scholarly journals Open Healing: A Minimally Invasive Protocol with Flapless Ridge Preservation in Implant Patients

Biology ◽  
2022 ◽  
Vol 11 (1) ◽  
pp. 142
Author(s):  
Alecsandru Ionescu ◽  
Aliona Dodi ◽  
Lucian Cristian Petcu ◽  
Mihnea Ioan Nicolescu
Keyword(s):  
Survival Rate ◽  
Minimally Invasive ◽  
Alveolar Bone ◽  
Tissue Level ◽  
Ridge Preservation ◽  
Bovine Bone ◽  
Alveolar Ridge ◽  
Extraction Socket ◽  
Atraumatic Extraction

We aimed to validate the safety and efficacy of the minimally invasive “open healing” flapless technique for post-extraction socket and alveolar ridge preservation, while assessing the alveolar bone changes. The study enrolled (n = 104) patients (0.55 sex ratio), with atraumatic extraction of (N = 135) hopeless teeth, followed by either immediate placement of tissue level implants (N1 = 26), or later stage implant insertion (N2 = 109). No flap was raised in either situation. Post-extraction sockets were filled with deproteinized bovine bone granules and covered by collagen resorbable membrane—left purposely exposed during healing. This yielded an uneventful healing, with sufficient bone formation, while avoiding soft-tissue problems. The need for additional augmentation was assessed clinically and by calibrated CBCT scans at six months, before either loading (N1) or implant insertion (N2). Implant success and survival rate were evaluated at 12-, 24-, and 60-month follow-up control sessions. The inserted implants had a survival rate of 98.5% and a success rate of 94.8% at five-year follow-up. Open healing technique with flapless approach can be favorable for preserving the 3D architecture of the post-extraction socket, as well as the alveolar ridge width and height.

scholarly journals A retrospective cohort study of how alveolar ridge preservation affects the need of alveolar ridge augmentation at posterior tooth implant sites

2021 ◽  
Author(s):  
Kai-Fang Hu ◽  
Ying-Chu Lin ◽  
Yu-Ting Huang ◽  
Yu-Hsiang Chou
Keyword(s):  
Treatment Modality ◽  
Alveolar Bone ◽  
Dental Treatment ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Ridge Augmentation ◽  
Posterior Tooth ◽  
Alveolar Ridge Preservation ◽  
Study Results ◽  
Treatment Plans

Abstract Objectives The aim of this study was to assess whether alveolar ridge preservation (ARP) can reduce the need of ridge augmentation at posterior tooth sites. Material and methods This study enrolled patients who received dental implants at posterior tooth sites during 2013–2019. Demographic data and dental treatment histories were collected. Based on healing patterns after tooth extraction, patients were divided into ARP and spontaneous healing (SH) groups. Three surgical treatment plans were devised according to the alveolar bone volume on cone-beam computed tomography (CBCT). The three treatment plans were to perform implant alone, simultaneous guided bone regeneration (GBR) and implantation, and staged GBR before implantation. Statistical analyses were performed to determine relationships. Results There were 92 implant records in the ARP group and 249 implant records in the SH group. A significant intergroup difference was observed regarding the frequency distribution of the treatment modality of staged GBR before implant (χ2 = 15.07, p = 0.0005). Based on the implant alone treatment modality and simple logistic regression, the SH pattern was related to staged GBR before implant (SH vs. ARP: crude odds ratio (OR) = 4.65, 95% confidence interval (CI) = 2.15–11.61, p = 0.0003). After adjusting confounding factors, the risk was still significant (adjusted OR = 5.02, 95% CI = 2.26–12.85, p = 0.0002). Conclusions The study results suggested that ARP is more likely to lead to the treatment modality of implant alone and reduce the need for staged GBR before implantation. Clinical relevance This study describes ARP capable of minimizing the need for staged GBR before implantation and shortening the treatment duration.

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.

Alveolar Ridge Preservation With Deproteinized Bovine Bone Graft and Collagen Membrane and Delayed Implants

2014 ◽  
Vol 25 (5) ◽  
pp. 1698-1702 ◽  
Author(s):  
Chaoyuan Pang ◽  
Yuxiang Ding ◽  
Hongzhi Zhou ◽  
Ruifeng Qin ◽  
Rui Hou ◽  
...  
Keyword(s):  
Bone Graft ◽  
Collagen Membrane ◽  
Ridge Preservation ◽  
Bovine Bone ◽  
Alveolar Ridge ◽  
Alveolar Ridge Preservation ◽  
Deproteinized Bovine Bone

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 Histomorphometric and Clinical Analysis of Ridge Preservation Procedures in Extraction Sockets with Buccal Bone Defects (>5mm) Using an In Situ Hardening Biphasic Calcium Phosphate (HA/β-TCP) Graft and a Bioresorbable Matrix: A Human Study at 6 Months

2020 ◽  
Vol 10 (9) ◽  
pp. 3034
Author(s):  
Fortunato Alfonsi ◽  
Niccolò Baldi ◽  
Stefano Romeggio ◽  
Paolo Tonelli ◽  
Giovanna Iezzi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Calcium Phosphate ◽  
Bone Loss ◽  
Biphasic Calcium Phosphate ◽  
Clinical Analysis ◽  
Poly Lactic Acid ◽  
P Value ◽  
Ridge Preservation ◽  
Alveolar Ridge ◽  
Extraction Socket

Many biomaterials have been proposed for ridge preservation techniques to counteract fresh extraction socket resorption. The primary aim of this prospective single cohort study was to evaluate the histomorphometric outcomes of a synthetic biphasic calcium phosphate (60% HA/40% β-TCP) and a synthetic poly-lactic acid membrane, used to graft fresh extraction socket sites with a full or partial (>5mm) resorption of the buccal bone plate. Patients recruited were treated at one esthetic site with a ridge preservation procedure to receive an implant-supported prosthesis. After 6 months of healing, a bone biopsy was harvested. Outcome evaluations were: biological complications, histomorphometrical analysis, and alveolar horizontal and vertical bone loss (ΔAHB, ΔAVB). Thirteen subjects were included in this study. Two cases of biological complication were recorded. All 13 patients received implant insertion. From histomorphometric analysis, a mean of 48.9 ± 11.9%, 29.0 ± 9.3%, and 22.0 ± 9.7% was recorded for soft tissues, new bone, and residual graft particles, respectively. From clinical analysis, a mean of 0.5 ± 1.0 mm (p-value < 0.05) and 0.9 ± 1.3 mm (p-value < 0.05) was recorded for alveolar horizontal and vertical bone loss, respectively. In conclusion, this prospective cohort study showed encouraging results in preserving alveolar ridge dimension. A moderate percentage of new bone and an acceptable alveolar ridge loss were achieved at a 6 month follow-up.

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.

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