scholarly journals Dimensional Changes of the Soft Tissue after Alveolar Ridge Preservation with a Collagen Material. A Clinical Randomized Trial

2018 ◽  
Vol 12 (1) ◽  
pp. 389-399
Author(s):  
Sigmar Schnutenhaus ◽  
Thomas Martin ◽  
Jens Dreyhaupt ◽  
Heike Rudolph ◽  
Ralph G. Luthardt
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Dimensional Change ◽  
Control Group ◽  
Collagen Membrane ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Soft Tissue Volume ◽  
Alveolar Ridge Preservation ◽  
Significant Difference

Background: Reduction of the soft tissue is an unavoidable consequence of tooth extraction without appropriate measures of Alveolar Ridge Preservation (ARP). Objectives: The objective of this study is the volumetric investigation of the dimensional change of the soft tissue post tooth extraction to compare an Alveolar Ridge Preservation (ARP) measure with the insertion of a combination material with a collagen cone to fill the alveolus, combined with a collagen membrane, with untreated extraction alveoli. Methods: In the context of a randomized clinical trial, 31 patients were treated with the combination material directly post tooth extraction in the maxilla (ARP). In 29 further patients, the extraction alveoli were left without further measures (control group). The changes of the soft tissue contour were measured 6 (+/- 1) weeks post extraction. The measurements were performed by superimposing digital models. The groups were compared using the Wilcoxon rank-sum-test. Results: The premolar subgroup revealed a significant difference of the soft tissue dimension post insertion of a collagen material into the alveolus in comparison to untreated alveoli. In these cases, the mean loss of soft tissue volume after use of the collagen material was significantly lower. Conclusion: The proposed hypothesis that there is a difference of the soft tissue preservation between alveoli with and without the use of a collagen material can be accepted with restrictions to the premolar region. A statistically significant lower volume reduction of the soft tissue by implantation of the collagen material could be detected with premolars.

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 Associations among Primary Stability, Histomorphometric Findings, and Bone Density: A Prospective Randomized Study after Alveolar Ridge Preservation with a Collagen Cone

2020 ◽  
Vol 8 (4) ◽  
pp. 112
Author(s):  
Sigmar Schnutenhaus ◽  
Werner Götz ◽  
Jens Dreyhaupt ◽  
Heike Rudolph ◽  
Ralph G. Luthardt ◽  
...  
Keyword(s):  
Bone Density ◽  
Tooth Extraction ◽  
Randomized Study ◽  
Primary Stability ◽  
Collagen Membrane ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Implant Placement ◽  
Randomized Clinical Study ◽  
Alveolar Ridge Preservation

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.

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 Alveolar Ridge Preservation: A Histomorphometric Analysis

2018 ◽  
Vol 12 (1) ◽  
pp. 916-928 ◽  
Author(s):  
Sigmar Schnutenhaus ◽  
Werner Götz ◽  
Jens Dreyhaupt ◽  
Heike Rudolph ◽  
Ralph G. Luthardt
Keyword(s):  
Bone Formation ◽  
Bone Quality ◽  
Tooth Extraction ◽  
Collagen Membrane ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Histomorphometric Analysis ◽  
New Bone Formation ◽  
Randomized Clinical Study ◽  
Alveolar Ridge Preservation

Objective: This study presents the histomorphometric findings after tooth extraction with and without Alveolar Ridge Preservation (ARP) with a collagen cone filling the socket in combination with a collagen membrane covering the socket. Materials and Methods: In a controlled randomized clinical study, 10 patients were treated with the combination material after tooth extraction. In 10 patients, the extraction sockets were left to heal without further intervention. Soft tissue, new bone formation, bone quality and bone remodeling, blood flow vascularization, and inflammation were evaluated histomorphometrically. This was performed (semi-) quantitatively using a blinded protocol. Results: The statistical evaluation showed no significant difference for any parameter. When the combination material was used, more pronounced remodeling, increased osteoblast activity, and increased vascularization were demonstrated based on the histomorphometric findings. In contrast, there were reduced levels of osteogenesis and less mineralization. There was slightly more bundle bone in patients with ARP. Conclusion: The histomorphometric analysis of ARP with a combination material consisting of a collagen cone and a collagen membrane showed no significant differences in terms of new bone formation and bone quality. Descriptively, however, different manifestations were seen that might benefit from being documented using larger samples and being tested for clinical relevance.

Comparison of Dehydrated Human Amnion-Chorion and Type 1 Bovine Collagen Membranes in Alveolar Ridge Preservation: A Clinical and Histological Study

2020 ◽  
Author(s):  
Samer A Faraj ◽  
Ahmad Kutkut ◽  
Robert Taylor ◽  
Alejandro Villasante-Tezanos ◽  
Sarandeep Huja ◽  
...  
Keyword(s):  
Collagen Membrane ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Human Amnion ◽  
Bovine Collagen ◽  
Implant Placement ◽  
Alveolar Ridge Preservation ◽  
Significant Difference ◽  
Delayed Implant Placement

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 &gt; 0.05) groups. The bone height and width did not differ, as determined by clinical measurements (P &gt; 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.

Flapless Alveolar Ridge Preservation Utilizing the “Socket-Plug” Technique: Clinical Technique and Review of the Literature

2014 ◽  
Vol 40 (6) ◽  
pp. 690-698 ◽  
Author(s):  
Georgios Kotsakis ◽  
Vanessa Chrepa ◽  
Nicolas Marcou ◽  
Hari Prasad ◽  
James Hinrichs
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Alveolar Bone ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Review Of The Literature ◽  
Tissue Architecture ◽  
Alveolar Ridge Preservation ◽  
Extraction Site ◽  
And Migration

It has been documented that after every extraction of one or more teeth, the alveolar bone of the respective region undergoes resorption and atrophy. Therefore, ridge preservation techniques are often employed after tooth extraction to limit this phenomenon. The benefits of a flapless procedure include maintenance of the buccal keratinized gingiva, prevention of alterations to the gingival contours, and migration of the mucogingival junction that are often experienced after raising a flap. The purpose of this article is to review the literature concerning flapless ridge preservation techniques with the aid of collagen plugs for occlusion of the socket. The term “socket-plug” technique is introduced to describe these techniques. The basic steps of the “socket-plug” technique consist of atraumatic tooth extraction, placement of the appropriate biomaterials in the extraction site, preservation of soft tissue architecture employing a flapless technique, and placement and stabilization of the collagen plug. A case example is presented that illustrates the steps used in this technique.

scholarly journals Comparison of the Efficacy of Platelet-Rich Fibrin and Bone Allograft for Alveolar Ridge Preservation after Tooth Extraction: A Clinical Trial

2020 ◽  
Author(s):  
Hassan Azangookhiavi ◽  
Safoura Ghodsi ◽  
Fatemeh Jalil ◽  
Yalda Dadpour
Keyword(s):  
Clinical Trial ◽  
Tooth Extraction ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Platelet Rich Fibrin ◽  
Implant Placement ◽  
Alveolar Ridge Preservation ◽  
Freeze Dried ◽  
Minimal Trauma ◽  
Significant Difference

Objectives: Bone remodeling after tooth extraction results in decreased ridge volume and complicates implant placement. Platelet-rich fibrin (PRF) is a rich source of autogenous cytokines and growth factors; it has been proven to effectively improve soft tissue healing and hard tissue regeneration. This study sought to compare the clinical application of freeze-dried bone allografts (FDBA) and PRF for alveolar ridge preservation after tooth extraction. Materials and Methods: This clinical trial was conducted on 32 patients presenting for the extraction of hopeless non-molar teeth. The teeth were extracted with minimal trauma, and the samples were randomly divided into two groups (n=16). Tooth sockets were filled with either FDBA or PRF (prepared using 10cc of the patient’s blood). Bone regeneration was assessed by evaluating changes in horizontal and vertical bone dimensions after 12 weeks (the time of implant placement) using an acrylic stent fabricated before tooth extraction and a periodontal probe. The results were compared by repeated-measures analysis of variance (ANOVA; P<0.05). Results: Ridge width showed a significant reduction compared to the baseline in both groups (P=0.001); ridge height changes were not significant (P>0.05). The evaluated groups did not show any significant difference in height/width changes (P>0.05). Conclusion: The results showed an acceptable efficacy for PRF without graft materials in alveolar ridge preservation. This material is cost-effective and could be easily prepared. PRF application in extraction sockets yielded similar results to FDBA.

Soft Tissue changes after using Collagen Matrix Seal or Collagen Sponge with Allograft in Ridge Preservation:A Randomized Controlled Volumetric Study

2020 ◽  
Author(s):  
Zuhair Natto ◽  
Andreas Parashis ◽  
Y. Natalie Jeong
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Collagen Matrix ◽  
Collagen Sponge ◽  
Tissue Loss ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Alveolar Ridge Preservation ◽  
Freeze Dried ◽  
Significant Difference

The objective of this study is to assess alterations in buccal soft tissue contour after alveolar ridge preservation (ARP) using either a collagen matrix seal (CMS) or a collagen sponge (CS) as barriers with freeze-dried bone allograft (FDBA). Participants (28 total) were randomly assigned into the CMS group or the CS group (14 each). The same clinical steps were used in both barriers. Cast models were taken at the baseline and at 4 months, then both models were optically scanned and digitally superimposed. Volumetric, surface, and distance-adjusted measurements were calculated to assess buccal soft tissues alterations. Surface area and volume loss in the CMS group were observed to be 71.44±1189.09 mm 2 and 239.58±231.89 mm 3 . The CS group showed measurements of 139.56±557.92 mm 2 and 337.23±310.18 mm 3, . Mean buccal soft tissue loss and minimum-maximum distance loss were less in the CMS (0.88±0.52 mm, and 0.2-2.15 mm respectively), compared with the CS group (1.63±1.03 mm and 0.3-3.68 mm respectively) with no statistically significant difference between the groups (p=0.2742). Both alveolar ridge preservation barriers were unable to entirely prevent soft tissue contour changes after extraction. However, collagen matrix seal application was slightly better in minimizing the amount of soft tissue reduction compared to the collagen sponge. ClinicalTrials.gov (NCT02697890).

scholarly journals Soft Tissue Dimensions Following Tooth Extraction in the Posterior Maxilla: A Randomized Clinical Trial Comparing Alveolar Ridge Preservation to Spontaneous Healing

2020 ◽  
Vol 9 (8) ◽  
pp. 2583
Author(s):  
Young Woo Song ◽  
Sung-Wook Yoon ◽  
Jae-Kook Cha ◽  
Ui-Won Jung ◽  
Ronald E. Jung ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Spontaneous Healing ◽  
Gingival Thickness ◽  
Level Change ◽  
Alveolar Ridge Preservation ◽  
Posterior Maxilla ◽  
Maxillary Molar

Background: To assess the soft tissue dimension following tooth extraction and alveolar ridge preservation in the posterior maxilla compared to spontaneous healing. Methods: Thirty-five patients randomly assigned to alveolar ridge preservation (ARP) and spontaneous healing (SH) after maxillary molar extraction. The crestal, buccal, and palatal gingival thickness at 6 months was measured around virtually placed implant fixtures using superimposed cone-beam computed tomography and intraoral scan taken at 6 months. Buccal mucogingival junction (MGJ) level change over 6 months was estimated using intraoral scans obtained at suture-removal and 6 months. Results: The crestal gingiva was significantly thinner in group ARP (−1.16 mm) compared to group SH (p < 0.05). The buccal and palatal gingiva was significantly thinner at the implant shoulder (IS) level in group ARP (buccal: −0.75 mm; palatal: −0.85 mm) compared to group SH (p < 0.05). The thickness at 2 mm below the IS of both sides and the buccal MGJ level change were similar in both groups (p > 0.05). Conclusions: ARP in the posterior maxilla resulted in a thinner soft tissue on top of and at the prospective level of the implant shoulder at 6 months. The buccal MGJ level changed minimal for 6 months in both groups.

scholarly journals A case series of profilometric changes in two implant placement protocols at periodontally compromised non-molar sites

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kwantae Noh ◽  
Daniel S. Thoma ◽  
Jung-Chul Park ◽  
Dong-Woon Lee ◽  
Seung-Yun Shin ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tooth Extraction ◽  
Case Series ◽  
Tissue Level ◽  
Ridge Preservation ◽  
Bone Augmentation ◽  
Implant Placement ◽  
Alveolar Ridge Preservation ◽  
Tissue Changes ◽  
Facial Area

AbstractInformation regarding profilometric changes at a soft tissue level following implant placement with different protocols is insufficient. Therefore, this study aimed to comparatively investigate the profilometric tissue changes with respect to late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites. Sixteen patients were randomly assigned to the following groups: implant placement 4 months post-ARP (group LP/ARP) and tooth extraction and implant placement 4–8 weeks post-extraction (group EP). Dental impressions were obtained immediately after final prosthesis insertion and at 3, 6, and 12 months. At the time of implant placement, bone augmentation was performed in the majority of the patients. Profilometric changes of the tissue contour were minimal between the final prosthesis insertion and 12 months in the mid-facial area (0.04–0.35 mm in group LP/ARP, 0.04–0.19 mm in group EP). The overall tissue volume increased in both groups (1.70 mm3 in group LP/ARP, 0.96 mm3 in group EP). In conclusion, LP/ARP and EP led to similar stability of the peri-implant tissue contour between the final prosthesis insertion and at 12 months. Moreover, the change of peri-implant tissue on the soft tissue level was minimal in both modalities.

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