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Gadzella TJ, Westover L, Addison O, Romanyk DL. Inverse finite element analysis for an axisymmetric model of vertical tooth extraction. J Mech Behav Biomed Mater 2024; 157:106641. [PMID: 38941913 DOI: 10.1016/j.jmbbm.2024.106641] [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: 02/23/2024] [Revised: 06/13/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVE Tooth extraction is a common clinical procedure with biomechanical factors that can directly influence patient outcomes. Recent development in atraumatic extraction techniques have endeavoured to improve treatment outcomes, but the characterization of extraction biomechanics is sparse. An axisymmetric inverse finite element (FE) approach is presented to represent the biomechanics of vertical atraumatic tooth extraction in an ex-vivo swine model. METHODS Geometry and boundary conditions from the model are determined to match the extraction of swine incisors in a self-aligning ex vivo extraction experiment. Material parameters for the periodontal ligament (PDL) model are determined by solving an inverse FE problem using clusters of data obtained from 10 highly-controlled mechanical experiments. A seven-parameter visco-hyperelastic damage model, based on an Arruda-Boyce framework, is used for curve fitting. Three loading schemes were fit to obtain a common set of material parameters. RESULTS The inverse FE results demonstrate good predictions for overall force-time curve shape, peak force, and time to peak force. The fit model parameters are sufficiently consistent across all three cases that a coefficient-averaged model was taken that compares well to all three cases. Notably, the initial modulus ,u, converged across trials to an average value of 0.472 MPa with an average viscoelastic constant g of 0.561. CONCLUSIONS The presented model is found to have consistent parameters across loading cases. The capability of this model to represent the fundamental mechanical characteristics of the dental complex during vertical extraction loading is a significant advancement in the modelling of extraction procedures. Future work will focus on verifying the model as a predictive design tool for assessing new loading schemes in addition to investigating its applications to subject-specific problems.
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Affiliation(s)
- Timothy J Gadzella
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada
| | - Lindsey Westover
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada
| | - Owen Addison
- University of Alberta, School of Dentistry, Edmonton, Canada; King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Kent, UK
| | - Dan L Romanyk
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada; University of Alberta, School of Dentistry, Edmonton, Canada.
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Beldhi M, Penmetsa GS, Gottumukkala SNVS, Ramesh KSV, Kumar P M, Manchala B. Evaluation and comparison of autologous particulate dentin with demineralized freeze dried bone allograft in ridge preservation procedures - a prospective clinical study. Clin Oral Investig 2024; 28:492. [PMID: 39167267 DOI: 10.1007/s00784-024-05861-6] [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: 05/31/2024] [Accepted: 07/29/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVES To compare effectiveness of Autologous Particulate Dentin (APD) with Demineralized Freeze-Dried Bone Allograft (DFDBA) in ridge preservation, using radiographic and clinical parameters. MATERIALS AND METHODS Thirty subjects with indication of mandibular posterior teeth extraction were randomly assigned to either test or control group. After atraumatic extraction, ridge preservation was performed using APD or DFDBA mixed with i-PRF in test and control groups respectively. Both groups had sockets sealed with A-PRF membrane. Clinical parameters (plaque, gingival and healing indices) and radiographic parameters (vertical ridge height, horizontal ridge width) were assessed at baseline and 6 months using CBCT. Statistical analysis was performed using an independent t-test to compare clinical and radiographic parameters between the groups. RESULTS Both groups had significant decreases in ridge dimensions over 6 months (p < 0.001). The test group showed less reduction in ridge dimensions than control group at 6 months (p < 0.001). Mean change in vertical height was not significant (1.37 ± 1.32, 1.7311 ± 0.563), but in horizontal ridge width (1.3120 ± 1.13, 1.8093 ± 1.16) was significantly different between test and control groups respectively. There was no statistical difference in clinical parameters between the groups at 6 months (p > 0.001). CONCLUSIONS APD grafts resulted in significant improvements in radiographic parameters, specifically in vertical ridge height and horizontal ridge width, compared to DFDBA group. CLINICAL RELEVANCE Autologous particulate dentin is a promising, versatile substitute for regenerative procedures. While more research on its long-term efficacy and application is needed, current evidence suggests it could significantly improve patient care and outcomes.
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Affiliation(s)
- Manisha Beldhi
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India
| | - Gautami S Penmetsa
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India.
| | - Sruthima N V S Gottumukkala
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India
| | - K S V Ramesh
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India
| | - Mohan Kumar P
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India
| | - Bhavya Manchala
- Department of Periodontics and Implantology, Vishnu dental college, Vishnupur, Bhimavaram, West Godavari, West Godavari, Andhra Pradesh, 534202, India
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Crespi R, Toti P, Covani U, Trasarti S, Crespi G, Menchini-Fabris GB. Conventional avulsion versus less traumatic extraction of ankylosed roots with a magnetoelectric device in anterior maxillary areas. J Craniomaxillofac Surg 2023; 51:760-765. [PMID: 37709625 DOI: 10.1016/j.jcms.2023.09.008] [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: 04/13/2023] [Accepted: 09/05/2023] [Indexed: 09/16/2023] Open
Abstract
The analysis aimed to compare two different single-tooth extraction surgical approaches in anterior maxillary areas of the ankylosed teeth: less traumatic magneto-electrical (mag) versus conventional tooth extraction (con) in minimizing the adverse effects on post-extractive sockets. Parameters of clinical interest such as intra-surgical fracture of the buccal bone plate, presence of postoperative inflammation, and application of stitches were acquired from medical records. The data were subjected to Pearson's χ2 analysis or to Fisher's exact test with significance at 0.05. Sixty-six hopeless maxillary permanent ankylotic teeth were extracted in the same number of patients. In the mag group 2 incisors suffered a fracture. Two patients out of 40 had signs and symptoms of inflammation that resolved completely within 3 days. In the con group 18 out of 26 patients suffered from buccal alveolar fracture. Six of these patients experienced signs of inflamed tissue. The two groups showed significant differences with p-values ≤0.0009 with regards to fracture (2/38 vs. 18/8) and tissue inflammation variables (2/38 vs. 10/16). A significantly different distribution about the presence of sutures was registered between the mag (4/36) and the con (18/8) group with a p-value <0.0001. Mag group seemed to have reduced frequency of fractured and infected post-extractive sites.
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Affiliation(s)
- Roberto Crespi
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Paolo Toti
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy; San Rossore Dental Unit, Pisa, Italy
| | - Ugo Covani
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Stefano Trasarti
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Giovanni Crespi
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy
| | - Giovanni-Battista Menchini-Fabris
- Tuscan Stomatologic Institute, Versilia Hospital, Lido di Camaiore, Italy; School of Dentistry, Saint Camillus International University of Health and Medical Sciences, Rome, Italy; San Rossore Dental Unit, Pisa, Italy.
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Gadzella TJ, Hynkova K, Westover L, Addison O, Romanyk DL. A novel method for simulating ex vivo tooth extractions under varying applied loads. Clin Biomech (Bristol, Avon) 2023; 110:106116. [PMID: 37797368 DOI: 10.1016/j.clinbiomech.2023.106116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Tooth extraction is a common surgical procedure where the invasiveness of the surgery can affect the nature of the dentoalveolar remodelling which follows. However, there is very little biomechanical data relating the loading applied during tooth extraction to the outcomes of the procedure. The purpose of this pilot study is to present a novel ex vivo experimental method for measuring tooth extraction mechanics and to explore preliminary metrics for predicting extraction success. METHODS A custom experimental apparatus was developed in-house to extract central incisors from ex vivo swine mandible samples. Twenty-five (n = 25) incisors were extracted at different rates in displacement- and force-control, along with an intermittent ramp-hold scheme for a total of five schemes. Peak forces and extraction success were recorded for each test. Video analysis assisted in determining the instantaneous stiffnesses of the dental complex during continuous extractions, which were compared using the K-means clustering algorithm. FINDINGS Tooth extraction forces ranged from 102 N to 309 N, with higher-rate tests tending towards higher peak forces (141 N - 308 N) than the lower-rate tests (102 N-204 N) for displacement- and force-controlled schemes. The K-means algorithm clearly identified load rates among tests, indicating that higher-rate loading increased system stiffness relative to the lower-rate tests. INTERPRETATION The developed experimental method demonstrated a desirable degree of control. The preliminary results suggest the influence of load rate on the mechanical response of the dental complex and extraction outcome. Future work will further investigate the biomechanics of tooth extraction and relate them to tissue damage to improve future tooth extraction procedures.
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Affiliation(s)
- Timothy J Gadzella
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada
| | - Kristyna Hynkova
- University of Alberta, School of Dentistry, Edmonton, Canada; Palacký University, Faculty of Medicine and Dentistry, Olomouc, Czech Republic
| | - Lindsey Westover
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada
| | - Owen Addison
- University of Alberta, School of Dentistry, Edmonton, Canada; King's College London, Faculty of Dentistry, Oral and Craniofacial Sciences, Kent, UK
| | - Dan L Romanyk
- University of Alberta, Department of Mechanical Engineering, Edmonton, Canada; University of Alberta, School of Dentistry, Edmonton, Canada.
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Ghallab NA, Elaskary A, Elsabagh H, Toukhy AE, Abdelrahman H, El-Kimary G. A novel atraumatic extraction technique using vestibular socket therapy for immediate implant placement: a randomized controlled clinical trial. Oral Maxillofac Surg 2023; 27:497-505. [PMID: 35718834 PMCID: PMC10457233 DOI: 10.1007/s10006-022-01089-4] [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: 03/15/2022] [Accepted: 06/05/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This randomized controlled clinical trial compared soft tissue changes following a novel vestibular atraumatic extraction technique (test group) versus the conventional incisal atraumatic extraction approach (control group) while implementing the vestibular socket therapy for immediate implant placement. METHODS Thirty patients with hopeless maxillary anterior teeth requiring atraumatic extraction were randomly assigned into two equal groups to receive either test or control. Vertical soft tissue alterations in mm were measured at baseline and 12 months post-restoration using intraoral digital scans at three reference points, distal papilla, mid-facial gingival margin, and mesial papilla, as well as pink esthetic scores (PESs) after 12 months. RESULTS Vestibular extraction technique showed significant soft tissue improvement and creeping when compared to incisal extraction (P < 0.05). The test group showed soft tissue measurements with a mean (± SD) of 0.26 (± 0.58), 0.39 (± 0.64), and 0.05 (± 0.37) mm for the mesial papilla, mid-facial gingival margin, and distal papilla respectively. While the incisal extraction technique demonstrated gingival recession at the distal papilla, mid-facial gingival margin, and mesial papilla of - 0.37 (± 0.54) mm, - 0.32 (± 0.68) mm, and - 0.39 (± 0.59) mm respectively. The overall PESs after 12 months were 12.67 (± 1.59) in vestibular extraction group, while incisal extraction group was 11.40 (± 1.40), with significant difference between them (P = 0.03). CONCLUSION This investigation suggests that both studied techniques were successful in the atraumatic extraction of hopeless severely damaged teeth. The novel vestibular extraction technique might be considered an alternative reliable atraumatic extraction approach compared to the conventional incisal extraction when performing the vestibular socket protocol for immediate implant placement with soft tissue enhancement.
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Affiliation(s)
- Noha Ayman Ghallab
- Department of Oral Medicine & Periodontology, Faculty of Dentistry, Cairo University, 43 Zahraa Street, Giza, 12311, Dokki, Egypt.
| | | | - Hossam Elsabagh
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Hams Abdelrahman
- Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Gillan El-Kimary
- Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Ansbacher T, Tohar R, Cohen A, Cohen O, Levartovsky S, Arieli A, Matalon S, Bar DZ, Gal M, Weinberg E. A novel computationally engineered collagenase reduces the force required for tooth extraction in an ex-situ porcine jaw model. J Biol Eng 2023; 17:47. [PMID: 37461028 DOI: 10.1186/s13036-023-00366-4] [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: 05/07/2023] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
The currently employed tooth extraction methods in dentistry involve mechanical disruption of the periodontal ligament fibers, leading to inevitable trauma to the bundle bone comprising the socket walls. In our previous work, we have shown that a recombinantly expressed truncated version of clostridial collagenase G (ColG) purified from Escherichia coli efficiently reduced the force needed for tooth extraction in an ex-situ porcine jaw model, when injected into the periodontal ligament. Considering that enhanced thermostability often leads to higher enzymatic activity and to set the basis for additional rounds of optimization, we used a computational protein design approach to generate an enzyme to be more thermostable while conserving the key catalytic residues. This process generated a novel collagenase (ColG-variant) harboring sixteen mutations compared to ColG, with a nearly 4℃ increase in melting temperature. Herein, we explored the potential of ColG-variant to further decrease the physical effort required for tooth delivery using our established ex-situ porcine jaw model. An average reduction of 11% was recorded in the force applied to extract roots of mandibular split first and second premolar teeth treated with ColG-variant, relative to those treated with ColG. Our results show for the first time the potential of engineering enzyme properties for dental medicine and further contribute to minimally invasive tooth extraction.
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Affiliation(s)
- Tamar Ansbacher
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
- Hadassah Academic College, 91010, Jerusalem, Israel
| | - Ran Tohar
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Adi Cohen
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Orel Cohen
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Shifra Levartovsky
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Adi Arieli
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Shlomo Matalon
- Department of Oral Rehabilitation, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Daniel Z Bar
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel
| | - Maayan Gal
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
| | - Evgeny Weinberg
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
- Department of Periodontology and Oral Implantology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, 6997801, Tel Aviv, Israel.
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Sangra V, Hemanth Kumar HR, Singh A, Singh S, Akhilasiri G, Agarwal V. Bilateral orthodontic extractions using physics versus conventional forceps among Indian patients. Bioinformation 2023; 19:143-148. [PMID: 37720274 PMCID: PMC10504498 DOI: 10.6026/97320630019143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 09/19/2023] Open
Abstract
It is of interest to assess whether or not physics forceps are superior to traditional forceps for the extraction of premolar teeth in orthodontic procedures. Tooth and buccal bone fractures, as well as extraction time, lacerated gingiva, postoperative discomfort, and infection, were all measured in this research of both types of forceps extraction. Twenty individuals who need orthodontic extraction on both jaws were enrolled in the research. One arch's premolars were removed in two appointments, the first using Physics forceps and the second using conventional ones. The subsequent assignment included extraction from the obverse arch. Intraoperative evaluations included assessments of factors such as tooth and buccal bone fractures, surgical time, and gingival lacerations; postoperative assessments of pain and infection were conducted on days 1, 3, and 7. With physics forceps, the average time to remove a patient's mandible was 86.55 seconds, whereas traditional forceps required just 35.70 seconds. Using traditional forceps, the average pain score was 0.865 on day one after surgery, but with physics forceps, it was 3.30. The use of physics forceps resulted in one buccal bone fracture out of twenty premolar extractions. That so, no meaningful statistical change was seen. There was no tooth damage or post-operative infection with either set of forceps, it was found. Each forceps caused a Grade I laceration to the gingiva. The average time required removing a maxillary using physics forceps was 224.05 seconds, whereas the time required doing it with conventional forceps was 141.50 seconds. On a Visual Analogue Scale (VAS), the average first-day pain after surgery using physics forceps was 4.90, whereas using traditional forceps resulted in just 3.15. The difference between using physics forceps and regular forceps was statistically significant by the third postoperative day (2.05 vs 0.75). There was a statistically insignificant increase in the occurrence of buccal bone fracture and tooth fracture while using physics forceps. Both forceps and scissors caused just grade I lacerations, and there was no postoperative infection. These findings suggest that the use of physics forceps, as opposed to conventional forceps, may significantly lengthen the time required to remove orthodontic premolars on both sides of the mouth. Non-significant results were also found for additional criteria such as buccal bone fracture, tooth fracture, gingival laceration, and post-operative discomfort. When it comes to orthodontic premolar extraction, this research found that traditional forceps performed better than modern forceps across a range of measures, including intraoperative time and postoperative discomfort.
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Affiliation(s)
- Vidhi Sangra
- Consultant Oral and Maxillofacial Surgeon at Pulse Hospital, Jammu, Jammu and Kashmir, India
| | - HR Hemanth Kumar
- Department of Dentistry, Karwar Institute of Medical Sciences, Karwar, Karnataka, India
| | - Arundhati Singh
- Department of Oral and Maxillofacial Surgery, Hazaribagh College of Dental Sciences and Hospital, Hazaribagh, Jharkhand, India
| | - Sandeep Singh
- Department of Orthodontic and Dentofacial Orthopedics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Godana Akhilasiri
- BDS, Private Practitioner at Ravi Dental Clinic, Kadapa, Andhra Pradesh, India
| | - Vivek Agarwal
- Department of Orthodontics and Dentofacial Orthopedics, Haldia Institute of Dental Sciences and Research, Haldia, West Bengal, India
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Alraqibah MA, Rao JKD, Alharbi BM. Periotome versus piezotome as an aid for atraumatic extraction: a randomized controlled trial. J Korean Assoc Oral Maxillofac Surg 2022; 48:356-362. [PMID: 36579907 PMCID: PMC9807373 DOI: 10.5125/jkaoms.2022.48.6.356] [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: 05/31/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 12/30/2022] Open
Abstract
Objectives A single-blinded randomized controlled trial was designed to compare and evaluate the effectiveness of the periotome and piezotome as aids for atraumatic extraction and its sequalae. Materials and Methods The study sample comprised 48 teeth, equally allotted to the piezotome or periotome groups by random allocation, in participants aged 19-62 years. All samples in both groups had either complete tooth structure or intact roots without crowns and had mobility ≤grade II. Clinical parameters of operative duration, presence or absence of gingival laceration, reported operative and postoperative pain, and intake of analgesics following extraction were recorded. IBM SPSS software package version 22 was used for data entry and analysis. Results The mean operation time was significantly (P≤0.05) longer in the piezotome group than in the periotome group. However, fewer gingival lacerations were observed with use of a piezotome than with a periotome, although no significant difference was observed. The piezotome group reported significantly (P≤0.05) higher visual analog scale (VAS) pain scores during the procedure and non-significantly higher scores thereafter until the third postoperative day. In the piezotome group, the dosage of analgesic was higher, although the periotome group had a higher percentage of participants who used analgesics postoperatively; however, these differences were not statistically significant. Conclusion The present clinical trial favors the use of periotome over piezotome for atraumatic extraction due to shorter operating time, lower postoperative VAS pain scores, and lower dosage of analgesics despite the superior ability of the piezotome to prevent gingival laceration.
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Affiliation(s)
- Mohammed Abdullah Alraqibah
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia,Mohammed Abdullah Alraqibah, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah 52381-7489, Saudi Arabia, TEL: +966-556876554, E-mail: , ORCID: https://orcid.org/0000-0002-9355-3274
| | | | - Bader Massad Alharbi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
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Sharma SD, Gupta A, Bansal P, Alexander M, Vidya B, Gupta H. Minimally traumatic extraction techniques in nonrestorable endodontically treated teeth: A comparative study. Natl J Maxillofac Surg 2022; 13:S91-S96. [PMID: 36393928 PMCID: PMC9651255 DOI: 10.4103/njms.njms_309_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/05/2021] [Accepted: 05/23/2021] [Indexed: 11/30/2022] Open
Abstract
AIM The goal of this study was to assess the effectiveness of piezotome as compared to periotome extractions of nonrestorable endodontic treatment of teeth in terms of operational time, pain control, and postoperative bone loss considering the prosthetic rehabilitation in future. MATERIALS AND METHODS A double-blind, randomized controlled trial was conducted with 100 patients who wanted single-rooted teeth to be extracted (which failed endodontically). The participants have been randomized into two equal groups named as - (i) a periotome group (ii) and a piezotome group. Duration of the surgery, postoperative pain within 7 days, complications (if any) associated with the extraction process were performed as a part of clinical assessment. Bone loss has been analyzed 6 months after the surgery radiographically. The data have been recorded and analyzed using the version 22.0 of the SPSS software package. RESULTS All parameters in the periotome category (P < 0.05) were statistically significant except for bone loss and gingival laceration in comparison to piezotome group. In the piezotome group, a longer time was observed for surgery and delayed pain control was achieved. In our study, we found statistically significant more marginal bone loss in piezotome group in comparison with periotome group. CONCLUSION The findings of this study indicate that for intraoperative and postoperative comfort periotome could be used as a safer and cheaper option for atraumatic extractions but piezosurgery may prove as a better choice soon for surgeries in the maxillofacial region to maintain soft-tissue integrity.
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Affiliation(s)
- Sneha D. Sharma
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India,Address for correspondence: Dr. Sneha D. Sharma, Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Sector-89, Kheri More, Faridabad - 121 002, Haryana, India. E-mail:
| | - Ashish Gupta
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Pankaj Bansal
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Mohan Alexander
- Department of Oral and Maxillofacial Surgery, MAHSA University, Kuala Lumpur, Malaysia
| | - B Vidya
- Department of Oral and Maxillofacial Surgery, Oxford Dental College, Bengaluru, Karnataka, India
| | - Himani Gupta
- Department of Oral and Maxillofacial Surgery, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
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Automated Periotome versus Conventional Periotome in Intra-Alveolar Extraction of Sheep Jaw: An In Vitro Study. Int J Dent 2022; 2022:5058606. [PMID: 35874120 PMCID: PMC9300340 DOI: 10.1155/2022/5058606] [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: 03/26/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Atraumatic dental extraction is the way forward in modern dentistry. This study aims to compare the effectiveness of automated periotome with conventional periotome with regard to operating time, postoperative gingival laceration, and bone and tooth structure fractures. Methods This is an in vitro study of forty posterior teeth of sheep mandibles. Ten sound healthy mandibles were selected, and each mandible was then divided into two quadrants with two teeth in each quadrant. Teeth were then extracted by conventional periotome for the first group (one quadrant) and by automated periotome for the second group (other quadrants). A statistically significant P value is set at below 0.05 with a 95% confidence interval. Results No bone fracture was seen in any of the cases of automated periotome with a significance of 0.004 when compared to the fractures seen in seven cases in the conventional group. Whereas comparing the other parameters among the different groups did not show any significant difference. Conclusion It is worthwhile to use the automated periotome in simple extractions, especially when implants are considered in the treatment plan.
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Tohar R, Alali H, Ansbacher T, Brosh T, Sher I, Gafni Y, Weinberg E, Gal M. Collagenase Administration into Periodontal Ligament Reduces the Forces Required for Tooth Extraction in an Ex situ Porcine Jaw Model. J Funct Biomater 2022; 13:jfb13020076. [PMID: 35735930 PMCID: PMC9225053 DOI: 10.3390/jfb13020076] [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: 05/03/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022] Open
Abstract
Minimally invasive exodontia is among the long-sought-for development aims of safe dental medicine. In this paper, we aim, for the first time, to examine whether the enzymatic disruption of the periodontal ligament fibers reduces the force required for tooth extraction. To this end, recombinantly expressed clostridial collagenase G variant purified from Escherichia coli was injected into the periodontal ligament of mesial and distal roots of the first and second split porcine mandibular premolars. The vehicle solution was injected into the corresponding roots on the contralateral side. Following sixteen hours, the treated mandibles were mounted on a loading machine to measure the extraction force. In addition, the effect of the enzyme on the viability of different cell types was evaluated. An average reduction of 20% in the applied force (albeit with a large variability of 50 to 370 newton) was observed for the enzymatically treated roots, reaching up to 50% reduction in some cases. Importantly, the enzyme showed only a minor and transient effect on cellular viability, without any signs of toxicity. Using an innovative model enabling the analytical measurement of extraction forces, we show, for the first time, that the enzymatic disruption of periodontal ligament fibers substantially reduces the force required for tooth extraction. This novel technique brings us closer to atraumatic exodontia, potentially reducing intra- and post-operative complications and facilitating subsequent implant placement. The development of novel enzymes with enhanced activity may further simplify the tooth extraction process and present additional clinical relevance for the broad range of implications in the oral cavity.
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Affiliation(s)
- Ran Tohar
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
| | - Hen Alali
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
| | - Tamar Ansbacher
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
- Hadassah Academic College, Jerusalem 91010, Israel
| | - Tamar Brosh
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
| | - Inbal Sher
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
| | - Yossi Gafni
- Department of Orthodontics, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel;
| | - Evgeny Weinberg
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
- Department of Periodontology and Oral Implantology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
- Correspondence: (E.W.); (M.G.)
| | - Maayan Gal
- Department of Oral Biology, Goldschleger School of Dental Medicine, Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; (R.T.); (H.A.); (T.A.); (T.B.); (I.S.)
- Correspondence: (E.W.); (M.G.)
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Wanis RW, Hosny MM, ElNahass H. Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2022; 24:307-319. [PMID: 35507735 DOI: 10.1111/cid.13091] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Soft tissue esthetics for immediate implant is considered challenging when restoring a tooth in an esthetic zone. This study aimed to evaluate the buccal aspect after immediate implant using the dual-zone therapeutic concept compared to grafting the buccal gap to the bone crest. MATERIALS AND METHODS Twenty-four patients were randomly assigned into either immediate implant with the dual-zone therapeutic concept (DZ, test group) or with bone grafting till buccal bone crest with immediate temporization (BCG, control group). Pink esthetic score (PES), buccal bone loss (BBL), mid-facial recession (MFR), soft tissue thickness (STT), keratinized tissue width (KTW), post-operative swelling (POS), and patient satisfaction (PS) were evaluated for 1 year. RESULTS At 12 months the PES in the test group was 11.36 ± 1.69, and 10.80 ± 1.55 in the control group, with no statistically significant difference (p = 0.45). MFR in the DZ and BCG groups was 0.27 ± 0.34 and 0.45 ± 0.44 after 12 months with no statistical significance difference (p = 0.195). The STT assessment showed a statistically significant increase in both groups, however the intergroup comparison was statistically not significant (p = 0.23). The mean KTW in the DZ and BCG groups was 4.55 ± 1.08 and 4.20 ± 0.82 mm, respectively with no statistical significance (p = 0.42). There was no statistical significant difference in patient satisfaction between the two groups except in question number 10 concerning the post-operative swelling which was higher in the DZ group (p = 0.009). CONCLUSIONS Both treatment modalities are considered reliable methods to achieve good soft tissue esthetics. However, both treatment modalities were not effective in preventing facial bone resorption despite the use of bone graft.
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Affiliation(s)
- Remon Wahid Wanis
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Manal Mohamed Hosny
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
| | - Hani ElNahass
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Cairo University, Old Cairo, Egypt
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13
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Risk factors for bleeding after dental extractions in patients receiving antithrombotic drugs - A case control study. J Dent Sci 2022; 17:780-786. [PMID: 35756819 PMCID: PMC9201513 DOI: 10.1016/j.jds.2021.10.005] [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: 09/22/2021] [Revised: 10/02/2021] [Indexed: 02/08/2023] Open
Abstract
Background/purpose Patients receiving antithrombotic drugs are more likely to suffer bleeding after tooth extraction and multiple factors are related to it. The aim of this study was to investigate the incidence of bleeding and risk factors for bleeding after dental extractions in patients receiving antithrombotic drugs. Materials and methods This retrospective case control study included patients receiving oral antithrombotic drugs or not. Tooth extractions were conducted under ECG monitoring and local hemostatic measures were performed. Risk factors for postoperative hemorrhage after tooth extraction were evaluated using univariate and multivariate analyses. Results Bleeding events were reported in 27 (27%) patients receiving antithrombotic drugs and 9 (9%) patients who didn't use antithrombotic drugs, the difference between which was significant (p < 0.01). Univariate analyses showed that age (OR = 2.717, p = 0.028), oral hygiene (OR = 4.110, p = 0.043), inferior nerve block (OR = 4.285, p = 0.038) and number of extracted tooth (OR = 4.758, p = 0.029) were significantly correlate with bleeding incidence. Multivariate analysis revealed that age (OR = 2.824, p = 0.036) and number of extracted tooth (OR = 5.268, p = 0.016) were significant risk factors for postextraction bleeding. Conclusion The results suggest that there is higher incidence of postextraction bleeding in patients receiving antithrombotic drugs compared to patients who don't. Age (>75 years), oral hygiene, inferior nerve block and number of extracted tooth may be related to bleeding after tooth extraction.
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Singh AK, Khanal N, Acharya N, Rokaya D, Hasan MR, Saito T. Are Physics Forceps Less Traumatic than Conventional Forceps for Tooth Extraction? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Dent J (Basel) 2022; 10:21. [PMID: 35200246 PMCID: PMC8871009 DOI: 10.3390/dj10020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/07/2022] [Accepted: 01/26/2022] [Indexed: 11/17/2022] Open
Abstract
This systematic review and meta-analysis studied the clinical outcomes with physics forceps compared to those with conventional forceps for closed dental extraction. A systematic literature search was performed to identify all the published randomized clinical trials that compared the relevant clinical outcomes with physics forceps to those with conventional forceps for closed dental extraction. A total of 11 studies were included. The adverse events were significantly lower with physics forceps (n = 48) compared to with conventional forceps (n = 120), with an odds ratio of 0.42 [0.25, 0.70], Z = 3.78 (p = 0.0002), and I2 = 21%. There were statistically significant differences in the incidence of GL (p = 0.04), and tooth or root fracture (p = 0.0009). Operating time was significantly lower in physics forceps than that of conventional forceps, mean difference (-20.13 (-30.11, -10.15)), Z = 3.78 (p = 0.0001), I2 = 79%. The available evidence is limited by a high risk of bias and low evidence certainty. Based on the current evidence, physics forceps might be better than the conventional extraction forceps in terms of the extraction duration, pain after extraction, trauma to both hard and soft tissue, and complications. Physics forceps are newer instruments that have not yet been introduced in the teaching of dental graduates. The introduction of physics forceps can be time saving, less invasive and reduce post-extraction complications.
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Affiliation(s)
| | - Nikita Khanal
- Dental Surgeon, Ek EK Paila Foundation, Kathmandu 44600, Nepal;
| | - Nisha Acharya
- Department of Conservative Dentistry and Endodontics, TU Teaching Hospital, MMC, IOM, Kathmandu 44600, Nepal;
| | - Dinesh Rokaya
- Department of Clinical Dentistry, Walailak University International College of Dentistry, Walailak University, Bangkok 10400, Thailand;
| | - Md Riasat Hasan
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari 061-0293, Japan;
| | - Takashi Saito
- Division of Clinical Cariology and Endodontology, Department of Oral Rehabilitation, School of Dentistry, Health Sciences University of Hokkaido, Ishikari 061-0293, Japan;
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Brahma Prasad Chary NO, Raju MS, Suresh Sajjan MC, Gottumukkala SN, Manyam R. Comparison of quality of bone and insertion torque values of early implants placed at 6 and 8 weeks in sockets preserved with advanced platelet-rich fibrin: A randomized controlled trial. J Indian Prosthodont Soc 2021; 21:366-374. [PMID: 34810364 PMCID: PMC8617450 DOI: 10.4103/jips.jips_331_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aim Successful functional and esthetic rehabilitation of edentulous jaws with implants depends on the optimal timing of placement, surgical protocol, materials used, cost-effectiveness, and satisfying patient needs. Increasing demand for shorter treatment times necessitates the immediate placement protocol. However, researchers have demonstrateda higher failure rate. A-PRF (Advanced platelet-rich fibrin) has exhibited accelerated bone regeneration potential. Early implant placement with a limited healing period, along with A-PRF, can be beneficial over conventional and immediate implant placement. Settings and Design This prospective randomized clinical trial aims to assess the outcome of early implant placement in sockets preserved using A-PRF at six weeks and eight weeks of post-extraction. Two groups of 10 participantseach were formed. All patients underwent atraumatic extraction and socket preservation using A-PRF. Materials and Methods A Partial-thickness pedicle graft was raised, and the extraction socket wasclosed. Implants wereplaced in at six and eight weeks of post-extraction in group A group B, respectively. The histomorphometric analysisassessedthe bone quality present at the timeof surgery. The insertion torque values were recorded during implant placement. Statistical Analysis Used The obtained data were statistically analyzed using parametric tests, namely independent T-test for intergroup comparison. Results T-test for torque values indicated a significantly higher torque value at eight weeks. The meanhistomorphometric value showeda significantly higher percentage of bone formation at eight weeks than at six weeks (P = 0.03). Conclusion Within the study's limitations, early implant placement in extraction sockets preserved with A-PRF had significantly higher insertion torque values and predictable bone at eight weeks compared to six weeks.
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Affiliation(s)
| | - M Satyanarayana Raju
- Department of Prosthodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - M C Suresh Sajjan
- Department of Prosthodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Sruthima Nvs Gottumukkala
- Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Ravikanth Manyam
- Department of Oral and Maxillofacial Pathology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Brown J, Baker R, Moore R. An investigation into the oral surgery curriculum and undergraduate experience in a sample of DFT's in the UK. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:421-434. [PMID: 33053250 DOI: 10.1111/eje.12617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/28/2020] [Accepted: 09/29/2020] [Indexed: 06/11/2023]
Abstract
AIM There is conflicting evidence concerning the ability of recent graduates to meet the standards required in exodontia to be independent practitioners. In particular, there is a lack of confidence in surgical extractions. This study evaluated Foundation Trainee's confidence levels in their oral surgery experience and the teaching of oral surgery in UK dental schools. MATERIALS AND METHODS Two separate studies were carried out, and the first was a survey to all foundation trainees in the Yorkshire and Humber Deanary in 2019 which analysed their oral surgery experience and confidence levels. The second study surveyed all Dental Schools in the UK with regard to their contact hours, assessment methods, instruments taught and number of extractions in oral surgery for their undergraduate programmes. RESULTS There was a response rate of 52% for the foundation trainees which showed that they were confident in performing non-surgical extractions but lacked confidence with surgical extractions. There was a positive correlation between the amount of undergraduate experience and confidence levels in exodontia. The second survey which had a response rate of 71% showed variations in the numbers of hours taught for oral surgery, instruments taught and assessment methods, with the structured clinical operative test used more commonly. On average, 41 non-surgical extractions were performed by students before graduation and two surgical extractions. CONCLUSION There is a need to identify how oral surgery teaching can be improved in UK dental schools to ensure that foundation trainees are more confident and competent in both surgical and non-surgical exodontia. In addition, teaching and assessment methods need to be developed to reflect such requirements.
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Affiliation(s)
- Justin Brown
- Academic Department of Oral Surgery, The University of Leeds, Leeds, UK
| | - Rosy Baker
- Academic Department of Oral Surgery, The University of Leeds, Leeds, UK
| | - Richard Moore
- Academic Department of Oral Surgery, The University of Leeds, Leeds, UK
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17
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Kanounisabet N, Mogharehabed A, Torabinia N, Nejad SMH, Yaghini J. Effect of systemic administration of omeprazole on osseointegration around titanium dental implants: A histomorphometric study in dogs. Dent Res J (Isfahan) 2021; 18:43. [PMID: 34429863 PMCID: PMC8351961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/04/2020] [Accepted: 09/20/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Dental implants are widely accepted substitutes for replacing missing teeth. Many factors, including the use of specific drugs such as proton-pump inhibitors (PPIs) (omeprazole), can affect the success of dental implantations. The aim of this study was to investigate the relationship between the use of omeprazole and osseointegration of dental implants. MATERIALS AND METHODS This experimental animal study was performed on eight native male dogs weighted 11-13 kg and aged 16-20 months. The dogs were divided into two groups (receivers and nonreceivers of omeprazole). After extraction of mandibular teeth, treatment was started randomly with the administration of omeprazole and saline. After a 2-month recovery period, six titanium implants were placed in the jaws of all dogs and the administration of omeprazole was continued for 2 weeks. After 4 and 12 weeks, the dogs were anesthetized and dental implants with their bone marrow were removed. The samples were examined histomorphometrically to determine osseointegration. Data were analyzed with two-way ANOVA test for 95% confidence interval. The P value was set at 0.05. RESULTS In the microscopic examination of the samples in week 4, the levels of bone-implant contact (BIC) in the study group were significantly lower than the control group (46.37 vs. 64.37%). In 12 weeks, BIC was significantly lower than that of the control group (67.33 vs. 82.00%). The type of bone formed in week 4 in both the groups was more woven, and in the 12th week, it was mostly lamellar. CONCLUSION Systemic administration of PPIs may interfere with osseointegration of dental implants.
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Affiliation(s)
- Negar Kanounisabet
- Department of Periodontology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Mogharehabed
- Department of Periodontology, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nakisa Torabinia
- Department of Oral Pathology, Dental Materials Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Seyedeh Marzieh Hashemi Nejad
- Department of Periodontology, Dental Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jaber Yaghini
- Department of Periodontology, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Address for correspondence: Dr. Jaber Yaghini, Hezar Jirib Street, Department of Periodontology, Dental Implant Research Center, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
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Yaghini J, Kanounisabet N, Mogharehabed A, Torabinia N, Nejad SH. Effect of systemic administration of omeprazole on osseointegration around titanium dental implants: A histomorphometric study in dogs. Dent Res J (Isfahan) 2021. [DOI: 10.4103/1735-3327.318938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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19
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Stumbras A, Januzis G, Gervickas A, Kubilius R, Juodzbalys G. Randomized and Controlled Clinical Trial of Bone Healing After Alveolar Ridge Preservation Using Xenografts and Allografts Versus Plasma Rich in Growth Factors. J ORAL IMPLANTOL 2020; 46:515-525. [PMID: 32315435 DOI: 10.1563/aaid-joi-d-19-00179] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF > control > BBM > FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.
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Affiliation(s)
- Arturas Stumbras
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Januzis
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Albinas Gervickas
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ricardas Kubilius
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Abstract
Exodontia services comprise the largest portion of clinical practice for most oral and maxillofacial surgeons in the United States. This article is an overview of the principles of exodontia including the physics principles underlying the appropriate use of dental elevators and forceps. Failure to understand the instrumentation and the physics principles being used can cause prolonged operative time, iatrogenic injury to the patient, and unnecessary fatigue and/or injury to the provider. Advances in materials, technology, and innovative design have produced interesting new instruments for exodontia. New instruments including periotomes, piezosurgery, physics forceps, and vertical extraction systems are introduced and reviewed.
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Arashiro FN, De‐Deus G, Belladonna FG, Cavalcante DM, Coelho MS, Silva EJNL, Pereira KFS, Silva PG, Lopes RT, Souza EM. Dentinal microcracks on freshly extracted teeth: the impact of the extraction technique. Int Endod J 2019; 53:440-446. [DOI: 10.1111/iej.13239] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 10/15/2019] [Indexed: 11/30/2022]
Affiliation(s)
- F. N. Arashiro
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - D. M. Cavalcante
- Department of Endodontics Fluminense Federal University Niterói Brazil
| | - M. S. Coelho
- Faculty of Dentistry São Leopoldo Mandic Campinas Brazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Brazil
| | - K. F. S. Pereira
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - P. G. Silva
- Department of Endodontics Federal University of Mato Grosso do Sul Campo Grande Brazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - E. M. Souza
- Department of Dentistry II Federal University of Maranhão São Luís Brazil
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Berton F, Costantinides F, Rizzo R, Franco A, Contarin J, Stacchi C, Maglione M, Visintini E, Di Lenarda A, Di Lenarda R. Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study. Clin Oral Investig 2018; 23:3183-3192. [PMID: 30392079 DOI: 10.1007/s00784-018-2739-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 10/24/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of this prospective comparative clinical study was to evaluate the effect of oral anticoagulants on peri- and post-operative bleeding during simple single tooth extractions, comparing patients in treatment with vitamin K antagonists (VKAs) and patients assuming direct oral anticoagulants (DOACs). MATERIALS AND METHODS Patients under oral anticoagulant therapy needing dental extraction were eligible for entering the study; patients were enrolled following inclusion and exclusion criteria and divided into VKAs and DOAC group according to the anticoagulation therapy. Included patients underwent a simple single dental extraction with elevators and forceps with a maximum surgical time of 15 minutes, without anticoagulation therapy discontinuation. All participants were assessed pre-operatively, during surgery, 30 min minutes and 7 days after surgery. Biological complications were registered and post-extraction bleeding was clinically defined according to Iwabuchi classification. Parametric and non-parametric tests were used to evaluate the variables between the groups. RESULTS Sixty-five patients per group were enrolled and 130 teeth were extracted. The two groups were comparable for pre-, peri-, and post-operative variables. Only 1 patient of DOAC group and 2 patients for VKA group needed medical evaluation for post-extractive bleeding. No statistically significant difference resulted in post-operative bleeding events between the groups (p = 0.425). CONCLUSIONS DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction. Bleeding events were not statistically significant and not clinically relevant. CLINICAL RELEVANCE Patients assuming DOACs can be treated similarly to patients in VKAs therapy with INR index between 2 and 3. Non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions.
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Affiliation(s)
- Federico Berton
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Fulvia Costantinides
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Rizzo
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Anna Franco
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Jenny Contarin
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Claudio Stacchi
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Michele Maglione
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Erika Visintini
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Andrea Di Lenarda
- Cardiovascular Center, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberto Di Lenarda
- Maxillofacial and Dental Surgical Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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Patel S, Foschi F, Condon R, Pimentel T, Bhuva B. External cervical resorption: part 2 - management. Int Endod J 2018; 51:1224-1238. [PMID: 29737544 DOI: 10.1111/iej.12946] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/30/2018] [Indexed: 12/11/2022]
Abstract
Effective management of external cervical resorption (ECR) depends on accurate assessment of the true nature and accessibility of ECR; this has been discussed in part 1 of this 2 part article. This aim of this article was firstly, to review the literature in relation to the management of ECR and secondly, based on the available evidence, describe different strategies for the management of ECR. In cases where ECR is supracrestal, superficial and with limited circumferential spread, a surgical repair without root canal treatment is the preferred approach. With more extensive ECR lesions, vital pulp therapy or root canal treatment may also be indicated. Internal repair is indicated where there is limited resorptive damage to the external aspect of the tooth and/or where an external (surgical) approach is not possible due to the inaccessible nature of subcrestal ECR. In these cases, root canal treatment will also need to be carried out. Intentional reimplantation is indicated in cases where a surgical or internal approach is not practical. An atraumatic extraction technique and short extraoral period followed by 2-week splinting are important prognostic factors. Periodic reviews may be indicated in cases where active management is not pragmatic. Finally, extraction of the affected tooth may be the only option in untreatable cases where there are aesthetic, functional and/or symptomatic issues.
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Affiliation(s)
- S Patel
- Department of Endodontology, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - F Foschi
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - R Condon
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - T Pimentel
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - B Bhuva
- Department of Endodontology, King's College London Dental Institute, London, UK
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24
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Saravanan B, Jayavelu P, Riaz R, Tariqsalam AR. Evaluation of the Accuracy of Cone Beam Computed Tomography for Immediate Implant Placement- A Case Report. J Pharm Bioallied Sci 2017; 9:S274-S280. [PMID: 29284979 PMCID: PMC5731030 DOI: 10.4103/jpbs.jpbs_94_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Diagnostic imaging acts as a distinctive method in analyzing and drawing in the appropriate treatment protocol for any procedure. Pertaining to immediate implant placement, determining the bone width and height plays a vital role in the success of the implant therapy. This visualization of the measurements done preoperatively will enhance the treatment by reducing the overall time span of the procedure. Currently, cone beam computed tomography (CBCT) plays a significant role in the preoperative determination of the measurements of the tooth and the bone. This case report is regarding, a 27-year-old male patient reporting to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital, with a chief complaint of fractured crown in relation to the upper left front tooth region. On clinical examination, there was the presence of an endodontically failed and fractured crown in relation to 22. With the interpretation of clinical and radiographic examination, the tooth was categorized under unfavorable prognosis. The patient was given a detailed description of the various treatment procedures available pertaining to that present condition, along with immediate implant placement procedure. Since the patient was young and conscious about his esthetics and accuracy, he opted for placement of immediate implant followed by extraction of the tooth. To accurately determine the length and width, the tooth and socket measurements were preoperatively measured by CBCT. This article evaluates the accuracy of CBCT by comparing the clinical quantity of bone and dimensions of tooth to be extracted and alveolar socket.
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Affiliation(s)
- B Saravanan
- Department of Oral and Maxillofacial Surgery, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - P Jayavelu
- Department of Oral and Maxillofacial Surgery, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - R Riaz
- Department of Oral and Maxillofacial Surgery, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
| | - A R Tariqsalam
- Department of Oral and Maxillofacial Surgery, Madha Dental College and Hospital, Chennai, Tamil Nadu, India
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25
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Chen J, He Y, Pan Q, Nie M. Application of Endodontic Files for the Extraction of Root Tips: A Biomechanical Investigation and Case Study. J Oral Maxillofac Surg 2016; 74:2345-2350. [PMID: 27677686 DOI: 10.1016/j.joms.2016.08.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/20/2016] [Accepted: 08/22/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To investigate the appropriate endodontic file for the extraction of root tips through a biomechanical study and to evaluate the clinic efficiency of this technique. MATERIALS AND METHODS Nine hundred molar roots were randomly divided into 3 groups (3, 5, and 7 mm) and amputated to the corresponding length. Different files were inserted into the root tips, and a pullout test was conducted using a universal testing machine. The pullout force was recorded and files with greatest pullout force were selected for clinical study. Patients' root tips were extracted using these files. The duration and incidence of postoperative complications were recorded. RESULTS The greatest pullout force was obtained for the 25# Hedström file, regardless of the length of the root tip and the type of file. The pullout force of Hedström files was significantly greater than that of Kerr files in each file group and root length group (P < .05). Clinically, the direct success ratio of this technique was 81.4%. The incidence of postoperative complications was very low. CONCLUSION The results of this study suggest that the application of endodontic files for the extraction of root tips is an acceptable technique. The 25# Hedström file is the optimum choice for root extraction in most cases when using endodontic files.
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Affiliation(s)
- Junliang Chen
- Attending, Orofacial Reconstruction and Regeneration Laboratory, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Yun He
- Associate Professor, Orofacial Reconstruction and Regeneration Laboratory, Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Southwest Medical University, Luzhou, China.
| | - Qin Pan
- Assistant, Orofacial Reconstruction and Regeneration Laboratory, Southwest Medical University, Luzhou, China
| | - Minhai Nie
- Professor, Department of Endodontics, Hospital of Stomatology, Southwest Medical University, Luzhou, China
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