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Oral Surgery, Oral Medicine, Oral... Mar 2023
Topics: Humans; Alveolar Process; Tooth Extraction; Alveolar Ridge Augmentation; Alveolar Bone Loss; Tooth Socket
PubMed: 36153300
DOI: 10.1016/j.oooo.2022.08.003 -
The British Journal of Oral &... Feb 2022This study aimed to compare socket repair with Nylon 5-0 suture and closure using cyanoacrylate biological glue after tooth extraction. Twenty male Wistar rats, each...
This study aimed to compare socket repair with Nylon 5-0 suture and closure using cyanoacrylate biological glue after tooth extraction. Twenty male Wistar rats, each weighing approximately 200 g were submitted to the extraction of the right and left first molar teeth. On the right side, the alveolus was closed with 2 ethyl-cyanoacrylate glue, whereas on the left side closure was with a single interrupted Nylon 5-0 suture (Ethilon). The animals were sacrificed after 3, 7, 15, and 30 postoperative days, and images of histological sections of the alveolus were captured for analysis. Histomorphometry was performed using Image J software to quantify bone neoformation in the alveolus. The results showed that on the seventh postoperative day the side treated with 2-ethyl-cyanoacrylate presented a delay in relation to the sutured side. However, on days 15 and 30, the difference in bone neoformation between gradually decreased until the thirtieth postoperative day, with no significant difference in bone neoformation in the last period of analysis. There was no difference between neoformation in the two sides (p = 0.902) after statistical analysis of the histomorphometric results. In conclusion, socket repair after alveolus closure with 2-ethyl-cyanoacrylate allows complete bone neoformation after tooth extraction, and there is no significant difference when compared with closure with Nylon 5-0.
Topics: Animals; Cyanoacrylates; Humans; Male; Nylons; Rats; Rats, Wistar; Sutures; Tooth Socket
PubMed: 34953568
DOI: 10.1016/j.bjoms.2021.01.017 -
Biochemical and Biophysical Research... Jun 2022In this study, a tooth extraction socket model was established in vivo, and Lv-YAP1-GFP, Lv-GFP or saline was injected locally into the extraction socket. Expression of...
In this study, a tooth extraction socket model was established in vivo, and Lv-YAP1-GFP, Lv-GFP or saline was injected locally into the extraction socket. Expression of markers of osteogenesis, osteoclastogenesis, adipogenesis, proliferation and apoptosis explore whether YAP can promote bone formation in the process of tooth extraction socket healing. 66 BALB/c mice were divided into 3 groups and underwent left maxillary first molar extraction, Lv-YAP1-GFP, Lv-GFP or saline was injected into the tooth extraction socket. The maxilla was harvested 1, 3, 7, and 10 days after operation for subsequent analysis by Micro-CT and immunohistochemical analysis. Quantitative analysis of the expression of TRAP, ALP, BMP2, RUNX2, Osterix, OCN, RANKL, PPARγ, and PCNA was conducted. The results of immunofluorescence showed that the lentivirus was successfully transfected into the extraction socket. On the middle and last stage of tooth extraction healing, results of Micro-CT showed that the BV/TV, Tb.Th and Tb.N were significantly higher in the experimental group, results of immunohistochemistry showed that the overexpression of YAP increase in the expression of BMP2, ALP, RUNX2, Osterix, OCN, and PCNA. The expression of PPARγ and TUNEL staining results were significantly lower in the experimental group. The expression of TRAP and RANKL showed no significant differences among the 3 groups. We conclude that YAP could promote bone formation in the middle and late stages of tooth extraction socket healing. The overexpression of YAP increased bone formation and cell proliferation, decreased adipogenic differentiation and apoptosis.
Topics: Animals; Core Binding Factor Alpha 1 Subunit; Mice; Osteogenesis; PPAR gamma; Proliferating Cell Nuclear Antigen; Tooth Extraction; Tooth Socket; YAP-Signaling Proteins
PubMed: 35413538
DOI: 10.1016/j.bbrc.2022.03.116 -
Journal of Clinical Periodontology Oct 2022The present pilot RCT aimed to investigate the influence of a connective tissue graft (CTG) in combination with the immediate implant placement (IIP) on hard and soft... (Randomized Controlled Trial)
Randomized Controlled Trial
Soft and hard tissue changes after immediate implant placement with or without a sub-epithelial connective tissue graft: Results from a 6-month pilot randomized controlled clinical trial.
AIM
The present pilot RCT aimed to investigate the influence of a connective tissue graft (CTG) in combination with the immediate implant placement (IIP) on hard and soft tissue healing, without a bone replacement graft in the gap between the implant and the socket walls.
MATERIALS AND METHODS
Thirty patients requiring extraction of one anterior tooth (from premolar to premolar) were randomly assigned to one of the two treatment groups (test: IIP + CTG; control: IIP). Cone-beam computed tomography and optically scans were performed before tooth extraction and at 6-month follow-up. Then, DICOM files were superimposed in order to allow the evaluation of osseous ridge and buccal bone changes, while the superimposition of DICOM and Standard Tessellation Language files allowed for evaluating of soft tissue contour. For testing the differences between the two groups, the non-parametric test as Wilcoxon rank-sum test, was used.
RESULTS
Twenty-six of the 30 enrolled patients attended the 6-month follow-up visit. The four patients of the control group that were lost to follow-up were analysed under the intention-to-treat principle. No statistically significant differences between the groups were observed for the vertical buccal bone resorption (p = .90), as well as for the horizontal buccal bone resorption at all measured levels. Significant differences were found between the test and control groups in the horizontal dimensional changes of osseous ridge at the most coronal aspect (p = .0003 and p = .02). Changes in tissue contour were between -0.32 and -0.04 mm in the test group and between -1.94 and -1.08 mm in the control group, while changes in soft tissue thickness varied between 1.33 and 2.42 mm in the test group and between -0.16 and 0.88 mm in the control group, with statistically significant differences for both variables at all measured levels. At 6 months, the mean volume increase was 6.76 ± 8.94 mm and 0.16 ± 0.42 mm in the test and control groups, respectively, with a statistically significant difference.
CONCLUSIONS
The findings of the present study indicate that the adjunct of a CTG at the time of IIP, without bone grafting, does not influence vertical bone resorption. Within the limits of this study, it can be suggested that the adjunct of a CTG at the time of IIP, without bone grafting, reduces the horizontal changes of the alveolar ridge. Moreover, it allows maintenance of the tissue contour due to an increase in soft tissue thickness.
Topics: Alveolar Process; Bone Resorption; Connective Tissue; Dental Implants, Single-Tooth; Humans; Pilot Projects; Tooth Extraction; Tooth Socket
PubMed: 35713267
DOI: 10.1111/jcpe.13685 -
Medical Hypotheses Sep 2020Bone change after tooth extraction has been well documented by different studies. Tooth extraction is followed by loss in height and width of the alveolar process. After...
Bone change after tooth extraction has been well documented by different studies. Tooth extraction is followed by loss in height and width of the alveolar process. After tooth loss, the natural healing process is governed by the formation of the blood clot, which is stabilized by a fibrin bridge, the starting structure for new bone apposition. The hematoma is then replaced by the granulation tissue which is rich in fibroblasts that synthesize the extra-cellular matrix. The adjoining of wound edges requires further contraction of the healing tissue which is exerted by myofibroblasts. Excessive myofibroblasts contraction at the early stage of healing might explain, in part, the pathophysiology of alveolar bone resorption. The authors advocate the use of collagen right after tooth extraction to sustain the soft tissue and releasing the tension at the most coronal portion of the wound, thus preventing excessive detrimental myofibroblasts contraction.
Topics: Alveolar Bone Loss; Alveolar Process; Humans; Periodontal Ligament; Tooth Extraction; Tooth Socket
PubMed: 32344287
DOI: 10.1016/j.mehy.2020.109746 -
The Journal of Prosthetic Dentistry Sep 2023Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome. (Meta-Analysis)
Meta-Analysis Review
STATEMENT OF PROBLEM
Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome.
PURPOSE
The purpose of this systematic review and meta-analysis was to investigate the treatment outcome in terms of the implant survival rate and success parameters of immediate implant placement in compromised extraction sockets.
MATERIAL AND METHODS
An electronic search was conducted in PubMed, Embase, Cochrane Library, and ISI Web of Science up to January 2021. Studies evaluating implant survival rate and main success parameters were included for a qualitative and quantitative analysis (risk ratio and mean difference).
RESULTS
In total, 43 studies with analysis of 4825 sockets were included. Compared with the noncompromised sockets, the compromised group showed no significant differences in implant survival rates (risk ratio=0.992; 95% confidence interval (CI)=0.979 to 1.005; P=.246). No significant statistical differences were found in marginal bone level at ≤12 months (mean difference [MD]=0.033; 95% CI=-0.012 to 0.078; P=.154) or esthetic parameters.
CONCLUSIONS
Immediate implant placement in compromised sites does not appear to decrease the survival and success rates. However, randomized clinical trials with large sample sizes should be conducted to draw a definite conclusion about the efficacy and safety of this treatment protocol in compromised sockets.
Topics: Dental Implantation, Endosseous; Dental Implants; Tooth Socket; Esthetics, Dental; Immediate Dental Implant Loading
PubMed: 34772483
DOI: 10.1016/j.prosdent.2021.09.025 -
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 -
Evidence-based Dentistry Dec 2021Design Randomised, controlled, single-blind, single-centre clinical trial.Case selection Adult patients in need of a single tooth extraction in the anterior maxillary... (Review)
Review
Design Randomised, controlled, single-blind, single-centre clinical trial.Case selection Adult patients in need of a single tooth extraction in the anterior maxillary and premolar region. Full mouth plaque scores below 25% and bleeding scores below 10%, with no active periodontal disease. As assessed by cone beam computed tomography; intact buccal plate, adequate mesiodistal space and adequate quality of bone.Data analysis Patients had immediate implant placement following extraction, either with a flap with no vertical releasing incision (control group) or a minimal split-thickness envelope flap (test group). The trial compared clinical, radiographic, aesthetic and patient-reported outcomes of immediately placed implants. Primary outcomes were measured using the pink (PES) and white (WES) aesthetic score. JMP Pro 13 was the statistical software used. Statistical comparisons were conducted at a 0.05 level of significance.Results In total, 28 patients were enrolled in the study, after exclusions. The total PES and WES scores were similar in the control and test groups. Implant survival and success rate after 12 months was 100%. Buccal plate thickness at 12 months post-loading was 2.78 mm in the control group and 2.54 mm in the test group, so there was no statistically significant difference between them. The majority of patients in both groups responded as 'positive' in the patient satisfaction questionnaire and visual analogue scale.Conclusions When comparing PES/WES scores, success/modified success rate, survival, mean buccal plate resorption and patient satisfaction, there were no differences between immediate implants placed with a flap or with a minimal split-thickness envelope flap.
Topics: Adult; Dental Implants; Dental Implants, Single-Tooth; Esthetics, Dental; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Single-Blind Method; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 34916634
DOI: 10.1038/s41432-021-0215-x -
Journal of Oral and Maxillofacial... May 2023Multiple preparation protocols for platelet-rich fibrin (PRF) are in use today, and clinical results are often heterogeneous. This study analyzes the impact of the... (Meta-Analysis)
Meta-Analysis
PURPOSE
Multiple preparation protocols for platelet-rich fibrin (PRF) are in use today, and clinical results are often heterogeneous. This study analyzes the impact of the chosen PRF preparation protocol on 1) wound healing and 2) alveolar ridge preservation.
METHODS
For this systematic review and meta-analysis, eligible studies were identified in PubMed and Cochrane databases. Included were randomized controlled and controlled clinical trials with healthy patients treated with PRF after atraumatic tooth extraction compared to untreated socket(s), reporting at least one of the following outcome variables: pain, swelling, soft tissue healing, alveolar osteitis risk, horizontal and vertical bone loss, socket fill, and new bone formation. Main predictor variable was relative centrifugal force (RCF) comparing high RCF (high PRF), intermediate RCF (standard [S-PRF]), low RCF (advanced PRF), and various RCF settings (concentrated growth factor preparation [CGF]). The type of centrifugation tubes (silica-coated plastic and glass) was a secondary predictor. Weighted or standardized mean differences, risk ratio and corresponding 95% confidence intervals were calculated.
RESULTS
Forty studies published between 2012 and 2022 were selected. The pooled effects of all outcomes were significant against untreated sockets. Within the subgroups high PRF or advanced PRF had the lowest efficacy for many outcome parameters. Pain reduction (in visual analog scale units) was highest for S-PRF (-1.18 [-1.48, -0.88], P < .00001) and CGF (-1.03 [-1.16, -0.90], P < .001). The risk ratio of alveolar osteitis (0.09 [0.01, 0.69], P < .02) and soft tissue healing (standardized mean difference = 2.55 [2.06, 3.03], P < .001) were best for CGF. No subgroup differences were found for bone-related outcomes. No meaningful analysis of the tube material effect was possible.
CONCLUSION
This study confirms that PRF is associated with reduced postoperative complications but indicates that preparation protocol influences clinical outcomes. S-PRF and CGF protocols appear to be superior for several outcome parameters.
Topics: Humans; Dry Socket; Pain; Platelet-Rich Fibrin; Randomized Controlled Trials as Topic; Systematic Reviews as Topic; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 36736375
DOI: 10.1016/j.joms.2023.01.004 -
Cell and Tissue Banking Mar 2020Dental stem cells have many applications in medicine, dentistry and stem cell biology in general due to their easy accessibility and low morbidity. A common surgical...
Dental stem cells have many applications in medicine, dentistry and stem cell biology in general due to their easy accessibility and low morbidity. A common surgical manoeuvre after a tooth extraction is the dental socket curettage which is necessary to clean the alveolus and favour alveolar bone healing. This procedure can cause very low morbidity compared to bone marrow collection procedures and the collected material is normally discarded. In order to investigate if the tissue obtained by dental socket curettage after a tooth extraction was a feasible alternative source to isolate human stem cells, we isolated and characterized two different stem cell populations based on STRO-1 and CD146 expression. We were able to collect and grow cells from dental socket of vital and non-vital teeth. Both populations were proliferative, clonogenic and expressed STRO-1, CD146, CD90, NG2, PDGFR-β, which are markers found in stem cells, presented in vitro multiline-differentiation into osteogenic, chondrogenic, and adipogenic tissue, and in vivo transplanted cells formed mineralized tissue. Interestingly, STRO-1 clonogenic cells presented better multidifferentiation than CD146 cells. Our results showed that mesenchymal stem cells can be isolated from the tiny tissue collected by dental socket curettage after vital and non-vital tooth extraction and suggest that STRO-1 is an important marker to be used to sort cells with multidifferentiation capacity.
Topics: Animals; Antigens, Surface; CD146 Antigen; Cell Differentiation; Cell Proliferation; Cells, Cultured; Humans; Immunomagnetic Separation; Male; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Mice, Inbred BALB C; Mice, Nude; Tooth Socket
PubMed: 31807957
DOI: 10.1007/s10561-019-09794-3