Classification Based on Extraction Socket Buccal Bone Morphology and Related Treatment Decision Tree

A radiographic and histological study to compare red (650 nm) versus near infrared (810 nm) diode lasers photobiomodulation for alveolar socket preservation

Previous findings indicated that the laser photobiomodulation is more effective than the control or placebo in preserving the alveolar socket. This study aimed to compare two different lasers regarding their effectiveness in aiding alveolar socket preservation. Twenty extraction sockets were selected then divided into two equal groups. Group A was exposed to 650 nm Diode laser, and Group B to 810 nm Diode laser following the same protocol and parameters after a standard alveolar socket preservation procedure with collagen plug. Radiographic analysis with cone beam computed tomography was done to compare the alveolar bone surface area immediately after extraction and three months post-operatively, while bone samples collected before implant drilling were histologically examined for newly formed bone evaluation and histomorphometric analysis in terms of percentage of new bone surface area, percentage of unmineralized bone and finally, immunohistochemical analysis of Osteocalcin reaction surface area as well as optical density. Radiographically, infrared (810 nm) Diode effect on alveolar bone surface area has significantly exceeded the red laser, while histologically, red (650 nm) Diode has demonstrated statistical significance regarding all parameters; newly formed bone surface area percentage, unmineralized bone area percentage and finally Osteocalcin bone marker reaction surface area percentage and optical density. Under the specified conditions and laser parameters, photobiomodulation using the 810 nm Diode got the upper hand radiographically, yet histologically, the red 650 nm Diode managed to dominate all histological parameters when both employed as an adjunct to alveolar socket preservation procedures.

Postextraction ridge preservation by using dense PTFE membranes: A systematic review and meta-analysis

STATEMENT OF PROBLEM

The use of dense polytetrafluoroethylene (dPTFE) membranes in alveolar ridge preservation may help reduce the risk of bacterial contamination and infection, maintaining the soft-tissue anatomy. However, systematic reviews on their efficacy in postextraction sites are lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to assess the efficacy of alveolar ridge preservation with dPTFE membranes when used alone or in combination with bone grafting materials in postextraction sites.

MATERIAL AND METHODS

An electronic search up to February 2021 was conducted by using PubMed, Embase, and the Cochrane library to detect studies using dPTFE membranes in postextraction sites. An additional manual search was performed in relevant journals. Clinical and radiographic dimensional changes of the alveolar ridge, histomorphometric, microcomputed tomography, implant-related findings, and rate of complications were recorded. One-dimensional meta-analysis was performed to calculate the overall means and 95% confidence intervals (α=.05).

RESULTS

A total of 23 studies, 14 randomized controlled trials, 4 retrospective cohort studies, 3 case series, and 2 prospective nonrandomized clinical trials, met the inclusion criteria. Five studies were included in the quantitative analysis. The meta-analysis revealed that the use of dPTFE membranes resulted in a statistically significant (P=.042) increase in clinical keratinized tissue of 3.49 mm (95% confidence interval [CI]: 0.16, 6.83) when compared with extraction alone. Metaregression showed that the difference of 1.10 mm (95% CI: -0.14, 2.35) in the radiographic horizontal measurements was not significant (P=.082), but the difference of 1.06 mm (95% CI: 0.51, 1.62) in the radiographic vertical dimensional change between dPTFE membranes+allograft and extraction alone was statistically significant (P<.001).

CONCLUSIONS

The use of dPTFE membranes was better than extraction alone in terms of keratinized tissue width and radiographic vertical bone loss.

Use of Injectable Platelet-Rich Fibrin Accompanied by Bone Graft in Socket Endurance: A Radiographic and Histological Study

Background Ridge preservation became a crucial dental health issue and strategy to keep away from ridge defacement after post-tooth loss. The recent scientific evolution of platelet-rich fibrin (PRF) comprises a parenteral formulation of PRF. The combined allograft for socket preservation gives benefits. In this study, bone allografts, demineralized freeze-dried bone allografts (DFDBA) and freeze-dried bone allografts (FDBA) are used in a 30:70 ratio alone or in combination with injectable PRF (I-PRF) for socket preservation. Methods This study is a radiographic and histological examination conducted on 60 participants aged between 19-65 years. Participating patients agreed voluntarily that they would not bear any fixed prosthesis for the next nine months and plan for implanted teeth placement, including multi-rooted mandibular molars denticles. Both groups received atraumatic extraction; then, the socket was preserved with bone allograft alone in the control group and bone allograft mixed with I-PRF, forming sticky bone, in the experimental group. Clinical, radiological, and histological assessments were taken at the inception stage, three months, six months, and nine months. A multivariate regression model and a generalized estimating equation (GEE) model were used to analyse the effects of these changes on outcomes. Results In all the parameters, the test group indicated a good amount of bone growth with increasing intervals of time for bone height radiographically with statistically significant difference present (p<0.05) and histologically after nine months when socket site grafted with bone graft in combination with I-PRF. Conclusion This study's results demonstrated that I-PRF possesses the potential to regenerate and heal in the tooth-extracted socket. This study further recommends the implementation of I-PRF in safeguarding and conserving the raised rim of the tooth. Future research should take place on the osteogenic capability of I-PRF in more comprehensive ridge accession surgical procedures and additional expanding and improving capacities in periodontal reconstruction.

Stability of guided bone regeneration with two ratios of biphasic calcium phosphate at implant sites in the esthetic zone: A randomized controlled clinical trial

AIMS

The aim of this randomized, double-blind, clinical trial was to compare the stability of the horizontal dimensions (facial bone thickness) of augmented bone using biphasic calcium phosphate (BCP) with hydroxyapatite/β-tricalcium phosphate ratio of either 60/40 or 70/30.

MATERIALS AND METHODS

Sixty dental implants placed with contour augmentation in the esthetic zone were randomized to 60/40 BCP (n = 30) or 70/30 BCP (n = 30). Cone-beam computed tomographic was used to assess facial bone thickness post-implantation and 6 months later at implant platform and 2, 4, and 6 mm apical to it.

RESULTS

The percentage of horizontal dimension reduction was 23.64%, 12.83%, 9.62%, and 8.21% in 70/30 BCP group, while 44.26%, 31.91%, 25.88%, and 21.49% in 60/40 BCP group at the level of the implant platform and 2, 4, and 6 mm apical, respectively. Statistically significant difference was found at 6 months at all levels of measurement (p-value < .05).

CONCLUSIONS

BCP bone grafts with HA/β-TCP ratio of 60/40 and 70/30 showed comparable outcomes for contour augmentation simultaneously with implant placement. Interestingly, the 70/30 ratio was significantly superior in maintaining facial thickness and showed more stable horizontal dimensions of the augmented site.

Automatic and Early Detection of Parkinson's Disease by Analyzing Acoustic Signals Using Classification Algorithms Based on Recursive Feature Elimination Method

Parkinson's disease (PD) is a neurodegenerative condition generated by the dysfunction of brain cells and their 60-80% inability to produce dopamine, an organic chemical responsible for controlling a person's movement. This condition causes PD symptoms to appear. Diagnosis involves many physical and psychological tests and specialist examinations of the patient's nervous system, which causes several issues. The methodology method of early diagnosis of PD is based on analysing voice disorders. This method extracts a set of features from a recording of the person's voice. Then machine-learning (ML) methods are used to analyse and diagnose the recorded voice to distinguish Parkinson's cases from healthy ones. This paper proposes novel techniques to optimize the techniques for early diagnosis of PD by evaluating selected features and hyperparameter tuning of ML algorithms for diagnosing PD based on voice disorders. The dataset was balanced by the synthetic minority oversampling technique (SMOTE) and features were arranged according to their contribution to the target characteristic by the recursive feature elimination (RFE) algorithm. We applied two algorithms, t-distributed stochastic neighbour embedding (t-SNE) and principal component analysis (PCA), to reduce the dimensions of the dataset. Both t-SNE and PCA finally fed the resulting features into the classifiers support-vector machine (SVM), K-nearest neighbours (KNN), decision tree (DT), random forest (RF), and multilayer perception (MLP). Experimental results proved that the proposed techniques were superior to existing studies in which RF with the t-SNE algorithm yielded an accuracy of 97%, precision of 96.50%, recall of 94%, and F1-score of 95%. In addition, MLP with the PCA algorithm yielded an accuracy of 98%, precision of 97.66%, recall of 96%, and F1-score of 96.66%.

How to Enhance Dental Implant Therapies and Definitive Restoration Outcomes to Reduce Complications and Improve Patient Well-Being

Dental implants have changed modern dentistry, providing a long-term, effective solution for tooth loss [...].

Clinical evaluations of alveolar ridge preservation in compromised extraction sockets with cortical-lamina anchoring technique: Case series study

OBJECTIVE

The objective of this study is to retrospectively evaluate the clinical outcomes of alveolar ridge preservation (ARP) in the compromised extraction sockets using autogenous cortical-lamina anchoring technique (CAT).

MATERIAL AND METHODS

Twenty patients were treated with ARP in the compromised extraction sockets by applying CAT. Then implant placement and crown delivery was performed. A planned follow-up was performed by analyzing various outcome measures to evaluate the clinical outcomes, including primary outcome measures [radiographic assessment of residual alveolar ridge height (RARH) and residual alveolar ridge width (RARW)] and secondary outcome measures [clinical assessment of the healing of the soft and hard tissue, survival rates of implants, marginal bone loss (MBL) evaluation of implants, buccal bone thickness (BBT), and esthetic treatment outcomes].

RESULTS

Among the 20 patients, 17 were consecutively treated and 3 dropped out after implant crown delivery because of loss to follow-up. After the ARP, the initial RARH (12.37 mm) significantly increased to 19.29 mm (P < .05). No significant difference was detected in the RARW before (7.92 ± 1.18 mm) and after (7.92 ± 1.18 mm) the ARP, but reduce to 6.99 ± 1.18 mm at the implant placement and 6.64 ± 0.77 mm at the 3-year follow-up (P < .05). The MBL at the implant crown delivery (0.13 ± 0.12 mm) significantly increased to 0.31 ± 0.14 mm at 1-year follow-up and 0.56 ± 0.23 mm at 3-year follow-up, respectively. The bone loss was limited (<1 mm) but statistically significant (P < .05). The BBT at the implant placement (2.53 ± 0.56 mm) significantly reduced to 2.23 ± 0.44 mm at implant crown delivery and 2.14 ± 0.40 mm at 3-year follow-up, respectively. The bone loss was also limited (<0.5 mm) but statistically significant (P < .05). Each implant site showed acceptable aesthetic outcome and the average score was 16.4. The incisions healed uneventful in all patients and the implant survival rate was 100% during the 3-year follow-up.

CONCLUSION

Autogenous CAT was successfully applied to preserve the height and width of alveolar ridge in the compromised extraction sockets.

Surgical interventions for implant placement in the anterior maxilla: A systematic scoping review with evidence mapping

OBJECTIVES

Simplification and standardization of interventions are critical challenges to improving performance in implant dentistry. This study aimed to systematically identify and schematically present the evidence base of the implant dentistry surgical interventions for the anterior maxilla as a basis for further development and standardization.

METHODS

Electronic searches were conducted in PubMed, Embase and Cochrane CENTRAL. Primary clinical studies reporting surgical interventions in the anterior maxilla, with a sample size of at least ten patients, were included. Bibliometric information and study details were extracted. Descriptive analysis and a mind map approach were used to describe the documentation of different surgical interventions.

RESULTS

Two hundred and seventy-two studies reporting on 9001 patients were included. Within the past two decades, the number of literatures on implant placement in the anterior maxilla has increased dramatically (7 studies before 2005, 151 studies after 2016). Overall, the evidence map identified six primary operations and 33 variations. For hopeless tooth extraction, immediate implant placement was the most frequently reported (141 studies, 4670 patients); flapless implant placement with hard tissue augmentation and immediate provisionalization was the most commonly reported variation (33 studies, 987 patients). Type 3/4 implant placement (62 studies, 1902 patients) and implant site augmentation (33 studies, 788 patients) were frequently reported for missing teeth. Geographical differences were observed, with type 2 placement studies almost exclusively from Europe.

CONCLUSIONS

Research on immediate implant placement was the most reported surgical intervention in the anterior maxilla. Hard tissue augmentation was frequently reported simultaneously with or before implant placement. Immediate provisionalization was mainly used for type 1 implant placement. The finding that six primary operations with 33 variations have been reported indicates the need for additional research to simplify and consolidate the surgical approach.

Comparison of Classifications and Indexes for Extraction Socket and Implant Supported Restoration in the Aesthetic Zone: a Systematic Review

OBJECTIVES

The primary objective of the present systematic review is to test the hypothesis - the revision of the complexity of the extraction sockets morphology classifications will reveal the most important parameters for implant aesthetic and functional success in case of immediate dental implant placement in aesthetic zone. The secondary objective is to revise the most important parameters of aesthetic indexes created for implant-supported restoration in aesthetic zone.

MATERIAL AND METHODS

MEDLINE (PubMed) and Cochrane Library search in combination with hand-search of relevant journals was conducted including human studies published in English between 1 January 2005 and 1 February 2022. After evaluation of the titles and abstracts in accordance with the PRISMA guidelines, risk-of-bias assessment was evaluated and data was extracted from the full papers.

RESULTS

Electronic and hand searching resulted in 477 entries. Five systematic reviews, research syntheses and 7 prospective studies met the inclusion criteria and were included in the final data synthesis. Selected articles reported the different classifications complexity of the extraction sockets morphology and aesthetic indexes for implant supported restoration in aesthetic zone.

CONCLUSIONS

The most important parameters for implant aesthetics and functional success, incorporated in classifications of extraction sockets are facial soft tissue level and quality, gingival biotype, keratinized gingival, mesial and distal papillae appearance, buccal bone level and thickness, labial and buccal bone plates damage and bone lesions. The most important aesthetic indexes parameters are soft tissue contour position, including colour and texture, interdental papilla, mesial and distal interproximal bone height, gingival biotype.