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Bighetti ACC, Cestari TM, Paini S, Pomini KT, Buchaim DV, Ortiz RC, Júnior RSF, Barraviera B, Bullen IRFR, Garlet GP, Buchaim RL, de Assis GF. Efficacy and safety of a new heterologous fibrin biopolymer on socket bone healing after tooth extraction: An experimental pre-clinical study. J Clin Periodontol 2024; 51:1017-1033. [PMID: 38685818 DOI: 10.1111/jcpe.13992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/13/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024]
Abstract
AIM To assess the efficacy of heterologous fibrin biopolymer (HFB) in promoting alveolar bone healing after tooth extraction in rats. MATERIALS AND METHODS The upper right incisors of 48 Wistar rats were extracted. Toothless sockets were filled with HFB (HFBG, n = 24) or blood clot (BCG, n = 24). The tooth extraction sites were subjected to micro-computed tomography (micro-CT), histological, histomorphometric and immunohistochemical (for Runt-related transcription factor 2/Runx2 and tartrate-resistant acid phosphatase/TRAP) analyses on days 0, 7, 14 and 42 after extraction. RESULTS Socket volume remained similar between days 0 and 14 (69 ± 5.4 mm3), except in the BCG on day 14, when it was 10% lower (p = .043). Although the number of Runx2+ osteoblasts was high and similar in both groups (34 × 102 cells/mm2), the HFBG showed lower inflammatory process and osteoclast activity than BCG at 7 days. On day 14, the number of Runx2+ osteoblasts remained high and similar to the previous period in both groups. However, osteoclast activity increased. This increase was 55% lower in the HFBG than BCG. In the BCG, the presence of an inflammatory process and larger and numerous osteoclasts on day 14 led to resorption of the alveolar bone ridge and newly formed bone. On day 42, numbers of Runx2+ osteoblast and TRAP+ osteoclasts decreased dramatically in both groups. Although the BCG exhibited a more mature cortical bone formation, it exhibited a higher socket reduction (28.3 ± 6.67%) and smaller bone volume (37 ± 5.8 mm3) compared with HFBG (socket reduction of 14.8 ± 7.14% and total bone volume of 46 ± 5.4 mm3). CONCLUSIONS HFB effectively suppresses osteoclast activity and reduces alveolar bone resorption compared with blood clot, thus preventing three-dimensional bone loss, particularly during the early healing period. HFB emerges as a promising biopharmaceutical material for enhancing healing processes after tooth extraction.
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Affiliation(s)
| | - Tania Mary Cestari
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Suelen Paini
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Karina T Pomini
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
| | - Daniela Vieira Buchaim
- Postgraduate Program in Structural and Functional Interactions in Rehabilitation, University of Marilia (UNIMAR), Marilia, Brazil
- Teaching and Research Coordination of the Medical School, University Center of Adamantina (UNI-FAI), Adamantina, Brazil
| | - Rafael Carneiro Ortiz
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rui Seabra Ferreira Júnior
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Benedito Barraviera
- Center for the Study of Venoms and Venomous Animals (CEVAP), São Paulo State University (Univ Estadual Paulista, UNESP), Botucatu, São Paulo, Brazil
- Graduate Program in Tropical Diseases, Botucatu Medical School (FMB), São Paulo State University (UNESP-Univ Estadual Paulista), Botucatu, São Paulo, Brazil
| | - Izabel R F R Bullen
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Gustavo Pompermaier Garlet
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
| | - Rogério Leone Buchaim
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
- Graduate Program in Anatomy of Domestic and Wild Animals, Faculty of Veterinary Medicine and Animal Science, University of São Paulo (FMVZ/USP), São Paulo, Brazil
| | - Gerson F de Assis
- Department of Biological Sciences, Bauru School of Dentristy, University of São Paulo, Bauru, São Paulo, Brazil
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Han Z, Wang C, Wei Y, Yang G, Hu W, Chung KH. Associations between the keratinized mucosa width and the underlying alveolar bone dimensions at partial edentulous molar sites: a retrospective cross-sectional study. BMC Oral Health 2024; 24:796. [PMID: 39010031 PMCID: PMC11251357 DOI: 10.1186/s12903-024-04590-2] [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: 02/20/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND The assessment of hard and soft tissue at edentulous sites is important for subsequent implant treatment design. The aim of the present study was to explore the associations between the keratinized mucosa width (KMW) and the underlying alveolar bone dimensions at partial edentulous molar sites. METHODS In this retrospective study, a total of 110 patients with at least one missing molar were selected. The buccal KMW of the edentulous molar sites was evaluated. Cone-beam computed tomography scans were collected, and the height discrepancy between the alveolar crest and the buccal bone plate (HC-B) as well as the alveolar bone height (ABH) were measured. The KMW was compared among the HC-B and ABH groups at both maxillary and mandibular sites. Linear regression and generalized estimation equations (GEEs) were used to explore the associations between the KMW and alveolar bone dimensions at α = 0.05. RESULTS Among the 110 patients, 158 edentulous molar sites were analyzed. The average HC-B and ABH were significantly lower at the maxillary sites (1.26 ± 1.62 mm, 11.62 ± 3.94 mm) than at the mandibular sites (3.67 ± 2.85 mm, 14.91 ± 3.01 mm, p < 0.001). The KMW was significantly lower at sites with HC-B > 2 mm than at sites with HC-B ≤ 2 mm both in the maxilla and mandible (p < 0.001). No significant differences were found between the KMW at sites with ABH < 10 mm and sites with ABH ≥ 10 mm (p > 0.05). Linear regression and GEEs analyses revealed that the HC-B was significantly associated with the KMW (B = -0.339, p < 0.001), while the association between the KMW and the ABH was not statistically significant (B = -0.046, p = 0.352). CONCLUSIONS The buccal KMW at edentulous molar sites was significantly associated with the HC-B. Alveolar ridges presenting with a sloped configuration were more prone to possess a narrower band of keratinized mucosa. Both hard and soft tissue augmentation should be considered for implant treatment at these sites. The correlations of dynamic changes between the KMW and alveolar bone dimensions after tooth extraction should be further investigated.
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Affiliation(s)
- Ziyao Han
- Department of Periodontology, National Center for 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, Peking University School and Hospital of Stomatology, Beijing, China
| | - Cui Wang
- Department of Periodontology, National Center for 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, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yiping Wei
- Department of Periodontology, National Center for 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, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gang Yang
- Department of Periodontology, National Center for 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, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wenjie Hu
- Department of Periodontology, National Center for 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, Peking University School and Hospital of Stomatology, Beijing, China.
- NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China.
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, WA, USA
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Afifi HHAL, Nasr SS, BinShabaib MS, Alharthi SS, Shoeib M. Socket Preservation Using Platelet-Rich Fibrin and Free Gingival Grafts. Int Dent J 2024:S0020-6539(24)00157-6. [PMID: 38987050 DOI: 10.1016/j.identj.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/16/2024] [Accepted: 06/06/2024] [Indexed: 07/12/2024] Open
Abstract
OBJECTIVE The present randomised controlled trial is based on the null hypothesis that there is no difference in crestal bone levels (CBLs) following socket preservation (SP) using platelet-rich fibrin (PRF) and free gingival graft (FGG). The aim was to evaluate CBLs following SP using PRF and FGG. METHODS This study is a parallel-arm randomised controlled trial. Patients in the test and control groups underwent SP using PRF and FGG, respectively. Intraoral visual examination was performed to clinically assess signs of swelling, pus/abscess, and stability of sutures and graft. Self-rated postoperative pain was assessed after 1 week and 6 months using the visual analogue scale (VAS). At the 6-month follow-up, cone-beam computed tomography was performed to evaluate CBL in mesiodistal and buccolingual dimensions. The preoperative cone-beam computed tomographic images were superimposed with those taken at the 6-month follow-up to compare CBLs. Statistical comparisons were performed and level of significance was set at P < .05. RESULTS The test and control groups each comprised 13 individuals with comparable ages. All teeth included in the test and control groups were located in the maxillary aesthetic zone. At the 1-week follow-up, VAS scores were higher in the control than in the test group (P < .01). At the 6-month follow-up, none of the participants reported self-rated pain. The change in buccolingual dimension was greater in the control group than in the test group (P < .05). CONCLUSIONS Both FGG and PRF are effective techniques for SP; however, the latter technique is more effcacious in maintaining buccolingual dimensions of the extraction socket.
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Affiliation(s)
| | - Shaimaa Saieed Nasr
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Fayoum University, Fayoum, Egypt; Oral Medicine and Periodontology Department, Faculty of Dentistry, 6th. Of October for Modern Science and Arts Univeristy, Cairo, Eygpt
| | - Munerah Saleh BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
| | - Shatha Subhi Alharthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Mona Shoeib
- Oral Medicine and Periodontology Departments, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Qi J, Matsumoto Y, Xie C, Rashed F, Ono T, Aoki K. Prevention of bone dehiscence associated with orthodontic tooth movement by prophylactic injection of bone anabolic agents in mice. Sci Rep 2024; 14:15749. [PMID: 38977767 PMCID: PMC11231170 DOI: 10.1038/s41598-024-66617-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
Although bone dehiscence may occur during orthodontic tooth movement into the narrow alveolar ridge, a non-invasive prevention method is yet to be fully established. We show for the first time prevention of bone dehiscence associated with orthodontic tooth movement by prophylactic injection of bone anabolic agents in mice. In this study, we established a bone dehiscence mouse model by applying force application and used the granular type of scaffold materials encapsulated with bone morphogenetic protein (BMP)-2 and OP3-4, the receptor activator of NF-κB ligand (RANKL)-binding peptide, for the prophylactic injection to the alveolar bone. In vivo micro-computed tomography revealed bone dehiscence with decreased buccal alveolar bone thickness and height after force application, whereas no bone dehiscence was observed with the prophylactic injection after force application, and alveolar bone thickness and height were kept at similar levels as those in the control group. Bone histomorphometry analyses revealed that both bone formation and resorption parameters were significantly higher in the injection with force application group than in the force application without the prophylactic injection group. These findings suggest that the prophylactic local delivery of bone anabolic reagents can prevent bone dehiscence with increased bone remodelling activity.
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Affiliation(s)
- Jia Qi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yoshiro Matsumoto
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Cangyou Xie
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Fatma Rashed
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Oral Biology, Faculty of Dentistry, Damanhour University, Damanhour, 22511, Egypt
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kazuhiro Aoki
- Department of Basic Oral Health Engineering, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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He G, Xian Y, Lin H, Yu C, Chen L, Chen Z, Hong Y, Zhang C, Wu D. An injectable and coagulation-independent Tetra-PEG hydrogel bioadhesive for post-extraction hemostasis and alveolar bone regeneration. Bioact Mater 2024; 37:106-118. [PMID: 39022616 PMCID: PMC11252469 DOI: 10.1016/j.bioactmat.2024.03.015] [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: 01/16/2024] [Revised: 02/29/2024] [Accepted: 03/10/2024] [Indexed: 07/20/2024] Open
Abstract
Effective control of post-extraction hemorrhage and alveolar bone resorption is critical for successful extraction socket treatment, which remains an unmet clinical challenge. Herein, an injectable Tetra-PEG hydrogel that possesses rapid gelation, firm tissue adhesion, high mechanical strength, suitable degradability, and excellent biocompatibility is developed as a sutureless and coagulation-independent bioadhesive for the management of extraction sockets. Our results demonstrate that the rapid and robust adhesive sealing of the extraction socket by the Tetra-PEG hydrogel can provide reliable protection for the underlying wound and stabilize blood clots to facilitate tissue healing. In vivo experiments using an anticoagulated rat tooth extraction model show that the hydrogel significantly outperformed clinically used cotton and gelatin sponge in hemostatic efficacy, wound closure, alveolar ridge preservation, and in situ alveolar bone regeneration. Histomorphological evaluations reveal the mechanisms for accelerated bone repair through suppressed long-term inflammation, elevated collagen deposition, higher osteoblast activity, and enhanced angiogenesis. Together, our study highlights the clinical potential of the developed injectable Tetra-PEG hydrogel for treating anticoagulant-related post-extraction hemorrhage and improving socket healing.
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Affiliation(s)
- Gang He
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518055, China
| | - Yiwen Xian
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518055, China
| | - Huajun Lin
- Department of Maxillofacial Surgery, Shenzhen Hospital, Southern Medical University, No. 1333 New Road, Baoan District, Shenzhen, Guangdong, 518101, China
| | - Chengcheng Yu
- Department of Maxillofacial Surgery, Shenzhen Hospital, Southern Medical University, No. 1333 New Road, Baoan District, Shenzhen, Guangdong, 518101, China
| | - Luyuan Chen
- Department of Maxillofacial Surgery, Shenzhen Hospital, Southern Medical University, No. 1333 New Road, Baoan District, Shenzhen, Guangdong, 518101, China
| | - Zhihui Chen
- Department of Maxillofacial Surgery, Shenzhen Hospital, Southern Medical University, No. 1333 New Road, Baoan District, Shenzhen, Guangdong, 518101, China
| | - Yonglong Hong
- Department of Maxillofacial Surgery, Shenzhen Hospital, Southern Medical University, No. 1333 New Road, Baoan District, Shenzhen, Guangdong, 518101, China
| | - Chong Zhang
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518055, China
| | - Decheng Wu
- Guangdong Provincial Key Laboratory of Advanced Biomaterials, Department of Biomedical Engineering, Southern University of Science and Technology, No. 1088 Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong, 518055, China
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van Orten A, Goetz W, Bilhan H. Alveolar Ridge Preservation Using a Novel Species-Specific Collagen-Enriched Deproteinized Bovine Bone Mineral: Histological Evaluation of a Prospective Case Series. Bioengineering (Basel) 2024; 11:665. [PMID: 39061747 PMCID: PMC11273417 DOI: 10.3390/bioengineering11070665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/08/2024] [Accepted: 06/15/2024] [Indexed: 07/28/2024] Open
Abstract
In recent years, the significance of maintaining the alveolar ridge following tooth extractions has markedly increased. Alveolar ridge preservation (ARP) is a commonly utilized technique and a variety of bone substitute materials and biologics are applied in different combinations. For this purpose, a histological evaluation and the clinical necessity of subsequent guided bone regeneration (GBR) in delayed implantations were investigated in a prospective case series after ARP with a novel deproteinized bovine bone material (95%) in combination with a species-specific collagen (5%) (C-DBBM). Notably, block-form bone substitutes without porcine collagen are limited, and moreover, the availability of histological data on this material remains limited. Ten patients, each scheduled for tooth extraction and desiring future implantation, were included in this study. Following tooth extraction, ARP was performed using a block form of C-DBBM in conjunction with a double-folded bovine cross-linked collagen membrane (xCM). This membrane was openly exposed to the oral cavity and secured using a crisscross suture. After a healing period ranging from 130 to 319 days, guided trephine drilling was performed for implant insertion utilizing static computer-aided implant surgery (s-CAIS). Cores harvested from the area previously treated with ARP were histologically processed and examined. Guided bone regeneration (GBR) was not necessary for any of the implantations. Histological examination revealed the development of a lattice of cancellous bone trabeculae through appositional membranous osteogenesis at various stages surrounding C-DBBM granules as well as larger spongy or compact ossicles with minimal remnants. The clinical follow-up period ranged from 2.5 to 4.5 years, during which no biological or technical complications occurred. Within the limitations of this prospective case series, it can be concluded that ARP using this novel C-DBBM in combination with a bovine xCM could be a treatment option to avoid the need for subsequent GBR in delayed implantations with the opportunity of a bovine species-specific biomaterial chain.
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Affiliation(s)
- Andreas van Orten
- Private Dental Practice Do24, Dortmunder Str. 24–28, 45731 Waltrop, Germany;
| | - Werner Goetz
- Policlinic of Orthodontics, Centre for Dental Care, Basic Science Research in Oral Biology, Friedrich-Wilhelms University, Welschnonnenstr. 17, 53111 Bonn, Germany;
| | - Hakan Bilhan
- Department of Periodontology, School for Health Sciences, Witten/Herdecke University, Alfred-Herrhausen-Str. 45, 58448 Witten, Germany
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Alasqah M, Alansary RD, Gufran K. Efficacy of Platelet-Rich Fibrin in Preserving Alveolar Ridge Volume and Reducing Postoperative Pain in Site Preservation of Post-Extracted Sockets. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1067. [PMID: 39064496 PMCID: PMC11278985 DOI: 10.3390/medicina60071067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Revised: 06/25/2024] [Accepted: 06/26/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: In socket preservation, the goal is to minimize bone resorption after tooth extraction to maintain the volume and contour of the alveolar ridge. The use of PRF in post extraction sites may reduce ridge resorption by encouraging the growth of new bone and acting as a scaffold for tissue. In addition, PRF may enhance healing and minimize postoperative pain. The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) in maintaining the ridges' dimensions at the extraction site, in the maxilla and mandible, as well as its impact on post-extraction discomfort. Methods: The study was conducted on 60 patients presenting for extraction of posterior teeth and was randomly divided into three groups: group I PRF (n = 20), group II PRF + collagen (n = 20), and group III control (n = 20). Sockets were filled with PRF (group I) and PRF + collagen (group II). At baseline and follow-up after 3 months, CBCT was used to assess the bone dimensions. The postoperative pain evaluations were performed at 24 h, 3 days, and 7 days after the tooth extraction. The pain rate was evaluated using a numerical rating scale from the British Pain Society. Results: The study examined the effects of platelet-rich fibrin (PRF) and PRF combined with collagen on the height and width of the ridges, as well as the pain experienced by the patients following alveolar ridge preservation surgery. ANOVA and t-tests were used to evaluate and compare the ridge dimensions. Comparing the results to the control group, there were no significant differences in the height or width of the ridges. However, both the PRF and PRF + Collaplug® treatments effectively reduced the short-term postoperative pain. Conclusions: The study findings suggest that platelet-rich fibrin (PRF) and PRF combined with collagen do not exert significant effects on ridge width and height compared to the standard treatment following alveolar ridge preservation. However, it is noteworthy that both the PRF and PRF + collagen treatments demonstrated efficacy in reducing postoperative pain in the short term, offering a potential advantage over standard treatment protocols.
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Affiliation(s)
- Mohammed Alasqah
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia
| | | | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj 11942, Saudi Arabia
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Manninen AA, Heliövaara A, Horelli J, Mesimäki K, Wilkman T, Lindford AJ, Lassus P. Long-term skeletal, cephalometric, and volumetric changes in two Helsinki bimaxillary face transplant patients. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00065-1. [PMID: 38906770 DOI: 10.1016/j.ijom.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 03/01/2024] [Accepted: 03/19/2024] [Indexed: 06/23/2024]
Abstract
Analysis of skeletal, cephalometric, and volumetric changes and occlusion during long-term follow-up was performed for two patients who underwent bimaxillary facial transplantation (FT). The study material consisted of the follow-up data of two bimaxillary composite FT performed in Helsinki University Hospital, one in 2016 and the other in 2018. Serial three-dimensional computed tomography scans obtained during follow-up (6 years for patient 1, 4 years for patient 2) were analyzed. The position of the maxilla remained stable in both patients. At 4 and 6 years, the changes in the anterior maxilla were ≤1 mm, while the anterior mandible had moved 2.6-4 mm anteriorly and the mandibular midline 0.4-3.7 mm to the left side. Patient 1 underwent re-osteosynthesis 4 months after transplantation due to mandibular non-union. Patient 2 had a sagittal mandibular osteotomy at 15 months after FT due to lateral crossbite and tension created by temporomandibular joint rotation. Thereafter both patients had a stable occlusion. A continuous bone volume reduction in the mandible was noticed in both patients (6% and 9% reduction of the transplanted volume). The volume of the transplanted maxilla decreased during the early postoperative period but increased back to the original transplanted volume during the follow-up.
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Affiliation(s)
- A A Manninen
- Department of Plastic Surgery, Park Hospital, Helsinki University Hospital (HUS), University of Helsinki, Helsinki, Finland.
| | - A Heliövaara
- Cleft Palate and Craniofacial Center, Department of Plastic Surgery, Helsinki University Hospital, Helsinki, Finland
| | | | - K Mesimäki
- Department of Oral and Maxillofacial Diseases, Meilahti Hospital, Helsinki University Hospital (HUS), Helsinki, Finland
| | - T Wilkman
- Department of Oral and Maxillofacial Diseases, Meilahti Hospital, Helsinki University Hospital (HUS), Helsinki, Finland
| | - A J Lindford
- Department of Plastic Surgery, Park Hospital, Helsinki University Hospital (HUS), University of Helsinki, Helsinki, Finland
| | - P Lassus
- Department of Plastic Surgery, Park Hospital, Helsinki University Hospital (HUS), University of Helsinki, Helsinki, Finland
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9
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Qu F, Huang YJ, Wang YY, Cao XM, Shen YY, Wu ZA, Wu YQ, Xu C. Cone-beam CT evaluation of post-extraction alveolar bone changes at the maxillary incisor sites in an East Asian population: A cross-sectional study. Heliyon 2024; 10:e32027. [PMID: 38868037 PMCID: PMC11167353 DOI: 10.1016/j.heliyon.2024.e32027] [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: 10/27/2023] [Revised: 04/26/2024] [Accepted: 05/27/2024] [Indexed: 06/14/2024] Open
Abstract
Objective Understanding the characteristics of alveolar bone resorption in an East Asian population after maxillary incisor extraction and providing a reference for implant treatment plans. Study design Cone-beam computerized tomography (CBCT) data of 125 East Asian patients with unilateral extraction of maxillary incisors for 3 months were collected. The alveolar bone width and height in the extraction sites were measured and compared with the corresponding contralateral sites. Results The differences in alveolar bone width between the extraction site and contralateral site were as follows: 4.11 mm, 2.68 mm, and 2.09 mm (3 mm, 5 mm, 7 mm apical from CEJ of the contralateral tooth). Data are expressed as the median. The horizontal resorption ratio of alveolar bone was 49.94 %, 31.5 %, and 24.46 %. The difference in alveolar bone height was 0.78 mm. The vertical resorption ratio was 7.78 %. The resorption did not differ significantly between sexes and was not significantly affected by tooth positions. Conclusions In the studied East Asian population, significant horizontal and vertical alveolar bone resorption occurs after natural healing of maxillary incisor extraction for 3 months. The closer to the alveolar ridge crest, the more significant the horizontal resorption, resulting in an "inverted triangle" shape residual alveolar bone.
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Affiliation(s)
- Fang Qu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Yu-Jie Huang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ying-Ying Wang
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Xi-Meng Cao
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ying-Yi Shen
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Zi-Ang Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Ya-Qin Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
- Shanghai Engineering Research Center of Advanced Dental Technology and Materials, Shanghai, China
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10
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Ko YC, Lee D, Kwon O, Seol YJ, Koo KT, Lee YM, Lee J. Preclinical comparison study of experimental peri-implantitis between alveolar ridge preservation and spontaneous healing sites in infected and noninfected tooth: a randomized blinded in vivo study. J Periodontol 2024. [PMID: 38865252 DOI: 10.1002/jper.23-0617] [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: 10/26/2023] [Revised: 03/19/2024] [Accepted: 04/07/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND This study compared the progression of experimental peri-implantitis between alveolar ridge preservation (ARP) and spontaneous healing (SH) sites in infected (IT) and noninfected tooth (NIT). METHODS Bilateral mandibular third or fourth premolars of six beagle dogs were randomly assigned to IT and NIT groups. Before extraction, chronic dehiscence defects were created at the mesial root of mid-buccal area in IT group. Four weeks later, the mesial roots of the third and fourth premolars were extracted in all groups.ARP procedure was randomly conducted on one side of the extraction sockets using collagenated bovine bone substitutes and resorbable collagen membrane, and contralateral side was allowded spontaneous healing. After 12 weeks of healing, bone-level implants (ϕ 3.6 × 8.0 mm) were placed at the extraction sockets. Three months of ligature induced peri-implantitis and three months of spontaneous progression were allowed, with radiographs taken at each phase. Biopsies were retrieved at the implant site for histomorphometric, immunohistochemical, and polarized light-microscopic analyses. RESULTS Radiography demonstrated that the changes in the marginal bone level during the spontaneous progression period showed no significant differences between ARP and SH sites. Only small and/or nonsignificant differences in the progression of peri-implantitis were observed between ARP and SH sites in histomorphometric, immunohistochemical, and polarized light microscopic analyses. Additionally, the IT and NIT groups exhibited similar outcomes for most parameters. CONCLUSION ARP with xenogenic bone substitutes might provide similarly robust results as SH sites regarding the progression of experimental peri-implantitis, irrespective of the infected or noninfected nature of the site before tooth extraction.
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Affiliation(s)
- Young-Chang Ko
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Dongseob Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
- National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, South Korea
| | - Obin Kwon
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, South Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, South Korea
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11
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López-Valverde N, Macedo de Sousa B, Blanco Rueda JA. Changes of the Alveolar Bone Ridge Using Bone Mineral Grafts and Collagen Membranes after Tooth Extraction: A Systematic Review and Meta-Analysis. Bioengineering (Basel) 2024; 11:565. [PMID: 38927801 PMCID: PMC11200736 DOI: 10.3390/bioengineering11060565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Alveolar preservation techniques for esthetic or functional purposes, or both, are a frequently used alternative for the treatment of post-extraction sockets, the aim of which is the regeneration of the lesion and the preservation of the alveolar bone crest. METHODS Studies published in PubMed (Medline), Web of Science, Embase, and Cochrane Library databases up to January 2024 were consulted. Inclusion criteria were established as intervention studies, according to the PICOs strategy: adult subjects undergoing dental extractions (participants), with alveoli treated with bone mineral grafts and collagen membranes (intervention), compared to spontaneous healing (comparison), and observing the response to treatment in clinical and radiological measures of the alveolar bone crest (outcomes). RESULTS We obtained 561 results and selected 12 studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool, and methodological quality was assessed using the Joanna Briggs Institute. Due to the high heterogeneity of the studies (I2 > 75%), a random-effects meta-analysis was used. Despite the trend, no statistical significance (p > 0.05) was found in the experimental groups. CONCLUSIONS The use of bone mineral grafts in combination with resorbable collagen barriers provides greater preservation of the alveolar ridge, although more clinical studies are needed.
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Affiliation(s)
- Nansi López-Valverde
- Department of Surgery, Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain;
| | - Bruno Macedo de Sousa
- Institute for Occlusion and Orofacial Pain, Faculty of Medicine, University of Coimbra, 3004-531 Coimbra, Portugal;
| | - José Antonio Blanco Rueda
- Department of Surgery, Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, 37008 Salamanca, Spain;
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12
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Khaddour AS, Ghiță RE, Ionescu M, Rîcă RG, Mercuț V, Manolea HO, Camen A, Drăghici EC, Radu A, Popescu SM. Healing of Extraction Sites after Alveolar Ridge Preservation Using Advanced Platelet-Rich Fibrin: A Retrospective Study. Bioengineering (Basel) 2024; 11:566. [PMID: 38927802 PMCID: PMC11201034 DOI: 10.3390/bioengineering11060566] [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: 05/14/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Over time, numerous surgical procedures and biomaterials have been proposed for the reconstruction of post-extraction bone defects, each with their advantages and disadvantages. The main objective of this study was to evaluate dimensional changes in the alveolar bone 3 months after tooth extraction, before implant planning, comparing alveolar ridge preservation (ARP) with spontaneous healing. METHODS A total of 84 patients with non-restorable molars were included in the study. Forty-two patients received ARP with advanced platelet-rich fibrin (A-PRF) and spontaneous healing was evaluated in these patients. Cone beam computed tomography (CBCT) analysis performed before and after surgical intervention was used to determine the changes in vertical and horizontal bone dimensions produced after tooth extraction. RESULTS CBCT measurements showed reduction in both vertical and horizontal alveolar bone size in both groups. For the study group, the alveolar parameters (height, width) were higher compared to the control group. The percentage variations between dimensional differences from the two groups were 38.58% for height, and for width were 36.88% at 0 mm, 35.56% at 3 mm, 36.61% at 5 mm, and 38.73% at 7 mm. The differences were statistically significant (p ˂ 0.0005). CONCLUSIONS The results obtained after ARP with A-PRF showed a reduced loss of bone volume compared to spontaneous healing.
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Affiliation(s)
- Antonia Samia Khaddour
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Răzvan Eugen Ghiță
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Radu Gabriel Rîcă
- Department of Dental Technology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Veronica Mercuț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Horia Octavian Manolea
- Department of Dental Materials, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Adrian Camen
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Emma Cristina Drăghici
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Andrei Radu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (E.C.D.); (A.R.); (S.M.P.)
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13
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Jafarian J, Shahrabi-Farahani S, Ferreira CF, Stewart CW, Luepke P. Histological Evaluation of Alveolar Ridge Preservation Using Different Bone Grafts: Clinical Study Analysis Part II. J ORAL IMPLANTOL 2024; 50:260-265. [PMID: 38660739 DOI: 10.1563/aaid-joi-d-23-00060] [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] [Indexed: 04/26/2024]
Abstract
To compare histologically the percentage of bone formation 12-20 weeks after ridge augmentation using 2 different techniques. Tooth loss is associated with 3-dimensional bone remodeling and ridge atrophy. Ridge preservation procedures can prevent alveolar bone volume loss. Different techniques and materials are used to preserve the alveolar ridge. Computer-generated randomization software was used to assign 2 ridge preservation techniques for 11 extraction sites. In group I, type I bovine Achilles tendon collagen plugs with bioactive resorbable calcium apatite crystals (CPCAC) were placed, and in group II, cortico-cancellous bone chips (CCBC) mix and an expanded polytetrafluoroethylene (ePTFE) barrier membrane were placed. The histomorphometric studies were performed using a computer-based image analysis system (ImageJ 1.4, National Institute of Health, Bethesda, Md) to calculate the pixel area of bone tissue and the remaining bone graft material. The histomorphometric data were analyzed using a Student t test to compare the measurements between the 2 experimental groups. This parametric statistical test was employed to determine if there were any statistically significant differences in the quantitative histological parameters between the groups. The sockets that received CPCAC showed a lower (31.89%) percentage of native bone surface area compared with the CCBC group (43.87%). However, the difference was not statistically significant (P < .05). In addition, the CPCAC group showed evidence of foreign-body reaction. The CCBC graft covered with an ePTFE barrier may induce more bone formation with minimal inflammation in an extraction socket compared with a collagen plug with calcium apatite crystals. In addition, histological analysis of the CPCAC graft showed evidence of foreign-body reaction, which indicates a negative clinical impact.
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Affiliation(s)
| | - Shokoufeh Shahrabi-Farahani
- Department of Diagnostic Sciences, University of Tennessee Health Science Center, College of Dentistry, Memphis, TN, USA
| | - Cimara Fortes Ferreira
- Department of Periodontology, University of Tennessee College of Dentistry, Memphis, TN, USA
| | - Colette Whitley Stewart
- Department of Dental Hygiene, University of Tennessee College of Dentistry, Memphis, TN, USA
| | - Paul Luepke
- Department of Periodontology, University of Tennessee College of Dentistry, Memphis, TN, USA
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14
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Mousavi Y, Paknejad M, Taheri M, Aslroosta H, Aminishakib P, Panjnoush M, Shamshiri A. Comparison of histologic and radiographic changes of sockets grafted with LPRF and sockets without intervention after tooth extraction. Oral Maxillofac Surg 2024; 28:667-677. [PMID: 37940776 DOI: 10.1007/s10006-023-01190-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES After tooth extraction, marked resorption occurs in extraction socket walls, leading to functional and esthetic problems in that area. One of the methods introduced to reduce this resorption is the use of platelet derivatives. This study aimed to evaluate the effects of leukocyte and platelet-rich fibrin (L-PRF) on the changes following tooth extraction. MATERIALS AND METHODS The participants were 24 patients who needed to replace at least one single-rooted tooth with an implant. They were randomly divided into test and control groups. After the tooth extraction, the sockets in the test group received LPRF clots, while in the control group, the sockets were left free of any interventions. CBCT scans were obtained from the extraction site both immediately after the tooth extraction and 8 weeks later. The histologic biopsy was also obtained while the implant site was being prepared 8 weeks after the extraction. RESULTS The average vertical bone loss in the buccal crest was not significantly different between the two groups (1.67 ± 1.67 in the test group and 2.3 ± 1.36 in the control group; mean difference = - 0.36, 95% CI: - 1.65-0.93, p-value = 0.57). Nor was the difference in resorption of the palatal wall (mean difference = - 0.19, 95% CI: - 1.51.12, p-value = 0.76). The mean ridge width resorption in 25% of the coronal aspect of sockets was also measured in the test (1.30 ± 0.66) and control group (0.58 ± 0.95) (mean difference = 0.73, 95% CI: 0.03-1.42, p-value = 0.04). The new bone formation in histologic view was not statistically different between groups (p-value = 0.15). CONCLUSION The LPRF neither reduces the rate of ridge resorption in vertical or horizontal dimensions of extraction sockets nor induces more new bone formation. CLINICAL RELEVANCE This study helps dentists choose the appropriate material for ridge preservation.
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Affiliation(s)
| | - M Paknejad
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Taheri
- Periodontist, Private Practice, Tehran, Iran
| | - H Aslroosta
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - P Aminishakib
- Oral and Maxillofacial Pathology Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Panjnoush
- Oral and Maxillofacial Radiology Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shamshiri
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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15
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Fok MR, Jin L. Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices. J Dent 2024; 145:104986. [PMID: 38574844 DOI: 10.1016/j.jdent.2024.104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice. SOURCES AND STUDY SELECTION To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration. DATA 11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low. CONCLUSION This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored. CLINICAL SIGNIFICANCE By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China.
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
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16
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Donker VJJ, Raghoebar GM, Slagter KW, Hentenaar DFM, Vissink A, Meijer HJA. Immediate implant placement with immediate or delayed provisionalization in the maxillary aesthetic zone: A 10-year randomized trial. J Clin Periodontol 2024; 51:722-732. [PMID: 38454548 DOI: 10.1111/jcpe.13971] [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: 09/14/2023] [Revised: 02/07/2024] [Accepted: 02/21/2024] [Indexed: 03/09/2024]
Abstract
AIM To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. MATERIALS AND METHODS Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri-implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. RESULTS After 10 years, the mean mesial and distal changes in marginal bone level were -0.47 ± 0.45 mm and -0.49 ± 0.52 mm in the IP group and -0.58 ± 0.76 mm and -0.41 ± 0.72 mm in the DP group (p = .61; p = .71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri-implant mucositis was 38.9% and 35.7% and of peri-implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p = .40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p = .48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p = .75). CONCLUSIONS The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. CLINICAL TRIAL REGISTRATION Registered in the National Trial Register (NL9340).
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Affiliation(s)
- Vincent J J Donker
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Kirsten W Slagter
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Diederik F M Hentenaar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arjan Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Restorative Dentistry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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17
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Balducci C, Zamuner A, Todesco M, Bagno A, Pasquato A, Iucci G, Bertelà F, Battocchio C, Tortora L, Sacchetto L, Brun P, Bressan E, Dettin M. Resorbable engineered barrier membranes for oral surgery applications. J Biomed Mater Res A 2024. [PMID: 38783716 DOI: 10.1002/jbm.a.37752] [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: 03/11/2024] [Revised: 05/06/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
Population aging, reduced economic capacity, and neglecting the treatments for oral pathologies, are the main causal factors for about 3 billion individuals who are suffering from partial/total edentulism or alveolar bone resorption: thus, the demand for dental implants is increasingly growing. To achieve a good prognosis for implant-supported restorations, adequate peri-implant bone volume is mandatory. The Guided Bone Regeneration (GBR) technique is one of the most applied methods for alveolar bone reconstruction and treatment of peri-implant bone deficiencies. This technique involves the use of different types of membranes in association with some bone substitutes (autologous, homologous, or heterologous). However, time for bone regeneration is often too long and the bone quality is not simply predictable. This study aims at engineering and evaluating the efficacy of modified barrier membranes, enhancing their bioactivity for improved alveolar bone tissue regeneration. We investigated membranes functionalized with chitosan (CS) and chitosan combined with the peptide GBMP1α (CS + GBMP1α), to improve bone growth. OsseoGuard® membranes, derived from bovine Achilles tendon type I collagen crosslinked with formaldehyde, were modified using CS and CS + GBMP1α. The functionalization, carried out with 1-ethyl-3-(3 dimethylaminopropyl)carbodiimide and sulfo-N-Hydroxysuccinimide (EDC/sulfo-NHS), was assessed through FT-IR and XPS analyses. Biological assays were performed by directly seeding human osteoblasts onto the materials to assess cell proliferation, mineralization, gene expression of Secreted Phosphoprotein 1 (SPP1) and Runt-Related Transcription Factor 2 (Runx2), and antibacterial properties. Both CS and CS + GBMP1α functionalizations significantly enhanced human osteoblast proliferation, mineralization, gene expression, and antibacterial activity compared to commercial membranes. The CS + GBMP1α functionalization exhibited superior outcomes in all biological assays. Mechanical tests showed no significant alterations of membrane biomechanical properties post-functionalization. The engineered membranes, especially those functionalized with CS + GBMP1α, are suitable for GBR applications thanks to their ability to enhance osteoblast activity and promote bone tissue regeneration. These findings suggest a potential advancement in the treatment of oral cavity problems requiring bone regeneration.
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Affiliation(s)
- Cristian Balducci
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Annj Zamuner
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Department of Civil, Architectural and Environmental Engineering, University of Padova, Padova, Italy
| | - Martina Todesco
- Department of Civil, Architectural and Environmental Engineering, University of Padova, Padova, Italy
| | - Andrea Bagno
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Antonella Pasquato
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | | | | | | | - Luca Tortora
- Department of Science, Roma Tre University, Rome, Italy
- National Institute for Nuclear Physics, INFN Roma Tre, Rome, Italy
| | - Luca Sacchetto
- Department of Neurosciences, Section of Dentistry, University of Padova, Padova, Italy
| | - Paola Brun
- Department of Molecular Medicine, University of Padova, Padova, Italy
| | - Eriberto Bressan
- Department of Neurosciences, Section of Dentistry, University of Padova, Padova, Italy
| | - Monica Dettin
- Department of Industrial Engineering, University of Padova, Padova, Italy
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18
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Chenchev LI, Ivanova VV, Chenchev IL, Daskalov HI. Minimally invasive extractions with physics forceps - clinical evaluation and comparison. Folia Med (Plovdiv) 2024; 66:235-242. [PMID: 38690819 DOI: 10.3897/folmed.66.e122678] [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: 03/09/2024] [Accepted: 04/09/2024] [Indexed: 05/03/2024] Open
Abstract
INTRODUCTION Tooth extraction is still one of the most common dental procedures, routinely performed for a variety of reasons. Tooth extraction forceps and elevators are well-known extraction instruments which have been the standard in tooth extraction procedures for well over a hundred years. Physics forceps are one possible alternative, aiming to perform less traumatic and more predictable extractions.
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19
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Kim S, Kim SG. Advancements in alveolar bone grafting and ridge preservation: a narrative review on materials, techniques, and clinical outcomes. Maxillofac Plast Reconstr Surg 2024; 46:14. [PMID: 38625426 PMCID: PMC11021384 DOI: 10.1186/s40902-024-00425-w] [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: 10/30/2023] [Accepted: 04/04/2024] [Indexed: 04/17/2024] Open
Abstract
This narrative review systematically explores the progression of materials and techniques in alveolar ridge preservation (ARP). We commence by delineating the evolution from traditional ARP methods to cutting-edge alternatives, including platelet-rich fibrin, injectable bone repair materials, and hydrogel systems. Critical examination of various studies reveals these innovative approaches not only accelerate bone healing but also significantly improve patient-reported outcomes, such as satisfaction, pain perception, and overall quality of life. Emphasis is placed on the correlation between advanced ARP techniques and enhanced patient comfort and clinical efficacy, underscoring their transformative potential in dental implantology. Highlighting the effectiveness of ARP, the implant survival rate over a span of 5 to 7 years was high, showcasing the reliability and success of these methods. Further, patients expressed high aesthetic satisfaction with the soft tissue outcome, evidenced by an average visual analog scale (VAS) score of 94. This positive aesthetic appraisal is linked to the clinical health of implants, potentially due to the employment of tooth-supported surgical guides. The economic analysis reveals a varied cost range for bone graft substitutes ($46.2 to $140) and socket sealing materials ($12 to $189), with a noteworthy correlation between the investment in barrier membranes and the diminished horizontal and vertical ridge resorption. This suggests that membrane usage significantly contributes to preserving ridge dimensions, offering a cost-effective strategy for enhancing ARP outcomes. In conclusion, this review illuminates the significant advancements in ARP, highlighting the shift towards innovative materials and techniques that not only promise enhanced bone regeneration and reduced healing times but also improve patient satisfaction and aesthetic outcomes. The documented high implant survival rate and the beneficial economic implications of membrane use further validate the effectiveness of contemporary ARP strategies, paving the way for their broader adoption in dental implantology.
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Affiliation(s)
- Suyoung Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea
| | - Seong-Gon Kim
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea.
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20
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Keddar M, Evrard L, Shall F. Horizontal ridge augmentation using guided bone regeneration with an association of particulate allografts mixed with platelet-rich fibrin, collagen membrane and tent-screws: A prospective study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101872. [PMID: 38582352 DOI: 10.1016/j.jormas.2024.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 03/21/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Guided Bone Regeneration (GBR) is a versatile technique employed not only to correct pre-implant alveolar bone defects but also to facilitate bone defect correction during simultaneous implant placement. The effectiveness of GBR varies significantly among different protocols, as reported in the literature. This study specifically aimed to radiologically evaluate the horizontal bone gain obtained using a GBR procedure combining a particulate allograft, platelet-rich fibrin, resorbable collagen membrane, and screw tents. MATERIALS AND METHODS A total of 42 patients with an insufficient alveolar bone width for dental implant placement were treated with a GBR technique using a mixture of particulate allograft (demineralised freeze-dried bone allograft 300-500 and 500-1000 µm), advanced platelet-rich fibrin (A-PRF), resorbable collagen membranes and screws tents (1.2 mm in diameter). Over the course of the study, a total of 63 GBR procedures were performed on these patients. Bone gains were measured by cone-beam computed tomography at 9.1 ± 2.0 months post-operative. RESULTS A significant mean increase (P < 0.001) of 3.2 ± 0.9 mm at the sites of the greatest bone defect was observed. This improvement was consistent across various locations, including both maxillary and mandibular regions, and in cases of terminal and embedded edentulism, without any post-operative complications during the entire post-operative follow-up. All patients benefited from implant placement following the bone augmentation protocol. CONCLUSION GBR combining particulate allografts, A-PRF, collagen membranes, and screw tents achieves reliable, predictable, and reproducible clinical gains that allow for future implant placement.
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Affiliation(s)
- Mehdi Keddar
- Oral and Maxillofacial Surgery Department, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), HUB Hôpital Erasme, 808 route de Lennik, B-1070, Bruxelles, Belgium.
| | - Laurence Evrard
- Oral and Maxillofacial Surgery Department, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), HUB Hôpital Erasme, 808 route de Lennik, B-1070, Bruxelles, Belgium
| | - Firas Shall
- Oral and Maxillofacial Surgery Department, Université libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), HUB Hôpital Erasme, 808 route de Lennik, B-1070, Bruxelles, Belgium
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21
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Lin CH, Wang HL, Yu LW, Chou PY, Chang HC, Chang CH, Chang PC. Deep learning for the identification of ridge deficiency around dental implants. Clin Implant Dent Relat Res 2024; 26:376-384. [PMID: 38151900 DOI: 10.1111/cid.13301] [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: 08/17/2023] [Revised: 11/12/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES This study aimed to use a deep learning (DL) approach for the automatic identification of the ridge deficiency around dental implants based on an image slice from cone-beam computerized tomography (CBCT). MATERIALS AND METHODS Single slices crossing the central long-axis of 630 mandibular and 845 maxillary virtually placed implants (4-5 mm diameter, 10 mm length) in 412 patients were used. The ridges were classified based on the intraoral bone-implant support and sinus floor location. The slices were either preprocessed by alveolar ridge homogenizing prior to DL (preprocessed) or left unpreprocessed. A convolutional neural network with ResNet-50 architecture was employed for DL. RESULTS The model achieved an accuracy of >98.5% on the unpreprocessed image slices and was found to be superior to the accuracy observed on the preprocessed slices. On the mandible, model accuracy was 98.91 ± 1.45%, and F1 score, a measure of a model's accuracy in binary classification tasks, was lowest (97.30%) on the ridge with a combined horizontal-vertical defect. On the maxilla, model accuracy was 98.82 ± 1.11%, and the ridge presenting an implant collar-sinus floor distance of 5-10 mm with a dehiscence defect had the lowest F1 score (95.86%). To achieve >90% model accuracy, ≥441 mandibular slices or ≥592 maxillary slices were required. CONCLUSIONS The ridge deficiency around dental implants can be identified using DL from CBCT image slices without the need for preprocessed homogenization. The model will be further strengthened by implementing more clinical expertise in dental implant treatment planning and incorporating multiple slices to classify 3-dimensional implant-ridge relationships.
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Affiliation(s)
- Cheng-Hung Lin
- Department of Electrical Engineering, College of Technology and Engineering, National Taiwan Normal University, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Li-Wen Yu
- Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Yung Chou
- Department of Electrical Engineering, College of Technology and Engineering, National Taiwan Normal University, Taipei, Taiwan
| | - Hao-Chieh Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chin-Hao Chang
- Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan
| | - Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Division of Periodontics, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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22
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Kiarashi M, Bayat H, Shahrtash SA, Etajuri EA, Khah MM, Al-Shaheri NA, Nasiri K, Esfahaniani M, Yasamineh S. Mesenchymal Stem Cell-based Scaffolds in Regenerative Medicine of Dental Diseases. Stem Cell Rev Rep 2024; 20:688-721. [PMID: 38308730 DOI: 10.1007/s12015-024-10687-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
Biomedical engineering breakthroughs and increased patient expectations and requests for more comprehensive care are propelling the field of regenerative dentistry forward at a fast pace. Stem cells (SCs), bioactive compounds, and scaffolds are the mainstays of tissue engineering, the backbone of regenerative dentistry. Repairing damaged teeth and gums is a significant scientific problem at present. Novel therapeutic approaches for tooth and periodontal healing have been inspired by tissue engineering based on mesenchymal stem cells (MSCs). Furthermore, as a component of the MSC secretome, extracellular vesicles (EVs) have been shown to contribute to periodontal tissue repair and regeneration. The scaffold, made of an artificial extracellular matrix (ECM), acts as a supporting structure for new cell development and tissue formation. To effectively promote cell development, a scaffold must be non-toxic, biodegradable, biologically compatible, low in immunogenicity, and safe. Due to its promising biological characteristics for cell regeneration, dental tissue engineering has recently received much attention for its use of natural or synthetic polymer scaffolds with excellent mechanical properties, such as small pore size and a high surface-to-volume ratio, as a matrix. Moreover, as a bioactive material for carrying MSC-EVs, the combined application of scaffolds and MSC-EVs has a better regenerative effect on dental diseases. In this paper, we discuss how MSCs and MSC-derived EV treatment may be used to regenerate damaged teeth, and we highlight the role of various scaffolds in this process.
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Affiliation(s)
- Mohammad Kiarashi
- College of Dentistry, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | | | - Enas Abdalla Etajuri
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Meysam Mohammadi Khah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Kamyar Nasiri
- Department of Dentistry, Islamic Azad University of Medical Sciences, Tehran, Iran.
| | - Mahla Esfahaniani
- Faculty of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Saman Yasamineh
- Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
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23
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Berberi A, Zoghbi AE, Aad G, Tehini G. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024; 25:213-220. [PMID: 38690692 DOI: 10.5005/jp-journals-10024-3659] [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] [Indexed: 05/02/2024]
Abstract
AIM The objective of this study was to assess marginal bone level around single implants inserted in fresh extraction sockets in the anterior maxillary region and instantly restored with computer-aided design/computer-aided manufacturing customized temporary crowns cemented on the final abutment. MATERIALS AND METHODS A total of 20 patients (15 females and 5 males, with a mean age of 30 years), where 20 were placed in fresh extraction sockets. After raising a full-thickness flap, atraumatic extraction was performed the implant site was prepared and fixtures were stabilized on the palatal bone wall. The implant location was immediately transmitted to the prepared master model using the pick-up impression coping seated in the surgical guide template. Prefabricated abutments were used as the final abutment on the master model, scanned and the crown was planned using computer-aided manufacturing customized software. Later on 8th weeks, abutments were torqued as per the manufacturer's recommendation, and the final crowns were cemented. Using personalized intraoral radiographs marginal bone level was evaluated mesially and distally to the implant shoulder as a reference at implant placement, 8 weeks, 1, 3, 5, and 10 years after loading. RESULTS Wholly implants were osteo-integrated positively after 10 years of practical loading, but only 18 were available for clinical and radiological follow-up, and 2 patients with two implants were excluded from the study due to relocation abroad without any implant failure. The average marginal bone loss (MBL) in the current report was 0.16 ± 0.167 mm at crown cementation, 0.275 ± 0.171 mm after 1 year, 0.265 ± 0.171 mm after 3 years, 0.213 ± 0.185 mm after 5 years, and 0.217 ± 0.194 mm at 10 years. CONCLUSION The strategy of inserting and not removing the final abutment at the time of implant placement facilitates the establishment of adequate attachment of both soft and hard tissues to the abutment surface, ensuring uninterrupted organization of tissue architecture and offers advantages in helping maintain soft tissue maturation and preventing marginal bone level. CLINICAL SIGNIFICANCE Immediately loaded implants in freshly extracted sockets lead to a significant reduction in marginal ridge resorption. The use of a temporary crown on a prefabricated abutment, exclusive of successive abutment manipulation, proved effective in preserving the primarily founding blood clot and served as a prototype for shaping the soft tissue around the previously wounded gum. How to cite this article: Berberi A, El Zoghbi A, Aad G, et al. Immediate Loading Using the Digitalized Customized Restoration of Single-tooth Implants Placed in Fresh Extraction Sockets in the Aesthetic Anterior Maxilla: A 10-Year Prospective Study of Marginal Bone Level. J Contemp Dent Pract 2024;25(3):213-220.
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Affiliation(s)
- Antoine Berberi
- Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon, Phone: +961 37331173, e-mail: ;
| | - Amine El Zoghbi
- Department of Prosthodontics and Occlusion, Faculty of Dental Medicine Saint Joseph University, Beirut, Lebanon
| | - Georges Aad
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon
| | - Georges Tehini
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut Lebanon, and College of Healthcare Technology, American University of Baghdad
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24
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Zhao R, Wang Y, Lin H, Cao M, Xu X, Yuan Z, Gong J. Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: A systematic review. Part I: Clinical trials. Medicine (Baltimore) 2024; 103:e37471. [PMID: 38489729 PMCID: PMC10940972 DOI: 10.1097/md.0000000000037471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but its clinical effectiveness remains undetermined. This systematic review aimed to comprehensively investigate BR grafts in diverse scenarios of ridge defect with simultaneous or staged implant placement. METHODS Electronic retrieval of MEDLINE, Embase, Cochrane Library(CENTRAL), Web of Science, Scopus, and citation search until August 3, 2023, was used to identify relevant clinical articles that utilized BR grafts for ridge defect reconstruction. The quality of evidence in the studies reviewed was assessed with the Joanna Briggs Institute Critical Appraisal tool. The protocol was registered in Prospective Register of Systematic Reviews (CRD42023453943). RESULTS Fourteen studies with 251 BRs were identified, of which 8 studies were for alveolar ridge augmentation, 4 studies were for extraction socket augmentation, and 2 studies were for sinus floor elevation. Reported sources of BRs included autografts, allografts, and xenografts. The follow-up period ranged from 4 months to 4.7 years. Regarding the primary outcomes, the utilization of BR grafts demonstrated favorable bone gain along with acceptable graft absorption and marginal bone loss. Regarding the secondary outcomes, satisfactory bone mineral density and implant stability were confirmed, accompanied by a recorded incidence of postoperative complications (20 cases) and an implant failure rate of 5.58%. CONCLUSIONS BR grafting with simultaneous or staged implant insertion is an effective approach for reconstructing alveolar ridge deficiencies. The BR grafts demonstrate favorable bone remodeling and osteointegration with the alveolar bone and implant; however, its success may be compromised by complications. Future studies should further investigate the clinical efficacy of BR grafting comparing to other bone augmentation techniques in diverse scenarios.
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Affiliation(s)
- Ruimin Zhao
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
| | - Yi Wang
- Department of Emergency, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
| | - Huijing Lin
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Min Cao
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Xu Xu
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Zhenfei Yuan
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Jiaming Gong
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
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25
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Chatzopoulos GS, Koidou VP, Sonnenberger M, Johnson D, Chu H, Wolff LF. Postextraction ridge preservation by using dense PTFE membranes: A systematic review and meta-analysis. J Prosthet Dent 2024; 131:410-419. [PMID: 35410705 DOI: 10.1016/j.prosdent.2022.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/15/2022]
Abstract
STATEMENT OF PROBLEM The use of dense polytetrafluoroethylene (dPTFE) membranes in alveolar ridge preservation may help reduce the risk of bacterial contamination and infection, maintaining the soft-tissue anatomy. However, systematic reviews on their efficacy in postextraction sites are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the efficacy of alveolar ridge preservation with dPTFE membranes when used alone or in combination with bone grafting materials in postextraction sites. MATERIAL AND METHODS An electronic search up to February 2021 was conducted by using PubMed, Embase, and the Cochrane library to detect studies using dPTFE membranes in postextraction sites. An additional manual search was performed in relevant journals. Clinical and radiographic dimensional changes of the alveolar ridge, histomorphometric, microcomputed tomography, implant-related findings, and rate of complications were recorded. One-dimensional meta-analysis was performed to calculate the overall means and 95% confidence intervals (α=.05). RESULTS A total of 23 studies, 14 randomized controlled trials, 4 retrospective cohort studies, 3 case series, and 2 prospective nonrandomized clinical trials, met the inclusion criteria. Five studies were included in the quantitative analysis. The meta-analysis revealed that the use of dPTFE membranes resulted in a statistically significant (P=.042) increase in clinical keratinized tissue of 3.49 mm (95% confidence interval [CI]: 0.16, 6.83) when compared with extraction alone. Metaregression showed that the difference of 1.10 mm (95% CI: -0.14, 2.35) in the radiographic horizontal measurements was not significant (P=.082), but the difference of 1.06 mm (95% CI: 0.51, 1.62) in the radiographic vertical dimensional change between dPTFE membranes+allograft and extraction alone was statistically significant (P<.001). CONCLUSIONS The use of dPTFE membranes was better than extraction alone in terms of keratinized tissue width and radiographic vertical bone loss.
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Affiliation(s)
- Georgios S Chatzopoulos
- Diplomate of the American Board of Periodontology and Private practice Limited to Periodontics and Implant Dentistry, London, UK; Former Resident, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn.
| | - Vasiliki P Koidou
- PhD Candidate, Centre for Oral Immunobiology and Regenerative Medicine and Centre for Oral Clinical Research, Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University London (QMUL), London, UK; Diplomate of the American Board of Periodontology and Former Resident, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn
| | - Michelle Sonnenberger
- PhD Candidate, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minn
| | - Deborah Johnson
- Clinical Professor and Diplomate of the American Board of Periodontology, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn
| | - Haitao Chu
- Professor, Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minn; Professor, Clinical Translational Science Institute (CTSI), University of Minnesota, Minneapolis, Minn
| | - Larry F Wolff
- Professor, Division of Periodontology, Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, Minneapolis, Minn
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26
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Saleh RN, Ashhab C, Kharoufeh MV, Lahham CE. Management of a severely atrophic maxilla using concentrated platelet-rich fibrin block. A case report. J Surg Case Rep 2024; 2024:rjae165. [PMID: 38505338 PMCID: PMC10948739 DOI: 10.1093/jscr/rjae165] [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: 02/07/2024] [Accepted: 02/24/2024] [Indexed: 03/21/2024] Open
Abstract
Tooth loss often leads to significant alveolar bone resorption, presenting a challenge for dental implant placement. This case report presents the effectiveness of concentrated platelet-rich fibrin (C-PRF) in combination with bone allograft for horizontal bone augmentation in a severely atrophic maxilla. A 33-year-old female patient with extensive bone loss in the upper anterior maxilla was treated in two stages. The initial stage involved horizontal bone augmentation using a mixture of C-PRF and bone allograft. This was followed, 5 months later, by dental implant placement. The preparation of C-PRF, surgical procedure, and postoperative care are thoroughly described. Post-treatment Cone Beam Computed Tomography showed an increase in alveolar bone thickness from 2.4-3.4 mm pre-operatively to 6.3-7.3 mm, demonstrating the procedure's effectiveness in achieving adequate bone volume for implant placement. The use of C-PRF with allograft in horizontal bone augmentation shows promise in enhancing bone regeneration, especially in a severely atrophic maxilla.
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Affiliation(s)
- Raghad N Saleh
- Oral and Maxillofacial Surgery Department, University College London, London EC4N 1SA, UK
| | - Celine Ashhab
- Graduate Studies, Arab American University, Ramallah 00970, Palestine
| | | | - Cezar Edward Lahham
- Periodontics Department, Arab American University, Bethlehem 00970, Palestine
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27
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Nagata K, Kamata M, Okuhama Y, Wakamori K, Okubo M, Tsuruoka H, Atsumi M, Kawana H. Volume change after maxillary sinus floor elevation with apatite carbonate and octacalcium phosphate. Int J Implant Dent 2024; 10:7. [PMID: 38329586 PMCID: PMC10853090 DOI: 10.1186/s40729-023-00518-7] [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: 11/02/2023] [Accepted: 12/19/2023] [Indexed: 02/09/2024] Open
Abstract
PURPOSE Maxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the volume of bone substitutes can affect the success of implant therapy. Therefore, this study aimed to compare the changes in the volume of two different bone substitutes-one based on carbonate apatite and the other on octacalcium phosphate-used in maxillary sinus floor elevation. METHODS Nineteen patients and 20 sites requiring maxillary sinus floor elevation were included in the study. Digital Imaging and Communications in Medicine data for each patient obtained preoperatively and immediately and 6 months postoperatively were used to measure the volume of the bone grafting material using a three-dimensional image analysis software. The immediate postoperative volume of octacalcium phosphate was 95.3775 mm3 per piece of grafting material used. It was multiplied by the number of pieces used and converted to mL to determine the immediate postoperative volume. RESULTS The mean resorption values of carbonate apatite and octacalcium phosphate were 12.7 ± 3.6% and 17.3 ± 3.9%, respectively. A significant difference in the amount of resorption of the two bone replacement materials was observed (P = 0.04). CONCLUSIONS The results of this study indicate that both bone substitute materials tend to resorb. The two bone grafting materials that are currently medically approved in Japan have not been in the market for a long time, and their long-term prognosis has not yet been reported. Further clinical data are warranted.
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Affiliation(s)
- Koudai Nagata
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Masanobu Kamata
- Department of Fixed Prosthodontics, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Yurie Okuhama
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Kana Wakamori
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Manabu Okubo
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Hayoto Tsuruoka
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Mihoko Atsumi
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan
| | - Hiromasa Kawana
- Department of Oral and Maxillofacial Implantology, Kanagawa Dental University, 82 Inaoka-Cho, Yokosuka, 238-8580, Japan.
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28
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Chokaree P, Poovarodom P, Chaijareenont P, Rungsiyakull P. Effect of Customized and Prefabricated Healing Abutments on Peri-Implant Soft Tissue and Bone in Immediate Implant Sites: A Randomized Controlled Trial. J Clin Med 2024; 13:886. [PMID: 38337580 PMCID: PMC10856257 DOI: 10.3390/jcm13030886] [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: 12/30/2023] [Revised: 01/28/2024] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to evaluate the effect of customized healing abutments compared to prefabricated healing abutments in immediate implant sites. Twelve patients requiring single immediate implant placement were divided into two groups: a prefabricated group received prefabricated titanium healing abutments, and a customized group received a polyetheretherketone (PEEK) customized healing abutments fabricated based on the individuals' digital impressions. Outcomes, including peri-implant horizontal and vertical soft tissue alteration, bone level change, volume change, pain score, and pink esthetic score (PES) change, were evaluated at the 1-, 4-, and 6-month follow-ups compared to pre-extraction teeth. At the 1- and 4-month follow-ups, the customized group had a significantly lower buccal volume variation (BVv). At the 6-month follow-up, neither group showed any significant difference in the marginal bone change; however, the customized group had a significantly lower PES change and a lower pain score. In the anterior and premolar regions, the customized group showed the preservation of peri-implant buccal horizontal soft tissue and buccal volume, while in the molar regions, the preservation of papilla height and midfacial height was observed. The morphology of the customized healing abutment demonstrated a better trend in preservation of peri-implant soft tissue, esthetic outcomes, and lower patient discomfort in immediate implant sites.
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Affiliation(s)
| | | | | | - Pimduen Rungsiyakull
- Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (P.C.); (P.P.); (P.C.)
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29
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Grassi A, Monica D, Minetti E, Ballini A, Gianfreda F, Bollero P, Cicciù M, Mastrangelo F. Innovative Alveolar Ridge Preservation Surgical Technique with Immediate Dental Implant Placement: A Retrospective Case Report of 1-Year Follow-Up. Eur J Dent 2024; 18:408-414. [PMID: 37995724 PMCID: PMC10959618 DOI: 10.1055/s-0043-1772676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023] Open
Abstract
Following tooth extraction, the alveolar ridge undergoes morphological and dimensional changes, including a clot formation that is gradually replaced by granulation tissue. Studies indicate that both horizontal and vertical ridge dimensions decrease after extraction; however, these changes can be mitigated through grafting with biomaterials and barrier membranes. Alveolar ridge preservation (ARP) techniques are employed to counteract bone resorption postextraction, encompassing periosteal inhibition and modified periosteal inhibition (MPI) techniques. The Degidi clot chamber technique offers a means to achieve biomaterial-free extraction sockets, promoting healing and osteointegration. This study aims to present the first rehabilitation of a postextraction dental implant in the maxilla using an innovative ARP procedure via a MPI technique. The technique does not involve autologous or heterologous grafting materials; instead, a cortical lamina and a customized screw are used in conjunction with the blood clot. The primary objective is to protect the vestibular cortical bone from preosteoclastic aggression, which can trigger bone resorption. The technique employs a 0.5-mm cortical lamina to mechanically shield the vestibular cortical bone, preventing vestibular cortical bone resorption and increasing its thickness without the need for biomaterial insertion, relying on the blood clot. The effectiveness of the technique was assessed through a 12-month postimplantation cone-beam computed tomography scan, revealing a 0.5-mm increase. Although based on a single case, the 1-year follow-up results are promising, and further studies are warranted to validate the technique's efficacy.
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Affiliation(s)
- Andrea Grassi
- Private Practice Dental Clinic, Reggio Emilia, Italy
| | - Daniele Monica
- Department of Clinical and Experimental Medicine, Dental School, University of Foggia, Foggia, Italy
| | - Elio Minetti
- Private Practice and Professor a c. University of Milan, Milan, Italy
| | - Andrea Ballini
- Department of Clinical and Experimental Medicine, Dental School, University of Foggia, Foggia, Italy
| | - Francesco Gianfreda
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Patrizio Bollero
- Department of System Medicine, Dental School, University of Rome “Tor Vergata”, Rome, Italy
| | - Marco Cicciù
- Department of General Surgery and Surgical-Medical Specialties, Dental School, University of Catania, Catania, Italy
| | - Filiberto Mastrangelo
- Department of Clinical and Experimental Medicine, Dental School, University of Foggia, Foggia, Italy
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Elsayed AO, Abdel-Rahman FH, Ahmed WM, Tawfik MAM. Clinical and Radiographic Outcomes of Autogenous Inlay Graft vs Autogenous Onlay Graft for Anterior Maxillary Horizontal Ridge Augmentation: A Randomized Control Clinical Study. J Contemp Dent Pract 2024; 25:107-113. [PMID: 38514406 DOI: 10.5005/jp-journals-10024-3634] [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] [Indexed: 03/23/2024]
Abstract
AIM This study aimed to compare the efficacy of autogenous onlay and inlay grafts for anterior maxillary horizontal ridge augmentation. MATERIALS AND METHODS This randomized clinical trial was performed on 14 patients with a deficient partially edentulous anterior maxillary ridge (3-5 mm in width). Patients were randomized and grouped into two equal groups: Group A was treated with symphyseal autogenous bone block, which was placed and fixed buccally as an onlay graft, and group B: was treated with symphyseal autogenous bone block, which was interpositioned and fixed in space created between buccal and lingual cortex as inlay graft. Patients were evaluated clinically and radiographically to evaluate the increase of bone width at [Baseline, immediate postoperative (T0)] and six months post-graft (T6). RESULTS A total of 14 patients (8 males and 6 females) with age range from 20 to 43 years old with a mean of 42.1 years were involved in our study. Radiographically, there was a significant statistical difference in comparing between two groups for the creation of a horizontal alveolar bone at T0. In the inlay group, the mean preoperative bone width was 3.9 ± 0.3 mm at T0 and 5.7 ± 0.5 mm at T6. While in the onlay group, the mean preoperative bone width was 3.7 ± 0.7 mm at T0 while at T6 the mean bone width was 6.1 ± 0.8 mm. This was statistically significant. CONCLUSION Inlay block graft appears to be a successful treatment option for horizontal ridge augmentation in the maxillary arch. CLINICAL SIGNIFICANCE both techniques are viable techniques for augmentation of atrophic alveolar ridge with uneventful healing. How to cite this article: Elsayed AO, Abdel-Rahman FH, Ahmed WMAS, et al. Clinical and Radiographic Outcomes of Autogenous Inlay Graft vs Autogenous Onlay Graft for Anterior Maxillary Horizontal Ridge Augmentation: A Randomized Control Clinical Study. J Contemp Dent Pract 2024;25(2):107-113.
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Affiliation(s)
- Ahmed O Elsayed
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Phone: +20 1028250524, e-mail: , Orcid: https://orcid.org/0009-0002-9887-0233
| | - Fakhreldin H Abdel-Rahman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0000-0003-4654-2078
| | - Wael Mas Ahmed
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0000-0002-4508-7010
| | - Mohamed A-M Tawfik
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, Orcid: https://orcid.org/0000-0001-7897-5535
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Abaza G, Abdel Gaber HK, Afifi NS, Adel-Khattab D. Injectable platelet rich fibrin versus hyaluronic acid with bovine derived xenograft for alveolar ridge preservation. A randomized controlled clinical trial with histomorphometric analysis. Clin Implant Dent Relat Res 2024; 26:88-102. [PMID: 37905704 DOI: 10.1111/cid.13289] [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: 03/29/2023] [Revised: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Alveolar ridge preservation (ARP) is a technique that aims to maintain bone volume and minimize resorption after tooth extraction. OBJECTIVE This study aimed to compare the effectiveness of injectable platelet-rich fibrin (I-PRF) versus hyaluronic acid (HA) in combination with xenografts for ARP. METHODS This randomized controlled trial included 36 patients (20 females and 16 males) who required implant placement in the upper arch. The patients were randomly allocated to one of three groups (n = 12 each): I-PRF with xenografts, HA with xenografts, or xenografts alone. All patients underwent ARP, and the extraction sockets were sealed with a free gingival graft harvested from the palate, a total of 36 implants were inserted. Cone-beam CT scans were performed before and 4 months postoperatively to measure radiographic bone gain as the primary outcome. Clinical parameters, including soft tissue thickness and clinical bone width, were evaluated preoperatively, and at 4 months and 1 year postoperatively. Additionally, histological assessment of core bone biopsies was performed 4 months postoperatively using histomorphometric analysis to determine the percentages of newly formed bone, mature bone, and residual grafts. RESULTS Regarding the radiographic bone gain 4 months postoperative the HA group exhibited the highest value (9.78 ± 0.87), which was significantly greater than the values observed in the I-PRF and control groups (8.60 ± 1.27 and 7.99 ± 0.89, respectively) (one-way ANOVA, p = 0.007). Crestal bone loss was significantly higher in the control group (-0.98 ± 0.18) than in the I-PRF group (-0.53 ± 0.11) and HA group (-0.33 ± 0.15) groups (one-way ANOVA, p < 0.001). In the histomorphometric analysis, the mean area fraction of newly formed bone trabeculae was significantly higher in the HA group (56.66 ± 7.35) than in the I-PRF group (28.74 ± 5.15) and the control group (24.05 ± 3.64) (repeated measures ANOVA, p < 0.001). Additionally, the mean area fraction of residual graft material was higher in the I-PRF group (6.76 ± 2.59), followed by the control group (2.71 ± 1.24), while the HA group had the lowest value (2.63 ± 1.27) (Repeated measures ANOVA, p < 0.001). CONCLUSION The combination of HA with xenografts yielded better radiographic and histological outcomes in terms of new bone formation and degree of bone maturation than the I-PRF and control groups. Furthermore, I-PRF improved soft tissue thickness. Please note that clinical trial registration was not completed prior to participant recruitment and randomization. The registration link for this trial is https://clinicaltrials.gov/ct2/show/NCT05781529.
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Affiliation(s)
- Gehad Abaza
- Master Periodontology, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Hala Kamal Abdel Gaber
- Department of Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Nermeen Sami Afifi
- Department of Oral Pathology, Faculty of Dentistry, Ain Shams University and Misr International University, Cairo, Egypt
| | - Doaa Adel-Khattab
- Department of Oral Medicine, Periodontology and Diagnosis, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Zhang Y, Du R, Yang B, Tao J, Jing W. Efficacy of autologous platelet concentrate products for alveolar preservation: A meta-analysis. Oral Dis 2024. [PMID: 38297960 DOI: 10.1111/odi.14874] [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: 09/23/2023] [Revised: 01/04/2024] [Accepted: 01/11/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE The purpose of the study was to systematically evaluate the efficacy of autologous platelet concentrate products in the preservation of the alveolar ridge after tooth extraction through meta-analysis and provide a theoretical basis for the clinical application of autologous platelet concentrates to reduce alveolar bone resorption. METHODS This study conducted a meta-analysis of clinical trials between 2013 and 2023, focusing on autologous platelet concentrate products (e.g., PRP, PRF, CGF, and PRCF) used for alveolar ridge preservation after tooth extraction. The analysis included 122 articles and 371 extraction sockets. All statistical analyses were performed using Review Manager version 5.4. RESULTS Results indicate that these platelet concentrates effectively reduced changes in horizontal width 1 mm below the alveolar crest and vertical socket height. They also promoted a higher percentage of new bone formation in extraction sockets compared with control groups. However, they did not significantly prevent horizontal bone resorption at 3 and 5 mm below the alveolar crest. CONCLUSION In conclusion, autologous platelet concentrates are useful for alveolar ridge preservation, but larger clinical studies are needed to confirm these findings due to the relatively small sample size in this study.
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Affiliation(s)
- Yi Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Ruiyu Du
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Baohua Yang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Junming Tao
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Jeanneau C, Catherine JH, Giraud T, Lan R, About I. The Added Value of a Collagenated Thermosensitive Bone Substitute as a Scaffold for Bone Regeneration. MATERIALS (BASEL, SWITZERLAND) 2024; 17:625. [PMID: 38591482 PMCID: PMC10856128 DOI: 10.3390/ma17030625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 04/10/2024]
Abstract
A pre-hydrated thermosensitive collagenated biomaterial which sets at body temperature and maintains the space of the missing alveolar bone volume, OsteoBiol GTO® (GTO), has been released as a bone substitute. This study was designed to check its angiogenic and osteogenic potentials compared to OsteoBiol Gen-Os® (Gen-Os) and Geistlich Bio-Oss® (Bio-Oss). Samples of materials were incubated in culture media to obtain the extracts. Collagen release was measured in the extracts, which were used to investigate human periodontal ligament (hPDL) cell proliferation (MTT), colonization (Scratch assays) and growth factor release (ELISA). The effects on endothelial cell proliferation (MTT) and organization (Matrigel® assays) were also studied. Finally, endothelial and mesenchymal Stem Cell (hMSC) recruitment (Boyden Chambers) were investigated, and hMSC Alkaline Phosphatase (ALP) activity was measured. A higher collagen concentration was found in GTO extract, which led to significantly higher hPDL cell proliferation/colonization. All materials increased VEGF/FGF-2 growth factor secretion, endothelial cell recruitment, proliferation, and organization, but the increase was highest with GTO. All materials increased hMSC recruitment and ALP activity. However, the increase was highest with collagenated GTO and Gen-Os, which enhanced C5a and BMP-2 secretion. Overall, GTO has higher angiogenic/osteogenic potentials than the collagenated Gen-Os and the anorganic Bio-Oss. It provides a suitable scaffold for endothelial and mesenchymal stem cell recruitment, which represent essential bone regeneration requirements.
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Affiliation(s)
| | - Jean-Hugues Catherine
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Thomas Giraud
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
| | - Romain Lan
- APHM, Hôpital Timone, Pôle Odontologie, Service de Chirurgie Orale, 13005 Marseille, France;
- Aix-Marseille University, CNRS, EFS, ADES, 13385 Marseille, France
| | - Imad About
- Aix-Marseille University, CNRS, ISM, 13009 Marseille, France (J.-H.C.)
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Han HS, Lee JT, Oh S, Cho YD, Kim S. Effectiveness of a collagen matrix seal and xenograft in alveolar ridge preservation: an experimental study in dogs. Sci Rep 2024; 14:163. [PMID: 38168516 PMCID: PMC10762190 DOI: 10.1038/s41598-023-50370-3] [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: 09/22/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Majority of previous studies on alveolar ridge preservation (ARP) used collagen membranes as barrier membranes, and further evidence for ARP in dehiscent extraction sockets with a deproteinized bovine bone mineral (DBBM) and matrix is needed. The aim of this study is to assess the impact of non-cross linked collagen membranes (membrane) and crosslinked collagen matrices (matrix) on ARP using DBBM in extraction sockets with buccal dehiscence. In six mongrel dogs, the mesial roots of three mandibular premolars (P2, P3, and P4) were extracted 1 month after dehiscence defect induction. Two experimental groups were randomly assigned: (1) DBBM with a membrane (DBBM/membrane group) and (2) DBBM with a matrix (DBBM/matrix group). Three-dimensional (3D) volumetric, microcomputed tomography (μCT), and histologic analyses were performed to assess the ridge preservation. Both groups were effective to maintain the ridge width (p > 0.05), and the DBBM/matrix group showed more favorable soft tissue regeneration and bone quality in the histological analysis (p = 0.05). Based on these results, DBBM/matrix could be better choice for ARP in cases of buccal dehiscence defects.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Tae Lee
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Seunghan Oh
- Department of Dental Biomaterials, The Institute of Biomaterial and Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
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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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Al Dary HH, Droubi L, Abuarqoub MA, Alhadidi A, Lubbadeh A. Five-Year Clinical, Radiographic, and Cone-Beam Follow-Up of Socket Shield Technique in Two Cases Treated with a Split Mouth Design. J Long Term Eff Med Implants 2024; 34:1-7. [PMID: 38305365 DOI: 10.1615/jlongtermeffmedimplants.2023045239] [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: 02/15/2023]
Abstract
The two presented cases of socket shield technique were done following a split mouth protocol in two patients, each received an immediate implant inserted conventionally on maxillary one side and another implant inserted applying the socket shield technique on the contralateral side. The outcomes including soft and hard tissue changes were compared clinically and radiographically. The four implants were followed for 5 years, and the outcomes were successful.
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Affiliation(s)
| | - Lina Droubi
- Department of Periodontics, Jordanian Ministry of Health, Amman, Jordan
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Hussain AA, Al-Quisi AF, Abdulkareem AA. Efficacy of Autogenous Dentin Biomaterial on Alveolar Ridge Preservation: A Randomized Controlled Clinical Trial. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7932432. [PMID: 38179035 PMCID: PMC10764647 DOI: 10.1155/2023/7932432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024]
Abstract
Background After tooth extraction, alveolar bone resorption is inevitable. This clinical phenomenon challenges dental surgeons aiming to restore esthetic and function. Alveolar ridge preservation can be applied to minimize dimensional changes with a new socket grafting material, an autogenous dentin graft, produced by mechanically and chemically processing natural teeth. This study assessed the safety and efficacy of using autogenous dentin biomaterial in alveolar ridge preservation. Materials and Methods Patients with nonrestorable maxillary anterior teeth bounded by natural sound teeth were included in this study. After a detailed clinical and tomographic examination, eligible participants were randomly allocated into two groups. The control group had spontaneous healing of extraction sockets. The study group had their extraction sockets filled with autogenous dentin biomaterial after processing their extracted retained roots with the KometaBio device. Standardized cone beam computed tomography (CBCT) scans were repeated four months later. A full-thickness mucoperiosteal flap reflection was achieved under local anesthesia to get core biopsies for histomorphometric analysis, and dental implants were placed at the same session. Results A total of 32 eligible patients were included in this study (n = 16 in each group). Both groups had significantly higher facial soft tissue thickness after four months than baseline (p < 0.05). However, the study group showed statistically significant lesser dimensional changes than the control group according to the standardized CBCT scans. Furthermore, core biopsies confirmed an excellent remodeling of the autogenous dentin biomaterial in the study group. In comparison, only new thin bone trabeculae-filled sockets were in the control group. Conclusion Autogenous dentin graft can be safely and successfully used for alveolar ridge preservation. Optimal graft remodeling histologically, better ridge dimensional stability, and uneventful wound healing support its clinical application. This trial is registered with TCTR20220615002.
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Affiliation(s)
| | - Ahmed Fadhel Al-Quisi
- Oral and Maxillofacial Surgery Department, College of Dentistry, University of Baghdad, Baghdad, Iraq
| | - Ali A. Abdulkareem
- Department of Periodontics, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Dupré N, Fournier BPJ, Gondel O, Riou MC, Isaac J, Garrec P, Vi-Fane B, Kribel S, De La Dure-Molla M, Carra MC, Felizardo R, Kerner SP. Reduced bone dimension in patients affected by oligodontia: A retrospective study on maxillary and mandibular CBCT. J Clin Periodontol 2023; 50:1590-1600. [PMID: 37653705 DOI: 10.1111/jcpe.13866] [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: 01/30/2023] [Revised: 07/13/2023] [Accepted: 08/04/2023] [Indexed: 09/02/2023]
Abstract
AIM Oligodontia (OD) is a rare developmental condition characterized by the absence of six or more teeth. Dental implant placement may be challenging due to anatomical factors. This study aims to evaluate the alveolar bone dimensions in OD patients compared with controls. MATERIALS AND METHODS On maxillary and mandibular cone-beam computed tomography (CBCT), bone height and width were measured at every tooth and edentulous site. The distance to the inferior alveolar nerve was also measured. Fifty-three OD patients (40 maxillary and 32 mandibular CBCT) and 82 controls (51 maxillary and 31 mandibular CBCT) were compared using mixed models. RESULTS Compared with those in OD patients, maxillary permanent teeth and edentulous sites showed significantly higher mean height in control patients (incisive-canine site height: +2.12 mm; edentulous incisive-canine site height: +4.46 mm [p > .001]). For the mandibular permanent teeth, mean height was higher in controls than in OD patients at the incisive-canine (+3.82 mm [p > .001]) and premolar areas (+2.06 mm [p > .001]). Only edentulous incisive-canine sites were significantly different between controls and OD patients (mean: +0.52 mm [p > .001]). Changes in alveolar nerve position were observed in case of molar agenesis. CONCLUSION Maxillary and mandibular bone dimensions are reduced in OD patients compared with controls both in sites with permanent teeth and in edentulous areas.
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Affiliation(s)
- Nicolas Dupré
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM U1138, Laboratory of Molecular Oral Pathophysiology, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
| | - Benjamin P J Fournier
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM U1138, Laboratory of Molecular Oral Pathophysiology, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
| | - Orianne Gondel
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Department of Periodontology, APHP, Bretonneau Hospital, Paris, France
| | - Margot C Riou
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM U1138, Laboratory of Molecular Oral Pathophysiology, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
| | - Juliane Isaac
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM U1138, Laboratory of Molecular Oral Pathophysiology, Paris, France
| | - Pascal Garrec
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Department of Orthodontics, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Brigitte Vi-Fane
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Department of Orthodontics, APHP, Pitié Salpêtrière Hospital, Paris, France
| | - Samia Kribel
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
| | - Muriel De La Dure-Molla
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
- INSERM UMR_S1163 Bases moléculaires et physiopathologiques des ostéochondrodysplasies, Institut Imagine Necker, Paris, France
| | - Maria Clotilde Carra
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
- UMS 011, Population-based Epidemiologic Cohorts Unit, INSERM, Villejuif, France
- Post Graduate Program in Periodontology and Implant Dentistry, Université Paris-Cité, Paris, France
| | - Rufino Felizardo
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
- CNRS, UMR 8045, BABEL, Université Paris Cité, Paris, France
| | - Stephane P Kerner
- Faculty of Odontology, Departments of Periodontology, Oral Biology, Pediatric Dentistry, Orthodontics and Imaging, Université Paris Cité, Paris, France
- Reference Centre for Oral and Dental Rare Diseases, ORARES, Rothschild Hospital AP-HP, Paris, France
- Centre de Recherche des Cordeliers, Université Paris Cité, Sorbonne Université, INSERM U1138, Laboratory of Molecular Oral Pathophysiology, Paris, France
- Service of Odontology, APHP, Rothschild Hospital, Paris, France
- Post Graduate Program in Periodontology and Implant Dentistry, Université Paris-Cité, Paris, France
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA
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Ashour SH, Mudalal M, Al-Aroomi OA, Al-Attab R, Li W, Yin L. The Effects of Injectable Platelet-Rich Fibrin and Advanced-Platelet Rich Fibrin on Gingival Fibroblast Cell Vitality, Proliferation, Differentiation. Tissue Eng Regen Med 2023; 20:1161-1172. [PMID: 37823991 PMCID: PMC10646031 DOI: 10.1007/s13770-023-00586-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/01/2023] [Accepted: 08/07/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Injectable Platelet Rich Fibrin (I-PRF) and Advanced-Platelet Rich Fibrin (A-PRF) are autologous materials derived from patients' blood and employed in periodontal regenerative surgery. Although I-PRF and A-PRF have different characteristics, their biological effects on gingival tissue fibroblasts remain unclear. This research aims to compare the in vitro capacity in inducing gene expression and proliferation of human gingival fibroblasts between A-PRF and I-PRF. METHODS Human donors undergoing dental implant surgery were sampled for normal human gingival fibroblasts (NHGFCs), followed by preparing A-PRF and I-PRF membranes. Enzyme-linked immunosorbent assay (ELISA) kit was used to assess the release of platelet-derived growth factor-AA (PDGF-AA), transforming growth factor-beta1 (TGF- β1), and insulin growth factor-1 (IGF-1) at different periods. Cell viability and proliferation of A-PRF and I-PRF were compared using CCK-8 assay. The impacts of platelet concentration on human gingival fibroblast cells (HGFCs) were evaluated by quantifying the level or amount of phosphorylated extracellular signal-regulated protein kinase (p-ERK), and Matrix metalloproteinases (MMPs), MMP-1 and MMP-3. The effects of PRF on aged human gingival fibroblast cells were examined retrospectively. RESULTS Overall, A-PRF demonstrated a higher release of TGF-B1 and PDGF-AA, while I-PRF reflected higher levels of IGF-1. A significantly higher level of cell proliferation was induced by higher cell proliferation by A-PRF and I-PRF. Additionally, in comparison to I-PRF, the expression of ERK phosphorylation and MMP-1 &MMP-3 in HGFCs was demonstrated by I-PRF and A-PRF. The increase in A-PRF was time-dependent (p < 0.05). CONCLUSION Both I-PRF and A-PRF induced a stimulatory biological impact on the proliferation of human gingiva fibroblasts, with the latter demonstrating better capacity in facilitating the release of different growth factors. A-PRF also induced higher gene expression of p-ERK, MMP-1 &MMP-3, and the proliferation of fibroblasts.
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Affiliation(s)
- Sarraj H Ashour
- Department of Oral Implantology, School/Hospital of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Mahmoud Mudalal
- Department of Oral and Maxillofacial Surgery and Periodontology, Faculty of Dentistry, The Arab American University, Jenin, 240, Palestine
| | - Omar A Al-Aroomi
- Department of Oral Implantology, School/Hospital of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China
- Department of Oral Implantology, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Reem Al-Attab
- Department of Oral Implantology, School/Hospital of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Wanxin Li
- Department of Oral Implantology, School/Hospital of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China
| | - Lihua Yin
- Department of Oral Implantology, School/Hospital of Stomatology, Lanzhou University, Lanzhou, Gansu, 730000, China.
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Serino G, Wada M, Mameno T, Stavropoulos A. Radiographic bone level and soft tissue dimensional changes following explantation of implants affected by peri-implantitis: A retrospective exploratory evaluation. Clin Exp Dent Res 2023; 9:945-953. [PMID: 37905730 PMCID: PMC10728526 DOI: 10.1002/cre2.802] [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: 09/05/2023] [Revised: 09/26/2023] [Accepted: 10/11/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND While the dimensional alteration of alveolar bone following tooth extraction have been extensively descripted in the literature, no information is available regarding potential hard and soft tissues changes following implant explantation. AIM To evaluate the radiographic bone healing and the horizontal and vertical soft tissue dimensional alterations at implant extraction alveoli, 6 months following implant explantation. MATERIAL AND METHODS Data from 31 patients scheduled for extraction of one implant with persisting peri-implantitis despite treatment were analysed. Bone crest level changes and the extent of bone healing at the apical aspect of the implant socket were assessed on the radiographs prior and 6 months following explantation. Regression analyses assessed the impact of various predictors (e.g., bone crest level, presence/absence of buccal bone) on bone level changes. Fisher's exact probability test was applied to assess the difference in probability to have mucosa recession of ≥2 mm in the presence or absence of alveolar buccal bone. RESULTS A vertical bone loss of 0.8 mm (standard deviation [SD] = 1.3) of the peri-implant bone crest and a gain of 0.8 mm (SD = 1.1) from the bottom of the peri-implant defect were recorded. Complete healing was noted in the intact implant extraction socket (i.e., the part of the implant not affected by peri-implantitis). A reduction of 0.4 mm (SD = 0.7) of the alveolar mucosa height was recorded in concomitant with a decrease of 0.7 mm (SD = 0.8) of the mucosa width. These alterations were more pronounced in the absence of the alveolar buccal bone. CONCLUSION The results of the present explorative study indicated a decrease in the height and width of the alveolar soft and hard tissues following explantation of peri-implantitis affected implants, and these changes were more pronounced in the absence of the buccal bone wall. Nevertheless, the apical portion of the implant alveolus (the intact implant socket) tend to heal with no further bone loss.
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Affiliation(s)
- Giovanni Serino
- Clinic of PeriodontologyPublic Dental ServiceBoråsRegion Västra GötalandSweden
- Research and Development UnitPublic Dental ServiceBoråsRegion Västra GötalandSweden
| | - Masahiro Wada
- Clinic of PeriodontologyPublic Dental ServiceBoråsRegion Västra GötalandSweden
- Research and Development UnitPublic Dental ServiceBoråsRegion Västra GötalandSweden
- Department of Removable Prosthodontics and Gerodontology, Graduated School of DentistryOsaka UniversityOsakaJapan
| | - Tomoaki Mameno
- Department of Removable Prosthodontics and Gerodontology, Graduated School of DentistryOsaka UniversityOsakaJapan
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of OdontologiMalmö UniversityMalmöSweden
- Division of Conservative Dentistry and Periodontology, University Clinic of DentistryMedical University of ViennaViennaAustria
- Department of Periodontology, School of Dental MedicineUniversity of BernBernSwitzerland
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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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Khoury G, Mrad S, Bassil J, Ghosn N, Younes R. A New Concept of Horizontal Bone Augmentation Using Collagen Bovine Bone Blocks Without Membrane at Implant Placement: A Preliminary Study. J Maxillofac Oral Surg 2023; 22:1099-1109. [PMID: 38105828 PMCID: PMC10719435 DOI: 10.1007/s12663-023-01917-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 04/07/2023] [Indexed: 12/19/2023] Open
Abstract
Purpose A buccal bone thickness (BBT) of at least 1.8-2 mm is necessary to ensure long-term implant stability, and a bone grafting procedure is commonly needed to restore this BBT. This study aims to prove the effectiveness of a novel bone augmentation technique in which minero-organic bone substitutes are solely used to restore adequate BBT, excluding the need for coverage membranes. Methods Fifty partially edentulous patients having a residual bone width ranging between 5 and 6 mm were enrolled in this study. The horizontal buccal defects were grafted simultaneously at implant placement. Minero-organic collagen bovine bone blocks (CBBB) were placed on the outer side of the buccal bone wall, and adapted to the defect morphology through slow compressive movements. The grafted sites were not covered with any type of membrane nor stabilized with fixation pins. Cone-beam computed tomography scans were obtained pre-operatively, immediately post-surgery, and four months later. Scans were superimposed on the ITK-Snap software to measure the amount of bone gain and assess the percentage of CBBB resorption. Measurements were effectuated at four different levels apically to crestal level. Results Radiographic findings showed BBT increase and CBBB resorption in all cases, four months post-grafting. A mean horizontal bone gain of 1.39 mm was calculated at a crestal level. Conclusion Based on these findings, it appears that this novel and user-friendly bone grafting technique can achieve positive outcomes from both clinical and radiographic perspectives.
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Affiliation(s)
- Georges Khoury
- Department of Advanced Surgical Implantology, Service of Odontology, U.F.R. of Odontology, Rothschild Hospital, AP-HP, University Denis Diderot, Paris, France
| | - Stephanie Mrad
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Campus of Medical Sciences, Damascus Road, Beirut, 1104 2020 Lebanon
| | - Joseph Bassil
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Campus of Medical Sciences, Damascus Road, Beirut, 1104 2020 Lebanon
| | - Nabil Ghosn
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Ronald Younes
- Department of Oral Surgery, Faculty of Dental Medicine, Saint Joseph University of Beirut, Campus of Medical Sciences, Damascus Road, Beirut, 1104 2020 Lebanon
- Cranio-Facial Research Laboratory, Faculty of Dental Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Feng Y, Zhao R, Li J, Yuan Z, Xu X, Gong J. Efficacy of autogenous particulated dentin graft for alveolar ridge preservation: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2023; 102:e36391. [PMID: 38050282 PMCID: PMC10695520 DOI: 10.1097/md.0000000000036391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/09/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Autogenous particulate dentin (APD) has been used as a bone graft material for bone augmentation, but the specifics of its effect on alveolar ridge preservation (ARP) are uncertain. The aim of this study was to investigate the clinical and histomorphometric performance of APD compared with blood clot healing or other grafted materials in ARP. METHODS MEDLINE, Embase, Web of Science, Scopus and the Cochrane Library and citation databases were searched until August 2, 2023 to identify randomized controlled trials that employed APD for ARP. Two independent meta-analyses were performed based on the different control groups (Group I: blood clot healing; Group II: other grafted materials). Weighted or mean differences (MDs) and corresponding 95% confidence intervals (CIs) were calculated. The protocol was prospectively registered with PROSPERO (CRD42023409339). RESULTS A total of 238 records were identified, of which ten studies with 182 participants were included. The meta-analysis indicated that APD resulted in fewer changes in horizontal ridge width (Group I: MD = 1.61, 95% CI 0.76-2.46; Group II: MD = 1.28, 95% CI 1.08-1.48) and labial bone height (Group I: MD = 1.75, 95% CI 0.56-2.94; Group II: P < .05) than the control treatments. Regarding histomorphometry, APD yielded a satisfactory proportion of vital bone area (MD = 10.51, 95% CI 4.70-16.32) and residual material area (MD = -8.76, 95% CI -12.81 to -4.71) in Group II, while there was no significant difference in Group I. Moreover, none of the secondary outcomes were significantly differed between groups. CONCLUSION Within this study limitations, APD effectively maintained the horizontal and vertical dimensions of the extraction sockets and exhibited favorable osteogenic properties and degradation capacity. Further well-designed randomized controlled trials with larger samples and longer follow-up periods are needed to evaluate whether APD is superior to other substitutes for ARP.
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Affiliation(s)
- Yuxia Feng
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou City, P. R. China
| | - Ruimin Zhao
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou people’s hospital, 100 Minjiang Dadao, Smart New City, Quzhou City, P. R. China
| | - Jianxue Li
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou City, P. R. China
| | - Zhenfei Yuan
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou people’s hospital, 100 Minjiang Dadao, Smart New City, Quzhou City, P. R. China
| | - Xu Xu
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou people’s hospital, 100 Minjiang Dadao, Smart New City, Quzhou City, P. R. China
| | - Jiaming Gong
- Department of Stomatology, The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Lanzhou City, P. R. China
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou people’s hospital, 100 Minjiang Dadao, Smart New City, Quzhou City, P. R. China
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Selvaprithiviraj V, Vaquette C, Ivanovski S. Hydrogel based soft tissue expanders for orodental reconstruction. Acta Biomater 2023; 172:53-66. [PMID: 37866723 DOI: 10.1016/j.actbio.2023.10.021] [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: 07/18/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
Tension-free flap closure to prevent soft tissue dehiscence is a prerequisite for successful bone augmentation in orodental reconstructive surgery. Since soft tissue contour follows the underlying jaw bony architecture, resorption of alveolar (jaw) bone limits the availability of soft tissue for wound closure following major bone reconstruction, required to facilitate oral rehabilitation with endosseous dental implants following tooth loss. Although there are several clinical procedures to increase soft tissue volume, these techniques are complicated and technically demanding. Soft tissue expansion, an established technique in reconstructive surgery, is an ideal alternative to generate surplus soft tissue prior to bone augmentation and dental implant placement. Increase in tissue volume can be achieved by using soft tissue expanders (STEs). Contemporary STEs have evolved from silicone balloons to osmotically inflating hydrogel-based systems. Here, we provide an overview of STEs in clinical oral surgery, outline the current research in STEs, and an update on recent clinical trials as well as the associated complications. Also, the mechanism governing soft tissue expansion and the critical factors that control the expansion process are covered. Design considerations for STEs for intraoral applications are given particular attention. Finally, we present our perspectives on utilization of minimally invasive methods to administer STEs for orodental applications. STATEMENT OF SIGNIFICANCE: Soft tissue expansion is required for a range of reconstructive applications and more notably in regenerative dentistry for vertical bone augmentation. This review describes the commercially available soft tissue expanders along with the latest systems being currently developed. This review insightfully discusses the biological and physical mechanisms leading to soft tissue expansion and critically assesses the design criteria of soft tissue expanders. A particular focus is given on the development of a new generation of hydrogel-based soft tissue expanders; their chemistry and required physical properties for tissue expansion is described and the obstacles towards clinical translations are identified. Finally, the review elaborates on promising minimally invasive injectable hydrogel-based tissue expanders and highlights the beneficial features of these systems.
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Affiliation(s)
- Vignesh Selvaprithiviraj
- The University of Queensland, School of Dentistry, Centre for Oral Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, Australia
| | - Cedryck Vaquette
- The University of Queensland, School of Dentistry, Centre for Oral Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, Australia; Herston Biofabrication Institute, Metro North Hospital and Health Service, Brisbane, QLD, Australia, S. Ivanovski, School of Dentistry, University of Queensland, 288 Herston Rd, Herston, Brisbane, QLD 4072, Australia
| | - Saso Ivanovski
- The University of Queensland, School of Dentistry, Centre for Oral Regeneration, Reconstruction and Rehabilitation (COR3), Herston, QLD, Australia.
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Sano T, Kuraji R, Miyashita Y, Yano K, Kawanabe D, Numabe Y. Biomaterials for Alveolar Ridge Preservation as a Preoperative Procedure for Implant Treatment: History and Current Evidence. Bioengineering (Basel) 2023; 10:1376. [PMID: 38135967 PMCID: PMC10740455 DOI: 10.3390/bioengineering10121376] [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: 10/27/2023] [Revised: 11/24/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
In implant treatment, the reduction and structural changes in the alveolar ridge that occur after tooth extraction limit the length, width, and placement position of the implant body, impair esthetics, and, in some cases, make implant placement difficult. To solve these problems, an alveolar ridge preservation (ARP) technique, which is performed simultaneously with tooth extraction, generally aims to promote bone regeneration and prevent alveolar ridge reduction by filling the extraction socket with bone graft material and then covering it with a barrier membrane to protect against the invasion of epithelial tissue. The extraction socket provides a favorable environment for bone regeneration throughout the healing period because the blood supply is abundant, and it effectively retains the bone graft material by using the remaining bone wall of the socket. In recent years, advances in bioengineering technology have led to the development of graft materials with various biological properties, but there is currently no clear consensus regarding the selection of surgical techniques and materials depending on the condition of the alveolar ridge. This review will provide a comprehensive survey of the evidence accumulated to date on ARP, present many cases according to the clinical situation, and discuss various treatment options.
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Affiliation(s)
- Tetsuya Sano
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo 1020071, Japan; (T.S.); (Y.M.); (Y.N.)
- Heartful Dental Clinic, 4-12-3, Mejirodai, Hachioji-shi, Tokyo 1930833, Japan
| | - Ryutaro Kuraji
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo 1020071, Japan; (T.S.); (Y.M.); (Y.N.)
| | - Yukihiro Miyashita
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo 1020071, Japan; (T.S.); (Y.M.); (Y.N.)
| | - Kosei Yano
- Lotus Dental Clinic, 3-13-11, Nishigotanda, Shinagawa-ku, Tokyo 1410031, Japan;
| | - Dai Kawanabe
- Kawanabe Dental Clinic, T Building 1F, 4-21-4, Nishikojiya, Ota-ku, Tokyo 1440034, Japan;
| | - Yukihiro Numabe
- Department of Periodontology, The Nippon Dental University School of Life Dentistry at Tokyo, 1-9-20, Fujimi, Chiyoda-ku, Tokyo 1020071, Japan; (T.S.); (Y.M.); (Y.N.)
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You S, Yu F, Fan Q, Xia T, Liang L, Yan Q, Zeng H, Shi B. Radiographic comparison of atelocollagen versus deproteinized bovine bone minerals covered with a collagen membrane in alveolar ridge preservation: a retrospective study. BMC Oral Health 2023; 23:901. [PMID: 37990178 PMCID: PMC10662564 DOI: 10.1186/s12903-023-03647-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Atelocollagen (AC) is a low-immunogenic collagen derivative with longer degradation time, which can be a suitable material for alveolar ridge preservation (ARP). However, there are few human studies on AC using for ARP. This research aims to radiographically evaluate the efficacy of AC in comparison to deproteinized bovine bone minerals covered with a collagen membrane (DBBM/CM) in ARP. METHODS Medical records in the Implantology Department of the Hospital of Stomatology of Wuhan University were screened for patients who received flapless ARP using either AC or DBBM/CM. A total of 58 patients were included in this retrospective study. 28 patients were treated with AC, while 30 patients were used DBBM/CM. Cone-beam computed tomography (CBCT) scans were taken before extraction and after 6 months of healing. To assess the dimensional change of the extraction sockets, the scanning data were output and transferred to the digital software to measure horizontal bone width change, vertical bone height change and bone volume change in region of interest. To evaluate the bone quality of healed sockets, the bone density of virtual implants was evaluated. RESULTS The horizontal bone width changes at all five different levels showed no significant difference between the two groups. The largest horizontal bone width decrement in both groups occurred at the crest of ridge, which decreased 3.71 ± 1.67 mm in AC group and 3.53 ± 1.51 mm in DBBM/CM group (p = 0.68). At the central buccal aspect, the ridge height reduced 0.10 ± 1.30 mm in AC group, while increased 0.77 ± 2.43 mm in DBBM/CM group (p = 0.10). The vertical bone height differences between two groups showed no statistical significance. The percentages of volume absorption in AC group and DBBM/CM group were 12.37%±6.09% and 14.54%±11.21%, respectively. No significant difference in volume absorption was found (p = 0.36). The average bone density around virtual implants in AC group (649.41 ± 184.71 HU) was significantly lower than that in DBBM/CM group (985.23 ± 207.85 HU) (p < 0.001). CONCLUSIONS ARP with AC had a similar effect on limiting the dimensional alteration of alveolar ridge, when radiographically compared with DBBM/CM.
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Affiliation(s)
- Sha You
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fan Yu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qihang Fan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ting Xia
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liang Liang
- Department of Oral Implantology, Jianli Stomatology Hospital, Dongguan, China
| | - Qi Yan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Hao Zeng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Bin Shi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
- Department of Implantology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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Elbanna RM, Abdelaziz MS, Alameldeen HE. Augmentation of single tooth extraction socket with deficient buccal walls using bovine xenograft with platelet-rich fibrin membrane. BMC Oral Health 2023; 23:874. [PMID: 37978487 PMCID: PMC10657028 DOI: 10.1186/s12903-023-03554-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Different techniques and materials such as bone grafts and bioactive agents have been used for alveolar ridge augmentation in extraction sockets with a defective wall, there is not a specific material or technique that has resulted in superior outcomes or prevented total bone loss. OBJECTIVES This clinical study aims to evaluate radiographically the effectiveness of using bovine xenograft with platelet-rich fibrin (PRF) membrane on vertical and horizontal alveolar ridge dimensional changes following tooth extraction that are complicated by buccal bone loss. MATERIALS AND METHODS This study was conducted in Egypt on fourteen patients with a single posterior tooth indicated for extraction. A preoperative cone-beam computed tomography (CBCT) scan confirmed more than 50% loss in buccal bone in each tooth. Extraction sockets were packed with minced PRF clots mixed with a bovine xenograft. Each extraction socket was sealed by PRF membranes. CBCT scans, performed before tooth extraction and after 6 months, were used to assess alveolar ridge changes both vertically and horizontally. RESULTS There was a significant gain in the buccal and middle of the extraction socket bone height, recording 86.01% (6.33 mm) and 206.45% (9.6 mm), respectively. There was an insignificant bone loss in the lingual bone height and width, recording - 8.49% (-1.06 mm) and - 13.39% (1.05 mm), respectively. The results also showed a non-significant decrease in alveolar bone density (-14.06%) between pre-operative bone present apical to the extraction socket and newly formed bone inside the socket. CONCLUSIONS Ridge preservation/augmentation techniques using a bone graft mixed with PRF and covered by PRF membranes in fresh extraction sockets complicated by the loss of buccal bone result in buccal bone augmentation and a reduction in horizontal and vertical ridge collapse after tooth extraction. CLINICAL RELEVANCE The bovine xenograft in conjunction with PRF can be used immediately after extraction for ridge preservation, providing adequate bone width and height for implant placement.
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Affiliation(s)
| | - Medhat Sameh Abdelaziz
- Faculty of Oral and Dental Medicine, Prosthodontics department, Future University in Egypt, Cairo, Egypt.
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Bruhnke M, Voß I, Sterzenbach G, Beuer F, Naumann M. Evaluating the prospective crown-root ratio after extrusion and crown lengthening procedures in vitro. Sci Rep 2023; 13:18899. [PMID: 37919362 PMCID: PMC10622524 DOI: 10.1038/s41598-023-46354-y] [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: 06/16/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
For restoration of extensively damaged teeth preprosthetic treatment measures are necessary. Crown lengthening and extrusion affect the prospective crown-root ratio (CRR). The subject of this in vitro study was to compute CRRs for both treatment approaches. 120 human maxillary central extracted incisors were measured. Measurements were calculated for five treatment groups: C (control), E-2 mm (extrusion of 2 mm), E-4 mm (extrusion of 4 mm), CL-2 mm (crown lengthening of 2 mm), and CL-4 mm (crown lengthening of 4 mm). Tooth (TL), root (RL), and crown lengths (CL) were measured from mesial (m) and facial (f) cemento-enamel junction (CEJ), and respective anatomic (CRR) and effective crown-root ratios (eCRR) were calculated. Following CRR values were computed for C: CRR-m = 0.4 ± 0.1, CRR-f = 0.7 ± 0.1. All crown-root ratios were lower (more favourable) for extrusion compared to crown lengthening (p < 0.001). ECRRs were higher than anatomic CRRs. CRR at mesial CEJ was significantly lower than CRR with facial CEJ as reference (p < 0.001). Mesial measurement-based calculations of CRR typically based on radiographic images should be interpreted with caution as they underestimate the eCRR. CRR can be expected as lower, i.e. more favourable, when teeth are extruded than crown lengthened.
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Affiliation(s)
- Maria Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany.
| | - Isabelle Voß
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
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Abdullrahman F, Assad M, Albash Z. Tent-pole technique for alveolar ridge width preservation with a compromised buccal plate: a prospective cohort study. Ann Med Surg (Lond) 2023; 85:5344-5349. [PMID: 37915712 PMCID: PMC10617838 DOI: 10.1097/ms9.0000000000001312] [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: 06/02/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives The aim of this study was to assess the effectiveness of the tent-pole technique for alveolar ridge preservation of compromised alveolar socket following the surgical extraction of incurable single root premolars. Materials and methods This study was conducted on 12 patients who presented to the department of oral and maxillofacial surgery and had alveolar ridge preservation using tent-pole technique between August 2021 and February 2022. The alveolar ridge width was analyzed using cone beam computed tomography scans taken preoperative and 6 months postoperative. Statistical analysis was performed to assess the alveolar ridge width at different levels. The alveolar ridge width differences between periods were assessed with paired t-test. The comparison of alveolar ridge width loss according to jaw, sex, and different levels were done with unpaired t-test. The level of significance considered was 5% (α=0.05). Results The mean alveolar ridge width before surgery was 10.03 mm. After 6 months, the mean alveolar ridge width was 8.4 mm. The range of alveolar ridge width loss was between 0.6 and 3.22 mm with a mean of 1.63 (16.25%). There was no statistically significant difference in width loss between the maxilla and mandibular whether in males or females. Alveolar bone width loss was the greatest at W1 level (26.8%). Conclusion According to the results of this study, the authors conclude that the tent-pole technique could preserve the alveolar bone ridge width without bone graft materials.
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Affiliation(s)
| | | | - Ziad Albash
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria
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Gowda TM, Jayashri M, Venkatesh UG, Shah R, Kumar ABT, Deepthi M, Priya S. Autologous tooth bone graft block compared with advanced platelet-rich fibrin in alveolar ridge preservation: A clinico-radiographic study. J Indian Soc Periodontol 2023; 27:619-625. [PMID: 38434501 PMCID: PMC10906784 DOI: 10.4103/jisp.jisp_43_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives To determine the clinico-radiographic efficiency of partially demineralized dentin matrix block (PDDM block), a mixture of PDDM with advanced-platelet-rich fibrin+ (A-PRF+) and injectable platelet-rich fibrin versus A-PRF+ alone in alveolar socket preservation. Materials and Methods Sixteen molar teeth indicated for extraction were randomly assigned into two groups. For the test group, sockets were packed with PDDM block and control group, with A-PRF+ plug alone. Clinical and radiographic cone-beam computed tomography methods were used to assess the horizontal and vertical ridge dimensional changes at baseline and 4 months. Results Clinically, the mid buccal and palatal crestal height (10.25 ± 0.86 and 9.75 ± 0.28 mm) and alveolar ridge width (11.37 ± 0.25 mm) were significantly higher in the test group as compared to the control group, 4 months after tooth extraction (P < 0.01). Radiographically, there was improved apposition and nonsignificant resorption for the test group in ridge height and width, whereas statistically significant higher resorption was seen in the control group at 4 months. Conclusion The application of the PDDM block demonstrated efficacy in maintaining the dimensions of the extraction socket when compared to A-PRF+ alone. This autologous and immune-free regenerative biomaterial is widely obtainable, offering a glimpse into the potential of next-generation biofuels for regeneration.
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Affiliation(s)
| | | | - Usha Govindaroy Venkatesh
- Department of Public Health Dentistry, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - Rucha Shah
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | | | - Manjunath Deepthi
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
| | - Saloni Priya
- Department of Periodontics, Bapuji Dental College and Hospital, Davanagere, Karnataka, India
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