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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 -
Clinical Oral Investigations Mar 2013The objective of this paper is to examine the effect of alveolar ridge preservation (ARP) compared to unassisted socket healing. (Review)
Review
OBJECTIVE
The objective of this paper is to examine the effect of alveolar ridge preservation (ARP) compared to unassisted socket healing.
METHODS
Systematic review with electronic and hand search was performed. Randomised controlled trials (RCT), controlled clinical trials (CCT) and prospective cohort studies were eligible.
RESULTS
Eight RCTs and six CCTs were identified. Clinical heterogeneity did not allow for meta-analysis. Average change in clinical alveolar ridge (AR) width varied between -1.0 and -3.5 ± 2.7 mm in ARP groups and between -2.5 and -4.6 ± 0.3 mm in the controls, resulting in statistically significantly smaller reduction in the ARP groups in five out of seven studies. Mean change in clinical AR height varied between +1.3 ± 2.0 and -0.7 ± 1.4 mm in the ARP groups and between -0.8 ± 1.6 and -3.6 ± 1.5 mm in the controls. Height reduction in the ARP groups was statistically significantly less in six out of eight studies. Histological analysis indicated various degrees of new bone formation in both groups. Some graft interfered with the healing. Two out of eight studies reported statistically significantly more trabecular bone formation in the ARP group. No superiority of one technique for ARP could be identified; however, in certain cases guided bone regeneration was most effective. Statistically, significantly less augmentation at implant placement was needed in the ARP group in three out of four studies. The strength of evidence was moderate to low.
CONCLUSIONS
Post-extraction resorption of the AR might be limited, but cannot be eliminated by ARP, which at histological level does not always promote new bone formation. RCTs with unassisted socket healing and implant placement in the ARP studies are needed to support clinical decision making.
CLINICAL RELEVANCE
This systematic review reports not only on the clinical and radiographic outcomes, but also evaluates the histological appearance of the socket, along with site specific factors, patient-reported outcomes, feasibility of implant placement and strength of evidence, which will facilitate the decision making process in the clinical practice.
Topics: Alveolar Ridge Augmentation; Bone Transplantation; Controlled Clinical Trials as Topic; Guided Tissue Regeneration, Periodontal; Humans; Osteogenesis; Randomized Controlled Trials as Topic; Tooth Socket; Wound Healing
PubMed: 22814758
DOI: 10.1007/s00784-012-0758-5 -
Clinical Oral Investigations Aug 2023The aim of the present randomized controlled trial (RCT) was to evaluate the efficacy of different alveolar ridge preservation (ARP) techniques on dimensional... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of the present randomized controlled trial (RCT) was to evaluate the efficacy of different alveolar ridge preservation (ARP) techniques on dimensional alterations after tooth extraction, based on clinical measurements.
BACKGROUND
Alveolar ridge preservation (ARP) is a common procedure in every day clinical practice, when dental implants are involved in treatment planning. In ARP procedures, a bone grafting material is combined with a socket sealing (SS) material in order to compensate the alveolar ridge dimensional alterations after tooth extraction. Xenograft and allograft are the most frequently used bone grafts in ARP, while free gingival graft (FGG), collagen membrane, and collagen sponge (CS) usually applied as SS materials. The evidence comparing xenograft and allograft directly in ARP procedure is scarce. In addition, FGG is usually combined with xenograft as SS material, while the evidence combing allograft with FGG is absent. Moreover, CS could probably be an alternative choice in ARP as SS material, since it has been used in previous studies but more clinical trials are required to evaluate its effectiveness.
MATERIALS AND METHODS
Forty-one patients were randomly assigned in four treatment groups: (A) freeze-dried bone allograft (FDBA) covered with collagen sponge (CS), (B) FDBA covered with free gingival graft (FGG), (C) demineralized bovine bone mineral xenograft (DBBM) covered with FGG, and (D) FGG alone. Clinical measurements were performed immediately after tooth extraction and 4 months later. The related outcomes pertained to both vertical and horizontal assessment of bone loss.
RESULTS
Overall, groups A, B, and C presented significantly less vertical and horizontal bone resorption compared to group D. No statistically significant difference was observed between allograft and xenograft, except for the vertical bone resorption at the buccal central site, where xenograft showed marginally statistically significantly reduced bone loss compared to allograft (group C vs group B: adjusted β coef: 1.07 mm; 95%CI: 0.01, 2.10; p = 0.05). No significant differences were observed in hard tissue dimensions when CS and FGG were applied over FDBA.
CONCLUSIONS
No differences between FDBA and DBBM could practically be confirmed. In addition, CS and FGG were equally effective socket sealing materials when combined with FDBA, regarding bone resorption. More RCTs are needed to compare the histological differences between FDBA and DBBM and the effect of CS and FGG on soft tissue dimensional changes.
CLINICAL RELEVANCE
Xenograft and allograft were equally efficient in ARP 4 months after tooth extraction in horizontal level. Xenograft maintained the mid-buccal site of the socket marginally better than the allograft, in vertical level. FGG and CS were equally efficient as SS materials regarding the hard tissue dimensional alterations.
TRIAL REGISTRATION
Clinical trial registration Number: NCT04934813 (clinicaltrials.gov).
Topics: Humans; Animals; Cattle; Tooth Socket; Alveolar Process; Alveolar Bone Loss; Collagen; Tooth Extraction; Alveolar Ridge Augmentation
PubMed: 37227497
DOI: 10.1007/s00784-023-05068-1 -
The Journal of Craniofacial Surgery Oct 2018
Topics: Immediate Dental Implant Loading; Tooth Socket
PubMed: 30052613
DOI: 10.1097/SCS.0000000000004750 -
Clinics in Plastic Surgery Apr 2004Treatment philosophies in the management of alveolar clefts have changed greatly over the years. Currently. the most widely accepted protocol is for repair using... (Review)
Review
Treatment philosophies in the management of alveolar clefts have changed greatly over the years. Currently. the most widely accepted protocol is for repair using autologous cancellous bone from the iliac crest during the stage of mixed dentition. Preliminary data suggest that the appropriate age for surgical repair during the secondary phase can be decreased without evidence of limitation of facial growth. Further long-term studies are necessary to support this protocol, however. With a multidisciplinary approach between the various medical and dental specialties, it is now commonplace to achieve normal dentofacial aesthetics and function. The continued advances in medical and dental technology have further contributed to the excellent outcomes that are now achieved.
Topics: Child; Child, Preschool; Humans; Infant; Infant, Newborn; Jaw Abnormalities; Oral Surgical Procedures; Orthodontics; Orthopedic Procedures; Time Factors; Tooth Socket; Treatment Outcome
PubMed: 15145671
DOI: 10.1016/S0094-1298(03)00129-9 -
Praxis 2022Influencing Hard and Soft Tissue Changes Following Tooth Extraction Influencing Hard and Soft Tissue Changes Following Tooth Extraction The loss of a tooth leads to the... (Review)
Review
Influencing Hard and Soft Tissue Changes Following Tooth Extraction Influencing Hard and Soft Tissue Changes Following Tooth Extraction The loss of a tooth leads to the initiation of resorption processes and thus to the remodeling of the tissues of the alveolar process. At the hard tissue level, this resorption mainly affects the bundle bone at the buccal side of the extracted tooth and occurs most rapidly in the first weeks and months after extraction. Tissue changes occur not only at the level of the hard tissue (bone), but also at the level of the soft tissue. These changes lead to a significant loss of volume, especially at the buccal area of the alveolar ridge. They are responsible for a volume loss of the alveolar ridge contour of up to 50 %.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Humans; Tooth Extraction; Tooth Socket
PubMed: 35232257
DOI: 10.1024/1661-8157/a003798 -
The International Journal of Esthetic... 2020The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate...
The socket-shield technique shows promising results in the esthetic zone. It is a technically challenging procedure but is effective in maintaining the buccal plate after tooth extraction and avoiding tissue collapse. Therefore, it could be considered a valid option in the immediate implant scenario. A careful shield preparation and handling are paramount for the success of the treatment and to minimize complications. Raising a flap can improve visibility and simplify the procedure. This article reports on a case in which a small crestal approach is used to visualize the root and the buccal plate, combined with a buccal semilunar flap, to gain access to the apical area. This surgical management is especially indicated when long roots are involved, in order to determine the correct axis for cutting and sectioning the root and to remove the apex if conventional drills are not long enough. Possible esthetic complications of raising a flap are also discussed.
Topics: Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Tooth Extraction; Tooth Socket
PubMed: 33089256
DOI: No ID Found -
The Journal of Craniofacial Surgery Sep 2020A cleft lip, palate, and alveolus is one of the most common birth defects. Depending on the type of cleft, multiple surgeries may be required throughout the growth...
A cleft lip, palate, and alveolus is one of the most common birth defects. Depending on the type of cleft, multiple surgeries may be required throughout the growth stage. Traditionally, an orthodontic-surgical approach has been adopted to treat maxillary retrusion. Osteodistraction it is the surgical choice in patients with severe midface retrusion that require maxillary advancement. Our objective is to present our experience using this orthodontic and surgical approach.
Topics: Adolescent; Cleft Lip; Face; Humans; Male; Osteogenesis, Distraction; Retrognathia; Tooth Socket
PubMed: 32877156
DOI: 10.1097/SCS.0000000000006887 -
Oral and Maxillofacial Surgery Clinics... Nov 2020Extensive reviews have concluded that grafting of the socket reduces bone loss regardless of product or method. However, nothing has been shown to reliably and... (Review)
Review
Extensive reviews have concluded that grafting of the socket reduces bone loss regardless of product or method. However, nothing has been shown to reliably and completely maintain alveolar dimensions. We advocate a biologically driven and anatomically based approach for reconstruction of the socket. There are various socket manipulations that we have found to predictably prepare a site for dental implant. The combination of graft construct design and socket management maximizes graft success for any practitioner. Each socket should be treated individually, and products or methods used that are coincident with the complexity of the defect in question.
Topics: Alveolar Ridge Augmentation; Humans; Tooth Extraction; Tooth Socket
PubMed: 33004150
DOI: 10.1016/j.coms.2020.07.010 -
The Journal of Craniofacial Surgery 2019The authors describe the use of the mandibular ramus as an autologous bone graft material for secondary alveolar bone grafting in cleft patients. This technique...
The authors describe the use of the mandibular ramus as an autologous bone graft material for secondary alveolar bone grafting in cleft patients. This technique represents a safe and effective alternative to currently used donor sites. Furthermore, it allows to minimize patient discomfort, so that they can be treated as outpatients.
Topics: Alveolar Bone Grafting; Bone Transplantation; Humans; Mandible; Tooth Socket; Treatment Outcome
PubMed: 31283642
DOI: 10.1097/SCS.0000000000005684