Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis.
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ABSTRACT:
SUBMITTER: Ibrahim A
PROVIDER: S-EPMC8708389 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:The aim of this study was to compare histologically the dimensional behavior of peri-implant tissues during osseointegration of immediately exposed or submerged implant placement in fresh extraction and healed sites. METHODS:Four fresh extraction and four delayed implant sites were placed in each hemimandible of five dogs at the bone crest level. In 2 implants of each side were installed a healing abutment (exposed) and two cover screw (submerged) and formed four groups: implant installed in fresh extraction submerged (group 1), implants in fresh extraction immediately exposed (group 2), implants installed in healed site submerged (group 3), and implants in healed site immediately exposed (group 4). After 12 weeks of healing period, histomorphometric analyses of the specimens were carried out to measure the crestal bone level values and the tissue thickness in the implant shoulder portion. RESULTS:The measure of crestal bone level showed some higher values for implants installed in fresh extraction sites in the buccal aspect: 1.88?±?0.42 mm for group 1 and 2.33?±?0.33 mm for group 2, with statistical significance among all four groups tested (P?<?0.001). For peri-implant tissue thickness, a significative higher statistical difference (P?<?0.001) for implants installed in healed sites (groups 3 and 4) was found. CONCLUSIONS:Within the limitations of the present animal study, our findings suggest that the implants placed in fresh extraction or healed site and with regards to the moment of exposition (immediately or no) are important factors to the amount of peri-implant tissues after remodeling over a period of 12 weeks. The null hypothesis was rejected.
| S-EPMC6890886 | biostudies-literature
Project description:The aim was to evaluate ridge reduction and mucosal recession following immediate placement of ultra-wide implants in molar sockets, without bone grafting. Impressions were taken prior to tooth extraction, 4 months and 1 year after implant placement. The casts were digitized and compared. Mucosal recessions and horizontal ridge reduction were measured. A total of 16 implants were in the maxilla and 11 in the mandible. At the buccal aspect, there was a mean reduction of 0.94 mm after 4 months and 0.89 mm after one year (p = 0.933). At the palatal/lingual aspect, this was 1.09 mm after 4 months and 0.69 mm after 1 year (p = 0.001). After 1 year, a recession of 0.59 mm was measured at the zenith, 1.04 mm at the mesial and 0.98 mm at the distal papilla. The mean midfacial horizontal ridge reduction was 1.23 mm after 4 months and 1.45 mm after 1 year. At the midpalatal/midlingual aspect, the mean horizontal reduction was 1.43 mm after 4 months and 1.16 mm after 1 year. Immediate implant placement without bone grafting in the posterior jaw yields a significant horizontal ridge reduction and minor mucosal recession. Clinicians should anticipate the amount of ridge reduction and consider augmentation at the time of implant placement.
| S-EPMC7464762 | biostudies-literature
Project description:Objectives:The aim of this systematic review is to compare immediate implant placement in infected extraction sockets with non-infected extraction sockets in terms of implant survival and function. Material and Methods:An electronic search was conducted in PubMed, ScienceDirect, ISI Web of Knowledge and Google Scholar between January 2010 and February 2020. Studies evaluating implant survival rate and main clinical parameters were included for a qualitative and quantitative analysis. Results:In total, nine studies were included and a pool of 2281 sockets were analysed. Compared with the non-infected group, the infected group showed no significant differences in implant survival rates (risk ratio [RR] = 0.99; 95% confidence interval [CI] = 0.98 to 1; P = 0.08). No significant statistical differences were found in marginal bone level (mean difference [MD] = -0.03; 95% CI = -0.1 to 0.04; P = 0.41), marginal gingival level (MD = -0.07; 95% CI = -0.17 to 0.04; P = 0.23), probing depth (MD = 0.06; 95% CI = -0.24 to 0.36; P = 0.7), modified bleeding index (MD = -0.00162196; 95% CI = -0.09 to 0.09; P = 0.97) and slight but significant changes were seen in width of keratinized gingiva (MD = 0.25; 95% CI = -0.3 to 0.8; P = 0.38) between the groups at the latest follow-up. Conclusions:There were no significant difference in implant survival rates, marginal bone level, marginal gingival level, modified bleeding index and probing depth between infected sockets and non-infected sockets. However, slight but significant changes were seen in width of keratinized gingiva favouring the non-infected group.
| S-EPMC7393932 | biostudies-literature
Project description:BACKGROUND:Immediate implants are frequently employed in the anterior maxillary area. However, the installation of dental implants simultaneously with tooth extraction can also provide with benefits in the posterior areas with a reduction in time prior the recovery of the masticatory function. Results previously reported in the literature show high-survival and success rates for implants placed in extraction sockets in molar areas; however, this topic has received limited systematic analysis. MATERIAL AND METHODS:Electronic and manual literature searches were performed by two independent reviewers in several data-bases, including MEDLINE, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to January 2019 reporting outcomes of immediate implants placed in molar areas. Primary outcomes included survival and success rates, as well as marginal bone loss. Secondary outcomes included the influence of implant position, type of implant connection, grafting protocol, flap or flapless approach, implant diameter, surgical phase, presence of buccal plate, and loading protocol. RESULTS:Twenty studies provided information on the survival rate, with a total sample of 1.106 implants. The weighted mean survival rate of immediate implants after 1 year of follow-up was 96.6%, and the success rate was 93.3%. On the other hand, marginal bone loss was 1.29 ± 0.24 mm. Secondary outcomes demonstrated that grafting the gap and the loading protocol have an effect on survival and success rates. Similarly, the presence or absence of the buccal bone affect crestal bone levels. Meta-analysis of 4 investigations showed a weighted mean difference of 0.31 mm ± 0.8 IC 95% (0.15-0.46) more marginal bone loss at immediate implant placement versus implants in healed sites (p < 0.001) I2 = 15.2%. CONCLUSION:In selected scenarios, immediate implant placement in molar extraction socket might be considered a predictable technique as demonstrated by a high survival and success rates, with minimal marginal bone loss.
| S-EPMC7413966 | biostudies-literature
Project description:The aim of this study was to determine the clinical differences between early and conventional loading protocols for dental implants. A comprehensive search of the Medline, Embase, and OVID databases for studies published through January 10, 2015 was conducted. Fourteen studies were included in our analysis. We found that early loading imposed a significantly higher risk of implant failure than did conventional loading (risk ratio = 2.09, 95% confidence interval [CI] [1.18, 3.69], P = 0.01), while no significant differences between the methods were found with regards to the marginal bone loss (weighted mean differences [WMD]?= 0.11, 95% CI [-0.07, 0.28], P = 0.23), periotest value (WMD?= 0.02, 95% CI [-0.83, 0.87], P = 0.96), or implant stability quotient (WMD?= 0.79, 95% CI [-0.03, 1.62], P = 0.06). As for the health status of the peri-implant tissue, conventionally loaded implants demonstrated better performance than did early loaded implants. Subgroup analyses demonstrated that the sample size, time of publication, loading definition, implant position, extent, and restoration type influenced the results. Although early implant loading is convenient and comfortable for patients, this method still cannot achieve the same clinical outcomes as the conventional loading method.
| S-EPMC4635353 | biostudies-literature
Project description:PurposeThe purpose of the present study was to evaluate the effect of silica-calcium phosphate composite (SCPC) granules on bone regeneration in extraction sockets.MethodsTen patients were selected for a split-model study. In each patient, bone healing in SCPC-grafted and control ungrafted sockets was analyzed through clinical, radiographic, histomorphometric, and immunohistochemical assessments 6 months postoperatively.ResultsA radiographic assessment using cone-beam computed tomography showed minimal ridge dimension changes in SCPC-grafted sockets, with 0.39 mm and 1.79 mm decreases in height and width, respectively. Core bone biopsy samples were obtained 6 months post-extraction during implant placement and analyzed. The average percent areas occupied by mature bone, woven bone, and remnant particles in the SCPC-grafted sockets were 41.3%±12%, 20.1%±9.5%, and 5.3%±4.4%, respectively. The percent areas of mature bone and woven bone formed in the control ungrafted sockets at the same time point were 31%±14% and 24.1%±9.4%, respectively. Histochemical and immunohistochemical analyses showed dense mineralized bundles of type I collagen with high osteopontin expression intensity in the grafted sockets. The newly formed bone was well vascularized, with numerous active osteoblasts, Haversian systems, and osteocytes indicating maturation. In contrast, the new bone in the control ungrafted sockets was immature, rich in type III collagen, and had a low osteocyte density.ConclusionsThe resorption of SCPC granules in 6 months was coordinated with better new bone formation than was observed in untreated sockets. SCPC is a resorbable bone graft material that enhances bone formation and maturation through its stimulatory effect on bone cell function.Trial registrationClinicalTrials.gov Identifier: NCT03897010.
| S-EPMC7758298 | biostudies-literature
Project description:Background and Objectives: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). Materials and Methods: Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. Results: The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, p < 0.001), as well as in the mandible (OR 2.866, p < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm (p < 0.001). There was an estimated decrease of 0.001 in OR (p = 0.566) and increase of 0.004 mm (p = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. Conclusions: Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.
| S-EPMC8780868 | biostudies-literature
Project description:Bone marrow-derived mesenchymal stem/progenitor cells (BMSCs) are commonly used in regeneration therapy. The current primary source of BMSCs is the iliac crest; however, the procedure is associated with various burdens on the patient, including the risk of pain and infection. Hence, the possibility to collect BMSCs from other, more accessible, sources would be an attractive approach. It is well known that stem cells migrate from surrounding tissues and play important roles in wound healing. We thus hypothesized that stem/progenitor cells could be isolated from granulation tissue in the dental socket, and we subsequently collected granulation tissue from dog dental socket 3 d after tooth extraction. After enzyme digestion of the collected tissue, the cells forming colonies constituted the dental socket-derived stem/progenitor cells (dDSCs). Next, dDSCs were compared with dog BMSCs (dBMSCs) for phenotype characterization. A flow cytometric analysis showed that dDSCs were positive for CD44, CD90, and CD271 but negative for CD34 and CD45, similar to dBMSCs. dDSCs also exhibited osteogenic, adipogenic, and chondrogenic differentiation ability, similar to dBMSCs, with a higher capacity for colony formation, proliferation, and motility than dBMSCs. In addition, an in vivo ectopic bone formation assay showed that dDSCs and dBMSCs both induced hard tissue formation, although only dDSCs formed a fibrous tissue-like structure connected to the newly formed bone. Finally, we tested the ability of dDSCs to regenerate periodontal tissue in a one-wall defect model. The defects in the dDSC-transplanted group (?-TCP/PGA/dDSCs) were regenerated with cementum-like and periodontal ligament-like tissues and alveolar bone, whereas only bony tissue was observed in the control group (?-TCP/PGA). In conclusion, we identified and characterized a population of stem/progenitor cells in granulation tissue obtained from the dental socket that exhibited several characteristics similar to those of BMSCs. Dental sockets could therefore be a novel source for isolating stem/progenitor cells from bone.
| S-EPMC4293764 | biostudies-literature
Project description:BACKGROUNDS:Clinical benefits in bone grafting of intact extraction socket have been widely known, but limited evidence is available for the procedure in damaged extraction sockets due to periodontal disease. PURPOSE:This study aimed to determine the dimensional alteration of alveolar ridge following bone grafting of damaged extraction sockets, and compare the outcomes of using deproteinized bovine (DBBM) versus porcine bone mineral (DPBM) in the damaged sockets. MATERIALS AND METHODS:One hundred patients (n?=?50 for each group) with periodontitis-induced damaged extraction socket were included in this randomized, single-blind trial. After removal of tooth and granulation tissue, sites were grafted with either DBBM (DBBM group) or DPBM (DPBM group), and covered with collagen membrane. Linear/volumetric analyses of hard and soft-tissue dimensions were performed on reconstructed/superimposed computed tomography and scanned cast images, taken immediately and 4 months after surgery. RESULTS:The two groups showed comparable hard tissue augmentation with minimal reductions in the grafted volume, as well as in vertical (1.22?±?2.16 and 1.45?±?1.92 mm for DPBM and DBBM group, respectively) and horizontal (1.43?±?3.40 and 1.83?±?2.85 mm on the central section, respectively) dimensions at 4 months after surgery. However, several cases showed large variations in maintenance of the grafted volume. None of the measured parameters in hard and soft tissue dimensions differed significantly between DBBM and DPBM sites. CONCLUSIONS:DBBM and DPBM can comparably augment damaged extraction sockets with minimal postoperative reduction of the grafted volume. However, the large variations in the results should be further evaluated for application in routine dental clinics.
| S-EPMC6220803 | biostudies-literature
Project description:OBJECTIVE:Impaired health conditions and related lack of adequate host healing are among the most important conditions that account for dental implant failure. Today clinicians face an increasing number of immunocompromised patients requesting implant-based rehabilitation. To provide clinical evidence for prospective decision-making, the aim of this systematic review and meta-analysis was to analyse the influence of immunodeficiency on dental implant survival. METHODS:The study was conducted according to the PRISMA Statement and the principles of the Cochrane Collaboration. MEDLINE and Web of Science were searched. Results were calculated by the pooled incidence of implant loss. Reported odds ratios (OR) from fully adjusted models were preferred. Distinct risk estimates were synthesised with 95% confidence intervals. RESULTS:A total of 62 publications including 1751 endosseous implants placed in immunocompromised patients were included. For the follow-up of 24?months and longer, the mean survival rate of implants in patients with HIV was 93.1%, chemotherapy was 98.8%, autoimmune disease was 88.75%, after organ transplantation was 100%. Crohn's disease showed a significant effect on early implant failure and resulted in increased, however not significant, implant loss. CONCLUSION:No significant effect of immunocompromised conditions on implant survival was detectable. Implant-based therapy in immunocompromised patients should not aggravate the general morbidity and must not interfere in life-saving therapies. A careful risk stratification prior implant therapy is fundamental. To further decipher the role of immunosuppression on dental implantology, more data from controlled and randomised studies are needed.
| S-EPMC6881487 | biostudies-literature