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Deng C, Xiong C, Huo J, Liu Y, Man Y, Qu Y. Posterior open wound healing in immediate implant placement using reactive soft tissue versus absorbable collagen sponge: a retrospective cohort study. Int J Oral Maxillofac Surg 2024; 53:436-443. [PMID: 38103945 DOI: 10.1016/j.ijom.2023.11.009] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/13/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
The soft and hard tissue healing of open wounds in immediate implant placement are yet to be explored. The aim of this study was to compare the clinical outcomes of open wound healing using reactive soft tissue (RST) and absorbable collagen sponge (ACS). Forty implants placed immediately in posterior sockets were included; autologous RST was used in 20 and ACS substitute was used in 20. Soft tissue healing was primarily assessed through a novel scoring system and the evaluation of gingival recession. The horizontal bone width (HBW) and interproximal marginal bone level (MBL) were measured on radiographs to observe the hard tissue healing. No significant difference in total soft tissue healing score was observed at 2 weeks postoperatively. Notably, the ACS group showed better tissue colour (P = 0.016) but worse fibrous repair (P = 0.043) scores than the RST group. Gingival recession levels were comparable in the two groups, both before tooth extraction and after placement of the restoration. Regarding hard tissue, HBW and MBL changes showed no intergroup differences. Within the limitations of this study, both RST and ACS seemed effective for open wound closure, achieving ideal soft and hard tissue healing in immediate implant placement.
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Affiliation(s)
- C Deng
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - C Xiong
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - J Huo
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Liu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Man
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Qu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Fok MR, Jin L. Learn, unlearn, and relearn post-extraction alveolar socket healing: Evolving knowledge and practices. J Dent 2024; 145:104986. [PMID: 38574844 DOI: 10.1016/j.jdent.2024.104986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE This review was to offer a comprehensive analysis of currently available evidence on post-extraction alveolar socket healing, including i) the histological and molecular events during alveolar socket healing, ii) the dimensional ridge alterations after socket healing and controversies relating to sinus pneumatisation, iii) the patient-specific factors, procedural elements, and site-related variables influencing socket healing, iv) techniques and effectiveness of alveolar ridge preservation (ARP) procedure, and v) the philosophies and cost-effectiveness of ARP in clinical practice. SOURCES AND STUDY SELECTION To investigate the dimensional profiles of the alveolar ridge following unassisted healing, an overview of systematic reviews was conducted in February 2024 by two independent reviewers. Four electronic databases were searched in Pubmed, Embase, Web of science and Cochrane Library between 2004 and 2024 to identify all relevant systematic reviews on post-extraction healing. A further manual search of reviews was also conducted. The articles were further reviewed in full text for relevance. The AMSTAR-2 appraisal tool was adopted to assess methodological quality. Current research pertaining to other listed objectives was objectively analysed in narration. DATA 11 out of 459 retrieved studies were selected and ultimately covered in this review on the dimensional changes of alveolar ridge following natural healing: Seven systematic reviews and four systematic reviews with meta-analyses. The methodological quality of all included reviews was critically low. CONCLUSION This review thoroughly examines the healing profiles of post-extraction alveolar sockets and highlights the dynamic process with overlapping phases and the inter-individual variability in outcomes. ARP procedure is a potential strategy for facilitating prosthetic site development, while the current evidence is limited. Herein, an individualised and prosthetically driven approach is crucial. Further well sized and designed trials with novel biomaterials need to be undertaken, and the role of artificial intelligence in predicting healing and assisting clinical decision-making could be explored. CLINICAL SIGNIFICANCE By advancing our understanding of alveolar socket healing and its management strategies, clinicians can make more informed decisions regarding patient and site level assessment and selection, surgical techniques, and biomaterial choices, ultimately contributing to the enhanced healing process with reduced complications and improved quality of life for patients undergoing tooth extraction and dental implant treatments.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China.
| | - Lijian Jin
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, PR China
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Mohammadi I, Najafi A, Razavi SM, Khazaei S, Tajmiri G. Effect of buccal fat autotransplantation on improving the alveolar socket bone regeneration: An in-vivo study. Heliyon 2024; 10:e28131. [PMID: 38524537 PMCID: PMC10958428 DOI: 10.1016/j.heliyon.2024.e28131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [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: 07/15/2023] [Revised: 03/04/2024] [Accepted: 03/12/2024] [Indexed: 03/26/2024] Open
Abstract
Background There are various materials used for socket preservation following dental extraction. The aim of the present animal study was to histologically investigate the efficacy of buccal fat autotransplantation on alveolar bone regeneration following dental extraction. Study design In this prospective, double-blind laboratory experiment with a split-mouth design, 16 mandibular second premolar teeth in eight beagle dogs were extracted, and half of the extraction sockets were randomly filled using buccal fat autotransplantation. Other samples were left untouched to heal normally by the formed blood clot. Buccal fat autotransplantation was the primary predictor variable, and the type and amount of newly formed bone were the primary outcome variables. Assessment methods were the H & E coloring technique and histomorphometric evaluation. The significance level was set at 0.05, and data was subjected to Chi-Square and Wilcoxon signed-rank tests using SAS statistical software version 9.4. Results From the total number of 16 samples in 8 dogs, 50% of the samples in the intervention group represented inflammation with lower intensity compared to 33% in the control group; however, this difference was not considered statistically significant (Chi-Square test, P-value = 0.55). Wilcoxon test results showed no statistically significant difference between the two groups regarding the mean amount of total bone formation (Z = 0.00, P-value = 1.00). Conclusion It was inferred from the outcomes of the present study that when compared to the normal healing of the socket, buccal fat autotransplantation did not represent with superior outcome concerning the socket bone regeneration.
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Affiliation(s)
- Iman Mohammadi
- Department of Oral and Maxillofacial Surgery, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Najafi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sayed Mohammad Razavi
- Department of Oral and Maxillofacial Pathology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saber Khazaei
- Department of Endodontics, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Golnaz Tajmiri
- Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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de Paula LM, de Andrade Fernandes AC, Evangelista BC, do Couto Lima-Moreira F, Andrade G, de Andrade Fernandes JV, de Castro FLA, Roriz VM. Clinical and thermographic evaluation after lower third molar extractions and the application of different photobiomodulation protocols: double-blind randomised clinical trial. Clin Oral Investig 2024; 28:203. [PMID: 38453808 DOI: 10.1007/s00784-024-05594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES to compare the parameters of pain, oedema, temperature, and soft tissue closure in dental sockets that received two different photobiomodulation (PBM) protocols following extractions. MATERIALS AND METHODS Thirty-one participants had their teeth 38 and 48 extracted. Subsequently, one of the dental sockets received PBM at a wavelength (WL) of 808 nanometers (808 group- nm) and the other dental socket received the PBM at WLs of 808 nm and 660 nm, simultaneously (808 + 660 group). The PBM was applied immediately after the surgical procedure and on the 3rd and 7th days. RESULTS The mean of Visual Analogue Scale (VAS) values for pain were 1.45 for the 3rd day and 0.52 for the 7th day in the 808 + 660 and 808 group, respectively. The mean the pogonion-tragus measurement, used to assess facial oedema on the 3rd day, was 15.38 cm (range 13.5-17.5) in the 808 + 660 group and 15.48 cm (range 14.0-17.5) in the 808 group. The mean facial temperatures in the 808 + 660 group were 34.9 degrees Celsius (ºC) (range 33.5-36.4) on the 3rd day and 35 ºC (range 33.4-36.4) on the 7th day. In the 808 group, the mean temperatures were 34.9 ºC (range 33.9-36.2) on the 3rd day and 34.9 ºC (33.7-36.2) on the 7th day. Regarding the dimensions of the dental socket, the mean were similar for both groups. Significant differences between the groups were only observed in the pain parameter and only on the 7th day, being greater for the 808 + 660 group (p = 0.031). CONCLUSIONS The association of the 660 nm with 808 nm, and the increase in energy did not showed more benefits in pain reduction oedema, or acceleration of the closure of the soft tissues of the dental sockets of lower third molars, in the protocols used here. CLINICAL RELEVANCE There is no need to combine lasers at wavelengths of 660 and 808 nm to reduce oedema, pain and repair of soft tissues after extraction of lower third molars. CLINICAL TRIAL REGISTRATION This trial was registered in the Brazilian Registry of Clinical Trials (ReBEC) with the following code: RBR-66pyrh8, on 29th December, 2022.
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Affiliation(s)
- Laiz Moreira de Paula
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - Alessah Carolyna de Andrade Fernandes
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - Beatriz Castro Evangelista
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | | | - Geovana Andrade
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | - João Victor de Andrade Fernandes
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil
| | | | - Virgílio Moreira Roriz
- Department of Periodontology, School of Dentistry, Federal University of Goias, Av. Universitaria, s/n, Setor Leste Universitário, Goiania, Goiás, 74605-020, Brazil.
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Diniz JA, Dourado ACAG, Barbirato DDS, da Silveira KG, Vasconcellos RJDH, Laureano Filho JR. Effect of simvastatin topical use on alveolar bone after tooth extraction: a scoping review. Clin Oral Investig 2024; 28:86. [PMID: 38195898 DOI: 10.1007/s00784-023-05482-5] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024]
Abstract
OBJECTIVES Conducting a scoping review (SR) to assess scientific evidence for topical simvastatin's impact on alveolar bone regeneration and determine its level of support for clinical applications. MATERIALS AND METHODS This SR followed the PRISMA-ScR and OSF registries protocol; systematic searching was conducted on MEDLINE/PubMed, Cochrane, Embase, Scopus, Web of Science, and LILACS, to identify relevant articles until June 2023. Inclusion criteria covered clinical trials, case series, prospective and retrospective studies, along with in vivo investigations, involving participants of any sex and age. RESULTS Out of 1312 identified studies, 20 (9 in vivo, 11 RCTs) met inclusion criteria. RCTs focused on third molar extraction, in vivo on mandibular incisor surgery. The majority of RCTs employed a collagen sponge and a simvastatin concentration of 10mg; conversely, most in vivo studies favored polylactide-co-glycolide and a 2 mg simvastatin concentration. RCTs had 3-month follow-ups; in vivo, studies extended to 8 weeks. Seven RCTs assessed pain outcomes, simvastatin did not significantly affect pain in six studies. Among four RCTs on postoperative swelling, only two observed a significant increase in the simvastatin group. In general, positive bone formation and the absence of adverse effects directly linked to topical simvastatin were observed across the study models. CONCLUSIONS Intra-alveolar simvastatin post-tooth extraction has been to be shown to be effective and safe for preserving alveolar bone, with varied concentrations and carriers, with no significant adverse effects. CLINICAL RELEVANCE This review provides critical insights into the effects of simvastatin on alveolar bone regeneration, informing potential benefits and possible challenges associated with its post-extraction application. OSF REGISTRY PROTOCOL: osf.io/q3bnf.
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Affiliation(s)
- Jiordanne Araújo Diniz
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | - Ana Cláudia Amorim Gomes Dourado
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil.
| | - Davi da Silva Barbirato
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | - Karoline Gomes da Silveira
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
| | | | - José Rodrigues Laureano Filho
- Division of Oral and Maxillofacial Surgery, Dental School, University of Pernambuco, Arnóbio Marques St., 310, Recife, PE, 50100-130, Brazil
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Mousavi Y, Paknejad M, Taheri M, Aslroosta H, Aminishakib P, Panjnoush M, Shamshiri A. Comparison of histologic and radiographic changes of sockets grafted with LPRF and sockets without intervention after tooth extraction. Oral Maxillofac Surg 2023:10.1007/s10006-023-01190-2. [PMID: 37940776 DOI: 10.1007/s10006-023-01190-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES After tooth extraction, marked resorption occurs in extraction socket walls, leading to functional and esthetic problems in that area. One of the methods introduced to reduce this resorption is the use of platelet derivatives. This study aimed to evaluate the effects of leukocyte and platelet-rich fibrin (L-PRF) on the changes following tooth extraction. MATERIALS AND METHODS The participants were 24 patients who needed to replace at least one single-rooted tooth with an implant. They were randomly divided into test and control groups. After the tooth extraction, the sockets in the test group received LPRF clots, while in the control group, the sockets were left free of any interventions. CBCT scans were obtained from the extraction site both immediately after the tooth extraction and 8 weeks later. The histologic biopsy was also obtained while the implant site was being prepared 8 weeks after the extraction. RESULTS The average vertical bone loss in the buccal crest was not significantly different between the two groups (1.67 ± 1.67 in the test group and 2.3 ± 1.36 in the control group; mean difference = - 0.36, 95% CI: - 1.65-0.93, p-value = 0.57). Nor was the difference in resorption of the palatal wall (mean difference = - 0.19, 95% CI: - 1.51.12, p-value = 0.76). The mean ridge width resorption in 25% of the coronal aspect of sockets was also measured in the test (1.30 ± 0.66) and control group (0.58 ± 0.95) (mean difference = 0.73, 95% CI: 0.03-1.42, p-value = 0.04). The new bone formation in histologic view was not statistically different between groups (p-value = 0.15). CONCLUSION The LPRF neither reduces the rate of ridge resorption in vertical or horizontal dimensions of extraction sockets nor induces more new bone formation. CLINICAL RELEVANCE This study helps dentists choose the appropriate material for ridge preservation.
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Affiliation(s)
| | - M Paknejad
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Taheri
- Periodontist, Private Practice, Tehran, Iran
| | - H Aslroosta
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - P Aminishakib
- Oral and Maxillofacial Pathology Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M Panjnoush
- Oral and Maxillofacial Radiology Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - A Shamshiri
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Solyom E, Szalai E, Czumbel ML, Szabo B, Váncsa S, Mikulas K, Radoczy-Drajko Z, Varga G, Hegyi P, Molnar B, Fazekas R. The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation - meta-analysis and systematic review. BMC Oral Health 2023; 23:226. [PMID: 37076844 PMCID: PMC10116659 DOI: 10.1186/s12903-023-02930-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [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: 01/30/2023] [Accepted: 04/02/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP. METHODS A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis. RESULTS The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth. CONCLUSIONS ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP. TRIAL REGISTRATION The study protocol was registered on PROSPERO (CRD42021287890).
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Affiliation(s)
- Eleonora Solyom
- Department of Periodontology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Eszter Szalai
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi Utca 47, 1088, Budapest, Hungary
| | - Márk László Czumbel
- Department of Periodontology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Szabo
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Krisztina Mikulas
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | | | - Gabor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Balint Molnar
- Department of Periodontology, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Reka Fazekas
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Szentkirályi Utca 47, 1088, Budapest, Hungary.
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Jang HJ, Choi YK, Kwon EY, Choi WH, Song JM. Is it worth applying self-irrigation after third molar extraction? A randomised controlled trial. Br J Oral Maxillofac Surg 2022; 60:877-883. [PMID: 35750564 DOI: 10.1016/j.bjoms.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/09/2021] [Accepted: 07/14/2021] [Indexed: 12/31/2022]
Abstract
In this study, we aimed to examine the effectiveness of self-irrigation following the extraction of mandibular third molars. A randomised controlled clinical trial was conducted with 155 patients who had undergone extraction of a mandibular third molar. The irrigation group was instructed to self-irrigate the extraction socket with tap water using a syringe three times a day, starting seven days after the tooth extraction. The incidence of complications and mouth opening, halitosis, plaque/gingival index, and oral health-related quality of life (OHRQoL) were measured. The irrigation group showed a lower incidence of complications than the non-irrigation group. The halitosis, plaque, and gingival scores were lower by mean (SD) 19.66 (5.19), 0.58 (0.06), and 0.62 (0.08), respectively, in the irrigation group than in the non-irrigation group (p = 0.0001). A greater amount of food packing was associated with higher halitosis, plaque, and gingival scores and poorer OHRQoL (p < 0.05). Further, more frequent irrigation was associated with lower halitosis, plaque, and gingival scores and better OHRQoL (p ≤ 0.016). Self-irrigation of the extraction socket using a syringe containing tap water is a very effective method for keeping the extraction socket clean. This technique reduced halitosis, improved plaque and gingival indices, and increased OHRQoL.
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Affiliation(s)
- Hyo-Jin Jang
- (Bio)medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
| | - Youn-Kyung Choi
- (Bio)medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Orthodontics, Biomedical Research Institute, Pusan National University Hospital, Yangsan, Busan, Republic of Korea.
| | - Eun-Young Kwon
- (Bio)medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Periodontology, Dental Clinic Center, Pusan National University Hospital, Busan, Republic of Korea.
| | - Won-Hyuk Choi
- (Bio)medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.
| | - Jae-Min Song
- (Bio)medical Research Institute, Pusan National University Hospital, Busan, Republic of Korea; Department of Oral and Maxillofacial Surgery, School of Dentistry, Pusan National University, Yangsan, Republic of Korea; Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea.
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9
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Dalirsani Z, Ghazi N, Delavarian Z, Pakfetrat A, Esmaily H, Davaji M, Alavi H, Salari Sedigh H, Shafieian R. Effects of diode low-level laser therapy on healing of tooth extraction sockets: a histopathological study in diabetic rats. Lasers Med Sci 2021; 36:1527-1534. [PMID: 33644838 DOI: 10.1007/s10103-021-03270-9] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 02/10/2021] [Indexed: 11/29/2022]
Abstract
Diabetes mellitus is mostly interrelated to deficiency in wound healing. Low-level laser therapy has been shown to exert reliable effects on the acceleration of wound healing process. This study aimed to determine the potential influence of low-level laser therapy (LLLT) on the healing of extraction sockets in diabetic rats. A total of 24 healthy male Wistar rats were selected for this study. After diabetes induction, the maxillary first molars of all rats were extracted bilaterally. Then, the animals were subjected either to Ga-Al-As laser at 808 nm or to Al-Ga-In-P laser at 660 nm at the right extracted socket every day for the next 14 days. The left sockets served as controls. Rats were sacrificed on the 3rd, 5th, 7th, and 14th days after tooth extraction. The samples were examined by a pathologist. LLLT at 808 nm was able to significantly repress inflammation, improve osteoid formation, and promote vascularization in comparison to the non-treated sockets. LLLT at 660 nm significantly suppressed inflammation and developed vascularization in comparison to the non-treated sockets, but failed to improve osteoid formation in the treated sockets. This study suggests that LLLT could be considered as a reliable treatment for wound healing in diabetic experimental rats.
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Affiliation(s)
- Zohreh Dalirsani
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Narges Ghazi
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Delavarian
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Atessa Pakfetrat
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mina Davaji
- Department of Endodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Alavi
- Oral & Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Salari Sedigh
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Reyhaneh Shafieian
- Department of Anatomy and Cell Biology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Abstract
Immediate implant placement (IIP) in fresh extraction sockets exhibits similar survival and success rates to delayed implant placement in healed sockets. Several advantages of IIP involve shortened total treatment time, reduction of the number of invasive surgeries, and subsequent reduction of patient discomfort due to lack of additional surgeries. The major shortcomings in IIP, however, include the inability to obtain early bony support, presence of a gap between the extraction socket and fixture, and the inability to cover the fixture with soft tissue, leading to increased risk of infection and implant loss. When IIP is performed, atraumatic or minimally traumatic extractions, conservation of the septal bone in molars, minimal flap elevation or flapless surgery, bone grafting the gap between the fixture and the extraction socket, and coverage with soft tissue or a membrane must be considered.
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Affiliation(s)
- Won Lee
- Department of Dentistry, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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11
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López-Pacheco A, Soto-Peñaloza D, Gómez M, Peñarrocha-Oltra D, Alarcón MA. Socket seal surgery techniques in the esthetic zone: a systematic review with meta-analysis and trial sequential analysis of randomized clinical trials. Int J Implant Dent 2021; 7:13. [PMID: 33615421 PMCID: PMC7897591 DOI: 10.1186/s40729-021-00294-2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/25/2021] [Indexed: 01/08/2023] Open
Abstract
Background The socket seal surgery (SSS) technique is a common alternative for the management of the post-extraction sockets that requires a primary closure of the wound to promote proper regeneration and ridge preservation. Objective To learn about the effect of different SSS techniques on alveolar ridge preservation Material and methods Two independent and calibrated reviewers conducted an electronic search in PubMed, Cochrane, and Web of Science for randomized clinical trials (RCT) published up to June 2020. The evaluation of the risk of bias in the included studies was carried out following the Cochrane manual for interventions of systematic reviews, version 5.1.0. A meta-analysis of ridge width changes at − 1, − 3, and − 5 mm cutoff points from bone crest was conducted using a random-effects model. The risk of types I and II errors against accrued data was appraised obtaining the required information size using a trial sequential analysis package (TSA). Results A total of 135 sockets located in the esthetic zone were evaluated with a minimum of a 3-month follow-up after tooth extraction in 6 RCTs. The evaluated SSS techniques were free gingival graft (FGG), collagen matrix (CM), collagen sponge (CS), acellular dermal matrix (ADM), and polytetrafluoroethylene membrane (PTFEm). The FGG in sockets without bone filling showed significant results in preserving both buccal and lingual bone height (− 1.42 mm in the experimental group versus − 0.01 in the control group). The comparison of CM and FGG with bone filling did not show clinical differences in terms of dimensional bone changes. No clinical differences were found in either width or gingival thickness when comparing CM and CS. The meta-analyses of RW changes comparing CM versus FGG showed no significant differences, but a trend for lessening horizontal reduction at − 1, − 3, and − 5 mm in favor of FGG. The TSA showed that accrued data did not reach the required information size, and more evidence is required for clinical significance inferences. Conclusions There are several predictable SSS techniques to improve clinical results in ridge preservation. More clinical studies in the form of clinical trials are required to demonstrate the superiority of one technique over another. Supplementary Information The online version contains supplementary material available at 10.1186/s40729-021-00294-2.
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Affiliation(s)
- Andrea López-Pacheco
- PerioImplant Research Group UPCH, Academic Department of Clinical Stomatology, Cayetano Heredia Peruvian University, Lima, Peru.
| | - David Soto-Peñaloza
- Oral Surgery Unit, Department of Stomatology, Valencia University Medical and Dental School, Valencia, Spain
| | - Mayra Gómez
- Academic Department of Clinical Stomatology, Section of Oral Implantology, Cayetano Heredia Peruvian University, Lima, Peru
| | - David Peñarrocha-Oltra
- Oral Surgery Unit, Department of Stomatology, Valencia University Medical and Dental School, Valencia, Spain
| | - Marco Antonio Alarcón
- PerioImplant Research Group UPCH, Academic Department of Clinical Stomatology, Cayetano Heredia Peruvian University, Lima, Peru
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Kim JJ, Ben Amara H, Chung I, Koo KT. Compromised extraction sockets: a new classification and prevalence involving both soft and hard tissue loss. J Periodontal Implant Sci 2021; 51:100-113. [PMID: 33913633 PMCID: PMC8090797 DOI: 10.5051/jpis.2005120256] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 08/06/2020] [Revised: 12/01/2020] [Accepted: 12/30/2020] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. METHODS A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. RESULTS The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). CONCLUSIONS The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.
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Affiliation(s)
- Jung Ju Kim
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), Seoul National University School of Dentistry, Seoul, Korea
| | - Heithem Ben Amara
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), Seoul National University School of Dentistry, Seoul, Korea
| | - Inna Chung
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), Seoul National University School of Dentistry, Seoul, Korea
| | - Ki Tae Koo
- Department of Periodontology and Dental Research Institute, Translational Research Laboratory for Tissue Engineering (TTE), Seoul National University School of Dentistry, Seoul, Korea.
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Verdugo F, Laksmana T, D'Addona A, Uribarri A. Facial cortical bone regeneration post-extraction in non-grafted sockets allows for early implant placement and long-term functional stability. Arch Oral Biol 2020; 112:104678. [PMID: 32062103 DOI: 10.1016/j.archoralbio.2020.104678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/13/2019] [Accepted: 02/05/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate posterior implant placement feasibility shortly after tooth extraction in non-grafted sockets with and without dehiscence at the time of extraction. DESIGN Ninety-five patients requiring posterior extractions entered this cross-sectional study. They were divided in three groups after extraction: G1 without dehiscence, G2 with dehiscence ≤5 and G3 > 5 mm. CBCT were taken prior to implant placement at an average of 12-weeks post-extraction to evaluate the need for grafting, cortical bone formation and bucco-lingual width (BLW). Actual BLW (n = 60) were compared to minimum expected BLW in 3 scenarios of BLW thickness averaging 6.4-7.4-8.4 mm. Peri-implant tissues were assessed for pocket formation and inflammation following established success criteria. RESULTS New cortical bone formation and sufficient BLW made implant placement feasible in sites with and without dehiscence at the time of extraction after an average healing time of 11.9 ± 2.4weeks (range: 8-18). Total average CBCT BLW was 10.1 ± 1.6 mm. All groups had a significantly higher BLW, than scenarios 1-3 (p < 0.0001). Molars were 20 times more likely than premolars to heal with BLW>10 mm (OR = 20; RR = 4.2; CI95 %: 5.3-74.2; p < 0.0001). Dehiscence sockets were 1.5 times more likely than non-dehiscenced sockets to present BLW ≤ 10 mm (OR = 1.5; RR = 0.6; CI95 %:0.9-2.5; p = 0.08). A band of keratinized tissue was present in all implants and success rates were 100 % at an average follow-up of 51.0 ± 23.4 months. CONCLUSION Implant placement is feasible without socket grafting shortly after tooth extraction. Non-grafted sockets present a significant osteogenic potential. Dehiscence sockets are likely to self-repair by forming a new cortical plate. The unassisted regenerated intra-socket bone allows for functional implant stability long-term.
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Iorio-Siciliano V, Ramaglia L, Blasi A, Bucci P, Nuzzolo P, Riccitiello F, Nicolò M. Dimensional changes following alveolar ridge preservation in the posterior area using bovine-derived xenografts and collagen membrane compared to spontaneous healing: a 6-month randomized controlled clinical trial. Clin Oral Investig 2019; 24:1013-1023. [PMID: 31286260 DOI: 10.1007/s00784-019-02979-w] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/20/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To assess dimensional changes following alveolar ridge preservation using bovine-derived xenograft with 10% collagen and collagen membrane compared to ridge preservation by means of bovine-derived xenograft particles and collagen membrane or spontaneous healing in posterior sites. MATERIALS AND METHODS Forty subjects with 40 posterior teeth or roots candidate to extraction and presenting integrity of alveolar bone walls were randomly allocated into three groups. Patients of test group were treated by ridge preservation technique using bovine-derived xenograft with 10% collagen and collagen membrane; patients of control group 1 were treated by means of bovine-derived xenograft particles and collagen membrane while in patients of control group 2, no grafting was performed. Changes in vertical and horizontal bone dimensions were compared at baseline and after 6-month observation time. RESULTS Statistically significant differences between baseline and 6 month were observed in all groups in terms of vertical and horizontal bone resorption (p < 0.001), except for vertical resorption in control group 2. After 6-month intergroup comparisons showed not statistically significant changes between test and control groups in terms of alveolar bone changes (p > 0.05). CONCLUSIONS Within the limits of this study, the sites grafted using bovine-derived xenograft with 10% collagen in combination with a collagen membrane showed no statistical differences in terms of vertical and horizontal bone resorption compared to control groups. CLINICAL RELEVANCE Ridge preservation in posterior area failed to show clinically relevant benefits in sites presenting integrity of alveolar bone walls and adequate buccal bone wall thickness.
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Affiliation(s)
| | - Luca Ramaglia
- Department of Oral Surgery, University of Naples Federico II, Naples, Italy. .,Università di Napoli Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy.
| | - Andrea Blasi
- Department of Periodontology, University of Naples Federico II, Naples, Italy
| | - Paolo Bucci
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Paolo Nuzzolo
- Department of Oral Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Riccitiello
- Department of Restorative Dentistry, University of Naples Federico II, Naples, Italy
| | - Michele Nicolò
- Department of Periodontology, University of Naples Federico II, Naples, Italy
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Ervolino E, Statkievicz C, Toro LF, de Mello-Neto JM, Cavazana TP, Issa JPM, Dornelles RCM, de Almeida JM, Nagata MJH, Okamoto R, Casatti CA, Garcia VG, Theodoro LH. Antimicrobial photodynamic therapy improves the alveolar repair process and prevents the occurrence of osteonecrosis of the jaws after tooth extraction in senile rats treated with zoledronate. Bone 2019; 120:101-113. [PMID: 30339908 DOI: 10.1016/j.bone.2018.10.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 09/26/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Abstract
This study evaluated the effects of antimicrobial photodynamic therapy (aPDT) in the alveolar repair of rats with major risk factors for bisphosphonate-related osteonecrosis of the jaws (BRONJ). Senile rats received 0.45 ml of vehicle (VEH and VEH/aPDT) or 0.45 ml of zoledronate (ZOL and ZOL/aPDT) every three days for seven weeks. After three weeks of treatment, the first lower left molar was extracted. VEH/aPDT and ZOL/aPDT were submitted to aPDT on the extraction site at 0, 2 and 4 days postoperatively. Euthanasia was performed 28 days postoperatively and the extraction site was evaluated by clinical, histological, histometric, histochemical and immunohistochemical analysis. ZOL showed tissue repair impairment; lower percentage of newly formed bone tissue (NFBT); higher percentage of non-vital bone tissue (NVBT); fewer mature collagen fibers and increased immunolabeling for tumor necrosis factor (TNFα), interleukin (IL)-1β and IL-6. ZOL/aPDT showed clinical and histological characteristics of the extraction site, percentage of NFBT and percentage of mature collagen fiber similar to VEH. Percentage of NVBT and immunolabeling for inflammatory cytokines in ZOL/aPDT was lower than in ZOL. Immunolabeling for tartarato-resistant acid phosphatase (TRAP) was lower in ZOL and ZOL/aPDT. aPDT in the dental extraction site improves tissue repair process and prevents the occurrence of BRONJ-like lesions after tooth extraction.
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Affiliation(s)
- Edilson Ervolino
- São Paulo State University (UNESP), School of Dentistry, Department of Basic Sciences, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil; São Paulo State University (UNESP), Institute of Biosciences, Rua Prof. Dr. Antônio Celso Wagner Zanin, 250, CEP 18618-689, Botucatu, SP, Brazil; Group for the Research and Study of Laser in Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil.
| | - Cristian Statkievicz
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Luan Felipe Toro
- São Paulo State University (UNESP), Institute of Biosciences, Rua Prof. Dr. Antônio Celso Wagner Zanin, 250, CEP 18618-689, Botucatu, SP, Brazil; Group for the Research and Study of Laser in Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - João Martins de Mello-Neto
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil; Group for the Research and Study of Laser in Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Thamires Priscila Cavazana
- São Paulo State University (UNESP), School of Dentistry, Department of Pediatric Dentistry and Public Health, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - João Paulo Mardegan Issa
- São Paulo University (USP), School of Dentistry, Department of Morphology, Physiology and Basic Pathology, Avenida do Café, s/n, CEP 14040-904, Ribeirão Preto, SP, Brazil
| | - Rita Cássia Menegati Dornelles
- São Paulo State University (UNESP), School of Dentistry, Department of Basic Sciences, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Juliano Milanezi de Almeida
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Maria José Hitomi Nagata
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Roberta Okamoto
- São Paulo State University (UNESP), School of Dentistry, Department of Basic Sciences, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil; São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Cláudio Aparecido Casatti
- São Paulo State University (UNESP), School of Dentistry, Department of Basic Sciences, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Valdir Gouveia Garcia
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil; Group for the Research and Study of Laser in Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
| | - Leticia Helena Theodoro
- São Paulo State University (UNESP), School of Dentistry, Department of Surgery and Integrated Clinic, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil; Group for the Research and Study of Laser in Dentistry, São Paulo State University (UNESP), School of Dentistry, Rua José Bonifácio, 1193, CEP 16015-050, Araçatuba, SP, Brazil
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16
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Matveeva N, Popovska L, Evrosimovska B, Chadikovska E, Nikolovska J. Morphological alterations in the position of the mandibular foramen in dentate and edentate mandibles. Anat Sci Int 2018; 93:340-50. [PMID: 29222672 DOI: 10.1007/s12565-017-0423-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 09/27/2017] [Indexed: 11/25/2022]
Abstract
The technique of inferior alveolar nerve (IAN) block must be based on precise anatomical knowledge regarding the correct position of the mandibular foramen (MF). The aim of the investigation reported here was to determine the anatomic and topographic localization of the MF according to mandibular ramus anatomic landmarks and to identify morphological alterations in the position of the MF and size and shape of the ramus in terms of the impact of tooth socket loss in the molar and premolar region. Seventy-three dry human adult mandibles were divided into two groups according to dental status. These were measured to determine the distances from the anterior and posterior ramus border (AB, PB) to the midpoint of the MF fossa, and from the mandibular notch (MN) and inferior ramus border (IB) to the MF entering point. A number of relevant ramus anatomic features were analyzed, such as ramus width (RW), height (RH), and thickness (RT). The MF was closer to the PB and IB in edentate mandibles (right/left mean PB-MF 10.66 ± 1.84/11.06 ± 2.05 mm; right/left mean IB-MF 21.77 ± 3.23/21.8 ± 2.27 mm) compared to dentate mandibles (right/left mean PB-MF 11.87 ± 2.08/12.04 ± 1.94 mm; right/left mean IB-MF 22.94 ± 3.09/22.74 ± 3.74 mm). Edentate mandibles demonstrated reduced RW (right/left mean RW 26.03 ± 3.53/26.49 ± 3.90 mm), significantly reduced (p = 0.03) right RH (right/left mean RH 43.56 ± 4.74/45.43 ± 4.86 mm), and significantly reduced (p < 0.05) RT in the area of the MF fossa depression (right/left mean RT 5.52 ± 1.21/5.21 ± 0.91 mm) compared to dentate mandibles (right/left mean RW 27.34 ± 3.84/27.48 ± 3.80 mm; right/left mean RH 46.33 ± 4.52/47.40 ± 4.20 mm; right/left mean RT 7.86 ± 1.98/8.10 ± 1.92 mm). Alterations in MF position and mandibular ramus anatomic features in edentate mandibles increase the potential risk of complications and failure of IAN block.
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Wang Z, Zhou L, Xu DL, Xu SL. [Classification of the anatomical structures of maxillary central incisor root by cone-beam CT]. Zhonghua Kou Qiang Yi Xue Za Zhi 2017; 52:656-660. [PMID: 29972943 DOI: 10.3760/cma.j.issn.1002-0098.2017.11.002] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To examine the root position of the maxillary central incisors and to provide clinical reference before the immediate implant placement. Methods: Cone-beam CT (CBCT) data of the maxillary central incisors of 934 patients (934 incisors) was selected and the root position classsified. The sagittal root position in the alveolar bone was classified as buccal, middle, or palatal. The buccally positoined type was further classified into three subtypes of Ⅰ,Ⅱ, and Ⅲ. Results: Most of the maxillary incisor root (95.4% [891/934]) was positioned buccally. Among the buccal-type incisors, the subtypes Ⅰ, Ⅱ and Ⅲ accounted for 47.5% (423/891), 44.2% (394/891), and 8.3% (74/891). In the 4 mm apical to the cemento-enamel junction and the middle of the root, the thickest buccal bone wall was 0.86 and 0.95 mm, the thickest palatal bone wall was 1.65 and 2.37 mm. In the apical location, the thickest buccal bone wall was 1.89 mm, the thickest palatal bone wall was 7.83 mm. Conclusions: Most of the maxillary central incisors studied are positioned buccally, and half of these patients have adequate buccal bone and are suitable for immediate implant placement.
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Affiliation(s)
- Z Wang
- Dental Implant Center, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China(Present address: Department of Stomatology, First People's Hospital of Baiyun District, Guangzhou 510400, China)
| | - L Zhou
- Dental Implant Center, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - D L Xu
- Dental Implant Center, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
| | - S L Xu
- Dental Implant Center, Stomatological Hospital, Southern Medical University, Guangzhou 510280, China
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18
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Tao R, Meng M, Niu LN, Chen JH, Nico CF, Ma C. [Investigation of sagittal root position in relation to the anterior maxillary alveolar bone: a cone-beam CT study in 300 cases with normal occlusion]. Zhonghua Kou Qiang Yi Xue Za Zhi 2017; 52:631-636. [PMID: 29972938 DOI: 10.3760/cma.j.issn.1002-0098.2017.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the sagittal root position and apical bone height of the maxillary anterior teeth in order to provide anatomical information for immediate implant placement in the esthetic region. Methods: Cone-beam CT (CBCT) data from 300 randomly selected patients who met the inclusion criteria were included in this study. After three-dimensional reconstruction, the sagittal plane (the sagittal plane through the long axis of the tooth) was determined. The positions and angulations of the tooth roots were classified with reference to the alveolar process. By comparing the buccal and palatal bone thickness at the mid-root level, the toot positions with reference to the mid-alveolar line were defined and classified as follows, type B (closer to the buccal alveolar surface), type M (midway between the buccal and palatal alveolar surface) and type P (closer to the palatal alveolar surface). By comparing the angulations of the alveolar process with the long axis of the roots, the angulations were classified as follows, type 1 (root apex angulated toward the palatal side or parallel to the alveolus), type 2 (root apex angulated toward the buccal side with the long axis passing posterior to point A) and type 3 (root apex angulated toward the buccal side with the long axis passing anterior to point A). The frequency of each category was counted and the apical bone height was measured. The subjects were divided into three age groups, 19-30 years, 31-50 years and 51-75 years. Results: The overall mean apical bone height of the healthy maxillary central incisors was (9.2±3.0) mm, the lateral incisors was (10.0±2.9) mm and the canine was (8.1±3.1) mm. There was no significant difference in the height of apical bone between central incisors and lateral incisors (P>0.05). There was no significant difference in the height of apical bone between male and female (P>0.05). The height of apical bone in group 31-50 years and 51-75 years were greater than that in group 19-30 years (P<0.05), respectively. The proportion of the maxillary anterior teeth type B, M, P was 98.5% (1 774/1 800), 0.3% (5/1 800) and 1.2% (21/1 800) respectively. The proportion of type 1, 2, 3 was 2.6% (46/1 800), 58.6% (1 055/1 800) and 38.8% (699/1 800) respectively. Conclusions: There was enough apical bone height in the area of maxillary anterior teeth, but the majority of roots positioned more buccally.
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Affiliation(s)
- R Tao
- Department of Operative Dentistry, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - M Meng
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - L N Niu
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - J H Chen
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
| | - C F Nico
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China [Present address: Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands]
| | - Chufan Ma
- Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University & State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology, Xi'an 710032, China
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19
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Chang H, Kim S, Hwang JW, Kim S, Koo KT, Kim TI, Seol YJ, Lee YM, Ku Y, Lee JH, Rhyu IC. Comparative, randomized, double-blind clinical study of alveolar ridge preservation using an extracellular matrix-based dental resorbable membrane in the extraction socket. J Periodontal Implant Sci 2017; 47:165-173. [PMID: 28680712 PMCID: PMC5494311 DOI: 10.5051/jpis.2017.47.3.165] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [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: 05/08/2017] [Accepted: 06/01/2017] [Indexed: 11/10/2022] Open
Abstract
Purpose The aim of this study was to radiographically and clinically compare the effect of extracellular matrix (ECM) membranes on dimensional alterations following a ridge preservation procedure. Methods One of 2 different ECM membranes was applied during a ridge preservation procedure. A widely used ECM membrane (WEM; Bio-Gide, Geistlich Biomaterials, Wolhusen, Switzerland) was applied in the treatment group and a newly developed ECM membrane (NEM; Lyso-Gide, Oscotec Inc., Seongnam, Korea) was applied in the control group. Cone-beam computed tomography (CBCT) scans and alginate impressions were obtained 1 week and 6 months after the ridge preservation procedure. Results were analyzed using the independent t-test and the nonparametric Mann-Whitney U test. Results There were no significant differences between the ECM membranes in the changes in the dimension, width, and height of the extraction socket or the quantity of bone tissue. Conclusions The NEM showed comparable clinical and radiographic results to the WEM following the ridge preservation procedure.
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Affiliation(s)
- Hyeyoon Chang
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Sulhee Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Jin Wook Hwang
- ESTeam Paris Sud, INSERM UMR-S 935, Paris-Sud University, Paris-Saclay University, Villejuif, France
| | - Sungtae Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Tae-Il Kim
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Yang-Jo Seol
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Yong-Moo Lee
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, Seoul National University School of Dentistry, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea
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20
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Hamad SA, Naif JS, Abdullah MA. Effect of Diode Laser on Healing of Tooth Extraction Socket: An Experimental Study in Rabbits. J Maxillofac Oral Surg 2015; 15:308-314. [PMID: 27752199 DOI: 10.1007/s12663-015-0842-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2015] [Accepted: 08/28/2015] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES To evaluate the effect of low-level laser therapy on healing of extracted tooth socket of healthy rabbits. DESIGN The sample of this study was 20 male rabbits of 2-2.5 kg weight with age range of 8-12 months. Right and left lower first premolar teeth were extracted. The extraction sockets of lower right first premolar were irradiated with 0.9 W gallium-aluminum-arsenide (GaAlAs) diode laser for 5 min, immediately after extraction and then every 72 h for the next 12 days. The extraction socket of left side were not exposed to laser and served as a control. The animals were sacrificed after 7, 14, 30 and 45 days and the experimental and control sockets were removed from the harvested mandibles and prepared for haematoxylin and eosin staining and Masson's stain. The prepared slides were examined under light microscope for histological and histomorphometric examination. RESULTS The histological examination showed that diode laser-treated sockets demonstrated early formed new bone with faster maturation of primary bone to secondary bone as compared to non-treated control sockets. Histomorphometric analysis revealed a statistically significant increase in the density and volume of trabecular bone in laser-treated sockets than control sockets. CONCLUSION Diode laser application to tooth extraction socket has a positive effect on bone formation.
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Affiliation(s)
- Shehab Ahmed Hamad
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Hawler Medical University, Erbil, Kurdistan Region Iraq
| | - Jandar S Naif
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Duhok University, Duhok, Kurdistan Region Iraq
| | - Mahdi A Abdullah
- Department of Histology, Faculty of Veterinary Medicine, University of Duhok, Duhok, Kurdistan Region Iraq
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21
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Kim DJ, Cha JK, Yang C, Cho A, Lee JS, Jung UW, Kim CS, Lee SJ, Choi SH. Changes in periodontium after extraction of a periodontally-involved tooth in rats. J Periodontal Implant Sci 2012. [PMID: 23185696 PMCID: PMC3498300 DOI: 10.5051/jpis.2012.42.5.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 11/30/2022] Open
Abstract
Purpose Recent interest has focused on intentional replantation to restore an original tooth. Some studies have shown successful results with intentional replantation for periodontally involved teeth. For long-term success of replantation, a healthy periodontal status of the recipient site is required so that delayed replantation is more suitable for periodontally involved teeth. To reveal the ideal timing for delayed replantation of periodontally involved teeth, the healing process of extraction sockets after extraction of periodontitis-induced teeth in rats was evaluated. Methods Twenty-eight rats were randomly divided into two groups: a control group (n=8) and test group (n=20). In the test group, periodontitis was induced by a ligature around the cervix of the mandibular first molar of all of the rats. Two weeks later, the mandibular first molars were extracted in all of the animals. The animals were sacrificed on days 0, 3, 7, and 10 after extraction and histological and immunohistochemical analysis was performed. Results In histological analysis of the test group, inflammatory cell infiltrate was found abundantly in the remaining periodontium 3 days after tooth extraction and decreased gradually at later time points. In immunohistochemical analysis of the test group, both interleukin-6 (IL-6) and, tumor necrosis factor-α (TNF-α) were numerous in the furcation area at each postextraction day. IL-6 was stained more heavily between 3 and 7 days after extraction; at day 10 after extraction, little staining was observed. TNF-α staining was more intense at 3 days after extraction and gradually weakened at later points in time. Conclusions Within the limits of this study, it takes at least 10 days to resolve periodontal inflammation in rat extraction sockets.
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Affiliation(s)
- Dong-Ju Kim
- Department of Periodontology, Yonsei University College of Dentistry, Seoul, Korea
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22
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Yun JH, Jun CM, Oh NS. Secondary closure of an extraction socket using the double-membrane guided bone regeneration technique with immediate implant placement. J Periodontal Implant Sci 2011; 41:253-8. [PMID: 22087417 PMCID: PMC3213237 DOI: 10.5051/jpis.2011.41.5.253] [Citation(s) in RCA: 11] [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: 08/11/2011] [Accepted: 09/26/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.
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Affiliation(s)
- Jeong-Ho Yun
- Department of Dentistry, Inha University School of Medicine, Incheon, Korea
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Haghighat A, Hekmatian E, Abdinian M, Sadeghkhani E. Radiographic Evaluation of Bone Formation and Density Changes after Mandibular Third Molar Extraction: A 6 Month Follow up. Dent Res J (Isfahan) 2011; 8:1-5. [PMID: 22132008 PMCID: PMC3177375] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND There is a controversy about exact time of bone healing. The aim of this study was evaluation of bone formation and change of density after mandibular third molar extraction. METHODS Radiographs were taken from 16 empty tooth sockets immediately after extraction of mandibular third molars and 2, 4 and 6 months later under similar condition. The radiographs were digitized and the density numbers of pixels were calculated. Then, socket and neighbor regions were compared using Photoshop software. Three expert observers evaluated and compared the radiographs by the longitudinal radiographic assessment (LRA) method. Paired t-test and McNemar test were used to analyze the data and investigate the inter-observer reliability, respectively. RESULTS Analysis of the quantitative digital subtraction radiography (QDSR) data indicated that the difference between the digital numbers of interest points and reference points has been decreased during the months 2, 4 and 6 but the difference between the month 4 and 6 was not significant. The alternative method indicated that the mean digital numbers in the socket within 0and 2 months period was less than 128 and within 4 and 6 months was more than 128. In evaluation of LRA method, lamina dura started to change gradually in month 2 and it might disappear completely after 6 months. CONCLUSION Both QDSR and LRA methods can be used in evaluation of the rate of bone formation in the tooth socket but the former is more precise.
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Affiliation(s)
- Abbas Haghighat
- Assistant Professor, Department of Oral and Maxillofacial Sergury and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ehsan Hekmatian
- Assistant Professor, Department of Oral and Maxillofacial Radiology and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Abdinian
- Assistant Professor, Department of Oral and Maxillofacial Radiology and Torabinejad Dental Research Center, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ezzeddin Sadeghkhani
- Dental Student, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Park JY, Koo KT, Kim TI, Seol YJ, Lee YM, Ku Y, Rhyu IC, Chung CP. Socket preservation using deproteinized horse-derived bone mineral. J Periodontal Implant Sci 2010; 40:227-31. [PMID: 21072219 PMCID: PMC2967810 DOI: 10.5051/jpis.2010.40.5.227] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [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: 06/20/2010] [Accepted: 09/07/2010] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. METHODS The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. RESULTS The surgical sites healed uneventfully. The mean ridge width was 7.75 ± 2.75 mm at baseline and 7.00 ± 2.45 mm at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was 7.5 ± 5.20 mm, and at 6 months, 3.50 ± 0.58 mm. The mean palatal crest height at baseline was 7.75 ± 3.10 mm, and at 6 months, 5.00 ± 0.82 mm. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was 9.88 ± 2.90%, the amount of graft particles was 42.62 ± 6.57%, and the amount of soft tissue was 47.50 ± 9.28%. CONCLUSIONS Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.
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Affiliation(s)
- Jang-Yeol Park
- Department of Periodontology and Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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25
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Kadkhodazadeh M, Mollaverdi F, Abdolsamadi HR, Azar R, Ghasemian Pour M, Ahmadpour S. Histologic effects of demineralized bone matrix on regeneration of alveolar socket in diabetic rats. Iran Endod J 2009; 4:20-4. [PMID: 23864872 PMCID: PMC3712264] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2008] [Revised: 10/06/2008] [Accepted: 11/08/2008] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this in vivo study was to determine the effect of demineralized bone matrix (DBM) on alveolar bone repair in type I diabetic rats. MATERIALS AND METHODS This study was carried out on 40 adult (8 weeks-old) albino rats with an average weight of 200-250 grams. The animals were divided into four groups (n=10) as follows: group 1 nondiabetic rats, group 2, 3 and 4 were diabetic rats, group 4 rats took one unit of insulin daily. Diabetes was induced by Alloxan Monohydrate through the tail veins of the rats in groups 2-4. Only group 4 received insulin NPH 1 unit daily. After 10 days, the upper right incisors of all samples were extracted and the socket was filled with DBM in groups 3 and 4. The animals were sacrificed at the end of week 1 and 2. The specimens were prepared and stained with H&E. RESULTS Histological results of group 4 displayed osteoblastic activity and bone formation with collagen fibers at the end of the first week and thick bone trabeculae formation in vicinity of DBM at the end of second week. In group 3, DBM showed some osteoinductivity at the end of the first week, but in some regions DBM particles were degraded by osteoclastic activity. Bone trabeculae formed with a dispersed and separate pattern at the end of second week. In group 2 hematoma and inflammation were dominant histological features at the end of first and second weeks; poor bone formation was detected in these two groups (2 and 3). In group 1, the results were as expected. CONCLUSION It seems demineralized bone matrix simulate osteoblastic activity.
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Affiliation(s)
- Mahdi Kadkhodazadeh
- Department of Periodontics, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
| | | | - Hamid Reza Abdolsamadi
- Department of Oral Medicine, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Ramin Azar
- Department of Orthodontic, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Madjid Ghasemian Pour
- Orthodontist, Dental Research Center, Iranian Center for Endodontic Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Corresponding author at: Madjid Ghasemian Pour, Iranian Center for Endodontic Research, Dental School, Shahid Beheshti University of Medical Sciences, Evin, Tehran, Iran. Tel: +98-2122413897, Fax: +98-2122427753. E-mail:
| | - Shahriyar Ahmadpour
- Histology and Embryology Department, Mashad University of Medical Sciences, Mashad, Iran.
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