Evidencia clínica e histológica de regeneración de tejido blando a partir de una matriz colágena porcina. Reporte de Caso

RESUMEN: La pérdida de un diente resulta en la pérdida de volumen de tejidos duros y blandos lo que dificulta lograr resultados estéticamente satisfactorios. Con el fin de disminuir la morbilidad que provoca un injerto autólogo en el sellado del alveolo se puede reemplazar por una matriz reabsorbible de colágeno. El presente reporte de caso evaluó clínica e histológicamente una matriz colágena de porcino, en la regeneración de tejido blando, durante la instalación de un implante inmediato a una extracción dentaria. A los 6 meses clínicamente se obtuvo un tejido con una apariencia estética final óptima e histológicamente se evidenció la formación de un tejido epitelial y conjuntivo compatible con la de una mucosa normal.

ABSTRACT: Tooth loss results in loss of hard and soft tissue volume, making it difficult to achieve aesthetically pleasing results. In order to decrease the morbidity caused by an autologous graft in the alveolus seal, it can be replaced by a resorbable matrix of collagen. The present case report evaluated clinically and histologically a porcine collagen matrix, in soft tissue regeneration, during the installation of an implant immediately after dental extraction. At 6 months, clinically, a tissue with an optimal final aesthetic appearance was obtained and histologically, the formation of an epithelial and connective tissue compatible with that of a normal mucosa was evidenced.

Alveolar Ridge Preservation after Tooth Extraction and Replacement with Fibre reinforced Composite Bridge in a Young Patient: A Case Report

ABSTRACT@#Alveolar ridge preservation is a surgical procedure aimed to preserve the alveolar bone after tooth extraction to eliminate or reduce the need for bone augmentation during implant placement. It includes the use of membrane that is either being used alone or in combination with a bone replacement graft. This case report describes the technique of alveolar ridge preservation after tooth extraction using a xenogenic bone graft combined with a resorbable collagen membrane, and the fabrication of an anterior fibre-reinforced composite (FRC) bridge in an 18-year-old male patient. This treatment allows him to have a good preservation of the volume and architecture of the alveolar ridge as well as soft tissues and temporarily replace a missing anterior tooth until a definitive restoration can be achieved.

The Evaluation of Bone Regeneration Following Socket Preservation with Concentrated Growth Factor (CGF) and Poly Lactic-Co-Glycolic Acid (PLGA) Scaffold in Rabbits

ABSTRACT@#Various grafting materials are utilised to facilitate regeneration. There is currently a paradigm shift towards applying poly lactic-co-glycolic acid (PLGA), which is regarded as an excellent scaffold for tissue engineering. Concentrated growth factor (CGF) has also been reported to promote wound healing. Nevertheless, the role of PLGA microspheres as a substitute for bone graft material with CGF in bone regeneration remains unclear. This study was designed to evaluate the effect of CGF with PLGA on bone formation and the expression of alkaline phosphatase (ALP) following socket preservation. PLGA microspheres were prepared using double solvent evaporation method and observed under scanning electron microscopy (SEM). A 6 mL of rabbit’s blood was collected from the marginal ear vein and centrifuged to obtain CGF. Blood was also collected for ALP assessment from 24 New Zealand White (NZW) male rabbits subjected to the first upper left premolar extraction. Sockets were filled with CGF, PLGA, CGF+PLGA or left empty and observed with microscopic computed tomography (micro-CT) at four weeks and eight weeks. The SEM image revealed a spherical shape with interconnected pores on the surface of the PLGA particles. Repeated measures ANOVA were used to evaluate the effect of time and treatment (p < 0.05) with significant differences in bone width, height, volume, volume fraction and expression of ALP was observed with CGF+PLGA. Both CGF and PLGA have the potential as the alternative grafting materials and this study could serve as an ideal benchmark for future investigations on the role of CGF+PLGA in bone regeneration enhancement.

Increased Expression of RUNX2 and ALP Resulting from a Combination of Propolis Extract and Bovine Bone Graft in Socket Preservation Material

Abstract The aim of this study was to determine the inductive effect of a combination of propolis and BBG extract on RUNX2 and ALP expression in the tooth extraction sockets of Cavia cobaya. Fifty- six Cavia cobaya were divided into four groups: polyethylene glycol (PEG), propolis extract + PEG, BBG + PEG, and propolis extract + BBG + PEG. The lower left incisor was extracted, and the socket subsequently filled with material according to the specific group of which the subject was a member. The subjects were sacrificed on the 14th and 30th days. Immunohistochemical staining was carried out under a light microscope at 400x magnification. Statistical analysis was then carried out by means of One-Way ANOVA and Tukey HSD tests. The mean number of RUNX2 and ALP expressions in each group was significantly different. The highest number of RUNX2 and ALP expressions occurred in the propolis + BBG + PEG group on the 30th day, while the lowest expressions were observed in the control group on the 14th day. A combination of propolis and BBG extract at a concentration of 2% of active substance effectively increases the expression of RUNX2 and ALP in preserving the tooth extraction sockets of Cavia cobaya.

Meta-analysis of the effect of platelet-rich fibrin in alveolar ridge preservation / 口腔疾病防治

Objective @#To evaluate the effect of platelet-rich fibrin (PRF) on alveolar ridge preservation after tooth extraction.@*Methods@#Randomized controlled trials (RCTs) published before August 25, 2020 about the use of PRF after tooth extraction were searched through the PubMed, Embase, Cochrane Library, HowNet, Wanfang, CBM databases and clinical trial registration centers in China and the United States. Outcome indicators included in the studies included dry socket occurrence, alveolar bone resorption in the horizontal and vertical directions, and the percentage of new bone. Meta-analysis was conducted with Review Manager Version 5.3 software.@*Results@# A total of 706 studies were retrieved. After screening, 8 studies were analyzed quantitatively. Meta-analysis results showed that PRF could reduce the absorption of alveolar bone after tooth extraction, which reduced the horizontal bone mass (WMD=-0.71, 95% CI=-1.11 to -0.32, P < 0.05) and buccal (WMD=-1.38, 95% CI =-1.87 to -0.88, P < 0.05) and lingual sides (WMD=-0.49, 95% CI=-0.92 to -0.06, P < 0.05) and increased the percentage of new bone (SMD=1.24, 95% CI =0.25 to 2.23, P < 0.05). However, there was no significant difference in preventing the occurrence of dry socket (RD < 0.01, 95% CI=-0.05 to 0.04, P=0.95) and reducing bone absorption in the vertical direction of mesial (WMD=-0.11, 95% CI=-1.17 to 0.95, P=0.84) and distal (WMD=-0.66, 95% CI=-1.93 to 0.60, P=0.30) alveolar ridge after tooth extraction. @*Conclusion @# Using PRF alone after tooth extraction can effectively preserve bone mass in the horizontal direction of the alveolar ridge and the vertical direction of the buccal and lingual sides.

A Clinical and Radiographic Comparative Evaluation of Self-healing Extraction Socket versus Use of Autogenous Dentin and Demineralized Freeze-Dried Bone Allograft for Socket Preservation Following Tooth Extraction

Introduction: Preservation of alveolar dimensions after tooth extraction is crucial to achieve optimal esthetic and functionalprosthodontic results. With the increasingly frequent use of dental implants to replace non-restorable teeth, preservation ofthe existing alveolus is essential to maintain adequate bone volume for placement and stabilization of the implants. The aimof the study was to clinically and radiographically compare and evaluate autogenous dentin as bone graft with demineralizedfreeze-dried bone allograft (DFDBA) and extraction socket left alone for healing.Materials and Methods: Ethical clearance was obtained for the study. A written informed consent was taken from all theparticipants. A total of 45 randomly selected adult patients were divided into three groups: (1) Extraction socket with graftmaterial placement: Autogenous dentin (natural tooth dentin) as a bone graft (15 participants). (2) Extraction socket with graftmaterial placement: DFDBA as a bone graft (15 participants). (3) Extraction socket to be left alone for healing (15 participants).The cases were examined at 3, 6, and 9 months post-intervention. For each visit, clinical and radiographic assessmentradiovisiography was done to access the bone tissue healing. The mean buccolingual bone ridge width and height werecompared both clinically and radiographically. The data collected were subjected to statistical analysis using SPSS 22.0.ANOVA and paired t-test were carried out for comparing the mean bone buccolingually on the radiograph. All P < 0.05 wereconsidered to be statistically significant.Results: The mean buccolingual ridge width measured by Vernier caliper for the I group was 7.13 ± 0.91, for II group, it was6.20 ± 0.86, and for the III group was 5.33 ± 0.61. The difference between the groups was statistically significant at 9 months.The mean height of the bone measured by radiograph showed that for I group, it was 6.33 ± 0.88, for II group, it was 6.13 ± 0.83,and for the III group, it was 5.33 ± 0.61. The difference in the mean outcome was significant between I and III as well as II andIII groups.Conclusion: The results of the grafted sites showed statistically significant difference compared to non-grafted sites.The alveolar ridge preservation shows reduction in buccolingual shrinkage. The present investigation shows thataugmenting the extraction socket with biomaterials may have the possibility to limit the buccolingual and coronalapical shrinkage.

Use of Autogenous Dentin Graft in Mandibular Third Molar Extraction Sockets: A Split-Mouth Randomized Double-Blind Study

Aim: Dentin graft has been recently used as a bone substitute in implant surgery. After third molar extraction a distal ridgedefect may result. This study aimed to evaluate the effectiveness and complications of using autogenous dentin graft afterlower third molars extraction. Materials and methods: The inclusion criteria included patients with mirror-image impactedlower third molars, at least 18 years old, non-smokers, and without any medical disease. Outcomes assessed included pocketdepth (PD) at the lower second molars, Recession (MG), Clinical Attachment level (CAL), Pain using visual analogue score(VAS), Swelling, and Healing. PD, MG and CAL were assessed at three time points (point 1: pre-surgery, point 2: onemonth post extraction, point 3: three months post extraction). The follow up visits were at 7 days (T1), 42 days (T2), and 92days (T3) postoperatively. Hypothesis testing was performed using a significance level of 0.05. Results: Ten patients wereenrolled in the study but 3 of them failed to follow up and were excluded. Pocket depth was not significantly differentbetween the intervention and control groups at T2 and T3. Gingival recession was significantly lower in the treatment groupat T2 (P 0.048) but was not significantly different at T3. The odds of being in a higher category in the dentin graft group attime 3 was 14% the odds in the control arm at time 3 (OR = 0.14, p = 0.09). There was no significant difference between theintervention and control groups for pain VAS, healing, and swelling. Conclusion: Dentin graft is a viable material for bonegrafting after extraction of third molar sockets. Although there was no statistically significant difference between tested andcontrol sites, this maybe a result of the small sample size and the nature of the included cases. Clinical significance:Autogenous dentin graft can be used as a cost-effective, safe, and biocompatible bone-substitute after third molarextractions.

Mandibular trabecular structures in alveolar ridge preservation using different grafting materials after tooth extraction / Estructura trabecular mandibular en preservación de reborde alveolar utilizando diferentes materiales de injerto después de la exodoncia

The aim was to describe the star volume analysis in ridge preservation using different grafting materials. Bilateral extraction of the first mandibular molars of sixteen male rabbits was performed, divided at random into four groups (n= 4 in each group) according to graft, using: blood clot (G1), xenograft (G2), pure phase beta-tricalcium phosphate (G3) and biphasic calcium phosphate (60 % HA / 40 % beta-TCP) (G4). Rabbits were euthanized at 4, 6, or 8 wk post-extraction; the trabecular bone structures was evaluated by star volume analysis. The Levene test was used to analyze variance, as was the independent sample t-test. A P-value of < 0.001 was used to establish a statistically significant. The star volume analysis of the mandibular trabecula shows that the marrow space star volume (V*m.space) was higher than the trabecular star volume (V*tr). At 6-week post-extraction, new trabecular bone was evident. At 8-week post-extraction V*tr increase in all groups and the V*m.space diminish, suggesting coarsening of the internal architecture. In G2, some trabecular bone was observed in the central region. In G3, most of the socket regions were occupied by newly formed and loose trabecular bone and in the G4, the sockets were almost entirely filled with trabecular bone. Star volume analysis is adequate to analysis of bone patterns formation using bone substitutes.

El objetivo de esta investigación fue describir el volumen estrella en preservación alveolar utilizando diferentes injertos óseos. La exodoncia bilateral del primer molar mandibular de 16 conejos machos fue realizada, dividiéndolos en 4 grupos (n= 4 en cada grupo) de acuerdo al injerto utilizado, siendo: coágulo sanguíneo (G1), xenoinjerto (G2), beta-tricalcio fosfato puro (G3) y fosfato de calcio bifásico (60 % HA / 40 % beta-TCP) (G4). Los conejos fueron sometidos a eutanasia a las 4, 6 u 8 semanas post exodoncia; el trabeculado óseo fue evaluado por medio del volumen estrella. La prueba de Levene fue utilizado para el análisis de varianza y luego la prueba t-test para muestras independientes. El valor de P menor a 0.001 fue establecido como significancia estadística. El análisis del volumen estrella del trabeculado mostró que el espacio medular de volumen estrella (V*m.space) fue mayor que trabeculado (V*tr). A 6 semanas post exodoncia, nuevo trabeculado óseo fue evidente. A las 8 semanas post exodoncia V*tr aumenta en todos los grupos y el V*m.space disminuye, sugiriendo un engrosamiento de la arquitectura interna. En el grupo G2, algún trabeculado óseo fue observado en la región central. En el G3, la mayoría del alveolo fue ocupado por nuevo hueso y perdió trabeculado óseo y en G4, el alveolo fue ocupado casi enteramente por hueso trabecular. El análisis de volumen estrella es adecuado para analizar el modelo de formación ósea utilizando sustitutos óseos.

Inward fragmentation and socket preservation in complex mandibular third molar surgery - a case report

Open extraction sockets following inward fragmentation of partially erupted mandibular third molars may compromise the hard tissue regeneration and lead to postoperative complications. in the case report, we present socket preservation to seal the open alveolous without flap displacement. a female patient aged 22, presented for removal of a partially erupted M3M was operated on via occlusal inward fragmentation under magnifying endoscopic vision. critical nerve structures were identified and protected before socket preservation with resorbable in situ hardening TCP particles was performed. the alveolar bone site healed uneventful, panoramic and cross-sectional conebeam reformats confirmed an complete hard tissue maintanence. endoscopically assisted inward fragmentation combined with socket preservation leads to the maintenance of adjacent hard tissues without need for flap transposition in complex anatomical sites.

Instalação imediata de implante após exodontia e provisório imediato em área estética: relato de caso clínico com um ano de acompanhamento pós-cirúrgico / Immediate post extraction implant placement in aesthetic area and provisional immediate installation: one year follow-up ­ a case report

As fraturas radiculares em dentes anteriores são bastante frequentes no consultório odontológico, sendo muitas vezes necessárias a remoção da raiz e a instalação de implantes. Os implantes podem ser instalados após a exodontia ou após o período de cicatrização do alvéolo. O presente relato de caso mostra uma fratura radicular do dente 11 com exodontia, instalação imediata do implante, confecção e instalação de provisório imediato. No caso clínico relatado neste artigo, a técnica de instalação imediata de implante após exodontia e instalação de provisório imediato mostrou-se previsível, tanto no que se refere à osseointegração quanto do ponto de vista estético.

Root fractures at anterior teeth are quite common in the office and the need for root removal and implant placement often is necessary. The dental implants may be installed immediately after the extraction or after the healing process. This case report shows a root fracture of tooth 11 with extraction, immediate implant placement, manufacture and installation of an immediate provisional tooth. According to the case reported in this article, in this case, immediate implant installation technique after the extraction, and immediate provisional tooth installation showed to be a predictable procedure to reach osseointegration and aesthetic outcome.

Preservación de alvéolos mediante fosfato tricálcico beta, con y sin membrana / Socket preservation using beta-tricalcium phosphate with or without membrane

El presente estudio evalúa los resultados de la utilización del fosfato tricálcico beta en la preservación de alvéolos postextracción al emplearlo solo o en conjunto con membranas no reabsorbibles. Se seleccionaron 18 dientes con indicación de extracción y con condiciones favorables para la preservación del alvéolo y posterior colocación de un implante oseointegrado. En 10 alvéolos se utilizó como relleno fosfato tricálcico beta en conjunto con membrana no reabsorbible, y 8 alvéolos fueron tratados solamente con fosfato tricálcico beta. Previo a la cirugía se evaluó el ancho y alto de cada alvéolo, mediante una tomografía computarizada de alta resolución, evaluación que fue repetida 6 meses después de realizada la intervención quirúrgica. Al momento de efectuar la técnica quirúrgica para la instalación de los implantes se tomaron muestras histológicas del sitio de colocación del implante para estudiar las características histológicas del sitio injertado después de 6 meses de realizada la cirugía de extracción dentaria y preservación de alvéolo. El uso de fosfato tricálcico beta, independiente o no del uso de membrana, mantuvo la altura del alvéolo transcurridos 6 meses desde su colocación, mientras que el ancho del alvéolo se mantuvo solo en el grupo sin membrana. Los resultados histológicos demostraron cantidades variables de regeneración ósea.

The present study evaluated the results of the post-extraction socket preservation technique using Beta-Tricalcium Phosphate with and without the use of a non-resorbable membrane. A total of 18 teeth with indication of extraction and socket preservation were selected, with 10 alveoli being treated with Beta-Tricalcium Phosphate combined with a non-resorbable membrane, and the other 8 with Beta-Tricalcium Phosphate only. The width and height of each socket was evaluated using computed tomography, prior to the extraction, and 6 months after the surgery. At the time of performing the surgical technique for installing the implants, histological specimens were taken from the implant site in order to study the graft site 6 months after the dental extraction surgery and alveoli preservation.The use of Beta-Tricalcium Phosphate, whether a membrane is used or not, maintained the alveolar height 6 months after the extraction, while the width of the alveolus only remained in the group without membrane. Histological results showed varying amounts of bone regeneration.

Various autogenous fresh demineralized tooth forms for alveolar socket preservation in anterior tooth extraction sites: a series of 4 cases / 대한악안면성형재건외과학회지

The aim of this study was to evaluate the clinical relevance of autogenous fresh demineralized tooth (Auto-FDT) prepared at chairside immediately after extraction for socket preservation. Teeth were processed to graft materials in block, chip, or powder types immediately after extraction. Extraction sockets were filled with these materials and dental implants were installed immediately or after a delay. A panoramic radiograph and a conebeam CT were taken. In two cases, tissue samples were taken for histologic examination. Vertical and horizontal maintenance of alveolar sockets showed some variance depending on the Auto-FDT and barrier membrane types used. Radiographs showed good bony healing. Histologic sections showed that it guided good new bone formation and resorption pattern of the Auto-FDT. This case series shows that Auto-FDT prepared at chairside could be a good material for the preservation of extraction sockets. This study will suggest the possibility of recycling autogenous tooth after immediate extraction.

Avaliação da remodelação do rebordo alveolar após exodontia minimamente traumática e utilização de enxerto xenógeno para preservação alveolar / Dimensional changes of alveolar bone in extraction sockets, after minimally traumatic extraction and socket fill with xenogenic bone

Introdução: Após a exodontia, a cicatrização natural do alvéolo provoca alterações dimensionais no rebordo alveolar, com diminuição dos tecidos moles e duros. Diferentes técnicas podem ser utilizadas para tentar diminuir essas alterações, com a intenção de facilitar a reabilitação estética e funcional com implantes, principalmente em áreas de dentes anteriores. Objetivos: Os objetivos deste estudo foram verificar a eficácia da utilização do material de origem xenógena Orthogen® na preservação do rebordo alveolar pós-exodontia e avaliar as características histológicas após 4 meses de reparo. Materiais e Métodos: 20 pacientes foram divididos aleatoriamente em 2 grupos, de acordo com a abordagem que iriam receber após a exodontia de uma raiz residual. No grupo teste, os alvéolos foram preenchidos com Orthogen® e selados com EGL (Enxerto Gengival Livre). No grupo controle, um coágulo foi preservado no alvéolo e o mesmo também foi selado com EGL, sem a utilização do Orthogen®. Em ambos os grupos as exodontias foram realizadas de maneira minimamente traumática, com o Kit de Extração Atraumática Neodent®. Modelos de gesso obtidos antes das exodontias (tempo 1) e após 4 meses (tempo 2), momentos antes da instalação dos implantes, foram utilizadas para as medidas dimensionais, através do escanemento dos modelos e medidas no programa Orthoanalyzer®. Amostras ósseas obtidas após 4 meses de reparo foram utilizadas para a análise histológica descritiva. Resultados: Os resultados demonstraram que, após 4 meses de reparo alveolar, os dois grupos apresentaram remodelação do rebordo alveolar e diminuição nas medidas realizadas. Porém, a remodelação do rebordo foi mais evidente no grupo controle (coágulo). Histologicamente foi possível observar formação de novo osso ao redor das partículas do Orthogen®. Conclusões: A utilização do Orthogen® para preenchimento dos alvéolos e preservação do rebordo alveolar foi eficaz na diminuição das...

Introduction: After tooth extraction, the natural healing of the socket is followed by dimensional changes of ridge contour, with marked reduce of hard and soft tissues. Socket reservation techniques can be used to improve functional and esthetics of the dental implants in this areas, especially in anterior teeth areas. Objectives: The aims of this study are to verify the efficacy of use Orthogen® to ridge preservation and analysis the histological characteristics after 4 months repair of the sockets. Material and Methods: 20 patients were randomly distributed in 2 groups, according with the treatments. In test group, the sockets were filled with Orthogen® and closed with a gingival free graft. In control group, the clots were preserved into the socket and free gingival graft was sutured in the deepithelialized marginal tissue of the socket. Stone casts were used to analyze the ridge dimensional changes with the Orthoanalyzer® software. After 4 months, bone samples were obtained during the dental implant procedure and were used to describe the histological characteristics. Results: The results showed that, after 4 months of wound healing, both groups showed a decrease in the measurements. However, the remodeling of the ridge was most evident in the control group (clot). Histological images showed the formation of new bone around the Orthogen® particles. Conclusion: The use of Orthogen® to socket preservation can collaborate to reduce the dimensional changes of the hard and soft tissue in post-extraction alveolar ridge sites.

Avaliação da remodelação do rebordo alveolar após exodontia minimamente traumática e utilização de enxerto xenógeno para preservação alveolar / Dimensional changes of alveolar bone in extraction sockets, after minimally traumatic extraction and socket fill with xenogenic bone

Introdução: Após a exodontia, a cicatrização natural do alvéolo provoca alterações dimensionais no rebordo alveolar, com diminuição dos tecidos moles e duros. Diferentes técnicas podem ser utilizadas para tentar diminuir essas alterações, com a intenção de facilitar a reabilitação estética e funcional com implantes, principalmente em áreas de dentes anteriores. Objetivos: Os objetivos deste estudo foram verificar a eficácia da utilização do material de origem xenógena Orthogen® na preservação do rebordo alveolar pós-exodontia e avaliar as características histológicas após 4 meses de reparo. Materiais e Métodos: 20 pacientes foram divididos aleatoriamente em 2 grupos, de acordo com a abordagem que iriam receber após a exodontia de uma raiz residual. No grupo teste, os alvéolos foram preenchidos com Orthogen® e selados com EGL (Enxerto Gengival Livre). No grupo controle, um coágulo foi preservado no alvéolo e o mesmo também foi selado com EGL, sem a utilização do Orthogen®. Em ambos os grupos as exodontias foram realizadas de maneira minimamente traumática, com o Kit de Extração Atraumática Neodent®. Modelos de gesso obtidos antes das exodontias (tempo 1) e após 4 meses (tempo 2), momentos antes da instalação dos implantes, foram utilizadas para as medidas dimensionais, através do escanemento dos modelos e medidas no programa Orthoanalyzer®. Amostras ósseas obtidas após 4 meses de reparo foram utilizadas para a análise histológica descritiva. Resultados: Os resultados demonstraram que, após 4 meses de reparo alveolar, os dois grupos apresentaram remodelação do rebordo alveolar e diminuição nas medidas realizadas. Porém, a remodelação do rebordo foi mais evidente no grupo controle (coágulo). Histologicamente foi possível observar formação de novo osso ao redor das partículas do Orthogen®. Conclusões: A utilização do Orthogen® para preenchimento dos alvéolos e preservação do rebordo alveolar foi eficaz na diminuição...

Introduction: After tooth extraction, the natural healing of the socket is followed by dimensional changes of ridge contour, with marked reduce of hard and soft tissues. Socket reservation techniques can be used to improve functional and esthetics of the dental implants in this areas, especially in anterior teeth areas. Objectives: The aims of this study are to verify the efficacy of use Orthogen® to ridge preservation and analysis the histological characteristics after 4 months repair of the sockets. Material and Methods: 20 patients were randomly distributed in 2 groups, according with the treatments. In test group, the sockets were filled with Orthogen® and closed with a gingival free graft. In control group, the clots were preserved into the socket and free gingival graft was sutured in the deepithelialized marginal tissue of the socket. Stone casts were used to analyze the ridge dimensional changes with the Orthoanalyzer® software. After 4 months, bone samples were obtained during the dental implant procedure and were used to describe the histological characteristics. Results: The results showed that, after 4 months of wound healing, both groups showed a decrease in the measurements. However, the remodeling of the ridge was most evident in the control group (clot). Histological images showed the formation of new bone around the Orthogen® particles. Conclusion: The use of Orthogen® to socket preservation can collaborate to reduce the dimensional changes of the hard and soft tissue in post-extraction alveolar ridge sites...

How much bone loss can be prevented by alveolar ridge preservation? Systematic literature review and meta-analysis

Aim: resorption of alveolar bone following tooth loss represents a major limitation in the use of dental implants. Procedures of ridge or socket preservation have been introduced to maintain bone dimensions and enable prosthetically driven implant positioning, yet circumventing two-stage bone graft surgery. The aim of the present systematic review and meta-analysis was to quantify reduction of alveolar ridge resorption in horizontal as well as vertical dimension (compared to untreated controls) reported in clinical trials on alveolar ridge grafting. Materials and Methods: systematic electronic and hand searches yielded 4 investigations published between 2000 and 2009 that met the inclusion criteria. A total of 74 ridge preservation procedures and 61 control sites were evaluated 6-7 months after surgery. Results: mean loss of bone height and width was 0.3 mm and 2.5 mm after ridge preservation surgery compared to 1.2 mm and 3.5 mm in the control group, respectively. Prevention of horizontal shrinkage (mean: 28%, range: 12-55%, OR = 1.6) was significantly less effective (p = 0.034) than reduction of vertical bone resorption (mean: 74%, range: 60-88%, OR = 4.9). Conclusion: alveolar ridge preservation may be effectively used to increase available bone height and width by 1 mm, on average

Endoscopically assisted root splitting (EARS): method and first results / Sección radicular endoscópicamente asistida (SREA): método y primeros resultados

The trauma of surrounding bone structures during exodontia represents a mayor clinical shortcoming of conventional oral surgery. An alternative minimal invasive technique is presented to support aesthetic rehabilitation by conservation of alveolar bone walls. Endoscopically assisted root splitting (EARS) is a new technique for root removal wothout ostectomy. EARS consists of enlargment of the root canal, longitudinal root splitting, inward mobilisation and removal of the fragments under endoscopic control. In 24 patients (11 m, 13 f), aged 18-66 years, 8 central incisors, 6 lateral incisor, 5 canines and 5 bicuspids were removed using EARS. Endoscopic observation revealed complete maintenance of the buccal wall at it's preoperative level, control radiographs showed no apical root remnants. EARS has revealed to be a valuable tool to avoid alveolar crest trauma during exodontia...

El trauma de las estructuras circundantes al hueso durante la exodoncia representa una de las principales deficiencias de la cirugía cirugía oral convencional. Se presenta una técnica alternativa mínimamente invasiva para apoyar la rehabilitación estética mediante la conservación de las paredes alveolares óseas. La sección radicular endoscópicamente asistida (SREA) es una nueva técnica para la eliminación de raíz sin osteotomía. La SREA consiste en la ampliación del canal de la raíz, división longitudinal de la raíz, movilización hacia el interior y eliminación de los fragmentos bajo control endoscópico. En 24 pacientes (11 hombres y 13 mujeres), con edades comprendidas entre 18-66 años, 8 incisivos centrales, 6 incisivos laterales, 5 caninos y 5 premolares fueron eliminadas mediante SREA. La observación endoscópica reveló la mantención completa de la pared ósea bucal a nivel preoperatorios, y las radiografías de control no mostraron restos radiculares apicales. SREA se muestra como una valiosa herramienta para evitar el trauma de la cresta alveolar durante la exodoncia...