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Elbanna RM, Abdelaziz MS, Alameldeen HE. Augmentation of single tooth extraction socket with deficient buccal walls using bovine xenograft with platelet-rich fibrin membrane. BMC Oral Health 2023; 23:874. [PMID: 37978487 PMCID: PMC10657028 DOI: 10.1186/s12903-023-03554-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Different techniques and materials such as bone grafts and bioactive agents have been used for alveolar ridge augmentation in extraction sockets with a defective wall, there is not a specific material or technique that has resulted in superior outcomes or prevented total bone loss. OBJECTIVES This clinical study aims to evaluate radiographically the effectiveness of using bovine xenograft with platelet-rich fibrin (PRF) membrane on vertical and horizontal alveolar ridge dimensional changes following tooth extraction that are complicated by buccal bone loss. MATERIALS AND METHODS This study was conducted in Egypt on fourteen patients with a single posterior tooth indicated for extraction. A preoperative cone-beam computed tomography (CBCT) scan confirmed more than 50% loss in buccal bone in each tooth. Extraction sockets were packed with minced PRF clots mixed with a bovine xenograft. Each extraction socket was sealed by PRF membranes. CBCT scans, performed before tooth extraction and after 6 months, were used to assess alveolar ridge changes both vertically and horizontally. RESULTS There was a significant gain in the buccal and middle of the extraction socket bone height, recording 86.01% (6.33 mm) and 206.45% (9.6 mm), respectively. There was an insignificant bone loss in the lingual bone height and width, recording - 8.49% (-1.06 mm) and - 13.39% (1.05 mm), respectively. The results also showed a non-significant decrease in alveolar bone density (-14.06%) between pre-operative bone present apical to the extraction socket and newly formed bone inside the socket. CONCLUSIONS Ridge preservation/augmentation techniques using a bone graft mixed with PRF and covered by PRF membranes in fresh extraction sockets complicated by the loss of buccal bone result in buccal bone augmentation and a reduction in horizontal and vertical ridge collapse after tooth extraction. CLINICAL RELEVANCE The bovine xenograft in conjunction with PRF can be used immediately after extraction for ridge preservation, providing adequate bone width and height for implant placement.
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Affiliation(s)
| | - Medhat Sameh Abdelaziz
- Faculty of Oral and Dental Medicine, Prosthodontics department, Future University in Egypt, Cairo, Egypt.
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Quisiguiña Salem C, Ruiz Delgado E, Crespo Reinoso PA, Robalino JJ. Alveolar ridge preservation: A review of concepts and controversies. Natl J Maxillofac Surg 2023; 14:167-176. [PMID: 37661984 PMCID: PMC10474543 DOI: 10.4103/njms.njms_224_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/06/2023] [Accepted: 04/10/2023] [Indexed: 09/05/2023] Open
Abstract
The loss of thickness and height of the alveolar process after tooth extraction is a significant impediment to implant placement, which limits the aesthetic results of many restorative treatments. Alveolar ridge preservation can reduce bone resorption. Knowing how beneficial this procedure is can help clinicians decide if it is worth doing. The purpose of this article is to present a contemporary review of the different approaches to preserving the dimensions of the alveolar ridge. We analyze the alveolar healing process, atraumatic extraction techniques, graft materials, and controversies.
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Affiliation(s)
- Cinthya Quisiguiña Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
| | - Emilio Ruiz Delgado
- Department of Prosthodontics and Implantology, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - Pablo A. Crespo Reinoso
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad de Cuenca, Cuenca, Ecuador
| | - James Jerez Robalino
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universidad Nacional Autónoma de México, Ciudad Universitaria, México
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Keil C, Gollmer B, Zeidler-Rentzsch I, Gredes T, Heinemann F. Histological evaluation of extraction sites grafted with Bio-Oss Collagen: Randomized controlled trial. Ann Anat 2021; 237:151722. [PMID: 33771659 DOI: 10.1016/j.aanat.2021.151722] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 11/27/2022]
Abstract
The combination of bovine bone matrix with collagen shows good results in bone and volume preservation after tooth extraction. To determine the ideal time to apply an implant after augmentation with Bio-Oss Collagen and to observe if there are differences in the age of the patients and the sex, the aim of this randomized controlled clinical trial was to compare the post-extraction changes in angiogenic and osteogenic aspects during spontaneous bone regeneration with those during socket preservation using Bio-Oss Collagen. Sixty-six patients were included in this study. After 8-12 weeks, bone biopsies were embedded in paraffin and histological and immune-histological investigated. Using qRT-PCR bone (Alpl, Bglap, Runx2) and angiogenic markers (VEGF, caveolin-1) were identified. The histomorphometric analysis of all examined samples showed no differences between treated and untreated sockets, but a tissue compression. After classification in bone regeneration stages, more samples with woven bone were present in treated sockets than in controls. The Alpl expression correlates with increase in mature bone tissue. In treated sockets a significant decrease in CD34 and caveolin-1 protein expression was found. Additionally, a significant increase of Runx2 and VEGF mRNA was detected in patients younger than 50 years. Thus, all specimens showed ossification in different stages after eight weeks of healing. The treated group gives an earlier stage of ossification than controls, but produces densified tissue with greater volume fraction. It can be assumed that successful implant placement in Bio-Oss Collagen augmented extraction sockets is possible after eight weeks of bone healing.
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Affiliation(s)
- Christiane Keil
- Department of Orthodontics, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Barbara Gollmer
- Department of Orthodontics, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Ines Zeidler-Rentzsch
- Department of Orthodontics, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Tomasz Gredes
- Department of Orthodontics, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany
| | - Friedhelm Heinemann
- Department of Prosthodontics, Gerodontology and Biomaterials, University of Greifswald, Rotgerberstr. 8, 17475 Greifswald, Germany
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Alexopoulou M, Lambert F, Knafo B, Popelut A, Vandenberghe B, Finelle G. Immediate implant in the posterior region combined with alveolar ridge preservation and sealing socket abutment: A retrospective 3D radiographic analysis. Clin Implant Dent Relat Res 2021; 23:61-72. [PMID: 33438320 DOI: 10.1111/cid.12974] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Customized sealing socket abutment (SSA) has been claimed to optimize the peri-implant hard and soft tissues in type 1 implant placement. However, the evidence to claim the benefits of this technique over the use a conventional healing abutment remains weak. PURPOSE The aim of this retrospective study was to provide a 3D-radiographic evaluation of hard tissues changes following immediate implant placement in molar sites combined to ARP technique and installation of SSA. MATERIALS AND METHODS Baseline and follow-up (FU) CBCTs (from 1 to 5 years) of 26 patients were collected and included in the study. Baseline and FU CBCTs were superimposed and horizontal and vertical bone changes were assessed. RESULTS A total of 26 patients and 27 implants were included. Horizontal bone remodeling was not significant in any of the measured areas except in the most cervical level, where a mean bone remodeling of 0.73 mm was found. Proximal and buccal vertical bone changes were not significant. CONCLUSIONS Within the limits of a retrospective study, dimensional alveolar ridge changes 1 to 5 years after immediate implant placement in molar sites with simultaneous ARP technique and installation of SSA seem to be very limited.
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Affiliation(s)
- Marianzela Alexopoulou
- Department of Periodontology and Oral and implant Surgery, Faculty of Medicine, University of Liege, Liege, Belgium
| | - France Lambert
- Dental Biomaterial Research Unit, University of Liege, Liege, Belgium.,Department of Periodontology and Oral and Implant Surgery, CHU of Liege, Liege, Belgium
| | | | - Antoine Popelut
- Department of Periodontology, Pellegrin Hospital, Bordeaux Private Practice, Odontia, Bordeaux, France
| | | | - Gary Finelle
- Harvard School, Boston, MA, USA, of Dental Medicine, Private Practice Paris & Marseille, Marseille, France
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Seok H, Jo YY, Kweon H, Kim SG, Kim MK, Chae WS. Comparison of Bio-degradation for Ridge Preservation Using Silk Fibroin-based Grafts and a Collagen Plug. Tissue Eng Regen Med 2017; 14:221-31. [PMID: 30603479 DOI: 10.1007/s13770-017-0055-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 04/04/2017] [Accepted: 04/06/2017] [Indexed: 10/19/2022] Open
Abstract
A material for ridge preservation should have dimensional stability to resist bio-degradation. This study was designed to compare bio-degradation of ridge preservation materials. Collagen plug was used as a positive control. Untreated, ethanol-treated, and 4-hexylresorcinol (4HR)-treated silk plugs were used for the experimental group. Each material underwent a scanning electron microscopic exam and a Fourier transform infrared (FT-IR) spectroscopic exam. Bio-degradation was evaluated by analyzing cylindrical bony defects in rabbit tibias. There were no prominent differences in microstructure among the silk plug groups. FT-IR exam demonstrated that the ethanol- and 4HR-treated silk plug groups had enhanced β-sheet structure. All silk plug groups exhibited significantly higher residual graft than the collagen plug group 4 weeks postoperative (p < 0.05). In conclusion, silk fibroin-based ridge preservation material was less bio-degradable than a collagen plug until at least 4 weeks after grafting.
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Rombouts C, Jeanneau C, Camilleri J, Laurent P, About I. Characterization and angiogenic potential of xenogeneic bone grafting materials: Role of periodontal ligament cells. Dent Mater J 2016; 35:900-907. [PMID: 27680032 DOI: 10.4012/dmj.2016-005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Adequate revascularization is a prerequisite for successful healing of periodontal bone defects. This study characterized three different xenogeneic bone grafting materials: Gen-Os of equine and porcine origins, and anorganic Bio-Oss. We also investigated their angiogenic potential. All materials were composed of poorly crystalline calcium oxide phosphate, with Bio-Oss exhibiting a carbonated phase and larger particle size and both Gen-Os showing the presence of collagen. Both Gen-Os materials significantly enhanced vascular endothelial growth factor (VEGF) secretion by PDL cells. A significant increase in endothelial cell proliferation was observed in cultures with both Gen-Os conditioned media, but not with that of Bio-Oss. Finally, angiogenesis was stimulated by both Gen-Os conditioned media as demonstrated by an increased formation of capillary-like structures. Taken together, these findings indicate an enhanced angiogenic potential of both Gen-Os bone grafting materials when applied on PDL cells, most likely by increasing VEGF production.
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