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Cureus Apr 2024Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as...
Alveolar bone resorption is a natural occurrence following tooth extraction, complicating the process of prosthetic rehabilitation with implants. Techniques such as socket preservation, atraumatic extraction, and immediate implant placement are employed to reduce the dimensional changes associated with extraction. The socket shield technique (SST) is effective in preserving the alveolar ridge's contour, enhancing the aesthetic results of rehabilitation by maintaining the integrity of the bundle bone complex even when the buccal bone is less than 1mm. This case report presents a 23-year-old female patient with a fractured upper central incisor. The socket shield technique was chosen based on the clinical findings from the cone beam computed tomography (CBCT) scan. Immediate temporization was provided to preserve soft tissue integration. A comparison of the initial and subsequent cone beam computed tomography (CBCT) scans, along with clinical observations, suggests that the socket shield technique is a viable method for preserving both hard and soft tissue structures in the anterior dental region, thereby improving aesthetic outcomes.
PubMed: 38738015
DOI: 10.7759/cureus.57940 -
ACS Applied Materials & Interfaces May 2024The excess production of reactive oxygen species (ROS) will delay tooth extraction socket (TES) healing. In this study, we developed an injectable thermosensitive...
The excess production of reactive oxygen species (ROS) will delay tooth extraction socket (TES) healing. In this study, we developed an injectable thermosensitive hydrogel (NBP@BP@CS) used to treat TES healing. The hydrogel formulation incorporated black phosphorus (BP) nanoflakes, recognized for their accelerated alveolar bone regeneration and ROS-scavenging properties, and dl-3--butylphthalide (NBP), a vasodilator aimed at enhancing angiogenesis. investigations strongly demonstrated that NBP@BP@CS improved TES healing due to antioxidation and promotion of alveolar bone regeneration by BP nanoflakes. The sustained release of NBP from the hydrogel promoted neovascularization and vascular remodeling. Our results demonstrated that the designed thermosensitive hydrogel provided great opportunity not only for ROS elimination but also for the promotion of osteogenesis and angiogenesis, reflecting the "three birds with one stone" concept, and has tremendous potential for rapid TES healing.
Topics: Animals; Hydrogels; Wound Healing; Phosphorus; Tooth Extraction; Tooth Socket; Neovascularization, Physiologic; Reactive Oxygen Species; Osteogenesis; Rats; Bone Regeneration; Male
PubMed: 38727024
DOI: 10.1021/acsami.4c03278 -
The International Journal of Esthetic... May 2024
Topics: Humans; Dental Implants, Single-Tooth; Dental Restoration Failure; Incisor; Tooth Socket
PubMed: 38726862
DOI: No ID Found -
Quintessence International (Berlin,... May 2024An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address...
OBJECTIVE
An altered sensation during endodontic treatment can occur due to the extrusion of endodontic materials. This study aims to discuss intentional replantation to address paresthesia resulting from an endodontic file penetrating the inferior alveolar nerve canal (IANC) and provide a protocol for managing nerve injuries in such incidents.
CASE PRESENTATION
A 12-year-old girl developed paresthesia when an endodontic file separated and was inadvertently pushed through the apical foramen into IANC during root canal treatment of the mandibular left first molar. A CBCT scan revealed the file penetrating the canal towards the inferior border of the mandible. After considering the treatment options, intentional replantation was deemed suitable. The tooth was a-traumatically extracted and preserved in sterile saline. The surgeon then carefully cleaned and irrigated the socket. The radiographic assessment confirmed successful file removal from the socket. The Root ends were resected, and retrograde preparation and obturation were conducted using ultrasonic tips and MTA. The tooth was then replanted into the socket. Successful replantation was confirmed by tooth stability and an audible click. The patient was prescribed antibiotics and steroids. Subsequently, after completing the endodontic treatment. a stainless-steel crown was cemented. The successful intentional replantation procedure resulted in rapid improvement in the patient's condition. The normal sensation had been restored, indicating nerve recovery. At the 15-month follow-up, Periapical bone healing and the eruption of the adjacent second molar were observed, affirming the treatment protocol's overall success.
CONCLUSION
Prompt intervention and immediate intentional replantation facilitated direct inspection of the separated file within the socket. Collaboration between an oral maxillofacial surgeon and an endodontist ensures expedited and targeted treatment, leading to favorable outcomes.
PubMed: 38726763
DOI: 10.3290/j.qi.b5316977 -
The International Journal of... May 2024A prospective clinical pilot study was carried out to evaluate a novel macroimplant design with a 12° angled platform. The implant is placed at the center of the...
A prospective clinical pilot study was carried out to evaluate a novel macroimplant design with a 12° angled platform. The implant is placed at the center of the socket, optimizing all the alveolar bone. In addition, the prosthetic emergence should be ideal, as it is corrected and emerges through the cingulate area. Twelve patients were enrolled in an immediate implant placement procedure with immediate aesthetic rehabilitation to replace an anterior maxillary tooth, and were treated with inverted body-shift design with 12° angled neck. Only type I sockets according to the Elian classification were considered eligible for the study. There were no implant failures after one year of loading. Regarding the horizontal and vertical hard tissue changes, there was a statistically significant median overall horizontal change of -0.99 mm at 1 mm and of -0.61 mm at 3 mm. On the other hand, stability was observed at 5 mm, since the result obtained was not statistically significant. The median pink esthetic score (PES) at one year of follow-up was 11.5. This implant may be useful in the immediate tooth replacement treatment of maxillary anterior post-extraction sockets, nevertheless, comparative studies with conventional implants should be carried out.
PubMed: 38717439
DOI: 10.11607/prd.7109 -
The International Journal of Oral &... May 2024Following tooth extraction, the healing process comprises bone resorption and soft tissue contraction, which have the potential to obstruct the optimal placement of...
PURPOSE
Following tooth extraction, the healing process comprises bone resorption and soft tissue contraction, which have the potential to obstruct the optimal placement of implants, causing both functional and aesthetic limitations. This study is aimed at assessing the healing process of the extraction socket and the dimensional changes that occur after alveolar ridge preservation, utilizing a polylactide-co-glycolide scaffold (PLGA).
MATERIALS AND METHOD
The present study involved the extraction of 28 teeth from 14 patients. The total number of sockets was 28, which were divided into two groups consisting of 14 study and 14 control sockets. The study group (SG) was subjected to socket preservation with PLGA scaffold while the control group (CG) was left for spontaneous healing. Measurements were taken before and after the operation, with cone beam computed tomographies (CBCT) being conducted at both the baseline and 4-month intervals. Samples for histological examination were obtained via trephine core biopsy and the implants were subsequently placed.
RESULTS
According to the histologic analyses, the PLGA scaffold was resorbed within four months. CBCT imaging revealed a decrease in the horizontal dimension of the crest at three distinct coronoapical levels in the SG, measuring 2.05±1.05 mm at -1 mm, 1.51±0.89 mm at -3 mm, and 0.92±0.7 mm at -5 mm level. The CG showed readings of 1.22±1 at -1 mm, 0.92±0.67 at -3 mm, and 0.73±0.69 at -5 mm levels. In comparison to CG, SG showed a significant reduction in horizontal losses at the -1 mm level. Vertical dimension of the crest decreased by 1.64±1.11 mm on the buccal bone height, 1.56±1.08 mm on lingual bone height in SG; in the CG, the buccal and lingual bone height had mean values of 2.08±1.44 mm and 1.73±1.27 mm, respectively. There was no significant statistical difference observed in the vertical losses between the groups.
CONCLUSIONS
Following a period of 4 months, it can be concluded that the PLGA scaffold was completely resorbed. Based on CBCT measurements, it was observed that horizontal resorption was lower than CG at the -1 mm coronal level.
PubMed: 38717351
DOI: 10.11607/jomi.10601 -
The International Journal of Oral &... May 2024The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly...
BACKGROUND
The use of ceramic-coated patient-specific CAD/CAM titanium abutments represents a therapeutic option for the rehabilitation of single tooth. The utilization of highly customized abutments enables the accurate three-dimensional positioning of the prosthetic emergence. This study evaluates the clinical performance of implant-prosthetic rehabilitations carried out using ceramic-coated CAD/CAM titanium abutments.
MATERIALS AND METHODS
Thirty implants were placed in thirty patients and rehabilitated with thirty single crowns attached to CAD/CAM titanium abutments. A conventional procedure was applied, with implant placement after post-extraction socket healing and prosthetic restoration after implant healing. Implants of lengths ranging from 6-15 mm and widths of 3.6, 4.2, and 4.8 mm were used in this study. At the time of prosthesis delivery (T0), after two years (T1), and after five years (T2), plaque (PI) and bleeding (BoP) indices, probing depths (PPD), marginal bone levels (MBL), and PES/WES were evaluated for each implant.
RESULTS
No patient dropped out of the study during the follow-up period. All thirty implants were clinically successful at five years post-prosthesis delivery (survival rate: 100%) and showed no signs of peri-implant infection. Peri-implant soft tissues were in good health (BoP at T2: 0% in 73% of patients; 25% in 13% of patients; 50% in 10% of patients; and 75% in 3% of patients). The mean PPD was 2.05±0.56 mm at T0, 1.992±0.6 mm at T1, and 1.867±0.439 mm at T2. The mean MBL at T0 was 0.413±0.440 mm, at T1 was 0.306±0.388 mm, and at T2 was 0.263±0.368 mm. The mean PES, WES, and PES/WES indices, 7.43±1.04, 7.57±0.82, and 15.00±1.17, respectively, indicate good integration of soft tissues, satisfactory aesthetics, and an overall positive outcome.
CONCLUSIONS
The success rates, maintenance of marginal bone levels, and periodontal and aesthetic indices suggest the validity of implant-prosthetic rehabilitations with CAD/CAM abutments in cases of single crowns.
PubMed: 38717350
DOI: 10.11607/jomi.10843 -
Journal of Dental Research Jun 2024() targets multiple signaling pathways that are involved in osteogenic differentiation and bone development. However, its therapeutic function in osteogenesis and bone...
() targets multiple signaling pathways that are involved in osteogenic differentiation and bone development. However, its therapeutic function in osteogenesis and bone regeneration remains unknown. In this study, we use in vitro and in vivo models to investigate the molecular function of overexpression and inhibition using a plasmid-based miR inhibitor system (PMIS) on osteogenic differentiation and bone regeneration. Inhibition of using significantly increased osteogenic biomarkers of human embryonic palatal mesenchyme cells and promoted bone regeneration in rat tooth socket defects. In rat maxillary M1 molar extractions, the supporting tooth structures were removed with an implant drill to yield a 3-mm defect in the alveolar bone. A collagen sponge was inserted into the open alveolar defect and plasmid DNA was added to the sponge and the wound sutured to protect the sponge and close the defect. It was important to remove the existing tooth supporting structure, which can influence alveolar bone regeneration. The alveolar bone was regenerated in 4 wk. The collagen sponge acts to stabilize and deliver the DNA to cells entering the sponge in the bone defect. We show that mesenchymal stem cells expressing CD90 and Stro-1 enter the sponges, take up the DNA, and express initiates a bone regeneration program in transformed cells in vivo. In vitro inhibition of was found to upregulate Wnt and BMP signaling activity as well as , and associated with osteogenesis. Liver and blood toxicity testing of -treated rats showed no increase in several biomarkers of liver disease. These results demonstrate the therapeutic function of for rapid bone regeneration. Furthermore, the studies were designed to demonstrate the ease of use of in solution and applied using a syringe in the clinic through a simple one-time application.
Topics: Animals; Bone Regeneration; Rats; MicroRNAs; Humans; Osteogenesis; Tooth Socket; Mesenchymal Stem Cells; Cell Differentiation; Rats, Sprague-Dawley; Male; Tooth Extraction; Alveolar Process; Plasmids; Alveolar Bone Loss; Collagen
PubMed: 38715225
DOI: 10.1177/00220345241242047 -
Head and Neck Pathology May 2024As per AJCC 8th edition TNM staging system, bone invasion is a poor prognostic marker that upstages oral cavity squamous carcinoma (OSCC) to pT4a. Cortical erosion alone...
BACKGROUND
As per AJCC 8th edition TNM staging system, bone invasion is a poor prognostic marker that upstages oral cavity squamous carcinoma (OSCC) to pT4a. Cortical erosion alone of bone or tooth socket by a gingival primary is not sufficient to upstage a tumour. The differentiation of cortical erosion from invasion through the cortical bone into the medulla is often challenging, limiting accurate staging. This review aims to assess the difficulties in differentiating cortical erosion from medullary invasion and evaluate the prognostic significance of different patterns of bone involvement.
METHODS
A retrospective review of OSCC with primary curative surgery and bone resection treated at a single-center over 10 years, was performed to assess the prognostic significance of bone invasion. Hematoxylin-eosin stained slides of a subset of cases were re-reviewed in a planned manner to assess difficulties in precise categorization (no invasion/erosion/cortical invasion and medullary invasion), evaluate interobserver agreement, and correlate with clinical outcome.
RESULTS
Five hundred and ninety patients were included, with a median follow-up of 28 months. On univariate analysis, the 3-year local, nodal and distant metastasis control were not significantly different in the 3 groups of no invasion, erosion, and invasion (p = 0.43, 0.47, and 0.47, respectively). Overall survival (OS) at 3 years was 78.1% and disease-free-survival(DFS) was 63.7% in the entire cohort. On univariate analysis, there was significant difference in OS and DFS based on these groups. This did not translate into independent prognostic benefit on multivariable analysis (p = 0.75 and 0.19, respectively). The independent prognostic factors were margin positivity, tumor differentiation, perineural invasion and pathological nodal involvement. Planned re-review of a subset of 202 cases resulted in a change in bone involvement category in 26/202 cases, which was mainly due to difficulty in assessing cortico-medullary junction near the tooth socket and bone fragmentation. The assessment showed moderate to near complete agreement (kappa 0.59-0.82) between 2 observers.
CONCLUSION
Our study shows that bone involvement is not an independent prognostic marker and there is no specific correlation of medullary invasion with outcome over those that showed cortical erosion. Several factors contribute to difficulties and interobserver variability in assessing bone involvement.
Topics: Humans; Retrospective Studies; Male; Female; Middle Aged; Prognosis; Mouth Neoplasms; Aged; Neoplasm Invasiveness; Adult; Aged, 80 and over; Bone Neoplasms; Squamous Cell Carcinoma of Head and Neck; Carcinoma, Squamous Cell
PubMed: 38710882
DOI: 10.1007/s12105-024-01642-5 -
The Journal of Craniofacial Surgery May 2024The presence of foreign bodies in the mandible is not listed as a risk factor or absolute contraindication for implant rehabilitation. However, possible complications...
The presence of foreign bodies in the mandible is not listed as a risk factor or absolute contraindication for implant rehabilitation. However, possible complications caused by foreign bodies, such as infection and cyst formation, could lead to implant failure. The authors report a case of dental implant placed 4 months after the surgical removal of embedded amalgam in the mandibular alveolus using a trephine bur and bone grafting with mineralized freeze-dried bone allograft. Clinical and radiographic evaluations were performed at each appointment to assess factors such as pain, implant mobility, probing depth, and marginal bone loss around the implant. Within 3 years of implant placement, there were no clinical signs and symptoms and no obvious radiographic marginal bone loss. Dental implant installation appears to be safe following the elimination of foreign materials, so long as anatomic and biological factors and appropriate implant choice, are taken into consideration.
PubMed: 38709071
DOI: 10.1097/SCS.0000000000010229