Modality and risk management for orthodontic extrusion procedures in interdisciplinary treatment for generating proper bone and tissue contours for the planned implant: a case report

Predictability of a New Orthodontic Extrusion Technique for Implant Site Development: A Retrospective Consecutive Case-Series Study

In clinical daily practice, there are situations in which implant sites have vertical and/or horizontal bone defects and often we must improve their morphology and dimensions before fixture insertion. It is crucial to carefully evaluate the surgical site as regards the characteristics of both hard and soft tissues. The orthodontic extrusion technique can be used for nonsurgical augmentation of the implant site as an alternative to traditional regenerative/reparative surgical therapies. The orthodontic extrusion is based on a biological mechanism that uses the portion of periodontal ligament, still present on the root before the tooth extraction, for the increase of hard and soft tissues. In the literature, there is no evidence of common guidelines for this technique but only tips based on personal experience and/or previous studies. The aim of this study was to investigate and to validate the reliability of a new orthodontic extrusion technique (MF Extrusion Technique, by Dr. Mauro Fadda) by means of a retrospective consecutive case-series study. After we have done a review of the literature, we evaluated the X-rays of twelve consecutively treated patients before the orthodontic extrusion (T0) and after the stabilization period (T1), in order to quantify, by two different measurements, area and linear, the bone gain obtained by the application of the new technique. All the patients examined showed a significant increase in bone areas with an average value of 31.575 mm². The linear bone gain had an average value of 4.63 mm. Data collected were statistically analysed by the Wilcoxon signed-rank test. The results obtained both from area and linear measurements at T0 and at T1 times showed that there was a statistically significant bone gain with p < 0.01.

Implementation of orthodontic extraction for pre-implant soft tissue management: A systematic review

OBJECTIVE

This systematic review aims to define the recommendations allowing an optimized clinical implementation for orthodontic extraction as a pre-implant soft tissue management procedure.

MATERIALS AND METHODS

A digital search was performed in the Cochrane Library, PubMed, Scopus, and DOSS databases; a pre-screening was conducted according to the title and summary of the articles. After a complete reading, only the articles meeting all of our inclusion criteria were selected, and a second search, this time manual, was performed within their references. The selected articles were then analysed according to twelve parameters.

RESULTS

Thirty-nine articles were included. Despite low statistical evidence in the available literature, some principal guidelines, which seem generally accepted by the scientific community, could be highlighted based on this analysis. However, no ideal clinical protocol could be established.

CONCLUSIONS

Orthodontic extraction is an efficient procedure for pre-implant soft tissue management, however, further studies are needed to establish full clinical recommendations and optimize its clinical implementation.