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Zhang H, Xu T, Wei Y, Wei N, Han Z, Hu W. Assessment of soft and hard tissue changes following micro crestal flap-Alveolar ridge preservation and augmentation at molar extraction sites in patients with stage III/IV periodontitis: A randomized controlled trial. J Clin Periodontol 2024. [PMID: 39043452 DOI: 10.1111/jcpe.14045] [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: 12/01/2023] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/25/2024]
Abstract
AIM This study aimed to assess hard and soft tissue contour changes following micro crestal flap-alveolar ridge preservation (MCF-ARP) and natural healing (NH) in periodontally compromised molar extraction sites and to analyse the feasibility and need for bone augmentation during implant therapy. MATERIALS AND METHODS Fifty-six patients with 70 sites were randomized into two groups at the site level (35 sites from 31 patients in the test group and 35 sites from 29 patients in the control group). Among whom, four patients contributed one tooth to the control group and one tooth to the test group. Hard tissue indicators were measured using cone beam computed tomography performed before tooth extraction and 6 months after surgery. Soft tissue contour changes were assessed using intraoral scanning performed before and immediately after surgery and also 2 weeks and 1, 3 and 6 months after surgery. RESULTS Six months after surgery, the MCF-ARP group showed less resorption in buccal bone height (p = .032) and greater augmentation in central bone height (p = .001) and ridge width (p = .009). The mean, vertical and horizontal collapse of buccal soft tissue contour in the MCF-ARP group were 0.95 mm (p = .010), 0.61 mm (p = .019) and 0.56 mm (p = .013) less than that in the NH group, respectively. There were significantly (p = .007) fewer sites in the MCF-ARP group than in the NH group (0% vs. 26.7%) for staged bone augmentation and more sites that could be treated with simple implant procedure in the MCF-ARP group than in the NH group (71.9% vs. 56.6%). CONCLUSIONS Compared with NH, MCF-ARP reduced bone resorption in periodontally compromised molar extraction sites and maintained the buccal soft tissue contour. MCF-ARP reduces the need for complex bone augmentation procedures in implant therapy. TRIAL REGISTRATION Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on 4 February 2022, Version 1.0.
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Affiliation(s)
- Haoyun Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Yiping Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Ning Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Ziyao Han
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
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Dai A, Li HY, Kang S, Lin R, Huang JP, Mao F, Ding PH. Effect of alveolar ridge preservation at periodontally compromised molar extraction sockets: A retrospective cohort study. J Periodontol 2024. [PMID: 38884702 DOI: 10.1002/jper.24-0064] [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: 01/29/2024] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND To date, the clinical evidence regarding the effectiveness of alveolar ridge preservation (ARP) in restricting alveolar bone height and width change after extraction at periodontally compromised molar extraction sockets still remains controversial. This retrospective cohort study aims to evaluate the effect of ARP in molars extracted for periodontal reasons. METHODS Retrospective data were collected from patient electronic records from January 2019 to December 2023. Patients with Stage III/IV periodontitis who underwent extraction of molars for periodontal reasons were screened for eligibility. The outcomes included the horizontal and vertical dimensions of alveolar bone. The need for additional augmentation procedure during implantation was also evaluated. A linear regression model was used to adjust for known confounders. RESULTS A total of 80 sockets were included in this study, of which 27 sockets received ARP therapy after extraction while 53 sockets experienced natural healing (NH). ARP resulted in significantly less bone height change in the periodontally compromised molar sites compared to the NH group (p < 0.001). In sockets displaying a height disparity of >2 mm between the buccal and palatal/lingual walls, the ARP group exhibited advantageous outcomes in terms of ridge width change, surpassing the NH group (p = 0.004). Moreover, the percentage for additional augmentation was significantly reduced in the ARP compared to the NH group (p = 0.006). Age, sex, smoking, jaw, location, and buccal wall thickness did not show any significant effect on bone height change. CONCLUSION ARP had benefits on limiting ridge resorption subsequent to molar extraction for periodontal reasons.
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Affiliation(s)
- Anna Dai
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
| | - Hao-Yu Li
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
| | - Sen Kang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
| | - Renjie Lin
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
- School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jia-Ping Huang
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
| | - Feifei Mao
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
| | - Pei-Hui Ding
- Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang Provincial Clinical Research Center for Oral Diseases, Cancer Center of Zhejiang University, Zhejiang University School of Medicine, Stomatology Hospital, Hangzhou, China
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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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Khairallah CM, Ghosn N, Khairallah C, Makary C, Traini T, Younes R. Alveolar Ridge Preservation Using the One-Piece Autologous Tuberosity Graft: A Clinical, Radiological, and Histological Pilot Study. J Long Term Eff Med Implants 2024; 34:29-44. [PMID: 38305368 DOI: 10.1615/jlongtermeffmedimplants.2023046867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
This prospective study investigated clinically and radiologically the effectiveness of the use of a combined hard and soft tissue graft retrieved from the maxillary tuberosity and designed for alveolar ridge preservation following tooth extraction. Seven patients scheduled for a single mono-rooted tooth extraction were included in the study. After atraumatic extraction, sockets were filled with a "one-piece" dual tissue graft harvested from the tuberosity using an adjusted trephine. CBCTs were performed before the extraction and 4 months after ridge preservation, to analyze the vertical and horizontal alterations of the ridge, using ITK-Snap software. Clinical measurements of both soft and hard tissues were also assessed during the extraction and implant placement. All sites healed uneventfully. After 4 months, the 3D super-imposition of both CBCTs showed a mean bone volume resorption of 65 ± 76.7 mm3 (10.2 ± 10%). The mean horizontal reduction at 2, 4, and 6 mm from the top of the crest was respectively 1.5 ± 1.3 mm, 0.47 ± 1.4 mm and 0.57 ± 0.7 mm, while the mean vertical loss was 0.026 mm ± 2 mm. The mean soft tissue horizontal gain was 1.73 ± 1.12 mm. The "one-piece" autologous tuberosity graft was proven to be a safe and effective alveolar ridge preservation technique and may represent a feasible, user-friendly, time saving, low-cost solution for minimizing dimensional loss following tooth extraction.
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Affiliation(s)
- Carla Maria Khairallah
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Nabil Ghosn
- Department of Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Carlos Khairallah
- Department of Aesthetic and Restorative Dentistry, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Christian Makary
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Tonino Traini
- Department of Innovative Technologies in Medicine and Dentistry, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Yang F, Ruan Y, Bai X, Li Q, Tang X, Chen J, Chen Y, Wang L. Alveolar ridge preservation in sockets with severe periodontal destruction using autogenous partially demineralized dentin matrix: A randomized controlled clinical trial. Clin Implant Dent Relat Res 2023; 25:1019-1032. [PMID: 37455372 DOI: 10.1111/cid.13247] [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: 02/27/2023] [Revised: 06/13/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND The preservation and reconstruction of alveolar ridge volume in extraction sockets of molars affected by severe periodontitis is a critical challenge that requires clinical attention. PURPOSE This randomized controlled clinical trial was designed to evaluate the efficiency of autogenous partially demineralized dentin matrix (APDDM) for alveolar ridge preservation (ARP) in severely periodontally compromised sockets compared to spontaneous healing (SH) on radiographic and histomorphometric outcomes. MATERIALS AND METHODS Thirty-two patients with 32 periodontally compromised molars were randomized into either the test group, which received ARP using APDDM covered with a collagen sponge, or the control group, which underwent SH. Linear and volumetric changes were assessed using superimposed cone-beam computed tomography (CBCT) acquired pre-extraction and after a 4-month healing time. Histomorphometric evaluation was performed on trephine cores harvested during implant placement. RESULTS All sites healed uneventfully. The ridge width at 1 mm apical to the bone crest increased by 5.03, 4.50, and 5.20 mm in the mesial, middle, distal area in the APDDM group, while decreasing by -1.98, -2.19, and -1.98 mm in the SH group, respectively (p < 0.05). The height increase of the central bone was significantly higher in the APDDM group than in the SH group (p < 0.05). The height decrease of the buccal (mesial, middle, distal) bone plate was lower in the APDDM group than in the SH group (p < 0.05). After a 4-month healing time, bone volume increased by 37.07% in the APDDM group and by only 2.33% in the SH group (p < 0.05). Histomorphometric analysis revealed that APDDM particles were surrounded by newly formed bone, with partially absorbed residual APDDM materials observed. New bone, APDDM remnants, and connective tissue occupied 39.67 ± 8.28%, 23.66 ± 9.22%, and 36.67 ± 17.05% of the areas in the APDDM group, respectively. CONCLUSIONS ARP using APDDM was effective, resulting in a significant increase in both linear and volumetric changes in severely periodontally compromised extraction sockets compared to SH. These findings suggest that APDDM may serve as a promising new clinical option for the reconstruction of alveolar ridge dimensions.
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Affiliation(s)
- Fan Yang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yan Ruan
- Department of Oral and Maxillofacial Surgery/Pathology, Amsterdam UMC and Academic Center for Dentistry Amsterdam (ACTA), Amsterdam Movement Science (AMS), Vrije Universiteit Amsterdam (VU), Amsterdam, Netherlands
| | - Xiaolei Bai
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Qi Li
- Department of Stomatology, Bengbu Medical College, Bengbu, China
| | - Xiaodong Tang
- Department of Stomatology, Tiantai Traditional Chinese Medicine Hospital, Taizhou, Zhejiang, China
| | - Jianping Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yunfang Chen
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Linhong Wang
- Center for Plastic & Reconstructive Surgery, Department of Stomatology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China
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Araújo MG, Dias DR, Matarazzo F. Anatomical characteristics of the alveolar process and basal bone that have an effect on socket healing. Periodontol 2000 2023; 93:277-288. [PMID: 37533162 DOI: 10.1111/prd.12506] [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: 01/31/2023] [Revised: 06/07/2023] [Accepted: 06/16/2023] [Indexed: 08/04/2023]
Abstract
Following tooth extraction, a sequence of events takes place in order to close the wound and restore tissue homeostasis, a process called socket healing. The outcome of socket healing includes a marked reduction of the ridge dimensions. The amount of tissue loss that occurs during healing is influenced by several local and systemic factors. Thus, the aim of the present review was to describe the effect of anatomical characteristics of the alveolar process and basal bone on the socket healing outcome. The studies included showed that the quantity (number) and quality (composition) of socket walls exhibited a significant influence on the ridge diminution. A damaged socket (3 walls or less), as well as a thin buccal bone wall, which quickly resorbs negatively affected the healing outcome. Periodontally compromised sockets appeared to promote more extensive dimensional changes. Angulation between tooth and basal bone in addition to basal bone dimensions may also have altered the wound environment and influenced socket healing. The findings from the present review suggest that some anatomical characteristics of the alveolar process and basal bone have an effect on socket healing.
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Affiliation(s)
- Maurício G Araújo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Debora R Dias
- Department of Dentistry, State University of Maringá, Maringá, Brazil
| | - Flavia Matarazzo
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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Kwon T, Choi DI, Hwang J, Lee T, Lee I, Cho S. Panoramic dental tomosynthesis imaging by use of CBCT projection data. Sci Rep 2023; 13:8817. [PMID: 37258603 DOI: 10.1038/s41598-023-35805-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/24/2023] [Indexed: 06/02/2023] Open
Abstract
Dental CBCT and panoramic images are important imaging modalities used in dental diagnosis and treatment planning. In order to acquire a panoramic image without an additional panoramic scan, in this study, we proposed a method of reconstructing a panoramic image by extracting panoramic projection data from dental CBCT projection data. After specifying the patient's dental arch from the patient's CBCT image, panoramic projection data are extracted from the CBCT projection data along the appropriate panoramic scan trajectory that fits the dental arch. A total of 40 clinical human datasets and one head phantom dataset were used to test the proposed method. The clinical human dataset used in this study includes cases in which it is difficult to reconstruct panoramic images from CBCT images, such as data with severe metal artifacts or data without teeth. As a result of applying the panoramic image reconstruction method proposed in this study, we were able to successfully acquire panoramic images from the CBCT projection data of various patients. The proposed method acquires a universally applicable panoramic image that is less affected by CBCT image quality and metal artifacts by extracting panoramic projection data from dental CBCT data and reconstructing a panoramic image.
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Affiliation(s)
- Taejin Kwon
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Da-In Choi
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Jaehong Hwang
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Taewon Lee
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea
| | - Inje Lee
- Department of ICT, Dentium Co., Ltd., Suwon, Korea
| | - Seungryong Cho
- Department of Nuclear and Quantum Engineering (NQE), Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.
- KAIST Institutes for ITC and HST, Korea Advanced Institute of Science and Technology, Daejeon, 34141, Korea.
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Seo GJ, Lim HC, Chang DW, Hong JY, Shin SI, Kim G, Shin SY. Primary flap closure in alveolar ridge preservation for periodontally damaged extraction socket: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 25:241-251. [PMID: 36515081 DOI: 10.1111/cid.13165] [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: 10/03/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The effect of primary wound closure (PC) on alveolar ridge preservation (ARP) in periodontally damaged sockets has yet to be fully discovered. METHODS Periodontally damaged sockets were allocated to one of the following groups: (1) ARP with PC (group PC), and (2) ARP without PC (group secondary wound closure [SC]). Following tooth extraction and flap elevation, granule-type xenogeneic bone substitute material and a collagen barrier were applied. Ridge change was evaluated using cone-beam computed tomographic (CBCT) scans immediately after ARP and at 4 months. Core biopsy specimens were examined histomorphometrically. RESULTS A total of 28 patients were included in the analysis (13 in group PC, 15 in group SC). Histomorphometrically, the percentage of newly formed bone was 26.2 ± 17.7% and 24.6 ± 18.4% in groups PC and SC, respectively (independent t-test, degree of freedom [df] = 25, p > 0.05). Horizontal ridge changes on CBCT were -4.9 ± 3.1 mm and - 4.2 ± 2.5 mm in groups PC and SC at the 1 mm level below the ridge crest, respectively (independent t-test, df = 26, p > 0.05). Approximately half of the sites required additional bone augmentation at implant placement. CONCLUSIONS ARP with/without PC yielded similar new bone formation and radiographic ridge change. This clinical trial was not registered prior to participant recruitment and randomization (https://cris.nih.go.kr/cris/search/detailSearch.do/19718).
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Affiliation(s)
- Gil-Jong Seo
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | | | - Ji-Youn Hong
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | - Seung-Il Shin
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | - Gyutae Kim
- Department of Oral and Maxillofacial Radiology, Kyung Hee University, School of Dentistry, Kyung Hee University Medical Center, Seoul, South Korea
| | - Seung-Yun Shin
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
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Fischer KR, Solderer A, Arlt K, Heumann C, Liu CC, Schmidlin PR. Bone envelope for implant placement after alveolar ridge preservation: a systematic review and meta-analysis. Int J Implant Dent 2022; 8:56. [PMID: 36477662 PMCID: PMC9729513 DOI: 10.1186/s40729-022-00453-z] [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: 06/21/2022] [Accepted: 10/17/2022] [Indexed: 12/12/2022] Open
Abstract
PURPOSE To assess the dimensional establishment of a bony envelope after alveolar ridge preservation (ARP) with deproteinized bovine bone mineral (DBBM) in order to estimate the surgical feasibility of standard diameter implants placement without any additional augmentation methods. METHODS PubMed, Embase and CENTRAL databases were searched for suitable titles and abstracts using PICO elements. Inclusion criteria were as follows: randomized controlled trials (RCTs) comprising at least ten systemically healthy patients; test groups comprised placement of (collagenated) DBBM w/o membrane and control groups of no grafting, respectively. Selected abstracts were checked regarding their suitability, followed by full-text screening and subsequent statistical data analysis. Probabilities and number needed to treat (NNT) for implant placement without any further need of bone graft were calculated. RESULTS The initial database search identified 2583 studies. Finally, nine studies with a total of 177 implants placed after ARP with DBBM and 130 implants after SH were included for the quantitative and qualitative evaluation. A mean difference of 1.13 mm in ridge width in favour of ARP with DBBM could be calculated throughout all included studies (95% CI 0.28-1.98, t2 = 1-1063, I2 = 68.0%, p < 0.01). Probabilities for implant placement with 2 mm surrounding bone requiring theoretically no further bone augmentation ranged from 6 to 19% depending on implant diameter (3.25: 19%, RD = 0.19, C = 0.06-0.32, p < 0.01/4.0: 14%, RD = 0.14, C = 0.05-0.23, p < 0.01/5.0: 6%, RD = 0.06, C = 0.00-0.12, p = 0.06). CONCLUSION ARP employing DBBM reduces ridge shrinkage on average by 1.13 mm and improves the possibility to place standard diameter implants with up to 2 mm circumferential bone housing; however, no ARP would have been necessary or additional augmentative bone interventions are still required in 4 out of 5 cases.
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Affiliation(s)
- Kai R. Fischer
- grid.7400.30000 0004 1937 0650Clinic of Conservative & Preventive Dentistry, Division of Periodontology & Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Alex Solderer
- grid.7400.30000 0004 1937 0650Clinic of Conservative & Preventive Dentistry, Division of Periodontology & Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Kristina Arlt
- grid.7400.30000 0004 1937 0650Clinic of Conservative & Preventive Dentistry, Division of Periodontology & Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Christian Heumann
- grid.5252.00000 0004 1936 973XDepartment of Statistics, Ludwig-Maximilian-University, Munich, Germany
| | - Chun Ching Liu
- grid.7400.30000 0004 1937 0650Clinic of Conservative & Preventive Dentistry, Division of Periodontology & Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
| | - Patrick R. Schmidlin
- grid.7400.30000 0004 1937 0650Clinic of Conservative & Preventive Dentistry, Division of Periodontology & Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032 Zurich, Switzerland
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De Angelis P, De Rosa G, Manicone PF, De Giorgi A, Cavalcanti C, Speranza A, Grassi R, D’Addona A. Hard and soft tissue evaluation of alveolar ridge preservation compared to spontaneous healing: a retrospective clinical and volumetric analysis. Int J Implant Dent 2022; 8:62. [PMID: 36480055 PMCID: PMC9732162 DOI: 10.1186/s40729-022-00456-w] [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: 06/11/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The remodeling process following tooth extraction can be observed as horizontal and vertical bone reduction of the alveolar ridge. Preservation procedures such as alveolar ridge preservation (ARP) aim to maintain the 3D volume of the extraction site. This retrospective study analyzed differences in the hard and soft tissue changes in patients treated with either spontaneous healing or ARP. METHODS After tooth extraction, the patients were treated either by spontaneous socket healing (SH group) or with ARP using a xenograft and a resorbable membrane (ARP group). One week before and 6 months after extraction, the patients underwent cone beam computed tomography. A volumetric analysis was performed by superimposing the digital models of the two time points. Intraoral radiography was performed after implant placement, upon prosthesis delivery, and at 1-year post-treatment. An esthetic assessment was conducted using the Pink Esthetic Score (PES). The patients' overall satisfaction with the implant restoration was investigated at 12 months. RESULTS Intragroup comparisons revealed significant differences between baseline and the 6-month follow-up in both groups at the measured locations (1 mm, 3 mm, and 5 mm below the most coronal aspect of the alveolar ridge) showing a reduction of the horizontal width (P < 0.05). Additionally, after treatment, the horizontal width at 1 mm was significantly different in the SH and ARP groups (P < 0.001), with mean changes of 2.03 ± 0.54 mm and 0.86 ± 0.49 mm, respectively. ARP was associated with an increased PES (11.6 ± 2.2) and a reduction in patients requiring additional grafting procedures in subsequent treatment phases (9% vs 26%; P = 0.11). CONCLUSIONS In both groups, significant horizontal and vertical bone loss was observed after the extraction. ARP can reduce linear and volumetric shrinkage of the alveolar ridge, leading to improved outcomes. It can also simplify implant restoration.
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Affiliation(s)
- Paolo De Angelis
- grid.8142.f0000 0001 0941 3192Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Giuseppe De Rosa
- grid.8142.f0000 0001 0941 3192Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Paolo Francesco Manicone
- grid.8142.f0000 0001 0941 3192Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Camilla Cavalcanti
- grid.8142.f0000 0001 0941 3192Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | | | - Roberta Grassi
- grid.6530.00000 0001 2300 0941Department of Oral Surgery, Tor Vergata University, 00133 Rome, Italy
| | - Antonio D’Addona
- grid.8142.f0000 0001 0941 3192Division of Oral Surgery and Implantology, Department of Head and Neck, Institute of Clinical Dentistry, Oral Surgery and Implantology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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11
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Atieh MA, Alnaqbi M, Abdunabi F, Lin L, Alsabeeha NHM. Alveolar ridge preservation in extraction sockets of periodontally compromised teeth: a systematic review and meta-analysis. Clin Oral Implants Res 2022; 33:869-885. [PMID: 35818637 DOI: 10.1111/clr.13975] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Alveolar ridge preservation (ARP) procedures can limit bone changes following tooth extraction. However, the role of ARP in periodontally compromised socket lacks strong scientific evidence. The aim of this systematic review and meta-analysis was to evaluate the outcomes of ARP following extraction of periodontally compromised teeth in comparison to extraction alone in terms of hard tissue changes, need for additional augmentation at the time of implant placement and patient-reported outcomes. MATERIAL AND METHODS Electronic databases were searched to identify randomized controlled trials (RCTs) that compared ARP in periodontally compromised sockets to spontaneous socket healing. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. RESULTS Five studies with 134 extraction sockets in 126 participants were included. Of these, ARP was performed in 77 sites, while the remaining sites were intentionally left to heal without any ARP treatment. The follow-up time varied between six and 12 months. Overall meta-analysis showed significant differences in changes in ridge height (mean difference (MD) -0.95; 95% confidence interval (CI) -1.43 to -0.47; P = 0.0001) and bone volume (MD -38.70; 95% CI -52.17 to -25.24; P < 0.0001) in favour of ARP. The use of ARP following extraction of periodontally compromised tooth was also associated with significantly less need for additional bone grafting at the time of implant placement. CONCLUSIONS Within the limitation of this review, ARP following extraction of periodontally compromised teeth may have short-term positive effects on alveolar ridge height and bone volume and minimize the need for additional augmentation procedures. However, the evidence is of very low to low certainty.
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Affiliation(s)
- Momen A Atieh
- Chair and Associate Professor of Periodontology, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine, Dubai Healthcare City, Dubai, United Arab Emirates. Honorary Associate Professor, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Maitha Alnaqbi
- Postgraduate student in Periodontology, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine Dubai Healthcare City, Dubai, United Arab Emirates
| | - Farida Abdunabi
- Dental intern, Mohammed Bin Rashid University of Medicine and Health Sciences, Hamdan Bin Mohammed College of Dental Medicine Dubai Healthcare City, Dubai, United Arab Emirates
| | - Lifeng Lin
- Associate Professor, Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Nabeel H M Alsabeeha
- Consultant Prosthodontist, Department of Dental Services, Emirates Health Services, Dubai, United Arab Emirates
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12
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Zhao L, Hu W, Liu Y, Chung KH. Evaluation of implant placement following ridge preservation in periodontally compromised molar extraction sockets: Three-year results of a prospective cohort study. Clin Oral Implants Res 2022; 33:735-744. [PMID: 35524437 DOI: 10.1111/clr.13949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 03/09/2022] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate the 3-year implant-related outcomes following alveolar ridge preservation in periodontally compromised molar sockets. MATERIAL AND METHODS Thirty implants were placed in 26 patients following either ridge preservation (test, n = 16) or natural healing (control, n = 14) at deficient molar extraction sites after a 6-month healing period. The need for additional augmentation procedures at implant placement was recorded. Patients were assessed for 3 years following a definitive restoration. Patient information being collected are modified plaque index, the modified sulcus bleeding index, the peri-implant probing depth clinically, and alterations of marginal bone level (MBL) radiographically. RESULTS There was a 100% survival rate of implants in both groups after 3-year follow-up. During implant placement operation, 35.7% in the control group and 6.3% in the test group required additional augmentation procedures. No statistically significant differences were determined for peri-implant parameters and marginal bone levels between the two groups. The overall mean difference of MBL was 0.072 mm (95% CI [-0.279, 0.423]) during the 3 years of follow-up. The success rate was 81.2% in the test and 78.6% in the control group. CONCLUSIONS Implants placed into periodontally compromised molar extracted sites after ridge augmentation resulted comparable outcomes to implants placement at naturally healed sites after 3-year functional loading.
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Affiliation(s)
- Liping Zhao
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Wenjie Hu
- Department of Emergency, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, PR China
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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13
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Gabay E, Katorza A, Zigdon-Giladi H, Horwitz J, Machtei EE. Histological and dimensional changes of the alveolar ridge following tooth extraction when using collagen matrix and collagen-embedded xenogenic bone substitute: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 24:382-390. [PMID: 35298865 PMCID: PMC9310752 DOI: 10.1111/cid.13085] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 12/01/2022]
Abstract
Aim To assess the horizontal and vertical dimensional changes of the alveolar ridge when using a collagen matrix in combination with collagen embedded xenogenic bone substitute, in comparison with natural healing after tooth extraction. Methods Patients that required extraction in non‐molars areas were included. Test group‐15 sockets were treated with deproteinized bovine bone mineral containing 10% collagen (DBBM‐C), covered by a procaine collagen membrane (CMXs). Control group‐15 sockets left for spontaneous healing. We used a custom‐made acrylic stent as a reference for alveolar ridge measurements. Six‐month postoperative, a single implant was placed in the experimental site. A core biopsy was taken from the site, using a trephine bur. Histomorphometric analysis assessed bone area, connective tissue, bone marrow, and residual bone graft. Results Six months later, horizontal ridge width at −3 mm showed a significant (p < 0.05) reduction in both groups albeit smaller in the test group 1.19 ± 1.55 mm, compared with the control 2.27 ± 1.52 (p = 0.087). At −5 mm sub‐crestally, statistically non‐significant reduction was noted in both groups, 1.61 ± 1.53 and 1.96 ± 1.52 mm for the test and control groups, respectively (p = 0.542). Vertical changes were smaller in the test group (0.14 ± 1.84 mm) compared with control (0.98 ± 1.49 mm). Keratinized tissue (KT) width was 7.3 ± 2.13 and 7.5 ± 3.49 mm in the test and control groups, respectively. Newly formed bone occupied 33.79 ± 17.37% and 51.14 ± 23.04% in the test and control groups, respectively, (p = 0.11). Connective tissue volume was 33.74 ± 13.81% and 30.12 ± 18.32% in the test and control groups, respectively (p = 0.65). Bone marrow occupied 19.57 ± 10.26% and 18.74 ± 17.15% in the test and control groups, respectively (p = 0.91). Residual graft occupied 12.9 ± 9.88% in the test group. Conclusion Alveolar ridge preservation using DBBM‐C resulted in reductions of the vertical and horizontal dimensions albeit not reaching statistical significance. The larger than anticipated standard deviation and smaller inter‐group differences might account for this phenomenon.
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Affiliation(s)
- Eran Gabay
- Rambam Health Care Campus, Department of Periodontology and Implant dentistry, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Anat Katorza
- Rambam Health Care Campus, Department of Periodontology and Implant dentistry, Haifa, Israel
| | - Hdar Zigdon-Giladi
- Rambam Health Care Campus, Department of Periodontology and Implant dentistry, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Jacob Horwitz
- Rambam Health Care Campus, Department of Periodontology and Implant dentistry, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Eli E Machtei
- Rambam Health Care Campus, Department of Periodontology and Implant dentistry, Haifa, Israel.,Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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14
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Chang CC, Kim SK, Lee CT. A novel approach to assess volumetric bone loss at immediate implant sites and comparison to linear measurements: a pilot study and measurement workflow. J Dent 2022; 120:104083. [PMID: 35247470 DOI: 10.1016/j.jdent.2022.104083] [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: 07/13/2021] [Revised: 02/22/2022] [Accepted: 02/28/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES Studies have evaluated changes in hard tissue following immediate implant placement (IIP) through cone beam computed tomography (CBCT) imaging, typically examining the amount of two-dimensional (2D) linear, rather than three-dimensional (3D) volumetric bone loss. This study compared the 3D volumetric changes of the alveolar bone at immediate implant sites with 2D linear measurement outcomes by using a novel image analysis workflow. METHODS Preoperative and 6-month postoperative CBCT images of patients who underwent IIP and bone grafting in the maxillary esthetic area were acquired. Linear and volumetric measurements of buccal bone dimensions were taken using a specially designed workflow. The 2D and 3D measurements were compared, and their correlations were determined. RESULTS Images from 13 patients (13 implants) were analyzed. Linear measurements revealed that the general linear buccal bone loss was less than 1mm in all segments. The 3D volumetric bone reduction (reported as median [first quantile, third quantile]) in the vertical, cervical, middle, and apical segments was 14.27 [11.33, 30.66] mm3 (51.30 [42.78, 66.91]%), 16.20 [10.35, 30.52] mm3 (18.20 [9.88, 24.74]%), 17.48 [8.42, 21.17] mm3 (24.05 [12.39, 28.22]%), and 6.87 [3.88, 9.45] mm3 (11.34 [5.14, 22.54]%), respectively. Significant positive correlations between 2D and 3D measurements were consistently identified in the cervical and middle segments, but no significant correlation was noted in the vertical segment. CONCLUSIONS The results revealed that linear measurements could not fully represent volumetric bone dimensional changes. Performing volumetric measurements and 3D rendering could be valuable in presenting the actual amount and topography of peri-implant bone remodeling. CLINICAL SIGNIFICANCE Linear measurements only partially represent the real-life event of 3D bone changes at immediate implant sites. Factors affecting hard tissue alterations following IIP should be reassessed using 3D volumetric measurement outcomes.
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Affiliation(s)
- Chi-Ching Chang
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054; Department of Periodontics, Chang Gung Memorial Hospital, No.199, Dun-Hua North Rd., Taipei, Taiwan, 105406; Chang Gung University, No.259, Wenhua 1st Rd., Taoyuan City, Taiwan, 333323
| | - Sung K Kim
- Department of Diagnostic and Biomedical Sciences, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, 7500 Cambridge St., Houston, TX, USA, 77054.
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15
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Ridge preservation in maxillary molar extraction sites with severe periodontitis: a prospective observational clinical trial. Clin Oral Investig 2021; 26:2391-2399. [PMID: 34622309 DOI: 10.1007/s00784-021-04204-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing. MATERIAL AND METHODS Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets. RESULTS Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases. CONCLUSIONS Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing. CLINICAL RELEVANCE Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.
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16
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Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CMJ, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev 2021; 4:CD010176. [PMID: 33899930 PMCID: PMC8092674 DOI: 10.1002/14651858.cd010176.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. This is an update of the Cochrane Review first published in 2015. OBJECTIVES To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 19 March 2021), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2021, Issue 2), MEDLINE Ovid (1946 to 19 March 2021), Embase Ovid (1980 to 19 March 2021), Latin American and Caribbean Health Science Information database (1982 to 19 March 2021), Web of Science Conference Proceedings (1990 to 19 March 2021), Scopus (1966 to 19 March 2021), ProQuest Dissertations and Theses (1861 to 19 March 2021), and OpenGrey (to 19 March 2021). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. A number of journals were also handsearched. SELECTION CRITERIA We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. Corresponding authors were contacted to obtain missing information. We estimated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants. We assessed four trials as at overall high risk of bias and the remaining trials at unclear risk of bias. Nine new trials were included in this update with six new trials in the category of comparing ARP to extraction alone and three new trials in the category of comparing different grafting materials. ARP versus extraction: from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width (MD -1.18 mm, 95% CI -1.82 to -0.54; P = 0.0003; 6 studies, 184 participants, 201 extraction sites), and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001; 6 studies, 184 participants, 201 extraction sites) in favour of xenografts, but we found no evidence of a significant difference for the need for additional augmentation (RR 0.68, 95% CI 0.29 to 1.62; P = 0.39; 4 studies, 154 participants, 156 extraction sites; very low-certainty evidence) or in implant failure rate (RR 1.00, 95% CI 0.07 to 14.90; 2 studies, 70 participants/extraction sites; very low-certainty evidence). From the one trial comparing alloplasts versus extraction, there is very low-certainty evidence of a reduction in loss of alveolar ridge height (MD -3.73 mm; 95% CI -4.05 to -3.41; 1 study, 15 participants, 60 extraction sites) in favour of alloplasts. This single trial did not report any other outcomes. Different grafting materials for ARP: three trials (87 participants/extraction sites) compared allograft versus xenograft, two trials (37 participants, 55 extraction sites) compared alloplast versus xenograft, one trial (20 participants/extraction sites) compared alloplast with and without membrane, one trial (18 participants, 36 extraction sites) compared allograft with and without synthetic cell-binding peptide P-15, and one trial (30 participants/extraction sites) compared alloplast with different particle sizes. The evidence was of very low certainty for most comparisons and insufficient to determine whether there are clinically significant differences between different ARP techniques based on changes in alveolar ridge width and height, the need for additional augmentation prior to implant placement, or implant failure. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes for any of the comparisons. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material, and fibrous adhesions at the cervical part of previously preserved sockets, for the comparisons xenografts versus extraction, allografts versus xenografts, alloplasts versus xenografts, and alloplasts with and without membrane. AUTHORS' CONCLUSIONS ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long-term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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Affiliation(s)
- Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Hm Alsabeeha
- RAK Dental Centre, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
| | - Alan Gt Payne
- Private practice, Northland Prosthodontics Ltd, c/o NorthShore Oral and Maxillofacial Surgeons, Auckland, New Zealand
| | - Sara Ali
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | | | - Marco Esposito
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Ben Amara H, Kim JJ, Kim HY, Lee J, Song HY, Koo KT. Is ridge preservation effective in the extraction sockets of periodontally compromised teeth? A randomized controlled trial. J Clin Periodontol 2021; 48:464-477. [PMID: 33316099 DOI: 10.1111/jcpe.13412] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/26/2020] [Accepted: 12/05/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To verify whether ridge preservation is effective in the reduction of dimensional loss and in bone formation compared to spontaneous healing in extraction sockets of periodontally compromised teeth. METHODS Twenty-six subjects requiring tooth extraction for stage III/IV periodontitis were randomly assigned to one of two interventions: alveolar ridge preservation using collagenated bovine bone mineral and a resorbable collagen membrane (test, RP) or spontaneous healing (control, SH). Six months later, postoperative cone-beam computed tomography (CBCT) was performed to measure the linear and volumetric changes of the sockets compared to baseline scans. Biopsies were retrieved at the implant site for histomorphometric calculations. Nonparametric tests were applied for statistical analysis. RESULTS Significantly less shrinkage occurred in RP compared to SH, mainly in the crestal zone. The width loss difference between groups was 3.3 mm and 2.2 mm at 1 mm and 3 mm below the crest, respectively (p < .05). RP yielded a gain in socket height of 0.25 mm, whereas a loss of -0.39 mm was observed in SH (p < .05). The percentage of volume loss recorded in RP was also less than that recorded in SH (-26.53% vs -50.34, p < .05). Significantly less bone proportion was detected in biopsies from RP (30.1%) compared with SH (53.9%). A positive association between baseline bone loss and ridge shrinkage was found in SH but not in RP. CONCLUSION Ridge preservation in extraction sockets of periodontally compromised teeth was effective in reducing the amount of ridge resorption.
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Affiliation(s)
- Heithem Ben Amara
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Ju Kim
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Hae-Young Kim
- Department of Health Policy and Management, Korea University, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun-Young Song
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
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Han Z. Clinical Analysis of Alveolar Bone Changes After Chronic Periodontitis Based on Cone Beam CT (CBCT). JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In the diagnosis and treatment of oral diseases, imaging examination is a more important auxiliary method. Among them, the application of digital X-ray examination is the most common. However, because the image information provided by this technology is a two-dimensional model, it is
difficult to obtain a comprehensive image, so there is a missed diagnosis. With the development of imaging technology, cone-beam CT (CBCT) is widely used in the diagnosis and treatment of oral diseases. This is a non-invasive imaging examination. The diagnosis effect is achieved by cone-beam
computed tomography or volume tomography. It has less radiation and low cost. Clear imaging and high spatial resolution. This study compared the diagnostic effect of cone-beam CT and traditional X-ray examination in diseases related to oral medicine to observe the diagnostic superiority of
cone-beam CT. In this study, we can know that 30 patients with periapical periodontal disease have been treated by this technique, and the detection accuracy rate is 100.00%. The damage of the apical root of the patient’s tooth is completely displayed in the image. The measurement results
of the bone defect around the tooth are accurate and space and the location image is presented in front of the doctor, so the detection accuracy of this technology is high. The study found that cone beam CT is effective in the diagnosis and treatment of diseases in oral medicine, and can clearly
show the three-dimensional structure of oral tissue, which is convenient for physicians to observe the shape of the disease and improve the accuracy of disease diagnosis.
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Affiliation(s)
- Zhenghua Han
- College of Stomatology, Sanquan College of Xinxiang Medical College, Xinxiang, Henan 453003, China
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Friedmann A, Meskeleviciene V, Yildiz MS, Götz W, Park JC, Fischer KR. Open healing of contained and non-contained extraction sockets covered with a ribose cross-linked collagen membrane: a pilot study. J Periodontal Implant Sci 2020; 50:406-417. [PMID: 33350180 PMCID: PMC7758302 DOI: 10.5051/jpis.2000400020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/21/2020] [Accepted: 08/27/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study investigated whether the placement of ribose cross-linked collagen (RCLC) membranes without primary soft tissue closure predictably resulted in sufficient alveolar ridge preservation in contained and non-contained extraction sockets. METHODS Membranes were positioned across extraction sockets, undermining full-thickness flaps, and the gingival margins were fixed by double-interrupted sutures without crossed horizontal mattress sutures for 1 week. In non-contained sockets, a bone substitute was used to support the membrane within the bony envelope. Radiographs and clinical images obtained 4 months later were analyzed by ImageJ software using non-parametric tests. RESULTS In 18 patients, 20 extraction sockets healed uneventfully and all sites received standard-diameter implants (4.1, 4.8, or 5.0 mm) without additional bone augmentation. Soft tissues and the muco-gingival border were well maintained. A retrospective analysis of X-rays and clinical photographs showed non-significant shrinkage in the vertical and horizontal dimensions (P=0.575 and P=0.444, respectively). The new bone contained vital bone cells embedded in mineralized tissues. CONCLUSIONS Within the limitations of this pilot study, open healing of RCLC membranes may result in sufficient bone volume for implant placement without additional bone augmentation in contained and non-contained extraction sockets.
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Affiliation(s)
- Anton Friedmann
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.
| | | | - Mehmet Selim Yildiz
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.,Department of Periodontology, Altınbaş University Faculty of Dentistry, Istanbul, Turkey
| | - Werner Götz
- Department of Orthodontics, Oral Biology Laboratory, University of Bonn, Bonn, Germany
| | - Jung Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Seoul, Korea
| | - Kai R Fischer
- Department of Periodontology, Witten/Herdecke University Faculty of Health, Witten, Germany.,Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-implant Diseases, University of Zurich, Zürich, Switzerland
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20
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Romanos GE, Romanos EB, Alqahtani F, Alqahtani M, Javed F. "Religious Belief": An Undervalued Ethical Inclusion Criterion for Clinical Trials on Bone Grafting Procedures. JOURNAL OF RELIGION AND HEALTH 2020; 59:2928-2934. [PMID: 31154591 DOI: 10.1007/s10943-019-00851-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The aim of the present review was to assess randomized controlled trials (RCTs) on bone grafting procedures that included religious belief as an eligibility criterion. Indexed databases were searched up to and including February 2019 using different search strategies. In strategy 1, the following terms were used: (a) belief; (b) bone graft; (c) faith; (d) inclusion; (e) exclusion; (f) eligibility; (g) criteria; (h) randomized clinical trial; (i) religion; and (j) xenograft. In strategy 2, the following terms were used in addition to those used in strategy 1: Xenografts AND oral surgery OR xenografts AND maxillofacial OR xenografts AND dental implants. These searches were filtered using the terms "Randomized clinical trial" and "human studies". The initial search yielded 3932 studies. Filtration of results using the terms "Randomized clinical trial" and "human studies" showed 0 studies. Evaluation of patients' religious beliefs seems to be undervalued in RCTs related to the placement of xenografts. This is an essential and ethical criterion that should be taken into consideration prior to inclusion of participants and signing the informed consent form for RCTs related to the placement of bone grafts.
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Affiliation(s)
- Georgios E Romanos
- Department of Periodontology, Stony Brook University, Stony Brook, NY, USA
- Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, 11794, USA
| | | | - Fawaz Alqahtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam Bin Abdul-Aziz University, Al-Kharj, 11942, Saudi Arabia
| | - Mana Alqahtani
- Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia
| | - Fawad Javed
- Department of Periodontology, Stony Brook University, Stony Brook, NY, USA.
- Laboratory for Periodontal-, Implant-, Phototherapy (LA-PIP), School of Dental Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
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21
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Deeb JG, Reichert A, Carrico CK, Laskin DM, Deeb GR. Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study. Clin Exp Dent Res 2020; 7:147-155. [PMID: 33150685 PMCID: PMC8019766 DOI: 10.1002/cre2.343] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 11/12/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate if the addition of biologic agents to a particulate bone graft enhances horizontal ridge augmentation outcomes in terms of bone dimensions, bone density, and successful implant placement. MATERIALS AND METHODS A retrospective chart review was done to assess the clinical and radiographic outcomes in 52 horizontal ridge augmentation sites in 43 patients. Information was gathered regarding surgical technique, type of graft material, biologic agents used (PRP or rhPDGF-BB), method of space maintenance, and achieved alveolar ridge width and bone density changes as quantified on CBCT scans. RESULTS The use of tenting screws, a resorbable membrane, and a combination of particulate allogenic and xenogenic bone graft material provided an average horizontal bone gain of 3.6 mm in the 52 augmented sites. There was no statistically significant difference observed in the amount of horizontal bone gain between sites treated with the addition of biologic agents (n = 21), or with a particulate bone graft alone (n = 31). A marginally statistically significant difference was found in the density of the grafted bone with the addition of biologics (p value = .0653). CONCLUSION The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.
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Affiliation(s)
- Janina Golob Deeb
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Amy Reichert
- Cardinal Dental Specialists, Harrisonburg, Virginia, USA
| | - Caroline K Carrico
- Dental Public Health and Policy, Oral Health Research Core, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Daniel M Laskin
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - George R Deeb
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
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22
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García-González S, Galve-Huertas A, Aboul-Hosn Centenero S, Mareque-Bueno S, Satorres-Nieto M, Hernández-Alfaro F. Volumetric changes in alveolar ridge preservation with a compromised buccal wall: a systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal 2020; 25:e565-e575. [PMID: 32683381 PMCID: PMC7473428 DOI: 10.4317/medoral.23451] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 07/02/2020] [Indexed: 12/19/2022] Open
Abstract
Background Many studies have addressed socket preservation, though fewer publications considering buccal wall loss can be found, since the literature typically considers sockets with four walls. A systematic review was made on the influence of type II buccal bone defects, according to Elian’s Classification, in socket grafting materials upon volumetric changes in width and height.
Material and Methods An electronic and manual literature search was conducted in accordance to PRISMA statement. The search strategy was restricted to randomized controlled trials (RCTs) and controlled clinical trials (CCTs) describing post-extraction sockets with loss of buccal wall in which alveolar ridge preservation (ARP) was carried out in the test group and spontaneous healing of the socket (SH) was considered in the control group.
Results The search strategy yielded 7 studies. The meta-analysis showed an additional bone loss of 2.37 mm in width (p > 0.001) and of 1.10 mm in height (p > 0.001) in the absence of ARP. The reconstruction of the vestibular wall was not evaluated in any study. The results also showed moderate to great heterogeneity among the included studies in terms of the changes in width and height.
Conclusions Despite the heterogeneity of the included studies, the results indicate a benefit of ARP versus SH. Further studies are needed to determine the volumetric changes that occur when performing ARP in the presence of a buccal bone wall defect. Key words:Alveolar ridge preservation, buccal wall defect, volumetric changes, bone loss, meta-analysis.
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23
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Sultan T, Cheah CW, Ibrahim NB, Asif MK, Vaithilingam RD. Three-dimensional assessment of the extraction sockets, augmented with platelet-rich fibrin and calcium sulfate: A clinical pilot study. J Dent 2020; 101:103455. [PMID: 32828845 DOI: 10.1016/j.jdent.2020.103455] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This clinical study assessed and compared the linear and volumetric changes of extraction sockets grafted with a combination of Platelet-Rich Fibrin (PRF) and Calcium Sulfate (CS) (PRF-CS), and extraction sockets grafted with a combination of PRF and xenograft (X) (PRF-X). METHODS Five single maxillary premolar extraction sockets received PRF-CS grafts and five single maxillary premolar sockets received PRF-X grafts. Linear (horizontal and vertical) measurements were accomplished using Cone Beam Computed Tomography (CBCT) images and volumetric changes were assessed using MIMICS software. Soft tissue level changes were measured using Stonecast models. All measurements were recorded at baseline (before extraction) and at 5-months post-extraction. RESULTS Significant reduction in vertical and horizontal dimensions were observed in both groups except for distal bone height (DBH = 0.44 ± 0.45 mm, p = 0.09) and palatal bone height (PBH = 0.39 ± 0.34 mm, p = 0.06) in PRF-X group. PRF-CS group demonstrated mean horizontal shrinkage of 1.27 ± 0.82 mm (p = 0.02), when compared with PRF-X group (1.40 ± 0.85 mm, p = 0.02). Vertical resorption for mesial bone height (MBH = 0.56 ± 0.25 mm, p = 0.008), buccal bone height (BBH = 1.62 ± 0.91 mm, p = 0.01) and palatal bone height (PBH = 1.39 ± 0.87 mm, p = 0.02) in PRF-CS group was more than resorption in PRF-X group (MBH = 0.28 ± 0.14 mm, p = 0.01, BBH = 0.63 ± 0.39 mm, p = 0.02 and PBH = 0.39 ± 0.34 mm, p = 0.06). Volumetric bone resorption was significant within both groups (PRF-CS = 168.33 ± 63.68 mm3, p = 0.004; PRF-X = 102.88 ± 32.93 mm3, p = 0.002), though not significant (p = 0.08) when compared between groups. In PRF-X group, the distal soft tissue level (DSH = 1.00 ± 0.50 mm, p = 0.03) demonstrated almost 2 times more reduction when compared with PRF-CS group (DSH = 1.00 ± 1.00 mm, 0.08). The reduction of the buccal soft tissue level was pronounced in PRF-CS group (BSH = 2.00 ± 2.00 mm, p = 0.06) when compared with PRF-X group (BSH = 1.00 ± 1.50 mm, p = 0.05). CONCLUSIONS PRF-CS grafted sites showed no significant difference with PRF-X grafted sites in linear and volumetric dimensional changes and might show clinical benefits for socket augmentation. The study is officially registered with ClinicalTrials.gov Registration (NCT03851289).
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Affiliation(s)
- Tipu Sultan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Chia Wei Cheah
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Norliza Binti Ibrahim
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Muhammad Khan Asif
- Department of Oral & Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Rathna Devi Vaithilingam
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, 50603, Malaysia
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Parvini P, Sahin D, Becker K, Sader R, Becker J, Schwarz F. Short-term outcomes of lateral extraction socket augmentation using autogenous tooth roots: A prospective observational study. Clin Oral Implants Res 2020; 31:881-888. [PMID: 32645746 DOI: 10.1111/clr.13633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 03/10/2020] [Accepted: 06/08/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To assess the short-term clinical outcomes of lateral augmentation of deficient extraction sockets and two-stage implant placement using autogenous tooth roots (TR). MATERIAL AND METHODS A total of n = 13 patients (13 implants) were available for the analysis. At the time of tooth extraction, each subject had received lateral augmentation using the respective non-retainable but non-infected tooth root where the thickness of the buccal bone was <0.5 mm or where a buccal dehiscence-type defect was present. Titanium implants were placed after a submerged healing period of 6 months and loaded after 20 ± 2 weeks (V8). Clinical parameters (e.g., bleeding on probing-BOP, probing pocket depth-PD, mucosal recession-MR, clinical attachment level-CAL) were recorded at V8 and after 26 ± 4 weeks (V9) of implant loading. RESULTS At V9, all patients investigated revealed non-significant changes in mean BOP (-19.23 ± 35.32%), PD (0.24 ± 0.49 mm), MR (0.0 ± 0.0 mm) and CAL (0.24 ± 0.49 mm) values, respectively. There was no significant correlation between the initial gain in ridge width and changes in BOP and PD values. CONCLUSIONS The surgical procedure was associated with stable peri-implant tissues on the short-term.
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Affiliation(s)
- Puria Parvini
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany
| | - Didem Sahin
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Kathrin Becker
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.,Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Robert Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
| | - Juergen Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Goethe University, Carolinum, Frankfurt, Germany.,Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
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25
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Xu D, Xie C, Yu H, Zhang Z, Zheng J, Xu S. Evaluation of factors affecting alveolar ridge height and facial bone thickness in Chinese maxillary central incisors by cone beam CT. J Dent Sci 2020; 16:229-235. [PMID: 33384802 PMCID: PMC7770285 DOI: 10.1016/j.jds.2020.05.021] [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] [Received: 05/07/2020] [Revised: 05/28/2020] [Indexed: 11/16/2022] Open
Abstract
Background/purpose In the immediate implantation of maxillary central incisors, the height of the alveolar bone is lost, and there is often a risk of bone fracture due to the thin buccal bone wall (BBW). The purpose of this study was to assess the effects of smoking, age, and root position in the alveolar bone on the BBW and the distance between the cemento-enamel junction (CEJ) and the facial bone crest (FBC) of Chinese maxillary central incisors. Materials and methods The patients were divided by smoking, gender, age, and root sagittal position in the alveolar bone. BBW thickness was measured at the following sites: the 4 mm apical to the CEJ, the middle of the root, and the apex. The distance from the CEJ to the FBC was also evaluated. Results Cone beam CT (CBCT) data for the maxillary central incisors of 645 patients (323 males and 322 females) were selected and analyzed. The CEJ-FBC distance in patients who smoked (2.79 ± 0.78 mm) was significantly greater than that of non-smokers (2.54 ± 0.69 mm). The BBW in subtype III (0.74 ± 0.43 mm, 0.81 ± 0.36 mm) was thinner than that in subtypes I and II at 4 mm apical to the CEJ and in the middle of the root, with a statistically significant difference (p < 0.05). Conclusion In most Chinese people, smoking, gender, age, and the position of the root in alveolar bone are all important factors that must be considered before immediate implantation is undertaken.
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Affiliation(s)
- Duoling Xu
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Chengjie Xie
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Huimin Yu
- Department of Periodontology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Zhiyong Zhang
- Department of Radiology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Junfa Zheng
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
| | - Shulan Xu
- Department of Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, 510280, China
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26
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Faria-Almeida R, Astramskaite-Januseviciene I, Puisys A, Correia F. Extraction Socket Preservation with or without Membranes, Soft Tissue Influence on Post Extraction Alveolar Ridge Preservation: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e5. [PMID: 31620267 PMCID: PMC6788420 DOI: 10.5037/jomr.2019.10305] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022]
Abstract
Objectives The purpose of this systematic review was to assess quantitatively and qualitatively the influence of two different factors: membranes and soft tissue graft influence for the extraction socket preservation. Material and Methods A wide-ranging electronic search was performed in six databases up to 30 of November 2018 in order to identify all the clinical and randomized clinical trials performed in humans published with no data restriction. The inclusion criteria were extraction socket preservation with and without membranes or a soft tissue graft in a intact socket with at least six months of follow-up, have more than 12 patients or treat more than 12 sites per group and evaluated at least one of the primary outcomes measures (radiographic measures histological assessment, clinical measures). Results From an initial search of 1524 studies only 6 papers fulfil the inclusion and exclusion criterions. All the six selected papers, presented a wide heterogeneity of treatments used, evaluated variables and observation period that made impossible to recommend any specific techniques and/or material to achieve better results. The limited data found suggest that the used of membrane reveals to achieve better results. It wasn’t possible to observe in any clinical trial that compares the used of soft tissue graft. Conclusions New trials need to be performed in order to identify what specific techniques and/or materials are better to decrease the reabsorption of the socket after tooth extraction. Clinical trials designed to understand when/how the soft tissues grafts influence at the socket preservation is needed.
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Affiliation(s)
- Ricardo Faria-Almeida
- Department of Oral Surgery and Oral Medicine, Porto University of Dental MedicinePortugal
| | - Inesa Astramskaite-Januseviciene
- Department of Oral and Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania
| | | | - Francisco Correia
- Department of Oral Surgery and Oral Medicine, Porto University of Dental MedicinePortugal
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27
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Ramanauskaite A, Becker K, Kassira HC, Becker J, Sader R, Schwarz F. The dimensions of the facial alveolar bone at tooth sites with local pathologies: a retrospective cone-beam CT analysis. Clin Oral Investig 2019; 24:1551-1560. [PMID: 31414272 DOI: 10.1007/s00784-019-03057-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/08/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the impact of various local pathologies on facial alveolar bone dimensions at tooth sites. MATERIALS AND METHODS Cone-beam computed tomography images of 60 patients were analyzed. Healthy teeth and teeth with local pathologies (i.e., endodontically treated, periodontally diseased teeth, and teeth with periapical lesions) were included. The thickness of the facial alveolar bone was measured at five locations: (1) the bone crest (W0), (2) 25% (W25), (3) 50% (W50), (4) 75% (W75) of the distance from the bone crest to the root apex (A), and (5) in the A region (W100). The results were considered statistically significant at p < 0.0008 (adjustment according to the statistical correction for multiple testing). RESULTS A total of 1174 teeth (707 healthy and 467 with the local pathologies) were assessed. Periodontally diseased maxillary premolars and anterior teeth in the mandible in the W0 position, as well as maxillary molars in the W25 position, tended to have a lower facial bone thickness when compared to the healthy teeth (0.68 mm vs. 0.84 mm, p = 0.008; 0.47 mm vs. 0.55 mm, p = 0.004; and 1.27 mm vs. 1.72 mm; p = 0.009, respectively). In contrast, the observed tendency pointed towards thicker facial bone wall for the periodontally diseased mandibular anterior teeth in the W50 position (0.74 vs. 0.52, p = 0.001). Healthy maxillary molars tended to display a thicker facial alveolar bone compared to the teeth with local pathologies in the W25, W50, and W75 positions (p = 0.001, p = 0.005, and p = 0.004, respectively). CONCLUSIONS The present analysis has indicated that local pathologies are commonly associated with a compromised socket morphology. CLINICAL RELEVANCE The facial bone thickness was particularly reduced at periodontally diseased teeth, which may challenge implant therapy.
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Affiliation(s)
- Ausra Ramanauskaite
- Department of Oral Surgery and Implantology, Carolinum Goethe University, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt am Main, Germany.
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany.
| | - K Becker
- Department of Oral Surgery and Implantology, Carolinum Goethe University, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt am Main, Germany
- Department of Orthodontics, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - J Becker
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - R Sader
- Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Theodor-Stern-Kai 7, Haus 29, 60596, Frankfurt am Main, Germany
| | - F Schwarz
- Department of Oral Surgery and Implantology, Carolinum Goethe University, Theodor-Stern-Kai 7; Building 29, 60596, Frankfurt am Main, Germany
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28
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Dankl L, Mayr A, Kaufmann G, Thaler M, Nogler M, Putzer D. Measuring bone defects for acetabular revision surgery for choosing an appropriate reconstruction strategy: A concept study on plastic models. Comput Biol Med 2019; 111:103336. [PMID: 31276945 DOI: 10.1016/j.compbiomed.2019.103336] [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: 03/19/2019] [Revised: 05/20/2019] [Accepted: 06/17/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Bone defects can be filled with autografts, allografts and artificial bone-materials. The aim of this study was to evaluate whether the digitization of known defect models with a navigation system is a reliable measurement method for estimating the size of a bone defect. METHODS Six preformed, cylindrical and cone-shaped defects on an artificial hip-bone were digitalized by six different observers. Reference volumes were gathered by measuring the depth of the defects, using an alginate impression material to fill out the defects and calculating the volumes from a CT scan. RESULTS One out of the six preformed defects showed a statistically significant difference between the digitalization and the calculation, four showed a significant difference between the digitalization and the mould as well as between the digitalization and the CT calculation. CONCLUSIONS This technique offers satisfactory results and consistent reproducibility when digitalizing big defects with relatively simple shape. Decreasing size and increasing complexity of the defects leads to more imprecise measurements.
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Affiliation(s)
- Lukas Dankl
- Medical University of Innsbruck, Department of Trauma Surgery, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Agnes Mayr
- Medical University of Innsbruck, Department of Radiology, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Gerhard Kaufmann
- Orthopaedic and Foot Center, Innsbruck, Innrain 2, 6020, Innsbruck, Austria
| | - Martin Thaler
- Medical University of Innsbruck, Department of Orthopaedic Surgery, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Michael Nogler
- Medical University of Innsbruck, Department of Orthopaedics - Experimental Orthopaedics, Innrain 36, 6020, Innsbruck, Austria
| | - David Putzer
- Medical University of Innsbruck, Department of Orthopaedics - Experimental Orthopaedics, Innrain 36, 6020, Innsbruck, Austria.
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29
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Woo S, Lee S, Chae J, Rim J, Lee J, Seo J, Lee C. Automatic matching of computed tomography and stereolithography data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 175:215-222. [PMID: 31104709 DOI: 10.1016/j.cmpb.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 03/10/2019] [Accepted: 04/02/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Computed tomography (CT) is one of the most frequently used medical imaging methods. An important application area of CT is dental implants, which require precise inspection and analysis of oral structures. Since CT provides a precise 3D model of the teeth, bones and nerves, it can be used as a surgical guide for dental implants. Along with CT, optical 3D images called stereolithography (STL) have also been widely used. STL images obtained from optical 3D images can be used to show the 3D surfaces of oral structures. Since CT data and STL data deploy different technologies to obtain dental information, we can obtain more accurate dental implants by combining the two datasets. Since the two datasets are acquired by using different sensors, the datasets need to be registered. METHODS An automatic matching algorithm is proposed for CT and STL image registration, which is based on depth maps and maximum intensity projection. Then, fine tuning was performed based on volume matching. RESULTS When applied to real-world databases, the proposed method provided an average matching error of 2.7 mm for the upper jaw and 2.3 mm for the lower jaw with an average processing time of about 19 s. CONCLUSIONS The proposed method performs accurate registration of CT and STL.
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Affiliation(s)
- S Woo
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 120-749, South Korea.
| | - S Lee
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 120-749, South Korea.
| | - J Chae
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 120-749, South Korea.
| | - J Rim
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 120-749, South Korea.
| | - J Lee
- Dio Implant, Seoul 182-4, South Korea.
| | - J Seo
- Dio Implant, Seoul 182-4, South Korea.
| | - C Lee
- School of Electrical and Electronic Engineering, Yonsei University, Seoul 120-749, South Korea.
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Yun Z, Yang S, Huang E, Zhao L, Yang W, Feng Q. Automatic reconstruction method for high-contrast panoramic image from dental cone-beam CT data. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 175:205-214. [PMID: 31104708 DOI: 10.1016/j.cmpb.2019.04.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 04/15/2019] [Accepted: 04/21/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Panoramic images reconstructed from dental cone beam CT (CBCT) data have been effectively used in dental clinics for disease diagnosis. Panoramic images generally have low contrast because excessive non-interest tissues participate in the reconstruction, which may affect the diagnosis. In this study, we developed a fully automatic reconstruction method to improve the global and detail contrast of panoramic images. METHODS The proposed method consists of dental arch thickness detection, image synthesis, and image enhancement. First, the dental arch thickness is detected from an axial maximum intensity projection (MIP) image generated from the axial slices containing the teeth to reduce non-interest tissues in panoramic image reconstruction. Then, a new synthesis algorithm is proposed at image synthesis stage to reduce the effect of non-interest tissues on image contrast. Finally, an image enhancement algorithm is applied to the synthesized image to improve the detail contrast of the final panoramic image. RESULTS A total of 129 real clinical dental CBCT data sets were used to test the proposed method. The panoramic images generated by three methods were subjectively scored by three experienced dentists who were blinded to the generated method. The evaluation of image contrast included the maxillary, mandible, teeth, and particular region (root canal, crown reconstruction, implants, and metal brackets). The overall image contrast score revealed that the proposed method scored the highest of 11.03 ± 2.46, followed by the ray sum and x-ray methods with corresponding scores of 6.4 ± 1.65 and 5.35 ± 1.56. The results of expert subjective scoring indicated that the image contrast of the panoramic image generated by the proposed method is higher than those of existing methods. CONCLUSIONS The proposed method provides a quick, effective and robust solution to improve the global and detail contrast of the panoramic image generated from dental CBCT data.
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Affiliation(s)
- Zhaoqiang Yun
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Shuo Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Erliang Huang
- Department of Medical Equipment, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China
| | - Lei Zhao
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Yang
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Qianjin Feng
- Guangdong Provincial Key Laboratory of Medical Image Processing, School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China.
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Sculean A, Stavropoulos A, Bosshardt DD. Self-regenerative capacity of intra-oral bone defects. J Clin Periodontol 2019; 46 Suppl 21:70-81. [DOI: 10.1111/jcpe.13075] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 12/31/2018] [Accepted: 01/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Anton Sculean
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
| | | | - Dieter D. Bosshardt
- Department of Periodontology; School of Dental Medicine; University of Bern; Bern Switzerland
- Robert K. Schenk Laboratory of Oral Histology; School of Dental Medicine; University of Bern; Bern Switzerland
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Al Rezk F, Al Rezk M, Al Rezk M, Al Rezk R. The utilization of vascularized pedicle combination epithelial-sub epithelial tissue graft for socket preservation in the esthetic zone-A novel approach. Clin Case Rep 2019; 7:1139-1148. [PMID: 31183083 PMCID: PMC6552950 DOI: 10.1002/ccr3.2166] [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: 01/29/2019] [Revised: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 11/25/2022] Open
Abstract
The vascularized tunneled combine epithelialize-subepithelialize connective tissue graft may yield biological outcomes superior to those achieved separately by rotated vascularization or combination interposition onlay tissue graft. This technique may provide clinicians with pathway to improve socket seal by improving the vascularity and the volume of the tissue seal, which would be paramount for the definitive esthetic and functional outcome for modern demand of our patients.
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Affiliation(s)
| | - Mania Al Rezk
- Research DepartmentKaweah Delta Medical CenterVisaliaCalifornia
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Abstract
Adequate bone remodeling may be a primary parameter for long-term successful complication-free dental implant treatment. A 1.8-mm osseous thickness around dental implants is thought to be the minimum thickness for adequate vasculature for osteocyte nutrition and function. A dental implant does not provide progenitor cells or angiogenic or osteogenic factors. Thus, the surrounding bone may need to have a 1.8-mm thickness to accommodate the vasculature necessary for nutrients for appropriate remodeling. Additionally, the 1.8-mm dimension may provide for mechanical load resistance. There is no evidence to illustrate the physiologic need for the 1.8-mm dimension. This dimension requirement is based on clinical outcome observations. Basic science research for bone survival around dental implants is needed.
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Xu J. [Immediate implantation following tooth extraction in fresh maxillary molar socket with poor bone quality]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2019; 39:100-105. [PMID: 30692074 DOI: 10.12122/j.issn.1673-4254.2019.01.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To explore the feasibility of immediate implantation after tooth extraction in the maxillary molar socket with poor bone quality beneath the sinus. METHODS We collected the data from the patients undergoing extraction of maxillary molars with poor bone quality between the sockets and sinuses. Sinus lifting and immediate implant following the extraction were performed simultaneously in these cases, and the primary stability of the implants, wound healing, and changes of the sinus were observed. At 6 months after the operations, the crowns were installed on the implants. The masticatory function was observed, and the growth of the alveolar bones and their changes after the operations were examined using microcomputed tomography (MCT). RESULTS We analyzed 32 extraction cases with immediate implantation in the maxillary molar sockets with poor bone quality beneath the sinus. The average age of the patients was 59.8 years, and the length and diameter of the implant ranged from 8.5 to 10 mm and from 4.5 to 5.5 mm, respectively. The torque force of the implants varied from the minimum (in which cases the implants remained fixed after insertion with fingers) to the maximum of 30 N·cm. The postoperative recovery was uneventful in all the cases and no failed or movable implants were found. At 6 months after the operation, none of the patients showed abnormalities in the sinus, and in all the cases the crowns were successfully installed on the implants with good recovery of the masticatory functions. Follow-up of the patients for 12 to 96 months after the operation showed successful immediate implantation in all the cases. After the operation, the changes of the mean alveolar ridge heights on the buccal, palatal, mesial, and distal sides of the patients were 0.8069±0.6253 mm (t=1.2904, P>0.1), 0.5272± 0.3331 mm (t=1.5836, P>0.05), 0.5416±0.4048 mm (t=1.3379, P>0.05), and 0.5172±0.3874 mm (t=1.3351, P>0.05), respectively; the change of the alveolar ridge width was 0.5522±0.4381 mm (t=1.2604, P>0.1) mm. The dimension of the alveolar bone underwent no significant changes after the operation in these patients. CONCLUSIONS Immediate implantation in the maxillary extraction socket with a poor bone quality can avoid damages to the sinus and achieve good outcomes with such advantages of less trauma, full use of the innate gingiva and alveolar ridge, and well preserved morphology of the alveolar ridge as compared with delayed implantation.
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Affiliation(s)
- Jing Xu
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University (Guangdong Provincial Stomatological Hospital), Guangzhou 510280, China
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Hingsammer L, Pommer B, Fürhauser R, Mailath-Pokorny G, Haas R, Busenlechner D. Single tooth implants in the esthetic zone following a two-stage all flapless approach: A retrospective analysis. Clin Implant Dent Relat Res 2018; 20:929-936. [DOI: 10.1111/cid.12669] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 06/26/2018] [Accepted: 08/09/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Lukas Hingsammer
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
- University Hospital of Linz, Department of Maxillofacial Surgery; Linz Austria
| | - Bernhard Pommer
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
| | - Rudolf Fürhauser
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
| | - Georg Mailath-Pokorny
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
| | - Robert Haas
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
| | - Dieter Busenlechner
- University Hospital of Zurich, Department of Cranio-Maxillo-Facial and Oral Surgery; 8091 Zurich Switzerland
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