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Types of devices used in ridge split procedure for alveolar bone expansion: A systematic review.

ABSTRACT: The aim of this systematic review was to evaluate instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration (GBR) and to identify the most used instruments for successful outcome. An electronic as well as manual literature search was conducted in several databases including Medline, Embase, and Cochrane Central Register of Controlled Trials, for articles written in English up to September 2016. The question in focus was to identify the type of device for ridge expansion that is most frequently used and provides adequate bone expansion and implant success rate. To meet the inclusion criteria, the studies were analysed for the following parameters: prospective or retrospective studies, cohort or case studies/series, cases with 5 or more human subjects, type of device used for surgery, location of defect, and minimum follow up period. The frequency of osteotome usage in this study was approximately 65%, and on average, the implant success was 97%. The motorized expanders and ultrasonic surgery system are easier to use and cause less trauma to the bone compared to the traditional/conventional instruments like mallets and osteotomes. However, their cost is a limiting factor; hence, osteotomes remain a popular mode of instrumentation.

SUBMITTER: Jha N

PROVIDER: S-EPMC5521746 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Types of devices used in ridge split procedure for alveolar bone expansion: A systematic review.

Jha Nayansi N Choi Eun Ha EH Kaushik Nagendra Kumar NK Ryu Jae Jun JJ

PloS one 20170721 7

The aim of this systematic review was to evaluate instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration (GBR) and to identify the most used instruments for successful outcome. An electronic as well as manual literature search was conducted in several databases including Medline, Embase, and Cochrane Central Register of Controlled Trials, for articles written in English up to September 2016. The question in focus was to identify the t ...[more]

PMID: 28732054

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Project description:Tooth extraction results in alveolar bone resorption and is accompanied by postoperative swelling and pain. Maresin 1 (MaR1) is a proresolving lipid mediator produced by macrophages during the resolution phase of inflammation, bridging healing and tissue regeneration. The aim of this study was to examine the effects of MaR1 on tooth extraction socket wound healing in a preclinical rat model. The maxillary right first molars of Sprague-Dawley rats were extracted, and gelatin scaffolds were placed into the sockets with or without MaR1. Topical application was also given twice a week until complete socket wound closure up to 14 d. Immediate postoperative pain was assessed by 3 scores. Histology and microcomputed tomography were used to assess socket bone fill and alveolar ridge dimensional changes at selected dates. The assessments of coded specimens were performed by masked, calibrated examiners. Local application of MaR1 potently accelerated extraction socket healing. Macroscopic and histologic analysis revealed a reduced soft tissue wound opening and more rapid re-epithelialization with MaR1 delivery versus vehicle on socket healing. Under micro-computed tomography analysis, MaR1 (especially at 0.05 μg/μL) stimulated greater socket bone fill at day 10 as compared with the vehicle-treated animals, resulting in less buccal plate resorption and a wider alveolar ridge by day 21. Interestingly, an increased ratio of CD206+:CD68+ macrophages was identified in the sockets with MaR1 application under immunohistochemistry and immunofluorescence analysis. As compared with the vehicle therapy, local delivery of MaR1 reduced immediate postoperative surrogate pain score panels. In summary, MaR1 accelerated extraction wound healing, promoted socket bone fill, preserved alveolar ridge bone, and reduced postoperative pain in vivo with a rodent preclinical model. Local administration of MaR1 offers clinical potential to accelerate extraction socket wound healing for more predictable dental implant reconstruction.

Project description:ObjectiveThe purpose of this study was to prospectively evaluate the efficacy of a demineralized dentin matrix (DDM) in decreasing the initial inflammatory response of the gingiva and facilitating the repair and regeneration of soft tissue in alveolar ridge preservation.MethodsThis clinical study employed a split-mouth design. Fourteen patients with a total of forty-four sites underwent extraction and alveolar ridge preservation (ARP) procedures. A Bilaterally symmetrical extraction operation were conducted on the premolars of each patient. The experimental group received DDM as a graft material for ARP, while the control group underwent natural healing. Within the first month postoperatively, the pain condition, color, and swelling status of the extraction sites were initially assessed at different time points Subsequently, measurements were taken for buccal gingival margin height, buccal-lingual width, extraction socket contour, and the extraction socket area and healing rate were digitally measured. Additionally, Alcian Blue staining was used for histological evaluation of the content during alveolar socket healing.ResultsBoth groups experienced uneventful healing, with no adverse reactions observed at any of the extraction sites. The differences in VAS pain scores between the two groups postoperatively were not statistically significant. In the early stage of gingival tissue healing (3 days postoperatively), there were statistically significant differences in gingival condition and buccal gingival margin height between the two groups. In the later stage of gingival tissue healing (7, 14, and 30 days postoperatively), there were statistically significant differences in buccal-lingual width, extraction socket healing area, and healing rate between the two groups. Furthermore, the histological results from Alcian Blue staining suggested that the experimental group may play a significant role in promoting gingival tissue healing, possibly by regulating inflammatory responses when compared to the control group.ConclusionThe application of DDM in alveolar ridge preservation has been found to diminish initial gingival inflammation after tooth extraction. Additionally, it has shown the ability to accelerate early gingival soft tissue healing and preserve its anatomical contour.Clinical trial registrationchictr.org.cn, identifier ChiCTR2100050650.

Project description:BackgroundThere is limited information on the need for bone augmentation in the context of delayed implant placement whether alveolar ridge preservation (ARP) is previously performed or not. The primary aim of this retrospective cohort study was to evaluate the efficacy of ARP therapy after tooth extraction compared with unassisted socket healing (USH) in reducing the need for ancillary bone augmentation before or at the time of implant placement.MethodsAdult subjects that underwent non-molar single tooth extraction with or without simultaneous ARP therapy were included in this study. Cone beam computed tomography scans obtained before tooth extraction and after a variable healing period were used to record the baseline facial bone thickness and to virtually plan implant placement according to a standard method. A logistic regression model was used to evaluate the effect of facial alveolar bone thickness upon tooth extraction and baseline therapy (USH or ARP) on the need for additional bone augmentation, adjusting for several covariates (i.e., age, sex, baseline KMW, and tooth type).ResultsOne hundred and forty subjects that were equally distributed between both baseline therapy groups constituted the study population. Implant placement was deemed virtually feasible in all study sites. Simultaneous bone augmentation was considered necessary in 60% and 11.4% of the sites in the USH and ARP group, respectively. Most of these sites (64.2% in the USH group and 87.5% in the ARP group) exhibited a thin facial bone phenotype (<1 mm) at baseline. Logistic regression revealed that the odds of not needing ancillary bone augmentation were 17.8 times higher in sites that received ARP therapy. Furthermore, the need for additional bone augmentation was reduced 7.7 times for every 1 mm increase in facial bone thickness, regardless of baseline therapy.ConclusionsBased on a digital analysis, ARP therapy, compared with USH, and thick facial alveolar bone largely reduce the need for ancillary bone augmentation at the time of implant placement in non-molar sites.

Dataset Information

Types of devices used in ridge split procedure for alveolar bone expansion: A systematic review.

Publications

Types of devices used in ridge split procedure for alveolar bone expansion: A systematic review.

Similar Datasets

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