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Wang Y, Xia Y, Qian J, Xie Y, Shu R, Lin Z. Native vs. ribosome-crosslinked collagen membranes for periodontal regeneration: A randomized clinical trial. J Periodontal Res 2024. [PMID: 38962931 DOI: 10.1111/jre.13321] [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: 04/21/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024]
Abstract
AIM To evaluate whether the ribosome-crosslinked collagen membrane (RCCM) is non-inferior to the natural collagen membrane (NCM) used in regeneration surgery in terms of clinical attachment level (CAL) gain at 6 months. METHODS Eighty patients diagnosed as generalized periodontitis presenting with isolated infrabony defect (≥4 mm deep) were enrolled and randomized to receive regenerative surgery, either with NCM or RCCM, both combined with deproteinized bovine bone mineral (DBBM). CAL, pocket probing depth (PPD), and gingival recession (GR) were recorded at baseline, 3, and 6 months postoperatively. Periapical radiographs were taken at baseline, immediately, and 6 months after surgery. Early wound healing index (EHI) and patients' responses were recorded at 2 weeks postoperatively. RESULTS At 6 months post-surgery, the mean CAL gain was 3.1 ± 1.5 mm in the NCM group and 2.9 ± 1.5 mm in the RCCM group, while the mean PPD was 4.3 ± 1.1 mm in the NCM group and 4.2 ± 1.0 mm in the RCCM group. Both groups demonstrated a statistically significant improvement from the baseline (p < .01). RCCM was non-inferior to NCM concerning the primary outcome (CAL gain at 6 months). The GR at 6 months postoperatively was 1.3 ± 1.2 and 1.2 ± 1.1 mm, which showed no difference compared with baseline. At 6 months follow-up, the radiographic linear bone fill (RLBF) was 6.5 ± 2.8 and 5.5 ± 2.6 mm (p > .05), while the bone fill percentage (BF%) was 102.3 ± 53.5% and 92.3 ± 40.1% (p > .05), in the NCM and RCCM groups, respectively. There was no significant difference in EHI and postoperative responses between two groups. CONCLUSION RCCM + DBBM resulted in no-inferior clinical and radiographic outcomes to NCM + DBBM for the treatment of isolated infrabony defect in 6 months.
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Affiliation(s)
- Yiwei Wang
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiru Xia
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Periodontology, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Jielei Qian
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yufeng Xie
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Department of Periodontology, Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Rong Shu
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Zhikai Lin
- Department of Periodontology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
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Braz SHG, Monteiro MF, Matumoto EK, Corrêa MG, Casarin RCV, Ribeiro FV, Cirano FR, Casati MZ, Pimentel SP. Microbial colonization in the partially exposed nonabsorbable membrane during alveolar ridge preservation. Clin Oral Investig 2024; 28:373. [PMID: 38874776 DOI: 10.1007/s00784-024-05763-7] [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: 03/21/2024] [Accepted: 06/01/2024] [Indexed: 06/15/2024]
Abstract
AIM This study evaluated the impact of the partial exposition of the nonabsorbable membrane (dPTFE) on microbial colonization during bone healing. MATERIALS AND METHODS Patients indicated for tooth extraction were randomized to dPTFE group (n = 22) - tooth extraction and alveolar ridge preservation (ARP) using an intentionally exposed dPTFE membrane and USH group (n = 22) - tooth extraction and unassisted socket healing. Biofilm samples were collected at the barrier in the dPTFE and on the natural healing site in the USH after 3 and 28 days. Samples from the inner surface of the dPTFE barrier were also collected (n = 13). The microbiome was evaluated using the Illumina MiSeq system. RESULTS Beta diversity was different from 3 to 28 days in both groups, and at 28 days, different microbial communities were identified between therapies. The dPTFE was characterized by a higher prevalence and abundance of gram-negative and anaerobic species than USH. Furthermore, the inner surface of the dPTFE membrane was colonized by a different community than the one observed on the outer surface. CONCLUSION Intentionally exposed dPTFE membrane modulates microbial colonization in the ARP site, creating a more homogeneous and anaerobic community on the inner and outer surfaces of the membrane. CLINICAL RELEVANCE DPTFE promoted faster biofilm colonization and enrichment of gram-negative and anaerobes close to the regenerated site in the membrane's inner and outer surfaces. dPTFE membrane can be used exposed to the oral site, but approaches for biofilm control should still be considered. The study was retrospectively registered at Clinicaltrials.gov (NCT04329351).
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Affiliation(s)
- Silvia Helena Garcia Braz
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Mabelle Freitas Monteiro
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, 13414-903, SP, Brazil.
| | - Edson Ken Matumoto
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Mônica Grazieli Corrêa
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Renato Corrêa Viana Casarin
- Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, Av. Limeira, 901, Areião, Piracicaba, 13414-903, SP, Brazil
| | - Fernanda Vieira Ribeiro
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Fabiano Ribeiro Cirano
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Marcio Zaffalon Casati
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
| | - Suzana Peres Pimentel
- Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, São Paulo, 04026-002, SP, Brazil
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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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Lin CY, Chiu MY, Kuo PY, Wang HL. Half- and full-grafting alveolar ridge preservation with different sealing materials: A three-arm randomized clinical trial. Clin Implant Dent Relat Res 2024; 26:651-662. [PMID: 38638057 DOI: 10.1111/cid.13327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/17/2024] [Accepted: 02/17/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE The objective of this study is to investigate the effect of different alveolar ridge preservation (ARP) approaches on bone resorption and their potential for facilitating implant placement. MATERIALS AND METHODS Patients who underwent one or two tooth extractions with a desire for restoration were included in the study. The participants were randomly assigned to one of three groups for ARP. The groups were as follows: (1) Half grafting of bovine bone mineral (DBBM-C) covered with non-resorbable dense polytetrafluoroethylene (dPTFE) membrane (Test 1 group); (2) Half grafting of bovine bone mineral (DBBM-C) covered with collagen membrane (Test 2 group); and (3) Full grafting with collagen membrane (DBBM-C + Collagen membrane) as the Control group. After 6-month healing period, the evaluation encompassed clinical, radiographic, implant-related outcomes, and the factors contributing to hard and soft tissue alterations. RESULTS Enrollment in this study comprised 56 patients. At the 6-month follow-up, radiographic analysis in computed beam computed tomography images was conducted for 18, 19, and 19 patients with 18, 20, and 20 tooth sites in Test 1, Test 2, and Control groups, respectively. Additionally, a total of 15, 17, and 17 patients with 15, 18, and 17 implants were evaluated. Based on radiographic analysis, all groups showed limited ridge resorption at 1 mm from crest horizontally (Test 1: 1.29 ± 1.37; Test 2: 1.07 ± 1.07; Control: 1.54 ± 1.33 mm, p = 0.328), while the Control group showed greater radiographic bone height gain in mid-crestal part vertically (Test 1: 0.11 ± 1.02; Test 2: 0.29 ± 0.83; Control: -0.46 ± 0.95 mm, p = 0.032). There were no significant intergroup differences in terms of keratinized mucosal width, bone density, insertion torque, and the need of additional bone graft. However, the use of a dPTFE membrane resulted in a significantly higher vertical mucosal thickness (Test 1: 2.67 ± 0.90; Test 2: 3.89 ± 1.08; Control: 2.41 ± 0.51 mm, p < 0.001). CONCLUSIONS The study showed comparable dimensional preservation with limited vertical shrinkage, while thin buccal bone plate, non-molar sites, and large discrepancy between buccal and palatal/lingual height may contribute to greater shrinkage. Thicker mucosa with dPTFE membrane required further investigation for interpretation. CLINICAL TRIAL REGISTRATION NUMBER NCT06049823. This clinical trial was not registered prior to participant recruitment and randomization.
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Affiliation(s)
- Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
- Chang Gung University, Taoyuan City, Taiwan
| | - Meng-Yao Chiu
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Pe-Yi Kuo
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Bienz SP, Ruales-Carrera E, Lee WZ, Hämmerle CHF, Jung RE, Thoma DS. Early implant placement in sites with ridge preservation or spontaneous healing: histologic, profilometric, and CBCT analyses of an exploratory RCT. J Periodontal Implant Sci 2024; 54:108-121. [PMID: 37524379 PMCID: PMC11065537 DOI: 10.5051/jpis.2300460023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/11/2023] [Accepted: 04/30/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. METHODS Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. RESULTS Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. CONCLUSIONS Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.
| | - Edwin Ruales-Carrera
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Department of Dentistry, Center for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianópolis, Brazil
- School of Dentistry, Universidad de Las Américas (UDLA), Quito, Ecuador
| | - Wan-Zhen Lee
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
- Department of Restorative Dentistry, National Dental Centre Singapore, Singapore
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
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Fok MR, Pelekos G, Jin L. Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:1198. [PMID: 38592010 PMCID: PMC10931845 DOI: 10.3390/jcm13051198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
AIM To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. METHODS An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. RESULTS Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. CONCLUSIONS Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Lee JH, Kim YT, Jeong SN. Alveolar ridge preservation of damaged or periodontally compromised extraction sockets with bovine- and porcine-derived block bone substitutes: A retrospective case-control study. Clin Implant Dent Relat Res 2023; 25:1033-1043. [PMID: 37431152 DOI: 10.1111/cid.13246] [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: 04/04/2023] [Revised: 05/30/2023] [Accepted: 06/23/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE Alveolar ridge preservation (ARP) was introduced to minimize postextraction alveolar bone loss and extraction socket remodeling; however, current knowledge of the ARP procedure for nonintact extraction sockets is still limited and inconclusive. This retrospective study aimed to evaluate the difference between using deproteinized bovine bone mineral with 10% collagen (DBBM-C) and deproteinized porcine bone mineral with 10% collagen (DPBM-C) when performing ARP procedures in damaged or periodontally compromised extraction sockets based on clinical, radiographic, and profilometric outcomes. METHODS In total, 108 extraction sockets were grafted with 67 DBBM-C and 41 DPBM-C. Changes in radiographic (horizontal width and vertical height) and profilometric outcomes were measured after the ARP procedure and before the implant surgery. Postoperative discomfort (including the severity and duration of pain and swelling), early wound healing outcomes (including spontaneous bleeding and persistent swelling), implant stability, and treatment modalities for implant placement were also assessed. RESULTS Radiographically, the DBBM-C group decreased by -1.70 ± 2.26 mm (-21.50%) and - 1.39 ± 1.85 mm (-30.47%) horizontally and vertically, and the corresponding DPBM-C group decreased by -1.66 ± 1.80 mm (-20.82%) and -1.44 ± 1.97 mm (-27.89%) horizontally and vertically at an average of 5.6 months. There were no serious or adverse complications in any of the cases, and none of the measured parameters differed significantly between the groups. CONCLUSION Within the limitations of this study, ARP with DBBM-C and DPBM-C showed similar clinical, radiographic, and profilometric outcomes in nonintact extraction sockets.
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Affiliation(s)
- Jae-Hong Lee
- Department of Periodontology, College of Dentistry and Institute of Oral Bioscience, Jeonbuk National University, Jeonju, South Korea
| | - Yeon-Tae Kim
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, South Korea
| | - Seong-Nyum Jeong
- Department of Periodontology, Daejeon Dental Hospital, Institute of Wonkwang Dental Research, Wonkwang University College of Dentistry, Daejeon, South Korea
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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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9
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Teimoori M, Nokhbatolfoghahaei H, Khojasteh A. Bilayer scaffolds/membranes for bone tissue engineering applications: A systematic review. BIOMATERIALS ADVANCES 2023; 153:213528. [PMID: 37352742 DOI: 10.1016/j.bioadv.2023.213528] [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: 04/09/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE This systematic review evaluates the purpose, materials, physio-mechanical, and biological effects of bilayer scaffolds/membranes used for bone tissue engineering applications. METHODS A comprehensive electronic search of English-language literature from 2012 to October 2022 was conducted in PubMed, Scopus, ScienceDirect, and Google Scholar online databases according to the PRISMA 2020 guidelines. The quality of animal studies was evaluated through the SYRCLE's risk of bias tool. RESULTS A total of 77 studies were sought for retrieval, and 39 studies met the inclusion criteria. According to the synthesis results, most bilayers had a dense barrier layer that prevented connective tissue penetration and a loose osteogenic layer that supported cell migration and osteogenesis. PLGA, PCL, and chitosan were the most common polymers in the barrier layers, while the most utilized polymers in osteogenic layers were PLGA and gelatin. Electrospinning and solvent casting were the most common fabrication methods to design the bilayer structures. Many studies reported higher biological results for bilayers compared to their single layers. Also, fabricated bilayers' in vitro osteogenesis and in vivo new bone formation were significantly superior or at least comparable to the frequently used commercial membranes. CONCLUSION 1) Bilayers with two distinct layers and different materials, porosities, mechanical properties, and biological behavior can significantly improve heterogeneous bone regeneration; 2) the addition of ceramics and/or drugs to the osteogenic layer enhances the osteogenic properties of the bilayers; 3) fabrication method and pore size of the layers play an important role in determining the mechanical and biological behavior of them.
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Affiliation(s)
- Mahdis Teimoori
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hanieh Nokhbatolfoghahaei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Khojasteh
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Cranio-Maxillofacial Surgery, University Hospital, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
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Kofina V, Monfaredzadeh M, Rawal SY, Dentino AR, Singh M, Tatakis DN. Patient-reported outcomes following guided bone regeneration: Correlation with clinical parameters. J Dent 2023; 136:104605. [PMID: 37419383 DOI: 10.1016/j.jdent.2023.104605] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 06/06/2023] [Accepted: 07/05/2023] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVES Postoperative oral health-related quality of life is procedure-dependent and may vary during early healing. There is scarce evidence on patient-reported outcome measures (PROMs) after extraction and guided bone regeneration (GBR) or on the clinical parameters influencing PROMs. This prospective observational study aimed to evaluate PROMs during the first 2 weeks following extraction and GBR and correlate them with clinical parameters. METHODS Patients undergoing extraction and GBR (bone graft and resorbable membrane) at a single tooth-bound site were recruited. PROMs (pain, swelling, difficulty of mouth opening, and OHIP-14) were recorded immediately preoperatively, and at 2, 7, and 14 days postoperatively. Flap advancement, gingival and mucosal thickness, duration of surgery, and wound opening were the clinical parameters assessed. RESULTS Twenty-seven patients were included. All PROMs peaked on postoperative day 2, decreased subsequently and were significantly correlated with each other. Although 41-56% of patients reported moderate to severe pain, swelling, or mouth opening difficulty on day 2, most patients experienced mild or no symptoms throughout the postoperative period. Pain, swelling and difficulty of mouth opening were determinants of OHIP-14 and were correlated with all OHIP-14 domains during different time points. Wound opening peaked on day 7. Flap advancement, soft tissue thickness, wound opening, duration of surgery and preoperative PROMs affected postoperative PROMs. CONCLUSIONS Within the limitations of the present study, postoperative symptoms after guided bone regeneration are worst on day 2 and oral health-related quality of life is significantly impacted by pain, swelling, difficulty of mouth opening, surgery duration and flap advancement. CLINICAL SIGNIFICANCE This is the first study to report PROMs following extraction and GBR with particulate bone graft and resorbable membrane in preparation for implant placement. It will help guide both practitioners and patients on what should be the anticipated experiences following such a routinely performed surgery.
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Affiliation(s)
- Vrisiis Kofina
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA.
| | - Morvarid Monfaredzadeh
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Swati Y Rawal
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Andrew R Dentino
- Department of Surgical Sciences, School of Dentistry, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Maharaj Singh
- College of Nursing, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA
| | - Dimitris N Tatakis
- Division of Periodontology, College of Dentistry, The Ohio State University, 4121 Postle Hall, 305 W 12th Ave, Columbus, OH 43210, USA
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11
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Li J, Zhao Y, Chen S, Wang S, Zhong W, Zhang Q. Research Hotspots and Trends of Bone Xenograft in Clinical Procedures: A Bibliometric and Visual Analysis of the Past Decade. Bioengineering (Basel) 2023; 10:929. [PMID: 37627814 PMCID: PMC10451653 DOI: 10.3390/bioengineering10080929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/11/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Bone defect therapy is a common clinical challenge for orthopedic and clinical physicians worldwide, and the therapeutic effect affects the physiological function and healthy life quality of millions of patients. Compared with traditional autogenous bone transplants, bone xenografts are attracting attention due to their advantages of unlimited availability and avoidance of secondary damage. However, there is currently a lack of bibliometric analysis on bone xenograft. This study aimed to use bibliometric methods to analyze the literature on bone xenograft from 2013 to 2023, to explore the current status, hotspots, and future trends of research in this field, and to promote its development and progress. METHODS Using the Web of Science Core Collection database, we retrieved and collected publication data related to xenogeneic bone grafting materials worldwide from January 2013 to March 2023. Origin (2021), CiteSpace (6.2.R2 standard), and an online bibliometric platform were used for bibliometric analysis and data visualization. RESULTS A total of 3395 documents were retrieved, and 686 eligible papers were selected. The country and institutions with the highest number of publications and centrality were the United States (125 papers, centrality = 0.44) and the University of Zurich (29 papers, centrality = 0.28), respectively. The most cited author was Araujo MG (163 times), and the author with the most significant centrality was Froum SJ (centrality = 0.09). The main keyword clusters were "tissue engineering", "sinus floor elevation", "dental implants", "tooth extraction", and "bone substitutes". The most significant bursting keywords in the last three years were "platelet rich fibrin". CONCLUSIONS Research on bone xenograft is steadily growing and will continue to rise. Currently, research hotspots and directions are mainly focused on dental implants related to bone-augmentation techniques and bone tissue engineering. In the future, research hotspots and directions may focus on decellularization technology and investigations involving platelet-rich fibrin.
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Affiliation(s)
- Jiayue Li
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Yujue Zhao
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Shili Chen
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Simin Wang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Wen Zhong
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
| | - Qing Zhang
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou 510182, China
- Laboratory for Myology, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 51081 BT Amsterdam, The Netherlands
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12
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Couso-Queiruga E, Weber HA, Garaicoa-Pazmino C, Barwacz C, Kalleme M, Galindo-Moreno P, Avila-Ortiz G. Influence of healing time on the outcomes of alveolar ridge preservation using a collagenated bovine bone xenograft: A randomized clinical trial. J Clin Periodontol 2023; 50:132-146. [PMID: 36345818 PMCID: PMC10100450 DOI: 10.1111/jcpe.13744] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 11/10/2022]
Abstract
AIM To evaluate the healing outcomes in non-molar post-extraction sockets filled with deproteinized bovine bone mineral with collagen (DBBM-C) as a function of time. MATERIALS AND METHODS Patients in need of non-molar tooth extraction were randomly allocated into one of three groups according to the total healing time (A-3 months; B-6 months; C-9 months). The effect of alveolar ridge preservation (ARP) therapy via socket filling using DBBM-C and socket sealing with a porcine collagen matrix (CM) was assessed based on a panel of clinical, digital, histomorphometric, implant-related, and patient-reported outcomes. RESULTS A total of 42 patients completed the study (n = 14 in each group). Histomorphometric analysis of bone core biopsies obtained at the time of implant placement showed a continuous increase in the proportion of mineralized tissue with respect to non-mineralized tissue, and a decrease in the proportion of remaining xenograft material over time. All volumetric bone and soft tissue contour assessments revealed a dimensional reduction of the alveolar ridge overtime affecting mainly the facial aspect. Linear regression analyses indicated that baseline buccal bone thickness is a strong predictor of bone and soft tissue modelling. Ancillary bone augmentation at the time of implant placement was needed in 16.7% of the sites (A:2; B:1; C:4). Patient-reported discomfort and wound healing index scores progressively decreased over time and was similar across groups. CONCLUSIONS Healing time influences the proportion of tissue compartments in non-molar post-extraction sites filled with DBBM-C and sealed with a CM. A variable degree of alveolar ridge atrophy, affecting mainly the facial aspect, occurs even after performing ARP therapy. These changes are more pronounced in sites exhibiting thin facial bone (≤1 mm) at baseline (Clinicaltrials.gov NCT03659617).
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Affiliation(s)
- Emilio Couso-Queiruga
- Department of Oral Surgery and Stomatology, University of Bern School of Dental Medicine, Bern, Switzerland.,Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Holly A Weber
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Carlos Garaicoa-Pazmino
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,Investigation Center, School of Dentistry, Espiritu Santo University, Samborondón, Ecuador
| | - Christopher Barwacz
- Department of Family Dentistry, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Marisa Kalleme
- Division of Biostatistics and Computational Biology, University of Iowa College of Dentistry, Iowa City, Iowa, USA
| | - Pablo Galindo-Moreno
- Department of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (IBS), Granada, Spain
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa, USA.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts, USA.,Private Practice, Atelier Dental Madrid, Madrid, Spain
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13
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Long-Term Changes in Adipose Tissue in the Newly Formed Bone Induced by Recombinant Human BMP-2 In Vivo. Biomimetics (Basel) 2023; 8:biomimetics8010033. [PMID: 36648819 PMCID: PMC9844441 DOI: 10.3390/biomimetics8010033] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Recombinant human bone morphogenetic protein-2 (rhBMP-2) induces osteogenesis and adipogenesis in bone scaffolds. We evaluated rhBMP-2-induced long-term changes in adipose tissue in the newly formed bone in different scaffolds forms. Bovine bone particles and blocks were grafted along with rhBMP-2 in the subperiosteal space of a rat calvarial bone, and the formation of new bone and adipose tissue were evaluated at 6 and 16 weeks after the surgery. The bone mineral density (BMD) and trabecular thickness (TbTh) of the 16w particle group were significantly higher than those of the 6w particle group (p = 0.018 and 0.012, respectively). The BMD and TbTh gradually increased in the particle group from weeks 6 to 16. The average adipose tissue volume (ATV) of the 6w particle group was higher than that of the 16w particle group, although the difference was not significant (p > 0.05), and it decreased gradually. There were no significant changes in the bone volume (BV) and BMD between the 6w and 16w block groups. Histological analysis revealed favorable new bone regeneration in all groups. Adipose tissue was formed between the bone particles and at the center in the particle and block groups, respectively. The adipose tissue space decreased, and the proportion of new bone increased in the 16w particle group compared to that in the 6w group. To summarize, in the particle group, the adipose tissue decreased in a time-dependent manner, BMD and TbTh increased, and new bone formation increased from 6 to 16 weeks. These results suggest that rhBMP-2 effectively induces new bone formation in the long term in particle bone scaffolds.
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14
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Seo GJ, Lim HC, Chang DW, Hong JY, Shin SI, Kim G, Shin SY. Primary flap closure in alveolar ridge preservation for periodontally damaged extraction socket: A randomized clinical trial. Clin Implant Dent Relat Res 2022; 25:241-251. [PMID: 36515081 DOI: 10.1111/cid.13165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION The effect of primary wound closure (PC) on alveolar ridge preservation (ARP) in periodontally damaged sockets has yet to be fully discovered. METHODS Periodontally damaged sockets were allocated to one of the following groups: (1) ARP with PC (group PC), and (2) ARP without PC (group secondary wound closure [SC]). Following tooth extraction and flap elevation, granule-type xenogeneic bone substitute material and a collagen barrier were applied. Ridge change was evaluated using cone-beam computed tomographic (CBCT) scans immediately after ARP and at 4 months. Core biopsy specimens were examined histomorphometrically. RESULTS A total of 28 patients were included in the analysis (13 in group PC, 15 in group SC). Histomorphometrically, the percentage of newly formed bone was 26.2 ± 17.7% and 24.6 ± 18.4% in groups PC and SC, respectively (independent t-test, degree of freedom [df] = 25, p > 0.05). Horizontal ridge changes on CBCT were -4.9 ± 3.1 mm and - 4.2 ± 2.5 mm in groups PC and SC at the 1 mm level below the ridge crest, respectively (independent t-test, df = 26, p > 0.05). Approximately half of the sites required additional bone augmentation at implant placement. CONCLUSIONS ARP with/without PC yielded similar new bone formation and radiographic ridge change. This clinical trial was not registered prior to participant recruitment and randomization (https://cris.nih.go.kr/cris/search/detailSearch.do/19718).
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Affiliation(s)
- Gil-Jong Seo
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | | | - Ji-Youn Hong
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | - Seung-Il Shin
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
| | - Gyutae Kim
- Department of Oral and Maxillofacial Radiology, Kyung Hee University, School of Dentistry, Kyung Hee University Medical Center, Seoul, South Korea
| | - Seung-Yun Shin
- Department of Periodontology, Kyung Hee University, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University Medical Center, Seoul, South Korea
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15
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Lim J, Jun SH, Tallarico M, Park JB, Park DH, Hwang KG, Park CJ. A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes. MATERIALS 2022; 15:ma15155294. [PMID: 35955229 PMCID: PMC9369984 DOI: 10.3390/ma15155294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022]
Abstract
The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.
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Affiliation(s)
- JaeHyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan-si 15355, Korea;
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Dae-Ho Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Kyung-Gyun Hwang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
- Correspondence: ; Tel.: +82-2-2290-8646
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16
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Effect of Different Membranes on Vertical Bone Regeneration: A Systematic Review and Network Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7742687. [PMID: 35872861 PMCID: PMC9303140 DOI: 10.1155/2022/7742687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 11/17/2022]
Abstract
This study is aimed at performing a systematic review and a network meta-analysis of the effects of several membranes on vertical bone regeneration and clinical complications in guided bone regeneration (GBR) or guided tissue regeneration (GTR). We compared the effects of the following membranes: high-density polytetrafluoroethylene (d-PTFE), expanded polytetrafluoroethylene (e-PTFE), crosslinked collagen membrane (CCM), noncrosslinked collagen membrane (CM), titanium mesh (TM), titanium mesh plus noncrosslinked (TM + CM), titanium mesh plus crosslinked (TM + CCM), titanium-reinforced d-PTFE, titanium-reinforced e-PTFE, polylactic acid (PLA), polyethylene glycol (PEG), and polylactic acid 910 (PLA910). Using the PICOS principles to help determine inclusion criteria, articles are collected using PubMed, Web of Science, and other databases. Assess the risk of deviation and the quality of evidence using the Cochrane Evaluation Manual, and GRADE. 27 articles were finally included. 19 articles were included in a network meta-analysis with vertical bone increment as an outcome measure. The network meta-analysis includes network diagrams, paired-comparison forest diagrams, funnel diagrams, surface under the cumulative ranking curve (SUCRA) diagrams, and sensitivity analysis diagrams. SUCRA indicated that titanium-reinforced d-PTFE exhibited the highest vertical bone increment effect. Meanwhile, we analyzed the complications of 19 studies and found that soft tissue injury and membrane exposure were the most common complications.
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17
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Di Stefano DA, Orlando F, Ottobelli M, Fiori D, Garagiola U. A comparison between anorganic bone and collagen-preserving bone xenografts for alveolar ridge preservation: systematic review and future perspectives. Maxillofac Plast Reconstr Surg 2022; 44:24. [PMID: 35821286 PMCID: PMC9276906 DOI: 10.1186/s40902-022-00349-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 04/25/2022] [Indexed: 11/10/2022] Open
Abstract
After tooth extraction, dimensional changes affect the alveolar socket, leading to loss in alveolar bone height and width. Histological modifications also occur, with initial formation of a blood clot that is replaced with granulation tissue and subsequently with a provisional connective tissue matrix. Spontaneous healing ends with socket filling with woven bone, which is gradually replaced with lamellar bone and bone marrow. Adequate alveolar ridge dimensions and bone quality are required to assure optimal stability and osseointegration following dental implant placement. When a tooth is extracted, alveolar ridge preservation (ARP) procedures are an effective method to prevent collapse of the post-extraction socket. Heterologous bone is widely chosen by clinicians for ARP, and anorganic bone xenografts (ABXs) made bioinert by heat treatment represents the most used biomaterial in clinical applications. Collagen-preserving bone xenografts (CBXs) made of porcine or equine bone are fabricated by less invasive chemical or enzymatic treatments to remove xenogenic antigens, and these are also effective in preserving post-extraction sites. Clinical differences between anorganic bone substitutes and collagen-preserving materials are not well documented in the literature but understanding these differences could clarify how processing protocols influence biomaterial behavior in situ. This systematic review of the literature compares the dimensional changes and histological features of ABXs versus CBXs in ridge preservation procedures to promote awareness of different bone xenograft efficacies in stimulating the healing of post-extraction sockets.
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Affiliation(s)
- Danilo Alessio Di Stefano
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L., Milan, Italy. .,Department of Dentistry, Vita-Salute San Raffaele University Milan, Milan, Italy.
| | - Francesco Orlando
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L., Milan, Italy.,Dental School, Vita-Salute University IRCCS San Raffaele, Milan, Italy
| | - Marco Ottobelli
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L., Milan, Italy
| | - Davide Fiori
- Private Practice, Centro Odontoiatrico e Protesico Civitali S.R.L., Milan, Italy
| | - Umberto Garagiola
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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18
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Fang CH, Lin HY, Sun CK, Lin YW, Hung MC, Li CH, Lin IP, Chang HC, Sun JS, Chang JZC. Decoronation-induced infected alveolar socket defect rat model for ridge preservation. Sci Rep 2022; 12:9940. [PMID: 35705614 PMCID: PMC9200756 DOI: 10.1038/s41598-022-14064-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/31/2022] [Indexed: 11/09/2022] Open
Abstract
Current rat alveolar ridge preservation models have not been well standardized. In this study, we proposed decoronation-induced infected alveolar socket model of rat. The bilateral maxillary first molars (M1) of twenty-four rats were decoronized or extracted. After 2, 6, 10, and 14 weeks, bone and soft tissue changes at M1 and periodontal conditions of maxillary second (M2) and third molars (M3) were evaluated by micro-computed tomography and histological analysis. Additional eighteen rats with standardized size defects were grafted with Bio-Oss Collagen to compare with unmanipulated contralateral side. Decoronation preserved greater bone and soft tissue dimensions at M1, provided larger three-dimensional (3D) bone contour volume, but also promoted periodontal breakdown of M2 Histological results showed intense inflammatory cell infiltrations and severe bone resorption within M1 socket and at mesial aspect of M2. The critical dimensions to accommodate largest standardized defect at M1 were 2.2-2.3 mm at vertical bone height and 2.8-3.2 mm at alveolar crestal width. Bio-Oss Collagen could not fully preserve buccal or palatal bone height but could be beneficial in preserving ridge width in large alveolar defects. Collectively, if periodontally-involved alveolar bone defect is preferred, we suggest extracting M1 roots 6 weeks after decoronation to allow periodontitis to occur at M2. If standardized critical dimension defect is preferred, we suggest extracting M1 roots 2 weeks after decoronation, and creating defect in the middle of M1 site with size no larger than 2.7 mm diameter to its full depth.
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Affiliation(s)
- Chih-Hsiang Fang
- Trauma and Emergency Center, China Medical University Hospital, No. 2, Xueshi Rd., North Dist., Taichung City, 404018, Taiwan
| | - Hung-Ying Lin
- Department of Dentistry, College of Medicine, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei, 10048, Taiwan
| | - Chung-Kai Sun
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec. 2, Linong Street, Taipei, 11221, Taiwan
| | - Yi-Wen Lin
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, No. 1, Sec. 4, Roosevelt Rd, Taipei, 10617, Taiwan
| | - Min-Chih Hung
- Department of Dentistry, College of Medicine, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei, 10048, Taiwan
| | - Ching-Hung Li
- Department of Dentistry, College of Medicine, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei, 10048, Taiwan
| | - I-Ping Lin
- Department of Dentistry, National Taiwan University Hospital, Hisnchu Branch, No. 25, Lane 442, Sec. 1 Jingguo Rd., Hsinchu City, 30059, Taiwan
| | - Hung-Chen Chang
- Gin Chen Dental Clinic, No. 31, Long Chiang Rd, Taipei, Taiwan
| | - Jui-Sheng Sun
- Trauma and Emergency Center, China Medical University Hospital, No. 2, Xueshi Rd., North Dist., Taichung City, 404018, Taiwan. .,School of Medicine, China Medical University-YingCai Campus, No. 91, Xueshi Rd., North Dist., Taichung City, 404333, Taiwan. .,Department of Orthopedic Surgery, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan. .,Department of Orthopedic Surgery, College of Medicine, China Medical University, No. 2, Yu-Der Rd, Taichung City, 40447, Taiwan.
| | - Jenny Zwei-Chieng Chang
- Department of Dentistry, College of Medicine, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei, 10048, Taiwan. .,School of Dentistry, College of Medicine, National Taiwan University, No 1, Chang-Te Street, Taipei, 10048, Taiwan.
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19
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Scaffold Pore Curvature Influences ΜSC Fate through Differential Cellular Organization and YAP/TAZ Activity. Int J Mol Sci 2022; 23:ijms23094499. [PMID: 35562890 PMCID: PMC9102667 DOI: 10.3390/ijms23094499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 12/12/2022] Open
Abstract
Tissue engineering aims to repair, restore, and/or replace tissues in the human body as an alternative to grafts and prostheses. Biomaterial scaffolds can be utilized to provide a three-dimensional microenvironment to facilitate tissue regeneration. Previously, we reported that scaffold pore size influences vascularization and extracellular matrix composition both in vivo and in vitro, to ultimately influence tissue phenotype for regenerating cranial suture and bone tissues, which have markedly different tissue properties despite similar multipotent stem cell populations. To rationally design biomaterials for specific cell and tissue fate specification, it is critical to understand the molecular processes governed by cell-biomaterial interactions, which guide cell fate specification. Building on our previous work, in this report we investigated the hypothesis that scaffold pore curvature, the direct consequence of pore size, modulates the differentiation trajectory of mesenchymal stem cells (MSCs) through alterations in the cytoskeleton. First, we demonstrated that sufficiently small pores facilitate cell clustering in subcutaneous explants cultured in vivo, which we previously reported to demonstrate stem tissue phenotype both in vivo and in vitro. Based on this observation, we cultured cell-scaffold constructs in vitro to assess early time point interactions between cells and the matrix as a function of pore size. We demonstrate that principle curvature directly influences nuclear aspect and cell aggregation in vitro. Scaffold pores with a sufficiently low degree of principle curvature enables cell differentiation; pharmacologic inhibition of actin cytoskeleton polymerization in these scaffolds decreased differentiation, indicating a critical role of the cytoskeleton in transducing cues from the scaffold pore microenvironment to the cell nucleus. We fabricated a macropore model, which allows for three-dimensional confocal imaging and demonstrates that a higher principle curvature facilitates cell aggregation and the formation of a potentially protective niche within scaffold macropores which prevents MSC differentiation and retains their stemness. Sufficiently high principle curvature upregulates yes-associated protein (YAP) phosphorylation while decreased principle curvature downregulates YAP phosphorylation and increases YAP nuclear translocation with subsequent transcriptional activation towards an osteogenic differentiation fate. Finally, we demonstrate that the inhibition of the YAP/TAZ pathway causes a defect in differentiation, while YAP/TAZ activation causes premature differentiation in a curvature-dependent way when modulated by verteporfin (VP) and 1-oleyl-lysophosphatidic acid (LPA), respectively, confirming the critical role of biomaterials-mediated YAP/TAZ signaling in cell differentiation and fate specification. Our data support that the principle curvature of scaffold macropores is a critical design criterion which guides the differentiation trajectory of mesenchymal stem cells’ scaffolds. Biomaterial-mediated regulation of YAP/TAZ may significantly contribute to influencing the regenerative outcomes of biomaterials-based tissue engineering strategies through their specific pore design.
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Canullo L, Del Fabbro M, Khijmatgar S, Panda S, Ravidà A, Tommasato G, Sculean A, Pesce P. Dimensional and histomorphometric evaluation of biomaterials used for alveolar ridge preservation: a systematic review and network meta-analysis. Clin Oral Investig 2021; 26:141-158. [PMID: 34826029 DOI: 10.1007/s00784-021-04248-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 10/23/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES This systematic review and network meta-analysis aimed to answer to the following questions: (a) In patients undergoing alveolar ridge preservation after tooth extraction, which grafting material best attenuates horizontal and vertical ridge resorption, as compared to spontaneous healing?, and (b) which material(s) promotes bone formation in the extraction socket? MATERIALS AND METHODS The MEDLINE, SCOPUS, CENTRAL, and EMBASE databases were screened in duplicate for RCTs up to March 2021. Two independent authors extracted the data and assessed the risk of bias of the included studies. Primary outcomes were ridge horizontal and vertical dimension changes and new bone formation into the socket. Both pairwise and network meta-analysis (NMA) were undertaken to obtain estimates for primary outcomes and compare different grafting materials. RESULTS Eighty-eight RCTs were included, with a total of 2805 patients and 3073 sockets. Overall, a total of 1740 sockets underwent alveolar ridge preservation with different materials (1432 were covered by a membrane). Pairwise meta-analysis showed that, as compared to spontaneous healing, all materials statistically significantly reduced horizontal and vertical shrinkage. According to the multidimensional scale ranking of the NMA, xenografts (XG) and allografts (AG), alone or combined with bioactive agents (Bio + AG), were the most predictable materials for horizontal and vertical ridge dimension preservation, while platelet concentrates performed best in the percentage of new bone formation. CONCLUSIONS Alveolar ridge preservation is effective in reducing both horizontal and vertical shrinkage, as compared to untreated sockets. NMA confirmed the consistency of XG for ridge dimension preservation, but several other materials and combinations like AG, Bio + AG, and AG + alloplasts, produced even better results than XG in clinical comparisons. Further evidence is needed to confirm the value of such alternatives to XG for alveolar ridge preservation. Bio + AG performed better than the other materials in preserving ridge dimension and platelet concentrates in new bone formation. However, alloplasts, xenografts, and AG + AP performed consistently good in majority of the clinical comparisons. CLINICAL RELEVANCE XG and Bio + AG demonstrated significantly better performance in minimizing post-extraction horizontal and vertical ridge dimension changes as compared with other grafting materials or with spontaneous healing, even if they presented the worst histological outcomes. Allografts and other materials or combinations (AG + AP) presented similar performances while spontaneous healing ranked last.
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Affiliation(s)
- L Canullo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - M Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - S Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - S Panda
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy.,Department of Periodontics and Oral Implantology, Siksha 'O' Anusandhan University, Bhubaneswar, India
| | - A Ravidà
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - G Tommasato
- IRCCS Orthopedic Institute Galeazzi, Milan, Italy
| | - A Sculean
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - P Pesce
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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21
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Ridge preservation in maxillary molar extraction sites with severe periodontitis: a prospective observational clinical trial. Clin Oral Investig 2021; 26:2391-2399. [PMID: 34622309 DOI: 10.1007/s00784-021-04204-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To assess alveolar bone changes and treatment modality alterations after ridge preservation on maxillary molar extraction sockets with severe periodontitis, compared to natural healing. MATERIAL AND METHODS Thirty-six maxillary infected-molar teeth either receiving ridge preservation (RG group) or undergoing natural healing (NT group) were investigated. Cone-beam computed tomography (CBCT) scanning was performed immediately after surgery (the baseline) and repeated 6 months later to measure the linear and volumetric changes of the sockets. RESULTS Based on radiographic measurements, alveolar bone width decreased by 1.58 ± 4.61 mm in the NT group but increased by 3.74 ± 4.17 mm in the RG group (p < 0.05). Significant increases in ridge height at the center of both the NT (7.54 ± 4.54 mm) and RG (9.20 ± 3.26 mm) groups were observed. Mean sinus pneumatization was 0.19 ± 0.45 mm in the RG group and 0.59 ± 0.63 mm in the NT group (p < 0.05). The relative increase in total ridge volume was 8.0% and 35.5% in the NT and RG group, respectively (p < 0.05). Implant placement with additional sinus augmentation procedure was performed in 16.7% of the RG group cases, whereas 50% in the NT group cases. CONCLUSIONS Ridge preservation in the maxillary molar extraction sockets with severe periodontitis can improve alveolar ridge dimensions and decrease the necessity of advanced regenerative procedures at implant placement compared to natural healing. CLINICAL RELEVANCE Ridge preservation on maxillary molar extraction sockets with severe periodontitis maintained the vertical bone height more efficiently and resulted in less need for sinus augmentation procedures at 6 months compared to natural healing.
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22
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Tien HK, Lee WH, Kim CS, Choi SH, Gruber R, Lee JS. Alveolar ridge regeneration in two-wall-damaged extraction sockets of an in vivo experimental model. Clin Oral Implants Res 2021; 32:971-979. [PMID: 34101908 PMCID: PMC8453892 DOI: 10.1111/clr.13791] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/24/2021] [Accepted: 05/22/2021] [Indexed: 12/24/2022]
Abstract
Aim To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two‐wall (both buccal and lingual)‐damaged extraction sockets. Materials and methods Distal roots of three mandibular premolars in six beagle dogs were extracted, and the whole buccal and lingual bony walls were surgically removed. Three treatment protocols were then applied according to the following group allocation: no graft (None), grafting DPBM (BG), and grafting DPBM with coverage by a collagen membrane (BG + M). Two observational periods (2 and 8 weeks) were used with the split‐mouth design, and quantitative and qualitative analyses were performed by microcomputed tomography and histology. Results The dimensions of the alveolar ridge at both grafted sites (BG and BG + M) remained similar to those of the pristine ridge in the histologic and radiographic analyses, whereas the ungrafted sites (None) collapsed both vertically and horizontally. Both grafting protocols produced substantial bony regeneration, but the addition of a covering membrane enhanced the proportion of mineralized tissue within the augmented area, and the BG + M group also showed a significantly larger area of regenerated ridge than the None group (p < .05). Conclusions Bone grafting with collagen membrane can maintain the alveolar ridge dimensions with substantial bone regeneration in a two‐wall‐damaged extraction socket.
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Affiliation(s)
- Hsu Kuo Tien
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Won-Ho Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Seong-Ho Choi
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Reinhard Gruber
- Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, South Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea.,Department of Oral Biology, School of Dentistry, Medical University of Vienna, Vienna, Austria
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23
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Labussiere M, Badran Z, Rethore G, Verner C, Soueidan A, Struillou X. Combination of bone substitutes and vectors in periodontology and implantology: A systematic review. Dent Mater J 2021; 40:839-852. [PMID: 34121025 DOI: 10.4012/dmj.2020-361] [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: 12/09/2022]
Abstract
The aim of the systematic review was to analyze the use of combination of bone substitutes and vectors in periodontology and implantology among animals models and humans. Electronic databases were searched, and additional hand search was performed. The research strategy was achieved according to the PRISMA guidelines. The including criteria were: combination of bone substitutes and vectors, in vivo studies, a precise number of specimens, histological and radiographic analysis, written in English. The risk of bias was evaluated for individual studies. Thirty-two articles were selected and investigated in this systematic review. The results do not show a superiority of the use of composite biomaterial in comparison with simple biomaterial but suggest the efficacity of their utilization as a carrier of bioactive agents. Future studies need to identify the suitable association of bone substitutes and vectors and explore interest in their use such as the support of growth factors.
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Affiliation(s)
- Marion Labussiere
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes
| | - Zahi Badran
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Gildas Rethore
- Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Christian Verner
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes
| | - Assem Soueidan
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
| | - Xavier Struillou
- Department of Periodontology, Faculty of Dental Surgery, University of Nantes.,Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, University of Nantes
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Atieh MA, Alsabeeha NH, Payne AG, Ali S, Faggion CMJ, Esposito M. Interventions for replacing missing teeth: alveolar ridge preservation techniques for dental implant site development. Cochrane Database Syst Rev 2021; 4:CD010176. [PMID: 33899930 PMCID: PMC8092674 DOI: 10.1002/14651858.cd010176.pub3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. This is an update of the Cochrane Review first published in 2015. OBJECTIVES To assess the clinical effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP, or both, in patients requiring dental implant placement following healing of extraction sockets. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 19 March 2021), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2021, Issue 2), MEDLINE Ovid (1946 to 19 March 2021), Embase Ovid (1980 to 19 March 2021), Latin American and Caribbean Health Science Information database (1982 to 19 March 2021), Web of Science Conference Proceedings (1990 to 19 March 2021), Scopus (1966 to 19 March 2021), ProQuest Dissertations and Theses (1861 to 19 March 2021), and OpenGrey (to 19 March 2021). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. A number of journals were also handsearched. SELECTION CRITERIA We included all randomised controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. Outcome measures were: changes in the bucco-lingual/palatal width of alveolar ridge, changes in the vertical height of the alveolar ridge, complications, the need for additional augmentation prior to implant placement, aesthetic outcomes, implant failure rates, peri-implant marginal bone level changes, changes in probing depths and clinical attachment levels at teeth adjacent to the extraction site, and complications of future prosthodontic rehabilitation. DATA COLLECTION AND ANALYSIS We selected trials, extracted data, and assessed risk of bias in duplicate. Corresponding authors were contacted to obtain missing information. We estimated mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes, with 95% confidence intervals (95% CI). We constructed 'Summary of findings' tables to present the main findings and assessed the certainty of the evidence using GRADE. MAIN RESULTS We included 16 RCTs conducted worldwide involving a total of 524 extraction sites in 426 adult participants. We assessed four trials as at overall high risk of bias and the remaining trials at unclear risk of bias. Nine new trials were included in this update with six new trials in the category of comparing ARP to extraction alone and three new trials in the category of comparing different grafting materials. ARP versus extraction: from the seven trials comparing xenografts with extraction alone, there is very low-certainty evidence of a reduction in loss of alveolar ridge width (MD -1.18 mm, 95% CI -1.82 to -0.54; P = 0.0003; 6 studies, 184 participants, 201 extraction sites), and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001; 6 studies, 184 participants, 201 extraction sites) in favour of xenografts, but we found no evidence of a significant difference for the need for additional augmentation (RR 0.68, 95% CI 0.29 to 1.62; P = 0.39; 4 studies, 154 participants, 156 extraction sites; very low-certainty evidence) or in implant failure rate (RR 1.00, 95% CI 0.07 to 14.90; 2 studies, 70 participants/extraction sites; very low-certainty evidence). From the one trial comparing alloplasts versus extraction, there is very low-certainty evidence of a reduction in loss of alveolar ridge height (MD -3.73 mm; 95% CI -4.05 to -3.41; 1 study, 15 participants, 60 extraction sites) in favour of alloplasts. This single trial did not report any other outcomes. Different grafting materials for ARP: three trials (87 participants/extraction sites) compared allograft versus xenograft, two trials (37 participants, 55 extraction sites) compared alloplast versus xenograft, one trial (20 participants/extraction sites) compared alloplast with and without membrane, one trial (18 participants, 36 extraction sites) compared allograft with and without synthetic cell-binding peptide P-15, and one trial (30 participants/extraction sites) compared alloplast with different particle sizes. The evidence was of very low certainty for most comparisons and insufficient to determine whether there are clinically significant differences between different ARP techniques based on changes in alveolar ridge width and height, the need for additional augmentation prior to implant placement, or implant failure. We found no trials which evaluated parameters relating to clinical attachment levels, specific aesthetic or prosthodontic outcomes for any of the comparisons. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Among the complications reported were delayed healing with partial exposure of the buccal plate at suture removal, postoperative pain and swelling, moderate glazing, redness and oedema, membrane exposure and partial loss of grafting material, and fibrous adhesions at the cervical part of previously preserved sockets, for the comparisons xenografts versus extraction, allografts versus xenografts, alloplasts versus xenografts, and alloplasts with and without membrane. AUTHORS' CONCLUSIONS ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is lack of evidence of any differences in the need for additional augmentation at the time of implant placement, implant failure, aesthetic outcomes, or any other clinical parameters due to lack of information or long-term data. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP. Further long-term RCTs that follow CONSORT guidelines (www.consort-statement.org) are necessary.
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Affiliation(s)
- Momen A Atieh
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
- Sir John Walsh Research Institute, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - Nabeel Hm Alsabeeha
- RAK Dental Centre, Ministry of Health and Prevention, Ras Al-Khaimah, United Arab Emirates
| | - Alan Gt Payne
- Private practice, Northland Prosthodontics Ltd, c/o NorthShore Oral and Maxillofacial Surgeons, Auckland, New Zealand
| | - Sara Ali
- Mohammed bin Rashid University of Medicine and Health Sciences, Hamdan bin Mohammed College of Dental Medicine, Dubai, United Arab Emirates
| | | | - Marco Esposito
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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Ben Amara H, Kim JJ, Kim HY, Lee J, Song HY, Koo KT. Is ridge preservation effective in the extraction sockets of periodontally compromised teeth? A randomized controlled trial. J Clin Periodontol 2021; 48:464-477. [PMID: 33316099 DOI: 10.1111/jcpe.13412] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/26/2020] [Accepted: 12/05/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To verify whether ridge preservation is effective in the reduction of dimensional loss and in bone formation compared to spontaneous healing in extraction sockets of periodontally compromised teeth. METHODS Twenty-six subjects requiring tooth extraction for stage III/IV periodontitis were randomly assigned to one of two interventions: alveolar ridge preservation using collagenated bovine bone mineral and a resorbable collagen membrane (test, RP) or spontaneous healing (control, SH). Six months later, postoperative cone-beam computed tomography (CBCT) was performed to measure the linear and volumetric changes of the sockets compared to baseline scans. Biopsies were retrieved at the implant site for histomorphometric calculations. Nonparametric tests were applied for statistical analysis. RESULTS Significantly less shrinkage occurred in RP compared to SH, mainly in the crestal zone. The width loss difference between groups was 3.3 mm and 2.2 mm at 1 mm and 3 mm below the crest, respectively (p < .05). RP yielded a gain in socket height of 0.25 mm, whereas a loss of -0.39 mm was observed in SH (p < .05). The percentage of volume loss recorded in RP was also less than that recorded in SH (-26.53% vs -50.34, p < .05). Significantly less bone proportion was detected in biopsies from RP (30.1%) compared with SH (53.9%). A positive association between baseline bone loss and ridge shrinkage was found in SH but not in RP. CONCLUSION Ridge preservation in extraction sockets of periodontally compromised teeth was effective in reducing the amount of ridge resorption.
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Affiliation(s)
- Heithem Ben Amara
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Ju Kim
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Hae-Young Kim
- Department of Health Policy and Management, Korea University, Seoul, Korea
| | - Jungwon Lee
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Hyun-Young Song
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), School of Dentistry, Seoul National University, Seoul, Korea
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Mayer Y, Ginesin O, Zigdon-Giladi H. Socket Preservation Using Xenograft Does Not Impair Implant Primary Stability in Sheep: Clinical, Histological, and Histomorphometric Study. J ORAL IMPLANTOL 2020; 46:580-588. [PMID: 32315436 DOI: 10.1563/aaid-joi-d-19-00237] [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: 11/22/2022]
Abstract
Implant primary stability, which depends mainly on the amount and quality of bone, is important for implant survival. Socket preservation aims to reduce bone volumetric changes after tooth extraction. This animal study aims to examine whether preserving a ridge by using xenograft impairs the primary stability of the implant. Eighteen artificial bone defects were prepared in 4 sheep (5- and 8-mm length). Defects were randomly grafted with xenografts: Bio-Oss (BO), Bio-Active bone (BB), or left for natural healing (control). After 8 weeks, bone biopsy was harvested and dental implants installed. During installation, peak insertion torque (IT) was measured by hand ratchet, and primary stability by the Osstell method. Histomorphometric analysis showed a higher percentage of new bone formation in the naturally healed defects compared to sites with xenograft (control: 68.66 ± 4.5%, BB: 48.75 ± 4.34%, BO: 50.33 ± 4.0%). Connective tissue portion was higher in the BO and BB groups compared to control (44.25 ± 2.98%, 41 ± 6%, and 31.33 ± 4.5%, P < .05, respectively). Residual grafting material was similar in BO and BB (7 ± 2.44%, 8.66 ± 2.1%, respectively). Mean IT and implant stability quotient (ISQ) values were not statistically different among the groups. A positive correlation was found between IT and ISQ (r = 0.65, P = 0). In conclusion, previously grafted defects with xenograft did not influence primary stability and implant insertion torque in delayed implant placement. These results may be attributed to a relatively high bone fill of the defect (∼50%) 2 months after grafting.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel
| | - Hadar Zigdon-Giladi
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus (RHCC), Haifa, Israel.,Laboratory for Hard Tissue Regeneration, Clinical Research Institute at Rambam Health Care Campus, Haifa, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israeli Institute of Technology, Haifa, Israel
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27
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Management of Postsurgical Complication in Multiple Implant-Infected Postextraction Sites in the Lower Arch. Int J Dent 2020; 2020:8869046. [PMID: 33061974 PMCID: PMC7542513 DOI: 10.1155/2020/8869046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/13/2020] [Accepted: 09/17/2020] [Indexed: 11/17/2022] Open
Abstract
Currently, dental implants are a very frequent therapeutic alternative for replacing missing teeth. However, they are not exempt from developing complications of infectious origin. Therefore, this case report describes a 67-year-old female patient presenting infectious complications caused by suture rupture. Surgery combined with therapeutic management with antibiotics was performed, allowing preservation of the osseointegration of the implants in the lower arch. Within the limitations of this study, it was shown that more research is needed to determine the success and survival of implants presenting complications due to infections during the osseointegration process.
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Alain H, Christophe RB, Héléne LH, Fabienne W, Bénédicte E, Pierre L. Healing Process with the use of a New Resorbable Synthetic Membrane. Open Dent J 2020. [DOI: 10.2174/1874210602014010450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Currently, absorbable membranes tend to be used most frequently for guided bone regeneration. They have many advantages and the most commonly reported complication is early exposure.
Objective:
This retrospective study reports the healing process of soft tissues over a four-week period using synthetic absorbable membranes.
Study Design:
One-hundred and ten cases were included. Soft tissue healing was assessed from anonymized photographs, in accordance with the criteria of the Early Healing Index (EHI) (Watchel et al., 2003). Cohen's Kappa (K) test was used to estimate the reliability of the measures and the variability between the examiners. Chi-squared test and Fisher’s exact test were used to assess the combination of healing outcomes with respect to the type of surgical intervention.
Results:
At 1-week, 81% of the cases showed a Primary Closure (PC) when the membrane was not initially exposed. The score increased to 98% at 4-weeks. Healing at 1-week varied significantly according to the type of intervention, with 73% of primary closure for bone augmentation during implantation, versus 60% for bone augmentation before implantation and 46% for alveolar preservation (Chi-square test, p = 0.049). No statistically significant differences in the healing process were observed between the smoking and non-smoking groups.
Conclusion:
This clinical study shows that the safety and exposure rates of this new synthetic membrane are comparable to the data gathered in the literature concerning non-cross-linked collagenous membranes.
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Sivolella S, Botticelli D, Prasad S, Ricci S, Bressan E, Prasad H. Evaluation and comparison of histologic changes and implant survival in extraction sites immediately grafted with two different xenografts: A randomized clinical pilot study. Clin Oral Implants Res 2020; 31:825-835. [DOI: 10.1111/clr.13626] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/10/2020] [Accepted: 05/13/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Stefano Sivolella
- Department of Neurosciences Dentistry Section University of Padova Padova Italy
| | | | - Sanjana Prasad
- Hard Tissue Research Laboratory, Biological and Diagnostic Sciences School of Dentistry University of Minnesota Minneapolis MN USA
| | - Sara Ricci
- Department of Neurosciences Dentistry Section University of Padova Padova Italy
| | - Eriberto Bressan
- Department of Neurosciences Dentistry Section University of Padova Padova Italy
| | - Hari Prasad
- Hard Tissue Research Laboratory, Biological and Diagnostic Sciences School of Dentistry University of Minnesota Minneapolis MN USA
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30
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Chen ST, Darby I. Alveolar ridge preservation and early implant placement at maxillary central incisor sites: A prospective case series study. Clin Oral Implants Res 2020; 31:803-813. [DOI: 10.1111/clr.13619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 04/26/2020] [Accepted: 04/28/2020] [Indexed: 01/17/2023]
Affiliation(s)
- Stephen T. Chen
- PeriodonticsMelbourne Dental SchoolThe University of Melbourne Parkville Vic. Australia
| | - Ivan Darby
- PeriodonticsMelbourne Dental SchoolThe University of Melbourne Parkville Vic. Australia
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Schnutenhaus S, Edelmann C, Dreyhaupt J, Rudolph H, Luthardt RG, Goetz W. Alveolar ridge preservation with a collagen cone: Histological, histochemical, and immunohistochemical results of a randomized controlled clinical trial. Clin Exp Dent Res 2020; 6:345-355. [PMID: 31967736 PMCID: PMC7301397 DOI: 10.1002/cre2.279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/18/2019] [Accepted: 12/20/2019] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES The objective of the present study was to examine the influence of a combination material of a collagen cone and a collagen membrane on the healing process of extraction sockets with regard to histological, histochemical, and immunohistochemical parameters. MATERIALS AND METHODS In a prospective randomized clinical study, 10 patients (test group) received a collagen combination material after tooth removal. The extraction sockets of 10 other patients (control group) were left to heal without further intervention. Eleven ±1 weeks after tooth extraction, histological biopsies were performed in both groups at the time of implant placement. Subsequently, the biopsies were evaluated semiquantitatively in terms of histological, histochemical, and immunohistochemical parameters for the identification of factors of bone metabolism and vascularization. RESULTS No significant difference between test and control group were found for any parameter. According to the descriptive data, the use of a collagen combination material seems to result in slightly higher values of the osteogenic Runt-related transcription factor 2 (Runx2) and vascularization. CONCLUSION The histological, histochemical, and immunohistochemical analysis of ARP with a collagen cone combined with a collagen membrane showed no significant differences in terms of bone metabolism and vascularization.
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Affiliation(s)
- Sigmar Schnutenhaus
- Center of Dentistry Dr. Schnutenhaus MVZ GmbHHilzingenGermany
- Department of Prosthetic Dentistry, Center of DentistryUlm UniversityUlmGermany
| | - Cornelia Edelmann
- Department of Prosthetic Dentistry, Center of DentistryUlm UniversityUlmGermany
| | - Jens Dreyhaupt
- Institute of Epidemiology and Medical BiometryUlm UniversityUlmGermany
| | - Heike Rudolph
- Center of Dentistry Dr. Schnutenhaus MVZ GmbHHilzingenGermany
| | | | - Werner Goetz
- Department of Orthodontics, Oral Biology LaboratoryUniversity of BonnBonnGermany
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Abe GL, Sasaki JI, Katata C, Kohno T, Tsuboi R, Kitagawa H, Imazato S. Fabrication of novel poly(lactic acid/caprolactone) bilayer membrane for GBR application. Dent Mater 2020; 36:626-634. [DOI: 10.1016/j.dental.2020.03.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/03/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022]
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Ikawa T, Akizuki T, Ono W, Maruyama K, Okada M, Stavropoulos A, Izumi Y, Iwata T. Ridge reconstruction in damaged extraction sockets using tunnel β-tricalcium phosphate blocks: A 6-month histological study in beagle dogs. J Periodontal Res 2020; 55:496-502. [PMID: 31985082 DOI: 10.1111/jre.12735] [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: 08/29/2019] [Revised: 12/17/2019] [Accepted: 01/05/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study aimed to evaluate the histological outcome of tunnel β-TCP blocks grafting in extraction sockets missing the buccal bone wall, after 6 months of healing. BACKGROUND Tunnel β-tricalcium phosphate (β-TCP) blocks made of randomly organized tunnel-shaped β-TCP ceramics appeared promising for alveolar ridge preservation in tooth extraction sockets missing the buccal bone, in a previous study in dogs, with a 2-month healing time. METHODS In six beagle dogs, the maxillary first premolars were extracted and the buccal bone was surgically removed to create bone defects of 4 mm (mesio-distal) × 5 mm (apico-coronal) × 4 mm (bucco-palatal). Thus, extraction sockets missing the buccal bone plate were grated with tunnel β-TCP blocks (test) or left empty for spontaneous healing (control). Histology/histomorphometry was performed after 6 months of healing. RESULTS The horizontal bucco-palatal width of the alveolar ridge was significantly greater at test sites than at control sites. The amount of mineralized tissue was greater at test sites (57.8% ± 11.1%) than at control sites (28.9% ± 8.5%), while the amount of connective tissue was significantly greater at control sites (41.7% ± 6.4%) than at test sites (19.6% ± 9.2%). No significant difference was found between sites in terms of basic multicellular units and bone marrow. Residual β-TCP at test sites was 5.8% ± 3.2%. CONCLUSION Grafting with tunnel β-TCP block significantly limited the resorption of the alveolar ridge at extraction sockets missing the buccal bone compared with sites left to heal spontaneously, even after 6-month follow-up.
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Affiliation(s)
- Takahiro Ikawa
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Tatsuya Akizuki
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Ono
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiichi Maruyama
- Oral Diagnosis and General Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan
| | - Munehiro Okada
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Yuichi Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Oral Care Perio Center, Southern TOHOKU General Hospital, Southern TOHOKU Research Institute for Neuroscience, Koriyama, Japan
| | - Takanori Iwata
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Sapata VM, Llanos AH, Cesar Neto JB, Jung RE, Thoma DS, Hämmerle CHF, Pannuti CM, Romito GA. Deproteinized bovine bone mineral is non-inferior to deproteinized bovine bone mineral with 10% collagen in maintaining the soft tissue contour post-extraction: A randomized trial. Clin Oral Implants Res 2020; 31:294-301. [PMID: 31886909 DOI: 10.1111/clr.13570] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 12/10/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To test the non-inferiority of demineralized bovine bone mineral (DBBM) compared to demineralized bovine bone mineral with 10% collagen (DBBM-C) for the maintenance of the soft tissue contour after tooth extraction in the esthetic zone. MATERIAL AND METHODS Sixty-five patients randomly received ridge preservation at a single site in the anterior maxilla with DBBM or DBBM-C. Both, DBBM and DBBM-C, were covered with a collagen matrix. Profilometric analyses were performed at baseline (BL), immediately after treatment (PO), and at 4 months (FU; day of implant placement). The main outcome was the horizontal mean change (HC) at the buccal aspect. The measurements also included changes of the estimated soft tissue thickness (eTT) at 1, 3, and 5 mm below the buccal gingival margin. Descriptive analysis was performed, and differences between groups were analyzed using independent samples t test. The non-inferiority test was performed for HC. RESULTS At 4 months, the horizontal mean change (HC) was -1.43 mm (±0.53 mm) (DBBM-C) and -1.32 mm (±0.53 mm) (DBBM). Change of the estimated soft tissue thickness (eTT) between baseline (BL) and four months of follow-up (FU) at 1, 3, and 5 mm amounted to -4.58 mm (±2.02 mm), -2.40 mm (±0.97 mm), and -1.37 mm (±0.78 mm) for DBBM-C and to -4.12 mm (±1.80 mm), -2.09 mm (±0.91 mm), and -1.23 mm (±0.72 mm) for DBBM. The differences between the groups were not statistically significantly for any of the outcome measures (p > .05). CONCLUSIONS DBBM is non-inferior to DBBM-C for the maintenance of the soft tissue contour 4 months after tooth extraction.
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Affiliation(s)
- Vítor M Sapata
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Alexandre H Llanos
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - João B Cesar Neto
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Cláudio M Pannuti
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Giuseppe A Romito
- Discipline of Periodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Photobiomodulation Therapy (PBMT) Applied in Bone Reconstructive Surgery Using Bovine Bone Grafts: A Systematic Review. MATERIALS 2019; 12:ma12244051. [PMID: 31817369 PMCID: PMC6947623 DOI: 10.3390/ma12244051] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/22/2019] [Accepted: 11/29/2019] [Indexed: 02/07/2023]
Abstract
The use of low-level laser therapy (LLLT) with biomodulatory effects on biological tissues, currently called photobiomodulation therapy (PBMT), assists in healing and reduces inflammation. The application of biomaterials has emerged in bone reconstructive surgery, especially the use of bovine bone due to its biocompatibility. Due to the many benefits related to the use of PBMT and bovine bones, the aim of this research was to review the literature to verify the relationship between PBMT and the application of bovine bone in bone reconstruction surgeries. We chose the PubMed/MEDLINE, Web of Science, and Scopus databases for the search by matching the keywords: “Bovine bone AND low-level laser therapy”, “Bovine bone AND photobiomodulation therapy”, “Xenograft AND low-level laser therapy”, and “Xenograft AND photobiomodulation therapy”. The initial search of the three databases retrieved 240 articles, 18 of which met all inclusion criteria. In the studies concerning animals (17 in total), there was evidence of PBMT assisting in biomaterial-related conduction, formation of new bone, bone healing, immunomarker expression, increasing collagen fibers, and local inflammation reduction. However, the results disagreed with regard to the resorption of biomaterial particles. The only human study showed that PBMT with bovine bone was effective for periodontal regeneration. It was concluded that PBMT assists the process in bone reconstruction when associated with bovine bone, despite divergences between applied protocols.
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Koo T, Song YW, Cha J, Jung U, Kim C, Lee J. Histologic analysis following grafting of damaged extraction sockets using deproteinized bovine or porcine bone mineral: A randomized clinical trial. Clin Oral Implants Res 2019; 31:93-102. [DOI: 10.1111/clr.13557] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/03/2019] [Accepted: 11/10/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Tae‐Hwan Koo
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
| | - Young Woo Song
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
| | - Jae‐Kook Cha
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
| | - Ui‐Won Jung
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
| | - Chang‐Sung Kim
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
- Department of Applied Life Science BK21 PLUS Yonsei University College of Dentistry Seoul Korea
- Department of Mechanical Engineering College of Engineering Yonsei University Seoul Korea
| | - Jung‐Seok Lee
- Department of Periodontology Research Institute for Periodontal regeneration Yonsei University College of Dentistry Seoul Korea
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37
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Canellas JVDS, Ritto FG, Figueredo CMDS, Fischer RG, de Oliveira GP, Thole AA, Medeiros PJD. Histomorphometric evaluation of different grafting materials used for alveolar ridge preservation: a systematic review and network meta-analysis. Int J Oral Maxillofac Surg 2019; 49:797-810. [PMID: 31699633 DOI: 10.1016/j.ijom.2019.10.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 08/29/2019] [Accepted: 10/09/2019] [Indexed: 02/08/2023]
Abstract
In this systematic review and network meta-analysis including only randomized clinical trials (RCTs), different grafting materials used in alveolar ridge preservation after tooth extraction were analysed, focusing on histomorphometric new bone formation (NBF) in core biopsies obtained during implant placement. The PubMed, Embase, Cochrane Library, Web of Science, Scopus, and LILACS databases, as well as the grey literature, were searched for published and unpublished trials (from database inception to January 14, 2019). The primary outcome was the percentage of NBF. The secondary outcomes were the percentage of residual biomaterial and the percentage of soft tissue. An arm-based network meta-analysis was performed. The rank of intervention efficacy was obtained to measure the probability of each biomaterial being ranked first across all interventions. A total of 1526 studies were found, of which 38 were included for quantitative analysis. Three trials were rated as having a high risk of bias and 35 trials as having an unclear risk of bias. The network meta-analysis showed that nine grafting materials decreased NBF and 25 did not decrease NBF. The grafting material with the highest amount of NBF was plasma rich in growth factors. Due to the lack of studies with a low risk of bias, further RCTs are needed for definitive conclusions.
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Affiliation(s)
- J V D S Canellas
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
| | - F G Ritto
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - C M D S Figueredo
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R G Fischer
- Department of Periodontology, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - G P de Oliveira
- Department of Histology and Embryology, Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - A A Thole
- Department of Histology and Embryology, Biology Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - P J D Medeiros
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Lim HC, Shin HS, Cho IW, Koo KT, Park JC. Ridge preservation in molar extraction sites with an open-healing approach: A randomized controlled clinical trial. J Clin Periodontol 2019; 46:1144-1154. [PMID: 31444908 DOI: 10.1111/jcpe.13184] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/03/2019] [Accepted: 08/21/2019] [Indexed: 12/27/2022]
Abstract
AIM To determine the effect of alveolar ridge preservation (ARP) in molar sites without primary flap closure. MATERIALS AND METHODS Three groups were established: extraction sockets grafted with deproteinized bovine bone mineral containing 10% collagen (DBBM-C) and covered by a native bilayer collagen membrane (NBCM) (test group 1), sockets grafted with DBBM-C only (test group 2), and sockets that healed naturally (control group). Primary flap closure was not attempted. Conebeam computed tomography scans were obtained immediately and then 4 months after ARP. A biopsy was performed. The change of the marginal bone level was measured. RESULTS There was significantly less horizontal resorption in test group 1 than in the control group at levels 1 mm (-1.02 ± 0.88 [mean ± SD] vs. -4.44 ± 3.71 mm) and 3 mm (-0.31 ± 1.51 vs. -2.27 ± 1.15 mm) below the crest, and significantly less vertical reduction in the midcrestal area in test group 1 than in test group 2 (-0.25 ± 0.95 vs. -1.15 ± 1.63 mm) (p < .05). There were no significant differences between test groups in clinical and histomorphometric measurements. All groups exhibited stable marginal bone levels after 1 year of loading. CONCLUSION Alveolar ridge preservation without primary flap closure in molar areas was effective in minimizing ridge resorption and facilitated implant treatment.
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Affiliation(s)
- Hyun-Chang Lim
- Department of Periodontology, School of Dentistry, Periodontal-Implant Clinical Research Institute, Kyung Hee University, Seoul, South Korea
| | - Hyun-Seung Shin
- Department of Periodontology, Dankook University College of Dentistry, Cheonan-si, South Korea
| | - In-Woo Cho
- Department of Periodontology, Dankook University College of Dentistry, Cheonan-si, South Korea
| | - Ki-Tae Koo
- Department of Periodontology, College of Dentistry, Seoul National University, Seoul, South Korea
| | - Jung-Chul Park
- Department of Periodontology, Dankook University College of Dentistry, Cheonan-si, South Korea
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Faria-Almeida R, Astramskaite-Januseviciene I, Puisys A, Correia F. Extraction Socket Preservation with or without Membranes, Soft Tissue Influence on Post Extraction Alveolar Ridge Preservation: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e5. [PMID: 31620267 PMCID: PMC6788420 DOI: 10.5037/jomr.2019.10305] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/05/2019] [Indexed: 12/11/2022]
Abstract
Objectives The purpose of this systematic review was to assess quantitatively and qualitatively the influence of two different factors: membranes and soft tissue graft influence for the extraction socket preservation. Material and Methods A wide-ranging electronic search was performed in six databases up to 30 of November 2018 in order to identify all the clinical and randomized clinical trials performed in humans published with no data restriction. The inclusion criteria were extraction socket preservation with and without membranes or a soft tissue graft in a intact socket with at least six months of follow-up, have more than 12 patients or treat more than 12 sites per group and evaluated at least one of the primary outcomes measures (radiographic measures histological assessment, clinical measures). Results From an initial search of 1524 studies only 6 papers fulfil the inclusion and exclusion criterions. All the six selected papers, presented a wide heterogeneity of treatments used, evaluated variables and observation period that made impossible to recommend any specific techniques and/or material to achieve better results. The limited data found suggest that the used of membrane reveals to achieve better results. It wasn’t possible to observe in any clinical trial that compares the used of soft tissue graft. Conclusions New trials need to be performed in order to identify what specific techniques and/or materials are better to decrease the reabsorption of the socket after tooth extraction. Clinical trials designed to understand when/how the soft tissues grafts influence at the socket preservation is needed.
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Affiliation(s)
- Ricardo Faria-Almeida
- Department of Oral Surgery and Oral Medicine, Porto University of Dental MedicinePortugal
| | - Inesa Astramskaite-Januseviciene
- Department of Oral and Maxillofacial Surgery, Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, KaunasLithuania
| | | | - Francisco Correia
- Department of Oral Surgery and Oral Medicine, Porto University of Dental MedicinePortugal
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Antimicrobial Activity of an Amnion-Chorion Membrane to Oral Microbes. Int J Dent 2019; 2019:1269534. [PMID: 31379946 PMCID: PMC6657630 DOI: 10.1155/2019/1269534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 06/09/2019] [Indexed: 01/18/2023] Open
Abstract
Objective The aim of this study was to evaluate wound biomodification by assessing antimicrobial properties present within a human-derived composite amnion-chorion membrane (ACM). Methods Membranes analyzed were the human-derived ACM BioXclude™ and the porcine-derived collagen membrane Bio-Gide®. Paper discs with and without tetracycline served as positive and negative controls, respectively. The same number of colony-forming units per milliliter for each bacterial species (Aggregatibacter actinomycetemcomitans, Streptococcus mutans, and Streptococcus oralis) was inoculated on each of the discs. Discs from each group were removed at 12 and 24 hours and sonicated to remove the bacteria off the membranes. A serial dilution was performed to quantify bacterial growth. Results The ACM inhibited growth at all time points, with all bacterial strains, identical to the negative control tetracycline discs. The collagen membrane and positive controls did not inhibit growth of any of the bacterial species throughout the 24-hour study period. P < 0.05 for microbial growth on ACM or negative control vs. either collagen membrane or positive control. Conclusion ACM was proven to be as bactericidal as paper discs inoculated with tetracycline at its minimum bactericidal concentration. The ACM bactericidal property may be beneficial in the early wound healing process.
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Iorio-Siciliano V, Ramaglia L, Blasi A, Bucci P, Nuzzolo P, Riccitiello F, Nicolò M. Dimensional changes following alveolar ridge preservation in the posterior area using bovine-derived xenografts and collagen membrane compared to spontaneous healing: a 6-month randomized controlled clinical trial. Clin Oral Investig 2019; 24:1013-1023. [PMID: 31286260 DOI: 10.1007/s00784-019-02979-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess dimensional changes following alveolar ridge preservation using bovine-derived xenograft with 10% collagen and collagen membrane compared to ridge preservation by means of bovine-derived xenograft particles and collagen membrane or spontaneous healing in posterior sites. MATERIALS AND METHODS Forty subjects with 40 posterior teeth or roots candidate to extraction and presenting integrity of alveolar bone walls were randomly allocated into three groups. Patients of test group were treated by ridge preservation technique using bovine-derived xenograft with 10% collagen and collagen membrane; patients of control group 1 were treated by means of bovine-derived xenograft particles and collagen membrane while in patients of control group 2, no grafting was performed. Changes in vertical and horizontal bone dimensions were compared at baseline and after 6-month observation time. RESULTS Statistically significant differences between baseline and 6 month were observed in all groups in terms of vertical and horizontal bone resorption (p < 0.001), except for vertical resorption in control group 2. After 6-month intergroup comparisons showed not statistically significant changes between test and control groups in terms of alveolar bone changes (p > 0.05). CONCLUSIONS Within the limits of this study, the sites grafted using bovine-derived xenograft with 10% collagen in combination with a collagen membrane showed no statistical differences in terms of vertical and horizontal bone resorption compared to control groups. CLINICAL RELEVANCE Ridge preservation in posterior area failed to show clinically relevant benefits in sites presenting integrity of alveolar bone walls and adequate buccal bone wall thickness.
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Affiliation(s)
| | - Luca Ramaglia
- Department of Oral Surgery, University of Naples Federico II, Naples, Italy. .,Università di Napoli Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Andrea Blasi
- Department of Periodontology, University of Naples Federico II, Naples, Italy
| | - Paolo Bucci
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Nuzzolo
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Riccitiello
- Department of Restorative Dentistry, University of Naples Federico II, Naples, Italy
| | - Michele Nicolò
- Department of Periodontology, University of Naples Federico II, Naples, Italy
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Lee JS, Choe SH, Cha JK, Seo GY, Kim CS. Radiographic and histologic observations of sequential healing processes following ridge augmentation after tooth extraction in buccal-bone-deficient extraction sockets in beagle dogs. J Clin Periodontol 2018; 45:1388-1397. [DOI: 10.1111/jcpe.13014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 07/17/2018] [Accepted: 09/16/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul South Korea
| | - Sun-Ho Choe
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul South Korea
| | - Jae-Kook Cha
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul South Korea
| | - Gi-Young Seo
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul South Korea
| | - Chang-Sung Kim
- Department of Periodontology; Research Institute for Periodontal Regeneration; College of Dentistry; Yonsei University; Seoul South Korea
- Department of Applied Life Science; BK21 PLUS Project; College of Dentistry; Yonsei University; Seoul South Korea
- Department of Mechanical Engineering; College of Engineering; Yonsei University; Seoul South Korea
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Lee JS, Cha JK, Kim CS. Alveolar ridge regeneration of damaged extraction sockets using deproteinized porcine versus bovine bone minerals: A randomized clinical trial. Clin Implant Dent Relat Res 2018; 20:729-737. [PMID: 30051954 PMCID: PMC6220803 DOI: 10.1111/cid.12628] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/26/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
Abstract
Backgrounds Clinical benefits in bone grafting of intact extraction socket have been widely known, but limited evidence is available for the procedure in damaged extraction sockets due to periodontal disease. Purpose This study aimed to determine the dimensional alteration of alveolar ridge following bone grafting of damaged extraction sockets, and compare the outcomes of using deproteinized bovine (DBBM) versus porcine bone mineral (DPBM) in the damaged sockets. Materials and Methods One hundred patients (n = 50 for each group) with periodontitis‐induced damaged extraction socket were included in this randomized, single‐blind trial. After removal of tooth and granulation tissue, sites were grafted with either DBBM (DBBM group) or DPBM (DPBM group), and covered with collagen membrane. Linear/volumetric analyses of hard and soft‐tissue dimensions were performed on reconstructed/superimposed computed tomography and scanned cast images, taken immediately and 4 months after surgery. Results The two groups showed comparable hard tissue augmentation with minimal reductions in the grafted volume, as well as in vertical (1.22 ± 2.16 and 1.45 ± 1.92 mm for DPBM and DBBM group, respectively) and horizontal (1.43 ± 3.40 and 1.83 ± 2.85 mm on the central section, respectively) dimensions at 4 months after surgery. However, several cases showed large variations in maintenance of the grafted volume. None of the measured parameters in hard and soft tissue dimensions differed significantly between DBBM and DPBM sites. Conclusions DBBM and DPBM can comparably augment damaged extraction sockets with minimal postoperative reduction of the grafted volume. However, the large variations in the results should be further evaluated for application in routine dental clinics.
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Affiliation(s)
- Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Chang-Sung Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Republic of Korea.,Department of Applied Life Science, BK21 PLUS Project, College of Dentistry, Seoul, Republic of Korea.,Department of Mechanical Engineering, College of Engineering, Yonsei University, Seoul, Republic of Korea
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Naenni N, Sapata V, Bienz SP, Leventis M, Jung RE, Hämmerle CHF, Thoma DS. Effect of flapless ridge preservation with two different alloplastic materials in sockets with buccal dehiscence defects-volumetric and linear changes. Clin Oral Investig 2018; 22:2187-2197. [PMID: 29280075 DOI: 10.1007/s00784-017-2309-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test whether or not one out of two alloplastic materials used for ridge preservation (RP) is superior to the other in terms of volumetric and linear ridge changes over time. MATERIALS AND METHODS In 16 adult beagle dogs, the distal roots of P3 and P4 were extracted and 50% of the buccal bone plate removed. Ridge preservation was performed randomly using two different alloplastic bone grafting substitutes (poly lactic-co-glycolic acid (PLGA) coated biphasic calcium phosphate particles consisting of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP=test 1), (a biphasic calcium phosphate consisting 60% HA and 40% ß-TCP=test 2) and a resorbable collagen membrane or a control group (sham). Sacrifice was performed at three time-points (4, 8, 16 weeks later). Impressions were taken before extraction, after RP, and at sacrifice, allowing for assessment of volumetric changes. A multi-way ANOVA was computed, and partial Type-II F tests were performed. RESULTS Both ridge preservation procedures minimized the volume loss compared to spontaneous healing. The median buccal volume changes between pre-extraction and sacrifice were - 1.76 mm (Q1 = - 2.56; Q3 = - 1.42) for test 1, - 1.62 mm (Q1 = - 2.06; Q3 = - 1.38) for test 2, and - 2.42 mm (Q1 = - 2.63; Q3 = - 2.03) for control. The mean ridge width measurements did not show statistically significant differences between test 1 (- 2.51 mm; Q1 = - 3.25; Q3 = - 1.70) and test 2 (- 2.04 mm; Q1 = - 3.82; Q3 = - 1.81) (p = 0.813), but between test and control (- 3.85 mm; Q1 = - 5.02; Q3 = - 3.27) (p = 0.003). CONCLUSIONS Both RP techniques were successful in maintaining the buccal contour from pre-extraction to sacrifice to a similar extent and more favorable compared to spontaneous healing. CLINICAL RELEVANCE Alloplastic materials can successfully be used for RP procedures.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Vitor Sapata
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Minas Leventis
- Laboratory of Experimental Surgery and Surgical Research N. S. Christeas, Medical School, University of Athens, Athens, Greece
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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Mayer Y, Ginesin O, Khutaba A, Machtei EE, Zigdon Giladi H. Biocompatibility and osteoconductivity of PLCL coated and noncoated xenografts: An in vitro and preclinical trial. Clin Implant Dent Relat Res 2018; 20:294-299. [PMID: 29508553 DOI: 10.1111/cid.12596] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 01/27/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cells, scaffolds, and growth factors are the key components in bone tissue engineering. Scaffold composition, topography, and architecture influence the amount of regenerated bone in the implantation site. The aims of the study were to compare viability and proliferation of mesenchymal stem cells (MSCs) seeded onto two commercial xenografts: Bio-Oss (BO) and bioactive bone bovine (BB). Next, these materials were compared for histomorphometric bone formation in a socket preservation model in rats. MATERIALS AND METHODS MSCs were seeded onto monolayers of BO or BB granules. Cell viability and proliferation were evaluated after incubation of 0, 2, 20, and 48 h. A total of 24 Sprague Dawley rats underwent unilateral extraction of maxillary molars. Rats were randomly divided into three groups: natural healing (nongrafted socket) or socket preservation with either BO or BB. Rats were sacrificed after 8 weeks, and histomorphometric analysis was done to evaluate bone formation and residual scaffold at the extraction site. RESULTS Differences in the metabolic activity of MSCs that were seeded onto BO or BB was observed at 2 h after seeding: the metabolic activity was elevated compared to baseline in the BB (P = .046) and not changed in the BO wells (P = .84). After 20 h, the metabolic activity of MSCs seeded onto BO was decreasing (P = .005), while cell viability was not changed in the BB group (P = .356). Intergroup comparison revealed higher metabolic activity of MSCs seeded on BB after 48 h compared with BO (P = .016). The in vivo results demonstrated differences in socket healing between the groups: percentage of new bone was higher in the BB compared to BO group (39.1 ± 14.3 vs. 23.7 ± 10.8%, respectively, P = .096). Connective tissue portion was higher in the BO group compared with BB (73.7 ± 11.1 vs. 49.6 ± 13.7%, respectively, P = .018). Residual grafting martial was higher in the BB (11.34 ± 4.18 vs. 2.62 ± 1.23%, P = .011). CONCLUSIONS The results of this study demonstrating higher vitality and proliferation of MSCs seeded onto BB. Furthermore, following ridge preservation, higher percentage of new bone and lower residual scaffold were found in the BB compared with BO. This enhanced regenerative response might be the result of an enhancement of metabolic activity in cells attached to it. Further research will be needed to understand the precise mechanism.
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Affiliation(s)
- Yaniv Mayer
- Department of Periodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Ofir Ginesin
- Department of Periodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Alaa Khutaba
- Department of Periodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Eli E Machtei
- Department of Periodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
| | - Hadar Zigdon Giladi
- Lab of Bone Regeneration, Department of Periodontics, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel
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Zhao L, Xu T, Hu W, Chung KH. Preservation and augmentation of molar extraction sites affected by severe bone defect due to advanced periodontitis: A prospective clinical trial. Clin Implant Dent Relat Res 2018; 20:333-344. [PMID: 29377475 DOI: 10.1111/cid.12585] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/03/2018] [Accepted: 01/03/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Studies of the extracted infected-molar ridge preservation are limited. PURPOSE To compare alterations of hard and soft tissue in infected-molar sockets receiving ridge preservation compared with natural healing. MATERIALS AND METHODS Thirty-five infected-molar extraction sites either preserving with Bio-Gide membrane covered the Bio-Oss material or receiving natural healing procedure as controls. The soft tissue profile was evaluated before tooth extraction and after 6-month healing. Cone-beam computed tomography scans were taken immediately and 6 months after extraction. Vertical and horizontal bone changes were assessed radiographically. Data were analyzed with Mann-Whitney U test and α = 0.05. RESULTS No significant differences in soft tissue and vertical bone changes in the medium region of the sockets were found (P > .05). Buccal bone changes in the mesial and distal sites in the test group were significantly lower than the control group (P < .05). Ridge width increased from 0.21mm to 5.30mm at 1mm apical from the crest in the test and reduced from 0.12 mm to 1.00 mm in the control groups. CONCLUSION Ridge preservation at periodontally compromised molar extraction sites might compensate for ridge width and buccal bone resorption that occurs with natural healing alone.
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Affiliation(s)
- Liping Zhao
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, People's Republic of China
| | - Kwok-Hung Chung
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
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de Oliveira GJPL, Aroni MAT, Medeiros MC, Marcantonio E, Marcantonio RAC. Effect of low-level laser therapy on the healing of sites grafted with coagulum, deproteinized bovine bone, and biphasic ceramic made of hydroxyapatite and β-tricalcium phosphate. In vivo study in rats. Lasers Surg Med 2018; 50:651-660. [PMID: 29331041 DOI: 10.1002/lsm.22787] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of low-level laser therapy (LLLT) on the healing of biomaterial graft areas (i.e., coagulum, deproteinized bovine bone, and biphasic ceramics comprising hydroxyapatite and β-tricalcium phosphate). MATERIAL AND METHODS Ninety rats were divided into two groups according to laser irradiation use (λ 808 nm, 100 mW, φ ∼600 μm, seven sessions with 28 J of irradiation dose in total): a laser group and a control group. Each of these groups was divided into three subgroups of 15 animals each according to the type of biomaterial used: Coagulum (COA), deproteinized bovine bone (DBB), and hydroxyapatite/β-tricalcium phosphate (HA/βTCP). Biomaterials were inserted into Teflon domes, and these domes were grafted to the lateral aspect of the mandibular branch of the rats. The animals were sacrificed after 30, 60, and 90 days. Scarring patterns were evaluated by microtomography and histometry. The expression levels of BMP2, osteocalcin (OCN), and alkaline phosphatase (ALP) were evaluated by immunohistochemistry. The mRNA expression levels of ALP, BMP2, Jagged1, Osterix, Runx2, and TGFβ1 were determined by RT-qPCR. RESULTS The animals treated with LLLT exhibited increased mineralized tissues and bone, particularly after 90 days. These increases were associated with increased BMP2, OCN, and ALP protein expression and ALP, BMP2, and Jagged1 mRNA expression. CONCLUSION LLLT improved the osteoconductive potential of DBB and HA/βTCP grafts and bone formation in ungrafted areas. Lasers Surg. Med. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Guilherme J P L de Oliveira
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Maurício A T Aroni
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Marcell C Medeiros
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Elcio Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
| | - Rosemary A C Marcantonio
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, State University of Sao Paulo (Universidade Estadual Paulista-UNESP), Humaitá st.1680, Araraquara, São Paulo, 14801-930, Brazil
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Cicciù M, Cervino G, Herford AS, Famà F, Bramanti E, Fiorillo L, Lauritano F, Sambataro S, Troiano G, Laino L. Facial Bone Reconstruction Using both Marine or Non-Marine Bone Substitutes: Evaluation of Current Outcomes in a Systematic Literature Review. Mar Drugs 2018; 16:E27. [PMID: 29342834 PMCID: PMC5793075 DOI: 10.3390/md16010027] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/12/2017] [Accepted: 12/22/2017] [Indexed: 12/25/2022] Open
Abstract
The aim of the present investigation was to systematically analyse the literature on the facial bone reconstruction defect using marine collagen or not and to evaluate a predictable treatment for their clinical management. The revision has been performed by searched MEDLINE and EMBASE databases from 2007 to 2017. Clinical trials and animal in vitro studies that had reported the application of bone substitutes or not for bone reconstruction defect and using marine collagen or other bone substitute material were recorded following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The first selection involved 1201 citations. After screening and evaluation of suitability, 39 articles were added at the revision process. Numerous discrepancies among the papers about bone defects morphology, surgical protocols, and selection of biomaterials were found. All selected manuscripts considered the final clinical success after the facial bone reconstruction applying bone substitutes. However, the scientific evidence regarding the vantage of the appliance of a biomaterial versus autologous bone still remains debated. Marine collagen seems to favor the dimensional stability of the graft and it could be an excellent carrier for growth factors.
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Affiliation(s)
- Marco Cicciù
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina of University, 98100 Messina, Italy.
| | - Gabriele Cervino
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina of University, 98100 Messina, Italy.
| | - Alan Scott Herford
- Department of Maxillofacial Surgery, Loma Linda University, Loma Linda, CA 92354, USA.
| | - Fausto Famà
- Department of Human Pathology, University of Messina, 98100 Messina, Italy.
| | - Ennio Bramanti
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina of University, 98100 Messina, Italy.
| | - Luca Fiorillo
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina of University, 98100 Messina, Italy.
| | - Floriana Lauritano
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, Messina of University, 98100 Messina, Italy.
| | | | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy.
| | - Luigi Laino
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", 80121 Naples, Italy.
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Pogrel MA. Nerve Damage From Bone Allografts and Xenografts-A Case Series. J Oral Maxillofac Surg 2017; 75:1351.e1-1351.e7. [PMID: 28343980 DOI: 10.1016/j.joms.2017.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 01/19/2017] [Accepted: 02/17/2017] [Indexed: 10/20/2022]
Abstract
The concept of socket preservation by placing a particulate bone allograft or xenograft into a tooth socket or on the alveolar ridge after tooth removal remains a somewhat controversial topic. The concept is that it will preserve the ridge from resorption and such that subsequent implant insertion will be easier, with fewer complications. However, one particular issue is that these materials, although not directly neurotoxic, appear to be an irritant to the nerves if they come in contact with them. We present a case series demonstrating this complication.
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Affiliation(s)
- M Anthony Pogrel
- Professor, Department of Oral and Maxillofacial Surgery, University of California, San Francisco, School of Dentistry, San Francisco, CA.
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50
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Scheyer ET, Heard R, Janakievski J, Mandelaris G, Nevins ML, Pickering SR, Richardson CR, Pope B, Toback G, Velásquez D, Nagursky H. A randomized, controlled, multicentre clinical trial of post-extraction alveolar ridge preservation. J Clin Periodontol 2016; 43:1188-1199. [PMID: 27617409 PMCID: PMC5132058 DOI: 10.1111/jcpe.12623] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2016] [Indexed: 11/29/2022]
Abstract
AIM To compare the effectiveness of two-ridge preservation treatments. MATERIALS AND METHODS Forty subjects with extraction sockets exhibiting substantial buccal dehiscences were enrolled and randomized across 10 standardized centres. Treatments were demineralized allograft plus reconstituted and cross-linked collagen membrane (DFDBA + RECXC) or deproteinized bovine bone mineral with collagen plus native, bilayer collagen membrane (DBBMC + NBCM). Socket dimensions were recorded at baseline and 6 months. Wound closure and soft tissue inflammation were followed post-operatively, and biopsies were retrieved for histomorphometric analysis at 6 months. RESULTS Primary endpoint: at 6 months, extraction socket horizontal measures were significantly greater for DBBMC + NBCM (average 1.76 mm greater, p = 0.0256). Secondary and Exploratory endpoints: (1) lingual and buccal vertical bone changes were not significantly different between the two treatment modalities, (2) histomorphometric % new bone and % new bone + graft were not significantly different, but significantly more graft remnants remained for DBBMC; (3) at 1 month, incision line gaps were significantly greater and more incision lines remained open for DFDBA + RECXC; (4) higher inflammation at 1 week tended to correlate with lower ridge preservation results; and (5) deeper socket morphologies with thinner bony walls correlated with better ridge preservation. Thirty-seven of 40 sites had sufficient ridge dimension for implant placement at 6 months; the remainder were DFDBA + RECXC sites. CONCLUSION DBBMC + NBCM provided better soft tissue healing and ridge preservation for implant placement. Deeper extraction sockets with higher and more intact bony walls responded more favourably to ridge preservation therapy.
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Affiliation(s)
- Eric Todd Scheyer
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Houston, TX, USA
| | - Rick Heard
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Victoria, TX, USA
| | - Jim Janakievski
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Tacoma, WA, USA.,Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - George Mandelaris
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Oakbrook Terrace, IL, USA.,Department of Graduate Periodontics, College of Dentistry, University of Illinois, Chicago, IL, USA
| | - Marc L Nevins
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Boston, MA, USA.,Department of Oral Medicine, Infection and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA, USA
| | - Stephen R Pickering
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, San Mateo, CA, USA
| | - Christopher R Richardson
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Richmond, VA, USA.,Department of Graduate Periodontics, Virginia Commonwealth School of Dentistry, Richmond, VA, USA
| | - Bryan Pope
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, San Mateo, CA, USA
| | - Gregory Toback
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, New London, CT, USA
| | - Diego Velásquez
- The McGuire Institute (Practice-based Clinical Research Network), Houston, TX, USA.,Private Practice, Fenton, MI, USA.,University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Heiner Nagursky
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Center - University of Freiburg, Freiburg im Breisgau, Germany
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