Alveolar Ridge Resorption Research Articles

Clinical Evaluation of Stability of Short Deep Threaded Dental Implant During Early Healing Period: A Prospective Controlled Clinical Trial

Objectives: To assess the initial stability of short, deep-threaded dental implants placed in the posterior mandible and to determine the influence of deep-thread design on implant stability during early healing. Methods: Twenty short, deep-threaded implants were placed in the posterior mandibular region of ten patients. Insertion torque value (ITV) was recorded at implant placement. Implant stability quotient (ISQ) was measured immediately post-surgery and at weeks 2, 3, 4, and 5. Results: No significant difference in ITV was observed between short and standard implants. ISQ values did not significantly differ between implant types across the evaluation period (F = 1.17, p = 0.3). Conclusion; Short, deep-threaded implants demonstrate comparable primary stability to standard implants in the posterior mandible. These findings support their use as a viable treatment option for patients with advanced alveolar ridge resorption

Evolving Techniques and Trends in Maxillary Sinus Lift Procedures in Implant Dentistry: A Review of Contemporary Advances.

The most challenging aspects of planning implant rehabilitation for the posterior maxillary region are the pneumatization of the maxillary sinus and the resorption of the residual alveolar ridge. To address the first aspect, there are two primary modalities for sinus augmentation: the direct or lateral window technique and the indirect or crestal technique. Clinicians must possess comprehensive knowledge of the maxillary sinus anatomy and be able to diagnose pathognomonic abnormalities through presurgical imaging and investigations. This skill is essential for performing technique-sensitive augmentation of the maxillary sinus with or without using biomaterials such as bone grafts, membranes, and platelet concentrates. These materials help create a suitable bone bed for either simultaneous or delayed implant placement through various traditional and evolving modified sinus augmentation techniques. It is also critical to effectively elevate the Schneiderian membrane during sinus floor elevation surgery, as complications in this process can adversely affect implant survival and potentially lead to implant failure. This review explores various aspects of maxillary sinus augmentation, ranging from traditional methods to evolving contemporary techniques, and draws on existing literature to examine their advantages, limitations, indications, and contraindications.

Effects of Simvastatin-Loaded Nanomicelles on the Early Preservation of Tooth Extraction Sites.

The present study intended to evaluate the effect of simvastatin-loaded nanomicelles (SVNs) on promoting new bone formation and reducing alveolar ridge resorption at the tooth extraction sites at the early healing of the extraction sockets. SVNs were synthesized using a dialysis method. The rabbit tooth extraction model was established, SVNs and simvastatin (SV) were loaded on gelatin sponge and inserted into the extraction socket. CBCT scans were performed at 0, 2, and 4weeks postoperatively to evaluate bone formation and alveolar ridge absorption in the extraction sockets. And all the animals were sacrificed and the mandibles were harvested. And HE staining and Masson staining were used for histological evaluation of the bone formation in the extraction sockets. Radiographic evaluation showed that compared with the blank control group, at 2 and 4weeks after extraction, SVNs increased the new bone density in the extraction sockets by 75.7% and 96.5%, and reduced the absorption rate of alveolar ridge length at the extraction sites by 60.8% and 49.1%, respectively. Histological evaluation showed that SVNs significantly improved the maturation of new bone tissue in the extraction sockets. SVNs can significantly accelerate healing and effectively reduce the absorption of alveolar ridge at the extraction sites in the early stage of tooth extraction socket healing.

Autologous platelet concentrates in alveolar ridge preservation: A systematic review with meta-analyses.

In order to evaluate the therapeutic advantages of various autologous platelet concentrates (APC) as a single biomaterial during alveolar ridge preservation (ARP), a systematic review with meta-analyses was conducted. PubMed, EMBASE, Web of Science, and Scopus were screened for randomized controlled trials (RCTs) that were released prior to 2024. The selected papers compared an APC with either unassisted healing (blood clot) or another biomaterial during ARP (third molars were not included). The outcome parameters included alveolar bone dimension alterations, soft tissue healing, and post-op pain intensity. The search yielded 35 papers (33 studies), one applying platelet-rich plasma (PRP), six using plasma rich in growth factors (PRGF), and 28 using leukocyte- and platelet-rich fibrin (L-PRF). These studies showed a large heterogeneity (e.g., outcome parameters, timing, surgical approach, and inclusion criteria), which hindered drawing strong conclusions. In most studies, however, ARP with PRP, PRGF, and L-PRF alone produced faster soft tissue healing, less post-extraction pain, less alveolar ridge resorption, more socket bone fill, and a higher bone density when compared to unassisted (spontaneous) healing. The ultimate benefit appears to be significantly influenced by the surgical approach. Limited literature exists comparing APC with other biomaterials for ARP, resulting in inconclusive data. APC application for ARP is a promising strategy to improve soft and hard tissue healing and reduce post-extraction pain.

Effect of thermocycling on tensile bond strength of autopolymerized, heat-polymerized, milled, and 3D printed denture base materials bonded to 4 different denture liners: an in vitro study

BackgroundDigitally fabricated dentures may require relining due to continual alveolar ridge resorption. However, studies evaluating the tensile bond strength (TBS) of digitally fabricated dentures bonded to denture liners are lacking. This study aimed to evaluate the TBS of autopolymerized, heat-polymerized, milled, and 3D printed denture base materials bonded to 2 acrylic-based and 2 silicone-based denture liners, both before and after thermocycling. Additionally, the impact of thermocycling on the TBS were also evaluated.MethodsThe TBS of 4 different denture base materials (Palapress (PL), Vertex Rapid Simplified (VR), Smile CAM total prosthesis (SC), and NextDent denture 3D+ (ND)) bonded to 2 acrylic-based (GC Soft-Liner (GC) and Tokuyama Rebase II (RB)) and 2 silicone-based (Ufi Gel P (UP) and Sofreliner Tough M (ST)) denture liners were tested. Specimens (n = 8) were divided into non-thermocycling and thermocycling groups. Non-thermocycling specimens were tested after 24-hours water immersion, while thermocycling specimens were underwent 5000 cycle and were immediately tested. Mode of failure was examined under a stereomicroscope. Data were analyzed using 2-way ANOVA and Tukey HSD tests (α = 0.05), and independent samples t test (α = 0.05) for TBS between non-thermocycling and thermocycling groups.ResultsFor the non-thermocycling groups, within the same denture liner material, no significant differences were found between denture base materials, except the ND + RB group, which had significantly lower TBS. For the thermocycling groups, within the same denture liner material, the TBS in the PL group exhibited the highest and the ND group exhibited the lowest. Within the same denture base material, in both non-thermocycling and thermocycling groups, the TBS in the ST group exhibited the highest; in contrast, that in the GC group exhibited the lowest. No significant differences were observed in TBS between non-thermocycling and thermocycling groups, except for denture base materials bonded to the ST group, SC + UP, and ND + UP groups.ConclusionsMilled denture base can be relined with acrylic-based or silicone-based denture liner. However, cautions should be exercised when relining 3D printed denture base. Thermocycling did not affect TBS between acrylic-based denture liners and denture bases. In contrast, it affected the bond between silicone-based denture liner and denture base.

Fish scale-derived hydroxyapatite for alveolar ridge preservation.

Alveolar ridge resorption following tooth extraction poses significant challenges for future dental restorations. This study investigated the efficacy of fish scale-derived hydroxyapatite (FSHA) as a socket preservation graft material to maintain alveolar bone volume and architecture. FSHA was extracted from *Labeo rohita* fish scales and characterized using Fourier transform infrared (FTIR) analysis. In vitro, biocompatibility and osteogenic potential were assessed using Saos-2 human osteosarcoma cells. Cell viability, migration, and proliferation were evaluated using MTT and scratch assays. In vivo performance was assessed in a rat model, and FSHA was compared to a commercial xenograft (Osseograft) and ungrafted controls. Histological analysis was performed at 8-week post-implantation to quantify new bone formation. FTIR confirmed the purity and homogeneity of FSHA. In vitro, FSHA enhanced Saos-2 viability, migration, and proliferation compared to controls. In vivo, FSHA demonstrated superior bone regeneration compared to Osseograft and ungrafted sites, with balanced graft resorption and new bone formation. Histological analysis revealed an active incorporation of FSHA into new bone, with minimal gaps and ongoing remodeling. Approximately 50%-60% of FSHA was resorbed by 8 weeks, closely matching the rate of new bone deposition. FSHA stimulated more bone formation in the apical socket region than in coronal areas. In conclusion, FSHA is a promising biomaterial for alveolar ridge preservation, exhibiting excellent biocompatibility, osteogenic potential, and balanced resorption. Its ability to promote robust bone regeneration highlights its potential as an effective alternative to currently used graft materials in socket preservation procedures.

Severe alveolar ridge resorption and mandibular torus in an edentulous patient undergoing rehabilitation by applying removable complete dentures with a soft denture liner using duplicate dentures: A case report

Severe alveolar ridge resorption and mandibular torus in an edentulous patient undergoing rehabilitation by applying removable complete dentures with a soft denture liner using duplicate dentures: A case report

A case report of esthetic improvement by fixed implant prosthesis for a patient with severe alveolar ridge resorption

A case report of esthetic improvement by fixed implant prosthesis for a patient with severe alveolar ridge resorption

Bone augmentation in dental implants among Indian patients.

It is of interest to compare guided bone regeneration (GBR) with titanium mesh, alveolar distraction osteo-genesis (DO), GBR with auto-genous bone and e-PTFE membranes and onlay bone grafts. This helps to restore vertically lacking alveolar ridges and their capacity to sustain the vertical bone growth acquired both prior to and following implant placement. The parameters such as (i) success and survival of dental implants (ii) peri-implant clinical parameters after prosthetic loading at 1 year, 2 year and 3 year follow up (iii) resorption of alveolar ridge regenerated before placement of dental implants and after placement of dental implants were assessed. Data shows that the distraction osteo-genesis is more predictable for long-term prognosis of vertical bone growth. However, all methods help to repair the vertically resorbed edentulous ridges.

Evaluation of Guided Bone Regeneration Using Xenograft/APRF Mixture in Atrophic Posterior Mandible (Clinical and Radiographic Study)

Introduction: The rehabilitation of the posterior mandible with dental implants represents a hard challenge for clinicians today due to the lack of supporting bone. Different surgical techniques are currently being used to augment the posterior mandible, where GBR is considered the most commonly used. Materials and Methods: Fifteen patients were selected to treat mandibular alveolar ridge resorption with guided bone regeneration using a titanium-reinforced membrane and a filling mixture of xenograft bovine bone and PRF. The membrane was fixed using a Meisinger pin control kit and Profix 3mm microscrews. A PRF membrane was used to cover the Ti-d-ptfe.
 Results: Swelling, pain, and numbness were evaluated using the mixture of PRF/xenograft as well as PRF membranes. The results showed promising results in terms of primary wound healing, whereas a significant bone quantity with a mean bone volume of 5.78 ± 0.81 was reported after 6 months. The primary implant stability recorded high values and significantly increased at a period of 6 months post-insertion (p = 0.037). Conclusion: It could be concluded that the PFR/xenograft mixture can be promising when used with the titanium-reinforced d-ptfe membrane in 3D ridge reconstruction of the atrophic posterior mandible; moreover, using the PRF membrane to cover the TI-d-ptfe membrane could enhance soft tissue healing as well as prevent soft tissue dehiscence due to the concentration of growth factors that can be released during primary wound healing. The xenograft/PRf mixture can be consistently utilized for the creation of new bone in severely atrophic ridges if used in GBR. The high ISQ at primary implant placement and at a period of 6 months post-insertion, according to Osstell, can explain the successful application of this mixture in 3D bone augmentation of the atrophic posterior mandible.

Trajtimi protetik i pacientëve me padhëmbësi totale te resorbimi i kockës alveolare

Alveolar bone resorption is a continuous process with mul- tifactorial etiology, and often a serious problem for elderly people, especially in cases with edentulous mandible. Nu- merous studies describe a correlation between multiple systemic and local factors and alveolar ridge resorption. This review aims to analyse the available evidence of factors that may affect the residual ridge resorption and the effect of different denture treatments used to reduce the residu- al ridge resorption. Each patient has unique treatment re- quirements considering that the residual ridge resorption has multifactorial etiology. Management of alveolar bone resorption is considered a challenge in prosthodontic treat- ment. Therefore, research should continue to find methods and materials which will reduce the alveolar bone resorp- tion.

Evaluation of Modified Shell Technique in 3D Ridge Reconstruction: A Clinical and Radiographic Study

Introduction: As a result of tooth loss, alveolar ridge resorption sacrifices bone volume including bone width. In order to replace the lost dentition with implants functionally and esthetically, bone augmentation procedures are carried out. Materials and Methods: Fifteen patients were selected to treat mandibular alveolar ridge resorption with an autogenous block graft harvested using piezoelectric surgical tips and split into two shells using a diamond disk then fixated on the decorticated defective ridge. Particulate xenograft bovine bone was then inserted between the fixated shell and ridge, the second shell was used to roof the bone particles. Results: The modified shell technique could be an alternative to other ridge augmentation techniques. This study shows promising clinical and radiographic results that carry the advantages of being: safe and precise cutting using Piezoelectric tips, the statistical data showed a significant difference in 3D bone volume where no unfavorable complication was detected. Conclusion: The modified shell technique showed a reliable technique in cases of 3D ridge reconstruction since it holds the advantages of autogenous bone properties and the rigidity of the bone shells that maintain the space necessary for augmentation. The use of PRF can accelerate wound healing and minimize the risk of flap dehiscence as well as it can speed up bone formation.

Single maxillary complete overdenture using novel magnetic attachment

Overdenture magnetic attachments are designed to treat patients experiencing complications from tooth loss due to aging, with issues like alveolar ridge resorption and reduced oral function. The novel Magteeth™ magnetic attachment system has undergone innovation compared to previous magnet attachment describing an improved efficiency in denture magnetic attraction. A 76-year-old female patient came to Department of Prosthodontic Clinic, Universitas Airlangga Dental Hospital to restore masticatory function and improve smile aesthetics. The clinical and radiographic evaluation revealed multiple missing teeth, specifically tooth numbers 18, 17, 15, 12, 11, 21, 22, 24, 26, 28, 37, 36, 35, 46, 47, and 48. Furthermore, there were chronic apical periodontitis, specifically gangrene radix, noted on teeth 16, 14, 13, 23, 27, 34, 38, and 44, and resorbed alveolar ridge on the missing tooth region. We use the Magteeth™ novel magnetic attachment in this case for the maxillary complete overdenture on tooth 25 to improve retention, and mandibular metal frame partial denture to ensure optimal function and patient satisfaction throughout the treatment process. Surface treatment on Magteeth™ root keeper and magnet is essential in denture and magnet integration. The novel Magteeth™ magnetic attachment is manage to overcome loss of retention problem during slight denture movements caused by chewing conventional attachments, which was the major disadvantage from the predecessor. Overall, the patient expresses satisfaction with the treatment in terms of both functionality and aesthetics.

Fenugreek Seed Ethanolic Extract Improves Alveolar Bone Parameters by Attenuating Inflammation in Ovariectomized Rats.

Alveolar bone residual ridge resorption remains a major challenge for dental implant placement in patients with edentulism. Fenugreek seed extracts have been reported to have potential roles in bone metabolism. This study aimed to evaluate the effects of fenugreek seed ethanolic extract (FSEE) on bone cells, inflammation, hormones, and angiogenesis parameters of alveolar bone tissue following teeth extraction in an ovariectomized (OVX) model. A total of 30 adults female Wistar rats were assigned into two major groups. Each group consisted of control, OVX, OVX+FSEE 100 mg/kg BW, OVX+FSEE 200 mg/kg BW, and OVX+FSEE 400 mg/kg BW. The FSEE treatment was applied through the intragastric route for 7 days in the first group and for 30 days in the second group of animals. The first molar tooth of the right maxilla was extracted before the FSEE treatment. The level of 17β-estradiol was measured by the ELISA method. The dissected maxilla alveolar bone processus was sectioned for histological evaluation by hematoxylin-eosin staining and an immunohistochemistry assay. This study found that FSEE reduced the blood estrogen level and increased estrogen receptor-α (ER-α) expression. FSEE administration modified the number of bone cells, angiogenesis, vascular endothelial growth factor (VEGF), sclerostin, and the osteoprotegerin/receptor activator of nuclear factor kappa-β ligand (OPG/RANKL) ratio. Alterations were seen in the inflammatory markers interleukin-6 (IL-6), transforming growth factor-β1 (TGF-β1), and the macrophage-1/macrophage-2 (M1/M2) ratio. In this study, inflammation was found to be attenuated by reductions in IL-6 and sclerostin, and an increase in TGF-β1. The maturation of bone osteocytes increased along with the increase in ER-α expression and ratio of OPG/RANKL.

Alveolar Ridge Preservation with The Use of Demineralized Bone Matrix Putty: Clinical, Radiographic and Histological Observations in A Case Series

<p>Alveolar ridge preservation (ARP) can minimize alveolar ridge resorption following tooth ex¬traction and facilitate restorative-driven implant placement. Demineralized bone matrix (DBM) comprises a human allograft that is osteoinductive and osteoconductive. This report describes radiographic, histologic and clinical findings of ARP using DBM putty and non-resorbable high-density polytetrafluoroethylene (d-PTFE) membrane in three cases. </p> <p>Materials and Methods: From January 2018 to May 2018, three patients underwent the ARP procedure. The surgery involved atraumatic extraction, socket debridement, filling the socket with DBM putty, applying a d-PTFE membrane, and suturing with 5-0 nylon. After healing for 6–7 months, an implant was placed and biopsy specimens were collected simultaneously. Using the same customized surgical stent and computed tomography, the preoperative and postoperative alveolar ridge heights and widths were measured. Histological evaluations in¬cluding the percentage of newly formed bone, residual graft particles, and fibrous connective tissue were performed. </p> <p>Results: In all three cases, the health status of the hard and soft tissue improved (mean fol¬low-up: 54 months). Guided bone regeneration was not required during implant placement. Radiographically, the mean change was 0.5 mm in the alveolar ridge height and 1.2, 0.87, and 0.73 mm in the alveolar ridge width at 2, 4, and 6 mm apical to the initial vertical measure¬ment, respectively. Histologically, the mean percentage of new bone, residual graft particles, and fibrous connective tissue was 40.5±5.9%, 10.7±6.9%, and 48.8±9.6%, respectively, and the voids were not included in these calculations. </p> <p>Conclusion: This case series demonstrated the effectiveness of DBM putty as a biocompatible filler in extraction sockets for ridge preservation prior to implantation. Further longitudinal studies regarding the efficacy and stability of DBM putty in ridge preservation are required.</p> <p> </p>

Customized Preliminary Impression: A Novel Impression Technique for Severely Resorbed Edentulous Ridges

Patients with long-term edentulism and/or ill-fitting (poorly fitted) dentures are more likely to experience severe mandibular alveolar ridge resorption. Some of these patients have genial tubercles that rise over the mandibular residual ridge in the anterior region and protrude into the floor of the mouth. Typically, the most prominent portions of the resorbed mandibular edentulous ridge are in contact with the lingual flanges of the mandibular stock impression trays (i.e., genial tubercles and internal oblique lines). In these situations, it is advised that a preliminary custom impression tray be created to pour an initial impression, allowing for the fabrication of individual custom trays. In general, dental practice for the fabrication of the complete denture, the stock trays are used for making the preliminary impression and the custom trays for the final impression. The present article portrays an innovative and efficient clinical technique involving the fabrication of a customized preliminary impression tray for preliminary impression making particularly in unconventional situations, that is, pronounced mandibular alveolar ridge resorption.

UNILATERAL HYBRID PROSTHESIS FOR THE REHABILITATION OF EXTENSIVELY RESORBED MAXILLARY PARTIAL ALVEOLAR RIDGE: CASE REPORT

The rehabilitation of an edentulous patient is getting complicated if the edentulous ridge is large and excessively defective. This clinical report describes the restoration of a severely resorbed maxilla of a 49-year-old male patient with a hybrid denture. The intermaxillary vertical occlusal distance was considerably increased due to resorption of alveolar ridge and tuber maxilla. An acrylic resin based implant retained hybrid denture was fabricated to compensate the increased vertical distance and decrease the weight of the prosthesis. After a follow-up period of 5 year it was noticed that the patient was satisfied with the functional and esthetic functions of the denture.

NOVEL SPACER DESIGNS TO LIMIT THE RESIDUAL ALVEOLAR RIDGE RESORPTION IN EDENTULOUS ARCHES

Objective: To provide a new system of spacer design for the fabrication of complete denture prosthesis bearing in mind the pattern of residual alveolar ridge resorption, the stress-bearing, and relieving areas. Background: Certain anatomical structures of the edentulous arches are incapable of bearing compression and thus, undergo detrimental changes. Hence, care should be taken to avoid the application of excessive forces on those structures. The residual alveolar ridge of maxillary and mandibular arches have different patterns of resorption. When areas susceptible to resorption are subjected to unwarranted compression, the rate of bone resorption accelerates leading to loss of retention of the prosthesis and diminished support available for the future prosthesis. Thus, it would be prudent to design spacers keeping in mind the resorption pattern of the edentulous arches. Conclusion: The spacer designs presented in this article are likely to provide better stress distribution by displacing the stress-bearing structures and preventing the resorption of vulnerable areas by relieving such areas. The new design of the spacer advocated could limit some amount of bone resorption, if not, completely prevent it.

Magnetic attachment for complete overdenture: A case report

Background: Overdenture is a partial or complete denture that has support from natural tooth roots that have been treated with endodontic treatment. Retain the remaining teeth prevent resorption of alveolar ridge. An overdenture with a magnetic attachment can be used to increase the retention of the denture. The magnets transfer the occlusal load to the bone through the periodontal ligament of retained roots that are attached with remaining root structure Objectives: This case report is aimed to report the step-by-step treatment of complete denture mandibula and complete overdenture maxilla with magnetic attachment retained design Case Report: A 62-year-old female visited the Prosthodontic Clinic of Dentistry Faculty, Airlangga University with a chief complaint of difficulty in eating. Clinical examination shown partial edentulous in the mandibula. The remaining teeth were 18, 14, 23, 25 and 43. Case management: After thorough observation from the clinical presentation and radiographic, magnetic attachment was planned on 14 in order to retain the remaining tooth and improving retention and stabilization of the maxillary denture. Conclusion: Magnetic maxilla overdenture is able to provide support, stability and retention.

Hyperlipidemia impairs bone regeneration of closed bone defects and tooth extraction wounds in mice.

To evaluate the effect of hyperlipidemia on the healing of bone defects. Apolipoprotein E (ApoE)-deficient mice and wild-type (WT) C57BL/6J mice were fed with an atherogenic high-fat diet (HFD) or a standard chow diet (as control) for 6 weeks. Blood samples were collected to evaluate serum lipid levels. Closed bone defects and open tooth extraction wounds were then created in the mandibles of these animals. One or two weeks after surgery, animals were euthanized. Micro-CT analysis and histomorphometric analysis were conducted to evaluate the healing of bone defects and the alveolar ridge resorption. Bone regeneration of closed bone defects was considerably delayed in the hyperlipidemic Apoe-/- mice and WT mice. No obvious difference was detected in the new bone formation of the tooth extraction wounds. The HFD-fed mice showed more prominent reduction in the lingual alveolar ridge height of the tooth extraction wounds when compared with the control group. Hyperlipidemia results in delayed bone regeneration in large closed bone defects. Although tooth extraction wounds are small and normally regenerated in a hyperlipidemic microenvironment, the prominent reduction in the alveolar ridge height is also a challenge for future restoration of the dentition.