Extraction Of Maxillary Anterior Teeth Research Articles

Immediate implants in maxillary anterior region with guided bone augmentation

Aim: This case is a combination of vertical and horizontal defect in maxillary anterior region accompanied with absence of facial soft tissue which rehabilitated following extraction of tooth was rehabilitated by guided bone regeneration (GBR) and immediate implant Background: Loss of the labial bony wall during extraction of maxillary anterior teeth is a commonly encountered conundrum. During planning for an immediate implant placement in such a compromised area, guided bone regeneration (GBR) is a well-accepted method for bone and soft tissue reconstruction. Case Description: In the presented case report, a combination of vertical and horizontal defect of more than 2 mm accompanied with absence of facial soft tissue following extraction of tooth was rehabilitated by GBR and immediate implant. The follow - up was performed 36 months after final loading with good esthetic outcome and bone graft well apposed to native bone in CBCT evaluation with no obvious complications. Conclusion: The vertical and horizontal ridge volumetric alterations positively can be achieved by simultaneous GBR with immediate implant placement. Clinical Significance: The purpose of discussing this case report is to portray the efficacy of GBR along with immediate implant in case with both vertical and horizontal bone defects.

Is nasopalatine nerve block still mandated for the extraction of maxillary anterior teeth?

Aim This study was conducted to investigate the effectiveness of a single labial injection of 4% articaine for the extraction of maxillary anterior teeth without the need for nasopalatine supplementary injection.Materials and methods A prospective, controlled, split-mouth clinical study was performed to evaluate the clinical performance of 4% articaine as a single labial infiltration anaesthesia for the extraction of maxillary anterior teeth and to compare it with the routine method of labial injection along with a supplementary nasopalatine injection using 2% lidocaine. Statistical analyses were performed, with the statistical significance being set at 5% level.Results A total of 37 patients met the inclusion criteria, and a statistically significant difference was observed in the reported pain during injection between the single labial articaine injection and the routine labial and palatal lidocaine injections (P <0.001). The extraction of maxillary anterior teeth was possible without the need for an additional nasopalatine injection in all the study patients (n = 37). The difference between both groups was statistically non-significant in terms of the pain encountered during extraction (P = 0.22).Conclusion With the use of 4% articaine as a single labial infiltration anaesthesia, nasopalatine nerve block for the extraction of maxillary anterior teeth may become an outdated modality.

Comparative assessment of anterior maxillary alveolar ridge preservation with and without adjunctive use of enamel matrix derivative: A randomized clinical trial.

The aim of this randomized, controlled, parallel-arm study was to evaluate the (a) radiographic bone dimensional changes, (b) postoperative discomfort, and (c) early soft tissue wound healing outcomes, following extraction of maxillary anterior teeth (central and lateral incisors) and treatment with alveolar ridge preservation (ARP) with and without the adjunctive use of enamel matrix derivative (EMD). Thirty extraction sockets were randomly assigned to two groups: deproteinized bovine bone mineral with 10% collagen covered with collagen membrane with the adjunctive use of EMD (test group) and without EMD (control group). Bone dimensional changes were measured using cone beam computed tomography at 3 and 5months after ARP. The severity and duration of pain and swelling were evaluated using self-reported questionnaires, and soft tissue wound healing outcomes were assessed clinically. Chi-square tests and t tests were conducted to compare differences between the two groups. Radiographic and clinical analyses showed no significant differences in horizontal and vertical bone dimensional changes and soft tissue wound healing outcomes (including spontaneous bleeding, persistent swelling, and ulceration) between the two groups. There were no significant differences in the severity of pain and swelling between the two groups, but the durations of pain (difference [df]=1.20, 95% CI=0.33-2.06; p=.008) and swelling (df=1.06, 95% CI=0.11-2.01; p=.029) were significantly reduced in the test group. Alveolar ridge preservation with the adjunctive use of EMD reduced the durations of postoperative pain and swelling following maxillary anterior teeth extraction.

The efficiency of using advanced PRF-xenograft mixture around immediate implants in the esthetic zone: a randomized controlled clinical trial

Aim Immediate implant placement in fresh extraction sockets is an accepted treatment modality and for better predictable outcomes the resultant peri-implant gap should be grafted. Many grafting materials are available; in this study, a xenograft was used with Advanced-Platelet-Rich Fibrin (A-PRF) as a supplement to tissue regeneration procedures. The aim of this study was to evaluate clinically and radiographically the efficiency of using A-PRF-xenograft mixture around immediate implants in the esthetic zone. Materials and methods For this randomized controlled clinical trial, 18 patients requiring extraction of maxillary anterior teeth and immediate implant placement were selected. They were randomly divided into two groups: the study group, where the peri-implant gap was filled with A-PRF-xenograft mixture, and the control group, where the gap was filled with xenograft alone. The variables studied were probing depth, implant stability, marginal bone height and bone density; the follow-up period was 9 months. For statistical analysis, independent and paired t-tests were used. Results Improvements were seen regarding all variables with no significant differences noticed during follow-up, except for implant stability which showed statistically significant differences. Conclusion The results highlighted the promising effects of A-PRF-xenograft mixture on bone and soft tissue healing around immediate implants in the esthetic zone.

Surgical management of oronasal fistula by using two different techniques (palatal rotational and labial advancement flap)

One of the clinical complications encountered by oral and maxillofacial surgeons is oronasal communication with the progressive formation of oronasal fistula (ONF). The incidence of this complication may vary after extraction of maxillary anterior teeth. This usually occurs following canine tooth extraction or extraction of teeth with severe periodontal disease leading to direct communication with the nasal cavity. ONF is an internal fistula, which represents an abnormal epithelized tract between oral and nasal cavity, thus impairing associated functions of deglutition and speech by nasal regurgitation of fluid and nasal speech respectively. In this article we have discussed about the closure of an oronasal fistulae, secondary to infected odontogenic keratocyst and trauma by bucco-labial advancement flap under local anesthesia and advanced random and palatal pedicled flap under general anesthesia secondary to trauma respectively.

Ridge preservation with acellular dermal matrix and anorganic bone matrix cell-binding peptide P-15 after tooth extraction in humans. A histologic and morphometric study

Aim The aim of this study was to analyze by histomorphometric parameters the use of acellular dermal matrix (ADM) with or without anorganic bovine bone matrix (ABM) / synthetic cell-binding peptide P-15 in the formation of bone in human alveoli. Materials and methods Eighteen patients in need of extraction of maxillary anterior teeth were selected and randomly assigned to the test group (ADM plus ABM/P-15) or the control group (ADM only). Histomorphometric measurements and histological analysis were recorded about 6 months after ridge preservation procedures in ten patients. The amount of newly formed bone, the most recently formed bone, fibrous tissue plus marrow spaces and remaining graft particles were measured and analyzed. Results At 6 months, the new bone area parameter and the percentage of fibrous tissue plus marrow space areas showed higher values to the control group, and statistically significant differences when compared with the test group (p=0.03). Conclusion The ADM acted as a membrane. The association of ABM/P-15 with ADM resulted in new bone formation within the alveoli, but the results were not considered relevant when used in this indication.

Ridge Preservation With Acellular Dermal Matrix and Anorganic Bone Matrix Cell‐Binding Peptide P‐15 After Tooth Extraction in Humans

Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result. Several regenerative techniques are available and are used for socket preservation. The aim of this study is to analyze by clinical parameters the use of acellular dermal matrix (ADM) and anorganic bovine bone matrix (ABM) with synthetic cell-binding peptide P-15 to preserve alveolar bone after tooth extraction. Eighteen patients in need of extraction of maxillary anterior teeth were selected and randomly assigned to the test group (ADM plus ABM/P-15) or the control group (ADM only). Clinical measurements were recorded initially and at 6 months after ridge-preservation procedures. In the clinical measurements (external vertical palatal measurement [EVPM], external vertical buccal measurement [EVBM], and alveolar horizontal measurement [AHM]) the statistical analysis showed no difference between test and control groups initially and at 6 months. The intragroup analysis, after 6 months, showed a statistically significant reduction in the measurements for both groups. In the comparison between the two groups, the differences in the test group were as follows: EVPM = 0.83 ± 1.53 mm; EVBM = 1.20 ± 2.02 mm; and AHM = 2.53 ± 1.81 mm. The differences in the control group were as follows: EVPM = 0.87 ± 1.13 mm; EVBM = 1.50 ± 1.15 mm; and AHM = 3.40 ± 1.39 mm. The differences in EVPM and EVBM were not statistically significant; however, in horizontal measurement (AHM), there was a statistically significant difference (P<0.05). The results of this study show that ADM used as membrane associated with ABM/P-15 can be used to reduce buccal-palatal dimensions compared to ADM alone for preservation of the alveolar ridge after extraction of anterior maxillary teeth.

Perbaikan estetik gigi anterior yang protrusi dengan gigitiruan imidiat yang disertai dengan alveolektomi interseptal

Generally, the treatment of immediate partial denture has the objective of enhancingthe aesthetics of the condition and position of protrusive anterior teeth that wouldimprove the appearance. Case study was carried out on 16-years-old female patientwith overjet far from normal that obstruct closing of the lips. The patient’s profilelooks convex with the labial maxilla protrudes and a clear undercut in anteriorregion. The diagnosis of patient was dentoalveolar protrusion along with multiplediastema, malocclusion class II division I of skeletal relation that caused by localizedaggressive periodontitis. The treatment was construction of immediate partial denturewith immediate extraction of maxillary anterior teeth accompanied with interseptalalveolectomy. Control was done 24 hours, three days, and seven days after insertion.Aesthetics, occlusion, articulation, retention dan stabilization looked very good.

Alveolar Ridge Preservation Following Extraction of Maxillary Anterior Teeth. Report on 23 Consecutive Cases

The purpose of this article was to clinically evaluate the predictability of a surgical procedure to preserve the alveolar ridge after extracting maxillary anterior teeth with advanced bone loss. This procedure is indicated when a tooth-supported fixed partial denture will rehabilitate the area. Non-resorbable hydroxyapatite crystals are used as graft material and a rotated pediculated split thickness palatal flap covers them. Twenty-three patients who were treated with this procedure were followed for 12 to 24 months. Results were predictable with minimal postoperative ridge deformation. Indications for this procedure are discussed.