Preservation or reconstruction of the Peri-implant bone- A Review

The main biological and biophysical process that has made dental implant therapy predictably successful for replacing missing teeth is Osseointegration. Teeth extraction is done for several purposes, often without any consideration for the preservation of the alveolar ridge. Alveolar bone post-extraction changes have been estimated to cause a 50% decrease in alveolar bone buccolingual width, and a further loss in height. This review will go through various techniques of ARP and bone regeneration techniques and explore the best way to obtain the best outcomes after implant placement.

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Postextraction Alveolar Ridge Preservation: Biological Basis and Treatments

International Journal of Dentistry ◽

10.1155/2012/151030 ◽

2012 ◽

Vol 2012 ◽

pp. 1-13 ◽

Cited By ~ 57

Author(s):

Giorgio Pagni ◽

Gaia Pellegrini ◽

William V. Giannobile ◽

Giulio Rasperini

Keyword(s):

Tooth Extraction ◽

Alveolar Bone ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Implant Placement ◽

Conscious Decision ◽

Alveolar Ridge Preservation ◽

Immediate Implant ◽

Implant Therapy ◽

Bone Structures

Following tooth extraction, the alveolar ridge undergoes an inevitable remodeling process that influences implant therapy of the edentulous area. Socket grafting is a commonly adopted therapy for the preservation of alveolar bone structures in combination or not with immediate implant placement although the biological bases lying behind this treatment modality are not fully understood and often misinterpreted. This review is intended to clarify the literature support to socket grafting in order to provide practitioners with valid tools to make a conscious decision of when and why to recommend this therapy.

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Impact of a Alveolar Ridge Preservation Technique on the Need of Performing Guided Bone Regeneration for Dental Implant Placement

Case Medical Research ◽

10.31525/ct1-nct04299750 ◽

2020 ◽

Author(s):

Keyword(s):

Bone Regeneration ◽

Dental Implant ◽

Guided Bone Regeneration ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Implant Placement ◽

Alveolar Ridge Preservation ◽

Preservation Technique

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New Implant Design with Midcrestal and Apical Wing Thread for Increased Implant Stability in Single Postextraction Maxillary Implant

Case Reports in Dentistry ◽

10.1155/2019/9529248 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Antonio Scarano ◽

Bartolomeo Assenza ◽

Francesco Inchingolo ◽

Filiberto Mastrangelo ◽

Felice Lorusso

Keyword(s):

Cortical Bone ◽

Dental Implant ◽

Alveolar Bone ◽

Primary Stability ◽

Implant Design ◽

Insertion Torque ◽

Fixture Design ◽

Implant Stability ◽

Implant Placement ◽

Immediate Placement

Background. The immediate placement of a dental implant could represent an option treatment for the rehabilitation of a postextractive missing tooth socket to replace compromised or untreatable teeth, with the advantage of single-session surgery. In this way, the anatomy of the alveolar bone defect, the preservation of the buccal cortical bone, and the primary stability of the fixture represent the critical factors that consent a precise implant placement. Objective. This case report describes a novel fixture design for postextractive alveolar socket immediate implant. Methods. Two patients (25 and 31 years old) were treated for postextractive dental implant placement to replace both central upper incisor teeth with four implants. The residual bone implant gap was not filled with graft or bone substitute. The restoration was provided following a standard loading protocol by a cement-sealed prosthetic abutment. Results. Clinically, all implants positioned showed an excellent insertion torque. No postoperative complications were reported. At 6 months of healing, the buccal cortical bone and the implant stability were present and well maintained. Conclusion. The evidence of this study allows us to underline the possible advantages of this new fixture design for postextractive implant technique.

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Bone Regeneration Using a Three-Dimensional Hexahedron Channeled BCP Block Combined with Bone Morphogenic Protein-2 in Rat Calvarial Defects

Materials ◽

10.3390/ma12152435 ◽

2019 ◽

Vol 12 (15) ◽

pp. 2435 ◽

Cited By ~ 3

Author(s):

So-Yeun Kim ◽

Eun-Bin Bae ◽

Jae-Woong Huh ◽

Jong-Ju Ahn ◽

Hyun-Young Bae ◽

...

Keyword(s):

Bone Regeneration ◽

Alveolar Bone ◽

Three Dimensional ◽

Bone Morphogenetic Protein 2 ◽

Graft Material ◽

Implant Placement ◽

Morphogenetic Protein ◽

Human Bone Morphogenetic Protein ◽

Calvarial Defects ◽

Rat Calvarial Defect

It is important to obtain sufficient bone mass before implant placement on alveolar bone, and synthetic bone such as biphasic calcium phosphate (BCP) has been studied to secure this. This study used a BCP block bone with a specific structure of the three-dimensional (3D) hexahedron channel and coating with recombinant human bone morphogenetic protein-2 (rhBMP-2) impregnated carboxymethyl cellulose (CMC) was used to examine the enhancement of bone regeneration of this biomaterial in rat calvarial defect. After the preparation of critical-size calvarial defects in fifteen rats, defects were divided into three groups and were implanted with the assigned specimen (n = 5): Boneplant (untreated 3D hexahedron channeled BCP block), Boneplant/CMC (3D hexahedron channeled BCP block coated with CMC), and Boneplant/CMC/BMP (3D hexahedron channeled BCP block coated with CMC containing rhBMP-2). After 4 weeks, the volumetric, histologic, and histometric analyses were conducted to measure the newly formed bone. Histologically, defects in the Boneplant/CMC/BMP group were almost completely filled with new bone compared to the Boneplant and Boneplant/CMC groups. The new bone volume (P < 0.05) and area (P < 0.001) in the Boneplant/CMC/BMP group (20.12% ± 2.17, 33.79% ± 3.66) were much greater than those in the Boneplant (10.77% ± 4.8, 16.48% ± 9.11) and Boneplant/CMC (10.72% ± 3.29, 16.57% ± 8.94) groups, respectively. In conclusion, the 3D hexahedron channeled BCP block adapted rhBMP-2 with carrier CMC showed high possibility as an effective bone graft material.

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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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