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The Journal of Craniofacial Surgery Jun 2023This systematic review answered the guiding question using the PICO system: "What are the effects of advanced platelet-rich fibrin (A-PRF) on alveolar ridge preservation...
This systematic review answered the guiding question using the PICO system: "What are the effects of advanced platelet-rich fibrin (A-PRF) on alveolar ridge preservation and tissue gain in reconstructive and jaw graft surgery?" Searches were performed in the PubMed|MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and LILACS|bvs databases. In total, 573 articles were found in the initial search, and 564 were evaluated after the removal of duplicates, of which 5 randomized controlled trials met the eligibility criteria and were included 2 studies investigated the effect of A-PRF on the preservation of the bone ridge, 1 study evaluated the tissue repair after tooth extraction with A-PRF, 1 evaluated the peri-implant gap filling with A-PRF-xenograft mixture, and other the A-PRF on the treatment of alveolar osteitis. Advanced-PRF preparation protocol varied between the included studies from 8 to 13 minutes of centrifugation, at 1300 RPM (200 g ). The use of A-PRF provided greater dimensions of height and more favorable maintenance of the ridge profile, probing depth, and gingival margin level after extraction. Advanced-PRF also increased bone density, vital bone, epithelial healing, and control of postoperative pain and swelling after tooth extraction and in the treatment of alveolar osteitis.
Topics: Humans; Dry Socket; Platelet-Rich Fibrin; Tooth Extraction; Wound Healing; Plastic Surgery Procedures; Randomized Controlled Trials as Topic
PubMed: 37143188
DOI: 10.1097/SCS.0000000000009328 -
Maxillofacial Plastic and... Jul 2022After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with... (Review)
Review
After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. Heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. Clinical differences between anorganic bone substitutes and collagen-preserving materials are not well documented in the literature but understanding these differences could clarify how processing protocols influence biomaterial behavior in situ. This systematic review of the literature compares the dimensional changes and histological features of ABXs versus CBXs in ridge preservation procedures to promote awareness of different bone xenograft efficacies in stimulating the healing of post-extraction sockets.
PubMed: 35821286
DOI: 10.1186/s40902-022-00349-3 -
Dentistry Journal Jul 2022Dry socket is one of the postoperative complications of tooth extraction. It is the partial or total loss of the post-extraction blood clot, resulting in severe pain... (Review)
Review
Dry socket is one of the postoperative complications of tooth extraction. It is the partial or total loss of the post-extraction blood clot, resulting in severe pain that usually starts one to five days postoperatively, with clinical evidence of exposed alveolar bone, necrotic debris, halitosis, and tenderness on examination. The purpose of our systematic review was to answer the question "Is there a relationship between smoking and dry socket?". After meeting the inclusion and exclusion criteria, eleven studies were included in this systematic review (according to the PRISMA statement guidelines). Based on a meta-analysis, tobacco smokers had a more than three-fold increase in the odds of dry socket after tooth extraction. Overall, the combined incidence of dry socket in smokers was found to be about 13.2% and in non-smokers about 3.8%. Despite the heterogeneity of the included studies (different types of teeth extracted, different age groups), cigarette smoking was related to an increased risk of dry socket after tooth extraction.
PubMed: 35877395
DOI: 10.3390/dj10070121 -
The Journal of Evidence-based Dental... Dec 2019To compare the success rates, tissue preservation, and esthetics of implants placed in fresh and preserved sockets and to evaluate the factors influencing the outcomes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To compare the success rates, tissue preservation, and esthetics of implants placed in fresh and preserved sockets and to evaluate the factors influencing the outcomes.
METHODS
Medline, Embase, CENTRAL, Wanfang, and China National Knowledge Infrastructure (CNKI) databases were searched electronically, and a manual search was conducted as well. Studies that compared the implant success rate, tissue preservation, and patient-related outcomes such as complications and esthetic outcomes of immediate implant placement (IIP) and alveolar ridge preservation (ARP) were included. A subgroup analysis according to the follow-up period, socket conditions, and regenerative strategies was performed to investigate how these factors influence the prognosis.
RESULTS
A total of 12 studies with 588 implants, where 298 are implants after ARP and the remaining 290 are after IIP. The IIP was performed in 58.4% of 250 implants inserted in the sockets with an intact buccal wall, whereas the percentage declined to 41.9% when the buccal wall was defective. The implant success rate was similar between ARP and IIP for an intact buccal wall but different for a defective buccal wall (ARP 98.6% vs IIP 89.6%). Moreover, hard-tissue preservation and the Pink Esthetic Score (PES) of the ARP group were significantly better than those of the IIP group in the molar region (P < .05). Also short-term complications showed no significant differences in the ARP group (P = .06). In the anterior region, there appeared to be no significant difference in hard- and soft-tissue preservation PES and patient-related outcomes between the 2 protocols.
CONCLUSION
An alveolar bone defect might reduce the success rate of IIP. Further studies on the tissue preservation and esthetics of implants placed by IIP and ARP are still needed.
Topics: China; Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Tissue Preservation; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 31843184
DOI: 10.1016/j.jebdp.2019.05.015 -
Orthodontics & Craniofacial Research Jun 2024The aim of this systematic review was to compare the effectiveness of pre-alveolar bonegraft (ABG) orthodontics with no orthodontic treatment for patients with... (Meta-Analysis)
Meta-Analysis Review
Effectiveness of pre-alveolar bone graft orthodontics for patients with non-syndromic complete unilateral cleft lip, alveolus and palate: A systematic review and meta-analysis.
UNLABELLED
The aim of this systematic review was to compare the effectiveness of pre-alveolar bonegraft (ABG) orthodontics with no orthodontic treatment for patients with non-syndromic unilateral cleft lip, alveolus and palate. All relevant studies from 1946 to October 30, 2022, were identified using several sources including The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS, Scopus, EMBASE, MEDLINE (Ovid) and EPUB ahead of publications and non-indexed citations. Randomized Controlled Trials (RCT) and Controlled Clinical Trials (CCT) were included.
POPULATION
Non-syndromic complete unilateral cleft lip, alveolus and palate patients who have had ABG surgery.
INTERVENTION
Orthodontics prior to ABG. Comparison: No orthodontic treatment prior to ABG.
PRIMARY OUTCOME
Successful eruption of permanent canines. All articles were screened for the title, abstract and full text independently and in duplicate by 2 reviewers. The quality assessment of RCT was performed using Cochrane's risk of bias tool and the CCT was assessed using ROBINS-I tool. Of the 904 studies retrieved in the search, one RCT and one CCT were included. Both studies were judged as high risk of bias. The results from one study showed a statistically significant increase in bone volume and decreased bone defect post-ABG in the orthodontic treatment group. However, there was no difference with respect to other variables. Both included studies were of low quality. There is not enough evidence to recommend orthodontic treatment pre-ABG for patients with complete unilateral cleft lip, alveolus and palate. Future high-quality studies are required to inform patients and clinicians about the effectiveness of pre-graft orthodontic treatment.
Topics: Humans; Cleft Palate; Cleft Lip; Alveolar Bone Grafting; Orthodontics, Corrective; Treatment Outcome; Bone Transplantation
PubMed: 38108550
DOI: 10.1111/ocr.12744 -
Journal of Periodontal & Implant Science Feb 2022This study was conducted to evaluate and compare the effects of different graft materials used in alveolar ridge preservation on dimensional hard tissue changes of the... (Review)
Review
Cone-beam computed tomographic evaluation of dimensional hard tissue changes following alveolar ridge preservation techniques of different bone substitutes: a systematic review and meta-analysis.
PURPOSE
This study was conducted to evaluate and compare the effects of different graft materials used in alveolar ridge preservation on dimensional hard tissue changes of the alveolar ridge, assessed using cone-beam computed tomography (CBCT) scans.
METHODS
A systematic electronic search of MEDLINE and the Cochrane Central Register of Controlled Trials and a manual search were conducted from November 2019 until January 2020. Randomized controlled trials were included if they assessed at least 1 variable related to vertical or horizontal hard tissue changes measured using CBCT scans. After a qualitative analysis of the included studies, subgroups were formed according to the graft material used, and a quantitative analysis was performed for 5 outcome variables: changes in vertical alveolar bone height at 2 points (midbuccal and midpalatal/midlingual) and changes in horizontal (buccolingual) alveolar bone width at 3 different levels from the initial crest height (1, 3, and 5 mm).
RESULTS
The search resulted in 1,582 studies, and after an independent 3-stage screening, 16 studies were selected for qualitative analysis and 9 for quantitative analysis. The meta-analysis showed a significantly (<0.05) lower reduction of alveolar ridge dimensions for the xenogenic subgroup than in the allogenic subgroup, both vertically at the midbuccal aspect (weighted mean difference [WMD]=-0.20; standard error [SE]=0.26 vs. WMD=-0.90; SE=0.22) as well as horizontally at 1 mm (WMD=-1.32; SE=0.07 vs. WMD=-2.99; SE=0.96) and 3 mm (WMD=-0.78; SE=0.11 vs. WMD=-1.63; SE=0.40) from the initial crest height. No statistical analysis could be performed for the autogenic subgroup because it was not reported in sufficient numbers.
CONCLUSIONS
Less vertical and horizontal bone reduction was observed when xenogenic graft materials were used than when allogenic graft materials were used; however, the loss of alveolar ridge dimensions could not be completely prevented by any graft material.
PubMed: 35187870
DOI: 10.5051/jpis.2007100355 -
Cureus Mar 2022An alveolar cleft is the most common congenital bone defect. This systematic review aimed to investigate the use of stem cells for alveolar cleft repair and summarize... (Review)
Review
An alveolar cleft is the most common congenital bone defect. This systematic review aimed to investigate the use of stem cells for alveolar cleft repair and summarize the outcomes of clinical research studies. The electronic databases PubMed, Scopus, Web of Sciences, and Google Scholar were utilized to search the literature for relevant studies after administering specific inclusion and exclusion criteria. The search included articles that were published from 2011 to 2021 and specific keywords were used in the databases. The search was completed by two independent reviewers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Only four studies satisfied both the inclusion and exclusion criteria and were included in this systematic review. These studies investigated different aspects of bone reconstruction in the maxillary alveolar bone by stem cells, including cell types, clinical applications, biomaterial scaffolds, and follow-up period. The accumulated evidence in this systematic review is limited and insufficient to support the role of stem cell use in bone regeneration of maxillary alveolar bone defects. The outcome of using stem cells was studied only in 57 subjects from the four included studies. Although the noninvasive methods of isolating stem cells make them attractive resources for bone regeneration, more research is required in order to standardize and investigate stem cell therapy. This should be done beforehand in adults in less invasive procedures such as bone defect repair in dentistry prior to considering this type of therapy in this vulnerable patient population.
PubMed: 35425680
DOI: 10.7759/cureus.23111 -
Clinical Implant Dentistry and Related... Aug 2021To assess the efficacy of using a bone substitute material (BSM) in the fixture-socket gap in patients undergoing tooth extraction and immediate implant placement. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the efficacy of using a bone substitute material (BSM) in the fixture-socket gap in patients undergoing tooth extraction and immediate implant placement.
MATERIALS AND METHODS
MEDLINE, EMBASE, and CENTRAL databases were searched for randomized controlled trials (RCTs). RCTs were screened for eligibility, and data were extracted by two authors independently. Risk of bias (ROB) was assessed using Cochrane's ROB tool 2.0. Primary outcomes were implant failure, overall complications, and soft-tissue esthetics. Secondary outcomes were vertical buccal bone resorption, vertical interproximal bone resorption, horizontal buccal bone resorption, and mid-buccal mucosal recession. Meta-analysis was performed using random-effects model with generic inverse variance weighing. GRADE was used to grade the certainty of the evidence.
RESULTS
After screening 19 544 potentially eligible references, 20 RCTs were included in this review, with a total of 848 patients (916 sites). Most included RCTs were deemed of some concerns (53%) or at low (38%) risk of bias, except for overall complications (high ROB). Implant failure did not differ significantly RR = 0.92 (confidence intervals [CI] 0.34 to 2.46) between using a BSM compared with not using a BSM (NoBSM). BSM use resulted in less horizontal buccal bone resorption (MD = -0.52 mm [95% CI -0.74 to -0.30]), a higher esthetic score (MD = 1.49 [95% CI 0.46 to 2.53]), but also more complications (RR = 3.50 [95% CI 1.11 to 11.1] compared with NoBSM. Too few trials compared types of BSMs against each other to allow for pooled analyses. The certainty of the evidence was considered moderate for all outcomes except implant failure (low), overall complications (very low), and vertical interproximal bone resorption (very low).
CONCLUSION
BSM use during immediate implant placement reduces horizontal buccal bone resorption and improves the periimplant soft-tissue esthetics. Although BSM use increases the risk of predominantly minor complications.
Topics: Bone Substitutes; Dental Implantation, Endosseous; Dental Implants; Esthetics, Dental; Humans; Tooth Extraction
PubMed: 34118175
DOI: 10.1111/cid.13014 -
Journal of the American Dental... Aug 2023Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Corticosteroids are used to manage pain after surgical tooth extractions. The authors assessed the effect of corticosteroids on acute postoperative pain in patients undergoing surgical tooth extractions of mandibular third molars.
TYPES OF STUDIES REVIEWED
The authors conducted a systematic review and meta-analysis. The authors searched the Epistemonikos database, including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the US clinical trials registry (ClinicalTrials.gov) from inception until April 2023. Pairs of reviewers independently screened titles and abstracts, then full texts of trials were identified as potentially eligible. After duplicate data abstraction, the authors conducted random-effects meta-analyses. Risk of bias was assessed using Version 2 of the Cochrane Risk of Bias tool and certainty of the evidence was determined using the Grading of Recommendations Assessment, Development and Evaluation approach.
RESULTS
Forty randomized controlled trials proved eligible. The evidence suggested that corticosteroids compared with a placebo provided a trivial reduction in pain intensity measured 6 hours (mean difference, 8.79 points lower; 95% CI, 14.8 to 2.77 points lower; low certainty) and 24 hours after surgical tooth extraction (mean difference, 8.89 points lower; 95% CI, 10.71 to 7.06 points lower; very low certainty). The authors found no important difference between corticosteroids and a placebo with regard to incidence of postoperative infection (risk difference, 0%; 95% CI, -1% to 1%; low certainty) and alveolar osteitis (risk difference, 0%; 95% CI, -3% to 4%; very low certainty).
PRACTICAL IMPLICATIONS
Low and very low certainty evidence suggests that there is a trivial difference regarding postoperative pain intensity and adverse effects of corticosteroids administered orally, submucosally, or intramuscularly compared with a placebo in patients undergoing third-molar extractions.
Topics: Humans; Molar, Third; Acute Pain; Adrenal Cortex Hormones; Dry Socket; Postoperative Complications; Pain, Postoperative
PubMed: 37500235
DOI: 10.1016/j.adaj.2023.04.018 -
Journal of Esthetic and Restorative... Dec 2021Immediate implant placement with socket shield technique (SST) may maintain the buccal bone plate and soft tissue levels, however, the potential clinical benefits of SST... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Immediate implant placement with socket shield technique (SST) may maintain the buccal bone plate and soft tissue levels, however, the potential clinical benefits of SST lack strong scientific evidence. The aim of this systematic review and meta-analysis was to evaluate the effects of SST on dimensional changes of hard tissues, esthetic outcomes, implant stability, complication, and implant failure rates.
METHODS
Electronic databases were searched to identify randomized controlled trials (RCTs) that compared immediate implant placement with and without SST. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program.
RESULTS
A total of 982 studies were identified, of which, seven RCTs with 206 immediately placed dental implants in 191 participants were included. Overall meta-analysis showed significant differences in the changes in buccal bone plate width (mean difference (MD) -0.22; 95% confidence interval (CI) -0.30 to -0.15; p < 0.0001) and height (MD -0.52; 95% CI -0.85 to -0.18; p = 0.002) in favor of SST. The use of SST was also associated with significantly less changes in peri-implant marginal bone levels and better pink esthetic score than immediately placing implants without SST. The differences in implant stability, complication and implant failure rates were not statistically significant between immediate implant placement with or without SST.
CONCLUSIONS
The short-term complication and implant failure rates following immediate implant placement with or without SST were comparable. The SST has short-term positive effects on the changes in width and height of buccal bone plate, peri-implant marginal bone levels and esthetic outcomes. Further evidence from long-term RCTs are still required to substantiate the current findings.
CLINICAL SIGNIFICANCE
SST can reduce changes in buccal plate width and height and improve the soft tissue profile following immediate implant placement in esthetic zone.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Extraction; Tooth Socket
PubMed: 34380176
DOI: 10.1111/jerd.12812