Accelerating Socket Repair via WNT3A Curtails Alveolar Ridge Resorption

2021 ◽  
pp. 002203452110199
Author(s):  
M. Arioka ◽  
I.M. Dawid ◽  
P.L. Cuevas ◽  
B.R. Coyac ◽  
B. Leahy ◽  
...  
Keyword(s):  
Tooth Extraction ◽  
Causal Link ◽  
Tartrate Resistant Acid Phosphatase ◽  
Alveolar Ridge ◽  
Extraction Socket ◽  
Reconstructive Procedures ◽  
Osteoprogenitor Cells ◽  
Dimensional Changes ◽  
Computed Tomographic ◽  
Proliferation And Differentiation

Tooth extraction triggers alveolar ridge resorption, and when this resorption is extensive, it can complicate subsequent reconstructive procedures that use dental implants. Clinical data demonstrate that the most significant dimensional changes in the ridge occur soon after tooth extraction. Here, we sought to understand whether a correlation existed between the rate at which an extraction socket heals and the extent of alveolar ridge resorption. Maxillary molars were extracted from young and osteoporotic rodents, and quantitative micro–computed tomographic imaging, histology, and immunohistochemistry were used to simultaneously follow socket repair and alveolar ridge resorption. Extraction sockets rapidly filled with new bone via the proliferation and differentiation of Wnt-responsive osteoprogenitor cells and their progeny. At the same time that new bone was being deposited in the socket, tartrate-resistant acid phosphatase–expressing osteoclasts were resorbing the ridge. Significantly faster socket repair in young animals was associated with significantly more Wnt-responsive osteoprogenitor cells and their progeny as compared with osteoporotic animals. Delivery of WNT3A to the extraction sockets of osteoporotic animals restored the number of Wnt-responsive cells and their progeny back to levels seen in young healthy animals and accelerated socket repair in osteoporotic animals back to rates seen in the young. In cases where the extraction socket was treated with WNT3A, alveolar ridge resorption was significantly reduced. These data demonstrate a causal link between enhancing socket repair via WNT3A and preserving alveolar ridge dimensions following tooth extraction.

scholarly journals Osteoporotic Changes in the Periodontium Impair Alveolar Bone Healing

2019 ◽  
Vol 98 (4) ◽  
pp. 450-458 ◽  
Author(s):  
M. Arioka ◽  
X. Zhang ◽  
Z. Li ◽  
U.S. Tulu ◽  
Y. Liu ◽  
...  
Keyword(s):  
Bone Healing ◽  
Tooth Extraction ◽  
Bone Repair ◽  
Alveolar Bone ◽  
Bone Fragility ◽  
Reconstructive Procedures ◽  
Osteoprogenitor Cells ◽  
Computed Tomographic ◽  
Cellular Assays ◽  
Socket Healing

Osteoporosis is associated with decreased bone density and increased bone fragility, but how this disease affects alveolar bone healing is not clear. The objective of this study was to determine the extent to which osteoporosis affects the jaw skeleton and then to evaluate possible mechanisms whereby an osteoporotic phenotype might affect the rate of alveolar bone healing following tooth extraction. Using an ovariectomized mouse model coupled with micro–computed tomographic imaging, histologic, molecular, and cellular assays, we first demonstrated that the appendicular and jaw skeletons both develop osteoporotic phenotypes. Next, we demonstrated that osteoporotic mice exhibit atrophy of the periodontal ligament (PDL) and that this atrophy was accompanied by a reduction in the pool of osteoprogenitor cells in the PDL. The paucity of PDL-derived osteoprogenitor cells in osteoporotic mice was associated with significantly slower extraction socket healing. Collectively, these analyses demonstrate that the jaw skeleton is susceptible to the untoward effects of osteoporosis that manifest as thinner, more porous alveolar bone, PDL thinning, and slower bone repair. These findings have potential clinical significance for older osteopenic patients undergoing reconstructive procedures.

scholarly journals Radiographic and Histologic Analysis 1–2 Years after Alveolar Ridge Preservation in Maxillary Premolar and Molar: A Case Report

2021 ◽  
Vol 11 (14) ◽  
pp. 6591
Author(s):  
Sung-Wook Yoon ◽  
Young Woo Song ◽  
Ui-Won Jung ◽  
Jae-Kook Cha
Keyword(s):  
Case Report ◽  
Bone Mineral ◽  
Tooth Extraction ◽  
Ridge Preservation ◽  
Bovine Bone ◽  
Alveolar Ridge ◽  
Dimensional Changes ◽  
Histologic Analysis ◽  
Alveolar Ridge Preservation ◽  
Bone Height

After tooth extraction, notable ridge alterations occur due to resorption of bundle bones during the healing process. In areas with thin or damaged socket walls and multiple adjacent tooth extraction, dimensional changes are more prominent in the marginal proportion. In addition to the marginal changes, upper molar teeth are also vulnerable to pneumatization of the maxillary sinus. To reduce dimensional changes in extraction sockets, alveolar ridge preservation (ARP) is favored by many clinicians in areas where a large amount of dimensional change is expected. This case report presents two cases of ARP using collagenated demineralized bovine bone mineral and demineralized porcine bone mineral in the apically involved upper premolar and molar, respectively. Implants were placed one and two years, respectively, after the ARP. Radiographic analyses of residual bone height and volume were measured using cone-beam-computed tomography (CBCT) and histologic analysis of newly formed mineralized bone and residual graft material percentages were measured from the collected tissue samples using a trephine bur. Implants were placed using a simple technique, without any additional bone grafts at the marginal proportion. The ARP technique could maintain the alveolar bone height and volume, as well as minimize the invasiveness of surgical procedures during implant surgery.

scholarly journals Maresin 1 Promotes Wound Healing and Socket Bone Regeneration for Alveolar Ridge Preservation

2020 ◽  
Vol 99 (8) ◽  
pp. 930-937 ◽  
Author(s):  
C.W. Wang ◽  
S.H. Yu ◽  
T. Fretwurst ◽  
L. Larsson ◽  
J.V. Sugai ◽  
...  
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Tooth Extraction ◽  
Alveolar Bone ◽  
Lipid Mediator ◽  
Preclinical Model ◽  
Alveolar Ridge ◽  
Extraction Socket ◽  
Socket Healing ◽  
Maresin 1

Tooth extraction results in alveolar bone resorption and is accompanied by postoperative swelling and pain. Maresin 1 (MaR1) is a proresolving lipid mediator produced by macrophages during the resolution phase of inflammation, bridging healing and tissue regeneration. The aim of this study was to examine the effects of MaR1 on tooth extraction socket wound healing in a preclinical rat model. The maxillary right first molars of Sprague-Dawley rats were extracted, and gelatin scaffolds were placed into the sockets with or without MaR1. Topical application was also given twice a week until complete socket wound closure up to 14 d. Immediate postoperative pain was assessed by 3 scores. Histology and microcomputed tomography were used to assess socket bone fill and alveolar ridge dimensional changes at selected dates. The assessments of coded specimens were performed by masked, calibrated examiners. Local application of MaR1 potently accelerated extraction socket healing. Macroscopic and histologic analysis revealed a reduced soft tissue wound opening and more rapid re-epithelialization with MaR1 delivery versus vehicle on socket healing. Under micro–computed tomography analysis, MaR1 (especially at 0.05 μg/μL) stimulated greater socket bone fill at day 10 as compared with the vehicle-treated animals, resulting in less buccal plate resorption and a wider alveolar ridge by day 21. Interestingly, an increased ratio of CD206+:CD68+ macrophages was identified in the sockets with MaR1 application under immunohistochemistry and immunofluorescence analysis. As compared with the vehicle therapy, local delivery of MaR1 reduced immediate postoperative surrogate pain score panels. In summary, MaR1 accelerated extraction wound healing, promoted socket bone fill, preserved alveolar ridge bone, and reduced postoperative pain in vivo with a rodent preclinical model. Local administration of MaR1 offers clinical potential to accelerate extraction socket wound healing for more predictable dental implant reconstruction.

scholarly journals Postextraction Ridge Width Alterations Following Socket Seal Surgery—A Retrospective Study

2020 ◽  
Vol 11 (1) ◽  
pp. 324
Author(s):  
Cobi Landsberg ◽  
Omer Bender ◽  
Miron Weinreb ◽  
Ronald Wigler ◽  
Tali Chackartchi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Tooth Extraction ◽  
Healing Time ◽  
Alveolar Ridge ◽  
Dimensional Changes ◽  
Post Surgery ◽  
Contour Following ◽  
Tissue Grafts ◽  
Soft Tissue Grafts

Background and objectives: Preservation of alveolar ridge contour following tooth extraction is important to allow for restoration with prosthetics and implants. Socket seal surgery was introduced more than two decades ago for preservation of the form, volume and bone quality of the postextraction ridge. The aim of this retrospective study was to assess the changes in alveolar ridge contour following socket seal surgery and to evaluate the survival of the soft tissue grafts sealing the extraction site. Materials and Methods: Digital images of the extraction sites treated with the socket seal surgery were obtained immediately after extraction and after a healing time of 6 months to measure the changes in the alveolar width. In addition, the sites were photographed 1 week postsurgery to evaluate the vitality of the soft tissue grafts. Results: The overall mean loss of buccal width following socket seal surgery was 5.3% (SD = 13.4%). The mean change in width at the incisor area (1.5% ± 13.1) was significantly lesser than those in the canine area (−17.0% ± 2.1, p < 0.01) or premolar area (−10.5% ± 11.2, p < 0.01). One-week post-surgery 69% of the grafts were vital, and 31% were partially vital. Complete necrosis of the grafts did not occur. Conclusions: Our results suggest that socket seal surgery has a beneficial effect on alveolar dimensional changes 6 months following tooth extraction and that the teeth that benefit mostly from socket seal surgery are incisors.

Scanning electron microscopy of composite hydroxylapatite/plaster implants for bone reconstruction

1986 ◽  
Vol 44 ◽  
pp. 326-327
Author(s):  
J. S. Hanker ◽  
B. L. Giammara
Keyword(s):  
Tooth Extraction ◽  
Alveolar Ridge ◽  
Small Particles ◽  
Alveolar Ridge Augmentation ◽  
Sintered Ceramic ◽  
Ridge Augmentation ◽  
Fibrovascular Tissue ◽  
Infrabony Defects ◽  
Edentulous Patients ◽  
Scanning Electron

Nonresorbable sintered ceramic hydroxylapatite (HA) is widely employed for filling defects in jaw bone. The small particles used for alveolar ridge augmentation in edentulous patients or for infrabony defects due to periodontal disease tend to scatter when implanted using water or saline as the vehicle. Larger blocks of this material used for filling sockets after tooth extraction don't fit well. Studies in our laboratory where we compared bovine serum albumin, collagen and plaster of Paris as binders to prevent particle scatter during implantation suggested that plaster was most useful for this purpose. In addition to preventing scatter of the particles, plaster enables the formation of implants of any size and.shape either prior to or during surgery. Studies with the PATS reaction have indicated that plaster acts as a scaffold for the incorporation of HA particles into bone in areas where the implant contacts either host bone or periosteum. The shape and integrity of the implant is maintained by the plaster component until it is replaced over a period of days by fibrovascular tissue.

scholarly journals Notch-Wnt signal crosstalk regulates proliferation and differentiation of osteoprogenitor cells during intramembranous bone healing

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
S. Lee ◽  
L. H. Remark ◽  
A. M. Josephson ◽  
K. Leclerc ◽  
E. Muiños Lopez ◽  
...  
Keyword(s):  
Wnt Signaling ◽  
Notch Signaling ◽  
Bone Regeneration ◽  
Bone Healing ◽  
Canonical Wnt Signaling ◽  
Osteoprogenitor Cells ◽  
Intramembranous Bone ◽  
Proliferation And Differentiation ◽  
Canonical Wnt ◽  
Wnt Signal

AbstractAdult bone regeneration is orchestrated by the precise actions of osteoprogenitor cells (OPCs). However, the mechanisms by which OPC proliferation and differentiation are linked and thereby regulated are yet to be defined. Here, we present evidence that during intramembranous bone formation OPC proliferation is controlled by Notch signaling, while differentiation is initiated by activation of canonical Wnt signaling. The temporospatial separation of Notch and Wnt signal activation during the early stages of bone regeneration suggests crosstalk between the two pathways. In vitro and in vivo manipulation of the two essential pathways demonstrate that Wnt activation leads to initiation of osteogenic differentiation and at the same time inhibits Notch signaling, which results in termination of the proliferative phase. Here, we establish canonical Wnt signaling as a key regulator that facilitates the crosstalk between OPC proliferation and differentiation during intramembranous, primary bone healing.

scholarly journals Effects of pre-extraction intermittent PTH administration on extraction socket healing in bisphosphonate administered ovariectomized rats

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jae-Young Kim ◽  
Hyo-Won Jang ◽  
Jung-In Kim ◽  
In-Ho Cha
Keyword(s):  
Tooth Extraction ◽  
Bisphosphonate Therapy ◽  
Ovariectomized Rats ◽  
Control Group ◽  
Micro Ct ◽  
Micro Computed Tomography ◽  
Extraction Socket ◽  
Before And After ◽  
Socket Healing ◽  
Positive Effect

AbstractThe purpose of this study was to investigate the effect of administering intermittent parathyroid hormone (iPTH) before tooth extraction versus after tooth extraction on the risk of developing MRONJ in experimental animal model. Twenty-five ovariectomized rats received 6 weeks of bisphosphonate therapy. They were classified into 3 groups, based on the timing of the medication, as Control, Pre-PTH and Post-PTH groups. For Control group, normal saline was administered before and after tooth extraction. iPTH was administered during 4 weeks before tooth extraction for Pre-PTH group and after tooth extraction for Post-PTH group. The animals were euthanized 8 weeks after tooth extraction. Macroscopic, histological, micro-computed tomography (micro-CT), and histomorphometric examinations were conducted. The incidences of impaired healing were 11.11% both in Pre-PTH and Post-PTH groups, which was lower than the Control group (42.86%). Bone healing in the extraction socket, based on micro-CT and histomorphometry evaluations, was best in Post-PTH and worst in Control group. The Pre-PTH group showed moderate healing pattern. Despite of limitations in this study, the authors identified Pre-PTH group seems to have positive effect on extraction socket healing. With regard to timing, administering iPTH after tooth extraction was superior to applying it before tooth extraction.

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