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Compendium of Continuing Education in... Apr 2021Various materials have been used for extraction socket preservation in anticipation of implant placement or to limit resorption of socket walls. Materials have ranged... (Review)
Review
Various materials have been used for extraction socket preservation in anticipation of implant placement or to limit resorption of socket walls. Materials have ranged from autogenous bone, allografts, and xenografts to synthetics. Ideally, the graft material being placed into the socket at the time of extraction should fully convert to host bone to yield vital bone that will permit implant osseointegration with as much contact between bone and the implant surface as possible. This article reviews different materials and presents two cases in which extraction of a molar was required and future implant placement planned.
Topics: Allografts; Bone Transplantation; Dental Implantation, Endosseous; Dental Implants; Osseointegration; Tooth Extraction; Tooth Socket
PubMed: 33961749
DOI: No ID Found -
Oral and Maxillofacial Surgery Clinics... Aug 2015The clinician is often asked to remove a tooth and place an implant into the site. The implant must be placed with appropriate stability to allow for integration to... (Review)
Review
The clinician is often asked to remove a tooth and place an implant into the site. The implant must be placed with appropriate stability to allow for integration to occur, which requires bone presence. Bone is also necessary to allow for ideal implant positioning within the alveolus for functional and esthetic concerns. The purpose of this article is to discuss the changes in socket dimensions over time and how to promote space maintenance, with an algorithm for treatment based on evidence.
Topics: Algorithms; Dental Implantation, Endosseous; Dental Implants; Humans; Molar; Osseointegration; Tooth Extraction; Tooth Socket
PubMed: 26078092
DOI: 10.1016/j.coms.2015.04.001 -
Journal of Periodontology Aug 2011Little attention has been given to understanding the variation in biomechanical behavior of oral soft tissues, and this represents an obstacle for the development of...
BACKGROUND
Little attention has been given to understanding the variation in biomechanical behavior of oral soft tissues, and this represents an obstacle for the development of biomaterials that perform with appropriate biomechanical characteristics. With this as our motivation, a uniaxial mechanical analysis was performed on lingual and buccal aspects of the attached gingiva, alveolar mucosa, and buccal mucosa to gain insight into human tissue performance and site-specific mechanical variation.
METHODS
A discrete quantitative mechanical evaluation of each soft tissue region using tensile, dynamic compression, and stress relaxation analysis was conducted to correlate tissue structure with function as assessed histologically.
RESULTS
Results confirm the keratinized gingiva to have increased tensile strength (3.94 ± 1.19 MPa) and stiffness (Young modulus of 19.75 ± 6.20 MPa) relative to non-keratinized mucosal regions, where densely arranged elastin fibers contribute to a tissue with increased viscoelastic properties. Dynamic compression analysis indicated the instantaneous modulus (E(int)), steady modulus (E(s)), and peak stress increased with loading frequency and strain amplitude, with the highest values found in the buccal attached gingiva.
CONCLUSION
These investigations quantify the biomechanical properties of oral soft tissues and show region-to-region variation that details structure-function relationships and provides key parameters to aid development of biomaterials that perform with appropriate biomechanical properties.
Topics: Analysis of Variance; Animals; Biomechanical Phenomena; Compressive Strength; Dental Prosthesis Design; Dental Stress Analysis; Elasticity; Gingiva; Humans; Mandible; Models, Animal; Mouth Mucosa; Stress, Mechanical; Swine; Tensile Strength; Tooth Socket
PubMed: 21309720
DOI: 10.1902/jop.2011.100573 -
The International Journal of Oral &... Dec 2023
Topics: Immediate Dental Implant Loading; Dental Implants, Single-Tooth; Tooth Socket; Tooth Extraction; Esthetics, Dental
PubMed: 38085738
DOI: No ID Found -
Journal of Prosthodontic Research Jul 2013A 2-day-old female infant with complete unilateral cleft lip, alveolus, and palate (left side) was presented to the Department of Prosthodontics, Government Dental...
PATIENT
A 2-day-old female infant with complete unilateral cleft lip, alveolus, and palate (left side) was presented to the Department of Prosthodontics, Government Dental College and Hospital, Nagpur for evaluation and treatment with presurgical nasoalveolar molding (PNAM) prior to surgical intervention.
DISCUSSION
The alignment of the alveolar segments creates the foundation upon which excellent results of primary lip and nasal surgery are dependent in the repair of the cleft lip, alveolus, and palate patient. Presurgical infant orthopedics has been employed since the 1950s as an adjunctive neonatal therapy for the correction of cleft lip and palate. One of the problems that the traditional approach failed to address was the deformity of the nasal cartilages and the deficiency of columella tissue in infants with unilateral and bilateral cleft lip and palate. The purpose of this article is to illustrate the step-by-step fabrication process of the PNAM prosthesis used to direct growth of the alveolar segments, lips, and nose in the presurgical treatment of cleft lip and palate.
CONCLUSION
As a result, the primary surgical repair of the lip and nose heals under minimal tension, thereby reducing scar formation and improving the esthetic result. Frequent surgical intervention to achieve the desired esthetic results can be avoided by PNAM.
Topics: Cleft Lip; Cleft Palate; Female; Humans; Infant, Newborn; Orthognathic Surgical Procedures; Orthopedic Procedures; Palatal Obturators; Preoperative Care; Plastic Surgery Procedures; Tooth Socket; Treatment Outcome
PubMed: 23773376
DOI: 10.1016/j.jpor.2013.03.002 -
Compendium of Continuing Education in... Dec 2007Dimensional changes after tooth extraction often result in bone resorption that complicates restorations with implant or traditional prostheses. Preservation of alveolar... (Review)
Review
Dimensional changes after tooth extraction often result in bone resorption that complicates restorations with implant or traditional prostheses. Preservation of alveolar dimensions after tooth extraction is crucial to achieve optimal esthetic and functional prosthodontic results. In addition, with the increasingly frequent use of dental implants to replace nonrestorable teeth, preservation of the existing alveolus is essential to maintain adequate bone volume for placement and stabilization of the implants. Atraumatic extraction and socket preservation techniques have been introduced to minimize bone resorption after tooth extraction. This article reviews the literature, presents clinical cases on the healing of the alveolus and its dimensional changes after tooth extraction, and discusses socket preservation techniques that have been introduced to minimize these dimensional changes.
Topics: Aged; Alveolar Bone Loss; Bone Regeneration; Bone Transplantation; Calcium Sulfate; Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Female; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Middle Aged; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 18186170
DOI: No ID Found -
The International Journal of... 2022Allografts have been routinely used for immediate grafting of extraction sites as modalities of alveolar ridge preservation (ARP). Solvent-dehydrated bone allograft...
Allografts have been routinely used for immediate grafting of extraction sites as modalities of alveolar ridge preservation (ARP). Solvent-dehydrated bone allograft (SDBA), which is commonly utilized for socket grafting, exists in the form of cortical and cancellous particles. This study aims to provide a histologic comparison of cortical and cancellous SDBA for ARP. A total of 35 extraction sockets were allocated to receive either a cortical (17 sites) or cancellous (18 sites) SDBA, followed by application of a resorbable collagen wound dressing in both groups. At approximately 4 months, a bone core biopsy sample was obtained during implant placement. Histomorphometric assessment was then conducted to compare the differences between both forms of SDBA. Within its limitations, a higher percentage of vital bone was observed in the cortical bone group compared to the cancellous bone group (28.6% vs 20.1%, respectively, P = .042), while there was a lack of statistically significant differences among other fractions of the bone biopsy sample (residual graft particles and nonmineralized tissues such as connective tissue or other components).
Topics: Allografts; Alveolar Process; Alveolar Ridge Augmentation; Cancellous Bone; Humans; Membranes, Artificial; Solvents; Tooth Extraction; Tooth Socket
PubMed: 35353091
DOI: 10.11607/prd.5563 -
The Journal of Contemporary Dental... Jul 2006The aim of this prospective study was to evaluate the clinical pattern of post-extraction wound healing with a view to identify the types, incidence, and pattern of...
AIM
The aim of this prospective study was to evaluate the clinical pattern of post-extraction wound healing with a view to identify the types, incidence, and pattern of healing complications following non-surgical tooth extraction.
STUDY DESIGN
A total of 311 patients, who were referred for non-surgical (intra-alveolar) extractions, were included in the study. The relevant pre-operative information recorded for each patient included age and gender of the patient, indications for extraction, and tooth/teeth removed. Extractions were performed under local anesthesia with dental forceps, elevators, or both. Patients were evaluated on the third and seventh postoperative days for alveolus healing assessment. Data recorded were: biodata, day of presentation for alveolus healing assessment, day of onset of any symptoms, body temperature (degrees C) in cases of alveolus infection, and presence or absence of pain.
RESULTS
Two hundred eighty-two patients (282) with 318 extraction sites were evaluated for alveolus healing. Healing was uneventful in 283 alveoli (89%), while 35 alveoli (11%) developed healing complications. These complications were: localized osteitis 26 (8.2%); acutely infected alveolus 5 (1.6%); and an acutely inflamed alveolus 4 (1.2%). Females developed more complications than males (p=0.003). Most complications were found in molars (60%) and premolars (37.1%). Localized osteitis caused severe pain in all cases, while infected and inflamed alveolus caused mild or no pain. Thirty patients (12%) among those without healing complications experienced mild pain.
CONCLUSIONS
Most of the post-extraction alveoli healed uneventfully. Apart from alveolar osteitis (AO), post-extraction alveolus healing was also complicated by acutely infected alveoli and acutely inflamed alveoli. This study also demonstrated a painful alveolus is not necessarily a disturbance of post-extraction site wound healing; a thorough clinical examination must, therefore, be made to exclude any of the complications.
Topics: Adolescent; Adult; Bone Diseases, Infectious; Chi-Square Distribution; Dry Socket; Female; Humans; Male; Middle Aged; Pain, Postoperative; Postoperative Complications; Prospective Studies; Tooth Extraction; Tooth Socket; Wound Healing
PubMed: 16820806
DOI: No ID Found -
The International Journal of... 2021This study aimed to characterize extraction sockets based on indirect digital root analysis. The outcomes of interest were estimated socket volume and dimensions of the...
This study aimed to characterize extraction sockets based on indirect digital root analysis. The outcomes of interest were estimated socket volume and dimensions of the socket orifice. A total of 420 extracted teeth, constituting 15 complete sets of permanent teeth (except third molars), were selected. Teeth were scanned to obtain STL files of the root complex for digital analysis. After digitally sectioning each root 2.0 mm apical to the cementoenamel junction (CEJ), root volume was measured in mm and converted to cc. Subsequently, a horizontal section plane was drawn at the most zenithal level of the buccal CEJ, and the surface area (in mm2) and buccolingual and mesiodistal linear measurements of the socket orifice (in mm) were computed. Maxillary first molars exhibited the largest mean root volume (0.451 ± 0.096 cc) and mandibular central incisors the smallest (0.106 ± 0.02 cc). Surface area analysis demonstrated that mandibular first molars presented the largest socket orifice area (78.56 ± 10.44 mm), with mandibular central incisors presenting the smallest area (17.45 ± 1.82 mm). Maxillary first molars showed the largest mean socket orifice buccolingual dimension (11.08 ± 0.60 mm), and mandibular first molars showed the largest mean mesiodistal dimension (9.73 ± 0.84 mm). Mandibular central incisors exhibited the smallest mean buccolingual (5.87 ± 0.26 mm) and mesiodistal (3.52 ± 0.24 mm) linear dimensions. Findings from this study can be used by clinicians to efficiently plan extraction-site management procedures (such as alveolar ridge preservation via socket grafting and sealing) and implant provisionalization therapy, and by the industry to design products that facilitate site-specific execution of these interventions.
Topics: Alveolar Process; Dentition, Permanent; Humans; Molar; Molar, Third; Tooth Extraction; Tooth Socket
PubMed: 33528463
DOI: 10.11607/prd.4969 -
The International Journal of... 2021Achieving primary stability is a critical challenge presented by immediate implant therapy. Surgeons often utilize wider, tapered implants for this purpose, or they use...
Achieving primary stability is a critical challenge presented by immediate implant therapy. Surgeons often utilize wider, tapered implants for this purpose, or they use longer implants to achieve primary stability. Both strategies are associated with negative ramifications. Prosthetically guided implant placement must respect biologic principles, such as tooth-implant and implant-implant distance, gap space between the implant and the facial cortex, and, when possible, screw-retention of the prosthesis. A novel implant design geared toward achieving a predictable level of primary stability while adhering to the aforementioned physiologic principles was recently introduced. Both primary and secondary implant stability, along with hard and soft tissue stability, are demonstrated in this study of 107 consecutively placed implants. Rotational and axial stability can be produced with this newly designed implant, along with predictable osseointegration and tissue preservation.
Topics: Dental Implantation, Endosseous; Dental Implants; Dental Implants, Single-Tooth; Dental Prosthesis Design; Humans; Osseointegration; Tooth Extraction; Tooth Socket
PubMed: 34076632
DOI: 10.11607/prd.5527