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Medicine Jul 2022The aim of this article is to assess the formation of new vital bone (VB) using histomorphometric analysis in alveolar ridge preservation (ARP), with and without primary... (Randomized Controlled Trial)
Randomized Controlled Trial
Histological and histomorphometric evaluation of alveolar ridge preservation using an allograft and nonresorbable membrane with and without primary closure: A pilot randomized controlled clinical trial.
The aim of this article is to assess the formation of new vital bone (VB) using histomorphometric analysis in alveolar ridge preservation (ARP), with and without primary closure. Eight patients needed bilateral tooth extraction and planned for ARP. All patients had a nonresorbable membrane with freeze-dried bone allograft after the extractions. Biopsies were obtained 6 months after ARP and were evaluated using histomorphometric analysis. The study included 6 males and 2 females, with an average age of 54.2 years (standard deviation, 9.7). The teeth requiring extraction included a bilateral canine (1 case), premolars (5 cases), and molars (2 cases). Histomorphometric values of new VB, residual bone (RB) substitute particles, and marrow tissue formation were 71.1 %, 16.2%, and 9.69% for closed flap and 50.9%, 15.3%, and 8.19 for open flap. P values were 0.066, 0.878, and 0.326, respectively. The present findings indicate that leaving the flap without primary closure did not have any effect on new VB, RB particles, and immature bone marrow compared with closed flap. However, the results favored the closed-flap technique.
Topics: Allografts; Alveolar Process; Alveolar Ridge Augmentation; Female; Humans; Male; Pilot Projects; Tooth Socket
PubMed: 35777057
DOI: 10.1097/MD.0000000000029769 -
Journal of Applied Oral Science :... Jan 2018This study aimed to evaluate bone repair in rat dental sockets after implanting nanostructured carbonated hydroxyapatite/sodium alginate (CHA) and nanostructured...
This study aimed to evaluate bone repair in rat dental sockets after implanting nanostructured carbonated hydroxyapatite/sodium alginate (CHA) and nanostructured carbonated hydroxyapatite/sodium alginate containing 5% strontium microspheres (SrCHA) as bone substitute materials. Twenty male Wistar rats were randomly divided into two experimental groups: CHA and SrCHA (n=5/period/group). After one and 6 weeks of extraction of the right maxillary central incisor and biomaterial implantation, 5 μm bone blocks were obtained for histomorphometric evaluation. The parameters evaluated were remaining biomaterial, loose connective tissue and newly formed bone in a standard area. Statistical analysis was performed by Mann-Withney and and Wilcoxon tests at 95% level of significance. The histomorphometric results showed that the microspheres showed similar fragmentation and bio-absorbation (p>0.05). We observed the formation of new bones in both groups during the same experimental periods; however, the new bone formation differed significantly between the weeks 1 and 6 (p=0.0039) in both groups. The CHA and SrCHA biomaterials were biocompatible, osteoconductive and bioabsorbable, indicating their great potential for clinical use as bone substitutes.
Topics: Alginates; Animals; Bone Regeneration; Bone Substitutes; Bone Transplantation; Carbonates; Durapatite; Glucuronic Acid; Hexuronic Acids; Male; Nanostructures; Osteogenesis; Random Allocation; Rats, Wistar; Reproducibility of Results; Spectroscopy, Fourier Transform Infrared; Strontium; Time Factors; Tooth Socket; Treatment Outcome
PubMed: 29364342
DOI: 10.1590/1678-7757-2017-0084 -
Oral Surgery, Oral Medicine, Oral... Apr 2013To assess the influence of anatomical location on computed tomography (CT) numbers in mid- and full field of view (FOV) cone beam computed tomography (CBCT) scans. (Comparative Study)
Comparative Study
OBJECTIVE
To assess the influence of anatomical location on computed tomography (CT) numbers in mid- and full field of view (FOV) cone beam computed tomography (CBCT) scans.
STUDY DESIGN
Polypropylene tubes with varying concentrations of dipotassium hydrogen phosphate (K₂HPO₄) solutions (50-1200 mg/mL) were imaged within the incisor, premolar, and molar dental sockets of a human skull phantom. CBCT scans were acquired using the NewTom 3G and NewTom 5G units. The CT numbers of the K₂HPO₄ phantoms were measured, and the relationship between CT numbers and K₂HPO₄ concentration was examined. The measured CT numbers of the K₂HPO₄ phantoms were compared between anatomical sites.
RESULTS
At all six anatomical locations, there was a strong linear relationship between CT numbers and K₂HPO₄ concentration (R(2)>0.93). However, the absolute CT numbers varied considerably with the anatomical location.
CONCLUSION
The relationship between CT numbers and object density is not uniform through the dental arch on CBCT scans.
Topics: Bicuspid; Cone-Beam Computed Tomography; Dental Arch; Durapatite; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Incisor; Molar; Phantoms, Imaging; Phosphates; Potassium Compounds; Radiation Dosage; Scattering, Radiation; Tooth Socket; X-Rays
PubMed: 23522649
DOI: 10.1016/j.oooo.2013.01.021 -
European Journal of Paediatric Dentistry Jun 2018Traumatic intrusion is a luxation type of injury where the tooth is displaced along the axis of the tooth, into the alveolus. This injury is regarded as serious because... (Review)
Review
Traumatic intrusion is a luxation type of injury where the tooth is displaced along the axis of the tooth, into the alveolus. This injury is regarded as serious because of the tissue damage that it causes. The traumatic movement is associated with severe damage to the periodontal ligament, pulpal tissue, root and alveolar socket. Despite its severity, the rare occurrence of this injury in permanent teeth has resulted in limited studies of immature and mature permanent incisors. The purpose of this paper is to review this luxation injury of permanent immature incisors, and to describe its diagnosis, treatment and management. In particular, we describe the repositioning strategies used in cases of intrusion injury. These include (i) monitoring spontaneous re-eruption, (ii) active orthodontic repositioning and (iii) surgical repositioning. Firstly, monitoring spontaneous re-eruption is observing and waiting for the intruded tooth to return to its original position. This process is not a normal developmental eruption and the outcome is not always predictable, nor is the time needed for this to happen. Secondly, active orthodontic repositioning is used to describe the process of rapidly moving the intruded tooth to its original position with the aid of an orthodontic appliance. Active orthodontic repositioning is often misunderstood as normal orthodontic movement. Orthodontic movement allows for periodontal ligament remodelling, using light intermittent forces. In contrast the active orthodontic repositioning used to move intruded incisors is rapid, and the primary aim is to achieve correct tooth position as rapidly as possible. Thirdly, surgical repositioning uses surgical intervention to bring the tooth back to its original position. A case of an intruded immature permanent incisor is presented, with a particular emphasis on these critical decisions on repositioning and showing the use of the three modalities of treatment in sequence, in order to achieve an outcome.
Topics: Child; Decision Making; Dentition, Permanent; Female; Humans; Incisor; Tooth Avulsion; Tooth Movement Techniques
PubMed: 29790773
DOI: 10.23804/ejpd.2018.19.02.03 -
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 -
International Journal of Environmental... Jun 2020The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in...
The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient's physician.
Topics: Aged; Aged, 80 and over; Dental Restoration Failure; Female; Follow-Up Studies; Humans; Immediate Dental Implant Loading; Male; Middle Aged; Retrospective Studies; Rivaroxaban; Tooth Extraction; Tooth Socket; Treatment Outcome
PubMed: 32604907
DOI: 10.3390/ijerph17124607 -
Brazilian Oral Research 2022The aim of this study was to use microscopic and molecular techniques to evaluate the effects of a single session of antimicrobial photodynamic therapy (aPDT) on the...
The aim of this study was to use microscopic and molecular techniques to evaluate the effects of a single session of antimicrobial photodynamic therapy (aPDT) on the alveolar repair process after tooth extraction in rats. The study sample included 84 rats divided into four groups, as follows: a) Control - untreated socket; b) Laser - socket treated using photobiomodulation; c) TBO - socket treated with topic application of the photosensitizer agent, toluidine blue O (TBO); and d) aPDT - socket treated with TBO and laser irradiation. An additional rat was used for thermal mapping during socket irradiation. The animals were euthanatized at 6, 15, and 28 days after unilateral extraction of the upper incisor. Quantitative and qualitative analyses of the connective and bone tissues, blood clot, blood vessel, and inflammatory infiltrate were performed, and real-time polymerase chain reaction was used to study the expression of genes (collagen type I, osteocalcin, alkaline phosphatase [ALP], runt-related transcription factor 2 [RUNX2], and vascular endothelial growth factor [VEGF]) involved in the bone healing process. No statistically significant differences in microscopic and molecular outcomes were observed between the groups (p > 0.05). A positive correlation was seen to exist between blood clot and VEGF (p = 0.000), and a negative correlation was observed between bone tissue and ALP (p = 0.028) and blood vessel and VEGF (p = 0.018). A single session of aPDT in the dental extraction site did not influence the alveolar repair process in rats.
Topics: Alveolar Process; Animals; Anti-Infective Agents; Photochemotherapy; Rats; Rats, Wistar; Tooth Extraction; Tooth Socket; Vascular Endothelial Growth Factor A
PubMed: 35170691
DOI: 10.1590/1807-3107bor-2022.vol36.0024 -
International Journal of Implant... Feb 2021The socket seal surgery (SSS) technique is a common alternative for the management of the post-extraction sockets that requires a primary closure of the wound to promote... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The socket seal surgery (SSS) technique is a common alternative for the management of the post-extraction sockets that requires a primary closure of the wound to promote proper regeneration and ridge preservation.
OBJECTIVE
To learn about the effect of different SSS techniques on alveolar ridge preservation MATERIAL AND METHODS: Two independent and calibrated reviewers conducted an electronic search in PubMed, Cochrane, and Web of Science for randomized clinical trials (RCT) published up to June 2020. The evaluation of the risk of bias in the included studies was carried out following the Cochrane manual for interventions of systematic reviews, version 5.1.0. A meta-analysis of ridge width changes at - 1, - 3, and - 5 mm cutoff points from bone crest was conducted using a random-effects model. The risk of types I and II errors against accrued data was appraised obtaining the required information size using a trial sequential analysis package (TSA).
RESULTS
A total of 135 sockets located in the esthetic zone were evaluated with a minimum of a 3-month follow-up after tooth extraction in 6 RCTs. The evaluated SSS techniques were free gingival graft (FGG), collagen matrix (CM), collagen sponge (CS), acellular dermal matrix (ADM), and polytetrafluoroethylene membrane (PTFEm). The FGG in sockets without bone filling showed significant results in preserving both buccal and lingual bone height (- 1.42 mm in the experimental group versus - 0.01 in the control group). The comparison of CM and FGG with bone filling did not show clinical differences in terms of dimensional bone changes. No clinical differences were found in either width or gingival thickness when comparing CM and CS. The meta-analyses of RW changes comparing CM versus FGG showed no significant differences, but a trend for lessening horizontal reduction at - 1, - 3, and - 5 mm in favor of FGG. The TSA showed that accrued data did not reach the required information size, and more evidence is required for clinical significance inferences.
CONCLUSIONS
There are several predictable SSS techniques to improve clinical results in ridge preservation. More clinical studies in the form of clinical trials are required to demonstrate the superiority of one technique over another.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Esthetics; Humans; Randomized Controlled Trials as Topic; Tooth Socket
PubMed: 33615421
DOI: 10.1186/s40729-021-00294-2 -
BMC Oral Health Apr 2021We previously reported similar efficacies of alveolar ridge preservation (ARP) on single extraction socket with two different E. coli derived recombinant human bone...
BACKGROUND
We previously reported similar efficacies of alveolar ridge preservation (ARP) on single extraction socket with two different E. coli derived recombinant human bone morphogenetic protein-2 (rhBMP-2) delivery systems (Cowell BMP, Cowell medi Co, Busan, Korea; β-tricalcium phosphate and hydroxyapatite particle & O-BMP, Osstem Implant Co, Busan, Korea; absorbable collagen sponge). After the trial, we completed implant therapy and observed over an average of 3 years. This follow-up study was performed retrospectively to compare result of implant treatment at the preserved alveolar ridge site.
METHODS
Patients who underwent extraction of single tooth and received ARP with one of two rhBMP-2 delivery systems from October 2015 to October 2016 were enrolled. Twenty-eight patients (Group 1: Cowell BMP 14; Group 2: O-BMP 14) who underwent implant therapy and prosthetic treatment were included in study. Stability and marginal bone loss (MBL) of each implant were collected from medical charts and radiographs, and analyzed. The survival and success rates of implants were calculated.
RESULTS
The primary implant stability represented by implant stability quotient (ISQ) for Groups 1 and 2 was 69.71 and 72.86, respectively. The secondary implant stability for Groups 1 and 2 was 78.86 and 81.64, respectively. Primary and secondary stabilities were not statistically different (P = 0.316 and 0.185, respectively). MBL at the latest follow-up was 0.014 mm in Group 1 over 33.76 ± 14.31 months and 0.021 mm in Group 2 over 40.20 ± 9.64 months, with no significant difference (P = 0.670). In addition, the success rate of implants was 100% (14/14) in Group 1 and 92.9% (13/14) in Group 2, with survival rate of 100% (14/14) in Group 1 and 92.9% (13/14) in Group 2.
CONCLUSIONS
We confirmed good prognosis in both groups as a result of implant therapy after ARP with each of two rhBMP-2 carriers.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Bone Morphogenetic Protein 2; Dental Implants; Dental Implants, Single-Tooth; Escherichia coli; Follow-Up Studies; Humans; Prognosis; Recombinant Proteins; Republic of Korea; Retrospective Studies; Tooth Extraction; Tooth Socket; Transforming Growth Factor beta
PubMed: 33879162
DOI: 10.1186/s12903-021-01565-5 -
BioMed Research International 2022Tooth extraction causes a wound with hard and soft tissue defects in the alveolar ridge. Few studies have reported the function of microRNAs (miRNAs) in the healing of...
OBJECTIVE
Tooth extraction causes a wound with hard and soft tissue defects in the alveolar ridge. Few studies have reported the function of microRNAs (miRNAs) in the healing of extraction sockets. This study used bioinformatics analysis to reveal the possible relevance and role of miRNAs during the early stages following tooth extraction.
MATERIALS AND METHODS
Socket tissues from beagle dogs (; two males and two females) were collected 1 and 12 hours after extraction of premolars on both sides of the mandible. miRNA expression was profiled through miRNA sequencing, and hub miRNAs showing characteristic expression patterns were selected and subjected to target enrichment analysis. Alkaline phosphatase (ALP) activity analysis and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were performed to verify the effect of hub miRNA on osteoblast differentiation and bone regeneration .
RESULTS
Five miRNAs were identified to have consistently high expression levels, with cfa-miR-451 showing the highest expression. Additionally, 20 hub miRNAs were selected as candidates expected to play an important role in the healing process. Pathways, such as the MAPK, axon guidance, TGF-, and Wnt signaling, were significantly enriched. Among hub miRNAs, miR-190a-5p increased ALP activity and mRNA expression of osteogenic markers and increased new bone formation .
CONCLUSIONS
Our findings suggest that miRNAs may be involved in the earliest stages of socket healing after tooth extraction and can play an important role in moderating the entire socket healing mechanism in the extraction socket.
Topics: Dogs; Male; Animals; Tooth Socket; MicroRNAs; Periodontal Ligament; Alveolar Process; Tooth Extraction
PubMed: 36317115
DOI: 10.1155/2022/7194640