Prosthetically Driven Alveolar Reconstructions: A Retrospective Study.

Guaracilei Maciel Vidigal Junior,Arthur Belém Novaes Junior,Luis Carlos De Moraes E Silva Junior,Luiz Roberto Figueiredo Dantas,Mario Groisman,Ricardo G Fischer

doi:10.1590/0103-6440202003218

Guaracilei Maciel Vidigal Junior, Arthur Belém Novaes Junior + Show 4 more

Open Access

https://doi.org/10.1590/0103-6440202003218

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Abstract

This study aims to evaluate the post-extraction alveolar bone reconstruction amongst 12 patients exhibiting loss of buccal bone plate in a tooth of the anterior region of the maxilla using the prosthetically-driven alveolar reconstruction technique (PDAR). In PDAR, a partial fixed provisional prosthesis (PFPP [conventional or adhesive]) with a specially designed pontic maintains the clot in a mechanically stable position during alveolar regeneration. Moreover, the pontic design, in hourglass shape and located in the subgingival area, also prevents gingival margins from collapsing. Gingival recession was evaluated through the 6-month healing period. Cone beam computed tomography (CBCT) was performed 1 month before and 8 months after PDAR treatment. For the primary outcome, in the panoramic imaging, the central area of bone defect in each tooth was selected for linear measurements. Measurements of the vertical buccal bone gain and the gain in thickness in the alveolar bone crest were obtained 8 months after PDAR. Descriptive statistics and intraclass correlation coefficient analysis were conducted. After treatment, all patients showed bone formation (a mean vertical gain of 7.1±3.7 mm, associated with a horizontal mean gain of 4.5±1.4 mm in the alveolar bone crest). The intraclass correlation coefficient for the measurements performed using CBCT was 0.999. No gingival recession, greater than 1 mm, was observed. Lower-morbidity procedures without the use of biomaterials may be a useful in post-extraction alveolar ridge regeneration and/or preservation. PDAR promoted alveolar bone formation without flaps, grafts and membranes.

Highlights

Conventional post-extraction alveolar regeneration results in quality [1] and dimensional alterations in the bone crest [2]
Conventional surgical techniques have been used to prevent absorption of the alveolar bone that occurs after extraction. [6,7] A flapless alveolar ridge reconstruction technique could result in less morbidity and benefit bone formation
In Prosthetically-driven alveolar reconstruction (PDAR), a partial fixed provisional prosthesis (PFPP [conventional or adhesive]) with a specially designed pontic provides mechanical stability to the clot, that probably stimulates the epigenetic memory of stem cells [9,10], during alveolar bone reconstruction healing phase, and prevents the mucosal margin recession, due to its concave subgingival design [11]

Summary

Introduction

Conventional post-extraction alveolar regeneration results in quality [1] and dimensional alterations in the bone crest [2]. In PDAR, a partial fixed provisional prosthesis (PFPP [conventional or adhesive]) with a specially designed pontic (with an hourglass shape extension located 3 mm in the subgingival area) provides mechanical stability to the clot, that probably stimulates the epigenetic memory of stem cells [9,10], during alveolar bone reconstruction healing phase, and prevents the mucosal margin recession, due to its concave subgingival design [11]. This study aimed to evaluate alveolar post-extraction regeneration using the PDAR technique, of adult patients in areas exhibiting loss of the buccal bone plate in the anterior region of the maxilla, through clinical evaluation and cone beam computed tomography (CBCT)

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