One-stage laser-microtextured implants immediately placed in the inter-radicular septum of molar fresh extraction sockets associated with GBR technique. A case series study

A novel concentrated growth factor (CGF) and bio-oss based strategy for second molar protection after impacted mandibular third molar extraction: a randomized controlled clinical study

BACKGROUND

The extraction of impacted mandibular third molars might cause large bone defects in the distal area of second molars. A new strategy was innovatively employed here combining autologous bone, Bio-Oss, concentrated growth factors (CGF) gel and CGF membrane for bone repair, and the present study aimed at exploring safety as well as short- and long-term efficacy of this new protocol clinically.

MATERIALS AND METHODS

A total of 66 participants were enrolled in this randomized single-blind clinical trial, and randomly allocated to control group (only blood clots), test A group (autogenous bone, Bio-Oss with barrier membrane) and test B group (autogenous bone, Bio-Oss, CGF gel with CGF membrane). The postoperative outcomes including PoSSe scale, periodontal probing depth (PD), degree of gingival recession and computed tomography measurements were assessed at 3rd, 6th, 12th month. A p-value < 0.05 was considered statistically significant.

RESULTS

In PoSSe scale, no significant difference was observed except a significant alleviation of early-stage pain perception in test B group (p < 0.05). Also, test B group exhibited better effect on periodontal healing and gingival recession reduction after 6 months (p < 0.05). Both two test groups showed more new bone formation than the control group (p < 0.05). It is noteworthy that the bone repair of test B group was significantly better than that of test A at 3rd and 6th month (p < 0.05), yet no difference was observed at 12th month (p > 0.05).

CONCLUSION

Both two test groups could achieve stable long-term efficacy on bone defect repair. The use of CGF gel and CGF membrane could accelerate early-stage bone repair, alleviate short-term pain after surgery, reduce long-term probing depth and relieve economic cost for patients. This new bone repair protocol is worthy of promoting by clinicians.

TRIAL REGISTRATION

This study was registered with the identification number ChiCTR2300068466 on 20/02/2023 at Chinese Clinical Trial Registry. Also, it was ethically approved from the institutional ethics committee at the Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (No:2023-010-01), and has been conducted in accordance to the guidelines of the declaration of Helsinki. Written informed consent was obtained from all participants in the study.

Immediate non-submerged implants with laser-microtextured collar placed in the inter-radicular septum of mandibular molar extraction sockets associated to GBR: Results at 3-year

Background

The aim of the present study was to radiographically evaluate the vertical socket walls changes, and the peri-implant marginal bone remodelling, and clinicallly the soft tissues conditions around the non-submerged single implants placed into the inter radicular septum of mandibular molar sockets, associated with a collagen membrane, after 3 years of loading.

Material and Methods

Thirty patients underwent to placement of a non-submerged implants with a laser-microtextured collar into the inter radicular septum of mandibular molar fresh extraction sockets. A collagen membrane and the mucoperiosteal flap were adapted around the neck of the implants, leaving the laser-microtextured collar to heal in a transmucosal fashion.

Results

At the end of the follow-up period, no statistical differences were found for each radiographic measurements used for the examination of extraction sockets vertical bone changes. Compared to implants placement, at the end of the 3-year follow-up, the vertical radiographic mesial and distal peri-implant marginal bone levels showed a statistically significant gain of 0.9 (SD 0.5), and 1.0 mm (SD 0.6), respectively (P=0.037).

Conclusions

In mandibular fresh extraction sockets, the method of GBR around transmucosal implants with laser-microtextured surface placed into the interadicular septum may be used successfully to counteract the ridge remodelling.

Key words:Non-submerged implants, GBR, laser-microtextured collar.