Alveolar Ridge Research Articles

Alveolar ridge preservation and its impact on marginal bone level changes around dental implants: A retrospective, cohort comparative study.

This retrospective study compared the outcomes of implants placed in alveolar ridge preservation (ARP) treated sites with those in spontaneously healed (SH) sites. The study included patients presenting with one implant placed in an ARP-treated socket and one in an SH site. The primary outcome was the comparison of Marginal Bone Level Changes (MBLC). Statistical analysis was performed to identify factors influencing MBLC, including age, gender, smoking, parafunctional habits, and prosthetic emergence angle. Of these, 28 patients (23 females, 82.1%) were included in this analysis. Sockets in the SH group were classified as type I, whereas type II sockets were more common in the ARP group. The SH group exhibited significantly higher MBLC than the ARP group (p = 0.032), with values, respectively, of 1.00 [0.25; 1.62] and 0.40 [0.00; 1.00] mm. Among all evaluated parameters, the performance of ARP was the only factor significantly affecting MBLC (β = -0.72, SE: 0.32, p = 0.026). Age, gender, smoking, parafunctional habits, and prosthetic emergence angle did not significantly affect MBLC. The study shows the potential role of ARP in maintaining stable marginal bone levels around implants. In our sample, ARP significantly reduced MBLC compared with spontaneous healing, highlighting its possible impact in clinical practice for better peri-implant bone stability.

Competence of allogenic demineralized tooth matrix in socket seal surgery for alveolar ridge preservation: a randomized control clinical trial.

To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft. Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol (n = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed (n = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant. Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35mm vs. 1.60 ± 0.66mm [p = .000] and 9.64 ± 15.39% mm3 vs. 31.45 ± 18.11% mm3 [p = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm3 vs. 5.25 ± 5.79% mm3). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance. Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

Comparative Evaluation of Primary Stability in Truncated Cone Implants with Different Macro-Geometries in Low-Density Polyurethane Blocks Simulating Maxillary Sinus Rehabilitations

After tooth loss, particularly in the posterior maxilla, the alveolar ridges undergo bone resorption. Therefore, ensuring the appropriate quantity and quality of alveolar bone is crucial for accurate implant positioning and achieving optimal esthetic and functional results. This study aimed to evaluate biomechanical parameters (insertion torque: IT, removal torque: RT, and implant stability quotient: ISQ) of distinct truncated cone implant designs (Sinus-plant and SLC) on polyurethane blocks simulating type D3 and D4 bone. SLC implants exhibited significantly higher IT, RT, and ISQ values compared to Sinus-plant implants, except in the 10 pounds per cubic foot (PCF) density block with a cortical layer for the IT (24.01 ± 0.91 vs. 23.89 ± 1.66 Ncm). The IT values for SLC implants ranged from 13.95 ± 0.19 Ncm in the lowest density block to 37.94 ± 0.45 Ncm in the highest density block, consistently providing significantly higher primary stability with an ISQ of approximately 70 in the highest density block. Despite lower ISQ in the lowest density block (48.60 ± 0.52 and 48.80 ± 0.42 in buccolingual and mesiodistal directions), it was deemed acceptable considering the inadequate bone densities in the maxillary region. These findings on SLC suggest potential clinical advantages, including reduced procedure duration and costs, improved stability, and the possibility of immediate implant placement following sinus augmentation, thereby streamlining the rehabilitation process.

Radiographic changes after alveolar ridge preservation using autogenous raw tooth particles versus xenograft: A prospective controlled clinical trial.

The use of extracted teeth has been introduced as an option for bone grafting. However, the current method requires special machines and solutions, posing significant time and cost. The aim of this study was to evaluate the clinical performance of autogenous raw tooth particles (RTP), a grafting material made from a ground tooth using basic equipment, for alveolar ridge preservation. Twenty-three patients (12 study/11 control), having 14 and 13 sites were included for the study and control groups (commercially available xenograft), respectively. Radiographic measurements were taken at the baseline and the 4-month follow-up appointment. Furthermore, a questionnaire survey concerning the general preference of the type of graft to receive (if needed), before and after knowing the price, was distributed at the completion of the procedure for patients to answer. Alveolar ridge width change was -1.03 ± 0.64 and -0.84 ± 0.35 for the study and the control groups, respectively. Regarding the height, the study group showed a buccal and lingual change of -0.66 ± 0.48 and -0.78 ± 0.81, respectively, while this was -0.78 ± 0.56 and -0.9 ± 0.41 for the xenograft group. There was no statistically significant difference between the groups. Patients preferred the raw tooth particles over other grafting materials (p = .01). No core biopsies were taken to evaluate bone formation, which should be done in future studies. Within its limitations, the current study demonstrated that RTP graft could be an alternative graft for bone augmentation, offering a new cost-effective option for clinicians when available.

Assessment of the application of a novel three-dimension printing individualized titanium mesh in alveolar bone augmentation: A retrospective study.

To assess the clinical and radiographic outcomes of alveolar ridge augmentation using a novel three-dimensional printed individualized titanium mesh (3D-PITM) for guided bone regeneration (GBR). Preoperative cone-beam computed tomography (CBCT) was used to evaluate alveolar ridge defects, followed by augmentation with high-porosity 3D-PITM featuring circular and spindle-shaped pores. Postoperative CBCT scans were taken immediately and after 6 months of healing. These scans were compared with preoperative scans to calculate changes in bone volume, height, and width, along with the corresponding resorption rates. A statistical analysis of the results was then conducted. A total of 21 patients participated in the study, involving alveolar ridge augmentation at 38 implant sites. After 6 months of healing, the average bone augmentation volume of 21 patients remained at 489.71 ± 252.53 mm3, with a resorption rate of 16.05% ± 8.07%. For 38 implant sites, the average vertical bone increment was 3.63 ± 2.29 mm, with a resorption rate of 17.55% ± 15.10%. The horizontal bone increment at the designed implant platform was 4.43 ± 1.85 mm, with a resorption rate of 25.26% ± 15.73%. The horizontal bone increment 2 mm below the platform was 5.50 ± 2.48 mm, with a resorption rate of 16.03% ± 9.57%. The main complication was exposure to 3D-PITM, which occurred at a rate of 15.79%. The novel 3D-PITM used in GBR resulted in predictable bone augmentation. Moderate over-augmentation in the design, proper soft tissue management, and rigorous follow-ups are beneficial for reducing the graft resorption and the incidence of exposure.

3D surface defect map for assessing buccolingual profile of single tooth gaps following alveolar ridge preservation.

A new, non-invasive approach suggests using single intraoral optical scanning to analyze the ridge profile of single-tooth gaps following alveolar ridge preservation in the absence of a baseline scan. This method involves creating a three-dimensional (3D) surface map to identify and assess contour changes and ridge profiles based on the adjacent teeth. The present study was designed as a cross-sectional pilot analysis on a convenience sample of patients undergoing alveolar ridge preservation. Intraoral optical scans were taken on 23 patients, capturing data from 30 edentulous sites. The digital models were then imported into an image analysis software for a 3D surface defect map analysis performed by one examiner. This analysis characterized the buccolingual profile of the single tooth gap relative to the adjacent teeth. 10 linear divergence points, spaced 0.5 mm apart in a corona-apical direction, were identified at the midfacial aspect of the sites. Based on these points the sites were plotted and grouped in three different buccolingual profiles (linear, concave, and convex). Clinical parameters including Keratinized mucosa Width (KMW), and soft tissue phenotype with Colorvue biotype probes were also recorded. Three different buccolingual patterns (linear, convex, and concave) were identified. Seven sites exhibited a linear profile, 10 sites displayed a concave shape, and 13 showed a convex profile. The linear profile had surface discrepancies similar to the neighboring teeth. In contrast, the convex profile revealed mid-buccal discrepancy localized only at the crestal aspect, while the concave had an extended divergence ranging from 1 to 5 mm below the soft tissue margin. Univariate and multiple logistic regression analyses did not reveal any statistically significant variables influencing profilometric analysis; however, when combining phenotype and KMW, thick phenotypes demonstrated a higher proportion of concavity (OR = 4.83) compared to thin ones, suggesting a significant trend. With every 1 mm of increase in KMW, the probability of showing a concavity decreased (p = 0.057). A 3D surface defect map represents a useful tool for objectively quantifying ridge defects and profiles by assessing profilometric and surface differences compared to adjacent dentition using a single intraoral scan. This method also indicates that KMW may play a critical role in preventing concavity defects. The 3D defect map can guide decision-making during soft tissue augmentation procedures by emphasizing the specific location of the defect and providing more detailed insights into its localization. These parameters can enable the tailoring of flap management and soft tissue grafting strategies to address the patient's individual needs.

Immediate single-tooth implant placement in bony defect sites: A 10-year randomized controlled trial.

It is unclear whether an intact buccal bony plate is a prerequisite for immediate implant placement in postextraction sockets. The aim of this 10-year randomized controlled trial was to compare peri-implant soft and hard tissue parameters, esthetic ratings of, and patient-reported satisfaction with immediate implant placement in postextraction sockets with buccal bony defects ≥5mm in the esthetic zone versus delayed implant placement after alveolar ridge preservation. Patients presenting a failing tooth in the esthetic region and a buccal bony defect ≥5mm after an extraction were randomly assigned to immediate (Immediate Group, n=20) or delayed (Delayed Group, n=20) implant placement. The second-stage surgery and provisional restoration placement occurred 3months after implant placement in both groups, followed by definitive restorations 3months thereafter. During a 10-year follow-up period, marginal bone levels (primary outcome), buccal bone thickness, soft tissue parameters, esthetics, and patient-reported satisfaction were recorded. The mean marginal bone level change was -0.71±0.59mm and -0.36±0.39mm in the Immediate Group and the Delayed Group after 10years (p=0.063), respectively. The secondary outcomes were not significantly different between both groups. Marginal bone level changes, buccal bone thickness, clinical outcomes, esthetics, and patients' satisfaction following immediate implant placement, in combination with bone augmentation in postextraction sockets with buccal bony defects ≥5mm, were not statistically different to those following delayed implant placement after ridge preservation in the esthetic zone. Immediate implant placement in case of a failing tooth is a favorable treatment option for patients because it considerably shortens treatment time and the number of surgical treatments. The question is if an intact buccal bone wall is necessary for immediate implant placement. A 10-year study was performed in which 20 patients with a failing tooth in the frontal region of the upper jaw were treated with immediate implant placement and were compared with 20 patients in whom a more conventional treatment strategy was followed in which the failing tooth was first removed and the bone gap restored and the implant placed in a second step. After a 10-year follow-up period, it appeared that the bone around the implant was very stable, gums were healthy, and patients were very satisfied with the result. There was no difference between the two treatment procedures. Such results mean that professionals can discuss the procedure with the patient and apply the individual's preference.

An innovative method for three-dimensional bone reconstruction of the anterior mandible with preserved dentition using an allogeneic bone block: A 6-month follow-up.

Bone defects around the teeth affect a large portion of the population. Bone regeneration in the area of existing teeth is completely different from that in an edentulous area. To date, no method has been developed for three-dimensional (3D) bone reconstruction in regions with preserved teeth. This study aimed to radiologically evaluate the results of the new method of 3D mandibular bone reconstruction in preserved dentition using a custom-made allogeneic bone block with a 6-month follow-up. Alveolar ridge dimensions were radiographically assessed before and 6 months after reconstruction using cone beam computed tomography (CBCT) scans in 32 patients (192 teeth). Reconstruction used a bone block that had been previously planned and prepared using CAD/CAM technology. The observed changes in alveolar bone dimensions were highly significant in most cases (p < 0.001). The closer to the tooth root apex, the lower the bone growth in the sagittal dimension (average of the mean values for each tooth examined in the measured heights): CEJ2: 2.9 mm, ½ CEJ2: 2.7 mm, ¼ CEJ2: 1.9 mm, and API: 1.4 mm. The maximum bone growth in the vertical dimension was observed on tooth 43 (9.9 mm), followed by 32 (9.8 mm), 33 (8.5 mm), 31 (8.4 mm), 42 (8 mm), and 41 (7 mm). The degree of decrease in vestibular dehiscence of the bone was greater the closer the tooth was to the midline (average of -3.8 mm and -3.4 mm for the central incisors; average of -2.8 mm and -2.6 mm for the lateral incisors; average of -2.6 mm and -2.5 mm for the canines). The results prove that it is possible to prevent bone dehiscence in patients undergoing orthodontic treatment, increasing the ability and effectiveness of covering recessions and improving the morphology of the lower part of the face.

Novel Technique for Alveolar Ridge Expansion: A Comparative Clinical Study

Background: Piezosurgery improved the split approach by making it safer, easier, and less prone to complications when treating extremely atrophic crests. Densah drills, with their unique design, expand the ridge by densifying bone in a reverse, non-cutting mode. Objective: To assess the effectiveness of sagittal piezosurgery, which involves cutting bone to the full implant depth and then expanding it using osseodensification drills. We use this technique to expand narrow alveolar bones and simultaneously place dental implants in the maxillary and mandibular arches. Methods: Fourteen patients received 31 dental implants. The maxillary arch received 19, and the mandible received 12 dental implants. This study will include patients who have narrow alveolar bone ridges (2.5–4 mm). After marking the implant sites with a pilot drill, we used a piezoelectric surgery tip to cut the alveolar crest to the depth of the planned dental implant. We then sequentially used Versah Drills, accompanied by extensive irrigation using cooled, sterile normal saline, and finally inserted the implant into the subcrestal level. Results: This study revealed a significant difference in alveolar ridge width immediately after the procedure, and the significant change in the mandible was slightly higher than that in the maxillary arch. However, all implants in both jaws achieved successful osseointegration. Conclusions: The alveolar ridge width changed a lot more in the mandible than in the maxillary arch after the procedure. These two strategies work well together to properly and simply expand severely atrophied alveolar ridges without affecting bone healing or the osseointegration process.

Comparative Effectiveness of an Autologous Dentin Matrix for Alveolar Ridge Preservation.

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.

Iliac crest vertical block grafts -placing outside or inside the bone contour: A cohort study.

Challenging defect configurations and dimensions arise from severe, localized vertical alveolar ridge defects caused by trauma or prior surgery. This study aims to analyze three-dimensional bone gain, assess marginal bone stability in such defect configurations, and evaluate the impact of grafting outside the bone contour on the overall outcome, with a focus on iliac crest block grafts as a valid treatment option. The prospective cohort study evaluated patients who required vertical block grafting due to localized bone defects in the maxilla or mandible and who had received iliac grafts. Three-dimensional bone gain was analyzed using cone beam computed tomography (CBCT) after 3 months of bone healing for each treated site and implant position. A comparison between bone grafts inside and outside the bone contour was conducted. Marginal bone stability was measured using intraoral radiographs during routine annual follow-up visits. Seventy patients with 89 treated sites were evaluated. After 3 months of graft healing, the mean vertical bone gain was 11.03 ± 3.54 mm, the mean horizontal bone gain was 7.18 ± 2.00 mm, and the mean graft length was 28.19 ± 11.01 mm. A total of 217 implants were placed in the augmented regions. On implant level, a mean vertical bone gain of 10.44 ± 3.44 mm and a mean horizontal bone gain of 6.54 ± 1.86 mm were measured. Over a 43-month observation period, mesial and distal marginal bone loss averaged 0.44 ± 0.92 mm and 0.49 ± 1.05 mm, respectively. Eight implants were diagnosed with periimplantitis, resulting in the loss of four implants, while no early implant losses were reported. Within the limitations of this study, vertical bone grafts with iliac crest block grafts were found to be a dependable treatment option for dental implant placement, and placing block grafts outside the bone contour did not lead to inferior outcomes.

Bio-materials Used to Enhance Bone Healing in Implant Dentistry – A Review from the Past to Current

Abstract An alternating way of replacing the missing teeth involves the use of implants. In implant dentistry, an adequate amount of bone is crucial for the long-term prognosis. Bone volume loss can be caused by congenital, post-traumatic or post-surgical abnormalities, as well as disease processes. In scenarios with a bone defect at a site, where the primary stability of an implant cannot be established or where implant placement is not achievable in the best possible position for subsequent prosthetic therapy, guided bone regeneration before implantation represents the method of choice. During implant placement, a partial discrepancy between the implant’s surface and the socket’s osseous walls frequently leaves the peri-implant region with insufficient bone. It has been shown that barrier membranes can be successfully placed to allow the peri-implant space to be filled with new bone rather than lowering the height of the alveolar ridge to produce a sufficient breadth for implantation.

The impact of antiplatelet and anticoagulant medications on early implant failure following sinus floor augmentation: A retrospective cohort analysis.

The effect of antiplatelet and anticoagulant medications on the outcomes of sinus floor augmentation remains unclear. This retrospective cohort study analyzed data from electronic medical records of consecutive patients undergoing sinus floor augmentation at a single medical center. Patients were categorized into three categories: patients under antiplatelet medications, patients under anticoagulation medications, and healthy individuals. Data collected included tobacco smoking, residual alveolar bone height, timing of implant placement, materials used, vertical bone gain, early implant failure (EIF), and complications such as Schneiderian membrane perforation and postoperative bleeding. Multivariable analysis was performed to assess risk factors for EIF. Statistical significance was considered below 5%. Among 110 patients with 305 implants, EIF occurred in 10% of patients and 4.65% of implants. No significant difference in postoperative bleeding or EIF was found between study groups. Univariate and multivariable analyses highlighted tobacco smoking (odds ratio [OR] = 7.92), lower residual alveolar ridge height (OR = 0.81), and staged implant placement (OR = 4.64) as significant EIF risk factors in this cohort. Anticoagulant and antiplatelet therapies do not significantly elevate the risk of EIF or postoperative bleeding following sinus floor augmentation. Tobacco smoking, residual alveolar ridge height and staged sinus floor augmentation were risk factors for EIF in patients using antiplatelet or anticoagulation medications undergoing sinus floor augmentation.

Clinical Study of Photobiomodulation Effect at Postoperative Clefted Alveolar Ridge Bone Grafting.

This study aimed to evaluate photobiomodulation (PBM) adjunct effect on pain, swelling, and face temperature in individuals with oral cleft submitted to alveolar ridge bone grafting (ABG). The sample consisted of 46 patients with either incomplete or complete unilateral cleft lip and palate aged from 9 to 18 years, both sexes, who underwent ABG with chin donor area. Subjects were randomly divided into 3 groups: (1) Control (C): ABG (n=17); (2) PBM: ABG with PBM (n=14); (3) Simulated photobiomodulation (SPBM): ABG with SPBM (n=15). Aluminum Gallium Arsenide (GaAlAs) infrared laser was used at 808±10nm and power of 100mW±20%. GaAlAs infrared laser was applied on 14 points in the subject's face at 4J per point, at 2 times: Immediate postoperative period and 24 hours postoperative. The authors evaluated pain, swelling, and face temperature at 24 hours postoperative; at 7-day postoperative, the authors evaluated pain, medication use, and swelling decreasing perception. No statistically significant difference occurred between groups C, PBM, and SPBM. At 24 hours postoperative, pain values showed statistically significant difference (P=0.04) between group C and SPBM. PBM at the tested parameters did not reduce pain and swelling and did not significantly change face temperature of individuals submitted to ARBG.

A 3D micro-CT assessment of composition and structure of bone tissue after vertical and horizontal alveolar ridge augmentation using CAD/CAM-customized titanium mesh.

To date, no studies have exploited micro-CT in humans to evaluate bone morphology and structure after bone augmentation with CAD/CAM-customized titanium mesh, in mandible and maxilla. The aim of this study was to assess the composition and microstructure of bone biopsy through micro-CT analysis. Bone augmentation at both maxillary and mandible sites was performed on 30 patients randomly treated with customized mesh, either alone (M-) or covered with resorbable membrane (M+), in both cases filled 50:50 with autogenous bone and xenograft. After 6 months, biopsies were taken and micro-CT was performed on consecutive 1-mm-thick VOIs from coronal to apical side, measuring tissue volumes, trabecular thickness, spacing, and number. In both groups, irrespective of membrane use, bone tissue (M-: 29.76% vs. M+: 30.84%) and residual graft material (M-: 14.87% vs. M+: 13.11%) values were similar. Differences were site-related (maxillary vs. mandibular) with higher percentage of bone tissue and trabecular density of low-mineralized bone and overall bone in the mandible. The composition and structure of bone tissue, as assessed by micro-CT after alveolar ridge augmentation using CAD/CAM-customized titanium meshes, showed similar features regardless of whether a collagen membrane was applied.

Healing patterns of alveolar bone following ridge preservation procedures.

Examine the histomorphometric bone composition, following alveolar ridge preservation techniques and unassisted socket healing. Forty-two patients (42) requiring a single rooted tooth extraction were randomly allocated into three groups (n = 14 per group): Group 1: Guided Bone Regeneration (GBR) using deproteinised bovine bone mineral (DBBM) and a porcine collagen membrane; Group 2: Socket Seal (SS) technique using DBBM and a porcine collagen matrix; Group 3: Unassisted socket healing (Control). Trephined bone biopsies were harvested following a 4-month healing period. Forty-two samples underwent Back-Scattered Electrons -Scanning Electron Microscopy (BSE-SEM) imaging, with 15 samples examined using Xray Micro-Tomography (XMT) (n = 6 for each GBR/SS and n = 3 Control). Images were analysed to determine the percentage (%) of connective tissue, new bone formation, residual DBBM particles and direct bone to DBBM particle contact (osseointegration). BSE-SEM analysis demonstrated that new bone formation was higher in the Control (45.89% ± 11.48) compared to both GBR (22.12% ± 12.7/p < .004) and SS (27.62% ± 17.76/p < .005) groups. The connective tissue percentage in GBR (49.72% ± 9), SS (47.81% ± 12.57) and Control (47.81% ± 12.57) groups was similar. GBR (28.17% ± 16.64) and SS (24.37% ± 18.61) groups had similar levels of residual DBBM particles. XMT volumetric analysis indicated a lower level of bone and DBBM particles in all test groups, when matched to the BSE-SEM area measurements. Osseointegration levels (DBBM graft and bone) were recorded at 35.66% (± 9.8) for GBR and 31.18% (± 19.38) for SS. GBR and SS ARP techniques presented with less bone formation when compared to unassisted healing. GBR had more direct contact/osseointegration between the DBBM particles and newly formed bone.

Internal Allo-Cortical Tenting: A Modified Ridge Split Technique in Three-Dimensional Ridge Augmentation.

Three-dimensional (3D) alveolar ridge deficiencies necessitate horizontal and vertical bone reconstruction for optimal implant positioning. Despite several available techniques, achieving desired augmentation outcomes remains challenging. This case study aims to present a modified ridge split technique for bone reconstruction in horizontal and vertical dimensions. The proposed technique was used to reconstruct the horizontal and vertical ridge defect from removing a previously failed implant. This technique includes placing a cortical allograft plate as an internal tent in the split ridge. A portion of the plate was inserted into the ridge, while the other part was placed in the coronal of the vertical defect. Additional guided bone regeneration was performed around the tented plate on both the buccal and lingual sides. After 5 months, cone beam computerized tomography revealed sufficient bone formation in horizontal and vertical dimensions. Within the limitations of the present case study, internal cortical tenting would be a reliable method for 3D bone reconstruction in cases where the ridge split is feasible.

Application of Concentrated Growth Factors in Combination with Bio-Oss for Extraction of Mandibular Proximal Impacted Wisdom Teeth

In this study, we investigate the combined application of concentrated growth factor (CGF) and Bio-Oss (BO) for the treatment of periodontal bone defect (BD) after extraction of impacted wisdom teeth. Firstly, we assess the osteogenic properties of CGF in periodontal ligament stem cells (PDLSCs). The concentration-dependent effect of CGF on enhancing the activity of PDLSCs has been demonstrated. Furthermore, CGF effectively promotes differentiation and enhances the osteogenic function of PDLSCs, leading to improved expression of related osteogenic proteins. Subsequently, a total of 64 patients with loss of alveolar bone in the second molar, who received treatment at our hospital between July 2020 and July 2023, are included. They are randomly divided into a BO group (treated with BO) and a CGF/BO group (treated with CGF+BO). We observe that the combined application of CGF and BO demonstrated superior efficacy in alleviating pain, reducing swelling, and preventing dry socket incidence. In addition, it exhibited enhanced effectiveness in restoring periodontal tissue, including reducing probing depth, gingival depth, and clinical attachment loss. It also displayed better inhibition of gingival inflammatory response and gingival bleeding. Furthermore, it could enhance the restoration of periodontal BD, such as increasing the width of the alveolar bone and root depth, reducing the vertical distance from the apex of the alveolar ridge, as well as improving dental function. Therefore, the combined application of CGF and BO holds great potential in periodontal BD therapy for promoting the regeneration of periodontal bone, thus restoring dental function.

Evaluation of alveolar ridge values with autogenous tooth graft and the provocative venture of allogeneic tooth graft from family members

Background Preserving the structural integrity of the alveolar ridge is paramount in ensuring the success of dental implant procedures and optimizing both aesthetic and physiological outcomes. This study aims to evaluate the efficacy of autologous dental grafting and explore intriguing results achieved through the utilization of allogeneic dental grafts obtained from a familial participant within the study’s framework. Methods Eleven patients necessitating bilateral dental extractions were enrolled in the study. Ten patients underwent autologous dental grafting on one side, while the contralateral side remained untreated. In the eleventh case, one side received autogenous dental grafting, while the other side was augmented with an allogeneic graft sourced from the patient’s son. Outcomes were monitored over a four-month period. Results Autogenous dental grafting led to a significant enhancement in bone density values and a reduction in osseous absorption rates(P&lt;0.05) when compared to untreated sites among the ten patients who underwent the procedure. However, notable advancements were observed in patient 11 who received an allogeneic dental graft from a familial donor, suggesting potential superiority over autologous grafting in promoting bone regeneration. These findings underscore the promising prospects of employing allogeneic dental grafts sourced from family members to achieve optimal outcomes in alveolar ridge preservation. Conclusions The study underscores the significance of utilizing autologous dental grafts for preserving alveolar ridge dimensions. Importantly, the noteworthy improvement observed in patient outcomes resulting from the use of allogeneic dental grafts compared to autologous grafts raises several inquiries, particularly concerning the potential relationship between the patient and the donor. Trial registration The study is registered as a BRAZILIAN CLINICAL TEST RECORD (ReBEC): U1111-1305-2793 on 28-05-2024 ( https://ensaiosclinicos.gov.br/rg/RBR-65qchvs).

Vertical Alveolar Ridge Augmentation using fixture-supported Titanium-mesh : Case Series

The vertical height of the alveolar bone and the amount of remaining bone are important factors in the long-term success of implants. If the remaining bone is insufficient, procedures such as vertical alveolar ridge augmentation, like guided bone regeneration, are necessary for ideal implant surgery. Among the non-resorbable membranes that can be used in these procedures, titanium mesh offers advantages such as maintaining space for bone grafting, protecting the underlying graft material, and allowing adjustment to match the defect site for desired shaping. However, fixation of titanium mesh, which is crucial in determining the overall success of the surgery, requires the use of multiple screws and may result in membrane exposure during the healing process. To overcome these problems, a recent development involves the use of fixture-supported titanium-mesh, which has demonstrated good results. This study suggests that vertical alveolar ridge augmentation using fixture-supported titanium mesh can resolve conventional problems and can be considered an effective and reasonable strategy for achieving ideal implants.