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Fok MR, Jin L. Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices. J Dent 2024; 145:104986. [PMID: 38574844 DOI: 10.1016/j.jdent.2024.104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice. SOURCES AND STUDY SELECTION To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration. DATA 11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low. CONCLUSION This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored. CLINICAL SIGNIFICANCE By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China.
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
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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. [PMID: 38638057 DOI: 10.1111/cid.13327] [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: 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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Eeckhout C, Seyssens L, Glibert M, Keppens L, Nollet B, Lambert M, Cosyn J. A Randomized Controlled Trial Comparing Collagen Matrix to Hemostatic Gelatin Sponge as Socket Seal in Alveolar Ridge Preservation. J Clin Med 2024; 13:2293. [PMID: 38673566 PMCID: PMC11051156 DOI: 10.3390/jcm13082293] [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: 02/02/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Objectives: This study aimed to compare a collagen matrix to a hemostatic gelatin sponge as a socket seal in alveolar ridge preservation (ARP). (2) Methods: Systemically healthy patients planned for ARP at two sites with more than 50% of the buccal bone wall remaining after tooth extraction were eligible for inclusion. ARP involved socket grafting using collagen-enriched deproteinized bovine bone mineral. Sites were then randomly assigned to the test group (collagen matrix) or the control group (hemostatic gelatin sponge). The primary outcome was soft tissue thickness in the center of the site at 4 months, analyzed on cone-beam computed tomography. Secondary outcomes included the buccal and lingual soft tissue heights, horizontal bone loss, buccal soft tissue profile changes, wound dimensions, and Socket Wound Healing Score (SWHS). (3) Results: In total, 18 patients (12 females, 6 males) with a mean age of 57.3 years (SD 11.1) were included. Four months after ARP, the soft tissue thickness in the center of the site amounted to 2.48 mm (SD 0.70) in the test group and 1.81 mm (SD 0.69) in the control group. The difference of 0.67 mm (95% CI: 0.20-1.14) in favor of the collagen matrix was statistically significant (p < 0.009). The buccal soft tissue height was also statistically significantly higher for the collagen matrix (0.72 mm; 95% CI: 0.06-1.38; p = 0.034). A trend favoring the collagen matrix was found for the lingual soft tissue height (p = 0.066). No significant differences between the groups in terms of horizontal bone loss, buccal soft tissue profile changes, wound dimensions, and the SWHS were found. (4) Conclusions: The absence of significant differences in hard tissue outcomes suggests that both the collagen matrix and hemostatic gelatin sponge effectively sealed the extraction socket and supported bone preservation. However, the collagen matrix better maintained soft tissue dimensions. The clinical relevance of this finding with respect to the necessity for adjunctive soft tissue augmentation at the time of implant placement is yet to be studied.
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Affiliation(s)
- Célien Eeckhout
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
| | - Lorenz Seyssens
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
| | - Maarten Glibert
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
| | - Laurens Keppens
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
| | - Baptist Nollet
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
| | - Martijn Lambert
- Department of Equal Lifelong Oral Health for All (ELOHA), Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium;
| | - Jan Cosyn
- Department of Periodontology and Oral Implantology, Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, C. Heymanslaan 10, B-9000 Ghent, Belgium; (L.S.); (M.G.); (L.K.); (B.N.); (J.C.)
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Mohammadi I, Najafi A, Razavi SM, Khazaei S, Tajmiri G. Effect of buccal fat autotransplantation on improving the alveolar socket bone regeneration: An in-vivo study. Heliyon 2024; 10:e28131. [PMID: 38524537 PMCID: PMC10958428 DOI: 10.1016/j.heliyon.2024.e28131] [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: 07/15/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background There are various materials used for socket preservation following dental extraction. The aim of the present animal study was to histologically investigate the efficacy of buccal fat autotransplantation on alveolar bone regeneration following dental extraction. Study design In this prospective, double-blind laboratory experiment with a split-mouth design, 16 mandibular second premolar teeth in eight beagle dogs were extracted, and half of the extraction sockets were randomly filled using buccal fat autotransplantation. Other samples were left untouched to heal normally by the formed blood clot. Buccal fat autotransplantation was the primary predictor variable, and the type and amount of newly formed bone were the primary outcome variables. Assessment methods were the H & E coloring technique and histomorphometric evaluation. The significance level was set at 0.05, and data was subjected to Chi-Square and Wilcoxon signed-rank tests using SAS statistical software version 9.4. Results From the total number of 16 samples in 8 dogs, 50% of the samples in the intervention group represented inflammation with lower intensity compared to 33% in the control group; however, this difference was not considered statistically significant (Chi-Square test, P-value = 0.55). Wilcoxon test results showed no statistically significant difference between the two groups regarding the mean amount of total bone formation (Z = 0.00, P-value = 1.00). Conclusion It was inferred from the outcomes of the present study that when compared to the normal healing of the socket, buccal fat autotransplantation did not represent with superior outcome concerning the socket bone regeneration.
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Affiliation(s)
- Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Najafi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saber Khazaei
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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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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Han HS, Lee JT, Oh S, Cho YD, Kim S. Effectiveness of a collagen matrix seal and xenograft in alveolar ridge preservation: an experimental study in dogs. Sci Rep 2024; 14:163. [PMID: 38168516 PMCID: PMC10762190 DOI: 10.1038/s41598-023-50370-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
Majority of previous studies on alveolar ridge preservation (ARP) used collagen membranes as barrier membranes, and further evidence for ARP in dehiscent extraction sockets with a deproteinized bovine bone mineral (DBBM) and matrix is needed. The aim of this study is to assess the impact of non-cross linked collagen membranes (membrane) and crosslinked collagen matrices (matrix) on ARP using DBBM in extraction sockets with buccal dehiscence. In six mongrel dogs, the mesial roots of three mandibular premolars (P2, P3, and P4) were extracted 1 month after dehiscence defect induction. Two experimental groups were randomly assigned: (1) DBBM with a membrane (DBBM/membrane group) and (2) DBBM with a matrix (DBBM/matrix group). Three-dimensional (3D) volumetric, microcomputed tomography (μCT), and histologic analyses were performed to assess the ridge preservation. Both groups were effective to maintain the ridge width (p > 0.05), and the DBBM/matrix group showed more favorable soft tissue regeneration and bone quality in the histological analysis (p = 0.05). Based on these results, DBBM/matrix could be better choice for ARP in cases of buccal dehiscence defects.
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Affiliation(s)
- Hee-Seung Han
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jung-Tae Lee
- One-Stop Specialty Center, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Seunghan Oh
- Department of Dental Biomaterials, The Institute of Biomaterial and Implant, School of Dentistry, Wonkwang University, Iksan, Republic of Korea
| | - Young-Dan Cho
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Sungtae Kim
- Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University and Seoul National University Dental Hospital, 101 Daehak-no, Jongno-gu, Seoul, 03080, Republic of Korea.
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Wei Y, Zhao L, Zhang H, Han Z, Hu W, Xu T. Ridge preservation in periodontally compromised molar sockets with and without primary wound closure: A comparative controlled clinical trial. Clin Oral Implants Res 2024; 35:131-139. [PMID: 37962104 DOI: 10.1111/clr.14204] [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: 01/10/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVE This study aimed to compare hard- and soft-tissue changes after ridge preservation in periodontally compromised molar sockets with and without primary wound closure. MATERIALS AND METHODS Forty molars with severe periodontitis requiring extraction were included and allocated to two treatment modalities. After tooth extraction, the sockets were filled with deproteinized bovine bone mineral and covered with a bioabsorbable porcine collagen membrane. Primary wound closure was achieved in the control group, whereas the test group underwent minimally invasive open healing. The dimensions of the bone and soft tissue were recorded at baseline and 6 months. RESULTS Over 6 months, the control and test groups had similar mean ridge heights at the center of sockets of 8.59 ± 2.47 mm and 8.47 ± 2.51 mm, respectively. The total volume of the control group increased from 1070.17 to 1713.52 mm3 for a mean gain of 643.35 mm3 , whereas that of the test group increased from 992.51 to 1514.05 mm3 for a mean gain of 521.54 mm3 . Compared with the test group, the control group showed a statistically significant decrease in keratinized tissue width of 1.08 ± 1.63 mm. CONCLUSIONS Bone dimensional changes following ridge preservation with and without primary wound closure were comparable. ARP without primary wound closure preserves more keratinized tissue than that with (Chinese Clinical Trial Registry: ChiCTR-ONN-16009433).
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Affiliation(s)
- Yiping Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Liping Zhao
- Department of Emergency, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Haoyun Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Ziyao Han
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Disease, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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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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Abad CE, Sanz-Sanchez I, Serrano V, Sanz Esporrin J, Sanz-Martin I, Sanz M. Efficacy of the application of leukocyte and platelet-rich fibrin (L-PRF) on alveolar ridge preservation. A randomized controlled clinical trial. Clin Implant Dent Relat Res 2023. [PMID: 37088697 DOI: 10.1111/cid.13208] [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: 12/18/2022] [Revised: 03/04/2023] [Accepted: 04/12/2023] [Indexed: 04/25/2023]
Abstract
INTRODUCTION Alveolar ridge preservation (ARP) is a well-defined treatment performed to reduce bone dimensional changes occurring during the healing of post-extraction sockets to allow for adequate implant placement. Leukocyte and platelet-rich fibrin (L-PRF) has been showing to potentially promote bone and tissue regeneration during wound healing. Therefore, the aim of this study is to evaluate its efficacy for ARP when applied to fresh extraction sockets, in comparison with spontaneous healing. MATERIALS AND METHODS Twenty-seven patients with hopeless non-molar teeth were treated. After randomization, fresh extraction sockets were either filled with L-PRF or allowed to heal spontaneously. CBCTs and intraoral scans were obtained immediately after extraction and at 4 months. Through superimposition of the obtained images, changes in the horizontal ridge width, height, buccal volume, and ridge contour changes were measured, as well as patient-reported outcome measures (PROM's). RESULTS The ridge dimensions changed similarly in both groups. Although less reduction occurred in the test group at 1 mm from the bone crest, differences were not statistically significant (p > 0.05). Application of L-PRF did not prevent reductions of ridge contours, neither in the linear vertical aspect nor in volumetric changes. There were no differences between groups in the need for bone regeneration when placing implants. Patients in both groups reported similar outcomes in terms of bleeding, pain, inflammation, and function at 1 and 4 weeks postoperatively. CONCLUSION Alveolar preservation with L-PRF neither minimized bone resorption occurring after tooth extraction in non-molar sites nor reduced the need for bone regeneration when placing implants. Furthermore, its use did not improve PROM's.
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Affiliation(s)
- Carolina Encalada Abad
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Ignacio Sanz-Sanchez
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid (UCM), Madrid, Spain
| | - Victor Serrano
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Javier Sanz Esporrin
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid (UCM), Madrid, Spain
| | - Ignacio Sanz-Martin
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
| | - Mariano Sanz
- Postgraduate program in Periodontology, Faculty of Odontology, Complutense University of Madrid (UCM), Madrid, Spain
- ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, Complutense University of Madrid (UCM), Madrid, Spain
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Guo Z, Yang L, Kang Y, Wang Z, Ren F, Sun X, Yang H, Zhang Z. Clinical evaluations of alveolar ridge preservation in compromised extraction sockets with cortical-lamina anchoring technique: Case series study. Clin Implant Dent Relat Res 2023; 25:46-56. [PMID: 36222202 PMCID: PMC10092589 DOI: 10.1111/cid.13141] [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: 03/08/2022] [Revised: 08/29/2022] [Accepted: 09/23/2022] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- Zehong Guo
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Liqing Yang
- Center of Oral Implantology, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Yujie Kang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Zhiping Wang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Fei Ren
- Oral Health Centre, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Xuan Sun
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Hong Yang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
| | - Zhaoqiang Zhang
- Department of Oral and Maxillofacial Surgery, Stomatological Hospital, Southern Medical University, Guangzhou, P. R. China
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Liu H, Wang C, Sun X, Zhan C, Li Z, Qiu L, Luo R, Liu H, Sun X, Li R, Zhang J. Silk Fibroin/Collagen/Hydroxyapatite Scaffolds Obtained by 3D Printing Technology and Loaded with Recombinant Human Erythropoietin in the Reconstruction of Alveolar Bone Defects. ACS Biomater Sci Eng 2022; 8:5245-5256. [PMID: 36336837 DOI: 10.1021/acsbiomaterials.2c00690] [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: 11/09/2022]
Abstract
The fast osteogenesis of the large alveolar fossa and the maintenance of the height of the alveolar ridge after tooth extraction have always been a clinical challenge. Therefore, this work describes the creation of innovative silk fibroin/collagen/hydroxyapatite (SCH) biological scaffolds by 3D printing technology, which are loaded with recombinant human erythropoietin (rh-EPO) for the reconstruction of bone defects. Low-temperature 3D printing can maintain the biological activity of silk fibroin and collagen. The SCH scaffolds showed the ideal water absorption and porosity, being a sustained-release carrier of rh-EPO. The optimized scaffolds had ideal mechanical properties in vitro, and MC3T3-E1 cells could easily adhere and proliferate on it. In vivo experiments in rabbits demonstrated that the composite scaffolds gradually degraded and promoted the accumulation and proliferation of osteoblasts and the formation of collagen fibers, significantly promoting the reconstruction of mandibular defects. In this study, a novel composite biological scaffold was prepared using 3D printing technology, and the scaffold was innovatively combined with the multifunctional growth factor rh-EPO. This provides a new optimized composite material for the reconstruction of irregular mandible defects, and this biomaterial is promising for clinical reconstruction of alveolar bone defects.
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Affiliation(s)
- Han Liu
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.,School of Medicine, Nankai University, Tianjin 300071, China
| | - Chao Wang
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Xiaoqian Sun
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.,School of Medicine, Nankai University, Tianjin 300071, China
| | - Chaojun Zhan
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.,School of Medicine, Nankai University, Tianjin 300071, China
| | - Zixiao Li
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.,School of Medicine, Nankai University, Tianjin 300071, China
| | - Lin Qiu
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing 100034, China
| | - Rui Luo
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China.,School of Medicine, Nankai University, Tianjin 300071, China
| | - Hao Liu
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Xiaodi Sun
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Ruixin Li
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Jun Zhang
- Tianjin Stomatological Hospital, The Affiliated Stomatological Hospital of Nankai University, Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
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