scholarly journals Techniques for Preservation of Post-extraction Alveolar Bone Loss: A Literature Review

Author(s):  
Shejali Jana ◽  
Rucha Shah ◽  
Raison Thomas ◽  
A. B. Tarun Kumar ◽  
D. S. Mehta

Sequelae to too the extraction includes progressive loss in the vertical and horizontal dimension of alveolar ridge. These lead to changes in the alveolar process in a 3 dimensional fashion causing hard and soft tissue deficiency which may affect the ability to restore the site. Preservation of the alveolar crest after tooth extraction is essential to maintain the vertical and horizontal dimensions of the alveolar ridge. Several techniques and materials have been introduced to minimize crestal bone loss. There is a broad consensus that ridge preservation procedures are efficient in limiting the post extraction dimensional loss of the ridge. However, the key to successful outcome is proper treatment planning according to the case and prognosis. Conclusion: The aim of this literature review is to discuss the several bone preservation techniques and materials to minimize post-extraction loss of hard and soft tissues.

Materials ◽  
2021 ◽  
Vol 14 (4) ◽  
pp. 940
Author(s):  
Guillermo Cadenas-Vacas ◽  
Natalia Martínez-Rodríguez ◽  
Cristina Barona-Dorado ◽  
Luis Sánchez-Labrador ◽  
Jorge Cortés-Bretón Brinkmann ◽  
...  

After tooth extraction, the alveolar bone undergoes a physiological resorption that may compromise the future placement of the implant in its ideal position. This study evaluated bone density, morphological changes, and histomorphometric results undergone by alveolar bone after applying a new biomaterial composed of calcium phosphate modified with silicon (CAPO-Si) compared with hydroxyapatite of bovine origin (BHA). Alveolar ridge preservation (ARP) was performed in 24 alveoli, divided into a test group filled with CAPO-Si and a control group filled with BHA. Three months later, the mineral bone density obtained by the biomaterials, horizontal and vertical bone loss, the degree of alveolar corticalization, and histomorphometric results were evaluated. Both biomaterials presented similar behavior in terms of densitometric results, vertical bone loss, and degree of alveolar corticalization. Alveoli treated with CAPO-Si showed less horizontal bone loss in comparison with alveoli treated with BHA (0.99 ± 0.2 mm vs. 1.3 ± 0.3 mm), with statistically significant difference (p = 0.017). Histomorphometric results showed greater bone neoformation in the test group than the control group (23 ± 15% vs. 11 ± 7%) (p = 0.039) and less residual biomaterial (5 ± 10% vs. 17 ± 13%) (p = 0.043) with statistically significant differences. In conclusion, the ARP technique obtains better results with CAPO-Si than with BHA.


Materials ◽  
2018 ◽  
Vol 11 (10) ◽  
pp. 2007 ◽  
Author(s):  
José Calvo-Guirado ◽  
Raúl Jiménez-Soto ◽  
Carlos Pérez Albacete-Martínez ◽  
Manuel Fernández-Domínguez ◽  
Sérgio Gehrke ◽  
...  

This in vivo study assessed (hard and soft) peri-implant tissue remodeling around implants with micro-ring and open-thread neck designs placed in a dog model. Twenty histological sections corresponding to four different implant designs that were placed in America Foxhound dogs were obtained from previous studies. All the implants had been placed under identical conditions and were divided into four groups: Group A, micro-rings on implant neck plus 0.5 mm refined surface; Group B, micro-rings on implant neck; Group C, open-thread neck; and, Group D, double-spiral neck. Eight weeks after surgery, the integrated implants were removed and processed for histological examination. Crestal bone loss and bone-to-implant contact was greater for micro-ring necks than open-thread necks. Soft tissues showed significant differences on both buccal and lingual aspects, so that the distance from peri-implant mucosa to the apical portion of the barrier epithelium was smaller in the micro-ring groups. So, in spite of generating greater bone-to-implant contact, implants with micro rings produced more bone loss than open-thread implants. Moreover, the outcomes that were obtained IPX implants smooth neck design produced less bone loss in the cervical area, following by Facility implants when compared with the other open thread and microthreaded implant designs. Implant thread design can influence on bone remodeling in the cervical area, related to bundle bone preservation.


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.


2017 ◽  
Vol 11 (1) ◽  
pp. 99-108 ◽  
Author(s):  
Behrang Baniasadi ◽  
Laurence Evrard

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.


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 10 (9) ◽  
pp. 3034
Author(s):  
Fortunato Alfonsi ◽  
Niccolò Baldi ◽  
Stefano Romeggio ◽  
Paolo Tonelli ◽  
Giovanna Iezzi ◽  
...  

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.


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