Alveoli; Tooth Socket; Gastrointestinal Diseases; Palate
PubMed: 36451981
DOI: 10.11604/pamj.2022.42.316.33040 -
Romanian Journal of Morphology and... 2019Functional and esthetic recovery of the patient after tooth extraction is a concern in the nowadays-dental medicine. Immediate implant placement in fresh sockets in...
Functional and esthetic recovery of the patient after tooth extraction is a concern in the nowadays-dental medicine. Immediate implant placement in fresh sockets in posterior sides of the jaws is difficult because of the high amount of bone loss and the disparity between the diameter of the alveolus and the implant. The objective is to evaluate the effect of laser biomodulation alveolar socket healing process of healthy patients. A number of 36 molars have been extracted due to advanced caries lesions from the same dental arch but on opposite sites. Laser irradiation was performed on one side after extraction; the other side was used as control. An Epic-X laser diode (Biolase) Indium-Gallium-Arsenide-Phosphorus (In-Ga-As-P) 940 nm was used in a continuous mode, 0.9 W, 36 J for 80 seconds, daily exposure, in the first seven days after extraction. Specimens of soft and hard tissue were surgically incised and removed by a 4.4 mm diameter trepan from the extraction sites, eight weeks after the surgical procedure. The specimens were prepared by use of two staining procedures: Hematoxylin-Eosin (HE) and Mallory's trichrome. The prepared slides were examined under Leica DM750 optical microscope, 5× and 10× magnification. Laser biomodulation therapy accelerates bone formation by increasing osteoblastic activity. The histological study demonstrates early new bone formation, the regeneration effects in fresh intact bony alveolus compared with the soft and bone regeneration level of non-treated fresh alveolus. Laser biomodulation therapy accelerates soft tissue regeneration and bone formation.
Topics: Adult; Alveolar Process; Bone Regeneration; Connective Tissue; Epithelium; Female; Humans; Lasers; Male; Middle Aged; Osteogenesis; Young Adult
PubMed: 32239104
DOI: No ID Found -
Clinical Oral Investigations Aug 2023To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone.
MATERIALS AND METHODS
A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted.
RESULTS
Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP).
CONCLUSION
The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed.
CLINICAL RELEVANCE
When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
Topics: Humans; Tooth Socket; Alveolar Process; Osteogenesis; Tooth; Platelet-Rich Plasma; Tooth Extraction; Fibrin; Alveolar Ridge Augmentation
PubMed: 37439800
DOI: 10.1007/s00784-023-05126-8 -
Clinical Oral Investigations Dec 2023To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment.
MATERIALS AND METHODS
Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies.
RESULTS
Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected.
CONCLUSIONS
HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth.
CLINICAL RELEVANCE
HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.
Topics: Humans; Animals; Tooth Socket; Hyaluronic Acid; Trismus; Dry Socket; Tooth Extraction; Molar, Third; Pain
PubMed: 37963982
DOI: 10.1007/s00784-023-05227-4 -
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 -
Journal of Indian Society of... 2022Complete tooth wear dentition is multifactorial and has challenges with diagnosis and etiology. Their rehabilitation often requires orthognathic surgery, orthodontics,...
Complete tooth wear dentition is multifactorial and has challenges with diagnosis and etiology. Their rehabilitation often requires orthognathic surgery, orthodontics, periodontal surgery, and prosthodontic guidelines for occlusion with harmonious facial and dental esthetics. A patient needs a multidisciplinary approach with systematic analysis to formulate evidence-based approach to improve function and esthetics. Contemporary periodontal therapy also encompasses esthetic treatment where needs are frequently associated with changes in tooth size, shape, proportion, and balance that can adversely affect smile appearance. The article provides an evidence-based guideline for reconstruction of a worn dentition. The completed work includes crown lengthening, provisionalization, socket shield technique, oral implants, and gain in lost vertical dimension with occlusion correction and minimally invasive prosthetic restorations.
PubMed: 35136323
DOI: 10.4103/jisp.jisp_690_20 -
Medicine Sep 2018The aim of this study was to introduce an improved surgical technique using a pouch design and tension-free wound closure for periodontally accelerated osteogenic... (Observational Study)
Observational Study
The aim of this study was to introduce an improved surgical technique using a pouch design and tension-free wound closure for periodontally accelerated osteogenic orthodontics (PAOO) in the anterior alveolar region of the mandible.Patients with bone dehiscence and fenestrations on the buccal surfaces of the anterior mandible region underwent the modified PAOO technique (using a pouch design and tension-free closure). Postoperative symptoms were evaluated at 1 and 2 weeks intervals following the procedure. Probing depth (PD), gingival recession depth (GRD), and clinical attachment level (CAL) were assessed at the gingival recession sites at baseline, postoperative 6 and 12 months. Cone-beam computerized tomography (CBCT) was used for quantitative radiographic analyses at baseline, 1 week and 12 months after bone-augmentation procedure.The sample was composed of a total of 12 patients (2 males and 10 females; mean age, 21.9 years) with 72 teeth showing dehiscence/fenestrations and 17 sites presenting with gingival recessions. Clinical evaluations revealed a statistically significant reduction in swelling, pain, and clinical appearance from postoperative week 1 to week 2 (P < .05). Moreover, gingival recession sites exhibited a significant reduction in the GRD and an increase in CAL after surgery with mean root coverage of 69.8% at the end of observation period (P < .01). Both alveolar bone height and width increased after surgery (P < .01) and decreased during the 12-month follow-up (P < .01). However, compared with the baseline records, there was still a significant increase in alveolar bone volume (P < .01).This modified PAOO technique may have advantages in terms of soft and hard tissue augmentation, facilitating extensive bone augmentation and allowing the simultaneous correction of vertical and horizontal defects in the labial aspect of the mandibular anterior area.
Topics: Adolescent; Adult; Cone-Beam Computed Tomography; Female; Gingival Recession; Humans; Male; Mandible; Minerals; Orthognathic Surgical Procedures; Osteogenesis; Piezosurgery; Tooth Movement Techniques; Tooth Socket; Young Adult
PubMed: 30212935
DOI: 10.1097/MD.0000000000012047 -
JPMA. the Journal of the Pakistan... Feb 2021Alveolar osteitis (AO) is an extremely distressing outcome following extraction of a tooth. Its pathophysiology is poorly understood due to varied nature of presentation... (Review)
Review
Alveolar osteitis (AO) is an extremely distressing outcome following extraction of a tooth. Its pathophysiology is poorly understood due to varied nature of presentation of the condition. However, a delay in the healing process of bone due to fibrinolysis is believed to be the underlying pathophysiology. This review highlights three major risk factors - trauma, bacterial accumulation due to poor oral hygiene, and smoking - in causing alveolar osteitis, and describes underlying related molecular events. Fibrinolysis results due to traumatic tooth extraction as well as due to accumulation of certain microorganisms which leads to the development of alveolar osteitis. Tumour necrosis factor-alpha (TNF-a), Runt-related transcription factor 2 (Runx 2) and osteocalcin (OCN) can be used as molecular markers for evaluating alveolar osteitis. Assessment assays of such biomarkers can lead to a better understanding of the pathological process in providing a clearer picture to researchers and clinicians.
Topics: Dry Socket; Humans; Risk Factors; Tooth; Tooth Extraction; Wound Healing
PubMed: 33819239
DOI: 10.47391/JPMA.491 -
Journal of Pharmacy & Bioallied Sciences Feb 2019It is fairly common to remove a severely compromised tooth and provide rehabilitation by means of an implant. Resorption of alveolar bone after extraction resulting in...
It is fairly common to remove a severely compromised tooth and provide rehabilitation by means of an implant. Resorption of alveolar bone after extraction resulting in loss of bone height and width is an unpleasant sequelae causing difficulty in implant placement. Few procedures have been promoted to attain the required bone height and width, such as guided bone regeneration socket preservation with the use of various graft materials and barrier membranes. The disadvantages of these techniques are some amount of ridge height loss and loss of buccal/facial, ridge contour. The socket shield technique is a new method where a buccal segment of root is retained as a shield, which aids in retaining periodontal ligament on buccofacial aspect. The implant is placed (immediate placement) lingual to this shield. This maintains the alveolar ridge height and buccofacial contour, thus providing superior aesthetics. This case report shows placement of an implant in upper anterior region using this technique.
PubMed: 30923434
DOI: 10.4103/jpbs.JPBS_228_18 -
Bone Reports Dec 2021Bone remodeling is a lifelong process that ranges from orthodontic tooth movement/alignment to bone damage/healing, to overall bone health. Osteoprotegerin (OPG) and...
BACKGROUND
Bone remodeling is a lifelong process that ranges from orthodontic tooth movement/alignment to bone damage/healing, to overall bone health. Osteoprotegerin (OPG) and transforming growth factor β1 (TGF-β1) are secreted by osteoblasts and participate in bone remodeling. OPG promotes bone remineralization and stabilization prominent in post-mechanical repositioning of the teeth in the dental alveolus. TGF-β1 participates in regulatory processes to promote osteoblast and osteoclast equilibrium. In the context of orthodontic tooth movement, post-treatment fixation requires additional, exogenous, stabilization support. Recent research showcases supplementary solutions, in conjunction to standard tooth fixation techniques, such as OPG injections into gum and periodontal tissues to accelerate tooth anchorage; however, injections are prone to post-procedure complications and discomfort. This study utilizes noninvasive bioelectric stimulation (BES) to modulate OPG and TGF-β1 as a novel solution to regulate bone remineralization specifically in the context of post-orthodontic tooth movement.
PURPOSE
The aim of this study was to investigate a spectrum of BES parameters that would modulate OPG and TGF-β1 expression in osteoblasts.
METHODS
Osteoblasts were cultured and stimulated using frequencies from 25 Hz to 3 MHz. RT-qPCR was used to quantify changes in OPG and TGFb-1 mRNA expression.
RESULTS
OPG mRNA expression was significantly increased at frequencies above 10,000 Hz with a maximum expression increase of 332 ± 8% at 100 kHz. Conversely, OPG mRNA expression was downregulated at frequencies lower than 1000 Hz. TGF-β1 mRNA expression increased throughout all stimulation frequencies with a peak of 332 ± 72% at 250 kHz. Alizarin Red tests for calcium, indicated that mineralization of stimulated osteoblasts in vitro increased 28% after 6 weeks in culture.
DISCUSSION
Results support the working hypothesis that OPG and TGF-β1 mRNA expression can be modulated through BES. Noninvasive BES approaches have the potential to accelerate bone remineralization by providing a novel tool to supplement the anchorage process, reduce complications, and promote patient compliance and reduce post-treatment relapse. Noninvasive BES may be applicable to other clinical applications as a novel therapeutic tool to modulate bone remodeling.
PubMed: 34692946
DOI: 10.1016/j.bonr.2021.101141