scholarly journals Comparative Study between a Novel In Vivo Method and CBCT for Assessment of Ridge Alterations after Socket Preservation—Pilot Study

Author(s):  
Vasilena Ivanova ◽  
Ivan Chenchev ◽  
Stefan Zlatev ◽  
Georgi Iordanov ◽  
Eitan Mijiritsky

The aim of this study was to compare two different methods for evaluation of alveolar bone resorption after the socket preservation procedure. In the current study, 9 patients with a total of nine teeth indicated for extraction were included. Patients received alveolar ridge preservation with allograft (BoneAlbumin™, OrthoSera Dental, Gyor, Hungary) or Platelet-Rich fibrin (PRF). CBCT (Planmeca ProMax 3D, Helsinki, Finland), was taken at 1 week and 4 months after the socket preservation procedure. A 3D scan, obtained with Trios (3Shape, Copenhagen, Denmark) of the alveolar bone of the surgical site and the adjacent teeth at the place of extraction was performed during the surgical procedure, immediately after the graft placement in the alveolar socket, and after 4 months. Virtual study models were generated using the three-dimensional file processing software “Meshlab” (ISTI—CNR Rome Italy). The changes of alveolar height and width were measured and analyzed. Results were taken from both methods. Radiographic examination revealed that the average value of horizontal resorption is 0.6–2.4 mm, and vertical resorption is 0.46–2.8 mm. On virtual models, the average value for horizontal resorption is 1.92–3.64 mm, the vertical resorption value is 0.95–2.10 mm. The Trios intraoral scan can provide non-invasive and more accurate quantitative insights into the dimensional changes in the alveolar ridge after the bone remodeling process. More research is needed for verification of these results.

Author(s):  
Kai-Fang Hu ◽  
Ying-Chu Lin ◽  
Yu-Ting Huang ◽  
Yu-Hsiang Chou

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.


2020 ◽  
Vol 99 (4) ◽  
pp. 402-409 ◽  
Author(s):  
G. Avila-Ortiz ◽  
M. Gubler ◽  
M. Romero-Bustillos ◽  
C.L. Nicholas ◽  
M.B. Zimmerman ◽  
...  

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).


2021 ◽  
Vol 11 (14) ◽  
pp. 6591
Author(s):  
Sung-Wook Yoon ◽  
Young Woo Song ◽  
Ui-Won Jung ◽  
Jae-Kook Cha

After tooth extraction, notable ridge alterations occur due to resorption of bundle bones during the healing process. In areas with thin or damaged socket walls and multiple adjacent tooth extraction, dimensional changes are more prominent in the marginal proportion. In addition to the marginal changes, upper molar teeth are also vulnerable to pneumatization of the maxillary sinus. To reduce dimensional changes in extraction sockets, alveolar ridge preservation (ARP) is favored by many clinicians in areas where a large amount of dimensional change is expected. This case report presents two cases of ARP using collagenated demineralized bovine bone mineral and demineralized porcine bone mineral in the apically involved upper premolar and molar, respectively. Implants were placed one and two years, respectively, after the ARP. Radiographic analyses of residual bone height and volume were measured using cone-beam-computed tomography (CBCT) and histologic analysis of newly formed mineralized bone and residual graft material percentages were measured from the collected tissue samples using a trephine bur. Implants were placed using a simple technique, without any additional bone grafts at the marginal proportion. The ARP technique could maintain the alveolar bone height and volume, as well as minimize the invasiveness of surgical procedures during implant surgery.


2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Giorgio Pagni ◽  
Gaia Pellegrini ◽  
William V. Giannobile ◽  
Giulio Rasperini

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.


2021 ◽  
Author(s):  
Dilinuer Keranmu ◽  
Nijiati Nuermuhanmode ◽  
Ailimaierdan Ainiwaer ◽  
Adili Moming ◽  
Gu Li ◽  
...  

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.


Author(s):  
Jeong Joon Han ◽  
Ah. Ryum Chang ◽  
Jaemyung Ahn ◽  
Seunggon Jung ◽  
Jongrak Hong ◽  
...  

Abstract Background The aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation. Materials and methods Eighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups. Results Both the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group. Conclusions The results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction. Trial registration Clinicaltrials.gov, NCT02714829, Registered 22 March 2016


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