Alveolar Ridge Preservation: A Histomorphometric Analysis

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.

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

Dentistry Journal ◽

10.3390/dj8040112 ◽

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.

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Postextractive Alveolar Ridge Preservation Using L-PRF: Clinical and Histological Evaluation

Case Reports in Dentistry ◽

10.1155/2020/5073519 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Giorgio Serafini ◽

Marco Lollobrigida ◽

Lorenzo Fortunato ◽

Giulia Mazzucchi ◽

Luca Lamazza ◽

...

Keyword(s):

Tooth Extraction ◽

Soft Tissues ◽

Oral Surgery ◽

Bone Biopsy ◽

Histological Evaluation ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Histomorphometric Analysis ◽

Alveolar Ridge Preservation ◽

Autologous Platelet Concentrate

Leukocyte- and platelet-rich fibrin (L-PRF) is an autologous platelet concentrate rich in growth factors and plasma proteins, obtained by centrifugation of patient whole blood, and widely used in oral surgery. This report describes a case of alveolar ridge preservation with L-PRF membranes. Postextractive alveolar healing was then assessed through a histologic and histomorphometric analysis. A patient requiring tooth extraction and subsequent implant rehabilitation was treated with simple extraction and socket filling with L-PRF membranes. Implant placement was performed at 3 months, and a bone biopsy was obtained for histomorphometric analysis. Histological examination of the grafted sites showed that the use of L-PRF could achieve good results in terms of bone dimension and quality and soft tissue healing. The results of this study support the use of L-PRF membranes to preserve hard and soft tissues after tooth extraction.

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

The Open Dentistry Journal ◽

10.2174/1874210601812010389 ◽

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.

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What grafting materials produce greater alveolar ridge preservation after tooth extraction? A systematic review and Network Meta-analysis

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2021.06.005 ◽

2021 ◽

Author(s):

João Vitor dos Santos Canellas ◽

Brunna Nogueira Soares ◽

Fabio Gamboa Ritto ◽

Mario Vianna Vettore ◽

Guaracilei Maciel Vidigal Junior ◽

...

Keyword(s):

Systematic Review ◽

Tooth Extraction ◽

Meta Analysis ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Alveolar Ridge Preservation ◽

Grafting Materials

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How does alveolar ridge preservation after tooth extraction compare with extraction alone?

Cochrane Clinical Answers ◽

10.1002/cca.993 ◽

2015 ◽

Author(s):

Jane Burch ◽

Sera Tort

Keyword(s):

Tooth Extraction ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Alveolar Ridge Preservation

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Application of Bovine Acellular Cancellous Bone Matrix in Alveolar Ridge Preservation Following Tooth Extraction

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2602 ◽

2021 ◽

Vol 11 (5) ◽

pp. 805-812

Author(s):

Hongguang Zhu ◽

Jianwen Bai ◽

Meirong Wei ◽

Ti Li

Keyword(s):

Bone Formation ◽

Cancellous Bone ◽

Tooth Extraction ◽

Bone Matrix ◽

Three Dimensional ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Bone Powder ◽

Bone Substitute Materials ◽

Main Component

Objective: In this article, we explored the microscopic structure and composition of the decellular-ized cancellous bone matrix of the calf, and established the animal model of Beagle dog extraction. By applying different bone substitute materials in the extraction of teeth, we observed the new collagen-rich in the preservation of the site after tooth extraction. The protein bone matrix maintained the three-dimensional shape of the alveolar ridge compared to other biological materials. Methods: The microstructure of the new collagen-rich bone matrix was observed by scanning electron microscopy. The porous structure, porosity and distribution of collagen fibers were observed. XRD and infrared spectroscopy were used to further detect the inorganic and organic components in the new collagen-rich bone matrix. The premolar extraction and site preservation model of Beagle dogs were constructed. The changes of collagen-rich bone matrix, Bio-oss bone powder, CGF filling and blank control alveolar ridge volume were compared by CBCT. HE staining was used to observe and compare new bone formation, bone remodeling and bone resorption between groups, and to observe the formation of blood vessels, osteogenic mineralization, trabecular bone formation and inflammatory response in different periods. Results: (1) The acellular bone matrix of bovine cancellous bone completely removes the immunogenicity of the cells and has good histocompat-ibility; the pore diameter and porosity closest to the physiological structure, the main component is hydroxyapatite and collagen. (2) Site preservation can reduce the absorption of alveolar ridge following tooth extraction, preserve sufficient bone mass for alveolar fossa, and retain a good width of attachment, which provides further protection for implant surgery. (3) In the post-extraction site preservation, the CGF group has better bone composition than the BABM group and Bio-oss bone powder. Conclusion: Bovine Acellular Cancellous Bone Matrix is a new type of biological bone matrix. The main components are collagen and hydroxyapatite, which can promote bone formation in the extraction socket.

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Efficacy of Alveolar Ridge Preservation: A Randomized Controlled Trial

Journal of Dental Research ◽

10.1177/0022034520905660 ◽

2020 ◽

Vol 99 (4) ◽

pp. 402-409 ◽

Cited By ~ 7

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).

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