Preservation Of Alveolar Bone Research Articles

Osseo-densification for preservation and compaction of alveolar bone in enhancing stability of dental implants: A systematic review

A higher implant failure rate may be associated with a lack of primary stability. Primary stability is a stationary, entirely mechanical parameter that determines when an implant is placed. Several methods have been developed to improve the primary implant's level of stability. However, Osseo-densification (OD) is a revolutionary implant preparation approach that addresses these issues and enhances the main stability of implants inserted into low-density bones. In light of this, the present systematic review was conducted to understand the Osseo-densification for preservation and compaction of alveolar bone in enhancing the stability of the dental implant. Research papers from PubMed, CINAHL, Web of Science, and Web of Science, Medline searched. The most recent literature suggests that using the Osseo-densification drilling protocol increases the overall value of implant insertion torque and, consequently, increases the primary stability of implants. To evaluate the caliber of the contained research, CARE, ARRIVE, and modified CONSORT checklists were employed. 133 full texts were chosen for further investigation after duplicates were removed and titles and abstracts were reviewed of these, 27 entire texts met the inclusion criteria. The thorough literature search identified 6 Case Studies & Case Series, 11 in vivo animal studies, and ten /experimental animal studies that noted the use of the Osseo-densification technique. The data from most recent animal in vivo/in vitro studies and case reports / case series suggest that Osseo-densification drilling protocol increases the overall value of implant insertion torque and, as a result, increases implant primary stability.

Tooth-Supported Overdentures Revisited.

The goal of prosthodontics is to provide a functional prosthesis to restore aesthetics, functions, and masticatory efficiencies. Tooth-supported overdentures are one of the treatment options for removable dentures. This article aims to discuss the advantages and disadvantages of tooth-supported overdentures and the principles of using various overdenture attachments, including non-attachment overdentures. The common treatment options in preparing the overdenture abutment are either with or without abutment copingwith or without attachment systems, which were discussed and illustrated. A range of tooth-supported overdenture systems were addressed, from low to high financial implications and treatment complexities. The clinician can choose a system that best fits the patient's condition and expectations. This allows clinicians to decide and consider tooth-supported overdentures as a treatment option before full edentulism. A well-executed tooth-supported overdenture ensures the preservation of alveolar bone, optimizes patient satisfaction in denture treatment, and eventually improves the patient's adaptation when transitioning to complete dentures.

Early implant placement Type 2, using flapless technique in one surgical stage. Five years follow-up

Postextractional implants placement is frecvently discussed in the literature as a method aimed to facilitate implant-prosthetic rehabilitation and preservation of alveolar bone. However, the opinions are divergent while the obtained results often are unfavorable due to bone loss and mucosal recessions. An alternative for postextractional placement is early type 2 implants placement. The study was based on results evaluation of 51 implants insearted in early period after teeth extractions (type 2) in one surgical step, using flapless surgery, without removing the socket content. For evaluation of healing process in the socket, histological analyses of it’s content were performed at 2, 4 and 8 weeks periods. The obained results showed that early implant placement type 2 is a safe method with an integration rate similar to the conventional method. The presence of healed soft tissues is an advantage upon the postextractional placement. The preservation of socket primary matrix lead to a good bone healing around implants without necessity of grafting.

The impact of immediate versus delayed mini-screw placement on alveolar bone preservation and bone density following tooth extraction: evidence from a canine model

The aim of this study was to evaluate the impact of mini-screw placement on the alveolar ridge using a split-mouth design. Twelve beagles underwent bilateral extraction of their lateral teeth. In the immediate group, a mini-screw was unilaterally placed approximately 3–4 mm below the alveolar crest of the extraction site on the experimental side. The delayed group received mini-screws six weeks after tooth extraction. On average, the dogs were sacrificed after 11 weeks, and the maxillary bones were excised and scanned using cone-beam computed tomography (CBCT). Histopathological examinations were conducted to assess inflammation and bone formation scores. The results showed that in the immediate group, bone height was significantly greater on the intervention side compared to the control side (p < 0.05), whereas there was no significant difference in the delayed group. In both groups, there was a significant increase in bone density around the mini-screws compared to the control sides (p < 0.05). Mini-screw insertion led to a significant enhancement of bone growth in both groups (p < 0.05), with no notable differences between the two groups. The mini-screws did not have any impact on bone inflammation or width. Overall, both immediate and delayed mini-screw placement in the extraction socket positively influenced bone dimensions, density, and histological properties. However, immediate insertion was more effective than delayed placement in preserving vertical bone height, despite delayed insertion resulting in higher bone density.

Tooth supported overdentures: Procedure, problems &amp; solutions

Preservation of residual alveolar bone is one of the most challenging tasks in hands of a Prosthodontist. With Preventive Prosthodontics gaining popularity, all attempts are made to preserve the natural tooth structure. Overdentures have been a commonly used treatment option that helps in preservation of bone and maintains the proprioceptive sensory impulses. The treatment option has been widely exercised with implants as implant supported overdentures as well. The treatment modality has some inherent challenges and require proper deliberation and well executed treatment plan to avoid post insertion complications and ensure longevity of prosthesis. The article showcases two cases of tooth supported overdentures, some common problems, and possible solutions.

Group 4 ITI Consensus Report: Patient benefits following implant treatment in partially and fully edentulous patients.

The aim of Working Group 4 was to address patient benefits associated with implant dentistry. Focused questions on (a) dental patient-reported outcomes (dPROs), (b) improvement in orofacial function, and (c) preservation of orofacial tissues in partially and fully edentulous patients following provision of implant-retained/supported dental prostheses were addressed. Three systematic reviews formed the basis for discussion. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary of the 7th ITI Consensus Conference, taking place in 2023 in Lisbon, Portugal. Edentulous patients wearing complete dentures (CD) experience substantial improvements in overall dPROs and orofacial function following treatment with either complete implant-supported fixed dental prostheses (CIFDP) or implant overdentures (IODs). With respect to dPROs, mandibular IODs retained by two implants are superior to IODs retained by one implant. However, increasing the number of implants beyond two, does not further improve dPROs. In fully edentulous patients, rehabilitation with CIFDP or IOD is recommended to benefit the preservation of alveolar bone and masseter muscle thickness. Completely edentulous patients benefit substantially when at least the mandible is restored using an CIFDP or an IOD compared to CD. In fully edentulous patients, implant prostheses are the best option for tooth replacement. The availability of this treatment modality should be actively promoted in all edentulous communities, including those with limited access and means.

MINIMALLY INVASIVE TOOTH EXTRACTIONS- THE NEWER ADVANCEMENTS TO THE CONVENTIONAL TECHNIQUES

Dental extractions are considered to be one of the procedures that can make a patient quite anxious. However, newer advancements have come to the rescue. Most of the extractions that are being done involve some extent of soft tissue trauma. Due to the damage that occurs to the adjacent tissues while removing the tooth, the rehabilitation and restoration of the tooth has become quite difficult and time consuming. From the crux of the traditional techniques, surgeons realised the importance of preserving the soft tissue and dentofacial complex in the course of tooth implantation. This led to the evolution of the new idea, the Minimally invasive dentistry and the Minimally invasive extraction. Few minimally invasive atraumatic extractions, certain methodsdeveloped are already being used by the clinicians to extract the teeth such as Periotome, Piezotome, Benex vertical extractor, rubber band extraction, extraction using implant drills. Easy Xtrac system is one such procedure which is claimed to be based on cork screw principle is used in tooth extractions. Keywords: Atraumatic Extraction, Preservation of alveolar bone, Absolute healing, Minimally invasive technique, Mucoperiosteal flap elevation.

Autotransplanation of immature premolars to replace a severely traumatized maxillary central incisor in young patients: Orthodontic and surgical cooperation

Young patients with a severely traumatized maxillary central incisor have limited possibilities to restore its loss. Autotransplantation of immature premolars has been documented as a predictable long-term outcome with the potential for preservation and regeneration of alveolar bone. They can also be successfully reshaped to the central incisor's morphology using direct composite build-ups. However, tooth transplantation is a technique sensitive procedure and requires good case selection, an understanding of relevant tooth transplantation biological principles and careful execution of the optimal surgical and follow-up protocols. Orthodontists play an important role in cooperation with the surgeon before and after surgery. This includes selection of suitable candidates based on orthodontic evaluation of occlusion and indications for premolar extraction, opening adequate space before transplantation and post-surgical alignment of the transplant for an optimal reshaping and establishing a stable occlusion. The aim of the paper is to present clinical application of autotransplanation of immature premolars to replace a traumatized central incisor in growing patients and to discuss the role of an orthodontist in the interdisciplinary team.

Esthetics and bone changes of immediate implants with or without vascularized interpositional periosteal connective tissue grafting: A 2-year randomized controlled trial.

To compare esthetics at single immediately placed implants with and without soft tissue augmentation. Patients with non-restorable maxillary teeth in the esthetic zone were assigned into 2 groups: immediately placed implants with simultaneous vascularized interpositional periosteal connective tissue grafting (VIP-CTG) or non-grafted immediately placed implants (NG). The outcomes included: pink esthetic score (PES), gingival thickness, keratinized tissue width, buccal bone changes, marginal bone loss, pain, and satisfaction. Eighteen implants were included. At 2 years the mean value for PES was 12 ± 3.2 for the VIP-CTG and 12.9 ± 1.3 for the NG (p=.855). Mucosal thickness and keratinized tissue width showed no statistically significant difference between the two groups (p=.253) and (p=.931) respectively. Clinically buccal bone showed mean bone loss of 2.03 ± 1.57 mm for VIP-CTG and 1.09 ± 1.3 mm for NG (p=.247) and radiographically showed 1.67 ± 0.84 mm at the VIP-CTG and 1.16 ± 0.47 mm at the NG (p=.118). No statistically significant difference between both groups was demonstrated regarding marginal bone level changes (p=.142), pain (p=.622), or satisfaction (p=.562) at any time point. Simultaneous soft tissue grafting with immediate implant placement did not provide a more favorable outcome regarding esthetics or alveolar bone preservation effect. Undisturbed healing with the least surgical intervention seems to provide more favorable outcomes.

Is sclerostin antibody an effective agent for alveolar bone regeneration in animal models? A scoping review

Objectives&#x0D; The use of Sclerostin Antibody(Scl-Ab) as a bone anabolic agent has shown significant benefit in bone disorders in preclinical animal models and human clinical trials. Currently available evidence on the use of Scl-Ab in alveolar bone regeneration is limited to animal studies and hence this scoping review encompasses the animal studies conducted to ascertain the effectiveness of Scl-Ab on alveolar bone regeneration. &#x0D; Materials and methods&#x0D; The search strategy was aimed to locate published animal studies in which the treatment arm includes Sclerostin antibody administration for alveolar bone preservation or regeneration. The search terms used were (((Animal model) OR Rodent) AND Alveolar bone defect) AND Anti sclerostin antibody) OR Sclerostin antibody) AND Alveolar bone regeneration) OR Bone regeneration) AND Bone fill. &#x0D; Results&#x0D; Of the 559 results from Medline/PubMed, Scopus, Web of Science, Google scholar and additional articles from the references, six were included in the review. Scl-Ab was found to be effective in improving the bone quality and quantity. It was also observed that Scl-Ab was useful in reduced bone density associated with diseases and conditiona affecting osteoblast activity. &#x0D; Conclusion&#x0D; The review concluded that Scl-Ab promotes alveolar bone augmentation and improves bone quality without surgical interventions.

Histologic Assessment of Peri-implant Tissues Around Endosseous Dental Implants Placed Along with Intentionally Retained Root Fragment in Animal Models: A Systematic Review.

To evaluate whether the placement of endosseous dental implants along with intentionally retained root fragments enhances peri-implant histologic characteristics and outcomes in healthy animal models. Two review authors independently performed electronic literature searches across the PubMed/MEDLINE, LILACS, EBSCOhost, and Science Direct databases by using different keywords and Medical Subject Headings terms to identify relevant articles. Only preclinical animal trials evaluating the histology of peri-implant tissues around endosseous dental implants placed along with intentionally retained root fragments were included in the review. The risk of bias assessment was investigated using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE) tool, and the reporting quality of each trial was evaluated using the Animal Research: Reporting in Vivo Experiments guidelines. Seven preclinical trials including a total of 33 animals and 155 endosseous dental implants were eligible for the analysis. One trial reported the histologic assessment of peri-implant tissues around endosseous dental implants with ankylotic root fragments, whereas the other six studies used nonankylotic root fragments. The effects of the length of retained root fragments on peri-implant tissues were reported in two trials that showed contrasting results. The effects of the width of retained root fragments were assessed in two trials reporting that a remaining thickness < 2 mm and buccal bone thickness > 3 mm favors alveolar bone preservation over a period of 12 weeks. Although the mean quality assessment score for all preclinical trials was moderately high, the summary for the risk of bias presented a high risk. Limited data and short-term preclinical evidence showed optimal peri-implant histologic findings of endosseous dental implants placed along with intentionally retained root fragments. However, further preclinical histologic evaluation with homogenous populations and long-term controlled clinical studies are needed to substantiate its applicability in clinical situations.

Major predictors of early dental implant loss: a systematic review

Introduction: In the dental implant (DI) scenario, it is estimated that about 18 million DI occur annually in the world. There are over 1,300 types of dental implants. DI also has several side effects such as biological complications, which are adverse reactions in the hard and soft tissues of the implant prosthesis, such as mucositis and peri-implantitis. Still, poor oral health, alcohol intake, and smoking are some of the underlying predictors that contribute to these complications. Objective: A systematic review was carried out on the main considerations of early loss of dental implants, presenting through clinical findings the main predictors of dental implant failure. Methods: The rules of the Systematic Review-PRISMA Platform. The research was carried out from December 2021 to February 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 244 articles were found. In total, 102 articles were fully evaluated and 32 were included and evaluated in this study. Lack of primary stability, surgical trauma, and infection are the main predictors. It can be said that the quality and quantity of bone enable a high success rate for the preservation of alveolar bone around implants. The highlights of predictors of DI failures are biological failures, mechanical failures, iatrogenic failures, inadequate adaptation, which includes aesthetic dissatisfaction and psychological problems. Conclusion: Despite the high success rate, implants fail. Primary instability, surgical trauma, and perioperative contamination appear to be the most important predictors of implant failure. Furthermore, the determination of this genetic pattern in osseous integration makes it possible to identify individuals at greater risk of implant loss. Thus, genetic markers are important, contributing to an adequate preoperative selection and development of prevention strategies and individualized therapy to modulate genetic markers and increase the success rate of treatments.

PRESERVATION OF RESIDUAL ALVEOLAR RIDGE USING TOOTH SUPPORTED OVERDENTURE PROSTHESIS- A CASE REPORT

Loss of alveolar bone is a great entity to be worried about after loss of natural teeth. Overdenture is a treatment modality in means of alveolar bone preservation retention and stability of prosthesis by preserving the roots of the remaining teeth thereby increase the patients perception, acceptance and quality of life. It is the most commonly treatment modality for elderly patient with two or more teeth remaining in the either arch. The use of copings and precision attachments on the remaining teeth enhances the retention of the denture. Dentists have a responsibility to prevent tooth loss whenever possible and everything should be done to keep the patient away from an edentulous state. Preventive prosthodontics emphasizes upon the importance of procedures that can delay or rectify the future problems in prosthesis and the overdentures are the optimum method to achieve this requirement. In this present case report described the rehabilitation of a patient with few natural teeth present using tooth supported overdenture which restored the function and evades the social stigma, thereby improving the quality of life of the patient.

Alveolar bone regeneration following autotransplantation of immature premolars to replace traumatized maxillary incisor

In children, alveolar bone preservation and regeneration after autotransplantation of an immature premolar to replace an avulsed or severely traumatized maxillary central incisor is an important outcome of this procedure. This phenomenon has been described in a few animal and clinical studies and is related to the regeneration potential of a vital periodontal ligament of the transplanted tooth. Important factors that help to achieve the successful healing and preservation of an intact periodontal ligament on the donor tooth are discussed in this paper. They include proper donor selection, sufficient space conditions at the recipient site, and a gentle surgical technique. Immature premolars are regarded as the optimal donors to replace traumatized maxillary central incisors. Complete regeneration of the alveolar process after autotransplantation of a developing mandibular premolar is presented in a young girl with a traumatically lost maxillary central incisor.

Preclinical Evaluation of BMP-9-Treated Human Bone-like Substitutes for Alveolar Ridge Preservation following Tooth Extraction.

The success of dental implant treatment after tooth extraction is generally maximized by preserving the alveolar ridge using cell-free biomaterials. However, these treatments can be associated with inflammatory reactions, leading to additional bone volume loss hampering dental implant positioning. Our group developed a self-assembled bone-like substitute constituted of osteogenically induced human adipose-derived stromal/stem cells (hASCs). We hypothesized that a bone morphogenetic protein (BMP) supplementation could improve the in vitro osteogenic potential of the bone-like substitute, which would subsequently translate into enhanced alveolar bone healing after tooth extraction. ASCs displayed a better osteogenic response to BMP-9 than to BMP-2 in monolayer cell culture, as shown by higher transcript levels of the osteogenic markers RUNX2, osterix (OSX/SP7), and alkaline phosphatase after three and six days of treatment. Interestingly, BMP-9 treatment significantly increased OSX transcripts and alkaline phosphatase activity, as well as pro-angiogenic angiopoietin-1 gene expression, in engineered bone-like substitutes after 21 days of culture. Alveolar bone healing was investigated after molar extraction in nude rats. Microcomputed tomography and histological evaluations revealed similar, or even superior, global alveolar bone preservation when defects were filled with BMP-9-treated bone-like substitutes for ten weeks compared to a clinical-grade biomaterial, with adequate gingival re-epithelialization in the absence of resorption.

Combination of Nanocrystalline Hydroxyapatite and Injectable Platelet-Rich Fibrin on Bone Graft Materials for Alveolar Bone Preservation

Alveolar bone resorption is one of post-extraction complications with a reduction in the dimensions and quality of the alveolar bone, which will make it challenging to install dental implants in the future. The resorption can be prevented by preserving the alveolar bone using bone grafts. Nanocrystalline hydroxyapatite (HA) is a widely developed material as a bone graft. However, there are still some limitations because it only has osteoconductive properties. The addition of injectable platelet-rich fibrin to HA can increase this material’s osteoinductive, antibacterial, and anti-inflammatory properties, making it suitable for use as bone graft material for the preservation of alveolar bone.

Overdentures the realms of overshadowness or obliviousness

The overdenture is a predictable and valuable option in the treatment of a patient with multiple missing teeth. It aids by preservation of alveolar bone, teeth and supporting structures, maintenance of proprioceptive response and neuromuscular co-ordination, and enhances the quality of a prosthesis by improving the stability, retention and patient acceptance. Often while fabricating an overdenture with retained attachments it becomes mandatory to cast the wax pattern and by no means can that be judged for parallelism with the abutments. A lucid method of obtaining parallelism has been described, adjunct with significant improvement of bite force has been portrayed.Careful case selection and abutment preparation as well as periodic recall is the key to a successful over denture rehabilitation. This case report also depicts the tooth supported overdenture as a viable option with the use of a customized parallelometer which has its ease of use and cost effectiveness for determining parallelism of abutments using a prefabricated ball attachment system and deciphers the increase in bite force in a dynamic manner.

Efficacy and safety of rhBMP/\u03b2-TCP in alveolar ridge preservation: a multicenter, randomized, open-label, comparative, investigator-blinded clinical trial

BackgroundThe aim of this multicenter, randomized, open-label, comparative, investigator-blinded study was to investigate the efficacy and safety of recombinant human bone morphogenetic protein 2 (rhBMP-2) combined with β-TCP (rhBMP-2/β-TCP) in alveolar ridge preservation.Materials and methodsEighty-four subjects from three centers were enrolled in this clinical trial. After tooth extraction, rhBMP-2/β-TCP (n = 41, test group) or β-TCP (n = 43, control group) were grafted to the extraction socket with an absorbable barrier membrane for alveolar ridge preservation. Using computed tomography images obtained immediately after and 12 weeks after surgery, changes in the alveolar bone height and width were analyzed for each group and compared between the two groups.ResultsBoth the test and control groups showed a significant decrease in alveolar bone height in the 12 weeks after surgery (both groups, p < 0.0001). However, the test group exhibited a significantly lower decrease in alveolar bone height than the control group (p = 0.0004). Alveolar bone width also showed significantly less resorption in the test group than in the control group for all extraction socket levels (ESL) (p = 0.0152 for 75% ESL; p < 0.0001 for 50% ESL; p < 0.0001 for 25% ESL). There were no statistically significant differences in the incidence of adverse events between the two groups. No severe adverse events occurred in either group.ConclusionsThe results of this study suggest that rhBMP-2/β-TCP is a safe graft material that provides a high alveolar bone preservation effect in patients receiving dental extraction.Trial registrationClinicaltrials.gov, NCT02714829, Registered 22 March 2016

Combigraft versus Bio‐Oss/Bio‐Gide in alveolar ridge preservation: A prospective randomized controlled trial

AbstractThe aim of this prospective study was to compare Combigraft with Bio‐Oss/Bio‐Gide complex in alveolar bone preservation in terms of clinical, laboratory and radiographic outcomes in a randomised controlled trial. 80 patients undergoing tooth extraction with the requirement of alveolar bone preservation were randomly allocated to the experimental and control groups. A total of 75 patients completed the study; 37 in the experimental group and 38 in the control group. Two patients who did not fully complete the study but had at least one record on the follow‐up period were analysed, significantly, 73 teeth among 77 dental sites were mandibular third molars which accounted for 94.8% of all subjects in this study. Bone grafting was performed using either of Combigraft or Bio‐Oss/Bio‐Gide complex. The primary outcome was to compare the height and width of alveolar ridge between immediate postoperation and six months postoperation by radiographic evaluation. A two‐sample t‐test was used for independent samples for quantitative variables (such as age) and a chi‐square statistic was used for nominal parameters. Six months after surgery, the height and width of alveolar ridge were 9.47 ± 1.61 mm and 14.71 ± 1.99 mm respectively using Combigraft while those were 9.82 ± 2.04 mm and 14.83 ± 2.04 mm respectively in the control group. There was no significant difference in the total effective rate between the two groups. Combigraft appears to be an alternative option to Bio‐Oss/Bio‐Gide complex for bone preservation in further clinical treatment. (No: CHiCTR19000230651).

Alveolar Bone Preservation Using an Orthodontic Mini-implant in an Adolescent Patient with Multiple Missing Teeth

Af ter tooth extraction, the alveolar ridge undergoes a series of structural changes, including the inevitable vertical and horizontal loss of alveolar bone. In this case, growth modif ication was performed on an 11-year-old patient with skeletal Class II malocclusion with multiple congenitally missing teeth and early loss of a deciduous tooth without succedaneous replacement using an intraoral orthopedic appliance. The space f rom the lost deciduous teeth was effectively maintained. At the age of 14 years, an orthodontic mini-implant with a diameter and length of 1.6 and 7 mm, respectively, was inserted into the alveolar bone to prevent additional alveolar bone resorption and maintain alveolar bone height until growth completion. At the age of 18 years, the second phase of orthodontic treatment was started to properly set the time of dental implant placement and the completion of orthodontic treatment. At the age of 19 years, the alveolar bone height was properly maintained until dental implant placement. The dental implant was successf ully placed without additional vertical bone augmentation. Therefore, we successf ully preserved the alveolar bone by inserting an orthodontic mini-implant into the site of early deciduous tooth loss without succedaneous replacement in an adolescent patient.