Schnutenhaus, Sigmar;Doering, Isabel;Dreyhaupt, Jens;Rudolph, Heike;Luthardt, Ralph G.
Journal of Periodontal and Implant Science
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v.48
no.4
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pp.236-250
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2018
Purpose: Resorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli. Methods: In this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (${\pm}1$)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography. Results: Both the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (P=0.03). Conclusions: The proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.
The author studied the vertical height of tooth crown and the amounts of alveolar bone resorption with age. All 84 subjects(44 male, 40female) who visited Dental hospital of Wonkwang University with no history of sever periodontal disease and no experience of periodontal surgery. 84 subject were divided into 3 groups by age, that is, group I(28-32yrs), group II(38-42yrs), and group III(48-52yrs). Informal radiogram with bite wing film(horizontal angulation : $0^{\circ}$, vertical angulation : $+5^{\circ}~+10^{\circ}$) were taken on premolar and molar area. The distances from cusp tip to cementoenamel junction (vertical height of tooth crown) and from cementoenamel junction alveolar crest(amount of alveolar bone resorption) were measured, and then recorded data from 946 teeth were statistically analysed. This study was undertaken to obtain the data for age estimation by the changes of tooth crown height and alveolar bone resorption in the point of forensic odontology. The obtained results were as follows : 1. The average crown height of mandibular right 1st. molar was 7.1mm in group I, 6.7mm in group II, and 6.6mm group III, and the average amount of alveolar bone resorption on mandibular right 1st. molar were 1.8mm in group I, 2.5mm in group II, and 3.0mm in group III. Ratio of tooth crown height to amount of alveolar bone resorption was 4.0:1 in groupI, 2.7:1 in group II, and 2.2:1 in group III, the ratio was decreased with age. 2. In comparison with upper teeth and lower teeth in ipsilateral side, the average value of tooth crown height and amount of alveolar bone resorption were slightly higher in upper arch than those in lower arch, but there was not a statistically significant difference. 3. The ratio of height of tooth crown to amount of alveolar bone resorption was decreased with age, and which depended mainly upon the change of amount of alveolar bone resorption rather than the change of tooth crown height.
Alveolar bone grows with development of tooth germs and roots; bone deposition occurs with tooth eruption. Bone components undergoes processes of resorption and deposition, and when the balance between them is disrupted, decrease in alveolar bone height or excessive bone deposition result. It has been hon that repositioning of teeth through orthodontic treatment can cause alveolar bone resorption which result in decreased alveolar bone height, and there have been many studies to evaluate such effects. X-ray films that could be replicated and standardized were chosen in clinical studies, and among them, bitewing films were used for objective evaluation of changes in alveolar bone level. Twenty subjects, 10 to 13-year- old (average 12.2) children with Cl I molar key, healthy oral condition, no congenital missing, no periodontal disease, and pre-and post-orthodontic bitewing films, were randomly selected for comparison of alveolar bone heights. Amounts of tooth and changes in alveolar bone heights were analyzed. The following results were obtained: 1. Amount of tooth movement in canine, premolar, and molar regions, changes in tooth axis, and changes in alveolar bone heights were measured, and the mean and median values were obtained. 2. When pre-and post-orthodontic alveolar bone levels were compared, larger changes were noticed in maxilla than mandible. 3. When mesio-distally compared, larger changes were observed in the distal sides of 3D3 and 4M3, mesial sides of 4M3 and 4D3, distal sides of 4D3 and 5M3, mesial sides of 5M3 and 5D3, md distal sides of 5D3 and 6M3. 4. When the amounts of tooth movements(TX, TY)and changes in tooth axis(A) were compared,34TX, 34TY, 34A of both sides in maxilla were greater, iud changes in alveolar bone level were greater than any other region.
The purpose of this study was to evaluate the histologic change of the inferior alveolar nerve according to distraction amount following mandibular lengthening. Seven rabbits weighing about 2 kg were used. Corticotomy was performed on the mandibular body anterior to the right first premolar region and unilateral external fixation device was placed. Every effort was made to preserve the inferior alveolar nerve during the corticotomy. The rabbits were then allowed to heal for 7 days without distraction of the device. The mandible was lengthened 0.36 mm/day, 0.76 mm/day, or 1.0 mm/day. Corticotomy and lengthening of mandible were not performed in control group. After the completion of the lengthening process, a 14-day-consolidation period was allowed. After consolidation, rabbits were sacrificed, and histologic examination of the inferior alveolar nerve was performed. The results obtained were as follows : 1. In the control group, normal trifascicular pattern of inferior alveolar nerve was observed. Epineurium, perineurium, endoneurium, and axon with myelin sheath were observed in normal appearance. 2. In 0.36 mm/day distraction group, the trifascicular pattern was normally shown, and there was no destruction in epineurium, perineurium, and endoneurium. The mild changes including myelin attenuation, axoplasmic swelling and darkening were observed. 3. In 0.72 mm/day distraction group, it was possible to differentiate the epineurium from the perineurium. Two normal fascicles and one injuried fascicle were observed with a partially destructed perineurium. Most of the axons had axoplasmic swelling and darkening. 4. In 1 mm/day distraction group, it was difficult to differentiate the nerve structures such as fascicles, epineurium, perineurium, and endoneurium. The axons were severely destroyed, except few which showed decreases in size and changes in shape. Some collagen matrices were observed around the axons. These results suggest that the higher the distraction amount, the more severe the injury to the inferior alveolar nerve, fascicles, axons. Although distraction osteogenesis may be useful, the amount of distraction should be carefully selected.
Solaleh Shahmirzadi;Taraneh Maghsoodi-Zahedi;Sarang Saadat;Husniye Demirturk Kocasarac;Mehrnoosh Rezvan;Rujuta A. Katkar;Madhu K. Nair
Imaging Science in Dentistry
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v.53
no.1
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pp.1-9
/
2023
Purpose: The aim of this study was to evaluate 3-dimensional cone-beam computed tomography (CBCT) images of alveolar bone changes in patients who underwent minimally invasive periodontal surgery-namely, the pinhole surgical technique (PST). Materials and Methods: Alveolar bone height was measured and compared on CBCT images of 254 teeth from 23 consecutive patients with Miller class I, II, or III recession who had undergone PST. No patient with active periodontal disease was selected for surgery. Two different methods were used to assess the alveolar bone changes postoperatively. In both methods, the distance between the apex of the tooth and the mid-buccal alveolar crestal bone on pre- and post-surgical CBCT studies was measured. Results: An average alveolar bone gain >0.5 mm following PST was identified using CBCT(P=0.05). None of the demographic variables, including sex, age, and time since surgery, had any significant effect on bone gain during follow-up, which ranged from 8 months to 3 years. Conclusion: PST appears to be a promising treatment modality for recession that results in stable clinical outcomes and may lead to some level of resolution on the bone level. More long-term studies must be done to evaluate the impact of this novel technique on bone remodeling and to assess sustained bone levels within a larger study population.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.25
no.4
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pp.350-355
/
1999
Purpose : The purpose of this study was 1) to find nerve damage after inferior alveolar nerve transposition and 2) to examine whether the soft tissue or bone changes around the nerve produce the compression to the nerve in the healing period. Materials and Method : Inferior alveolar nerve was exposed through the bony window and the scratch was made in the bone to be thought as the inferior alveolar canal. Suture was made after the nerve was repositioned. The nerve and surrounding tissues were examined with the light microscope and the fluorescent microscope before surgery and at 1 month, 3 months, and 5 months after surgery. Results : After surgery, the epineurium was damaged and the nerve was divided to several fascicles covered with the perineurium The newly formed fibrous connective tissue and vessels were seen around fascicles. There was new bone formation. However the nerve was not compressed by the connective tissue or the new bone. Conclusion : The results of this study suggest that neurosensory disturbances after inferior alveolar nerve transposition are resulted by the direct trauma in surgery rather than the compression to the nerve by the scar or new bone formation in the healing period.
Akyalcin, Sercan;Schaefer, Jeffrey S.;English, Jeryl D.;Stephens, Claude R.;Winkelmann, Sam
Imaging Science in Dentistry
/
v.43
no.2
/
pp.85-90
/
2013
Purpose: This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Materials and Methods: Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. Results: The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. Conclusion: RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.
Statement of problem: Alteration of tooth function is assumed to be changed by stress/strain on the adjacent alveolar bone, producing changes in morphology similar to those described for other load-bearing bones. When teeth are removed, opposing teeth will not be functioned. When edentulous area is restored by implant prostheses, opposing teeth will be received physiologic mechanical stimuli. Purpose: The aim of this study was to evaluate the bone changes around the teeth opposing implant restoration installed mandibular posterior area. Material and method: Eight patients who had mandibular posterior edentulous area were treated with implants. Radiographs of the opposing teeth were taken at implant prostheses delivery(baseline), 3 months, and 6 months later. Customized film holding device was fabricated to standardize the projection geometry for serial radiographs of opposing teeth. Direct digital image was obtained. Gray values of region of interest at each digital image were measured and compared according to time lapse. Repeated measured analysis of variance and post-hoc Scheffe's test were performed at the 95% significance level. Results: Alveolar bone changes around the natural teeth opposing the posterior implant in mandible showed statistically significant difference compared to control group(P<0.05). And gray values of alveolar bone around the teeth opposing implants were increased. There were no statistically significant differences of alveolar bone changes between crestal group and middle group and between mesial group and distal group according to time lapse(P>0.05). There were no statistically significant differences of alveolar bone changes among mesial-crestal group, mesial-middle group, distal-crestal group, distal-middle group, and control group(P>0.05). Conclusion: Alveolar bone around the natural teeth opposing the implant prosthesis showed gradual bony apposition.
Objective: Alveolar bone loss is a common adverse effect of intrusion treatment. Mandibular incisors are prone to dehiscence and fenestrations as they suffer from thinner alveolar bone thickness. Methods: Thirty skeletal class II patients treated with mandibular intrusion arch therapy were included in this study. Lateral cephalograms and cone-beam computed tomography images were taken before treatment (T1) and immediately after intrusion arch removal (T2) to evaluate the tooth displacement and the alveolar bone changes. Pearson's and Spearman's correlation was used to identify risk factors of alveolar bone loss during the intrusion treatment. Results: Deep overbite was successfully corrected (P < 0.05), accompanied by mandibular incisor proclination (P < 0.05). There were no statistically significant change in the true incisor intrusion (P > 0.05). The labial and lingual vertical alveolar bone levels showed a significant decrease (P < 0.05). The alveolar bone is thinning in the labial crestal area and lingual apical area (P < 0.05); accompanied by thickening in the labial apical area (P < 0.05). Proclined incisors, non-extraction treatment, and increased A point-nasion-B point (ANB) degree were positively correlated with alveolar bone loss. Conclusions: While the mandibular intrusion arch effectively corrected the deep overbite, it did cause some unwanted incisor labial tipping/flaring. During the intrusion treatment, the alveolar bone underwent corresponding changes, which was thinning in the labial crestal area and thickening in the labial apical area vice versa. And increased axis change of incisors, non-extraction treatment, and increased ANB were identified as risk factors for alveolar bone loss in patients with mandibular intrusion therapy.
Regular radiographic examination has been considered an essential diagnositic method for osseointegrated dental implantation. This study investigated marginal bone loss through the measurement on periapical radiographs and changes in bone density through digital subtraction image radiographic method around 88 endoseous root-form dental implants in 43 human subjects. Four types of endosseous dental implants were investigated : Standard series, Mini series and Hex-lock system of Steri-Oss Dental implant system, and $Br{\aa}nemark$-type implant from 3i dental implant system, in a 3 month interval for a total period of 12 months. The results were as follows : 1. Rapid bone loss occurred in the first 3 months in all 4 groups, and the bone level stabilized at the first thread of the implant fixtures. Amount of bone loss for 12 months showed correlation with the length of the polished neck portion. 2. Most of the implant systems showed resorption of alveolar bone up to the polished neck portion although a long polished neck could delay the resolution. 3. Alveolar bone loss apical to the polished neck portion stabilized at the first thread of the fixtures with no correlation to either the time of exposure of the polished neck or types of implant systems. 4. No changes in bone density around the implant threads were observed throughout the experimental period. Bone density decreased at the marginal bone, and increased at the newly-formed alveolar crest. These results indicate that most of the alveolar bone loss occur within the first 12 months after installation of endosseous root-form dental implants resulting in the exposure of polished neck portions, and the bone level stabilizes thereafter at the first thread portions of the implant fixtures. The experimental period of 12 months seems insufficient for observing changes in bone density, and a long-term observation should be needed.
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