scholarly journals Tissue Expansion Improves the Outcome and Predictability for Alveolar Bone Augmentation: Prospective, Multicenter, Randomized Controlled Trial

2020 ◽  
Vol 9 (4) ◽  
pp. 1143
Author(s):  
Soo-Hwan Byun ◽  
Sun-Hyun Kim ◽  
Sura Cho ◽  
Ho Lee ◽  
Ho-Kyung Lim ◽  
...  

Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

2021 ◽  
pp. 014556132110079
Author(s):  
Tongyu Cao ◽  
Qingguo Zhang

Objectives: Ear reconstruction is a challenging surgery for the complicated conditions in patients with microtia. The tissue expansion techniques were necessary and relatively safe for patients with insufficient soft tissue. However, complications such as necrosis of expanded flap and exposure of tissue expander limited the popularization of this method. This study described the use of modified Brent method to handle the exposure of the postauricular tissue expander. Methods: From January 2013 to December 2019, 27 ear reconstruction patients with trauma or necrosis on an expanded skin flap and subsequent exposure of tissue expander were treated with modified Brent method, which consisted of 3 stages: removal of the expander, tension-free closure of wound, and framework fabrication; elevation of reconstructed ear; lobule rotation; and minor modification. Results: Fifty-six percent of exposures occurred in the lower pole of the tissue expander. Exposure usually occurred 54.5 days after implantation. The majority of reconstructed ears had a satisfactory appearance and showed relatively stable outcomes. Only one case of cartilage exposure required revision surgery and was repaired by the temporoparietal fascia. Conclusion: With reasonable distribution of expanded flap, prolonged interval, and sutures under tension-free conditions, complications like the occurrence of trauma or necrosis-induced exposure of tissue expander can be repaired efficiently by a staging modified Brent method.


2014 ◽  
Vol 4 (3) ◽  
pp. 129-138
Author(s):  
Robert Spears ◽  
Ibtisam Al-Hashimi ◽  
Eric S Solomon ◽  
David G Kerns ◽  
William W Hallmon ◽  
...  

ABSTRACT Calcium sulfate is a biologically compatible osteoconductive graft material that binds underlying bone graft and provide space maintenance. The purpose of this study was to evaluate calcium sulfate as a barrier compared to a collagen membrane for augmentation of a standardized surgically created ridge defect. For this purpose, bilateral extraction of mandibular premolars was performed on six foxhounds (Canis familiaris). Eight weeks later, a standardized osseous ridge defects (24 total) were created using a 6 mm trephine. The study was approved by the Institutional Animal Care and Use Committee (IACUC) at Baylor College of Dentistry. The osseous defects were allocated into three groups (8 defects each): group 1 received autogenous bone graft covered with collagen membrane (CM); group 2 received autogenous bone graft covered with calcium sulfate barrier (CS), and group 3 was used as control and did not receive bone augmentation and was used as control. The animals were sacrificed after 12 weeks following bone augmentation and sites were evaluated histologically for total ridge width, percentage of bone gain and cortical bone thickness. Results All sites exhibited bony fill within the defect. Analysis of variance did not reveal statistically significant difference in the mean total bone gain among CM, CS, and control groups (12.2,11.6, and 11.9) mm2, respectively, p = 0.875. Conclusion Calcium sulfate does not appear to improve bone regeneration in an osseous defect. How to cite this article Heaton ML, Kerns DG, Hallmon WW, Kessler HP, Spears R, Solomon ES, Al-Hashimi I. Comparison of Calcium Sulfate and Bovine Collagen Barriers for Alveolar Ridge Augmentation. J Contemp Dent 2014;4(3):129-138.


Scanning ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jin-Hyun Kim ◽  
Puneet Wadhwa ◽  
HongXin Cai ◽  
Dong-Hyung Kim ◽  
Bing Cheng Zhao ◽  
...  

This study is aimed at assessing the dimensional alterations occurring in the alveolar bone after premolar extraction in dogs with histomorphometric and histological analysis. After atraumatic premolar extraction, tooth-derived bone graft material was grafted in the extraction socket of the premolar region in the lower jaws of six dogs in two experimental groups. In the second experimental group, BM-MSCs were added together with the graft. The control was left untreated on the opposite side. After twelve weeks, all six animals were sacrificed. Differences in alveolar bone height crests lingually and buccally, and alveolar bone width at 1, 3, and 5 mm infracrestally, were examined. Histologic study revealed osteoconductive properties of tooth biomaterial. A statistically significant difference was detected between the test and control groups. In the test groups, a reduced loss of vertical and horizontal alveolar bone dimensions compared with the control group was observed. Tooth bone graft material may be considered useful for alveolar ridge preservation after tooth extraction, as it could limit the natural bone resorption process.


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).


2020 ◽  
Vol 31 (7) ◽  
pp. 585-594 ◽  
Author(s):  
Soo‐Hwan Byun ◽  
Seon‐Yeong Kim ◽  
Ho Lee ◽  
Ho‐Kyung Lim ◽  
Ju‐Won Kim ◽  
...  

Author(s):  
Constantin von See ◽  
Nils-Claudius Gellrich ◽  
Ulrike Jachmann ◽  
Matthias W. Laschke ◽  
Kai-Hendrik Bormann ◽  
...  

Author(s):  
Luigi Barbato ◽  
Alessio Gonnelli ◽  
Niccolò Baldi ◽  
Edoardo Francioni ◽  
Paolo Tonelli

Aim: In a human pilot case, we used a root formed temporary prosthetical device (Intra-alveolar Device - IAD), to investigate the effect of mechanical stimulation on hard tissue clinically and radiographically. Background: The extraction of a tooth determines the resorption of the alveolar bone. This determines challenge to place an implant and to integrate the prosthesis in soft tissue. Mechanical stimulation is fundamental for bone tropism but is not understood the effect of mechanical stimulation on post-extraction site. Case presentation: A 24 years old woman was enrolled. The IAD&rsquo;s were used as expected by protocol. Clinical healing was uneventfully. Vertical radiographical bone resorption measured on CBCT was -0,14mm (5,6%) while horizontal bone resorption was -0,21mm (12,36%). Conclusion: This study demonstrated the feasibility of the proposed model. We need clinical prospectical studies enrolling more patients


2020 ◽  
pp. 232020682097601
Author(s):  
Gözde Işık ◽  
Tayfun Günbay ◽  
Yig˘it Uyanıkgil ◽  
Hüseyin Kısaog˘lu ◽  
Meltem Özden Yüce

Aim: To evaluate the effect on vertical bone augmentation of the screw tent-pole technique using particulate allograft in combination with injectable platelet-rich fibrin, and to compare this with autogenous block bone graft. Materials and Methods: This split-mouth randomized controlled study involved patients with bilateral partial edentulism and vertical bone loss in the posterior mandible. In each patient, the control side was treated with autogenous block bone graft harvested from the mandibular ramus and, on the test side, the screw tent-pole technique was employed, using particulate allograft in combination with injectable platelet-rich fibrin. All augmented sites were covered by leukocyte and platelet-rich fibrin membrane. The primary outcome variable of this study was the radiographic changes to bone height 6 months after augmentation. The secondary outcome variables were the percentage of newly formed bone and the implant survival rate. The data were analyzed with a significance level of α = 0.05. Results: Of the 13 patients included, a total of 11 patients (7 females, 4 males; mean age 50.92) completed the study. The mean values of vertical bone gain were 1.72 ± 0.78 mm for the test group and 2.83 ± 0.89 mm for the control group, which constitutes a significant difference ( P = .008). The percentage of newly formed bone was 18.08% ± 2.17% for the test group and 14.26% ± 1.76% for the control group. The difference between the groups was statistically significant ( P < .001). The implant survival rates were 100% for both study groups. Conclusions: Based on the study results, screw tent-pole can be considered a feasible technique for bone augmentation. Further randomized studies will be necessary to fully evaluate vertical bone augmentation using the screw tent-pole technique, with different graft materials and with larger samples.


2016 ◽  
Vol 20 (3) ◽  
pp. 149-154
Author(s):  
N. Trtić ◽  
A. Bošnjak ◽  
R. Arbutina ◽  
Ž. Kojić ◽  
V. Veselinović

Summary Background: Aggressive periodontitis is one of the most severe forms of periodontal disease, resulting in the destruction of junctional epithelium and alveolar bone around teeth in a very short period of time. The early diagnosis of aggressive periodontitis and timely therapy is of outmost importance in controlling the progress of the disease.Application of the techniques of subgingival air polishing of periodontal pockets (pflow) with glycine powder has contributed to reduce damage to the root surface of the teeth and surrounding soft tissue.Aim: The goal of this paper was to determine the effectiveness of two different types of subgingival air polishing therapy for the periodontal tissue status at the patients with aggressive periodontitis.Methods and materials: the study included 46 patients of both sexes diagnosed with aggressive peridontitis. The patients were divided into two groups: test group (PFLOW), and control group (sonic SRP). The size of the destruction of periodontal tissue was estimated by CAL and assessment of oral hygiene and gingival inflammation was performed using FMPS and FMBS.Results: Monitored indexes values in both groups were reduced.Conclusion: Subgingival air polishing showed equally good results as the SRP, while pflow was more advantageous with respect to patients acceptability, time usability and safety for the soft tissue.


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