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Shi M, Gong Z, Zeng P, Xiang D, Cai G, Liu H, Chen S, Liu R, Chen Z, Zhang X, Chen Z. Multi-Quantifying Maxillofacial Traits via a Demographic Parity-Based AI Model. BME FRONTIERS 2024; 5:0054. [PMID: 39139805 PMCID: PMC11319927 DOI: 10.34133/bmef.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/08/2024] [Indexed: 08/15/2024] Open
Abstract
Objective and Impact Statement: The multi-quantification of the distinct individualized maxillofacial traits, that is, quantifying multiple indices, is vital for diagnosis, decision-making, and prognosis of the maxillofacial surgery. Introduction: While the discrete and demographically disproportionate distributions of the multiple indices restrict the generalization ability of artificial intelligence (AI)-based automatic analysis, this study presents a demographic-parity strategy for AI-based multi-quantification. Methods: In the aesthetic-concerning maxillary alveolar basal bone, which requires quantifying a total of 9 indices from length and width dimensional, this study collected a total of 4,000 cone-beam computed tomography (CBCT) sagittal images, and developed a deep learning model composed of a backbone and multiple regression heads with fully shared parameters to intelligently predict these quantitative metrics. Through auditing of the primary generalization result, the sensitive attribute was identified and the dataset was subdivided to train new submodels. Then, submodels trained from respective subsets were ensembled for final generalization. Results: The primary generalization result showed that the AI model underperformed in quantifying major basal bone indices. The sex factor was proved to be the sensitive attribute. The final model was ensembled by the male and female submodels, which yielded equal performance between genders, low error, high consistency, satisfying correlation coefficient, and highly focused attention. The ensemble model exhibited high similarity to clinicians with minor processing time. Conclusion: This work validates that the demographic parity strategy enables the AI algorithm with greater model generalization ability, even for the highly variable traits, which benefits for the appearance-concerning maxillofacial surgery.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Zhuofan Chen
- Hospital of Stomatology,
Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Xinchun Zhang
- Hospital of Stomatology,
Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
| | - Zetao Chen
- Hospital of Stomatology,
Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou 510055, China
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Redko N, Drobyshev A, Le TH, Lezhnev D, Deev R, Bozo I, Miterev A, Shamrin S, Skakunov Y, Meliev D. Comparative Effectiveness of an Autologous Dentin Matrix for Alveolar Ridge Preservation. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1280. [PMID: 39202563 PMCID: PMC11356695 DOI: 10.3390/medicina60081280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/02/2024] [Accepted: 08/05/2024] [Indexed: 09/03/2024]
Abstract
An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.
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Affiliation(s)
- Nikolai Redko
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Alexey Drobyshev
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Thanh Hieu Le
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Dmitry Lezhnev
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Roman Deev
- Department of Pathological Anatomy, North-Western State Medical University Named after I.I. Mechnikov, 191015 Saint Petersburg, Russia
| | - Ilya Bozo
- Department of Reconstructive and Plastic Surgery, Petrovsky National Research Center of Surgery, 119435 Moscow, Russia
| | - Andrey Miterev
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Sergey Shamrin
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Yaroslav Skakunov
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
| | - Davronbek Meliev
- Department of Maxillofacial and Plastic Surgery, Federal State Budgetary Educational Institution of Higher Education “Russian University of Medicine” of the Ministry of Healthcare of the Russian Federation, 127006 Moscow, Russia; (A.D.); (A.M.); (S.S.); (Y.S.); (D.M.)
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Kim H, Han HS, Ghanaati S, Zadeh HH, Kim S, Cho YD. Alveolar Ridge Preservation Using a Collagenated Xenograft: A Randomized Clinical Trial. Int Dent J 2024:S0020-6539(24)00202-8. [PMID: 39117478 DOI: 10.1016/j.identj.2024.07.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVES This study sought to evaluate the efficacy of cancellous bovine bone mineral granules and 10% porcine collagen (deproteinized bovine bone mineral with collagen [DBBM-C]; (OCS-B Collagen® [Straumann XenoFlex], NIBEC, Korea) in a mouldable block form, with or without socket seal, using autogenous free gingival graft (FGG). METHODS Fifty-four patients were included and randomly assigned to one of three groups: (1) spontaneous healing (control group), (2) alveolar ridge preservation (ARP) using DBBM-C (DBBM-C group), and (3) ARP employing DBBM-C sealed with FGG (DBBM-C/FGG group). Bone biopsy and implant fixture placement were performed 180 days after ARP. Cone-beam computed tomography, histological analysis, implant stability, and three-dimensional volumetric analysis were conducted. RESULTS Of the 54 patients, 4 dropped out owing to loss of follow-up and osseointegration failure. The changes in alveolar bone during follow-up were not significantly different. Between 84- and 180-day postextraction, the volume of the DBBM-C and DBBM-C/FGG groups was maintained at 3 mm below the alveolar ridge crest (0.72 ± 0.80 mm, 6.05 ± 6.69%), whereas the volume in the control group decreased (-0.37 ± 1.31 mm, -2.10% ± 8.37%) (P = .026). The DBBM-C/FGG group exhibited less horizontal ridge resorption at 1 mm below the alveolar crest (-9.19 ± 5.09 mm, -73.67% ± 32.53%) between preextraction and 84 days postextraction (P = .049). In all groups, the implant stability quotient remained above 70. CONCLUSIONS Within the limitations of this study, both ARP using DBBM-C with and without socket sealing effectively preserved the width dimension of the alveolar ridge, with no significant difference in alveolar bone resorption. However, socket sealing appeared to enhance the stability of the bone graft and bone quality. CLINICAL RELEVANCE The use of DBBM-C for ARP seems to aid in volume maintenance as compared with spontaneous healing. Gingival sealing with an FGG can help maintain the width of the alveolar ridge. This clinical trial was not registered prior to participant recruitment and randomization. This study was registered at WHO ICTRP (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008266).
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Affiliation(s)
- Hyunjae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Hee-Seung Han
- Department of Periodontology, Korea University Anam Hospital, Seoul, Republic of Korea
| | - Shahram Ghanaati
- Clinic of Oro-Maxillofacial and Plastic Surgery, FORM-Lab, University Medical Center of the Goethe University, Frankfurt, Germany
| | - Homayoun H Zadeh
- VISTA Institute for Therapeutic Innovations, Woodland Hills, California, USA
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, Seoul, Republic of Korea.
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Bighetti ACC, Cestari TM, Paini S, Pomini KT, Buchaim DV, Ortiz RC, Júnior RSF, Barraviera B, Bullen IRFR, Garlet GP, Buchaim RL, de Assis GF. Efficacy and safety of a new heterologous fibrin biopolymer on socket bone healing after tooth extraction: An experimental pre-clinical study. J Clin Periodontol 2024; 51:1017-1033. [PMID: 38685818 DOI: 10.1111/jcpe.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/13/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
AIM To assess the efficacy of heterologous fibrin biopolymer (HFB) in promoting alveolar bone healing after tooth extraction in rats. MATERIALS AND METHODS The upper right incisors of 48 Wistar rats were extracted. Toothless sockets were filled with HFB (HFBG, n = 24) or blood clot (BCG, n = 24). The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric and immunohistochemical (for Runt-related transcription factor 2/Runx2 and tartrate-resistant acid phosphatase/TRAP) analyses on days 0, 7, 14 and 42 after extraction. RESULTS Socket volume remained similar between days 0 and 14 (69 ± 5.4 mm3), except in the BCG on day 14, when it was 10% lower (p = .043). Although the number of Runx2+ osteoblasts was high and similar in both groups (34 × 102 cells/mm2), the HFBG showed lower inflammatory process and osteoclast activity than BCG at 7 days. On day 14, the number of Runx2+ osteoblasts remained high and similar to the previous period in both groups. However, osteoclast activity increased. This increase was 55% lower in the HFBG than BCG. In the BCG, the presence of an inflammatory process and larger and numerous osteoclasts on day 14 led to resorption of the alveolar bone ridge and newly formed bone. On day 42, numbers of Runx2+ osteoblast and TRAP+ osteoclasts decreased dramatically in both groups. Although the BCG exhibited a more mature cortical bone formation, it exhibited a higher socket reduction (28.3 ± 6.67%) and smaller bone volume (37 ± 5.8 mm3) compared with HFBG (socket reduction of 14.8 ± 7.14% and total bone volume of 46 ± 5.4 mm3). CONCLUSIONS HFB effectively suppresses osteoclast activity and reduces alveolar bone resorption compared with blood clot, thus preventing three-dimensional bone loss, particularly during the early healing period. HFB emerges as a promising biopharmaceutical material for enhancing healing processes after tooth extraction.
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Affiliation(s)
| | - Tania Mary Cestari
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Suelen Paini
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Karina T Pomini
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
- Teaching and Research Coordination of the Medical School, University Center of Adamantina (UNI-FAI), Adamantina, Brazil
| | - Rafael Carneiro Ortiz
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rui Seabra Ferreira Júnior
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Izabel R F R Bullen
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo, Brazil
| | - Gerson F de Assis
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
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van Orten A, Goetz W, Bilhan H. Alveolar Ridge Preservation Using a Novel Species-Specific Collagen-Enriched Deproteinized Bovine Bone Mineral: Histological Evaluation of a Prospective Case Series. Bioengineering (Basel) 2024; 11:665. [PMID: 39061747 PMCID: PMC11273417 DOI: 10.3390/bioengineering11070665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/08/2024] [Accepted: 06/15/2024] [Indexed: 07/28/2024] Open
Abstract
In recent years, the significance of maintaining the alveolar ridge following tooth extractions has markedly increased. Alveolar ridge preservation (ARP) is a commonly utilized technique and a variety of bone substitute materials and biologics are applied in different combinations. For this purpose, a histological evaluation and the clinical necessity of subsequent guided bone regeneration (GBR) in delayed implantations were investigated in a prospective case series after ARP with a novel deproteinized bovine bone material (95%) in combination with a species-specific collagen (5%) (C-DBBM). Notably, block-form bone substitutes without porcine collagen are limited, and moreover, the availability of histological data on this material remains limited. Ten patients, each scheduled for tooth extraction and desiring future implantation, were included in this study. Following tooth extraction, ARP was performed using a block form of C-DBBM in conjunction with a double-folded bovine cross-linked collagen membrane (xCM). This membrane was openly exposed to the oral cavity and secured using a crisscross suture. After a healing period ranging from 130 to 319 days, guided trephine drilling was performed for implant insertion utilizing static computer-aided implant surgery (s-CAIS). Cores harvested from the area previously treated with ARP were histologically processed and examined. Guided bone regeneration (GBR) was not necessary for any of the implantations. Histological examination revealed the development of a lattice of cancellous bone trabeculae through appositional membranous osteogenesis at various stages surrounding C-DBBM granules as well as larger spongy or compact ossicles with minimal remnants. The clinical follow-up period ranged from 2.5 to 4.5 years, during which no biological or technical complications occurred. Within the limitations of this prospective case series, it can be concluded that ARP using this novel C-DBBM in combination with a bovine xCM could be a treatment option to avoid the need for subsequent GBR in delayed implantations with the opportunity of a bovine species-specific biomaterial chain.
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Affiliation(s)
- Andreas van Orten
- Private Dental Practice Do24, Dortmunder Str. 24–28, 45731 Waltrop, Germany;
| | - Werner Goetz
- Policlinic of Orthodontics, Centre for Dental Care, Basic Science Research in Oral Biology, Friedrich-Wilhelms University, Welschnonnenstr. 17, 53111 Bonn, Germany;
| | - Hakan Bilhan
- Department of Periodontology, School for Health Sciences, Witten/Herdecke University, Alfred-Herrhausen-Str. 45, 58448 Witten, Germany
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Menini M, Canullo L, Iacono R, Triestino A, Caponio VCA, Savadori P, Pesce P, Pedetta A, Guerra F. Effect of Different Graft Material Consistencies in the Treatment of Minimal Bone Dehiscence: A Retrospective Pilot Study. Dent J (Basel) 2024; 12:198. [PMID: 39056985 PMCID: PMC11275297 DOI: 10.3390/dj12070198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/10/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Among different therapeutic strategies proposed in the case of bone volume deficit, guided bone regeneration (GBR) is a consolidated surgical procedure. The objective of this study is to retrospectively evaluate the behavior of two bone grafts with different consistencies in the GBR procedure by measuring the volumetric tissue changes 1 year after surgery. For this retrospective analysis, 25 cases of GBR with simultaneous implant insertion were selected. A total of 13 were grafted with a porcine cortico-cancellous bone mix (CCBM group), and 12 were grafted with a pre-hydrated granulated cortico-cancellous bone mix of porcine origin blended with 20% TSV gel (Collagenated-CCBM). A collagen membrane was fixed to cover the bone defect. A total of 42 implants were placed with computer-guided surgery. Preoperative and 12-month postoperative digital impressions were used to evaluate dimensional changes. Student's t-test used for independent samples showed no statistically significant differences between the integrated distance (p = 0.995) and mean distance (p = 0.734). The mean integrated distance in the CCBM group was 41.80 (SD. 101.18) compared to a mean of 42.04 (SD. 66.71) in the Collagenated-CCBM group. Given the limitations of this study, in patients with peri-implant bone dehiscence, simple heterologous and collagenated heterologous cortico-cancellous bone grafts are suitable for filling the bone defect to promote bone regeneration, although further studies are needed.
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Affiliation(s)
- Maria Menini
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Luigi Canullo
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Roberta Iacono
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
| | | | - Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Viale Pinto 1, 7100 Foggia, Italy;
| | - Paolo Savadori
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Della Commenda, 10/12, 20122 Milan, Italy
- IRCCS Fondazione Cà Granda IRCCS Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genoa, Largo R. Benzi 10, 16132 Genoa, Italy; (M.M.); (L.C.); (P.P.)
| | - Andrea Pedetta
- Private Practice, Via Colledoro 41, 00034 Colleferro, Italy;
| | - Fabrizio Guerra
- Department of Oral and Maxillo-Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy; (R.I.); (F.G.)
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Fok MR, Jin L. Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices. J Dent 2024; 145:104986. [PMID: 38574844 DOI: 10.1016/j.jdent.2024.104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice. SOURCES AND STUDY SELECTION To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration. DATA 11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low. CONCLUSION This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored. CLINICAL SIGNIFICANCE By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China.
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
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Lin CY, Chiu MY, Kuo PY, Wang HL. Half- and full-grafting alveolar ridge preservation with different sealing materials: A three-arm randomized clinical trial. Clin Implant Dent Relat Res 2024; 26:651-662. [PMID: 38638057 DOI: 10.1111/cid.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/17/2024] [Accepted: 02/17/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE The objective of this study is to investigate the effect of different alveolar ridge preservation (ARP) approaches on bone resorption and their potential for facilitating implant placement. MATERIALS AND METHODS Patients who underwent one or two tooth extractions with a desire for restoration were included in the study. The participants were randomly assigned to one of three groups for ARP. The groups were as follows: (1) Half grafting of bovine bone mineral (DBBM-C) covered with non-resorbable dense polytetrafluoroethylene (dPTFE) membrane (Test 1 group); (2) Half grafting of bovine bone mineral (DBBM-C) covered with collagen membrane (Test 2 group); and (3) Full grafting with collagen membrane (DBBM-C + Collagen membrane) as the Control group. After 6-month healing period, the evaluation encompassed clinical, radiographic, implant-related outcomes, and the factors contributing to hard and soft tissue alterations. RESULTS Enrollment in this study comprised 56 patients. At the 6-month follow-up, radiographic analysis in computed beam computed tomography images was conducted for 18, 19, and 19 patients with 18, 20, and 20 tooth sites in Test 1, Test 2, and Control groups, respectively. Additionally, a total of 15, 17, and 17 patients with 15, 18, and 17 implants were evaluated. Based on radiographic analysis, all groups showed limited ridge resorption at 1 mm from crest horizontally (Test 1: 1.29 ± 1.37; Test 2: 1.07 ± 1.07; Control: 1.54 ± 1.33 mm, p = 0.328), while the Control group showed greater radiographic bone height gain in mid-crestal part vertically (Test 1: 0.11 ± 1.02; Test 2: 0.29 ± 0.83; Control: -0.46 ± 0.95 mm, p = 0.032). There were no significant intergroup differences in terms of keratinized mucosal width, bone density, insertion torque, and the need of additional bone graft. However, the use of a dPTFE membrane resulted in a significantly higher vertical mucosal thickness (Test 1: 2.67 ± 0.90; Test 2: 3.89 ± 1.08; Control: 2.41 ± 0.51 mm, p < 0.001). CONCLUSIONS The study showed comparable dimensional preservation with limited vertical shrinkage, while thin buccal bone plate, non-molar sites, and large discrepancy between buccal and palatal/lingual height may contribute to greater shrinkage. Thicker mucosa with dPTFE membrane required further investigation for interpretation. CLINICAL TRIAL REGISTRATION NUMBER NCT06049823. This clinical trial was not registered prior to participant recruitment and randomization.
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Affiliation(s)
- Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
- Chang Gung University, Taoyuan City, Taiwan
| | - Meng-Yao Chiu
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Pe-Yi Kuo
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Wong I, Zhang Z, Dang X, Yu X, Lin X, Li Y, Deng F, Xu R. Single missing molar with wide mesiodistal length restored using a single or double implant-supported crown: A self-controlled case report and 3D finite element analysis. J Prosthodont Res 2024:JPR_D_23_00278. [PMID: 38644231 DOI: 10.2186/jpr.jpr_d_23_00278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
PURPOSE Based on a self-controlled case, this study evaluated the finite element analysis (FEA) results of a single missing molar with wide mesiodistal length (MDL) restored by a single or double implant-supported crown. METHODS A case of a missing bilateral mandibular first molar with wide MDL was restored using a single or double implant-supported crown. The implant survival and peri-implant bone were compared. FEA was conducted in coordination with the case using eight models with different MDLs (12, 13, 14, and 15 mm). Von Mises stress was calculated in the FEA to evaluate the biomechanical responses of the implants under increasing vertical and lateral loading, including the stress values of the implant, abutment, screw, crown, and cortical bone. RESULTS The restorations on the left and right sides supported by double implants have been used for 6 and 12 years, respectively, and so far have shown excellent osseointegration radiographically.The von Mises stress calculated in the FEA showed that when the MDL was >14 mm, both the bone and prosthetic components bore more stress in the single implant-supported strategy. The strength was 188.62-201.37 MPa and 201.85-215.9 MPa when the MDL was 14 mm and 15 mm, respectively, which significantly exceeded the allowable yield stress (180 MPa). CONCLUSIONS Compared with the single implant-supported crown, the double implant-supported crown reduced peri-implant bone stress and produced a more appropriate stress transfer model at the implant-bone interface when the MDL of the single missing molar was ≥14 mm.
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Affiliation(s)
- Iohong Wong
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Zhengchuan Zhang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaobing Dang
- Guangdong Janus Biotechnology Co., Ltd., Guangzhou, China
- Guangdong CAS Angels Biotechnology Co., Ltd., Foshan, China
| | - Xiaoran Yu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xiaoxuan Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yiming Li
- Department of Stomatology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Feilong Deng
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ruogu Xu
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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10
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Mohammadi I, Najafi A, Razavi SM, Khazaei S, Tajmiri G. Effect of buccal fat autotransplantation on improving the alveolar socket bone regeneration: An in-vivo study. Heliyon 2024; 10:e28131. [PMID: 38524537 PMCID: PMC10958428 DOI: 10.1016/j.heliyon.2024.e28131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background There are various materials used for socket preservation following dental extraction. The aim of the present animal study was to histologically investigate the efficacy of buccal fat autotransplantation on alveolar bone regeneration following dental extraction. Study design In this prospective, double-blind laboratory experiment with a split-mouth design, 16 mandibular second premolar teeth in eight beagle dogs were extracted, and half of the extraction sockets were randomly filled using buccal fat autotransplantation. Other samples were left untouched to heal normally by the formed blood clot. Buccal fat autotransplantation was the primary predictor variable, and the type and amount of newly formed bone were the primary outcome variables. Assessment methods were the H & E coloring technique and histomorphometric evaluation. The significance level was set at 0.05, and data was subjected to Chi-Square and Wilcoxon signed-rank tests using SAS statistical software version 9.4. Results From the total number of 16 samples in 8 dogs, 50% of the samples in the intervention group represented inflammation with lower intensity compared to 33% in the control group; however, this difference was not considered statistically significant (Chi-Square test, P-value = 0.55). Wilcoxon test results showed no statistically significant difference between the two groups regarding the mean amount of total bone formation (Z = 0.00, P-value = 1.00). Conclusion It was inferred from the outcomes of the present study that when compared to the normal healing of the socket, buccal fat autotransplantation did not represent with superior outcome concerning the socket bone regeneration.
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Affiliation(s)
- Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Najafi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saber Khazaei
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Fok MR, Pelekos G, Jin L. Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:1198. [PMID: 38592010 PMCID: PMC10931845 DOI: 10.3390/jcm13051198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
AIM To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. METHODS An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. RESULTS Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. CONCLUSIONS Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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12
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Jeanneau C, Catherine JH, Giraud T, Lan R, About I. The Added Value of a Collagenated Thermosensitive Bone Substitute as a Scaffold for Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2024; 17:625. [PMID: 38591482 PMCID: PMC10856128 DOI: 10.3390/ma17030625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 04/10/2024]
Abstract
A pre-hydrated thermosensitive collagenated biomaterial which sets at body temperature and maintains the space of the missing alveolar bone volume, OsteoBiol GTO® (GTO), has been released as a bone substitute. This study was designed to check its angiogenic and osteogenic potentials compared to OsteoBiol Gen-Os® (Gen-Os) and Geistlich Bio-Oss® (Bio-Oss). Samples of materials were incubated in culture media to obtain the extracts. Collagen release was measured in the extracts, which were used to investigate human periodontal ligament (hPDL) cell proliferation (MTT), colonization (Scratch assays) and growth factor release (ELISA). The effects on endothelial cell proliferation (MTT) and organization (Matrigel® assays) were also studied. Finally, endothelial and mesenchymal Stem Cell (hMSC) recruitment (Boyden Chambers) were investigated, and hMSC Alkaline Phosphatase (ALP) activity was measured. A higher collagen concentration was found in GTO extract, which led to significantly higher hPDL cell proliferation/colonization. All materials increased VEGF/FGF-2 growth factor secretion, endothelial cell recruitment, proliferation, and organization, but the increase was highest with GTO. All materials increased hMSC recruitment and ALP activity. However, the increase was highest with collagenated GTO and Gen-Os, which enhanced C5a and BMP-2 secretion. Overall, GTO has higher angiogenic/osteogenic potentials than the collagenated Gen-Os and the anorganic Bio-Oss. It provides a suitable scaffold for endothelial and mesenchymal stem cell recruitment, which represent essential bone regeneration requirements.
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Affiliation(s)
| | - Jean-Hugues Catherine
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Thomas Giraud
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Romain Lan
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
- Aix-Marseille University, CNRS, EFS, ADES, 13385 Marseille, France
| | - Imad About
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
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13
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Ruggiero T, Carossa M, Camisassa D, Bezzi M, Rivetti G, Nobile V, Pol R. Hyaluronic Acid Treatment of Post-Extraction Tooth Socket Healing in Subjects with Diabetes Mellitus Type 2: A Randomized Split-Mouth Controlled Study. J Clin Med 2024; 13:452. [PMID: 38256586 PMCID: PMC10816872 DOI: 10.3390/jcm13020452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/03/2024] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
The present study aimed to investigate the effect of HA in improving post-extraction socket healing in subjects with diabetes mellitus (DM) type 2. DM patients requiring bilateral extraction of the homologous teeth were visited at the C.I.R. Dental School, University of Turin. After the extractions, one site was randomly assigned to the test (T) group (postoperative application of HA), while the other site was assigned to the control group (C, no treatment). Patients were then followed after 3, 7, 14, and 21 days. Primary outcomes were the healing index and socket closure. The Mann-Whitney test or the Student's t-test was used for nonparametric or parametric distributed variables. The chi-square test was used if the estimated data in any given cell were >5, otherwise the Fisher test was adopted. A p < 0.05 was considered statistically significant. In total, 36 patients (n = 36) were enrolled in this study for a total of 72 extractions (n = 72). Sockets treated with HA showed significantly (p < 0.05) better healing index values at day 7 (p = 0.01) and at day 14 (p = 0.02) and significantly (p < 0.05) better socket closure values at day 3 (p = 0.04), day 7 (p = 0.001) and day 14 (p = 0.001) compared to the C group. Based on the clinical results, HA seems to be promising in improving the timing and the quality of post-extractive wound healing in DM patients. Further clinical research, as well as histological investigations, are required to confirm the results.
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Affiliation(s)
- Tiziana Ruggiero
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
- Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Massimo Carossa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Davide Camisassa
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Marta Bezzi
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Giulia Rivetti
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
| | - Vincenzo Nobile
- Complife Italia S.r.l., Via Mons. Angelini 21, 27028 San Martino Siccomario, Italy
| | - Renato Pol
- C.I.R. Dental School, Department of Surgical Sciences, University of Turin, 10126 Turin, Italy
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14
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Chou YH, Chen YJ, Pan CP, Yen WH, Liu PF, Feng IJ, Lin YC, Hu KF. Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study. Clin Implant Dent Relat Res 2023; 25:1000-1007. [PMID: 37424382 DOI: 10.1111/cid.13243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis. MATERIALS AND METHODS This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05. RESULTS The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI. CONCLUSION ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.
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Affiliation(s)
- Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Jun Chen
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Pin Pan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsi Yen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Fang Hu
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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15
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Zhang J, Wang J, You J, Qin X, Chen H, Hu X, Zhao Y, Xia Y. Surface demineralized freeze-dried bone allograft followed by reimplantation in a failed mandibular dental implant. Regen Biomater 2023; 11:rbad102. [PMID: 38173777 PMCID: PMC10761198 DOI: 10.1093/rb/rbad102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/24/2023] [Accepted: 11/03/2023] [Indexed: 01/05/2024] Open
Abstract
The removal of a failed implant with high torque causes significant damage to the surrounding tissue, compromising bone regeneration and subsequent osseointegration in the defect area. Here, we report a case of carrier screw fracture followed by immediate implant removal, bone grafting and delayed reimplantation. A dental implant with a fractured central carrier screw was removed using the bur-forceps technique. The resulting three-wall bone defect was filled with granular surface demineralized freeze-dried bone allograft (SD-FDBA). Cone-beam computerized tomography was performed at 1 week, 6 months and 15 months postoperatively and standardized for quantitative evaluation. The alveolar bone width and height at 15 months post-surgery were about 91% of the original values, with a slightly lower bone density, calculated using the gray value ratio. The graft site was reopened and was found to be completely healed with dense and vascularized bone along with some residual bone graft. Reimplantation followed by restoration was performed 8 months later. The quality of regenerated bone following SD-FDBA grafting was adequate for osseointegration and long-term implant success. The excellent osteogenic properties of SD-FDBA are attributed to its human origin, cortical bone-like structure, partly demineralized surfaces and bone morphogenetic protein-2-containing nature. Further investigation with more cases and longer follow-up was required to confirm the final clinical effect.
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Affiliation(s)
- Jing Zhang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
| | - Jie Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
| | - Jiayi You
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
| | - Xuan Qin
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
| | - Huimin Chen
- Department of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
| | - Xiantong Hu
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, 100048, PR China
- Beijing Engineering Research Center of Orthopedics Implants, Beijing 100048, PR China
- State Key Laboratory of Military Stomatology, Xi'an 710032, PR China
| | - Yantao Zhao
- Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing, 100048, PR China
- Beijing Engineering Research Center of Orthopedics Implants, Beijing 100048, PR China
- State Key Laboratory of Military Stomatology, Xi'an 710032, PR China
| | - Yang Xia
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
- Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Nanjing, Jiangsu 210029, PR China
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16
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Xu X, Peng D, Zhou B, Lin K, Wang S, Zhao W, Zheng M, Yang J, Guo J. Demineralized dentin matrix promotes gingival healing in alveolar ridge preservation of premolars extracted for orthodontic reason: a split-mouth study. Front Endocrinol (Lausanne) 2023; 14:1281649. [PMID: 37929019 PMCID: PMC10622762 DOI: 10.3389/fendo.2023.1281649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objective The purpose of this study was to prospectively evaluate the efficacy of a demineralized dentin matrix (DDM) in decreasing the initial inflammatory response of the gingiva and facilitating the repair and regeneration of soft tissue in alveolar ridge preservation. Methods This clinical study employed a split-mouth design. Fourteen patients with a total of forty-four sites underwent extraction and alveolar ridge preservation (ARP) procedures. A Bilaterally symmetrical extraction operation were conducted on the premolars of each patient. The experimental group received DDM as a graft material for ARP, while the control group underwent natural healing. Within the first month postoperatively, the pain condition, color, and swelling status of the extraction sites were initially assessed at different time points Subsequently, measurements were taken for buccal gingival margin height, buccal-lingual width, extraction socket contour, and the extraction socket area and healing rate were digitally measured. Additionally, Alcian Blue staining was used for histological evaluation of the content during alveolar socket healing. Results Both groups experienced uneventful healing, with no adverse reactions observed at any of the extraction sites. The differences in VAS pain scores between the two groups postoperatively were not statistically significant. In the early stage of gingival tissue healing (3 days postoperatively), there were statistically significant differences in gingival condition and buccal gingival margin height between the two groups. In the later stage of gingival tissue healing (7, 14, and 30 days postoperatively), there were statistically significant differences in buccal-lingual width, extraction socket healing area, and healing rate between the two groups. Furthermore, the histological results from Alcian Blue staining suggested that the experimental group may play a significant role in promoting gingival tissue healing, possibly by regulating inflammatory responses when compared to the control group. Conclusion The application of DDM in alveolar ridge preservation has been found to diminish initial gingival inflammation after tooth extraction. Additionally, it has shown the ability to accelerate early gingival soft tissue healing and preserve its anatomical contour. Clinical trial registration chictr.org.cn, identifier ChiCTR2100050650.
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Affiliation(s)
- Xiaofeng Xu
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Affiliated Hospital of Putian University, Putian, China
| | - Dongsheng Peng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Bowei Zhou
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kaijin Lin
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Siyi Wang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Wei Zhao
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Minqian Zheng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jin Yang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jianbin Guo
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
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17
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Udeabor SE, Heselich A, Al-Maawi S, Alqahtani AF, Sader R, Ghanaati S. Current Knowledge on the Healing of the Extraction Socket: A Narrative Review. Bioengineering (Basel) 2023; 10:1145. [PMID: 37892875 PMCID: PMC10604628 DOI: 10.3390/bioengineering10101145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/31/2023] [Accepted: 09/27/2023] [Indexed: 10/29/2023] Open
Abstract
The concept of extraction socket healing has been severally researched and reported over the years, since tooth extraction remains one of the most common procedures performed in the dental clinic. Understanding this healing process is of utmost importance because the outcome has a direct bearing on future prosthetic rehabilitation and, by extension, on patients' esthetics and masticatory function, among others. This mini review, therefore, summarized the current knowledge on the different stages of socket healing, including the biologic and clinical events that occur following tooth extraction up until the complete closure of the socket. Additionally, the modeling of the alveolar bone/process post extraction, and the resultant dimensional changes that, altogether, shape the bone, were reviewed and documented. The effects of various socket preservation interventions to mitigate these dimensional changes, and therefore preserve the alveolar process in a condition suitable for future prosthetic rehabilitation, were highlighted. Finally, a review of some of the factors that influence the entire process was also carried out.
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Affiliation(s)
- Samuel E. Udeabor
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Khalid University, Abha 62529, Saudi Arabia;
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery & Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany; (A.H.); (S.A.-M.); (R.S.)
| | - Anja Heselich
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery & Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany; (A.H.); (S.A.-M.); (R.S.)
| | - Sarah Al-Maawi
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery & Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany; (A.H.); (S.A.-M.); (R.S.)
| | - Ali F. Alqahtani
- Department of Periodontics and Community Dentistry, King Khalid University, Abha 62529, Saudi Arabia;
| | - Robert Sader
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery & Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany; (A.H.); (S.A.-M.); (R.S.)
| | - Shahram Ghanaati
- Department of Oral, Cranio-Maxillofacial, and Facial Plastic Surgery & Frankfurt Orofacial Regenerative Medicine (FORM) Lab, Johann Wolfgang Goethe University, 60590 Frankfurt am Main, Germany; (A.H.); (S.A.-M.); (R.S.)
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Li J, Zhao Y, Chen S, Wang S, Zhong W, Zhang Q. Research Hotspots and Trends of Bone Xenograft in Clinical Procedures: A Bibliometric and Visual Analysis of the Past Decade. Bioengineering (Basel) 2023; 10:929. [PMID: 37627814 PMCID: PMC10451653 DOI: 10.3390/bioengineering10080929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Bone defect therapy is a common clinical challenge for orthopedic and clinical physicians worldwide, and the therapeutic effect affects the physiological function and healthy life quality of millions of patients. Compared with traditional autogenous bone transplants, bone xenografts are attracting attention due to their advantages of unlimited availability and avoidance of secondary damage. However, there is currently a lack of bibliometric analysis on bone xenograft. This study aimed to use bibliometric methods to analyze the literature on bone xenograft from 2013 to 2023, to explore the current status, hotspots, and future trends of research in this field, and to promote its development and progress. METHODS Using the Web of Science Core Collection database, we retrieved and collected publication data related to xenogeneic bone grafting materials worldwide from January 2013 to March 2023. Origin (2021), CiteSpace (6.2.R2 standard), and an online bibliometric platform were used for bibliometric analysis and data visualization. RESULTS A total of 3395 documents were retrieved, and 686 eligible papers were selected. The country and institutions with the highest number of publications and centrality were the United States (125 papers, centrality = 0.44) and the University of Zurich (29 papers, centrality = 0.28), respectively. The most cited author was Araujo MG (163 times), and the author with the most significant centrality was Froum SJ (centrality = 0.09). The main keyword clusters were "tissue engineering", "sinus floor elevation", "dental implants", "tooth extraction", and "bone substitutes". The most significant bursting keywords in the last three years were "platelet rich fibrin". CONCLUSIONS Research on bone xenograft is steadily growing and will continue to rise. Currently, research hotspots and directions are mainly focused on dental implants related to bone-augmentation techniques and bone tissue engineering. In the future, research hotspots and directions may focus on decellularization technology and investigations involving platelet-rich fibrin.
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Affiliation(s)
- Jiayue Li
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Yujue Zhao
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Shili Chen
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Simin Wang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Wen Zhong
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Qing Zhang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 51081 BT Amsterdam, The Netherlands
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19
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Caponio VCA, Baca-González L, González-Serrano J, Torres J, López-Pintor RM. Effect of the use of platelet concentrates on new bone formation in alveolar ridge preservation: a systematic review, meta-analysis, and trial sequential analysis. Clin Oral Investig 2023; 27:4131-4146. [PMID: 37439800 PMCID: PMC10415431 DOI: 10.1007/s00784-023-05126-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 06/20/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES To investigate the histomorphometric changes occurring in alveolar ridge preservation (ARP) based on the use of different plasma concentrates (PCs) in randomized clinical trials (RCT). There is controversy whether the placement of PCs in ARP is effective in the formation of new bone. MATERIALS AND METHODS A systematic review search was conducted in PubMed, Scopus, Web of Science, and Cochrane Database to answer the PICO question: In patients undergoing tooth extraction followed by ARP, do PCs alone in the post-extraction socket in comparison with spontaneous healing improve new vital bone formation percentage in histomorphometric analysis after more than 10 weeks? The risk of bias was assessed and a meta-analysis was conducted. RESULTS Of 3809 results, 8 studies were considered suitable for inclusion. A total of 255 teeth were extracted in 250 patients. Regarding the PCs used, ARP was performed with platelet- and leukocyte-rich fibrin (L-PRF) in 120 sockets, and with pure platelet-rich plasma (P-PRP) in 31 sockets and 104 sockets were controlled. PCs improved new bone formation in ARP with respect to the spontaneous healing group (SMD = 1.77, 95%C.I. = 1.47-2.06, p-value < 000.1). There were no differences between the different PCs (L-PRF and P-PRP). CONCLUSION The results of this meta-analysis support the efficacy of the use of PCs in new bone formation in ARP. With respect to the different types of PCs studied, no differences were observed. CLINICAL RELEVANCE When planning implant surgery after tooth extraction, treatment with PCs should be considered for ARP. Any PC increases new bone formation compared to spontaneous healing.
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Affiliation(s)
- Vito Carlo Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Laura Baca-González
- Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - José González-Serrano
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain.
- Departamento de Especialidades Clínicas Odontológicas, Facultad de Odontología, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Jesús Torres
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
| | - Rosa María López-Pintor
- ORALMED Research Group, Department of Dental Clinical Specialties, School of Dentistry, Complutense University, Madrid, Spain
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20
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Blašković M, Blašković D, Hangyasi DB, Peloza OC, Tomas M, Čandrlić M, Rider P, Mang B, Kačarević ŽP, Trajkovski B. Evaluation between Biodegradable Magnesium Metal GBR Membrane and Bovine Graft with or without Hyaluronate. MEMBRANES 2023; 13:691. [PMID: 37623752 PMCID: PMC10456676 DOI: 10.3390/membranes13080691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/12/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
Bone substitutes and barrier membranes are widely used in dental regeneration procedures. New materials are constantly being developed to provide the most optimal surgical outcomes. One of these developments is the addition of hyaluronate (HA) to the bovine bone graft, which has beneficial wound healing and handling properties. However, an acidic environment that is potentially produced by the HA is known to increase the degradation of magnesium metal. The aim of this study was to evaluate the potential risk for the addition of HA to the bovine bone graft on the degradation rate and hence the efficacy of a new biodegradable magnesium metal GBR membrane. pH and conductivity measurements were made in vitro for samples placed in phosphate-buffered solutions. These in vitro tests showed that the combination of the bovine graft with HA resulted in an alkaline environment for the concentrations that were used. The combination was also tested in a clinical setting. The use of the magnesium metal membrane in combination with the tested grafting materials achieved successful treatment in these patients and no adverse effects were observed in vivo for regenerative treatments with or without HA. Magnesium based biodegradable GBR membranes can be safely used in combination with bovine graft with or without hyaluronate.
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Affiliation(s)
- Marko Blašković
- Department of Oral Surgery, Faculty of Dental Medicine Rijeka, University of Rijeka, Krešimirova 40/42, 51000 Rijeka, Croatia;
- Dental Clinic Dr. Blašković, Linićeva ulica 16, 51000 Rijeka, Croatia;
| | - Dorotea Blašković
- Dental Clinic Dr. Blašković, Linićeva ulica 16, 51000 Rijeka, Croatia;
| | | | - Olga Cvijanović Peloza
- Department of Anatomy, Faculty of Medicine, University of Rijeka, Braće Branchetta 20/1, 51000 Rijeka, Croatia;
| | - Matej Tomas
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia; (M.T.); (M.Č.)
| | - Marija Čandrlić
- Department of Dental Medicine, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia; (M.T.); (M.Č.)
| | - Patrick Rider
- Botiss Biomaterials, Ullsteinstrasse 108, 12109 Berlin, Germany; (P.R.); (B.M.)
| | - Berit Mang
- Botiss Biomaterials, Ullsteinstrasse 108, 12109 Berlin, Germany; (P.R.); (B.M.)
| | - Željka Perić Kačarević
- Department of Anatomy, Embriology, Pathology and Pathohistology, Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, 31000 Osijek, Croatia
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21
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De Angelis N, Bagnasco F, Amaroli A. Bone Regeneration: Overview and Future Trends. J Clin Med 2023; 12:4529. [PMID: 37445566 DOI: 10.3390/jcm12134529] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
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Affiliation(s)
- Nicola De Angelis
- Unit of Implant and Prosthodontics, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
- Faculty of Dentistry Department of Periodontology, Trisakti University, Jakarta 11440, Indonesia
- Faculty of Dentistry, Tunku Abdul Raman University (UTAR), Sungai Buloh 31900, Malaysia
| | - Francesco Bagnasco
- Unit of Implant and Prosthodontics, Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, 16132 Genoa, Italy
| | - Andrea Amaroli
- Department of Earth, Environmental and Life Sciences (DISTAV), University of Genoa, 16132 Genoa, Italy
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Vuylsteke F, Cosyn J, Tytgat M, Eghbali A. The Effect of Terra-Cortril as Local Pain Medication on the Healing Process of a Fresh Extraction Socket: A Retrospective Cohort Study. J Clin Med 2023; 12:4372. [PMID: 37445407 DOI: 10.3390/jcm12134372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/07/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
(1) Background: Use of Terra-Cortril may reduce pain and discomfort after tooth extraction. It is widely used among dentists, especially for third molar extraction and for treatment of dry socket. Only few case reports described unsuccessful healing with formation of myospherulosis. (2) Aim: The primary objective of this retrospective cohort study was to compare the occurrence of unsuccessful healing between extraction sockets locally treated with Terra-Cortril (TC) (exposure cohort) and extraction sockets subjected to unassisted healing (non-exposure cohort). The assessment of the three-dimensional morphology of the bone was a secondary objective. (3) Material and methods: The records of patients who had one or more extractions between 1 January 2020 and 1 July 2021 followed by implant placement in one private practice were retrieved and data were extracted. At the time of implant placement, practitioners established, both clinically and radiographically, if the healing was successful or unsuccessful. Explanatory demographic as well as clinical variables were extracted from patient files, checked and supplemented by contacting patients in cases of missing data. (4) Results: 69 patients were included who had, in total, 99 extractions. The exposure cohort included 55 sites, while the non-exposure cohort included 44 sites. A total of 56 sites demonstrated successful healing, and 53 showed unsuccessful healing. The regression model identified TC as a significant predictor (p = 0.014) for unsuccessful healing with an odds ratio of 2.86. Sites treated with Terra-Cortril had a significantly greater bone defect at level -1 mm, level -3 mm, and level -5 mm from the bone crest, and significantly greater maximal vertical and horizontal bone defects. At sites where Terra-Cortril was used, significantly more surgical consequences were reported (70.91% vs. 18.18%, p < 0.001). (5) Conclusions: fresh extraction sockets treated with Terra-Cortril increased the likelihood of unsuccessful healing with an odds ratio of 2.86. The greater defect size leads to significantly more limitations when planning implants at sites previously treated with TC.
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Affiliation(s)
- Fauve Vuylsteke
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium
| | - Manon Tytgat
- Department of Periodontology and Oral Implantology, Faculty of Medicine and Health Sciences, Oral Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium
| | - Aryan Eghbali
- Private Practice Orthoparocare, Mankevosstraat 5, B-1860 Meise, Belgium
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23
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Zigmantavičius J, Kilinskaitė G, Leketas M. Dimensional Changes of Buccal Bone after Immediate Implantation Using Different Grafting Materials: A Systematic Review. ANNALS OF DENTAL SPECIALTY 2023. [DOI: 10.51847/vykvdvpn8e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
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Pesce P, Mijiritsky E, Canullo L, Menini M, Caponio VCA, Grassi A, Gobbato L, Baldi D. An Analysis of Different Techniques Used to Seal Post-Extractive Sites—A Preliminary Report. Dent J (Basel) 2022; 10:dj10100189. [PMID: 36285999 PMCID: PMC9600503 DOI: 10.3390/dj10100189] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Bone grafting in post-extractive site improves tissue regeneration. Soft tissue sealing of the grafted post-extractive alveolus is supposed to limit microbiological contamination from the oral cavity and to stabilize the coagulum. Several techniques are presented in the literature to reach this goal using different heterologous matrices or autogenous grafts. In addition, recently, a technique based on the use of granulation tissue in the post-extractive alveolus has been proposed. Aim: To compare the effect of different graft sealing approaches in post-extractive sites by qualitatively evaluating their healing process. Materials and Methods: This retrospective investigation included 30 patients requiring post-extractive site regeneration in the aesthetic area. Post-extractive sites were regenerated using a bovine bone matrix and patients were divided into three groups (10 patients in each group) according to the material used to seal the alveolar socket. In the UD group, the granulation tissue was used to seal the defect; in the PC group, epithelial-connective soft tissue graft was used, and in the COLL group, a collagen-based membrane was employed. Images of the post-extractive sites at different follow-up periods (2 and 12 weeks) were taken and the healing process was blindly evaluated by two independent practitioners. The Healing Index (HI) by Landry, Turnbull and Howley was used to assess the quality of the healing process. The combination of presence/absence of five clinical criteria defines an HI ranging from 1 (very poor) to 5 (excellent). Patients’ clinical-pathological variables were recorded. One-way ANOVA was used to explore the dependence of HI on the different socket preservation protocols. Results: Based on clinical-pathological characteristics of the included patients, there were no statistically significant differences among the different sealing techniques. At the 2-week follow-up appointment, HI did not differ among the socket preservation protocols evaluated. Moreover, smoking status and reason for extraction did not influence the HI among the three groups (two-way ANOVA p-value = 0.686, p-value = 0.248 respectively). At the 2-week follow-up appointment, HI was significantly different among the socket preservation protocols investigated. Specifically, the group undergoing collagen-based socket preservation procedure reported the highest HI, compared to the other two techniques (COLL mean 4.60 ± 0.5; PC mean 3.5 ± 1.2; UD mean 3.4 ± 0.5, one-way ANOVA p-value 0.006). Conclusions: The use of collagen porcine membranes may represent a suitable option to improve the patient healing process in grafted post-extractive sites together with reducing the surgical intervention time compared to alternative sealing techniques.
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Affiliation(s)
- Paolo Pesce
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | - Eitan Mijiritsky
- Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6139001, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Luigi Canullo
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | - Maria Menini
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
| | | | | | | | - Domenico Baldi
- Department of Surgical Sciences, University of Genova, 16100 Genoa, Italy
- Correspondence:
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Li J, Sheng Z, Sun J, Wang R, Yu X. Characterizations of alveolar repair after mandibular second molar extraction: an experimental study in rats. J Appl Oral Sci 2022; 30:e20220010. [PMID: 35830122 PMCID: PMC9275398 DOI: 10.1590/1678-7757-2022-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/03/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Characterizations of rat mandibular second molar extraction socket with significantly different buccal and lingual alveolar ridge width remain unclear. OBJECTIVE To observe alterations in the alveolar ridge after extraction of mandibular second molars, and to examine processes of alveolar socket healing in an experimental model of alveolar ridge absorption and preservation. METHODOLOGY Eighteen Wistar rats were included and divided into six groups regarding healing time in the study. Bilateral mandibular second molars were extracted. The rats with tooth extraction sockets took 0, 1.5, 2, 3, 4 and 8 weeks of healing. Histological observation, tartrate-resistant acidic phosphatase (TRAP) staining, Masson's trichrome staining, immunohistochemical staining and micro-computed tomography (micro-CT) were applied to estimate alterations in the alveolar ridge. RESULTS Different buccal and lingual alveolar ridge width led to different height loss. Lingual wall height (LH) decreased significantly two weeks after tooth extraction. Buccal wall height rarely reduced its higher ridge width. From two to eight weeks after extraction, bone volume (BV/TV), density (BMD), and trabecular thickness (Tb.Th) progressively increased in the alveolar socket, which gradually decreased in Tb.Sp and Tb.N. LH showed no significant change during the same period. Osteogenic marker OCN and OPN increased during bone repair from two to eight weeks. The reduced height of the lingual wall of the tooth extraction socket was rarely repaired in the later repair stage. Osteoclast activity led to absorption of the alveolar ridge of the alveolar bone wall within two weeks after operation. We observed positive expression of EMMPRIN and MMP-9 in osteoclasts that participated in the absorption of the spire region. CONCLUSION Extraction of rat mandibular second molars may help the study of alveolar ridge absorption and preservation. The EMMPRIN-MMP-9 pathway may be a candidate for further study on attenuating bone resorption after tooth extraction.
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Affiliation(s)
- Jianbin Li
- Binzhou Medical College, School of Stomatology, Shandong, China.,Central Laboratory of Jinan Stomatological Hospital, Jinan Key Laboratory of Oral Tissue Regeneration, Department of Endodontics, Shandong Province, China
| | - Zhenxian Sheng
- Binzhou Medical College, School of Stomatology, Shandong, China.,Central Laboratory of Jinan Stomatological Hospital, Jinan Key Laboratory of Oral Tissue Regeneration, Department of Endodontics, Shandong Province, China
| | - Jing Sun
- Central Laboratory of Jinan Stomatological Hospital, Jinan Key Laboratory of Oral Tissue Regeneration, Department of Periodontology, Shandong Province, China
| | - Ronglin Wang
- Central Laboratory of Jinan Stomatological Hospital, Jinan Key Laboratory of Oral Tissue Regeneration, Department of Prosthodontics, Shandong Province, China
| | - Xijiao Yu
- Central Laboratory of Jinan Stomatological Hospital, Jinan Key Laboratory of Oral Tissue Regeneration, Department of Endodontics, Shandong Province, China
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