Clinical and aesthetic outcomes of alveolar ridge preservation and delayed implant placement vs Type II implant placement in the anterior maxilla after 5-11 years in function

2021 ◽  
Author(s):  
◽  
Dinusha Thalagala
Author(s):  
Samer A Faraj ◽  
Ahmad Kutkut ◽  
Robert Taylor ◽  
Alejandro Villasante-Tezanos ◽  
Sarandeep Huja ◽  
...  

Alveolar ridge preservation maintains ridge dimensions and bone quality for implant placement. The aim of this randomized controlled clinical study is to compare the use of a human amnion-chorion membrane to a collagen membrane in an exposed-barrier ridge preservation technique.  Furthermore, this study will determine if intentional membrane exposure compromises ridge dimensions and bone vitality.Forty-three patients requiring extraction and delayed implant placement were randomly assigned into either the experimental or control group. Twenty-one participants received human amnion-chorion membrane (test) during ridge preservation while twenty-two participants received the collagen membrane (control). In both groups, demineralized freeze-dried bone allografts were used to graft the socket and primary closure was not achieved.The patients underwent implant placement after an average healing period of 19.5 weeks, and 2.7 X 8-mm core bone specimens were obtained for histomorphometric analyses. The clinical ridge dimensions were measured after extraction and at the time of delayed implant placement. No significant difference was observed in the mean vital bone formation between the experimental (51.72 ± 8.46%) and control (49.96 ± 8.31%; P > 0.05) groups. The bone height and width did not differ, as determined by clinical measurements (P > 0.05). Using either a human amnion-chorion membrane or type 1 bovine collagen as the open barrier did not change healing, compromise ridge dimensions, or affect bone vitality between the two groups.


2020 ◽  
Vol 99 (4) ◽  
pp. 402-409 ◽  
Author(s):  
G. Avila-Ortiz ◽  
M. Gubler ◽  
M. Romero-Bustillos ◽  
C.L. Nicholas ◽  
M.B. Zimmerman ◽  
...  

Alveolar ridge preservation (ARP) therapy is indicated to attenuate the physiologic resorptive events that occur as a consequence of tooth extraction with the purpose of facilitating tooth replacement therapy. This randomized controlled trial was primarily aimed at testing the efficacy of ARP as compared with unassisted socket healing. A secondary objective was to evaluate the effect that local phenotypic factors play in the volumetric reduction of the alveolar bone. A total of 53 subjects completed the study. Subjects were randomized into either the control group, which involved only tooth extraction (EXT n = 27), or the experimental group, which received ARP using a combination of socket grafting with a particulate bone allograft and socket sealing with a nonabsorbable membrane (dPTFE) following tooth extraction (ARP n = 26). A set of clinical, linear, volumetric, implant-related, and patient-reported outcomes were assessed during a 14-wk healing period. All linear bone assessments (horizontal, midbuccal, and midlingual reduction) revealed that ARP is superior to EXT. Likewise, volumetric bone resorption was significantly higher in the control group (mean ± SD: EXT = −15.83% ± 4.48%, ARP = −8.36% ± 3.81%, P < 0.0001). Linear regression analyses revealed that baseline buccal bone thickness is a strong predictor of alveolar bone resorption in both groups. Interestingly, no significant differences in terms of soft tissue contour change were observed between groups. Additional bone augmentation to facilitate implant placement in a prosthetically acceptable position was deemed necessary in 48.1% of the EXT sites and only 11.5% of the ARP sites ( P < 0.004). Assessment of perceived postoperative discomfort at each follow-up visit revealed a progressive decrease over time, which was comparable between groups. Although some extent of alveolar ridge remodeling occurred in both groups, ARP therapy was superior to EXT as it was more efficacious in the maintenance of alveolar bone and reduced the estimated need for additional bone augmentation at the time of implant placement (ClinicalTrials.gov NCT01794806).


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Mogammad Thabit Peck ◽  
Johan Marnewick ◽  
Lawrence Stephen

In order for a dental implant to be restored optimally, it must be placed in an ideal anatomic position. However, this is not always possible, since physiological wound healing after tooth removal, often results in hard and soft tissue changes which ultimately compromises ideal implant placement. With the aim of minimising the need for tissue augmentation, several alveolar ridge preservation (ARP) techniques have been developed. These often require the use of grafting material and therefore increase the risk of disease transmission. Leukocyte and platelet-rich fibrin (L-PRF) is a newly developed platelet concentrate that is prepared from the patient's own blood. Clinical research has indicated that it improves wound healing and stimulates bone formation. We present a case where L-PRF was successfully used in an ARP procedure to facilitate implant placement in a compromised extraction socket.


2020 ◽  
Vol 8 (4) ◽  
pp. 112
Author(s):  
Sigmar Schnutenhaus ◽  
Werner Götz ◽  
Jens Dreyhaupt ◽  
Heike Rudolph ◽  
Ralph G. Luthardt ◽  
...  

Background: The objective of this investigation was to examine whether determination of bone density (BD) with a cone beam computed tomography (CBCT) scan could help predict the primary stability (PS) of the implants and to investigate whether associations between the histomorphometric findings and the CBCT scan could be observed. Materials and methods: In this randomized clinical study, the efficacy of alveolar ridge preservation (ARP) with a combination of a collagen cone and a collagen membrane procedure after tooth extraction was investigated. CBCT scans were obtained after a healing period of 8 (±1) weeks. Subsequently, the CBCT scans were evaluated in terms of BD at different heights of the former socket. Eleven (±1) weeks after tooth extraction, implant placement was performed and PS was measured with resonance frequency analysis. Potential associations among the radiologically measured BD, the histomorphometric results, and the PS were analyzed. Results: No direct association was observed between the radiologically determined BD and the histomorphometric findings. No significant associations could be found between the BD and the PS. Conclusion: No significant associations were observed among the BD determined by the CBCT, the histomorphometric findings, and the PS.


2020 ◽  
Vol 46 (5) ◽  
pp. 515-525 ◽  
Author(s):  
Arturas Stumbras ◽  
Gintaras Januzis ◽  
Albinas Gervickas ◽  
Ricardas Kubilius ◽  
Gintaras Juodzbalys

The aim of this study was to compare bone regeneration in the anterior maxilla between bone substitutes and autologous platelet concentrate in alveolar ridge preservation. Forty patients requiring tooth extraction in the anterior maxilla were randomly allocated to the following 4 treatment modalities: spontaneous healing (control), natural bovine bone mineral covered with resorbable native collagen membrane (BBM/CM), freeze-dried bone allograft covered with resorbable native collagen membrane (FDBA/CM), and plasma rich in growth factors (PRGF) alone. Bone biopsies and histomorphometrical analysis were performed after 3 months of healing. The following parameters were assessed: newly formed mineralized tissue, newly formed nonmineralized tissue, and residual bone-grafting material (if applicable). Statistical analysis was performed to provide descriptive analysis and to compare the parameters of the bone regeneration between the study groups. Histomorphometrical analysis revealed the highest new mineralized tissue formation in the PRGF group. Statistically significant differences in new mineralized tissue formation were found between control/PRGF (46.4% ± 15.2% vs 75.5% ± 16.3%), control/(BBM/CM) (46.4% ± 15.2% vs 20.3% ± 21.9%), control/(FDBA/CM) (46.4% ± 15.2% vs 7.2% ± 8.6%), PRGF/(BBM/CM) (75.5% ± 16.3% vs 20.3% ± 21.9%), and PRGF/(FDBA/CM) (75.5% ± 16.3% vs 7.2% ± 8.6%) groups. The new mineralized tissue formation was in the following order: PRGF &gt; control &gt; BBM &gt; FDBA. Alveolar ridge preservation in the esthetic zone with PRGF was the most effective for bone regeneration of the alveolar ridge.


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