ABSTRACT
OBJECTIVE: The purpose of this study was to compare different materials' effects on alveolar ridge preservation of postextraction sockets in anterior maxilla. MATERIALS AND METHOD: In this prospective, single center, randomized, controlled clinical trial, healthy patients who needed one single anterior maxillary tooth extraction (including bicuspids) were selected. After a minimally traumatic extraction without complications, 44 patients were randomly allocated into 4 groups: 1) natural socket healing (blood clot), 2) xenograft and gingival free graft, 3) dense polytetrafluoroethylene membrane, and 4) platelet rich fibrin plugs. Alveolar ridge height and width loss were evaluated in cone beam computed tomography (CBCT) and in dental casts at 3 moments: 1) preoperative (T1), 2) 7 days postoperative (T2), and 3) 120 days postoperative (T3). Height and width alveolar ridge loss detected in CBCT and in dental casts were compared among the groups (two-way analysis of variance [ANOVA]; P < .05). RESULTS: Forty patients (24 women and 16 men) ranging from 25 to 70 years old (mean of 42 years old) participated in this study. Group 2 showed the least alveolar ridge height loss results in CBCT (9.8 ± 1.9% at T3) and dental cast analysis (1.0 ± 0.2 mm). Groups 2 (12.7 ± 4.7% at T3) and 3 (15.4 ± 2.7% at T3) showed the least alveolar ridge width loss measured in CBCT compared with groups 1 and 4, but the difference between groups 2 and 3 were not statistically significant (P = .968). Group 3 (0.9 ± 0.2 mm) and group 2 (1.0 ± 0.2 mm) showed the least width loss compared with groups 1 and 4 in dental cast analysis. Again, the difference between groups 3 and 2 was not statistically significant (P = 1.000). CONCLUSION: In postextraction sockets of the anterior maxilla and bicuspid region, group 2 (xenogenous bone graft with free gingival graft) and group 3 (dense polytetrafluoroethylene) obtained the best results in alveolar preservation, with group 2 being more indicated when the vertical alveolar ridge preservation is mandatory.
Subject(s)
Alveolar Bone Loss , Alveolar Ridge Augmentation , Male , Humans , Female , Adult , Middle Aged , Aged , Tooth Socket/diagnostic imaging , Tooth Socket/surgery , Alveolar Bone Loss/diagnostic imaging , Alveolar Bone Loss/prevention & control , Alveolar Bone Loss/surgery , Prospective Studies , Alveolar Process/diagnostic imaging , Alveolar Process/surgery , Tooth Extraction , Polytetrafluoroethylene , Alveolar Ridge Augmentation/methodsABSTRACT
OBJECTIVE: To assess bone thickness augmentation and implant survival in ridges with horizontal atrophy managed through split crest technique with concomitant installation of dental implants. MATERIALS AND METHODS: Thirteen patients with maxillary bone atrophy underwent surgery and had their bone thickness assessed through cone beam computed tomography 6 months pre- and postoperatively. Comparative measurements of initial and final bone height and thickness were taken using Dolphin Imaging® 11.5 software. The distance between the nasal fossa floor or the maxillary sinus and the alveolar crest determined the bone height, while the measurement of bone thickness took into account the distance between the vestibular cortical bone and the palatal cortical bone at the crest level, and at 5 mm and 10 mm from it. RESULTS: The bone height loss of 0.68 mm was statistically significant (p = 0.01). The average horizontal bone gain was 3.45 mm at ridge level, 3.03 mm at 5 mm from it and 2.42 mm at 10 mm from it. The mean horizontal gain for the three regions was 2.97 mm, and the values were statistically significant for all three regions assessed (p < 0.01). No complications were associated with the surgical procedures, and 23 implants were installed following the surgical expansion. No implants were lost (100% survival). CONCLUSION: The split crest technique proved to be viable and predictable, enabling a significant increase in ridge thickness and a high percentage of implant survival.
ABSTRACT
O processo de remodelação óssea que inicia-se após a extração de um dente pode dificultar a reabilitação através de implantes dentários. Nesse sentido, a técnica de regeneração óssea guiada (ROG), com o uso de membrana não reabsorvível, busca minimizar estes efeitos, favorecendo a cicatrização do alvéolo e diminuindo a necessidade de enxertos ósseos. Sendo assim, o objetivo deste trabalho foi avaliar a utilização da membrana densa de politetrafluoretileno (d-PTFE) em alvéolos pós-extração. Para isso, 8 pacientes que foram submetidos à remoção de elemento dentário receberam em seus alvéolos a colocação da membrana d-PTFE. A mesma foi posicionada sobre o alvéolo imediatamente após a extração e deixada no local por 21 dias. Para avaliar a preservação do rebordo alveolar, tomografias foram realizadas no pré-operatório e no pós-operatório de 90 dias. Os resultados mostraram uma efetiva preservação do rebordo alveolar proporcionado pelo uso da membrana. A perda óssea em espessura dos alvéolos foi de apenas 0,32 mm, em média. Já a perda óssea em altura foi de 0,79 mm, em média. Oito implantes foram instalados, sendo que nenhuma complicação ou perda de implantes foi observada. A membrana de PTFE denso mostrou-se efetiva na manutenção da arquitetura alveolar, minimizando a perda óssea em altura e espessura (AU).
The process of bone remodeling that begins after the extraction of a tooth can make rehabilitation difficult through dental implants. In this sense, the technique of guided bone regeneration (ROG), with the use of a non-resorbable membrane, seeks to minimize these effects, favoring healing of the alveolus and reducing the need for bone grafts. Therefore, the objective of this work was to evaluate the use of polytetrafluoroethylene dense membrane (d-PTFE) in post-extraction alveoli. For this, 8 patients who were submitted to tooth removal, received in their alveoli the placement of the d-PTFE membrane. It was placed on the alveolus immediately after extraction and left in place for 21 days. To evaluate the preservation of the alveolar ridge, CT scans were performed preoperatively and postoperatively for 90 days. The results showed an effective preservation of the alveolar ridge provided by the use of the membrane. The bone loss in the alveoli thickness was only 0.32 mm on average. The bone loss in height was 0.79 mm on average. Eight implants were installed, and no complications or loss of implants were observed. The dense PTFE membrane was effective in maintaining the alveolar architecture, minimizing bone loss in height and thickness (AU).
