-
The Journal of Craniofacial Surgery Jun 2016Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein... (Comparative Study)
Comparative Study Randomized Controlled Trial
Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2.
Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2.
Topics: Bone Morphogenetic Protein 2; Bone Transplantation; Child; Child, Preschool; Cleft Lip; Cleft Palate; Esthetics, Dental; Female; Follow-Up Studies; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Infant; Male; Postoperative Complications; Recombinant Proteins; Tomography, X-Ray Computed; Tooth Socket; Transforming Growth Factor beta
PubMed: 27244210
DOI: 10.1097/SCS.0000000000002652 -
Periodontology 2000 Oct 2014In recent years, immediate implant placement has become a common clinical therapeutic protocol representing an alternative to the classical delayed surgical protocol of... (Review)
Review
In recent years, immediate implant placement has become a common clinical therapeutic protocol representing an alternative to the classical delayed surgical protocol of implant placement. This protocol, however, has not been fully validated, either in terms of fully understanding the influence of implant placement on the socket-healing process or on the clinical outcomes. This narrative review evaluates the different experimental studies in humans and animals assessing the bone-healing dynamics of the socket after tooth extraction and the dimensional changes occurring at the socket bone walls. These experimental studies describe, in detail, the hard- and soft-tissue healing of implants placed into fresh extraction sockets, demonstrating that marked morphological changes of the alveolar ridge will occur, independently of the implant installation, thus demonstrating that postextraction bone loss is an inevitable biological process. This evidence has also been corroborated in clinical studies in humans, demonstrating the risk of significant peri-implant tissue loss, mainly in the areas of high esthetic demand. There is a lack of long-term evidence on the impact of this protocol on the preservation of the peri-implant tissues. In conclusion, despite the obvious advantages of this surgical protocol, it also has limitations and is more technically demanding than placing an implant into a healed crest. When selecting this protocol, clinicians should always consider: (a) the gingival biotype of the patient; (b) the thickness and integrity of the socket bony walls; (c) the implant selection as well as the adequate vertical and horizontal position of the implant; and (d) the ideal patient (a nonsmoker with good plaque control).
Topics: Alveolar Process; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Esthetics, Dental; Gingiva; Humans; Patient Selection; Periodontium; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 25123766
DOI: 10.1111/prd.12044 -
International Journal of Oral and... Sep 2011The aim of this systematic review was to assess if the use of autologous platelet concentrates may be beneficial to the healing of extraction sockets. Medline, Embase... (Review)
Review
The aim of this systematic review was to assess if the use of autologous platelet concentrates may be beneficial to the healing of extraction sockets. Medline, Embase and Cochrane Central Register of Controlled Trials were searched using a combination of specific search terms. Hand searching of the relevant journals and of the bibliographies of reviews was also performed. Prospective comparative studies evaluating the effect of a platelet concentrate on fresh extraction sockets were included. Outcome variables related to hard and soft tissue healing, aesthetics and postoperative discomfort were considered. A methodological study quality assessment was made. The initial search yielded 425 articles, eight were finally included. 207 tooth extractions (104 tests and 103 controls) in 115 patients were evaluated. The articles provided a broad range of variable outcomes to assess the regenerative potential of platelet concentrate and its possible benefits to the treatment. Favourable effects on hard and soft tissue healing and postoperative discomfort reduction were often reported. A large heterogeneity was found regarding study design, sample size, surgical techniques and methods for preparing platelet concentrates. Standardization of experimental design is needed in order to detect the true effect of platelet concentrates in regenerative procedures of extraction sockets.
Topics: Biological Dressings; Evidence-Based Dentistry; Humans; Outcome Assessment, Health Care; Platelet-Rich Plasma; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 21602028
DOI: 10.1016/j.ijom.2011.04.009 -
European Journal of Oral Implantology 2016To assess the outcome of immediate or early placement of implants after tooth extraction supporting a single-tooth restoration with focus on the marginal bone level and... (Review)
Review
AIM
To assess the outcome of immediate or early placement of implants after tooth extraction supporting a single-tooth restoration with focus on the marginal bone level and its stability over time.
MATERIAL AND METHODS
An electronic literature search without time restrictions was conducted of the Medline/PubMed database accompanied by a handsearch. Clinical human studies reporting on periimplant marginal bone level (BL) and/or changes in bone level (BLC) and with a follow-up period of at least 12 months were selected for the present review.
RESULTS
The search strategy resulted in 816 articles and 115 relevant publications were included for full-text analysis. Only few randomised controlled trials exist comparing immediate or early implant placement with placement in healed bone (the conventional protocol). Summarising the results from prospective studies, it was found that the mean marginal bone loss around immediately or early placed implants from baseline (at implant placement or placement of restoration) to the latest followup visit (between 1 and 10 years) was less than 1.5 mm.
CONCLUSION
The current literature indicates that immediate or early placement of single-tooth implants after tooth extraction may be a viable treatment with long-term survival rates and marginal bone level conditions matching those for implants placed conventionally in healed bone ridges.
Topics: Alveolar Bone Loss; Alveolar Process; Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Humans; Longitudinal Studies; Survival Analysis; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 27314115
DOI: No ID Found -
Journal of Oral Rehabilitation Jan 2008In recent years, immediate or early implant placement after tooth extraction has becoming more common. The present review focuses on the clinical outcome of immediate or... (Review)
Review
In recent years, immediate or early implant placement after tooth extraction has becoming more common. The present review focuses on the clinical outcome of immediate or early implant placement. Only limited knowledge exists about most of the factors with particular significance for this treatment mode. Randomized controlled clinical studies comparing the various treatment protocols are scarce. With the background in the existing literature some conclusions can be drawn with caution. Survival rates for implants placed immediately, early, delayed, or late seem to be similar in the short perspective and amounts to approximately 95%. Successful immediate implant placement may be possible in all regions of the jaws, although replacement of molars is more challenging. Chronic infection is not an absolute contraindication for immediate implant placement. It is controversial whether immediate placement of implants may preserve the alveolar bone. Small gaps between implant surface and socket wall have a potential for spontaneous healing. No consensus exists on the need for bone augmentation in these situations. With the limited information available it may be stated that a good prognosis can be obtained following immediate/early functional or non-functional loading of immediately placed implants. However, higher risk of failures seems to exist compared with a delayed, conventional approach. It is advocated that this treatment modality should be restricted to skilled well-trained teams. Data on the aesthetic outcomes following immediate/early implant placement are inconclusive, but this treatment can offer high patient satisfaction with the aesthetic and functional outcomes.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Retention; Dental Restoration Failure; Humans; Time Factors; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 18181932
DOI: 10.1111/j.1365-2842.2007.01827.x -
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 -
Kathmandu University Medical Journal... 2013Any type of aesthetic correction in dental practice is always a challenging task, especially when it is complicated with cleft lip and alveolus. Careful examination and...
Any type of aesthetic correction in dental practice is always a challenging task, especially when it is complicated with cleft lip and alveolus. Careful examination and correct decision making at early stage of treatment and multi disciplinary approach is always necessary for long term success. This paper described a multidisciplinary approach in managing a 19-year-old female patient with unilateral cleft alveolus impacted maxillary canine , missing lateral incisor and hypoplastic central incisor by surgical , orthodontic and prosthodontic means. The impacted canine was surgically exposed and orthodontic traction given to bring it into the normal alignment. The missing lateral incisor was replaced by a fixed bridge with a ceramic gingival fixed prosthesis to manage alveolar cleft. At the same time the hypoplastic defect of central incisor was hidden by the full coverage retainer used for the bridge abutment on the tooth.
Topics: Cleft Lip; Female; Humans; Incisor; Maxilla; Tooth Socket; Tooth, Impacted; Young Adult
PubMed: 24096229
DOI: 10.3126/kumj.v11i2.12497 -
Tissue Engineering and Regenerative... Jun 2022Platelet rich fibrin (PRF) has shown great potential in osteogenesis; however, some studies still question utilizing it as a grafting material. Thus, the aim of this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Platelet rich fibrin (PRF) has shown great potential in osteogenesis; however, some studies still question utilizing it as a grafting material. Thus, the aim of this review is to evaluate the effect of PRF when used in socket and ridge preservation procedures.
METHODS
Electronic searches through MEDLINE, EMBASE, and Cochrane, Science Citation Index Expanded databases and manual searches of unpublished data, academic theses, and journals were conducted up until July 2021. The outcomes were to assess the ability of PRF as a graft material to preserve bone width, height, and density after tooth extraction.
RESULTS
Twelve studies were included in the review, using PRF showed significant results in all three outcomes when compared to no grafting at all, however when compared to other commonly used grafting materials it showed a lesser effect. On the other hand, most studies included reported mixing PRF with a graft material showed the best result. The meta-analysis also revealed the significant results in using PRF on the three outcomes.
CONCLUSION
The meta-analysis of the studies included proved the beneficial effect of PRF in socket preservation surgeries alone or in combination with other graft materials, but further individual multi-centre randomized controlled studies with appropriate sample size are still needed to further confirm our findings.
Topics: Osteogenesis; Platelet-Rich Fibrin; Tooth Extraction; Tooth Socket
PubMed: 35334092
DOI: 10.1007/s13770-021-00428-y -
Emergency Medicine Journal : EMJ Jun 2007Injuries to teeth can be very distressing for patients. Prompt treatment is essential. Injuries of the tooth bearing portion of the mandible are common and can even... (Review)
Review
Injuries to teeth can be very distressing for patients. Prompt treatment is essential. Injuries of the tooth bearing portion of the mandible are common and can even result after a relatively low impact trauma. The alveolus (tooth bearing portion of bone) and/or the tooth may be damaged. Segmental fractures involve multiple teeth and the supporting alveolar bone.
Topics: Adult; Child; Emergency Medicine; Emergency Service, Hospital; Humans; Medical History Taking; Physical Examination; Tissue Preservation; Tooth Avulsion; Tooth Injuries; Tooth Replantation; Tooth Socket; Tooth, Deciduous
PubMed: 17513544
DOI: 10.1136/emj.2006.035949 -
Archives of Oral Biology May 2021This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological... (Review)
Review
OBJECTIVE
This systematic review aimed to address whether the alveolar socket repair after a tooth extraction is impacted by an osteoporotic phenotype and propose methodological observations.
DESIGN
A search strategy in MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases was performed. Quality assessment was carried out through the SYRCLE Risk of Bias tool.
RESULTS
Out of the 1147 potentially relevant records, 25 met the inclusion criteria. Most of the studies were performed in rats, and ovariectomy (OVX) was the most frequent osteoporosis induction method. Histomorphometry, micro-computed tomography (microCT), and immunohistochemistry were the main bone repair evaluation methods. Most of the included studies (88 %) presented negative impacts of osteoporosis on the alveolar socket repair. Only three studies (12 %) showed no statistical differences among groups. Overall, most of the quality assessment categories presented a high percentage of unclear risk of bias due to insufficient information in the studies.
CONCLUSIONS
The results indicated that an osteoporotic phenotype seems to impair alveolar socket repair after tooth extraction. However, there is still a lack of information and standardization. Therefore, further studies should consider the proposed methodological aspects regarding animal characteristics, OVX associated with a low calcium diet, waiting 8 weeks to osteoporosis induction, maxillary molars as the best option for tooth extraction, confirming and reporting OVX and osteoporosis success, and an appropriate method of repair analysis.
Topics: Animals; Female; Humans; Osteoporosis; Ovariectomy; Rats; Tooth Extraction; Tooth Socket; Tooth, Impacted; X-Ray Microtomography
PubMed: 33667958
DOI: 10.1016/j.archoralbio.2021.105054