• Title/Summary/Keyword: Socket preservation

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Improving oral rehabilitation through the preservation of the tissues through alveolar preservation

  • Afrashtehfar, Kelvin Ian;Kurtzman, Gregori Michael;Mahesh, Lanka
    • The Journal of Advanced Prosthodontics
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    • v.4 no.3
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    • pp.174-178
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    • 2012
  • When performing a tooth extraction, imminent collapse of the tissue by resorption and remodeling of the socket is a natural occurrence. The procedure for the preservation of the alveolar ridge has been widely described in the dental literatures and aims to maintain hard and soft tissues in the extraction site for optimal rehabilitation either with conventional fixed or removable prosthetics or implant-supported prosthesis.

Socket preservation using deproteinized horse-derived bone mineral

  • Park, Jang-Yeol;Koo, Ki-Tae;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.40 no.5
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    • pp.227-231
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    • 2010
  • Purpose: The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. Methods: The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. Results: The surgical sites healed uneventfully. The mean ridge width was $7.75{\pm}2.75\;mm$ at baseline and $7.00{\pm}2.45\;mm$ at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was $7.5{\pm}5.20\;mm$, and at 6 months, $3.50{\pm}0.58\;mm$. The mean palatal crest height at baseline was $7.75{\pm}3.10\;mm$, and at 6 months, $5.00{\pm}0.82\;mm$. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was $9.88{\pm}2.90%$, the amount of graft particles was $42.62{\pm}6.57%$, and the amount of soft tissue was $47.50{\pm}9.28%$. Conclusions: Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.

Factors Affecting Primary Stability on Sites of Alveolar Ridge Preservation Using Porcine-derived Bone Minerals

  • Lee, Su-Yeon;Lee, Young;Choi, Seong-Ho;Lee, Dong-Woon
    • Journal of Korean Dental Science
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    • v.14 no.1
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    • pp.1-11
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    • 2021
  • Purpose: The alveolar ridge preservation (ARP) is widely conducted for implant placement. However, experimental results using deproteinized porcine bone mineral (DPBM) have been scarce. This retrospective study evaluated factors affecting the primary stability of implants in an area where ARP was performed using DPBM. Materials and Methods: Thirty-eight patients were divided into two groups based on the primary stability, with torque value of 30 Ncm as borderline. To determine the factors that affect the primary stability of implants, we collected data from patients' medical records including age, sex, reentry time, socket location, remaining bone wall at the time of extraction, and type of collagen membrane, as well as from radiographs and histomorphometric analysis. Result: The results showed statistically significant difference for the remaining extraction socket wall (P=0.014), residual graft (P=0.029), and fibrovascular tissue (P=0.02) between the two groups. There was an insignificant tendency toward the time of reentry surgery (P=0.052) and location (P=0.077). All implants placed in sites using DPBM functioned well up to 3 years. Conclusion: Within the limitations of the present study, extraction socket wall, residual graft, and fibrovascular tissue can affect the primary stability at the time of implant placement on grafted sites using DPBM and collagen membranes. In addition, reentry time and locations can be considered. In future studies, comparative experiments in quantified models will be required to supporting the findings.

Compromised extraction sockets: a new classification and prevalence involving both soft and hard tissue loss

  • Kim, Jung-Ju;Amara, Heithem Ben;Chung, Inna;Koo, Ki-Tae
    • Journal of Periodontal and Implant Science
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    • v.51 no.2
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    • pp.100-113
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    • 2021
  • Purpose: Previous studies have solely focused on fresh extraction sockets, whereas in clinical settings, alveolar sockets are commonly associated with chronic inflammation. Because the extent of tissue destruction varies depending on the origin and the severity of inflammation, infected alveolar sockets may display various configurations of their remaining soft and hard tissues following tooth extraction. The aim of this study was to classify infected alveolar sockets and to provide the appropriate treatment approaches. Methods: A proposed classification of extraction sockets with chronic inflammation was developed based upon the morphology of the bone defect and soft tissue at the time of tooth extraction. The prevalence of each type of the suggested classification was determined retrospectively in a cohort of patients who underwent, between 2011 and 2015, immediate bone grafting procedures (ridge preservation/augmentation) after tooth extractions at Seoul National University Dental Hospital. Results: The extraction sockets were classified into 5 types: type I, type II, type III, type IV (A & B), and type V. In this system, the severity of bone and soft tissue breakdown increases from type I to type V, while the reconstruction potential and treatment predictability decrease according to the same sequence of socket types. The retrospective screening of the included extraction sites revealed that most of the sockets assigned to ridge preservation displayed features of type IV (86.87%). Conclusions: The present article classified different types of commonly observed infected sockets based on diverse levels of ridge destruction. Type IV sockets, featuring an advanced breakdown of alveolar bone, appear to be more frequent than the other socket types.

Extraction Socket Preservation and Reconstruction Using Autogenous Tooth Bone Graft: Case Report (자가치아골이식재를 이용한 발치창 보존 및 재건술)

  • Kim, Young-Kyun;Kim, Su-Gwan;Kim, Kyung-Wook;Um, In-Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.3
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    • pp.264-269
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    • 2011
  • An extraction socket was preserved and reconstructed using an autogenous tooth bone graft powder and block in two patients. The grafted site was healed 3 to 3.5 months after surgery. Implant treatment was successfully completed.

Clinical presentation of a horse-derived biomaterial and its Biocompatibility: A Clinical Case Report

  • Koo, Ki-Tae;Park, Jang-Yeol;Park, Jun-Seok;Kim, Tae-Il;Seol, Yang-Jo;Lee, Yong-Moo;Ku, Young;Rhyu, In-Chul;Chung, Chong-Pyoung
    • Journal of Periodontal and Implant Science
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    • v.39 no.sup2
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    • pp.287-291
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    • 2009
  • Purpose: The objective of this clinical presentation was to present a clinical case series report of socket preservation, sinus augmentation, and bone grafting using a horse-derived biomaterial. Methods: A horse-derived biomaterial was used in 8 patients for different indications including socket preservation following tooth extraction, osseous bone grafting, and sinus augementation procedures. Surgeries were performed by a well trained specialist and clinical radiographs were obtained at designated intervals. Biopsy cores of 2 ${\times}$ 8 mm prior to implant placement was obtained following a healing interval of 4 - 6 months. A clinical and histologic evaluation was performed to evaluate the clinical effectiveness and biocompatibility of the biomaterial. Results: All surgeries in 8 patients were successful with uneventful healing except for one case with membrane exposure that eventually resulted with a positive outcome. Radiographic display of the healing phase during different intervals showed increased radiopacity of granular nature as the healing time increased. No signs of adverse effect or infection was observed clinically and the tissues surrounding the biomaterial seemed well-tolerated with good intentional healing. The augmented sinuses healed uneventfully suggesting in part, good biocompatibility of the biomaterial. Dental implants placed following socket preservation were inserted with high initial torque suggesting good initial stability and bone quality. Conclusions: Our results show that at least on a tentative level, a horse-derived biomaterial may be used clinically in socket preservation, sinus augmentation, bone grafting techniques with good intentional healing and positive results.

Effect of immediate provisional restoration on the preservation of gingival contour (발치 창에 삽입한 임시 수복물의 치은형태 보존 효과)

  • Lee, Jin-Gyu;Lee, Ju-Youn;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
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    • v.33 no.4
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    • pp.563-571
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    • 2003
  • One of the central components of periodontal therapy is the improvement of esthetics. The presence and appearance of interdental papillae plays an important role of periodontal esthetics. The aim of the present study was to investigate how immediate provisional restoration preserve the shape of interdental papilla around the extraction socket and the width of bucco-lingual of gingiva. Another aim was to investigate the change in the interdental papilla and the amount of vertical bone fill of a extraction socket in relation to the interdental alveolar bone levels adjacent the alveolar socket. A total of 19 patients (11 male, 8 female, mean age of 50.57${\pm}$8.16), who visited the Department of Periodontology, Pusan National University and had more than one anterior tooth scheduled to be extracted due to an advanced periodontal disease were included in the present study. After initial periodontal therapy, the extracted teeth were reshaped of the root and placed into the socket followed by splinting with adjacent teeth with self-curing resin. The width of hucco-lingual of gingiva and interdental papilla height were measured at baseline, 1, 3, 6, 9 and 12 month and the periapical radiographic examination were taken at baseline, 6 and 12month following the extraction. The amount of vertical bone fill in the extraction socket were calculated. At 12 months following the extraction, the changes in mesial and distal interdental papilla and the width of bucco-lingual showed -1.06${\pm}$0.48mm, -0.844${\pm}$0.50mm, -1.50${\pm}$0.96m, relatively. The positional change in the interproximal papillae was significantly associated with the interdental bone level adjacent to the extraction socket(p=0.028). The higher the interproximal bone level adjacent the extraction socket, the greater the amount of bone fill in the extraction socket(p<0.001). In conclusion, it was thought that immediate provisional restoration could minimize the loss of the width of bucco-lingual and interproximal papillae around the extraction socket. In addition, the higher the interproximal bone level adjacent the extraction socket, the greater the amount of bone fill and the smaller the reduction of papillary height around the extraction socket.

Application of rhBMP-2 loaded collagen membrane on the buccal plate for ridge preservation: a pilot study in dogs (성견의 발치와 협측골 외측에 적용한 교원질 차단막과 재조합 골형성단백질의 치조제 보존 효과)

  • Lim, Hyun-Chang;Kim, Min-Soo;Yang, Cheryl;Lee, Jung-Seok;Choi, Seong-Ho;Jung, Ui-Won
    • The Journal of the Korean dental association
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    • v.53 no.5
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    • pp.348-359
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    • 2015
  • Objective: The aim of this study was to determine the effect of multi-layer of a collagen membrane alone or loaded rhBMP-2 on the buccal plate for ridge preservation after tooth extraction. Material and methods: Following bilateral extraction of the maxillary 1st and 3rd premolars in five dogs, rhBMP-2 loaded collagen membrane was applied to the buccal plates at the 1st premolar and collagen membrane only was applied to the buccal plates at the 3rd premolar unilaterally. The collagen membranes applied in the experimental groups were piled into four layers. The corresponding sites of the contralateral side healed naturally. After 3months of healing, the animals were sacrificed. Radiographic and histologic analyses were performed. Results: There was no significant difference in the healing of extraction socket at both 1st and 3rd premolars. In microcomputed tomography, the widths of the residual ridge of the experimental groups were similar with the controls. Histologically, the experimental groups did not exhibit different pattern compared to the controls regardless of the addition of rhBMP-2. Conclusion: Layering of the collagen membrane with or without rhBMP-2 on the buccal plate failed to show the effectiveness in dimensional preservation of the extraction socket.