Przegląd wybranych atraumatycznych metod ekstrakcji

2019 ◽  
Vol 24 (3) ◽  
Author(s):  
Piotr Grad ◽  
Aleksandra Paruzel-Pliskowska ◽  
Andrzej Żegleń ◽  
Jolanta Pytko-Polończyk
Keyword(s):  
Tooth Extraction ◽  
Alveolar Bone ◽  
Optimal Conditions ◽  
Excessive Force ◽  
Prosthetic Rehabilitation ◽  
Prosthetic Reconstruction ◽  
Surgical Tools ◽  
Periodontal Tissues ◽  
Fracture Formation ◽  
Mucoperiosteal Flap

Tooth extraction is one of the most common dental surgical procedures. Its success depends on the operator’s knowledge, skills and experience. Proper choice of tools is also important. Incorrect tooth extraction using excessive force may cause local complications, such as damage to the soft tissue or to the extracted or neighbouring tooth with potential translocation, bone fracture, formation of an oral sinus communication or even mandibular dislocation. Currently, efforts are being made to develop methods that will allow for the preservation of intact surrounding periodontal tissues to facilitate subsequent prosthetic rehabilitation. Surgical tools used in atraumatic tooth extraction include, among other things, Physics Forceps, periotomes, luxators, and the Benex extractor system. These tools reduce the risk of damage to the vestibular lamina of the alveolar bone, allow for avoiding the need for a mucoperiosteal flap and reduce the incidence of postoperative pain. This helps create optimal conditions for subsequent implant prosthetic reconstruction. The paper presents the characteristics and application of selected tools used in atraumatic tooth extraction.

scholarly journals Dimensional Ridge Preservation with a Novel Highly Porous TiO2Scaffold: An Experimental Study in Minipigs

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Hanna Tiainen ◽  
Anders Verket ◽  
Håvard J. Haugen ◽  
S. Petter Lyngstadaas ◽  
Johan Caspar Wohlfahrt
Keyword(s):  
Experimental Study ◽  
Bone Graft ◽  
Tooth Extraction ◽  
Alveolar Bone ◽  
Ridge Preservation ◽  
Convex Shape ◽  
Prosthetic Reconstruction ◽  
Defect Site ◽  
Bone Graft Substitutes ◽  
Highly Porous

Despite being considered noncritical size defects, extraction sockets often require the use of bone grafts or bone graft substitutes in order to facilitate a stable implant site with an aesthetically pleasing mucosal architecture and prosthetic reconstruction. In the present study, the effect of novel TiO2scaffolds on dimensional ridge preservation was evaluated following their placement into surgically modified extraction sockets in the premolar region of minipig mandibles. After six weeks of healing, the scaffolds were wellintegrated in the alveolar bone, and the convex shape of the alveolar crest was preserved. The scaffolds were found to partially preserve the dimensions of the native buccal and lingual bone walls adjacent to the defect site. A tendency towards more pronounced vertical ridge resorption, particularly in the buccal bone wall of the nongrafted alveoli, indicates that the TiO2scaffold may be used for suppressing the loss of bone that normally follows tooth extraction.

scholarly journals General Factors of Anatomical Variation on the Size and Number of Dental Roots Influencing the Choice of Immediate Implants

2021 ◽  
Vol 6 (7) ◽  
Keyword(s):  
Tooth Extraction ◽  
Bone Repair ◽  
Alveolar Bone ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Periodontal Tissues ◽  
Osseointegrated Implants ◽  
Tooth Roots ◽  
Immediate Implants ◽  
Dimensional Boundary

Bone metabolism is gaining more prominence due to osseointegrated implants. Even after a minimally traumatic tooth extraction, there are natural reductions and losses in the proportions of the alveolar bone and other periodontal tissues. Maintaining these dimensions has become a challenge for researchers. Immediate implants are set in the same surgical act as tooth extraction. Implants are recommended aiming at reducing the waiting time for bone repair and thus offering the necessary stimuli to the bone for its dimensional, functional, and esthetic maintenance. Planning prior to immediate setting should take into account anatomical variations and even anomalies mainly related to the dimensions and number of tooth roots. Among the general factors of anatomical variation, those related to Gender, Age, Biotype, and Ethnicity stand out. These data were provided in studies carried out by several authors in several countries, correlating them with the dimensions and number of tooth roots. A selection of works using measurement methods as Cone Beam Computed Tomography or direct measurements in extracted teeth was carried out. Studies confirm that Panoramic Radiography presents greater distortions and does not provide sharpness for dimensional boundary markings. Significant data were obtained and confirm the correlation of these general factors of anatomical variation with the length and number of tooth roots. Further studies need to be carried out, in order to provide clinicians with details of these variants, important in the planning and prior choice of the best shape and size of the dental implant to be installed.

Orthodontic Force–Induced BMAL1 in PDLCs Is a Vital Osteoclastic Activator

2021 ◽  
pp. 002203452110199
Author(s):  
Y. Xie ◽  
Q. Tang ◽  
S. Yu ◽  
W. Zheng ◽  
G. Chen ◽  
...  
Keyword(s):  
Bone Remodeling ◽  
Alveolar Bone ◽  
Tooth Movement ◽  
Orthodontic Tooth Movement ◽  
Nuclear Factor Κb ◽  
Periodontal Ligament Cells ◽  
Orthodontic Force ◽  
Periodontal Tissues ◽  
Alveolar Bone Remodeling ◽  
Biomechanical Stimuli

Orthodontic tooth movement (OTM) depends on periodontal ligament cells (PDLCs) sensing biomechanical stimuli and subsequently releasing signals to initiate alveolar bone remodeling. However, the mechanisms by which PDLCs sense biomechanical stimuli and affect osteoclastic activities are still unclear. This study demonstrates that the core circadian protein aryl hydrocarbon receptor nuclear translocator–like protein 1 (BMAL1) in PDLCs is highly involved in sensing and delivering biomechanical signals. Orthodontic force upregulates BMAL1 expression in periodontal tissues and cultured PDLCs in manners dependent on ERK (extracellular signal–regulated kinase) and AP1 (activator protein 1). Increased BMAL1 expression can enhance secretion of CCL2 (C-C motif chemokine 2) and RANKL (receptor activator of nuclear factor–κB ligand) in PDLCs, which subsequently promotes the recruitment of monocytes that differentiate into osteoclasts. The mechanistic delineation clarifies that AP1 induced by orthodontic force can directly interact with the BMAL1 promoter and activate gene transcription in PDLCs. Localized administration of the ERK phosphorylation inhibitor U0126 or the BMAL1 inhibitor GSK4112 suppressed ERK/AP1/BMAL1 signaling. These treatments dramatically reduced osteoclastic activity in the compression side of a rat orthodontic model, and the OTM rate was almost nonexistent. In summary, our results suggest that force-induced expression of BMAL1 in PDLCs is closely involved in controlling osteoclastic activities during OTM and plays a vital role in alveolar bone remodeling. It could be a useful therapeutic target for accelerating the OTM rate and controlling pathologic bone-remodeling activities.

scholarly journals Granulocyte colony-stimulating factor (G-CSF) mediates bone resorption in periodontitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hui Yu ◽  
Tianyi Zhang ◽  
Haibin Lu ◽  
Qi Ma ◽  
Dong Zhao ◽  
...  
Keyword(s):  
Bone Resorption ◽  
Alveolar Bone ◽  
Bone Volume ◽  
Granulocyte Colony Stimulating Factor ◽  
Colony Stimulating Factor ◽  
Periodontal Tissues ◽  
Gingival Epithelial Cells ◽  
Trap Staining ◽  
Experimental Periodontitis ◽  
Stimulating Factor

Abstract Background Granulocyte colony-stimulating factor (G-CSF) is an important immune factor that mediates bone metabolism by regulating the functions of osteoclasts and osteoblasts. Bone loss is a serious and progressive result of periodontitis. However, the mechanisms underlying the effects of G-CSF on periodontal inflammation have yet not been completely elucidated. Here, we examined whether an anti-G-CSF antibody could inhibit bone resorption in a model of experimental periodontitis and investigated the local expression of G-CSF in periodontal tissues. Methods Experimental periodontitis was induced in mice using ligatures. The levels of G-CSF in serum and bone marrow were measured; immunofluorescence was then performed to analyze the localization and expression of G-CSF in periodontal tissues. Mice with periodontitis were administered anti-G-CSF antibody by tail vein injection to assess the inhibition of bone resorption. Three-dimensional reconstruction was performed to measure bone destruction‐related parameters via micro-computed tomography analysis. Immunofluorescence staining was used to investigate the presence of osteocalcin-positive osteoblasts; tartrate-resistant acid phosphatase (TRAP) staining was used to observe osteoclast activity in alveolar bone. Results The level of G-CSF in serum was significantly elevated in mice with periodontitis. Immunofluorescence analyses showed that G-CSF was mostly expressed in the cell membrane of gingival epithelial cells; this expression was enhanced in the periodontitis group. Additionally, systemic administration of anti-G-CSF antibody significantly inhibited alveolar bone resorption, as evidenced by improvements in bone volume/total volume, bone surface area/bone volume, trabecular thickness, trabecular spacing, and trabecular pattern factor values. Immunofluorescence analysis revealed an enhanced number of osteocalcin-positive osteoblasts, while TRAP staining revealed reduction of osteoclast activity. Conclusions G-CSF expression levels were significantly up-regulated in the serum and gingival epithelial cells. Together, anti-G-CSF antibody administration could alleviates alveolar bone resorption, suggesting that G-CSF may be one of the essential immune factors that mediate the bone loss in periodontitis.

scholarly journals Inflammation in the Human Periodontium Induces Downregulation of the α1- and β1-Subunits of the sGC in Cementoclasts

2021 ◽  
Vol 22 (2) ◽  
pp. 539
Author(s):  
Yüksel Korkmaz ◽  
Behrus Puladi ◽  
Kerstin Galler ◽  
Peer W. Kämmerer ◽  
Agnes Schröder ◽  
...  
Keyword(s):  
Protein Expression ◽  
Alveolar Bone ◽  
Soluble Guanylyl Cyclase ◽  
Cathepsin K ◽  
Staining Intensity ◽  
Cyclic Guanosine Monophosphate ◽  
Heme Iron ◽  
Guanosine Monophosphate ◽  
Independent Manner ◽  
Periodontal Tissues

Nitric oxide (NO) binds to soluble guanylyl cyclase (sGC), activates it in a reduced oxidized heme iron state, and generates cyclic Guanosine Monophosphate (cGMP), which results in vasodilatation and inhibition of osteoclast activity. In inflammation, sGC is oxidized and becomes insensitive to NO. NO- and heme-independent activation of sGC requires protein expression of the α1- and β1-subunits. Inflammation of the periodontium induces the resorption of cementum by cementoclasts and the resorption of the alveolar bone by osteoclasts, which can lead to tooth loss. As the presence of sGC in cementoclasts is unknown, we investigated the α1- and β1-subunits of sGC in cementoclasts of healthy and inflamed human periodontium using double immunostaining for CD68 and cathepsin K and compared the findings with those of osteoclasts from the same sections. In comparison to cementoclasts in the healthy periodontium, cementoclasts under inflammatory conditions showed a decreased staining intensity for both α1- and β1-subunits of sGC, indicating reduced protein expression of these subunits. Therefore, pharmacological activation of sGC in inflamed periodontal tissues in an NO- and heme-independent manner could be considered as a new treatment strategy to inhibit cementum resorption.

Compressive Force Induces VEGF Production in Periodontal Tissues

2009 ◽  
Vol 88 (8) ◽  
pp. 752-756 ◽  
Author(s):  
A. Miyagawa ◽  
M. Chiba ◽  
H. Hayashi ◽  
K. Igarashi
Keyword(s):  
Alveolar Bone ◽  
Tooth Movement ◽  
Vascular System ◽  
Orthodontic Tooth Movement ◽  
Compressive Force ◽  
Vegf Mrna ◽  
Angiogenic Activity ◽  
Periodontal Tissues ◽  
Pdl Cells

During orthodontic tooth movement, the activation of the vascular system in the compressed periodontal ligament (PDL) is an indispensable process in tissue remodeling. We hypothesized that compressive force would induce angiogenesis of PDL through the production of vascular endothelial growth factor (VEGF). We examined the localization of VEGF in rat periodontal tissues during experimental tooth movement in vivo, and the effects of continuous compressive force on VEGF production and angiogenic activity in human PDL cells in vitro. PDL cells adjacent to hyalinized tissue and alveolar bone on the compressive side showed marked VEGF immunoreactivity. VEGF mRNA expression and production in PDL cells increased, and conditioned medium stimulated tube formation. These results indicate that continuous compressive force enhances VEGF production and angiogenic activity in PDL cells, which may contribute to periodontal remodeling, including angiogenesis, during orthodontic tooth movement.

scholarly journals Alveolar Ridge Preservation After Tooth Extraction with DFDBA and Platelet Concentrates: A Radiographic Retrospective Study

2017 ◽  
Vol 11 (1) ◽  
pp. 99-108 ◽  
Author(s):  
Behrang Baniasadi ◽  
Laurence Evrard
Keyword(s):  
Bone Loss ◽  
Tooth Extraction ◽  
Alveolar Bone ◽  
Bone Allograft ◽  
Ridge Preservation ◽  
Platelet Concentrates ◽  
Freeze Dried ◽  
Significant Difference ◽  
Removable Prosthesis ◽  
The Mean

Objectives: The purpose of this study was to evaluate vertical alveolar bone loss 3 months after tooth extraction when a technique of ridge preservation was applied using a particulate demineralized freeze-dried bone allograft 300 - 500 µm associated with platelet concentrates (platelet-rich-fibrin) in the form of gel and membranes. Material and Methods: A retrospective radiological clinical study was conducted on 56 patients for whom 95 extractions had been performed immediately followed by alveolar filling. Among the patients, 17 were smokers and 16 were provided with an immediate removable temporary prosthesis after extractions. Vertical bone loss was measured radiologically by panoramic X-ray before extractions and by a computed tomography scan 3 months after, at the level of mid-buccal bone wall, by two independent observers. For statistical analysis, Student’s t-test was performed to compare the mean bone loss between mono- and pluri-radicular teeth and to compare the mean bone loss between tobacco users versus non users and finally to compare the mean bone loss between individuals that had provisional removable prosthesis and those that had not. Results: Three months after tooth extraction, the mean of vertical loss of the mid-buccal bone wall was 0.72 (SD 0.71) mm (5.53% SD 5.19). No significant difference between bone loss at mono-radicular and pluri-radicular teeth (P = 0.982) was observed. There was no significant correlation between tobacco habits and bone loss (P = 0.2), nor between provisional removable prosthesis and bone loss (P = 0.786). Conclusion: These results indicate a good potential for the technique using Demineralized Freeze-Dried Bone Allograft 300 - 500 µm and platelet concentrates in alveolar bone preservation.

scholarly journals Effects of DSPP Gene Mutations on Periodontal Tissues

2021 ◽  
Author(s):  
Zhaojun Jing ◽  
Zhibin Chen ◽  
Yong Jiang
Keyword(s):  
Alveolar Bone ◽  
Gene Mutations ◽  
Specific Protein ◽  
Dentinogenesis Imperfecta ◽  
Dentin Sialophosphoprotein ◽  
Periodontal Tissues ◽  
Furcation Involvement ◽  
Almost All ◽  
Alveolar Bone Defect ◽  
Deficient Mice

AbstractDentin sialophosphoprotein (DSPP) gene mutations cause autosomal dominantly inherited diseases. DSPP gene mutations lead to abnormal expression of DSPP, resulting in a series of histological, morphological, and clinical abnormalities. A large number of previous studies demonstrated that DSPP is a dentinal-specific protein, and DSPP gene mutations lead to dentin dysplasia and dentinogenesis imperfecta. Recent studies have found that DSPP is also expressed in bone, periodontal tissues, and salivary glands. DSPP is involved in the formation of the periodontium as well as tooth structures. DSPP deficient mice present furcation involvement, cementum, and alveolar bone defect. We speculate that similar periodontal damage may occur in patients with DSPP mutations. This article reviews the effects of DSPP gene mutations on periodontal status. However, almost all of the research is about animal study, there is no evidence that DSPP mutations cause periodontium defects in patients yet. We need to conduct systematic clinical studies on DSPP mutation families in the future to elucidate the effect of DSPP gene on human periodontium.

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