Dataset Information

Alveolar ridge preservation using an open membrane approach for sockets with bone deficiency: A randomized controlled clinical trial.

ABSTRACT:

Background

Various approaches are used for alveolar ridge preservation (ARP); however, there is no standard method or material.

Purpose

To investigate the effect of ARP with a dense polytetrafluoroethylene (d-PTFE) membrane and freeze-dried irradiated allogenic bone for sockets with bone deficiency.

Materials and methods

Thirty-four patients (with sockets exhibiting ?3 mm hard tissue loss in ?1 walls) were randomized to undergo natural socket healing (control) or ARP with a d-PTFE membrane and freeze-dried irradiated allogenic bone (test group). After 4 months, horizontal and vertical ridge changes were measured using cone beam computed tomography.

Results

Ridge width at l mm below the ridge crest demonstrated significantly less change in the test group (median?=2.3; Q1?=?0.6; Q3?=?4.3 mm) than in the control group (median?=3.9; Q1?=2.6; Q3?=?7.8 mm; P?=?.021). There was no significant difference between the two groups in horizontal ridge changes at 3 and 5 mm below the crest or vertical changes (P?> .05). Requirement for bone augmentation at implant placement was significantly reduced in the test group compared to the control group (P?ConclusionARP with a d-PTFE membrane and freeze-dried irradiated allogenic bone substitute reduced horizontal bone resorption in sockets with bone deficiency.

SUBMITTER: Sun DJ

PROVIDER: S-EPMC6587521 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Alveolar ridge preservation using an open membrane approach for sockets with bone deficiency: A randomized controlled clinical trial.

Sun Dong-Joo DJ Lim Hyun-Chang HC Lee Dong-Woon DW

Clinical implant dentistry and related research 20181105 1

<h4>Background</h4>Various approaches are used for alveolar ridge preservation (ARP); however, there is no standard method or material.<h4>Purpose</h4>To investigate the effect of ARP with a dense polytetrafluoroethylene (d-PTFE) membrane and freeze-dried irradiated allogenic bone for sockets with bone deficiency.<h4>Materials and methods</h4>Thirty-four patients (with sockets exhibiting ≥3 mm hard tissue loss in ≥1 walls) were randomized to undergo natural socket healing (control) or ARP with a ...[more]

PMID: 30394672

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Project description:ObjectiveThe objective of this study is to retrospectively evaluate the clinical outcomes of alveolar ridge preservation (ARP) in the compromised extraction sockets using autogenous cortical-lamina anchoring technique (CAT).Material and methodsTwenty patients were treated with ARP in the compromised extraction sockets by applying CAT. Then implant placement and crown delivery was performed. A planned follow-up was performed by analyzing various outcome measures to evaluate the clinical outcomes, including primary outcome measures [radiographic assessment of residual alveolar ridge height (RARH) and residual alveolar ridge width (RARW)] and secondary outcome measures [clinical assessment of the healing of the soft and hard tissue, survival rates of implants, marginal bone loss (MBL) evaluation of implants, buccal bone thickness (BBT), and esthetic treatment outcomes].ResultsAmong the 20 patients, 17 were consecutively treated and 3 dropped out after implant crown delivery because of loss to follow-up. After the ARP, the initial RARH (12.37 mm) significantly increased to 19.29 mm (P < .05). No significant difference was detected in the RARW before (7.92 ± 1.18 mm) and after (7.92 ± 1.18 mm) the ARP, but reduce to 6.99 ± 1.18 mm at the implant placement and 6.64 ± 0.77 mm at the 3-year follow-up (P < .05). The MBL at the implant crown delivery (0.13 ± 0.12 mm) significantly increased to 0.31 ± 0.14 mm at 1-year follow-up and 0.56 ± 0.23 mm at 3-year follow-up, respectively. The bone loss was limited (<1 mm) but statistically significant (P < .05). The BBT at the implant placement (2.53 ± 0.56 mm) significantly reduced to 2.23 ± 0.44 mm at implant crown delivery and 2.14 ± 0.40 mm at 3-year follow-up, respectively. The bone loss was also limited (<0.5 mm) but statistically significant (P < .05). Each implant site showed acceptable aesthetic outcome and the average score was 16.4. The incisions healed uneventful in all patients and the implant survival rate was 100% during the 3-year follow-up.ConclusionAutogenous CAT was successfully applied to preserve the height and width of alveolar ridge in the compromised extraction sockets.

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: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

Alveolar ridge preservation using an open membrane approach for sockets with bone deficiency: A randomized controlled clinical trial.

Background

Purpose

Materials and methods

Results

Publications

Alveolar ridge preservation using an open membrane approach for sockets with bone deficiency: A randomized controlled clinical trial.

Similar Datasets

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