Buccal Wall Research Articles

Clinical Benefits of the Immediate Implant Socket Shield Technique.

Extraction-socket resorption is considered a major problem that can limit implantological rehabilitation options and compromise the esthetic outcome. Surgical techniques to reduce remodeling are of restricted predictability and commonly require several surgical interventions and grafting. This increases the treatment cost and places a physical and psychological strain on the patient. This clinical case report presents a replacement of an upper canine using the socket-shield technique (SST) with a CAD/CAM surgical guide, resulting in a predictable, high esthetic, and functional result. The SST is an alternative approach to curbing remodeling and resorption by retaining the facial part of the root during tooth extraction. An immediately placed implant supports the facial root fragment, preventing the collapse of the buccal wall. The SST with digital precision planning in combination with a CAD/CAM surgical guide benefits patients by preserving their tissue architecture and causing only insignificant trauma. Furthermore, the SST reduces the number of surgical and prosthetic interventions required to one each for pre-operative planning, surgical procedures, and prosthetic rehabilitation. The socket shield technique is a minimally invasive implantological approach offers patients and clinicians multiple benefits. The socket-shield technique (SST) represents an alternative approach to intervene remodeling and resorption processes by the maintenance of the facial part of the root during tooth extraction. The immediate placement of an implant supports the facial root fragment and thereby prevents a collapse of the buccal wall. The SST associated with a CAD/CAM fabricated surgical guide, can reduce the amount of appointments, due to the immediate fabrication of the definitive restoration with the existing model. Therefore, no further necessary appointments are required apart from first pre-operative planning, second for surgical treatment, and third for prosthetic rehabilitation. (J Esthet Restor Dent 29:93-101, 2017).

Correction of Buccal Dehiscence During Immediate Implant Placement Using the Flapless Technique: A Tomographic Evaluation.

The aim of this study was to evaluate a new technique for treating dehiscence buccal bone sites (Class II) with immediate implant and collagen-enriched bovine-derived xenograft blocks without a surgical flap or membrane. Individuals with at least 5 mm of buccal bone dehiscence were selected for a flapless surgical approach to insert xenograft blocks into buccal dehiscence defects as well as the gap between implant and residual bone wall. No membrane was used. Buccal bone wall height was measured by computed tomography in the preoperative period (T0) and 6 to 12 months after procedure (T1). Likewise, buccal-lingual width of alveolar ridge as well as thickness of buccal wall was compared with the contralateral tooth. Fourteen patients were selected. Buccal wall height at T1 was not significantly different after 6 to 12 months between the treated and contralateral teeth, although both were greater than T0 (P <0.01). The heights ranged from 6.4 to 16.30 mm at T0, 12.8 to 25.6 mm at T1, and 14.8 to 25.29 mm in the contralateral teeth. Significant differences were observed between treated teeth (T1) and their contralateral, both buccal-lingually in the alveolar ridge (P = 0.007) and in buccal wall thickness (P = 0.003). Wall thickness ranged from 0.9 mm to 3.81 mm at T1 and 0.25 mm to 1.60 mm in the contralateral teeth. Immediate implant placement at dehiscence buccal bone sites using flapless surgery combined with xenograft blocks provided complete formation of the buccal bone wall up to the implant shoulder.

Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue.

Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

Fracture Resistance of Premolars Restored Either with Short Fiber or Polyethylene Woven Fiber-Reinforced Composite.

To compare the fracture resistance of endodontically treated maxillary premolars with one remaining cavity wall restored either with short fiber-reinforced composite or polyethylene woven fiber-reinforced composite. Forty-eight maxillary premolars were endodontically treated and randomly assigned to four groups (n = 12). Palatal cusp was removed, buccal wall was remained. In groups 1 to 3, standardized cavities were prepared in the palatal canal entrances. In group 1, short fiber-reinforced composite was used for restoration both of deep cavity and coronal part. In group 2, short fiber-reinforced composite was placed inside the deep cavity and core part of the restoration. Coronal restoration was restored by using conventional filler composite. In group 3, both deep cavities and coronal parts were built up by using conventional filler composite. In group 4, post space was prepared in the palatal canal. Polyethylene woven fiber-reinforced composite post then was placed into post space and the coronal part was restored by using conventional filler composite. Specimens were placed into a universal testing machine. The fracture loads were recorded and analyzed statistically using one-way ANOVA (α = 0.05). Fracture patterns were analyzed by using Chi-square test (α = 0.05). No statistically significant difference was found in fracture strength (p > 0.05). Group 1 exhibited the highest and group 4 exhibited the lowest incidence of restorable fracture (p < 0.05). The restoration of severely weakened premolar teeth with the use of short fiber-reinforced composite might have advantages over conventional filler composite or polyethylene woven fiber-reinforced composite techniques. The results of this in vitro study will be helpful to understand reinforced composite materials for restoring endodontically treated maxillary premolars. (J Esthet Restor Dent 28:412-418, 2016).

Effect of endodontic sealers on bond strength of restorative systems to primary tooth pulp chamber

Background/purposeAlthough current literature suggests that root canal sealers affect the bonding ability of restorative systems to pulp chamber dentin of permanent teeth, primary teeth have not been investigated. This study intended to evaluate the microtensile bond strength (μTBS) of three restorative systems to pulp chamber dentin in primary teeth and to determine the effect of two different root canal sealers on the μTBS. Materials and methodsNinety primary molars were used in this study. The teeth were randomly divided into three main groups according to canal sealers: (1) control (without sealer); (2) Metapex; and (3) zinc-oxide eugenol. The main groups were further divided into three subgroups depending on the coronal restorative system: (1) compomer (Prime Bond NT + Dyract EXTRA); (2) composite (Clearfil Tri-S Bond + Clearfil Photo Posterior); and (3) resin-modified glass ionomer (Fuji II LC). After restoration, the buccal wall of the pulp chamber was sectioned to obtain sticks (1 mm × 1 mm). The μTBS was then measured. Data were analyzed with two-way analysis of variance, followed by a posthoc test. The interfacial morphology of the bonded space was evaluated using scanning electron microscopy. ResultsIn the control group, a significant difference was observed only for the μTBS of the composite (P < 0.05). Compared with the control groups, Metapex and zinc-oxide eugenol significantly reduced the μTBS of restorative systems (P < 0.05). ConclusionComposite materials seemed to bond to pulp chamber dentin in primary teeth with a higher strength than compomer and resin-modified glass ionomer. Metapex and zinc-oxide eugenol canal filling materials reduced the bond strength of all three restorative systems.

Is Alveolar Ridge Split a Risk Factor for Implant Survival?

There is a paucity of studies that have assessed the long-term outcomes of the alveolar ridge split (ARS). This study evaluated the intraoperative and postoperative complications and assessed the placed dental implant and prosthesis. A retrospective study of the ARS was conducted in a single private dental clinic. The predictor variable was the ARS technique (1 stage vs 2 stages). The primary outcome was the dental implant survival rate. Secondary outcomes were intraoperative complications, marginal bone loss, prosthetic complications, and prosthesis success rate. Descriptive analysis was performed for patients' demographic data, implant details, and prosthetic complications. The Kaplan-Meier method was used to assess implant survival rate and prosthesis success rate. Twenty patients (mean age, 55 ± 6yr) had a mean follow-up time of 5years. Delayed implant placement was performed when the residual alveolar bone width was narrower than 3mm. No intraoperative or postoperative complications were reported. The survival rate of the 31 implants was 100% and the prosthesis success rate was 96.8%. The ARS is an effective technique for horizontal bone augmentation in the mandible. Delayed dental implant placement when the alveolar bone width is narrower than 3mm could minimize the risk of buccal wall fracture.

Guidelines for Selecting the Implant Diameter During Immediate Implant Placement of a Fresh Extraction Socket: A Case Series.

This prospective case series proposes a method for selecting the diameter of immediate postextraction anterior implants and guiding the placement position of the implant based on the buccolingual dimension with the goal of preserving the buccal bone wall. The socket buccolingual distance was measured to determine the appropriate implant diameter, considering a 3-mm gap to the buccal wall. Pre- and postoperative cone-beam computed tomography images were compared to evaluate the buccal bone. The socket width measurements were not significantly different (P = .931). The mean widths of the postoperative buccal bone were 3.01 ± 0.18 mm, 2.92 ± 0.38 mm, and 2.83 ± 0.42 mm for the crestal bone at the implant platform and at 2 and 4 mm apically, respectively, after 35 months of follow-up. This new diameter selection method for implants demonstrated predictable buccal plate preservation.

MDCT evaluation of nasopalatine canal morphometry and variations: An analysis of 100 patients.

The goal of this study was to investigate the possible variations in morphology of nasopalatine canal (NPC) morphometry depending on age, gender and absence of anterior incisors using multidetector row computed tomography (MDCT). A total of 100 patients (50 men, 50 women) with a mean age of 43.29±18.81 (SD) years (range: 18-90years) who have undergone head MDTC were included into the study. Foramen nasalis diameter (P1), foramen incisivum diameter (P2), NPC length (P3), distance between buccal wall of incisive foramen and facial side of the buccal bone (P4), distances between buccal bone wall of NPC and facial side of buccal bone (P5), distance between mid-NPC buccal wall and facial side of buccal bone (P6), distance between buccal wall of NPC and the apex of anterior central incisors (P7) and NPC angle (P8) were measured. Formal variations in NPC were searched for. Differences in morphometric data were searched using Student t-test or Mann-Whitney test. Gender-based analysis of the variations was done with the χ2 test. Pearson's test was used to search for correlation between morphometric data and age. P1 was larger in men (3.72±1.41mm) than in women (3.07±1.34mm) (P<0.001). Similarly, P3 was larger in men (13.68±2.73mm) than in women (11.43±2.78mm) (P<0.001). No differences in the other NPC measurements (P2, P4, P5, P6, P7, P8) were found between men and women. Morphological variations in NPC (cylindrical, hourglass, banana shape, funnel shape, single canal, Y-type canal, parallel canal and others) were detected with frequencies ranging from 8 to 65.3%. A significant negative correlation was found between NCP measurements and patient age for P3 (r=-0.311; P=0.002), P4 (r=-0.267; P=0.007) and P8 (r=-0.318; P<0.001). New NPC variations, which were not reported before were found in 19% of our patients. NPC shows myriad potential variations that have various prevalences. It is assumed that familiarity with these variations may help decrease the incidence of complications during facial or dental surgery.

Evaluation of the Effect of Bovine Bone Graft on the Preservation of Buccal Plate of Extracted Socket

In order to preserve the original ridge dimensions following tooth extraction and promote bone regeneration of the residual alveolar socket, various bone grafts and substitutes were used. Among these grafting materials, bovine bone xenograft was used in order to promote bone regeneration. The aim of this study was to evaluate the effectof bovine bone graft on the preservation of buccal plate of bone of extracted socket.Twelve patients with non-restorable maxillary tooth or remaining root were included in this study. They were divided equally into two groups. Group A: augmentation with bovine xenograft was performed after extraction. Group B: Extraction was performed without grafting. Delayed-immediate implants were placed for all patients at eight weeks after extraction. There was no significant difference in buccal cortical plate thickness between the two groups with. There was a significant increase in bone density of the study group at six months postoperatively. It was concluded that buccal plateaugmentation by the “pouch technique” is not enough to compensate the bone loss that occurs in the buccal wall after extraction.

Impact of a Core Ferrule Design on Fracture Resistance of Teeth Restored with Cast Post and Core.

Objectives. To investigate the influence of a contra bevel on the fracture resistance of teeth restored with cast post and core. Materials and Methods. Sixty plastic analogues of an upper incisor were endodontically treated and prepared with 6° internal taper and 2 mm of ferrule in order to receive a cast post and core. The prepared samples were divided into two groups (n = 30); the first group serves as control while the second group was prepared with an external 30° bevel on the buccal and lingual walls. All samples crowned were exposed to a compressive load at 130° to their long axis until fractures occurred. Fracture resistance loads were recorded and failure modes were also observed. Mann-Whitney test was carried out to compare the two groups. Results. Mean failure loads for the groups were, respectively, 1038.69 N (SD ±243.52 N) and 1078.89 N (SD ±352.21 N). Statistically, there was no significant difference between the two groups (P = 0.7675 > 0.05). Conclusion. In the presence of a ferrule and a crown in the anterior teeth, adding a secondary ferrule to the cast post and core will not increase the resistance to fracture.

Influence of operating microscope in the sealing of cervical perforations.

Context:Accidental root canal perforations are among the main complications of endodontic treatment.Aim:This study evaluated the influence of operating microscope (OM) in the marginal adaptation of mineral trioxide aggregate (MTA) (Angelus®) and glass ionomer (Vitremer) inserted into cervical perforations.Materials and Methods:Perforations were made in the cervical third of the buccal wall of the root canal in mandibular incisors. Next, the teeth were divided into four groups (N = 10): MG — MTA without OM; VG — Vitremer without OM; MOMG — MTA with OM; VOMG — Vitremer with OM. The perforations were sealed according to the group and the teeth were prepared for analysis by confocal laser scanning microscope. Images of perforation region (1,024×) were made and the gap presented by the materials was measured using the Image J program. LEXT OLS4100 three dimensional (3D) measuring laser microscope measured the volumetric misfit. Data of gap were analyzed by Kruskal-Wallis and Dunn's tests. Analysis of variance (ANOVA) and Tukey's tests compared the volumetric misfits.Results:The results showed lower volume and gap in the interface dentin/material in VOMG compared to the other groups (P < 0.05).Conclusion:The use of OM improved the quality of cervical perforations sealed with Vitremer, being indicated in clinical situations of iatrogenic cervical perforations.

Demineralized freeze-dried bone allograft in treatment of interproximal vertical defect - a clinical report

Bone destruction due to periodontal disease is one of the factors responsible for loss of teeth. The ultimate goal of periodontal therapy is predictable regeneration of lost periodontal tissue including bone defects. Various bone graft materials have been used for periodontal regeneration, which include autogenous grafts, allografts, xenografts, and synthetically produced ones. Amongst allogenic bone grafts, demineralized freeze-dried bone allograft (DFDBA) is most commonly used. All the bone allografts are osteoconductive, but DFDBA also provide an osteoinductive effect. DFDBA has been successfully used to reconstruct intraosseous periodontal defects and furcation defects. This case report describes the management of an intrabony defect in a maxillary left canine where the osseous defect included loss of buccal wall extending up to the periapical region. This localized periodontitis was successfully treated with periodontal regenerative technique using DFDBAs. DFDBA was used because it contains BMP, which induces new bone formation during the healing process. After 1-year follow-up of treatment, the tooth was functional without any signs and symptoms. Clinical and radiographic changes revealed healthy periodontal support.

Benefits of mineralized bone cortical allograft for immediate implant placement in extraction sites: an in vivo study in dogs.

PurposeThe aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model.MethodsSix mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry.ResultsFew residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months.ConclusionsThe preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.

Coronal Discoloration Induced by Calcium-Enriched Mixture, Mineral Trioxide Aggregate and Calcium Hydroxide: A Spectrophotometric Analysis.

Introduction:The aim of this study was to compare the discoloration potential of calcium-enriched mixture (CEM) cement, white mineral trioxide aggregate (WMTA) and calcium hydroxide (CH), after placement in pulp chamber. Methods and Materials:Access cavities were prepared in 40 intact maxillary central incisors. Then, a 2×2 mm box was prepared on the middle third of the inner surface on the buccal wall of the access cavity. The specimens were randomly assigned into four groups; the boxes in the control group were left empty, in groups 1 to 3, the boxes were filled with CH, WMTA and CEM cement, respectively. The access cavities and the apical openings were sealed using resin modified glass ionomer (RMGI). The color measurement was performed with a spectrophotometer at the following intervals: before (T0), immediately after placement of the filling material (T1), one week (T2), 1 month (T3), 3 months (T4) and 5 months (T5) after filling of the box and finally immediately after removing the material from the boxes (T6). Color change (ΔE) values were calculated using the sample Kolmogorov-Smirnov test to determine the normal distribution of data, followed by ANOVA, repeated measured ANOVA and post-hoc Tukey’s tests. Results:All materials led to clinically perceptible crown discoloration after 1 week. The highest ΔE value belonged to WMTA group. Discoloration induced by CEM cement was not significantly different from CH or the control group (P>0.05). Conclusion:CEM cement may be the material of choice in the esthetic region, specifically pertaining to its lower color changing potential compared to WMTA.

Does platelet-rich plasma enhance healing in the idiopathic bone cavity? A single-blind randomized clinical trial

The presence of an idiopathic bone cavity (IBC) is usually identified during routine dental radiographic examinations. The purpose of this study was to investigate the effect of platelet-rich plasma (PRP) on bone healing in the idiopathic bone cavity. This was a single-blind randomized clinical trial. Twenty-four subjects were assigned randomly to two groups. Subjects in group 1 received PRP through a buccal window approach, and those in group 2 underwent conventional management via the creation of a window on the buccal wall and curettage of the walls of the defect. Subjects were followed up at 3, 6, and 9 months after the intervention. The amount of bone formation as determined on panoramic radiographs was divided into four categories: stage 1: ≤25% of the defect showed opacity; stage 2: 25–50% of the defect showed opacity; stage 3: 50–75% of the defect showed opacity; and stage 4: >75% of the defect showed opacity. There was a significant difference between the two groups with regard to the various healing stages at the three time points (P<0.05). When compared with conventional management of the idiopathic bone cavity, the use of PRP may enhance bone formation.

Changes in Morphology of Alveolar Buccal Walls Following Atraumatic Internal Root Fragmentation

La pared alveolar bucal representa la estructura mas importante para proveer la forma y el volumen de los alveolos dentales posterior a la extraccion dental. El objetivo del estudio fue evaluar las estructuras de hueso alveolar bucal despues de la cirugia minimamente invasiva. En 15 pacientes (3 hombres, 12 mujeres), con edades entre 20 a 67 anos, 3 incisivos centrales, 5 incisivos laterales y 7 premolares fueron removidos utilizando enucleacion sin colgajo. La enucleacion comprende el seccionamiento mesio-distal de la raiz dental endoscopicamente asisitido a traves de fragmentacion interna de la porcion lingual y apical radicular y posteriomente una reduccion interna de la lamela de raiz bucal. La altura osea bucal antes de la extraccion fue 10,61 mm y despues de la extraccion fue 10,50 mm. La anchura de la cresta osea bucal fue 1,11 mm y 1,40 mm despues de la extraccion del diente. El grosor del hueso apical antes de la extraccion fue 0,66 mm y 0,40 mm despues de la extraccion. La altura gingival fue 13,58 mm antes de la extraccion y 13,56 mm despues de la extraccion. Despues de la enucleacion transalveolar, la pared del hueso alveolar bucal se mantiene sin cambios en relacion con la altura y del grosor del reborde alveolar.

Alveolar ridge split on horizontal bone augmentation: a systematic review.

Many techniques have been proposed to overcome the limitations displayed by maxillary atrophy. The aim of this systematic review was to assess the predictability, dimensional changes, and associated factors to successfully perform the alveolar ridge split (ARS) technique of augmentation. An electronic and manual literature searches was conducted by two independent reviewers in several databases, including Medline, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register, for articles written in English up to February 2014. A manual search was also performed to ensure a thorough screening process. Based on the PICO (problem, intervention, comparison, outcome) model, the chief question of this study was: Can patients with horizontal ridge deficiency be successfully treated with the ARS technique and implant therapy? Overall, 17 articles met the inclusion criteria, and a subsequent meta-analysis was performed. A Cohen kappa interagreement rate of 0.82 was reached. The implant survival rate of the included studies was 97.0% (range, 94.4% to 100%) with the full-thickness flap (FTF) approach and 95.7% (range, 86.6% to 100%) with the partial-thickness flap (PTF) approach. The weighted mean (WM) of horizontal bone width gain was calculated for included studies using FTF for the ARS technique. Four studies that had data were included in the meta-analysis. The WM ± standard deviation of bone width gain was 3.19 ± 1.19 mm (range, 2.00 to 4.03 mm). For studies using PTF for ARS, only one study provided mean and standard deviation of horizontal bone width gain (4.13 ± 3.13 mm); hence, meta-analysis could not be performed. Buccal wall fracture represented the most frequent postoperative complication, followed by postoperative ridge resorption. In selected scenarios, the ARS technique might represent a predictable approach as demonstrated by a high implant survival rate, adequate horizontal bone gain, and minimal intra- and postoperative complications. Further research is needed to determine the influence of the grafting materials inserted and flap tissue biotype, as well as the anatomical characteristics on final bone augmentation outcomes.

The Influence of Brushing Motion on the Cutting Behavior of 3 Reciprocating Files in Oval-shaped Canals

IntroductionThe purpose of this study was to compare the cutting efficiency of 3 reciprocating single-file systems used with a brushing motion in oval-shaped canals. MethodsSixty premolars with single oval canals were selected and randomly assigned to 3 groups according to the file used in canal instrumentation: R25 Reciproc (VDW, Munich, Germany), Primary WaveOne ((Dentsply Maillefer, Ballaigues, Switzerland), and a novel prototype instrument (UFile; MicoMega, Besancon, France). Instrumentation was performed in 4 consecutive steps; according to manufacturers' instructions, 5 brushing strokes against the buccal wall with a nonworking instrument followed by another 5 and 15 brushing strokes with a working file. Cone-beam computed tomographic scans were taken after each step of preparation. Pre- and postinstrumentation images were superimposed at the apical and midroot levels and then evaluated in terms of changes in the maximum buccolingual (ΔBL) and mesiodistal dimensions (ΔMD). ResultsInstrumentation with a brushing motion resulted in the following findings. At the apical levels, no significant difference was found in ΔBL for the 3 groups (P > .05). However, ΔMD was significantly less for the Reciproc (P = .006) and UFile (P = .03) groups. At the midroot levels, the UFile group showed the highest significance in terms of ΔBL (P < .0001) but the lowest in terms of ΔMD (P = .003). ΔMD was significantly the highest for the WaveOne group at the midroot levels (P = .05). ConclusionsThe prototype file was more efficient than the other files at the midroot levels, whereas all systems acted the same at the apical levels. The increase in the number of brushing strokes resulted in more dentinal cutting in the direction of those strokes.

Comparison of Clinical and Histologic Outcomes of Zirconia Versus Titanium Implants Placed in Fresh Sockets: A 5-Month Study in Beagles.

Purpose: This study evaluated the clinical and histomorphometric results of titanium (Ti) and custom-made zirconia (Zr) implants placed into fresh extraction sockets in beagles that did not receive oral hygiene attention or a softened diet during postoperative healing. Materials and Methods: The roughness of the Ti and Zr implant surfaces was assessed by confocal microscopy. In eight beagle dogs, four implants each (two Ti and two Zr) were placed in the distal sockets of the third and fourth premolars with the implant shoulder at the bone crest and subjected to submerged healing. Standardized radiographs were taken after placement and 5 months after placement (at sacrifice). Histologic and histomorphometric measurements were performed on nondecalcified histologic sections. The main outcome measures included implant survival, bone-implant contact (BIC), and bone loss on the buccal and lingual plates. Results: Topographic analysis showed significant differences between the Zr and Ti surfaces. Roughness was higher for Ti than for Zr implants, kurtosis was close to 3 for Ti, and skewness was negative for Zr. After 5 months, the mean BIC was similar for the Zr (57.0% ± 15.2%) and Ti (56.5% ± 14.4%) implants, and the most severe bone loss site was observed on the buccal wall. The risk of failure was significantly higher for the Zr (43.8%) than for the Ti (12.5%) implants. Conclusion: The implant failure rate for the Zr implants was 3.5 times higher than that of the Ti implants. This may be partially explained by the less favorable topography of the Zr implants, which had, on average, significantly lower roughness (Ra = 0.85 ± 0.04 μm), negative skewness of the surface profile (-1.56 ± 0.27), and higher kurtosis (7.88 ± 1.99).

Alveolar ridge dimensional changes following ridge preservation procedure with novel devices: Part 1--CBCT linear analysis in non-human primate model.

AimThis study sought to investigate dimensional changes to the alveolar bone following extraction and application of novel devices used for obturation of socket orifice (socket cap) and space maintenance in sockets with facial dehiscence (socket cage).Material and methodsSix Macaca fascicularis had six teeth each removed according to the following intervention groups (groups A–C intact alveolar bone; D–E facial dehiscence): negative control (A); socket obturated with cap (B); filled with anorganic bovine bone mineral (ABBM) + socket cap (C); dehiscence negative control (D); socket cap + socket cage (E); ABBM + socket cap + socket cage (F). Serial CBCT scans at preoperatively, 6 and 12 weeks following intervention were compared to quantify linear alveolar bone alterations.ResultsWithout therapeutic intervention, intact sockets exhibited significant reduction in width at the crestal 2 mm of the ridge crest within 6 weeks. Compared with the negative control sites which lost up to 52% of crestal bone width, sites treated with socket cap + ABBM lost at most 4% of bone width at the crestal 2 mm. Similar results were seen in the dehiscence groups, with the combination of socket cap + socket cage + ABBM maintaining the greatest socket width and height dimensions.ConclusionsResults from the current non‐human primate study suggest that the socket cap and socket cage devices, when used in conjunction with xenograft proved effective in minimizing post‐extraction socket width loss and height seen in both intact sockets and sockets with facial dehiscence defects.