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Aiuto R, Dioguardi M, Angiero F, Peñarrocha-Diago M, Peñarrocha-Diago M, Crippa R. A clinical protocol for immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser. Minerva Dent Oral Sci 2024; 73:53-60. [PMID: 37255309 DOI: 10.23736/s2724-6329.23.04406-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Placement of dental implants into fresh extraction sockets offers some advantages, such as reduced treatment times and enhanced patient comfort. The Er,Cr:YSGG (Erbium, Chromium-doped: Yttrium, Scandium, Gallium, and Garnet) laser can significantly reduce bacterial concentration after the extraction of a compromised tooth. The aim of this article is to provide a clinical protocol for the management of implants placed in infected extraction sites decontaminated with Er,Cr:YSGG laser. METHODS A compromised tooth, which was an abutment for a fixed bridge, with clinical and radiological signs of infection was extracted. The infected site was treated and decontaminated with an Er,Cr:YSGG laser device (Biolase iPlus®) and two implants (Straumann®) were placed in the same surgery, in order to rehabilitate the edentulous area. The intervention was completed by tissue regeneration with biomaterials. RESULTS Prosthetic rehabilitation after the surgical phase allowed us to provide correct function and satisfactory esthetics. In the follow-up visit, clinicians found good tissue healing and did not observe any complications, such as implant loss or peri-implantitis. The technique used in our study is repeatable and predictable, but patient selection is very important for this type of protocol as the presence of contraindications can lead to failure. The photoacoustic effect exerted by this type of laser has been proven to be effective against many pathogens. Several authors have previously demonstrated the effectiveness of this technique. CONCLUSIONS Immediate implantation in infected sites decontaminated with Er,Cr:YSGG laser does not seem to contribute to an increased risk of failure; however, it is necessary to follow a certain set of protocols and procedures to prevent peri-implantitis and other complications.
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Affiliation(s)
- Riccardo Aiuto
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain -
| | - Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca Angiero
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genoa, Italy
| | - María Peñarrocha-Diago
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Rolando Crippa
- Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genoa, Italy
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Hu L, Han X, Zhang D, Wu J, Huang S. Buccal plate preservation with immediate post-extraction implant placement and provisionalization in anterior maxillary tooth: Preliminary results of a new technique using Teruplug collagen. J Stomatol Oral Maxillofac Surg 2023; 124:101536. [PMID: 37307912 DOI: 10.1016/j.jormas.2023.101536] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Bone resorption and remodelling are inevitable results of dental extraction and begin immediately after the extraction procedure. The buccal plate is especially predisposed to these phenomena, and if affected, may result in an increased risk of facial soft-tissue recession and other adverse clinical effects that may decrease the predictability of implant placement or impair the final aesthetic result. PERPOSE The application of Teruplug collagen to prevent buccal plate resorption technique is a new technique aimed at maintaining or improving the appearance of the soft and hard tissues after dental extraction procedures. METHODS All patients underwent teeth extraction and buccal plate preservation followed by immediate implant placement and provisionalisation using Teruplug collagen. The distance from the external surface of the labial bone to the buccal surface of the implant was measured immediately after placement 6 months and 12 months using computed tomography(CT) images. The aesthetic outcome of 35 implant supported dentures was evaluated by the pink aesthetic score (PAS). Patient aesthetic satisfaction was investigated by a visual analogue scale (VAS). RESULTS In a four-wall intact socket, this approach is aimed at optimising the ability of the Teruplug collagen to improve regeneration and maintain or improve labial/buccal contours without interfering with the natural healing capability of the alveolus after extraction and implant placement. During the different observation period, there were no major biologic or prosthodontic complications as determined by a clinical examination at each follow-up visit. CONCLUSIONS Buccal plate preservation as described may help to maintain or improve the appearance and contours of the ridge after tooth extraction, laying the groundwork for optimal functional and aesthetic replacement of the missing tooth with an implant-supported prosthesis.
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Affiliation(s)
- Lihua Hu
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250012, China
| | - Xiaohui Han
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250012, China
| | - Dongsheng Zhang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250012, China
| | - Jinfeng Wu
- Shanghai Teelthy dental clinic, Shanghai, China
| | - Shengyun Huang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250012, 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Madi M, Almindil I, Alrassasi M, Alramadan D, Zakaria O, Alagl AS. Cone-Beam Computed Tomography and Histological Findings for Socket Preservation Techniques Using Different Grafting Materials: A Systematic Review. J Funct Biomater 2023; 14:jfb14050282. [PMID: 37233391 DOI: 10.3390/jfb14050282] [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: 04/07/2023] [Revised: 05/06/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Socket preservation techniques have been used to maintain the ridge dimension following tooth extraction. The materials used influence the quality and quantity of newly formed bone. Therefore, the aim of this article was to systematically review the literature reporting both histological and radiographic outcomes of socket preservation techniques after tooth extraction in human subjects. MATERIAL AND METHOD A systematic electronic search was performed in the electronic databases. English language clinical studies that were published between 2017 and 2022 and included both histological and radiographic findings for the test and control groups. Our primary search produced 848 articles, and of these, 215 were duplicate studies. A total of 72 articles were then eligible for full-text reading. RESULTS The review included eight studies that met its inclusion criteria. Three outcomes were compared in the included studies. The percentage of newly formed bone ranged from 21.34 ± 9.14% to more than 50% of new bone formation. The materials that showed more than 50% of newly formed bone formation were demineralized dentin graft, platelet-rich fibrin, freeze-dried bone allograft, corticocancellous porcine, and autogenous bone. Four Studies did not report the percentage of the residual graft materials, while those who reported showed a variable range of a minimum 1.5% to more than 25%. One study did not report the changes in horizontal width at the follow-up period, while other studies ranged from 0.6 mm to 10 mm. CONCLUSION Socket preservation represents an efficient technique to preserve the ridge contour with satisfactory newly formed bone in the augmented site and maintaining the vertical and horizontal dimensions of the ridge.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Ibrahim Almindil
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Maria Alrassasi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Doha Alramadan
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
| | - Adel S Alagl
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 32210, Saudi Arabia
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Çolak S, Demïrsoy MS. Retrospective analysis of dental implants immediately placed in extraction sockets with periapical pathology: immediate implant placement in infected areas. BMC Oral Health 2023; 23:304. [PMID: 37208620 DOI: 10.1186/s12903-023-02986-0] [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: 02/03/2023] [Accepted: 04/24/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND The aim of this study is to examine the survival rates of immediate implants placed in extraction sockets with chronic periapical pathology. METHODS 69 patients and 124 immediate implants were included in the study. The patients included in the study were examined in 3 groups. Group 1: Patients who underwent tooth extraction with periapical pathology and immediate implant placement. Group 2: patients who underwent tooth extraction with periapical pathology, immediate implant placement and guided bone regeneration. Group 3: Patients who underwent tooth extraction with periapical pathology, sinus lift procedure and immediate implant placement. In statistical analysis, t-test and Anova analysis were used in the evaluation of quantitative data, cross-tables and chi-square (χ2) test were used in the evaluation of classified qualitative data. Statistical significance was determined as p < 0.05. RESULTS It was observed that 116 (95.55%) of 124 implants were successful and 8 (4.45%) failed. The success rate was 97.2% in Group 1, 93.5% in Group 2 and 81.8% in Group 3. A significant correlation was found between the study groups and implant success in terms of χ2 test (p = 0.037). A significant relationship was found between smoking and success in terms of the χ2 test (p = 0.015). CONCLUSIONS High survival rates are observed for immediate implant placement in sockets with periapical pathology. The success rates observed in guided bone regenerations simultaneously with immediate implant placement are at satisfactory levels. In cases where simultaneous sinus lifting procedures are required, the success rates were observed to be significantly lower. In case of adequate curettage and debridement in sockets with periapical pathology, high implant survival rates are observed. As the complexity of the surgical procedure increases, treatment protocols may progress in safer ways.
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Affiliation(s)
- Sefa Çolak
- Tokat Gaziosmanpasa University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, 60030, Merkez / Tokat, Turkey.
| | - Mustafa Sami Demïrsoy
- Sakarya University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Mithatpasa mah, Adnan Menderes Cd. No:122/B, 54100, Adapazarı / Sakarya, Turkey
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Babayi M, Ashtiani MN, Emamian A, Ramezanpour H, Yousefi H, Mahdavi M. Peri-implant cell differentiation in delayed and immediately-loaded dental implant: A mechanobiological simulation. Arch Oral Biol 2023; 151:105702. [PMID: 37086495 DOI: 10.1016/j.archoralbio.2023.105702] [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: 12/09/2022] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 04/24/2023]
Abstract
OBJECTIVE This study aimed to investigate the effect of immediate versus delayed dental implant placement strategies on cell differentiation in a dental callus. DESIGN The implant was placed in the mandible with two nearby teeth using an idealized two-dimensional finite element model. Eight weeks after surgery, the mechanobiological modeling of healing was used to estimate cell differentiation. It was assumed that the callus was initially filled by mesenchymal cells. The model then transformed mechanical stimuli received by the callus from loadings in terms of distortional and dilatational strains into predictions of the cellular phenotypes, including fibroblasts, chondrocytes, and osteoblasts, or whether they would remain unchanged or die. RESULTS The results demonstrated that delayed loading led to greater bone formation than immediate loading. Osteoblast colonies were observed in the base of threads in the immediately-loaded implant, whereas the delayed loading caused distant bone formation from the surrounding bone side towards the implant. The osteoblasts were differentiated from both intramembranous and endochondral mechanisms of ossification. After eight weeks, approximately 61 % of the callus was ossified in the delayed placement model compared to 35 % in the immediate placement model, resulting in a greater amount of fibrocartilaginous tissue on the bone side of the callus. CONCLUSIONS Immediate and delayed loading models generated different results. In the delayed strategy, bone cells were supplied appropriately during the first few weeks following surgery, whereas the immediate loading caused fibrocartilaginous tissue differentiation. In the form of distant osseointegration, the secondary stability of the dental implant was higher and faster due to the delayed placement.
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Affiliation(s)
- Masumeh Babayi
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran
| | - Mohammed N Ashtiani
- Faculty of Medical Sciences, Tarbiat Modares Unviersity, Tehran, Islamic Republic of Iran.
| | - Amirhossein Emamian
- Department of Biomedical Engineering, Sahand University of Technology, Tabriz, Islamic Republic of Iran; Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hosseinali Ramezanpour
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Hashem Yousefi
- Research and Development Department, Avita Dental System, Tehran, Islamic Republic of Iran
| | - Majid Mahdavi
- Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Islamic Republic of Iran
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Taschieri S, Morandi B, Alberti A, Tarasenko S, Diachkova E, Francetti L, Corbella S. Immediate implant positioning using tooth-derived bone substitute material for alveolar ridge preservation: Preliminary results at 6 months. Clin Exp Dent Res 2023; 9:17-24. [PMID: 36366869 PMCID: PMC9932247 DOI: 10.1002/cre2.685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/07/2022] [Accepted: 10/19/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES In the present study we evaluated the effectiveness of the use of a novel autologous bone substitute derived directly from processing the extracted tooth in the upper premolar area to preserve a suitable esthetic score and functionality. MATERIAL AND METHODS Fourteen bone-level implants with platform switching were inserted in 12 patients immediately after atraumatic extraction of premolars for restorative or endodontic reasons. The implant buccal bone gap was filled using autologous tooth extracted-derived material. Clinical and radiographic parameters, including Pink Esthetic Score (PES) were evaluated at 6 months. RESULTS A total of 10 patients accounting for 11 implants were included. PES showed a suitable esthetic result, and all the implant-prosthetic rehabilitation reported full satisfaction for masticatory function, phonetics, and aesthetics. Bone levels were stable and not affected by implant location, lesion type, or bone quality. CONCLUSION Radiographically the autologous bone substitute used appears stable in the surgical site and there is good continuity between the autologous bone and the graft. No adverse effects such as periodontal inflammation, infection, or graft rejection was reported.
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Affiliation(s)
- Silvio Taschieri
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
- Department of DentistryIRCCS Istituto Ortopedico GaleazziMilanItaly
- Department of Oral Surgery, Institute of DentistryI. M. Sechenov First Moscow State Medical UniversityMoscowRussian federation
| | - Benedetta Morandi
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
- Department of DentistryIRCCS Istituto Ortopedico GaleazziMilanItaly
| | - Alice Alberti
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
- Department of DentistryIRCCS Istituto Ortopedico GaleazziMilanItaly
| | - Svetlana Tarasenko
- Department of Oral Surgery, Institute of DentistryI. M. Sechenov First Moscow State Medical UniversityMoscowRussian federation
| | - Ekaterina Diachkova
- Department of Oral Surgery, Institute of DentistryI. M. Sechenov First Moscow State Medical UniversityMoscowRussian federation
| | - Luca Francetti
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
- Department of DentistryIRCCS Istituto Ortopedico GaleazziMilanItaly
| | - Stefano Corbella
- Department of Biomedical, Surgical and Dental SciencesUniversità degli Studi di MilanoMilanItaly
- Department of DentistryIRCCS Istituto Ortopedico GaleazziMilanItaly
- Department of Oral Surgery, Institute of DentistryI. M. Sechenov First Moscow State Medical UniversityMoscowRussian federation
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Wakankar J, Mangalekar SB, Kamble P, Gorwade N, Vijapure S, Vhanmane P. Comparative Evaluation of the Crestal Bone Level Around Pre- and Post-loaded Immediate Endoosseous Implants Using Cone-Beam Computed Tomography: A Clinico-Radiographic Study. Cureus 2023; 15:e34674. [PMID: 36909066 PMCID: PMC9996191 DOI: 10.7759/cureus.34674] [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: 12/09/2022] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Dental implants replace missing teeth. Dental implants are surgically placed tooth root replacements that secure prosthetic teeth and bridges. Branemark's original dental implant technique included a mesiobuccal flap and a two-stage approach, needing 6-8 months of recovery following extraction, sterile conditions, machined titanium implants, 3-6 months without stress for osseointegration, and a detachable temporary prosthesis. The restoration would usually be ready a year following the implant surgery. Implant treatment seeks the best function, aesthetics, and complication risk. Implant therapy with low patient morbidity and fast extraction-to-restoration times is a secondary target. Instantaneous implant insertion has made implant dentistry more convenient for patients and clinicians. This study measures bone height before, after, and one month after implant placement using cone-beam computed tomography (CBCT). Materials and Methods Participants were selected from oral evaluation candidates. This investigation included 11 people missing front maxillary or mandibular teeth or root components. Diagnostic castings determined the interarch connection before surgery. Alginate maxillary and mandibular arch imprints were cast in Type III dental stone for diagnosis. CBCT scans were taken pre-operatively, post-implant, and post-prosthesis. After the tooth was removed, the empty socket was cleaned up with curettes. An intraoral periapical radiograph and manual probing were done to determine the implant's size. The implant was removed for examination after three months, and healing abutments and gingival formers were placed. Finally, fins were placed. The CBCT images also captured the bone height around the implants. The soft tissue parameters were recorded and evaluated at baseline and one-month following prosthetic loading as plaque index (PI). Radiographic evaluation was done at baseline and one-month following functional loading using CBCT. After one month following functional loading, crestal bone levels were measured again with the help of CBCT using Image J software (National Institutes of Health, Bethesda, Maryland, US). Results The sample population had an average age of 42.81 years, with a standard deviation of 13.44 years. Using a paired t-test, we found that the mean PI dropped significantly from pre-loading levels to one-month post-loading levels, with a p-value of less than 0.001. The mean crestal bone level (mesial) evaluated by CBCT at baseline and one-month post-loading was 2.52 ± 1.97 mm and 1.17 ± 1.31 mm, respectively. The mean difference between mean crestal bone loss (distal) at baseline and one-month post-loading was 0.94 ± 1.89 mm, which was not statistically significant. The mean difference between mean crestal bone loss (buccal) at baseline and one-month post-loading was 1.82 ± 1.60 mm, which was statistically significant. The mean difference between mean crestal bone loss (lingual) at baseline and one-month post-loading was 1.91 ± 1.53 which was statistically significant. Conclusion CBCT provides all the diagnostic data needed for implant placement; hence, it is recommended.
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Affiliation(s)
- Janak Wakankar
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
| | - Sachin B Mangalekar
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
| | - Pallavi Kamble
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli , IND
| | - Nitin Gorwade
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
| | - Shashank Vijapure
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
| | - Priyanka Vhanmane
- Department of Periodontology, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Sangli, IND
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Crippa R, Aiuto R, Dioguardi M, Nieri M, Peñarrocha-Diago M, Peñarrocha-Diago M, Angiero F. Immediate dental implant placement in post-extraction-infected sites decontaminated with Er,Cr:YSGG laser: a retrospective cohort study. Odontology 2023; 111:255-262. [PMID: 36074306 PMCID: PMC9810677 DOI: 10.1007/s10266-022-00734-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 08/08/2022] [Indexed: 01/07/2023]
Abstract
Dental implants placed in fresh extraction alveoli provide several advantages, including shorter treatment periods and improved patient comfort. After a compromised tooth extraction, the Er,Cr:YSGG laser can considerably reduce bacterial concentration. The objective of this controlled study conducted after at least 1 year of follow-up was to compare the use of immediate post-extraction implants in infected sites treated with laser (test group) versus conventional implants in edentulous sites (control group) through an analysis of pre- and post-operative radiographs. The study was based on a series of patients treated between 2014 and 2019, with a 1-year minimum follow-up, and up to over 4 years. An analysis of the clinical history of the treated patients and pre- and post-operative radiographs was performed to evaluate the implant success and to measure the marginal bone level (MBL). Overall, 149 implants were studied. There was only one failure in the test group (1%) and no failures in the control group. The test group gained 0.1 mm of the MBL compared to the baseline, while the control group lost 0.1 mm of the MBL. The difference between the two groups of only 0.2 mm was not statistically significant (P = 0.058). Immediate dental implants in infected sockets debrided and decontaminated using Er,Cr:YSGG laser do not appear to enhance the likelihood of failure; however, peri-implantitis and associated problems must be avoided by following a certain set of protocols and procedures.
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Affiliation(s)
- Rolando Crippa
- grid.5606.50000 0001 2151 3065Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
| | - Riccardo Aiuto
- grid.5338.d0000 0001 2173 938XStomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain ,grid.4708.b0000 0004 1757 2822Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Mario Dioguardi
- grid.10796.390000000121049995Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Nieri
- grid.8404.80000 0004 1757 2304Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - María Peñarrocha-Diago
- grid.5338.d0000 0001 2173 938XStomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Miguel Peñarrocha-Diago
- grid.5338.d0000 0001 2173 938XStomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Francesca Angiero
- grid.5606.50000 0001 2151 3065Department of Medical Sciences and Diagnostic Integrated, S. Martino Hospital, University of Genoa, Genova, Italy
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10
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Akin R, Chapple AG. Clinical Advantages of Immediate Posterior Implants With Custom Healing Abutments: Up to 8-Year Follow-Up of 115 Cases. J Oral Maxillofac Surg 2022; 80:1952-1965. [PMID: 36155739 DOI: 10.1016/j.joms.2022.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Proper management of the soft tissues around dental implants is crucial to their long-term function and esthetics. The purpose of this article is to report the survival rate of immediate posterior implants when using an immediate chair-side technique for custom healing abutments. MATERIALS AND METHODS The investigator implemented a retrospective case series analysis of a sample of 115 consecutive patients with 1 posterior dental implant placed between February 1, 2012 and December 9, 2014, in the author's private practice who underwent the previously published technique for immediate custom chair-side healing abutment fabrication. In this descriptive analysis, the primary outcome variable was implant survival. Other variables included patient gender and age. RESULTS Of the 115 patients in this cohort, 66 were female and 49 were male, with a mean age of 58 years, with 73% of the sites being first molars and 27% second molars. This study sample had a 98.26% overall implant survival rate with 3 implant failures. Median follow-up time was 1 year with identical 1-year and 5-year survival rates. Follow-up at up to 8 years demonstrated a 98.26% overall survival rate with 100% survival in the maxilla and 96.08% in the mandible. CONCLUSIONS This case series demonstrates that the Anatomic Harmony Abutment technique, by applying principles of flapless posterior immediate implant surgery with immediate custom healing abutment placement, can lead to highly successful implant outcomes.
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Affiliation(s)
- Richard Akin
- Board Certified Oral and Maxillofacial Surgeon, Clinical Assistant Professor, LSU Health Sciences Center, Private Practice, Baton Rouge, LA.
| | - Andrew G Chapple
- Biostatistics Assistant Professor, School of Public Health, LSU Health Sciences Center, New Orleans, LA
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11
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Lee SJ, Kim EH, Lee DK, Song IS, Jun SH. The effect of loading time on marginal bone change of implants immediately placed after extraction: a retrospective study. Int J Implant Dent 2022; 8:44. [PMID: 36194298 PMCID: PMC9532494 DOI: 10.1186/s40729-022-00442-2] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study is to compare and analyze the treatment outcomes between two groups which are both immediately placed implant cases, one is immediate loading, and the other is conventional loading group. METHODS Medical records of the patients who underwent implant treatment which were immediately placed after tooth extraction were analyzed. Demographic data were collected and by using periapical or panoramic radiographic image, marginal bone level and distant crestal bone level were measured. Marginal bone change over time was analyzed and compared between immediate loading group and conventional loading group. RESULTS A total of 71 patients, 112 immediately placed implants after tooth extraction were initially involved. Measuring was done with implants which had not failed (81). 10 implants were had failed and removed. The others were excluded because of follow-up loss, absence of radiographic image, etc. Demographic data were collected, and measured values were averaged at each follow-up and showed in linear graphs. CONCLUSIONS In case of immediate implantation of dental implant after extraction, loading time could affect marginal bone level or biological width of the implant. Immediate loading group showed 0.92 mm (mean value) more bone loss compared to conventional loading group at bone-implant contact points 24 months after implantation. At distant crestal points, there was no noticeable difference in bone change pattern between two groups.
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Affiliation(s)
- Sung-Jae Lee
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, Republic of Korea
| | - Euy-Hyun Kim
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, Republic of Korea
| | - Dong-Keon Lee
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, Republic of Korea
| | - In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, Republic of Korea
| | - Sang-Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73, Goryeodae-Ro, Seongbuk-Gu, Seoul, Republic of Korea.
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12
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Li J, Fan Z, Huang M, Xie Y, Guan Z, Ruan J. Enhanced healing process of tooth sockets using strontium-doped TiO 2. RSC Adv 2022; 12:17817-17820. [PMID: 35765343 PMCID: PMC9199484 DOI: 10.1039/d2ra00341d] [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: 01/18/2022] [Accepted: 05/20/2022] [Indexed: 11/21/2022] Open
Abstract
Prevention of residual ridge resorption is important for tooth socket healing in clinical treatment. As a well known biomaterial, titanium dioxide (TiO2) has been reported to show desirable bone regeneration capability. On the other hand, strontium plays a role in maintaining normal function in organisms and balancing bone remodeling. Hence, we synthesized strontium-doped titanium dioxide mesoporous nanospheres functionalized with amino-group using diphenyl diisocyanate. After incorporation with segmented polyurethane, the obtained injectable SPU/Sr-TiO2/MDI nanocomposite adhesive showed satisfactory antibacterial activity and cell nontoxicity. This nanocomposite was used for tooth socket healing, and greatly promoted the formation of new bone tissue in the tooth extraction socket.
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Affiliation(s)
- Jialing Li
- College of Stomatology, Department of Preventive Dentistry, Xi'an Jiao Tong University Xi'an Shaanxi People's Republic of China .,Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan People's Republic of China
| | - Zilu Fan
- Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan People's Republic of China
| | - Min Huang
- Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan People's Republic of China
| | - Yonglin Xie
- Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan People's Republic of China
| | - Zhenju Guan
- Nanchong Central Hospital, The Second Clinical College of North Sichuan Medical College Nanchong Sichuan People's Republic of China
| | - Jianping Ruan
- College of Stomatology, Department of Preventive Dentistry, Xi'an Jiao Tong University Xi'an Shaanxi People's Republic of China
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13
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Ravi Kiran S, Bammidi N, Kumar AK, Kumar PS, Karnam Y. Evaluation of the Effect of Topical Melatonin Application on Immediately Placed Dental Implants Using Cone Beam Computed Tomography (CBCT). Cureus 2022; 14:e25233. [PMID: 35755538 PMCID: PMC9217677 DOI: 10.7759/cureus.25233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 05/22/2022] [Indexed: 11/05/2022] Open
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14
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Jyothirmayee K, Goutam M, Batra N, Bagrecha N, Deshmukh P, Malik S. A comparison of xenograft graft material and synthetic bioactive glass allograft in immediate dental implant patients. J Pharm Bioallied Sci 2022; 14:S980-S982. [PMID: 36110740 PMCID: PMC9469445 DOI: 10.4103/jpbs.jpbs_808_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 11/04/2022] Open
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15
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Ekhlasmandkermani M, Amid R, Kadkhodazadeh M, Hajizadeh F, Abed PF, Kheiri L, Kheiri A. Sinus floor elevation and simultaneous implant placement in fresh extraction sockets: a systematic review of clinical data. J Korean Assoc Oral Maxillofac Surg 2021; 47:411-426. [PMID: 34969014 PMCID: PMC8721410 DOI: 10.5125/jkaoms.2021.47.6.411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 11/07/2022] Open
Abstract
Combining different procedures to reduce the number of surgical sessions and patient discomfort in implant placement and sinus floor elevation has been recommended, and evidence supports good outcomes. The aim of this study was to review the results of clinical studies on sinus floor elevation through extraction sockets and simultaneous immediate posterior implant placement. An electronic search was carried out in PubMed, Scopus, and Web of Science to find English articles published in or before August 2020. A manual search was also performed. Titles, abstracts, and the full-text of the retrieved articles were studied. Thirteen studies met our eligibility criteria: 6 retrospective case series, 3 case reports, 2 prospective cohort caseseries, 1 prospective case series, and 1 randomized controlled trial. Overall, 306 implants were placed; 2 studies reported implant survival rates of 91.7% and 98.57%. The others either did not report the survival rate or reported 100% survival. Sinus floor elevation through a fresh extraction socket and simultaneous immediate implant placement appears to be a predictable modality with a high success rate. However, proper case selection and the expertise of the clinician play fundamental roles in the success of such complex procedures.
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Affiliation(s)
- Mehdi Ekhlasmandkermani
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Amid
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Kadkhodazadeh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hajizadeh
- Department of Periodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pooria Fallah Abed
- Department of Periodontology, Texas A and M College of Dentistry, Dallas, TX ,USA
| | - Lida Kheiri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | - Aida Kheiri
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Le Thieu MK, Homayouni A, Hæren LR, Tiainen H, Verket A, Ellingsen JE, Rønold HJ, Wohlfahrt JC, Cantalapiedra AG, Muñoz FMG, Mendaña MP, Lyngstadaas SP, Haugen HJ. Impact of simultaneous placement of implant and block bone graft substitute: an in vivo peri-implant defect model. Biomater Res 2021; 25:43. [PMID: 34823602 PMCID: PMC8620131 DOI: 10.1186/s40824-021-00245-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/15/2021] [Indexed: 12/31/2022] Open
Abstract
Background Insufficient bone volume around an implant is a common obstacle when dental implant treatment is considered. Limited vertical or horizontal bone dimensions may lead to exposed implant threads following placement or a gap between the bone and implant. This is often addressed by bone augmentation procedures prior to or at the time of implant placement. This study evaluated bone healing when a synthetic TiO2 block scaffold was placed in circumferential peri-implant defects with buccal fenestrations. Methods The mandibular premolars were extracted and the alveolar bone left to heal for 4 weeks prior to implant placement in six minipigs. Two cylindrical defects were created in each hemi-mandible and were subsequent to implant placement allocated to treatment with either TiO2 scaffold or sham in a split mouth design. After 12 weeks of healing time, the samples were harvested. Microcomputed tomography (MicroCT) was used to investigate defect fill and integrity of the block scaffold. Distances from implant to bone in vertical and horizontal directions, percentage of bone to implant contact and defect fill were analysed by histology. Results MicroCT analysis demonstrated no differences between the groups for defect fill. Three of twelve scaffolds were partly fractured. At the buccal sites, histomorphometric analysis demonstrated higher bone fraction, higher percentage bone to implant contact and shorter distance from implant top to bone 0.5 mm lateral to implant surface in sham group as compared to the TiO2 group. Conclusions This study demonstrated less bone formation with the use of TiO2 scaffold block in combination with implant placement in cylindrical defects with buccal bone fenestrations, as compared to sham sites.
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Affiliation(s)
- Minh Khai Le Thieu
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Amin Homayouni
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Lena Ringsby Hæren
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Hanna Tiainen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Anders Verket
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Jan Eirik Ellingsen
- Department of Prosthetic Dentistry and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hans Jacob Rønold
- Department of Prosthetic Dentistry and Oral Function, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Johan Caspar Wohlfahrt
- Department of Periodontology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Antonio Gonzalez Cantalapiedra
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Fernando Maria Guzon Muñoz
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Maria Permuy Mendaña
- Universidade de Santiago de Compostela, Facultad de Veterinaria, Campus Universitario, s/n, 27002, Lugo, Spain.,Ibonelab S.L., Laboratory of Biomaterials, Avda. da Coruña, 500 (CEI-NODUS), 27003, Lugo, Spain
| | - Ståle Petter Lyngstadaas
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Håvard Jostein Haugen
- Department of Biomaterials, Institute of Clinical Dentistry, University of Oslo, 0317, Oslo, Norway.
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17
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Mao Z, Lee CT, He SM, Zhang S, Bao J, Xie ZG. Buccal bone dimensional changes at immediate implant sites in the maxillary esthetic zone within a 4-12-month follow-up period: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2021; 23:883-903. [PMID: 34761503 DOI: 10.1111/cid.13051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/13/2021] [Revised: 09/15/2021] [Accepted: 10/09/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the changes in buccal bone dimensions (CBD) following immediate implant placement in the maxillary esthetic zone and to identify the factors influencing the degree of buccal bone resorption for different placement and restoration protocols. MATERIAL AND METHODS An electronic search was conducted using the EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and MEDLINE (PubMed) databases, combined with a manual and gray literature search, up to January 2021. Selected clinical studies had to report the changes in horizontal buccal bone dimension in maxillary immediate implantation sites (premolar to premolar) at baseline and at follow-up visits within a year of implantation. A meta-analysis was conducted to calculate the mean value of the changes in horizontal and vertical buccal bone dimensions (CHBD and CVBD) around implants. To further investigate the heterogeneity and identify factors associated with buccal bone loss after immediate implant placement, subgroup analysis and univariate meta-regression were performed. RESULTS From a total of 3498 articles, 4 randomized controlled trials and 12 nonrandomized controlled trials were included for analysis. The mean survival rate of 568 implants was 99.6%. The mean CHBD and CVBD values were 0.71 mm (95% confidence interval: [0.56, 0.86]) and 0.58 mm (95% confidence interval: [0.43, 0.72]), respectively. For possible factors that related to bone resorption, including buccal bone thickness, flap design, bone grafting, horizontal defect dimension, and restoration protocol, bone grafting was the only variable that significantly influenced CHBD. CONCLUSIONS This study demonstrated that immediate implant placement in the esthetic zone does not prevent buccal bone from resorption. Due to data heterogeneity and the small sample size of the studies included in the analysis, further well-conducted, randomized controlled trials with homogeneous samples are required to investigate the correlation of CBD with different variables.
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Affiliation(s)
- Zhen Mao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Chun-Teh Lee
- Department of Periodontics and Dental Hygiene, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| | - Si Meng He
- Research Center of Molecular Imaging, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, China
| | - Shu Zhang
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Jibo Bao
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Zhi Gang Xie
- Department of Oral Implantology, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
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18
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Ji H, Wang Y, Liu H, Liu Y, Zhang X, Xu J, Li Z, Luo E. Programmed core-shell electrospun nanofibers to sequentially regulate osteogenesis-osteoclastogenesis balance for promoting immediate implant osseointegration. Acta Biomater 2021; 135:274-288. [PMID: 34492371 DOI: 10.1016/j.actbio.2021.08.050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/06/2021] [Accepted: 08/29/2021] [Indexed: 02/05/2023]
Abstract
The biology of immediate post-extraction implant osseointegration is mediated by a coordinated cascade of osteoblast-osteoclast interactions. The aim of this study was to develop a dual-delivery system that allowed sequential release of substance P (SP) to promote bone regeneration and alendronate (ALN) to reduce bone resorption, which will improve the implant osseointegration. We used coaxial electrospinning to fabricate the core-shell poly lactic-co-glycolic acid (PLGA)/gelatin nanofibers, which consists of SP in the shell and ALN in the core. This programmed delivery system was shown to release SP and ALN sequentially to match the spatio-temporal specificity of bone healing. The migration assay demonstrated that the SP-ALN dual-delivery system increased bone marrow mesenchymal stem cells (BMSCs) transmigration. Besides, the expression of osteogenic/osteoclastic markers, Alizarin Red staining, tartrate-resistant acid phosphatase (TRAP) staining, F-actin staining and bone resorption experiment showed that the dual-delivery system can render a microenvironment favorable for osteogenic differentiation and adverse to osteoclastogenesis. Using a rat immediate implant model, we validated the promoted osteogenic property and osseointegration around the implants of SP-ALN dual-delivery system by micro-computed tomography (micro-CT) and histological analysis. These findings suggest that the dual-delivery system with time-controlled release of SP and ALN by core-shell nanofibers provides a promising strategy to facilitate immediate implant osseointegration through favorable osteogenesis. STATEMENT OF SIGNIFICANCE: Immediate implant placement is potentially challenged by the difficulties in achieving primary implant stability and early osteogenesis. Initial period of osteointegration is regulated by osteoblastic/osteoclastic cells resulting in a coordinated healing process. To have an efficient bone regeneration, the coaxial electrospinning was used to fabricate a programmed dual-delivery system. The SP released rapidly and favored for BMSCs migration and osteogenic differentiation, while the sustained release of ALN can reduce the bone resorption. The rat immediate implant model indicated that the SP-ALN dual-delivery system could present the promoted peri‑implant osteogenic property and osseointegration through modulating the osteogenesis-osteoclastogenesis balance. This work highlights the sequential dual delivery of SP and ALN has a promising potential of achieving enhanced osseointegration for immediate implant placement.
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Affiliation(s)
- Huanzhong Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Yiyao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China; Department of Oral and Maxillofacial Surgery, Sichuan Hospital of Stomatology, Chengdu 610031, PR China
| | - Hanghang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Yao Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Xiaohui Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China
| | - Jiazhuang Xu
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - Zhongming Li
- College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu 610065, PR China
| | - En Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, No. 14 Section 3, Renmin South Road, Chengdu, Sichuan 610041, PR China.
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Kim BJ, Kim CH, Kim JH. Immediate implant placement following tooth extraction with simultaneous lateral sinus augmentation: a retrospective clinical study after at least 1 year of loading. Int J Implant Dent 2021; 7:96. [PMID: 34528155 PMCID: PMC8443712 DOI: 10.1186/s40729-021-00377-0] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background Lateral sinus augmentation is necessary when the residual bone height is insufficient in the posterior maxilla. Immediate implant placement following tooth extraction with lateral sinus augmentation will shorten the number of operations and treatment time. Purpose To evaluate radiologic and clinical results for at least 1 year after loading in patients who underwent tooth extraction, implant placement, and lateral sinus augmentation at the same time. Materials and methods We retrospectively evaluated 35 implants placed in 25 patients. Preoperative and postoperative CBCT were compared and analyzed for residual bone height (RBH) and increased bone height (IBH), the initial torque value (ITV), and the implant stability quotient (ISQ). A comparative evaluation was performed between a 1-stage (non-submerged) group and a 2-stage (submerged) group. After loading for at least 1 year, clinical and radiological evaluations were performed to evaluate the survival rate. Results One of the 35 implants failed in osseointegration, and the remaining 34 showed successful results. The failure-free survival rate at 1 year was 97.06% (95% CI, 91.38-100.0%). The RBH ranged from 3.1 to 9.6 mm (mean, 5.62 ± 1.68 mm), and the IBH ranged from 3 to 15.3 mm (mean, 8.87 ± 2.74 mm). Among the RBH, ITV, ISQ, treatment period, final bone height, and failure evaluation by stage of implant placement, only ISQ showed statistical significance between the groups (p < .001). A comparison of RBH, ITV, and ISQ, regardless of group, showed that each value tended to increase, but there were no statistically significant differences. Conclusions Immediate implant placement following tooth extraction with simultaneous lateral sinus augmentation is considered reliable even though the procedures had been performed at the same time.
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Affiliation(s)
- Bok-Joo Kim
- Department of Oral and Maxillofacial Surgery, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Seo-gu, Busan, 49201, South Korea
| | - Chul-Hoon Kim
- Department of Oral and Maxillofacial Surgery, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Seo-gu, Busan, 49201, South Korea
| | - Jung-Han Kim
- Department of Oral and Maxillofacial Surgery, College of Medicine, Dong-A University, 26, Daesingongwon-ro, Seo-gu, Busan, 49201, South Korea.
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20
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Dai Y, Xu J, Han XH, Cui FZ, Zhang DS, Huang SY. Clinical efficacy of mineralized collagen (MC) versus anorganic bovine bone (Bio-Oss) for immediate implant placement in esthetic area: a single-center retrospective study. BMC Oral Health 2021; 21:390. [PMID: 34376169 DOI: 10.1186/s12903-021-01752-4] [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: 02/22/2021] [Accepted: 07/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The purpose of this retrospective study was to evaluate the clinical efficacy of mineralized collagen (MC) versus anorganic bovine bone (Bio-Oss) for immediate implant placement in esthetic area. METHODS Medical records of Department of Oral and Maxillofacial Surgery of Shandong Provincial Hospital were screened for patients who had been treated with immediate implant implantation in the esthetic area using either MC (Allgens®, Beijing Allgens Medical Science and Technology Co., Ltd., China) or Bio-Oss (Bio-Oss®, Geistlich Biomaterials, Wolhusen, Switzerland), between January 2018 and December 2019. All patients fulfilling the in-/exclusion criteria and following followed for a minimum period of 1 year after surgery were enrolled into the presented study. Implant survival rate, radiographic, esthetic and patient satisfactory evaluations were performed. RESULTS Altogether, 70 patients were included in the study; a total of 80 implants were inserted. All implants had good initial stability. The survival rate of implants was 100% at 1-year follow-up. The differences in horizontal and vertical bone loss between the MC group (0.72 ± 0.26 mm, 1.62 ± 0.84 mm) and the Bio-Oss group (0.70 ± 0.52 mm, 1.57 ± 0.88 mm) were no significant difference statistically no significant 6 months after permanent restoration. Similar results occurred at 12 months after permanent restoration functional loaded. Clinical acceptability defined by pink esthetic score (PES) ≥ 6 (6.07 ± 1.62 vs. 6.13 ± 1.41) was not significantly different between groups. Patient satisfaction estimated by visual analog scale (VAS) was similar (8.56 ± 1.12 vs. 8.27 ± 1.44), and the difference was no significant difference between the two groups. CONCLUSIONS The biomimetic MC showed a similar behaviour as Bio-Oss not only in its dimensional tissues changes but also in clinical acceptability and patient satisfaction. Within the limitations of this study, these cases show that MC could be considered as an alternative bone graft in IIP.
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Affiliation(s)
- Yan Dai
- Department of Oral and Maxillofacial Surgery, Zibo Central Hospital, Zibo, 255036, China
| | - Jin Xu
- Department of Basic Medicine, Kangda College of Nanjing Medical University, Lianyungang, 222000, China
| | - Xiao-Hui Han
- Department of Prosthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Fu-Zhai Cui
- State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing, 100084, China
| | - Dong-Sheng Zhang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
| | - Sheng-Yun Huang
- Department of Oral and Maxillofacial Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
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Abdel-Rahman FH, Salem AS, El-Shinnawi UM, Hammouda NI, El-Kenawy MH, Maria OM. Efficacy of Autogenous Platelet-Rich Fibrin Vs Slowly Resorbable Collagen Membrane With Immediate Implants in the Esthetic Zone. J ORAL IMPLANTOL 2021; 47:342-351. [PMID: 32870251 DOI: 10.1563/aaid-joi-d-20-00124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Fakhreldin H Abdel-Rahman
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ahmed S Salem
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Una M El-Shinnawi
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Nelly I Hammouda
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mohamed H El-Kenawy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Ola M Maria
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
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Eini E, Yousefimanesh H, Ashtiani AH, Saki-Malehi A, Olapour A, Rahim F. Comparing success of immediate versus delay loading of implants in fresh sockets: a systematic review and meta-analysis. Oral Maxillofac Surg 2021. [PMID: 34251545 DOI: 10.1007/s10006-021-00983-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 06/21/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND AIMS The replacement of teeth with osseointegrated implants is one of the significant advances in the field of restorative dentistry. The time interval between tooth extraction and the implant can be very short or long. This systematic review and meta-analysis aimed to collect and evaluate articles related to determining the effect of instant loading of dental implants are placed in the fresh socket initial stability on the clinical success of the implant compared to delay loading dental implants. MATERIALS AND METHODS In this study, all the available articles indexed in leading databases, including PubMed, ISI Web of Science, Embase, PsycINFO, PROSPERO, and Scopus, were searched. The full text of the articles meeting the primary criteria to be included in this research was obtained and appraised. Data of studies were extracted if they were scored as a high or moderate level of evidence. RESULTS A total of 2258 published articles were found through electronic database searching. After screening the titles and abstracts, and full text of articles, 16 studies met the inclusion criteria and were included in the analysis. The results of this study revealed that regarding the success rate, although there was no significant difference between immediate and delayed of dental implants, immediate procedure showed a lower incidence of bone loss in single implants. CONCLUSION Based on the results of this study, immediate loading of dental implant, under certain conditions, is a successful treatment process and is effective in reducing treatment time. Thus, immediate loading represents a valid alternative to the traditional delayed loading rehabilitation.
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El Chaar E, White C, Salama T, Andrawis A. Quantifying the Emergence Profile Contour for Immediate Provisionalization: A Proposed Mathematical Model. J ORAL IMPLANTOL 2021; 47:191-198. [PMID: 33201184 DOI: 10.1563/aaid-joi-d-20-00338] [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] [Indexed: 11/22/2022]
Abstract
Identifying the ideal position of the final restoration prior to implant surgery is essential for optimal esthetics. The study of the emergence contour design of implant restorations has been limited. The aim of this report is to compile the factors that affect the final esthetic outcome and integrate those factors into an easy-to-use model. This geometric model includes a linear distance created by the placement of an implant platform in relation to the free gingival margin and a circle representing the emergence profile to create an emergence curve. If this model is evaluated and available, a practitioner can make appropriate decisions based on 3-dimensional immediate implant concepts.
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Affiliation(s)
| | | | | | - Andrew Andrawis
- Ashman Department of Periodontology and Implant Dentistry, New York University, New York, NY; and private practice, New York, New Jersey
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Bakkali S, Rizo-Gorrita M, Romero-Ruiz MM, Gutiérrez-Pérez JL, Torres-Lagares D, Serrera-Figallo MÁ. Efficacy of different surgical techniques for peri-implant tissue preservation in immediate implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:1655-75. [PMID: 33515121 DOI: 10.1007/s00784-021-03794-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Preserving peri-implant tissues after immediate implant placement (IIP), especially in aesthetic zones, is a topic of interest. OBJECTIVES This systematic review investigated the effects of currently available surgical procedures for preserving peri-implant tissue or ensuring dimensional stability following immediate implant placement. MATERIALS AND METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement's guidelines were followed, and articles were sought on the PubMed and Cochrane databases with no date restrictions. Only randomised clinical trials that evaluated changes in soft and hard tissues around immediately placed implants were included. Statistical analyses were performed, and the studies´ quality was assessed using the Cochrane Collaboration tool. The agreement between reviewers was assessed based on Cohen's kappa statistics. RESULTS Of the 14 studies that met the inclusion criteria, 11 were analysed in the meta-analysis (kappa = 0.814; almost perfect agreement). The use of connective tissue grafts resulted in a significantly greater improvement of the facial gingival level (MD = -0.51; 95% CI: -0.76 to -0.31; p = < .001), and the placement of bone grafts significantly reduced the horizontal resorption of the buccal bone (MD = -0.59; 95% CI: -0.78 to -0.39; p < .001). CONCLUSION Connective tissue grafts and bone grafts positively influence tissue preservation around immediately placed implants. Neither the flapless technique nor palatal implant positioning resulted in significant improvements to any of the investigated parameters. Additional longitudinal studies are required. CLINICAL RELEVANCE This meta-analysis is useful for discerning the effects of soft tissue augmentation, bone grafting, the flapless technique, and palatal implant positioning on preserving peri-implant tissues after immediate implant placement.
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Lim HC, Paeng KW, Kim MJ, Jung RE, Hämmerle CHF, Jung UW, Thoma DS. Immediate implant placement in conjunction with guided bone regeneration and/or connective tissue grafts: an experimental study in canines. J Periodontal Implant Sci 2021; 52:170-180. [PMID: 35505577 PMCID: PMC9064777 DOI: 10.5051/jpis.2104040202] [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: 07/17/2021] [Revised: 09/29/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose This study was conducted to assess the effect of hard and/or soft tissue grafting on immediate implants in a preclinical model. Methods In 5 mongrel dogs, the distal roots of P2 and P3 were extracted from the maxilla (4 sites in each animal), and immediate implant placement was performed. Each site was randomly assigned to 1 of the following 4 groups: i) gap filling with guided bone regeneration (the GBR group), ii) subepithelial connective tissue grafting (the SCTG group), iii) GBR and SCTG (the GBR/SCTG group), and iv) no further treatment (control). Non-submerged healing was provided for 4 months. Histological and histomorphometric analyses were performed. Results Peri-implant tissue height and thickness favored the SCTG group (height of peri-implant mucosa: 1.14 mm; tissue thickness at the implant shoulder and ±1 mm from the shoulder: 1.14 mm, 0.78 mm, and 1.57 mm, respectively; median value) over the other groups. Bone grafting was not effective at the level of the implant shoulder and on the coronal level of the shoulder. In addition, simultaneous soft and hard tissue augmentation (the GBR/SCTG group) led to a less favorable tissue contour compared to GBR or SCTG alone (height of peri-implant mucosa: 3.06 mm; thickness of peri-implant mucosa at the implant shoulder and ±1 mm from the shoulder: 0.72 mm, 0.3 mm, and 1.09 mm, respectively). Conclusion SCTG tended to have positive effects on the thickness and height of the peri-implant mucosa in immediate implant placement. However, simultaneous soft and hard tissue augmentation might not allow a satisfactory tissue contour in cases where the relationship between implant position and neighboring bone housing is unfavorable.
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Affiliation(s)
- Hyun-Chang Lim
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Korea
- Department of Periodontology, Dental Hospital, Kyung Hee University Medical Center, Seoul, Korea
| | - Kyeong-Won Paeng
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Myong Ji Kim
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Ronald E. Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph HF. Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Daniel S. Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Seyssens L, De Lat L, Cosyn J. Immediate implant placement with or without connective tissue graft: A systematic review and meta-analysis. J Clin Periodontol 2020; 48:284-301. [PMID: 33125754 DOI: 10.1111/jcpe.13397] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 08/07/2020] [Revised: 09/29/2020] [Accepted: 10/25/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES To assess the effect of connective tissue graft (CTG) in terms of vertical mid-facial soft tissue change when applied at the buccal aspect 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 January 2020. Randomized controlled trials (RCTs) and non-randomized controlled studies (NRSs) comparing IIP with CTG and without CTG over a mean follow-up of at least 12 months were included for a qualitative analysis. Meta-analyses were performed on data provided by RCTs. RESULTS Out of 1814 records, 5 RCTs and 3 NRSs reported on 409 (IIP + CTG: 246, IIP: 163) immediately installed implants with a mean follow-up ranging from 12 to 108 months. Only 1 RCT showed low risk of bias. Meta-analysis revealed a significant difference in terms of vertical mid-facial soft tissue change between IIP + CTG and IIP pointing to 0.41 mm (95% CI [0.21; 0.61], p < .001) in favour of soft tissue grafting. This outcome was clinically relevant since the risk for ≥1 mm asymmetry in mid-facial vertical soft tissue level was 12 times (RR 12.10, 95% CI [2.57; 56.91], p = .002) lower following IIP + CTG. Soft tissue grafting also resulted in a trend towards less bleeding on probing (MD 17%, 95% CI [-35%; 1%], p = .06). Meta-analyses did not reveal significant differences in terms of pink aesthetic score, marginal bone level change and probing depth. Results were inconclusive for horizontal mid-facial soft tissue change and papilla height change. Based on GRADE guidelines, a moderate recommendation for the use of a CTG following IIP can be made. CONCLUSION CTG contributes to mid-facial soft tissue stability following IIP. Therefore, CTG should be considered when elevated risk for mid-facial recession is expected in the aesthetic zone (thin gingival biotype, <0.5 mm buccal bone thickness).
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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
| | - Liesa De Lat
- 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.,Faculty of Medicine and Pharmacy, Oral Health Research Group (ORHE), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Stumbras A, Galindo-Moreno P, Januzis G, Juodzbalys G. Three-dimensional analysis of dimensional changes after alveolar ridge preservation with bone substitutes or plasma rich in growth factors: Randomized and controlled clinical trial. Clin Implant Dent Relat Res 2020; 23:96-106. [PMID: 33084205 DOI: 10.1111/cid.12950] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 07/10/2020] [Revised: 08/28/2020] [Accepted: 09/09/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To evaluate alveolar ridge dimensional changes of different alveolar ridge preservation techniques after 3 months of tooth extraction and to compare the efficacy of autologous plasma rich in growth factor (PRGF) to the bone substitutes in alveolar ridge preservation and sites left to heal spontaneously. MATERIALS AND METHODS Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the four following treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM) and PRGF alone. Cone beam computed tomography (CBCT) scans were taken after surgery and 3 months later. The measurements of height and width (at 1, 3, and 5 mm below the crest) were performed after superimposing the 2 consecutive CBCT scans. RESULTS The greatest horizontal alveolar bone resorption at 1 mm below bone crest was observed in the control group (-1.61 ± 1.76 mm, P = .037), whereas the least reduction in width was found in the BBM/CM group (-0.68 ± 0.67 mm, P = .037). The most pronounced alveolar height reduction was observed in the control group (-0.86 ± 0.43 mm), whereas alveolar ridge preservation with BBMC/CM (-0.26 ± 0.91 mm) and PRGF (-0.54 ± 0.86 mm) successfully reduced the alveolar height reduction as compared to the control group. CONCLUSIONS Alveolar ridge preservation technique in the esthetic zone using BBM/CM or using PRGF is beneficial to reduce horizontal and vertical bone changes.
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Affiliation(s)
- Arturas Stumbras
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Pablo Galindo-Moreno
- Oral Surgery and Implant Dentistry Department, University of Granada, Granada, Andalucía, Spain
| | - Gintaras Januzis
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Oral and Maxillofacial Surgery, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Noelken R, Pausch T, Wagner W, Al‐Nawas B. Peri‐implant defect grafting with autogenous bone or bone graft material in immediate implant placement in molar extraction sites—1‐ to 3‐year results of a prospective randomized study. Clin Oral Implants Res 2020; 31:1138-1148. [DOI: 10.1111/clr.13660] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 07/29/2020] [Accepted: 08/13/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Robert Noelken
- Private Practice for Oral Surgery Lindau/Lake Constance Germany
- Department of Oral and Maxillofacial Surgery – Plastic Surgery University Medical CenterJohannes Gutenberg University of Mainz Mainz Germany
| | - Tobias Pausch
- Private Practice for Oral Surgery Weiden in the Upper Palatinate Weiden Germany
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery – Plastic Surgery University Medical CenterJohannes Gutenberg University of Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery – Plastic Surgery University Medical CenterJohannes Gutenberg University of Mainz Mainz Germany
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Hattingh A, De Bruyn H, Van Weehaeghe M, Hommez G, Vandeweghe S. Contour Changes Following Immediate Placement of Ultra-Wide Implants in Molar Extraction Sockets without Bone Grafting. J Clin Med 2020; 9:jcm9082504. [PMID: 32759638 PMCID: PMC7464762 DOI: 10.3390/jcm9082504] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 01/18/2023] Open
Abstract
The aim was to evaluate ridge reduction and mucosal recession following immediate placement of ultra-wide implants in molar sockets, without bone grafting. Impressions were taken prior to tooth extraction, 4 months and 1 year after implant placement. The casts were digitized and compared. Mucosal recessions and horizontal ridge reduction were measured. A total of 16 implants were in the maxilla and 11 in the mandible. At the buccal aspect, there was a mean reduction of 0.94 mm after 4 months and 0.89 mm after one year (p = 0.933). At the palatal/lingual aspect, this was 1.09 mm after 4 months and 0.69 mm after 1 year (p = 0.001). After 1 year, a recession of 0.59 mm was measured at the zenith, 1.04 mm at the mesial and 0.98 mm at the distal papilla. The mean midfacial horizontal ridge reduction was 1.23 mm after 4 months and 1.45 mm after 1 year. At the midpalatal/midlingual aspect, the mean horizontal reduction was 1.43 mm after 4 months and 1.16 mm after 1 year. Immediate implant placement without bone grafting in the posterior jaw yields a significant horizontal ridge reduction and minor mucosal recession. Clinicians should anticipate the amount of ridge reduction and consider augmentation at the time of implant placement.
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Affiliation(s)
- André Hattingh
- Private Practice for Periodontology and Oral Implantology, Sevenoaks, Kent TN15 8BQ, UK;
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Hugo De Bruyn
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Dental Faculty, Radboud University Medical Hospital, 6525EX Nijmegen, The Netherlands
| | - Manù Van Weehaeghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Geert Hommez
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
| | - Stefan Vandeweghe
- Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University, 9000 Ghent, Belgium; (H.D.B.); (M.V.W.); (G.H.)
- Correspondence: ; Tel.: +32-9-332-59-22
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Schickert SDL, Jansen JA, Bronkhorst EM, van den Beucken JJJP, Leeuwenburgh SCG. Stabilizing dental implants with a fiber-reinforced calcium phosphate cement: An in vitro and in vivo study. Acta Biomater 2020; 110:280-288. [PMID: 32330608 DOI: 10.1016/j.actbio.2020.03.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/16/2020] [Accepted: 03/18/2020] [Indexed: 01/30/2023]
Abstract
Stabilization of dental implants by means of biomaterials such as bioceramic granules and cements is currently compromised by the poor mechanical properties of these bioceramics. Recently, our group developed a calcium phosphate cement reinforced with poly(vinyl alcohol) fibers with improved flexural strength and toughness. Herein we evaluated the capacity of these fiber-reinforced calcium phosphate cements to stabilize dental implants in vitro and in vivo using a range of mechanical and biological test methods. In vitro, filling of circumferential crestal peri‑implant bone defects with synthetic bone analogues with fiber-reinforced calcium phosphate cement demonstrated superior implant stability as compared to fiber-free calcium phosphate cement over a 12-week period. Similarly, filling of circumferential crestal peri‑implant bone defects with fiber-reinforced calcium phosphate cement effectively stabilized dental implants installed in a rabbit femoral condyle defect as assessed via both Implant Stability Quotient (ISQ) and torque-out measurements. Moreover, histological and histomorphometric evaluation demonstrated the osteocompatibility of fiber-reinforced calcium phosphate cement, as evidenced by absence of soft tissue ingrowth, direct contact between the bone and cement, and gradual degradation of the biomaterial and replacement by newly-formed bone. These data demonstrate that fiber-reinforced calcium phosphate cement stabilize dental implants during osseointegration. STATEMENT OF SIGNIFICANCE: Dental implants can be placed immediately after a tooth is removed. However, in some cases the implant might not have enough bone surrounding it and becomes loose. To solve this, bioceramics have been used to fill the implant-bone gap. However, these materials have poor mechanical properties and are often not capable to stabilize the implant. Recently, our research group developed a new bone cement that is reinforced with fibers and has, therefore, enhanced mechanical properties. In this study, we have proven that by molding this cement into the implant-bone gap, we stabilize the implant and allow for a direct connection between the implant and the surrounding bone. Using this innovative cement is therefore a safe and efficient way of stabilizing dental implants.
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Kabi S, Kar R, Samal D, Deepak KC, Kar IB, Mishra N. Immediate dental implant placement with or without autogenous bone graft: A comparative study. Natl J Maxillofac Surg 2020; 11:46-52. [PMID: 33041576 PMCID: PMC7518474 DOI: 10.4103/njms.njms_59_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/05/2019] [Accepted: 12/25/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction Immediate dental implants are the most accepted contemporary treatment option for the replacement of missing teeth. One pitfall of immediate implant use, however, is the inevitable residual space that remains between the implant and the socket wall, called the jumping distance, which may lead to bone resorption and formation of a bony defect, decreasing the implant stability. When this jumping distance is more than 2 mm, use of bone grafts is recommended. However, the use of grafts when the jumping distance is <2 mm is not defined in the literature. Aim To evaluate the peri-implant hard and soft tissue changes following immediately placed implants with a jumping distance of 2 mm with or without autogenous bone grafts. Settings The study was conducted between January 2016 and December 2017 in the Department of Oral and Maxillofacial Surgery. Subjects and Methods This was a prospective, single-center, two-arm, parallel, randomized study on patients undergoing replacement of missing anterior teeth with immediate implants. There were two groups: the study group which received bone graft and the control group which did not receive any graft. Temporary prosthesis was placed following implant placement which was replaced with definitive prosthesis 4 months later. Patients were followed up for a period of 9 months. The alveolar bone loss was evaluated radiologically using cone-beam computed tomography, and pain, suppuration, mobility, and periodontal probing depth were evaluated clinically. Results There were 16 participants in the study group and 17 in the control group. The alveolar bone loss was greater in the study group; however, pain, suppuration, and mobility showed no difference between the groups. Conclusion The immediate implants placed with or without bone grafts had similar alveolar hard and soft tissue changes when the jumping distance was <2 mm.
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Affiliation(s)
- Sonalika Kabi
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Rosalin Kar
- Department of Prosthetic Dentistry, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Dipti Samal
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Kumar C Deepak
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Indu Bhusan Kar
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India
| | - Niranjan Mishra
- Department of Oral and Maxillofacial Surgery, SCB Dental College and Hospital, Cuttack, Odisha, India
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Kızıldağ A, Tasdemir U, Arabacı T, Kızıldağ CA, Albayrak M, Şahin B. Effects of Autogenous Tooth Bone Graft and Platelet-Rich Fibrin in Peri-Implant Defects: An Experimental Study in an Animal Model. J ORAL IMPLANTOL 2020; 46:221-226. [PMID: 32582918 DOI: 10.1563/aaid-joi-d-19-00038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to evaluate the effect of autogenous tooth bone graft (ATBG) combined with platelet-rich fibrin (PRF) on bone healing in rabbit peri-implant osseous defects. Eighteen New Zealand rabbits were divided into 3 groups. Bone defects were prepared in each rabbit, and then an implant cavity was created in the defects. Dental implants were placed, and the peri-implant bone defects were treated with the following 3 methods: no graft material was applied in the control group, bone defects were treated with ATBG in the ATBG group, and bone defects were treated with ATBG combined with PRF in the ATBG+PRF group. After 28 days, the rabbits were sacrificed, and the dental implants with surrounding bone were removed. New bone formation and the percentage of bone-to-implant contact (BIC) were determined with histomorphometric evaluations. New bone formation was significantly higher in the ATBG+PRF group than the control and ATBG groups (P < .05). In addition, BIC was significantly higher in the ATBG+PRF group than in the control and ATBG groups (P < .05). The combination of ATBG with PRF contributed to bone healing in rabbits with peri-implant bone defects.
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Affiliation(s)
- Alper Kızıldağ
- Department of Periodontology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Ufuk Tasdemir
- Department of Maxillofacial Surgery, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Taner Arabacı
- Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Canan Aksu Kızıldağ
- Department of Orthodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Mevlüt Albayrak
- Medical Laboratory Department, Health Services Vocational Training School, Atatürk University, Erzurum, Turkey
| | - Barbaros Şahin
- Experimental Surgery Application and Research Center, Pamukkale University, Denizli, Turkey
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Abstract
Chronic endodontic infections are associated with osseous changes in the peri-apical regions. Dental implants are often placed after the extraction of hopeless teeth with periapical infections. This clinical report describes a patient with a radiopaque mass attached to the root apex of the mandibular right second premolar tooth (No. 45). The differential diagnoses of the radiopaque mass were bone- and tissue-borne diseases. Based on the clinical and radiologic findings (bone density and trabeculation of the bone), the definitive diagnosis of the osseous mass was condensing osteitis. The osseous tumor associated with tooth 45 was atraumatically extracted under local anesthesia. Guided bone regeneration was performed immediately after extraction of tooth 45, and a dental implant was placed in the site after 6 months of healing.
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Affiliation(s)
- Fawaz Alqahtani
- Department of Prosthodontics, College of Dentistry, Prince Sattam bin Abdulaziz University, Al-kharj, Saudi Arabia
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Lee C, Sanz‐Miralles E, Zhu L, Glick J, Heath A, Stoupel J. Predicting bone and soft tissue alterations of immediate implant sites in the esthetic zone using clinical parameters. Clin Implant Dent Relat Res 2020; 22:325-332. [DOI: 10.1111/cid.12910] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 03/01/2020] [Accepted: 03/29/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Chun‐Teh Lee
- Department of Periodontics and Dental Hygiene The University of Texas Health Science Center School of Dentistry Houston Texas USA
| | - Elena Sanz‐Miralles
- Division of Periodontics, Section of Oral and Diagnostic Sciences Columbia University College of Dental Medicine New York New York USA
| | - Liang Zhu
- Biostatistics & Epidemiology Research Design Core, Center for Clinical and Translational Sciences, Department of Internal Medicine, Medical School The University of Texas Health Science Center at Houston Houston Texas USA
| | | | - Andrew Heath
- Department of Pediatric and Special Needs Dentistry Arkansas Children's Hospital Little Rock Arkansas USA
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Nguyen VG, Flanagan D, Syrbu J, Nguyen TT. Socket Shield Technique Used in Conjunction With Immediate Implant Placement in the Anterior Maxilla: A Case Series. Clin Adv Periodontics 2020; 10:64-68. [DOI: 10.1002/cap.10087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/18/2019] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - John Syrbu
- Department of Family DentistryUniversity of Iowa College of Dentistry and Dental Clinics Iowa City IA
| | - Thomas T. Nguyen
- Division of PeriodontologyDepartment of Oral Medicine, Infection and ImmunityHarvard School of Dental Medicine Boston MA
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Sommer M, Zimmermann J, Grize L, Stübinger S. Marginal bone loss one year after implantation: a systematic review of different loading protocols. Int J Oral Maxillofac Surg 2020; 49:121-134. [DOI: 10.1016/j.ijom.2019.03.965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/08/2019] [Accepted: 03/18/2019] [Indexed: 12/24/2022]
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Amin V, Kumar S, Joshi S, Hirani T, Shishoo D. A clinical and radiographical comparison of buccolingual crestal bone changes after immediate and delayed implant placement. Med Pharm Rep 2019; 92:401-407. [PMID: 31750442 PMCID: PMC6853050 DOI: 10.15386/mpr-1213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/28/2018] [Accepted: 01/31/2019] [Indexed: 11/25/2022] Open
Abstract
Aim The study aims to clinically and radiographically compare the bucco-lingual crestal bone changes after immediate and delayed placement of implants. Methods Two groups that consisted of fifty implants were considered for this study. In group A the implants were placed immediately post extraction, whereas, in group B implants placement were delayed by four to six weeks. All the implants were submerged within the alveoli confines. Bone grafts were only placed if the jumping distance was more than 1.5 mm. Barrier membrane was not placed in any of the cases. Bucco-lingual width was measured at the time of implant placement and during abutment placement after four to six weeks. Primary flap closure was ensured in all the cases. Results Thirty-one implants were placed in the mandible and nineteen were placed in the maxilla. All the implants achieved osseointegration. Immediate implant group showed a mean width of 8.80 mm (SD2.280) at the time of implant placement whereas, 7.60 mm (SD 1.871) after six months. Delayed implant group showed a mean width of 8.40 mm (SD1.673) at the time of implant placement, and 7.40 mm (SD 1.658) after six months. Intragroup showed statistically significant data (P<0.05). When the intergroup comparison of group 1 and group 2 was made at implant placement day and abutment placement day, it was found to be statistically non-significant. Conclusion This study suggests that circumferential defect heals on itself without any guided bone regeneration in both the groups. The data suggests that the healing in both the group were equally good. The equally good results suggest placing the implant immediately post extraction. This saves the cost, time and most importantly the need for an extra surgery.
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Affiliation(s)
- Viraj Amin
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Surabhi Joshi
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Tanvi Hirani
- Department of Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Deepak Shishoo
- Department of Physiology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, Gujarat, India
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De Tullio I, Caputi S, Perfetti G, Mavriqi L, Wismeijer D, Traini T. A Human Clinical and Histomorphometrical Study on Different Resorbable and Non-Resorbable Bone Substitutes Used in Post-Extractive Sites. Preliminary Results. Materials (Basel) 2019; 12:E2408. [PMID: 31357726 DOI: 10.3390/ma12152408] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/27/2022]
Abstract
Background: The healing of sockets following teeth extraction results in a marked reduction of the height and width of the ridge. This in vivo study aims to assess and compare the efficacy of calcium sulphate (CS) and sintered nano-hydroxyapatite (NHA) in postextraction sockets. Materials and Methods: 10 subjects were enrolled for single or multiple tooth extraction and implant placement. Each site was randomly assigned to one of four groups and filled with CS, NHA, a combination of CS and NHA, or left to normal healing. After five months tissue samples were harvested from the extraction sites and prepared for histological investigations. Results: Histomorphometric analysis showed that the average percentages of vital bone was 13.56% ± 13.08% for CS, 17.84% ± 7.32% for NHA, 58.72% ± 8.77% for CS + NHA%, and 80.68% ± 21.8% for the controls; for the connective tissue the results were 33.25% ± 35.75% for CS, 55.88% ± 21.86% for NHA, 17.34% ± 8.51% for CS + NHA, and 22.62% ± 0.52% for the controls; for residual biomaterial the results were 0.56% ± 0.52% for CS group, 21.97% ± 0.79% for NHA, and 47.54% ± 20.13% for CS + NHA. Conclusions: Both biomaterials led to bone tissue formation after five months of healing. The combination of the biomaterials presented a better behavior when compared to the individual application.
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Zimmermann J, Sommer M, Grize L, Stubinger S. Marginal bone loss 1 year after implantation: a systematic review for fixed and removable restorations. Clin Cosmet Investig Dent 2019; 11:195-218. [PMID: 31406478 PMCID: PMC6642649 DOI: 10.2147/ccide.s208076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/27/2019] [Indexed: 11/23/2022] Open
Abstract
This systematic review analyses the difference of the mean marginal bone loss (MBL) 1 year after implantation depending on the fixation of the restoration. 889 publications on controlled clinical trials were identified, and based on inclusion and exclusion criteria, 22 studies were selected. Related to fixed restorations, the lowest MBL was 0.05±0.67 mm and the highest 1.37±0.5 mm. The MBL for removable restorations ranged from 0.13±0.35 mm to 1.03±0.65 mm. Three studies analyzed the MBL around implants of overdentures in the lower jaw. The estimate for this restoration type was 0.476 mm (95% CI: −0.305 to 1.258). 19 randomized controlled studies dealt with restorations which were fixed to the implants. The estimate for the mean MBL was 0.459 mm (95% CI: 0.325–0.593). There was a decrease in 1-year implant survival with an increase of 1 mm MBL (−0.083%; 95% CI: −0.179 to 0.0123; p=0.083) in fixed restorations. The difference in MBL between fixed and removable restorations was 0.363 mm (95% CI: −0.319 to 1.044; p=0.279). This systematic review indicates that implants with fixed and with removable restorations lead to comparable MBL.
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Affiliation(s)
- Jennifer Zimmermann
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Melanie Sommer
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Leticia Grize
- Swiss Tropical and Public Health Institute , Basel, Switzerland.,University of Basel , Basel, Switzerland
| | - Stefan Stubinger
- Hightech Research Center, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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Abstract
In the dental implant era, there has been growing interest in exploring the most effective methods to minimize morphologic alteration in the postextraction site. Despite modern methods of ridge preservation, resorption of the ridge is inevitable. The optimal approach to minimizing the rate and amount of these changes is still a subject of controversy. This article provides a contemporary review of the different approaches to preserve alveolar ridge dimensions. A suggested classification for single extraction sockets is presented along with multiple treatment options for each class.
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Affiliation(s)
- Firas Al Yafi
- Arab Board of Oral Surgery, Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, 800 Rose Street, 4th floor, Room D436, Dental Science Bldg, Lexington, KY 40536-0297, USA.
| | - Basem Alchawaf
- Department of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia
| | - Katja Nelson
- Department of Dental and Craniofacial Sciences, Clinic of Oral and Maxillofacial Surgery, Freiburg University Hospital, Hugstetter Street 55, Freiburg im. Breisgau D-79106, Germany
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41
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Dos Santos JG, Oliveira Reis Durão AP, de Campos Felino AC, Casaleiro Lobo de Faria de Almeida RM. Analysis of the Buccal Bone Plate, Root Inclination and Alveolar Bone Dimensions in the Jawbone. A Descriptive Study Using Cone-Beam Computed Tomography. J Oral Maxillofac Res 2019; 10:e4. [PMID: 31404187 PMCID: PMC6683387 DOI: 10.5037/jomr.2019.10204] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/29/2019] [Indexed: 11/16/2022]
Abstract
Objectives This study aims to determine if there are enough buccal alveolar bone thickness to perform an immediate dental implant placement in anterior and posterior maxillary teeth. Material and Methods A total of 1463 teeth were examined, from 202 cone-beam computed tomography scans with voxel sizes of 0.15 mm. On each tooth, the following measures were determined: the alveolar bone thickness in two locations; the vertical distance between the buccal alveolar crest and cementoenamel junction; the angle between the tooth's long axis and the alveolar bone axial inclination in the sagittal plane. Results In the most coronal location of maxillary teeth, the thickness of alveolar bone was lower than 0.6 (SD 0.6) mm in 50% of the teeth, and in the middle of the root the bone thickness was, on average, 0.96 (SD 0.6) mm. For the same maxillary teeth, the vertical distance between the buccal alveolar crest and cementoenamel junction and the angulation measured were, on average, 3.6 (SD 1.2) mm and 12.1º (SD 1.4º), respectively. Conclusions The present study revealed that in most cases the thickness of buccal alveolar bone was less than 1 mm. Consequently, in such cases, immediate dental implant placement operation is not recommended, or should be combined with bone regeneration techniques.
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De Angelis P, De Angelis S, Passarelli PC, Liguori MG, Manicone PF, D'Addona A. Hard and Soft Tissue Evaluation of Different Socket Preservation Procedures Using Leukocyte and Platelet-Rich Fibrin: A Retrospective Clinical and Volumetric Analysis. J Oral Maxillofac Surg 2019; 77:1807-1815. [PMID: 31202703 DOI: 10.1016/j.joms.2019.05.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/05/2019] [Accepted: 05/06/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE The extraction of a tooth is followed by hard and soft tissue changes that can compromise implant placement. The aim of the present retrospective study was to compare the clinical and radiographic outcomes of different ridge preservation procedures based on the use of leukocyte and platelet-rich fibrin (L-PRF). MATERIALS AND METHODS The study population consisted of all patients who had undergone surgery from January 1, 2017 to January 1, 2018 for alveolar ridge preservation on single posterior teeth using 3 clinical protocols: L-PRF alone, L-PRF mixed with a bone xenograft, and bone xenograft alone. Clinical and radiographic measures were recorded preoperatively and at 6 months postoperatively to determine the horizontal and vertical ridge resorption. RESULTS A total of 45 patients were included in the present study. All the surgeries were performed successfully, and no intraoperative complications developed. The L-PRF group experienced significantly greater horizontal and vertical bone resorption. The L-PRF plus bone xenograft group had less vertical and horizontal bone resorption than the bone xenograft alone group. Statistically significant differences in postoperative pain and wound healing were observed, with the bone xenograft alone group, in particular, having higher values for pain and experiencing delayed wound healing. CONCLUSIONS Within the limitations of the present retrospective study, the use of a bone xenograft alone or L-PRF combined with a bone xenograft to perform alveolar ridge preservation procedures significantly limited bone resorption.
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Affiliation(s)
- Paolo De Angelis
- Resident, Division of Oral Surgery and Implantology, Department of Head and Neck, Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy.
| | | | - Pier Carmine Passarelli
- Resident, Division of Oral Surgery and Implantology, Department of Head and Neck, Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Margherita Giorgia Liguori
- Private Practitioner, Division of Oral Surgery and Implantology, Department of Head and Neck Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Francesco Manicone
- Professor, Division of Oral Surgery and Implantology, Department of Head and Neck Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio D'Addona
- Department Head, Division of Oral Surgery and Implantology, Department of Head and Neck Oral Surgery, and Implantology Unit, Institute of Clinical Dentistry, Fondazione Policlinico Universitario A. Gemelli IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
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43
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Zhang S, Song S, Wang S, Duan Y, Zhu W, Song Y. Type 2 diabetes affects postextraction socket healing and influences first‐stage implant surgery: A study based on clinical and animal evidence. Clin Implant Dent Relat Res 2019; 21:436-445. [PMID: 31025528 DOI: 10.1111/cid.12780] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Sijia Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Implant DentistrySchool of Stomatology, The Fourth Military Medical University Xi'an China
- Department of Biochemistry and Molecular BiologyCenter for DNA Typing, Air Force Medical University, 169 Changle West Road, Xi'an, Shaanxi 710032 P.R. China
| | - Shuang Song
- Peking University, School of Stomatology Beijing China
| | - Shuyan Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Disease, School of StomatologyThe Fourth Military Medical University Xi'an China
| | - Yansheng Duan
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Implant DentistrySchool of Stomatology, The Fourth Military Medical University Xi'an China
| | - Wenzhong Zhu
- Department of Implant DentistryThe Second People's Hospital Xi'an China
| | - Yingliang Song
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Engineering Research Center for Dental Materials and Advanced Manufacture, Department of Implant DentistrySchool of Stomatology, The Fourth Military Medical University Xi'an China
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44
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Affiliation(s)
- Mauricio G. Araújo
- Department of Dentistry State University of Maringá Maringá Parana Brazil
| | - Cleverson O. Silva
- Department of Dentistry State University of Maringá Maringá Parana Brazil
| | - Andrė B. Souza
- Department of Prosthodontics Tufts University School of Dental Medicine Boston Massachusetts
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45
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Kinaia BM, Kazerani S, Korkis S, Masabni OM, Shah M, Neely AL. Effect of guided bone regeneration on immediately placed implants: Meta-analyses with at least 12 months follow up after functional loading. J Periodontol 2019; 92:1749-1760. [PMID: 30702152 DOI: 10.1002/jper.18-0543] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 09/15/2018] [Revised: 12/19/2018] [Accepted: 12/24/2018] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Immediate implant placement (IIP) into fresh extraction socket is a favorable treatment option. If successfully managed, it reduces the overall treatment time, and increases patient's satisfaction. Surgical and restorative factors affect IIP success rates. In this systematic review we evaluate the effect of guided bone regeneration (GBR) at the time of IIP on crestal bone level (CBL) changes after at least 12-months of functional loading. METHODS Reviewers conducted an independent search of the National Center for Biotechnology Information PubMed, Medline, and the Cochrane Collaboration Library from 1966 to January 2017 following the inclusion criteria. A hand search of bibliographies of reviews and clinical trials related to IIP was also performed. This study looked into CBL changes around IIP primarily and further extracted the data to conduct three meta-analysis of "IIP using GBR versus IIP without GBR", "IIP using bone graft alone versus IIP using bone graft with membrane" and "IIP using GBR versus conventional implant placement" which were further subdivided to provide more detailed information for each. Four reviewers independently assessed the study data and methodologic quality using data extraction and assessment forms. RESULTS The electronic search identified 714 potential studies and the hand search retrieved 55 studies. Crestal bone level (CBL) changes were determined in three meta-analyses. The results revealed a mean difference in CBL changes of 0.179 ± 0.174 mm in favor of IIP without GBR when compared with implant with GBR. However, IIP with bone graft and membrane showed better results when compared with IIP with bone graft alone [CBL changes of 0.532 ± 0.572 mm]. CBL preservation was noted in IIP with GBR versus conventional implant placement [CBL changes of - 0.001 ± 0.049 mm]. CONCLUSIONS Meta-analyses showed minimal difference in CBL around IIP with bone graft versus without bone graft and with IIP with GBR compared with conventional implant placement. However, IIP with bone graft and membrane reported better CBL preservation compared with IIP with bone graft alone. Nonetheless, these results should be interpreted with caution because of moderate heterogeneity between studies.
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Affiliation(s)
- Bassam M Kinaia
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI.,Private practice, Sterling Heights, MI
| | - Shahrdad Kazerani
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Samuel Korkis
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Omar Mario Masabni
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
| | - Maanas Shah
- Department of Periodontology, Hamdan Bin Mohammed College of Dental Medicine, Dubai, UAE
| | - Anthony L Neely
- Division of Graduate Periodontics, University of Detroit Mercy, Detroit Mercy Dental, Detroit, MI
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Natale Júnior V, Souza FÁ, Vedovatto E, Nishioka RS, Poli PP, Carvalho PSPD. Preservation of Dental Sockets Filled with Composite Bovine Bone. A Single-Blind Randomized Clinical Trial. Braz Dent J 2018; 29:583-591. [DOI: 10.1590/0103-6440201802064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 06/22/2018] [Indexed: 01/11/2023] Open
Abstract
Abstract The purpose of this study was to evaluate the preservation of alveolar dimensions in human fresh extraction sockets filled with a composite bovine bone graft by means of design of single-blind randomized clinical trial. Forty participants had monoradicular teeth extracted (one teeth in each participant), and after were randomly divided into 2 groups: individuals whose fresh sockets were filled with the composite heterologous bone graft (Biomaterial Group), or with blood clot (Control Group). After extraction, the fresh sockets were measured at their greatest mesiodistal (MD) and bucco-lingual/palatal (BL/P) distance. Primary closure of the soft tissue was performed with a fibro-mucosal plug. After 120 post-operative days, the re-entry procedure was performed and the largest MD and BL/P measurements were again obtained to calculate the remodeling of the alveolar bone measured in percentage. In the biomaterial group, a percentage reduction of 1.62% and 3.29% in the MD and BL/P dimensions was observed 120 days after the extractions, whereas a reduction of 4.97% and 7.18% in the MD and BL/P dimensions occurred in the control group. There was a statistically significant difference (p<0.05) between the two groups for the bucco-palatal and mesiodistal measurements in the maxilla. In view of the results obtained, it can be concluded that composite bovine bone graft limited but did not impede alveolar bone remodeling.
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Affiliation(s)
- Vail Natale Júnior
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil
| | | | - Eduardo Vedovatto
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil
| | | | | | - Paulo Sérgio Perri de Carvalho
- Faculdade de Medicina e Odontologia e Centro de Pesquisas Odontológicas São Leopoldo Mandic, Brazil; Universidade Estadual Paulista, Brazil
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47
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Cheng AW, Berridge JP, McGary RT, Erley KJ, Johnson TM. The Extraction Socket Management Continuum: A Hierarchical Approach to Dental Implant Site Development. Clin Adv Periodontics 2018; 9:91-104. [DOI: 10.1002/cap.10049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/16/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Albert W. Cheng
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Joshua P. Berridge
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Ryan T. McGary
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Kenneth J. Erley
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
| | - Thomas M. Johnson
- United States Army Advanced Education Program in Periodontics Fort Gordon GA
- Department of PeriodonticsArmy Postgraduate Dental SchoolUniformed Services University of the Health Sciences Fort Gordon GA
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Noelken R, Moergel M, Kunkel M, Wagner W. Immediate and flapless implant insertion and provisionalization using autogenous bone grafts in the esthetic zone: 5-year results. Clin Oral Implants Res 2018. [PMID: 29537706 DOI: 10.1111/clr.13119] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES As the 2-year results for immediately inserted and provisionalized implants have been reported, it remained an open issue, whether the initially high success rates and the esthetic outcome remain stable for longer observation periods. Therefore, this prospective study examines the 5-year hard and soft tissue changes at implants placed in the anterior maxilla. MATERIAL AND METHODS Meanwhile, 37 microthreaded implants were placed in 21 patients into extraction sockets with and without facial bone deficiencies by a flapless approach. Facial gaps and bony defects were grafted with autogenous bone chips. The implants were immediately provisionalized. The primary outcome parameters were the interproximal marginal bone level and the thickness of the facial bony wall. Implant success and Pink Esthetic Score (PES) were considered as secondary outcome parameters. RESULTS Two patients with four implants withdrew from the study (dropouts), and the remaining 33 implants were still in function at a follow-up period of 68 months. Marginal bone height averaged 0.04 mm coronal to the implant shoulder. The thickness of the facial bony lamellae increased significantly between pre-op examination and 1-year follow-up (p = .002) and thereafter remained stable. Within 5 years of follow-up, 24 of 33 implants were clinically stable, free of signs and symptoms, and showed bone loss less than 1 mm. The mean PES ratings improved slightly from 10.7 pre-operatively to 11.7 at the last follow-up (p = .02). CONCLUSIONS Interproximal marginal bone levels, survival rates, and esthetic results remain stable at the 5-year follow-up in implants used in an immediate insertion, reconstruction, and provisionalization concept. Facial marginal bone levels decreased slightly; however, this reduction did not affect the PES so far.
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Affiliation(s)
- Robert Noelken
- Private Practice for Oral Surgery, Lindau/Lake Constance, Germany.,Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Maximilian Moergel
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Martin Kunkel
- Department of Oral and Maxillofacial Surgery, University Hospital of Bochum, Bochum, Germany
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz, Germany
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Pal US, Daga D, Singh RK, Kumar L, Singh M. Comparison of stability with two-time use of platelet-rich growth factor versus one-time use of platelet-rich growth factor in immediate placement of dental implant in infected socket. Natl J Maxillofac Surg 2018; 9:209-214. [PMID: 30546237 PMCID: PMC6251289 DOI: 10.4103/njms.njms_1_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The aim is to evaluate the outcome and compare the stability with two-time use of platelet-rich growth factor (PRGF) versus one-time use of PRGF in immediate placement of dental implant in infected socket. MATERIALS AND METHODS This study comprised placement of immediate implant in infected sockets in 100 patients with two-time use of PRGF (Group B) versus one-time use of PRGF (Group A). Proper administration of antibiotics, careful debridement of the socket, and meticulous suturing were done in every case. In Group A, it was placed at the time of immediate implant placement. In Group B, it was placed twice: at the time of placement of implant and 1 month after placement of implant. Clinical assessment of pain and swelling was done. Stability was assessed by radiofrequency analyzer immediately after placement and at follow-up of 2 months and 3 months. RESULTS The stability of implants with two-time placement of PRGF was more than that with one-time placement of dental implant. All except 14 implants osseointegrated in this study. There was significant decrease of pain and swelling in both the groups from day 1 to week 1 and was nil by 12 weeks. CONCLUSION It can be concluded that placement of immediate implant in infected socket with two-time use of PRGF is an effective and better alternative for rehabilitation. However, more studies with longer follow-up and large number of patients are needed to confirm the results of this study.
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Affiliation(s)
- Uma Shankar Pal
- Department of Oral and Maxillofacial Surgery, Crowns and Bridges, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Dipti Daga
- Department of Oral and Maxillofacial Surgery, Crowns and Bridges, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - R. K. Singh
- Department of Oral and Maxillofacial Surgery, Crowns and Bridges, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Lakshya Kumar
- Department of Prosthodontics, Crowns and Bridges, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Mayank Singh
- Department of Prosthodontics, Crowns and Bridges, King George's Medical University, Lucknow, Uttar Pradesh, India
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Chappuis V, Araújo MG, Buser D. Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites. Periodontol 2000 2018; 73:73-83. [PMID: 28000281 DOI: 10.1111/prd.12167] [Citation(s) in RCA: 192] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The key to achieving pleasing esthetics in implant dentistry is a thorough understanding of the biological processes driving dimensional bone and soft tissue alterations post-extraction. The aim of the present report is first to characterize the extent of bone and soft tissue changes post-extraction and second to identify potential factors influencing tissue preservation in order to facilitate successful treatment outcomes. The facial bone wall thickness has been identified as the most critical factor influencing bone resorption and can be used as a prognostic tool in order to identify sites at risk for future facial bone loss subsequent to tooth extraction. Clinical studies indicated that thin bone wall phenotypes exhibiting a facial bone wall thickness of 1 mm or less revealed progressive bone resorption with a vertical loss of 7.5 mm, whereas thick bone wall phenotypes showed only minor bone resorption with a vertical loss of 1.1 mm. This is in contrast to the dimensional soft tissue alterations. Thin bone wall phenotypes revealed a spontaneous soft tissue thickening after flapless extraction by a factor of seven, whereas thick bone wall phenotypes showed no significant changes in the soft tissue dimensions after 8 weeks of healing. In sites exhibiting a limited bone resorption rate, immediate implant placement may be considered. If such ideal conditions are not present, other timing protocols are recommended to achieve predictable and pleasing esthetics. Socket preservation techniques for ridge preservation utilizing different biomaterials and/or barrier membranes often result in a better maintenance of tissue volumes, although the inevitable biological process of post-extraction bone resorption and bone modeling cannot be arrested. In summary, the knowledge of the biological events driving dimensional tissue alterations post-extraction should be integrated into the comprehensive treatment plan in order to limit tissue loss and to maximize esthetic outcomes.
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