Alveolar Ridge Preservation Using Allografts and Dense Polytetrafluoroethylene Membranes With Open Membrane Technique in Unhealthy Extraction Socket

2017 ◽  
Vol 43 (4) ◽  
pp. 267-273 ◽  
Author(s):  
Gi-Beom Cheon ◽  
Kyung Lhi Kang ◽  
Mi-Kyung Yoo ◽  
Jeoung-A Yu ◽  
Dong-Woon Lee
Keyword(s):  
Fibrous Tissue ◽  
Control Group ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Alveolar Ridge Preservation ◽  
Membrane Technique ◽  
Freeze Dried ◽  
The Mean ◽  
Open Membrane

We evaluated the effectiveness of the open membrane technique using a high-density polytetrafluoroethylene (dPTFE) membrane with freeze-dried bone allografts in damaged sockets for alveolar ridge preservation (ARP). This retrospective study included 26 sites from 20 patients who had received ARP for the placement of dental implants. ARP was conducted using dPTFE membrane with allografts on the day of extraction without primary closure. When the membrane was removed after 4 weeks, the newly formed reddish tissue at the grafted site was checked (first outcome, clinical evaluation). Four months after membrane removal, a core biopsy was performed from the center of the grafted site before implant placement (second outcome, histomorphometric evaluation). Radiographic measurements of alveolar bone changes between implant prosthesis delivery and the 1-year follow-up were obtained (third outcome, radiographic evaluation). A total of 23 sites from 18 patients had no complications during the follow-up period. Three sites from two patients were excluded because of early membrane removal. Newly formed reddish tissue was found at 15 sites, and partially formed tissue was found at 8 sites. Although we were unable to harvest bone core from all sites, histomorphometric analysis in 11 patients indicated that the mean area of new bone was 28.48% ± 6.60%, that of the remaining graft particle was 27.68% ± 9.18%, and that of fibrous tissue was 43.84% ± 6.98%. The mean loss of marginal bone was 0.13 ± 0.06 mm at the mesial area and 0.15 ± 0.06 mm at the distal area, as assessed using radiographic evaluations. The results of this nonrandomized study suggest that this technique may be an appropriate procedure for ARP. Further studies with a control group and more subjectives can be designed based on this study.

Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

2020 ◽  
Vol 99 (4) ◽  
pp. 402-409 ◽  
Author(s):  
G. Avila-Ortiz ◽  
M. Gubler ◽  
M. Romero-Bustillos ◽  
C.L. Nicholas ◽  
M.B. Zimmerman ◽  
...  
Keyword(s):  
Tooth Extraction ◽  
Alveolar Bone ◽  
Controlled Trial ◽  
Control Group ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Bone Augmentation ◽  
Randomized Controlled ◽  
Implant Placement ◽  
Alveolar Ridge Preservation

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).

scholarly journals Alveolar Ridge Preservation Using Xenogeneic Collagen Matrix and Bone Allograft

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Andreas O. Parashis ◽  
Charalampos J. Kalaitzakis ◽  
Dimitris N. Tatakis ◽  
Konstantinos Tosios
Keyword(s):  
Bone Allograft ◽  
Immunohistochemical Analysis ◽  
Collagen Matrix ◽  
Normal Mucosa ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Keratinized Tissue ◽  
Alveolar Ridge Preservation ◽  
Freeze Dried ◽  
Atraumatic Extraction

Alveolar ridge preservation (ARP) has been shown to prevent postextraction bone loss. The aim of this report is to highlight the clinical, radiographic, and histological outcomes following use of a bilayer xenogeneic collagen matrix (XCM) in combination with freeze-dried bone allograft (FDBA) for ARP. Nine patients were treated after extraction of 18 teeth. Following minimal flap elevation and atraumatic extraction, sockets were filled with FDBA. The XCM was adapted to cover the defect and 2-3 mm of adjacent bone and flaps were repositioned. Healing was uneventful in all cases, the XCM remained in place, and any matrix exposure was devoid of further complications. Exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2-3 months. Radiographic and clinical assessment indicated adequate volume of bone for implant placement, with all planned implants placed in acceptable positions. When fixed partial dentures were placed, restorations fulfilled aesthetic demands without requiring further augmentation procedures. Histological and immunohistochemical analysis from 9 sites (4 patients) indicated normal mucosa with complete incorporation of the matrix and absence of inflammatory response. The XCM + FDBA combination resulted in minimal complications and desirable soft and hard tissue therapeutic outcomes, suggesting the feasibility of this approach for ARP.

scholarly journals Sinus Augmentation with Simultaneous, Non-Submerged, Implant Placement Using a Minimally Invasive Hydraulic Technique

Medicina ◽  
2020 ◽  
Vol 56 (2) ◽  
pp. 75
Author(s):  
Liat Chaushu ◽  
Gavriel Chaushu ◽  
Hadar Better ◽  
Sarit Naishlos ◽  
Roni Kolerman ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Radiographic Evaluation ◽  
Control Group ◽  
Insertion Torque ◽  
Alveolar Ridge ◽  
Marginal Bone Loss ◽  
Sinus Augmentation ◽  
Ridge Height ◽  
The Mean

Background and objectives: To evaluate whether sinus augmentation, using a minimally invasive implant device, via a non-submerged surgical approach, might negatively influence the outcome. Materials and Methods: A retrospective cohort study was conducted by evaluating patients’ files, classifying them into two groups. Fifty patients (22 men 28 women) were included in the study, 25 in each group. The use of an implant device based on residual alveolar ridge height for sinus augmentation, radiographic evaluation, insertion torque, membrane perforation, post-operative healing, and a minimum of 12 months follow-up were evaluated. Results: The mean residual alveolar ridge height was 5.4 mm for the non-submerged group and 4.2 mm for the submerged group. There were no intraoperative or postoperative complications (including membrane perforations). The mean insertion torque was 45 N/cm for the study group and 20 N/cm for the control group. Complete soft tissue healing was observed within three weeks. Mean bone gain height was 8 mm for the study and 9.3 mm for the control group. All implants osseointegrated after 6–9 months of healing time. Mean follow-up was 17.5 months, range 12–36 months. Marginal bone loss at last follow-up was not statistically significantly different: 1 mm in the non-submerged vs. 1.2 mm in the submerged group. Conclusions: Submerged and non-submerged healing following maxillary sinus augmentation was comparable provided residual alveolar ridge height >5 mm and insertion torque >25 N/cm.

scholarly journals Clinical applications of concentrated growth factors combined with bone substitutes for alveolar ridge preservation in maxillary molar area: a randomized controlled trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shi-chen Lin ◽  
Xin Li ◽  
Hang Liu ◽  
Fang Wu ◽  
Lian Yang ◽  
...  
Keyword(s):  
Growth Factors ◽  
Bone Substitutes ◽  
Control Group ◽  
Ridge Preservation ◽  
Bovine Bone ◽  
Alveolar Ridge ◽  
Alveolar Ridge Preservation ◽  
Ridge Area ◽  
Maxillary Molar ◽  
Concentrated Growth Factors

Abstract Purpose To evaluate the clinical effects of concentrated growth factors (CGFs) combined with bone substitutes for alveolar ridge preservation (ARP) in the maxillary molar area. Methods Thirty-six patients who underwent extraction of the upper molars were recruited and randomly divided into three groups: 1. Grafted with CGFs combined with deproteinized bovine bone mineral (DBBM) and covered with CGFs membrane (CGFs/DBBM group), 2. Grafted with DBBM alone and covered with collagen membrane (DBBM group), 3. Control group spontaneous healing. The area of the alveolar bone in center (C-), mesial (M-) and distal (D-) section was compared with preoperative in radiography. Bone cores were obtained for histopathology observation and comparison. Results In C-, M- and D-section, the alveolar ridge area in all three groups was significantly reduced at 8 months postoperatively compared to the baseline (P < 0.05). The alveolar ridge area declines in the CGFs/DBBM group (C-12.75 ± 2.22 mm2, M-14.69 ± 2.82 mm2, D-16.95 ± 4.17 mm2) and DBBM group (C-14.08 ± 2.51 mm2, M-15.42 ± 3.47 mm2, D-16.09 ± 3.97 mm2) were non-significant differences. They were significantly less than the decline in the control group (C-45.04 ± 8.38 mm2 M-31.98 ± 8.34 mm2, D-31.85 ± 8.52 mm2) (P < 0.05). The percentage of newly formed bone in the CGFs/DBBM group (41.99 ± 12.99%) was significantly greater than that in DBBM group (30.68 ± 10.95%) (P < 0.05). The percentage of residual materials in the CGFs/DBBM group (16.19 ± 6.63%) was significantly less than that in the DBBM group (28.35 ± 11.70%) (P < 0.05). Conclusion Combined application of CGFs and DBBM effectively reduced the resorption of alveolar ridge and resulted in more newly formed bone than the use of DBBM with collagen membranes.

Prospective Clinical and Radiographic Study of Alveolar Ridge Preservation Combining Freeze-Dried Bone Allograft With Two Xenogeneic Collagen Matrices

2016 ◽  
Vol 87 (4) ◽  
pp. 416-425 ◽  
Author(s):  
Andreas O. Parashis ◽  
Charles E. Hawley ◽  
Paul C. Stark ◽  
Rumpa Ganguly ◽  
James B. Hanley ◽  
...  
Keyword(s):  
Bone Allograft ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Radiographic Study ◽  
Collagen Matrices ◽  
Alveolar Ridge Preservation ◽  
Freeze Dried

scholarly journals Alveolar Ridge Preservation Using a Novel Synthetic Grafting Material: A Case with Two-Year Follow-Up

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Peter Fairbairn ◽  
Minas Leventis ◽  
Chas Mangham ◽  
Robert Horowitz
Keyword(s):  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Implant Stability ◽  
Secondary Intention ◽  
Primary Implant ◽  
Alveolar Ridge Preservation ◽  
Tissue Healing ◽  
Attached Gingiva ◽  
Synthetic Biomaterial

This case report highlights the use of a novel in situ hardening synthetic (alloplastic), resorbable, bone grafting material composed of beta tricalcium phosphate and calcium sulfate, for alveolar ridge preservation. A 35-year-old female patient was referred by her general dentist for extraction of the mandibular right first molar and rehabilitation of the site with a dental implant. The nonrestorable tooth was “atraumatically” extracted without raising a flap, and the socket was immediately grafted with the synthetic biomaterial and covered with a hemostatic fleece. No membrane was used, and the site was left uncovered without obtaining primary closure, in order to heal by secondary intention. After 12 weeks, the architecture of the ridge was preserved, and clinical observation revealed excellent soft tissue healing without loss of attached gingiva. At reentry for placement of the implant, a bone core biopsy was obtained, and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological analysis revealed pronounced bone regeneration while high levels of primary implant stability were recorded. The implant was successfully loaded 12 weeks after placement. Clinical and radiological follow-up examination at two years revealed stable and successful results regarding biological, functional, and esthetic parameters.

scholarly journals Clinical application of concentrate growth factors combined with bone substitute in Alveolar ridge preservation of anterior teeth

2021 ◽  
Author(s):  
Dilinuer Keranmu ◽  
Nijiati Nuermuhanmode ◽  
Ailimaierdan Ainiwaer ◽  
Adili Moming ◽  
Gu Li ◽  
...  
Keyword(s):  
Growth Factors ◽  
Alveolar Bone ◽  
Gingival Tissue ◽  
Control Group ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Anterior Teeth ◽  
Alveolar Ridge Preservation ◽  
Bone Powder ◽  
Significant Difference

Abstract Objective: To investigate the clinical effect of concentrated growth factors (CGF) combined with Bio-oss bone powder on Alveolar ridge preservation (ARP) during implantology. Methods: A total of 38 patients were selected and randomly divided into 2 groups, with 19 cases in each group. The extraction sockets were filled with Bio-oss bone powder with or without CGF. VAS pain score was recorded within1 week and Landry wound healing index (LWHI) was recorded at 1, 2 and 3 weeks after operation. CBCT was taken 3 and 6 months after operation to measure and compare the changes of vertical height, width and gray value of alveolar bone at extraction site. The changes of alveolar bone contour were observed clinically and compared between the two groups. Results: The VAS score of CGF group was lower than control group on the 1st and 3rd day after operation (P < 0.05). The LWHI of CGF group was higher than control group 1 week after operation (P < 0.05). The absorption of the labial and palatal plates height and the width in the CGF group was significantly less than the control group at 3 months (P<0.05). The gray value of alveolar bone in CGF group was significantly higher than control group at 3 months (P < 0.05). There was no significant difference in new bone contour between the two groups (P > 0.05). 94.7% cases in CGF group did not undergo bone grafting, which was significantly higher than control group (78.9%). Conclusions: The use of CGF combined with Bio-oss bone powder can help to reduce postoperative pain at the early stage of healing, form sufficient keratinized gingival tissue, effectively maintain the height and width of alveolar bone in the three-dimensional direction and provide good conditions for implant repair in the future.

scholarly journals Efficacy and safety of rhBMP/β-TCP in alveolar ridge preservation: a multicenter, randomized, open-label, comparative, investigator-blinded clinical trial

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Jeong Joon Han ◽  
Ah. Ryum Chang ◽  
Jaemyung Ahn ◽  
Seunggon Jung ◽  
Jongrak Hong ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Alveolar Bone ◽  
Test Group ◽  
Control Group ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Efficacy And Safety ◽  
Open Label ◽  
Alveolar Ridge Preservation ◽  
Bone Height

Abstract Background The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation. Materials and methods Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups. Results Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group. Conclusions The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction. Trial registration Clinicaltrials.gov, NCT02714829, Registered 22 March 2016

scholarly journals Ridge Preservation Using a Novel Enzyme-Treated Xenograft. A Preliminary Retrospective Histomorphometric Investigation

2020 ◽  
Vol 10 (12) ◽  
pp. 4256
Author(s):  
Danilo Alessio Di Stefano ◽  
Francesco Orlando
Keyword(s):  
Survival Outcomes ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Histomorphometric Analysis ◽  
Implant Survival ◽  
New Bone Formation ◽  
Marginal Bone Loss ◽  
Implant Placement ◽  
Freeze Dried

The use of xenografts to preserve the post-extraction alveolar ridge is an established and effective procedure. Recently, a novel freeze-dried, enzyme-deantigenic equine bone (EDEB) particulate combined with a hydrogel carrier (Exur®) containing ascorbic acid has been developed (EDEBEX). The aim of this study was to preliminarily investigate histomorphometric and early implant survival outcomes following the graft of EDEBEX in post-extractive sockets. Records of patients who underwent ridge preservation using EDEBEX followed by two-step implant placement were retrospectively collected and analyzed. Newly Formed Bone (NFB) and Residual Biomaterial (RB) at the implant placement site were measured through histomorphometric analysis, and early Marginal Bone Loss (MBL) for implants was calculated at the final follow-up. Records concerned 13 patients (nine women and four men, average age 54.1 ± 9.5 years). The 13 sockets were considered healed 4.5 ± 2.6 months (mean ± SD) after grafting, with NFB and RB values of 43.2 ± 22.1% and 8.8 ± 5.9%, respectively. 8.4 ± 5.8 months after implant placement, the median MBL was 0.20 [0.00–0.45] mm. No correlation was observed between MBL and NFB. EDEBEX grafted in post-extractive sockets for ridge preservation seems to allow for new bone formation with satisfactory implant outcomes. Future prospective studies are necessary to confirm these preliminary findings.

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