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Yankov YG. Socket Preservation and Guided Bone Regeneration: Prerequisites for Successful Implant Dentistry. Cureus 2023; 15:e48785. [PMID: 38098920 PMCID: PMC10720259 DOI: 10.7759/cureus.48785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/17/2023] Open
Abstract
Implant success is measured not only by implant survival but also by the long-term aesthetic and functional results. Implant placement should be prosthetically driven, with proper three-dimensional positioning for optimal support and stability of the tissues. Several procedures could be performed to ensure this requirement. While socket preservation (SP) is performed at the stage of tooth extraction, guided bone regeneration (GBR) takes place before or simultaneous to implant placement. The current review aims to summarize and discuss the procedures used for the preparation of the implant site, the preservation of the existing tissues, and their augmentation in cases of deficiency. An electronic search using Google Scholar, PubMed, and Scopus was conducted up to October 2023, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review summarizes the current knowledge on SP and GBR as prerequisites for future implant placement. Their indications, advantages, and limitations have been thoroughly evaluated and some recommendations for further research have been suggested. Implant placement in sites with severe bone resorption is extremely challenging. It necessitates the application of different surgical techniques, especially augmentation procedures, including guided bone regeneration. The need for such procedures could be avoided or at least minimized by the execution of SP after tooth extraction or immediate/early implant placement.
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Affiliation(s)
- Yanko G Yankov
- Clinic of Maxillofacial Surgery, University Hospital "St. Marina", Varna, BGR
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Abdullrahman F, Assad M, Albash Z. Tent-pole technique for alveolar ridge width preservation with a compromised buccal plate: a prospective cohort study. Ann Med Surg (Lond) 2023; 85:5344-5349. [PMID: 37915712 PMCID: PMC10617838 DOI: 10.1097/ms9.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives The aim of this study was to assess the effectiveness of the tent-pole technique for alveolar ridge preservation of compromised alveolar socket following the surgical extraction of incurable single root premolars. Materials and methods This study was conducted on 12 patients who presented to the department of oral and maxillofacial surgery and had alveolar ridge preservation using tent-pole technique between August 2021 and February 2022. The alveolar ridge width was analyzed using cone beam computed tomography scans taken preoperative and 6 months postoperative. Statistical analysis was performed to assess the alveolar ridge width at different levels. The alveolar ridge width differences between periods were assessed with paired t-test. The comparison of alveolar ridge width loss according to jaw, sex, and different levels were done with unpaired t-test. The level of significance considered was 5% (α=0.05). Results The mean alveolar ridge width before surgery was 10.03 mm. After 6 months, the mean alveolar ridge width was 8.4 mm. The range of alveolar ridge width loss was between 0.6 and 3.22 mm with a mean of 1.63 (16.25%). There was no statistically significant difference in width loss between the maxilla and mandibular whether in males or females. Alveolar bone width loss was the greatest at W1 level (26.8%). Conclusion According to the results of this study, the authors conclude that the tent-pole technique could preserve the alveolar bone ridge width without bone graft materials.
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Affiliation(s)
| | | | - Ziad Albash
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria
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Liñares A, Dopico J, Magrin G, Blanco J. Critical review on bone grafting during immediate implant placement. Periodontol 2000 2023; 93:309-326. [PMID: 37658586 DOI: 10.1111/prd.12516] [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: 01/29/2023] [Revised: 07/11/2023] [Accepted: 07/24/2023] [Indexed: 09/03/2023]
Abstract
In the last 20 years, immediate implant placement has been proposed as a predictable protocol to replace failing teeth. The research conducted in preclinical and clinical studies have focused on soft and hard tissue changes following tooth extraction and immediate implant placement. Different approaches for hard and soft tissue grafting together with provisional restorations have been proposed to compensate tissue alterations. This review analyzed some relevant clinical and preclinical literature focusing on the impact of bone grafting procedures on immediate implant placement in terms of hard and soft tissue changes, aesthetic results, and patient-related outcomes.
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Affiliation(s)
- Antonio Liñares
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - José Dopico
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Magrin
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
- Department of Dentistry, Centre for Education and Research on Dental Implants (CEPID), Federal University of Santa Catarina, Florianopolis, Brazil
| | - Juan Blanco
- Unit of Periodontology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Amid R, Kadkhodazadeh M, Moscowchi A. Immediate implant placement in compromised sockets: A systematic review and meta-analysis. J Prosthet Dent 2023; 130:307-317. [PMID: 34772483 DOI: 10.1016/j.prosdent.2021.09.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/20/2022]
Abstract
STATEMENT OF PROBLEM Immediate implant placement provides a popular therapeutic option. However, compromised sockets may jeopardize the treatment outcome. PURPOSE The purpose of this systematic review and meta-analysis was to investigate the treatment outcome in terms of the implant survival rate and success parameters of immediate implant placement in compromised extraction sockets. MATERIAL AND METHODS An electronic search was conducted in PubMed, Embase, Cochrane Library, and ISI Web of Science up to January 2021. Studies evaluating implant survival rate and main success parameters were included for a qualitative and quantitative analysis (risk ratio and mean difference). RESULTS In total, 43 studies with analysis of 4825 sockets were included. Compared with the noncompromised sockets, the compromised group showed no significant differences in implant survival rates (risk ratio=0.992; 95% confidence interval (CI)=0.979 to 1.005; P=.246). No significant statistical differences were found in marginal bone level at ≤12 months (mean difference [MD]=0.033; 95% CI=-0.012 to 0.078; P=.154) or esthetic parameters. CONCLUSIONS Immediate implant placement in compromised sites does not appear to decrease the survival and success rates. However, randomized clinical trials with large sample sizes should be conducted to draw a definite conclusion about the efficacy and safety of this treatment protocol in compromised sockets.
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Affiliation(s)
- Reza Amid
- Associate Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Anahita Moscowchi
- Assistant Professor, Department of Periodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Antibacterial Effect of Triazine in Barrier Membranes with Therapeutic Activity for Guided Bone Regeneration. Polymers (Basel) 2022; 14:polym14214482. [PMID: 36365476 PMCID: PMC9658774 DOI: 10.3390/polym14214482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 11/07/2022] Open
Abstract
Objective: This study aimed to develop polymer-based barrier membranes based on poly(butylene-adipate-co-terephthalate) (PBAT) with the addition of 1,3,5-triacriloilhexahydro-1,3,5-triazine (TAT). Materials and Methods: Polymeric solutions were used to produce membranes with 5 wt% and 10 wt% of TAT by solvent casting. Membranes without the addition of TAT were used as controls. The membranes were chemically characterized by Fourier transform infrared spectroscopy (FTIR) and thermogravimetry (TGA); surface properties were assessed by profilometry and contact angle; the mechanical behavior was evaluated by a tensile test, and the biological properties were assessed by direct−indirect cell viability and antibacterial activity by S. mutans and S. aureus colony-forming units. Results: TAT was detected in the FTIR and TGA analyses and modified the top surface of the membranes, increasing their roughness and wetness in both concentrations compared to the control group (p < 0.05). The addition of TAT, regardless of concentration, reduced the tensile strength and increased membrane stiffness (p < 0.05). The cell viability of 5 wt% TAT and 10 wt% TAT was 86.37% and 82.36%, respectively. All tested concentrations reduced the formation of biofilm on the membranes when compared to the control. Conclusion: The addition of TAT successfully resulted in the antimicrobial ability of PBAT-based barrier membranes, while it maintained acceptable levels of cell viability in membranes with adequate handling and surface properties.
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Seyssens L, Eeckhout C, Cosyn J. Immediate implant placement with or without socket grafting: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2022; 24:339-351. [PMID: 35313067 DOI: 10.1111/cid.13079] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/19/2022] [Accepted: 02/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the effect of grafting the gap (SG) between the implant surface and alveolar socket on hard and soft tissue changes following single immediate implant placement (IIP). MATERIALS AND METHODS Two independent reviewers conducted an electronic literature search in Pubmed, Web of Science, Embase and Cochrane databases as well as a manual search to identify eligible clinical studies up to August 2021. Randomized controlled trials (RCTs) comparing IIP with and without SG were included for a qualitative analysis. Meta-analyses were performed when possible. RESULTS Out of 3627 records, 15 RCTs were selected and reported on 577 patients who received 604 single immediate implants (IIP + SG: 298 implants in 292 patients; IIP: 306 implants in 285 patients) with a mean follow-up ranging from 4 to 36 months. Two RCTs showed low risk of bias. Meta-analysis revealed 0.59 mm (95% CI [0.41; 0.78], p < 0.001) or 54% less horizontal buccal bone resorption following IIP + SG when compared to IIP alone. In addition, 0.58 mm (95% CI [0.28; 0.88], p < 0.001) less apical migration of the midfacial soft tissue level was found when immediate implants were installed with SG. A trend towards less distal papillary recession was found (MD 0.60 mm, 95% CI [-0.08; 1.28], p = 0.080) when SG was performed, while mesial papillae appeared not significantly affected by SG. Vertical buccal bone changes were also not significantly affected by SG. Insufficient data were available for meta-analyses on horizontal midfacial soft tissue changes, pink esthetic score, marginal bone level changes, probing depth and bleeding on probing. Based on GRADE guidelines, a moderate recommendation for SG following IIP can be made. CONCLUSION SG may contribute to horizontal bone preservation and soft tissue stability at the midfacial aspect of immediate implants. Therefore, SG should be considered as an adjunct to IIP in clinical practice.
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Affiliation(s)
- Lorenz Seyssens
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Célien Eeckhout
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
| | - Jan Cosyn
- Faculty of Medicine and Health Sciences, Oral Health Sciences, Department of Periodontology and Oral Implantology, Ghent University, Ghent, Belgium
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Chen H, Gu T, Lai H, Gu X. Evaluation of hard tissue 3-dimensional stability around single implants placed with guided bone regeneration in the anterior maxilla: A 3-year retrospective study. J Prosthet Dent 2021; 128:919-927. [PMID: 33795161 DOI: 10.1016/j.prosdent.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Guided bone regeneration (GBR) is widely used to reconstruct peri-implant bone defects in the esthetic zone. However, the dimensional stability of this bone-biomaterial composite is not fully understood. PURPOSE The primary aim was to evaluate the hard tissue 3-dimensional (3D) stability around single implants placed with simultaneous GBR by using deproteinized bovine bone mineral (DBBM) in the anterior maxilla and explore possible influencing factors. MATERIAL AND METHODS The records of patients who had received implants in the anterior maxilla from January 2015 to March 2016 were reviewed retrospectively. The change in volume and thickness of the facial hard tissue were analyzed. To explore possible influencing factors, the thickness and surface area of facial graft were measured, and the time point at which implants were placed and the healing protocol were recorded. Secondary outcome measures were peri-implant marginal bone loss, bleeding on probing (BOP), and pink esthetic score (PES). Statistical analysis was conducted by using the Student t test, Mann-Whitney U test, Kruskal-Wallis test, or generalized estimating equation analysis (α=.05). RESULTS Fifty-five participants were included in this study, and no implants had been lost after 3 years. BOP was present in 10 (18.2%) participants. The mean ±standard deviation PES of all implants for this study was 11.0 ±2.1. The mean ±standard deviation percentage of residual hard tissue volume was 36.9 ±23.5%, with a significant difference found between time points before 9 months (P<.05). Type 3 implant placement (OR=1.449, P=.031) was found to have a higher percentage of residual hard tissue volume. A greater reduction of the facial hard tissue thickness was observed in participants with thicker postoperative facial grafting (OR=1.463, P=.001). No statistically significant difference was found between the facial, palatal, mesial, and distal peri-implant sites in terms of marginal bone loss (P>.05). CONCLUSIONS Although single-tooth implant placement combined with GBR using DBBM in the anterior maxilla offered satisfactory esthetic and functional outcomes after a 3-year follow-up, significant hard tissue volume and thickness reduction in grafted sites was detected, especially during the initial 9-month postoperative period. This phenomenon may be correlated with the timing of implant placement and the thickness of the facial graft.
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Affiliation(s)
- Haida Chen
- Resident Physician, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
| | - Tianyi Gu
- Graduate student, School of Stomatology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, PR China
| | - Haiyan Lai
- Resident Physician, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
| | - Xinhua Gu
- Professor, Department of Stomatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China.
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Kolerman R, Qahaz N, Barnea E, Mijiritsky E, Chaushu L, Tal H, Nissan J. Allograft and Collagen Membrane Augmentation Procedures Preserve the Bone Level around Implants after Immediate Placement and Restoration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041133. [PMID: 32053928 PMCID: PMC7068471 DOI: 10.3390/ijerph17041133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 01/30/2020] [Accepted: 02/08/2020] [Indexed: 11/16/2022]
Abstract
Background: Immediate implant placement and restoration (IPR), is a reliable treatment modality. Purpose: This historical prospective study evaluated the medium-term outcomes of hard tissue after IPR in the anterior maxilla with simultaneous hard tissue augmentation. Methods: Seventy-three patients treated with single-implant IPR in the anterior maxilla were followed for 1-8 years. Treatment involved, atraumatic extraction, immediate implant placement and abutment adaptation, followed by simultaneous augmentation with mineralized freeze-dried bone allograft (FDBA) particles to fill the gaps and restore the ridge. The surgical site was stabilized with a resorbable collagen membrane, followed by the connection of an acrylic provisional restoration. Results: All implants osseointegrated during the follow-up period (mean, 34 ± 22 months). Radiographic evaluation of the distance between the implant shoulder (IS) and crestal bone level (CBL) was of 0.86 ± 0.86 mm and 0.8 ± 0.84 mm mesially and distally, respectively. Splitting the results into up to 3 years and 3-8 years of follow-up data, the corresponding values were 0.90 ± 0.83 and 0.68 ± 0.88 for the mesial aspect and 0.99 ± 0.87and 0.74 ± 0.83 for the distal aspect, respectively. Mean peri-implant probing depth was 3.63 mm (SD ± 1.06) and 16 implants (22%) presented at least one bleeding pocket of ≥5 mm (peri implant mucositis). Conclusions: The immediate replacement of a single maxillary tooth by implants combined with guided bone regeneration is a predictable treatment modality with favorable peri-implant bony response.
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Affiliation(s)
- Roni Kolerman
- Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 39040, Israel; (L.C.); (H.T.)
- Correspondence:
| | - Nayrouz Qahaz
- Dentist, Kolerman Periodontal and Implant Clinic, Tel-Aviv 64389, Israel;
| | - Eitan Barnea
- Prosthodontist, Implant and Prosthodontic Clinic, Tel-Aviv 64163, Israel;
| | - Eitan Mijiritsky
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 39040, Israel;
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 39040, Israel;
| | - Liat Chaushu
- Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 39040, Israel; (L.C.); (H.T.)
| | - Haim Tal
- Department of Periodontology and Dental Implantology, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 39040, Israel; (L.C.); (H.T.)
| | - Joseph Nissan
- Department of Oral Rehabilitation, the Maurice and Gabriela Goldschleger School of Dental Medicine, Tel-Aviv University, Tel Aviv 39040, Israel;
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