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Clinical Oral Implants Research May 2024The aim of this retrospective clinical study was to compare the 5-year radiological and clinical outcomes of patients undergoing immediate implantation with or without...
AIMS
The aim of this retrospective clinical study was to compare the 5-year radiological and clinical outcomes of patients undergoing immediate implantation with or without the modified socket-shield technique.
MATERIALS AND METHODS
Patients who underwent anterior tooth replacement via the modified socket-shield technique (MSST) or the conventional immediate implantation technique (CIIT) between 2016 and 2017 were included. The labial bone thickness was assessed at different measurement levels (0, 2, 4 and 6 mm apical to the implant shoulder (IS)) postoperatively (T1), 6 months postoperatively (T2) and 5 years postoperatively (T3). The pink aesthetic score (PES) was evaluated before surgery (T0) and at T2 and T3. Implant success, complications and patient satisfaction were evaluated at every visit.
RESULTS
Thirty-six patients (18 in the MSST group) underwent follow-up for 5 years, with no cases of implant failure. Two cases of exposure were detected in the MSST group, but there were no significant effects on hard or soft tissue. Patients in the MSST group showed less and more stable bone resorption than did those in the CIIT group at any measurement level and any time. A higher PES was achieved in the MSST group. Patient satisfaction was similar in both groups.
CONCLUSIONS
The MSST is a reliable immediate implantation method because of its ability to preserve the alveolar bone and provide superior recovery of aesthetics.
PubMed: 38747494
DOI: 10.1111/clr.14281 -
Journal of Periodontology May 2024Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time...
BACKGROUND
Bone readiness for implant placement is typically evaluated by bone quality/density on 2-dimensional radiographs and cone beam computed tomography at an arbitrary time between 3 and 6 months after tooth extraction and alveolar ridge preservation (ARP). The aim of this study is to investigate if high-frequency ultrasound (US) can classify bone readiness in humans, using micro-CT as a reference standard to obtain bone mineral density (BMD) and bone volume fraction (BVTV) of healed sockets receiving ARP in humans.
METHODS
A total of 27 bone cores were harvested during the implant surgery from 24 patients who received prior extraction with ARP. US images were taken immediately before the implant surgery at a site co-registered with the tissue biopsy collection location, made possible with a specially designed guide, and then classified into 3 tiers using B-mode image criteria (1) favorable, (2) questionable, and (3) unfavorable. Bone mineral density (hydroxyapatite) and BVTV were obtained from micro-CT as the gold standard.
RESULTS
Hydroxyapatite and BVTV were evaluated within the projected US slice plane and thresholded to favorable (>2200 mg/cm; >0.45 mm/mm), questionable (1500-2200 mg/cm; 0.4-0.45 mm/mm), and unfavorable (<1500 mg/cm; <0.4 mm/mm). The present US B-mode classification inversely scales with BMD. Regression analysis showed a significant relation between US classification and BMD as well as BVTV. T-test analysis demonstrated a significant correlation between US reader scores and the gold standard. When comparing Tier 1 with the combination of Tier 2 and 3, US achieved a significant group differentiation relative to mean BMD (p = 0.004, true positive 66.7%, false positive 0%, true negative 100%, false negative 33.3%, specificity 100%, sensitivity 66.7%, receiver operating characteristics area under the curve 0.86). Similar results were found between US-derived tiers and BVTV.
CONCLUSION
Preliminary data suggest US could classify jawbone surface quality that correlates with BMD/BVTV and serve as the basis for future development of US-based socket healing evaluation after ARP.
PubMed: 38742564
DOI: 10.1002/JPER.23-0370 -
Cureus Apr 2024Solitary median maxillary central incisor (SMMCI) syndrome is complex and usually develops 35-38 days postconception during the intrauterine period. A noteworthy...
Solitary median maxillary central incisor (SMMCI) syndrome is complex and usually develops 35-38 days postconception during the intrauterine period. A noteworthy discovery is that just one central incisor in the maxillary alveolus, found exactly on the centerline, is present in both deciduous and permanent dentitions with other congenital anomalies. Around one in every 50,000 live babies exhibits this abnormality. This report describes the case of a 13-year-old female patient with SMMCI syndrome with a complaint about an unsightly appearance due to a single large upper front tooth. We underline the importance of increasing clinician awareness of SMMCI syndrome and the need for a multidisciplinary approach to its care.
PubMed: 38741811
DOI: 10.7759/cureus.58101 -
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 -
Current Topics in Developmental Biology 2024The mammalian lung completes its last step of development, alveologenesis, to generate sufficient surface area for gas exchange. In this process, multiple cell types... (Review)
Review
The mammalian lung completes its last step of development, alveologenesis, to generate sufficient surface area for gas exchange. In this process, multiple cell types that include alveolar epithelial cells, endothelial cells, and fibroblasts undergo coordinated cell proliferation, cell migration and/or contraction, cell shape changes, and cell-cell and cell-matrix interactions to produce the gas exchange unit: the alveolus. Full functioning of alveoli also involves immune cells and the lymphatic and autonomic nervous system. With the advent of lineage tracing, conditional gene inactivation, transcriptome analysis, live imaging, and lung organoids, our molecular understanding of alveologenesis has advanced significantly. In this review, we summarize the current knowledge of the constituents of the alveolus and the molecular pathways that control alveolar formation. We also discuss how insight into alveolar formation may inform us of alveolar repair/regeneration mechanisms following lung injury and the pathogenic processes that lead to loss of alveoli or tissue fibrosis.
Topics: Animals; Humans; Pulmonary Alveoli; Pulmonary Gas Exchange; Regeneration; Lung; Lung Injury
PubMed: 38729684
DOI: 10.1016/bs.ctdb.2024.01.002 -
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; Tooth Socket; Dental Restoration Failure; Incisor; Female; Male
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