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Australian Dental Journal Mar 2014Augmentation of the extraction socket (ridge preservation) is increasingly being advocated in anticipation of implant placement. The aim of this article is to review the... (Review)
Review
Augmentation of the extraction socket (ridge preservation) is increasingly being advocated in anticipation of implant placement. The aim of this article is to review the available evidence with regards to ridge preservation procedures, investigating whether these techniques improve dental implant treatment outcomes. Evidence is examined to compare these techniques to other treatment alternatives such as implant placement with simultaneous lateral augmentation. An electronic PubMed search was conducted using search terms relevant to assessing treatment outcomes in association with ridge preservation. Titles were screened and full text obtained where relevant. Further full text articles were obtained from analysis of those papers yielded from the original search. Twenty-two papers were finally selected for analysis. Ridge preservation techniques are effective in minimizing post-extraction alveolar ridge contraction. However, there is insufficient evidence to suggest that the use of these techniques in conjunction with dental implant treatment improves implant treatment outcomes. Furthermore, ridge preservation does not necessarily eliminate the need for further simultaneous augmentation at the time of implant placement. The delayed healing associated with ridge preservation using socket grafting necessitates a commitment to a delayed placement protocol. The extended treatment time, compromised healing and expense related to ridge preservation suggests a more cautious approach with regards to the indication of such techniques.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Bone Substitutes; Dental Implants; Guided Tissue Regeneration, Periodontal; Humans; Minerals; Organ Sparing Treatments; Tooth Extraction; Tooth Socket
PubMed: 24588310
DOI: 10.1111/adj.12098 -
Scientific Reports Oct 2020The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and...
The purpose was to predict the crown-to-implant ratio variation in the edentulous posterior mandibles rehabilitated with short dental implants. Hence, vertical and horizontal dimensions of dentulous posterior mandibles in a sample of 18- to 25-year-olds were measured, and correlations of these dimensions with sex and site were investigated. Mandibular computed tomography scans from 100 subjects were considered. Vertical and horizontal bone and tooth measurements were taken at the sites of the second premolar (PM), and the mesial and distal roots of the first and second molars (M1m, M1d, M2m and M2d, respectively). A hypothetical crown-to-implant ratio (C/I R) was calculated assuming the insertion of short and extra short implants (5, 6 or 7 mm), at 1.5 mm from the inferior alveolar canal, maintaining the position of the existing occlusal plane. All vertical bone dimensions decreased from the PM to the M2d. Width measurements increased from the mesial (PM) to the distal sites (M1m, M1d, M2m and M2d). Males had significantly greater vertical and horizontal measurements than females at all sites. The mean C/I R was higher than 2 for all sizes of implant. The C/I R was lower for the second molar than for the second premolar, while it was similar for the first molar and the second premolar. Males had a higher C/I R than females. Computed tomography can be used to study the anatomical features of alveolar bone, and to predict some clinical aspects of prosthetic rehabilitation with implants, such as the crown-to-implant ratio in conditions of serious bone atrophy.
Topics: Adolescent; Adult; Alveolar Process; Dental Implants; Humans; Jaw, Edentulous; Male; Mandible; Radiography, Dental; Retrospective Studies; Tomography, X-Ray Computed; Tooth Crown; Young Adult
PubMed: 33004827
DOI: 10.1038/s41598-020-73180-3 -
Clinical Oral Investigations Mar 2023Agenesis of the maxillary lateral incisor occurs in up to 4% of all individuals and requires multidisciplinary treatment. Its developmental origins, however, are not...
BACKGROUND AND OBJECTIVE
Agenesis of the maxillary lateral incisor occurs in up to 4% of all individuals and requires multidisciplinary treatment. Its developmental origins, however, are not fully understood. Earlier studies documented genetic factors contributing to agenesis but also an association with craniofacial morphology. In this study, we assessed the association between maxillary morphology and lateral incisor agenesis by a geometric morphometric approach to disentangle the roles of developmental plasticity and genetic factors.
MATERIALS AND METHODS
We quantified the maxillary alveolar ridge by 19 two-dimensional landmarks on cross-sectional images of 101 computed tomography scans. We compared the shape and size of the alveolar ridge across patients with unilateral or bilateral agenesis of maxillary lateral incisors and patients with extracted or in situ incisors.
RESULTS
The maxillary alveolar ridge was clearly narrower in patients with agenesis or an extracted incisor compared to the control group, whereas the contralateral side of the unilateral agenesis had an intermediate width. Despite massive individual variation, the ventral curvature of the alveolar ridge was, on average, more pronounced in the bilateral agenesis group compared to unilateral agenesis and tooth extraction.
CONCLUSIONS
This suggests that pleiotropic genetic and epigenetic factors influence both tooth development and cranial growth, but an inappropriately sized or shaped alveolar process may also inhibit normal formation or development of the tooth bud, thus leading to dental agenesis.
CLINICAL RELEVANCE
Our results indicate that bilateral agenesis of the lateral incisor tends to be associated with a higher need of bone augmentation prior to implant placement than unilateral agenesis.
Topics: Humans; Incisor; Anodontia; Maxilla; Alveolar Process; Tomography, X-Ray Computed
PubMed: 36036293
DOI: 10.1007/s00784-022-04690-9 -
TheScientificWorldJournal 2022Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the...
BACKGROUND
Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the buccal and alveolar bone at the central incisors using CBCT in relation to gender and side to determine the anatomical features and choose the best implant treatment option for minimizing the surgical complications.
METHODS
One hundred CBCT images were investigated (50 females and 50 males, aged 20 to 50 years old). The buccal bone thickness and alveolar bone thickness were evaluated for right and left sides of each subject at three sites; C: crest (3 mm); M: middle (6 mm); A: apical (9 mm) from the cementoenamel junction.
RESULTS
The mean thickness of buccal bone was less than 2 mm on the incisors according to side and gender. Buccal bone thickness revealed a statistically significant difference between right and left sides at the apical point in both females and males with values of ( ≤ 0.001) and (0.001), respectively. The buccal bone thickness displayed statistically significant differences between genders at all sites. The alveolar thickness demonstrated similar significant differences between genders except for the crest site.
CONCLUSIONS
Iraqi participants had about 1 mm buccal bone thickness at 3 mm apical from the CEJ in right and left central incisors with a progressive rise in bone thickness to be less than 2 mm at the apex. Alveolar bone also showed the same increase in bone thickness from crest to apex. Bone thickness was greater in males than females. The present study provided valuable CBCT data on bone thickness of the esthetic maxillary region as a preoperative analysis for establishing an immediate implant treatment plan with aesthetically pleasing long-term outcomes.
Topics: Adult; Alveolar Process; Cone-Beam Computed Tomography; Female; Humans; Incisor; Iraq; Male; Maxilla; Middle Aged; Young Adult
PubMed: 35185395
DOI: 10.1155/2022/7226998 -
Brazilian Dental Journal 2020This study aims to evaluate the post-extraction alveolar bone reconstruction amongst 12 patients exhibiting loss of buccal bone plate in a tooth of the anterior region...
This study aims to evaluate the post-extraction alveolar bone reconstruction amongst 12 patients exhibiting loss of buccal bone plate in a tooth of the anterior region of the maxilla using the prosthetically-driven alveolar reconstruction technique (PDAR). In PDAR, a partial fixed provisional prosthesis (PFPP [conventional or adhesive]) with a specially designed pontic maintains the clot in a mechanically stable position during alveolar regeneration. Moreover, the pontic design, in hourglass shape and located in the subgingival area, also prevents gingival margins from collapsing. Gingival recession was evaluated through the 6-month healing period. Cone beam computed tomography (CBCT) was performed 1 month before and 8 months after PDAR treatment. For the primary outcome, in the panoramic imaging, the central area of bone defect in each tooth was selected for linear measurements. Measurements of the vertical buccal bone gain and the gain in thickness in the alveolar bone crest were obtained 8 months after PDAR. Descriptive statistics and intraclass correlation coefficient analysis were conducted. After treatment, all patients showed bone formation (a mean vertical gain of 7.1±3.7 mm, associated with a horizontal mean gain of 4.5±1.4 mm in the alveolar bone crest). The intraclass correlation coefficient for the measurements performed using CBCT was 0.999. No gingival recession, greater than 1 mm, was observed. Lower-morbidity procedures without the use of biomaterials may be a useful in post-extraction alveolar ridge regeneration and/or preservation. PDAR promoted alveolar bone formation without flaps, grafts and membranes.
Topics: Alveolar Bone Loss; Alveolar Process; Cone-Beam Computed Tomography; Humans; Maxilla; Retrospective Studies; Tooth Extraction; Tooth Socket
PubMed: 33146327
DOI: 10.1590/0103-6440202003218 -
Medicina Oral : Organo Oficial de La... 2004One of the principal problems in dental implantation is the lack of sufficient bone height or width. In the case of the alveolar ridge, a very effective technique for... (Review)
Review
One of the principal problems in dental implantation is the lack of sufficient bone height or width. In the case of the alveolar ridge, a very effective technique for resolving this problem is distraction osteogenesis, introduced in this context about a decade ago. This technique is based on the gradual separation of a mobile but fully vascularized bone segment from the basal bone, leading to the formation of an intervening soft callus which gradually transforms to mature bone. A key researcher in the development of this technique was the Russian traumatologist Ilizarov. The present article reviews alveolar ridge distraction procedures and their clinical application. Alveolar ridge distraction may often be preferable to bone grafting or guided bone regeneration for increasing ridge height and width prior to implantation.
Topics: Alveolar Process; Forecasting; Humans; Osteogenesis, Distraction
PubMed: 15292871
DOI: No ID Found -
Annals of Anatomy = Anatomischer... Feb 2023This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain,...
PURPOSE
This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications.
MATERIAL AND METHODS
The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool.
RESULTS
Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used.
CONCLUSIONS
After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.
Topics: Humans; Alveolar Ridge Augmentation; Bone Transplantation; Bone Substitutes; Minerals; Alveolar Process; Dentin; Tooth Socket; Tooth Extraction
PubMed: 36396018
DOI: 10.1016/j.aanat.2022.152024 -
Journal of Periodontology Feb 2020The objective of this study was to histologically evaluate and compare vital bone formation, residual graft particles, and fraction of connective tissue (CT)/other...
BACKGROUND
The objective of this study was to histologically evaluate and compare vital bone formation, residual graft particles, and fraction of connective tissue (CT)/other tissues between three different time points at 2-month intervals after alveolar ridge preservation with a cancellous allograft and dense-polytetrafluoroethylene (d-PTFE) membrane.
METHODS
Ridge preservation with a cancellous allograft and d-PTFE membrane was performed at 49 extraction sockets (one per patient). Volunteers were assigned to implant placement at three different time points of 2, 4, and 6 months, at which time core biopsies were obtained. Histomorphometric analysis was performed to determine the percentages of vital bone, residual graft particles, and connective tissue/other non-bone components, and subjected to statistical analyses.
RESULTS
There was a statistically significant difference in the amount of vital bone at every time point from 28.31% to 40.87% to 64.11% (at 2-, 4-, and 6-month groups, respectively) (P < 0.05). The percentage of residual graft particles ranged from 44.57% to 36.16% to 14.86%, showing statistical significance from 4 to 6 months (21.29%, P < 0.001), and 2 to 6 months (29.71%, P < 0.001), while there were no significant differences for the amount of CT/other tissue among the different time points.
CONCLUSIONS
This study provided the first histologic comparison of alveolar ridge preservation using a cancellous allograft and d-PTFE membrane at three different time points. Extraction sockets that healed for 6 months produced the highest amount of vital bone in combination with the least percentage of residual graft particles, while similar results were observed for the fraction of CT/other tissues between the three time points.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Transplantation; Humans; Membranes, Artificial; Polytetrafluoroethylene; Tooth Extraction; Tooth Socket
PubMed: 31378923
DOI: 10.1002/JPER.19-0142 -
Journal of Clinical Periodontology Feb 2023To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time.
MATERIALS AND METHODS
Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A-3 months; B-6 months; C-9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes.
RESULTS
A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups.
CONCLUSIONS
Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617).
Topics: Swine; Humans; Animals; Cattle; Tooth Socket; Alveolar Bone Loss; Heterografts; Alveolar Process; Wound Healing; Collagen; Tooth Extraction; Alveolar Ridge Augmentation
PubMed: 36345818
DOI: 10.1111/jcpe.13744 -
PloS One 2017The aim of this systematic review was to evaluate instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration... (Review)
Review
The aim of this systematic review was to evaluate instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration (GBR) and to identify the most used instruments for successful outcome. An electronic as well as manual literature search was conducted in several databases including Medline, Embase, and Cochrane Central Register of Controlled Trials, for articles written in English up to September 2016. The question in focus was to identify the type of device for ridge expansion that is most frequently used and provides adequate bone expansion and implant success rate. To meet the inclusion criteria, the studies were analysed for the following parameters: prospective or retrospective studies, cohort or case studies/series, cases with 5 or more human subjects, type of device used for surgery, location of defect, and minimum follow up period. The frequency of osteotome usage in this study was approximately 65%, and on average, the implant success was 97%. The motorized expanders and ultrasonic surgery system are easier to use and cause less trauma to the bone compared to the traditional/conventional instruments like mallets and osteotomes. However, their cost is a limiting factor; hence, osteotomes remain a popular mode of instrumentation.
Topics: Alveolar Process; Dental Implantation, Endosseous; Humans
PubMed: 28732054
DOI: 10.1371/journal.pone.0180342