Maxillary Molar Extraction Research Articles

Effect of intraoral administration of parathyroid hormone on osseous and soft tissue healing around implants in ovariectomized rat maxillae.

Intermittent administration of parathyroid hormone (PTH) increases systemic bone mass. However, the effect of PTH on osseous and soft tissue healing around implants in osteoporosis patients remains unclear. This study aimed to investigate the effects of PTH on tissue healing around implants in ovariectomized rats and to compare systemic and intraoral administration routes. Implants were placed at the healed sites of ovariectomized rats 3 weeks after maxillary first molar extraction. Rats were randomly divided into two groups that received either daily systemic subcutaneous or local intraoral PTH administration. Maxillae were dissected to examine bone architectures with micro-computed tomography images. Histomorphometric and immunohistochemical analyses were performed to evaluate osseous and soft tissue healing around the implants. Regardless of the administration route, PTH significantly increased bone area and the numbers of osteoblasts, osteoclasts, and osteocytes in the first and second inside and outside areas of implant threads, in addition to decreasing the number of sclerostin+ osteocytes. However, the intraoral PTH administration route was superior to the systemic route by significantly improving bone quality and promoting collagen production in the connective tissue around implants. Parathyroid hormone administration promoted both osseous and soft tissue healing around implants, irrespective of administration route. Interestingly, intraoral administration improved the evaluated parameters more than systemic administration. Thus, the intraoral route could become a useful treatment strategy for implant treatment in osteoporosis patients.

Displacement of the maxillary third molar into the infratemporal fossa during extraction: A case report

A 34-year-old healthy woman was referred to our department for extraction of the right maxillary third molar. A rare complication happened during the procedure and management options were discussed with the patient; the agreement was to extract the tooth under general anaesthesia. Tooth extraction is a routine procedure performed in oral and maxillofacial surgery. However, complications may occur even with an experienced surgeon. Herein, we present a rare complication of the maxillary third molar displacement into the infratemporal fossa during extraction and its management.

Repair of Oroantral Fistulas Using Free Bone and Mucoperiosteal Flaps After Endoscopic Removal of the Medial Wall of the Maxillary Sinus.

Oroantral fistula (OAF) refers to a pathological connection between the oral cavity and maxillary sinus. It may lead to symptoms that include purulent mucus, nasal congestion, facial swelling, bad breath, and nasal regurgitation of food, all of which negatively impact patients' quality of life. This study presents a novel approach for OAF repair using a 2-layered structure composed of free bone and a mucoperiosteal flap obtained from the medial wall of maxillary sinus. Ten OAF patients who underwent repair using this method were retrospectively reviewed between August 2015 and June 2022. The extraction of maxillary molars was the most common cause of OAF. The size of the fistulas ranged from 1×2mm to 5×8mm. Nine of the 10 patients achieved successful OAF closure following the initial operation using the 2-layer structure composed of free bone and mucoperiosteal flag. One patient was lost to follow-up. The 9 patients were observed for 6 months to 1 year, and they exhibited no obvious complications or recurrence. The use of free bone and mucoperiosteal flag from the medial wall of maxillary sinus through an endoscope was effective for OAF repair.

Effects of Photobiomodulation Therapy on Hard Tissue Healing in Rat Tooth Extraction Sockets.

Objective: To investigate the effects of photobiomodulation therapy (PBMT) on hard tissue healing in rat maxillary first molar extraction sockets. Methods: A total of 20 male Wistar rats were used in the study. The right extraction sockets were irradiated with a Ga-Al-As laser (500 mW, 980 nm) for 51.7 J/cm2 every 24 h for 7 days, while the left sockets served as controls. Rats were sacrificed on days 3, 7, 14, and 28 after tooth extraction, and microcomputed tomography (CT) analysis, histopathological evaluation, and enzyme-linked immunosorbent assay (ELISA) were conducted at different time points. Results: Micro-CT analysis showed that the percentage of bone volume/tissue volume (TV) and bone mineral density were significantly higher in the experimental group compared to the control group on day 28 (p < 0.05). Histopathological evaluation revealed that PBMT promoted new bone formation and accelerated bone remodeling. ELISA demonstrated a significant increase in alkaline phosphatase expression in the laser sides on days 7 and 14 (p < 0.05). Conclusions: One application postextraction followed by seven consecutive daily applications of PBMT can effectively promote hard tissue healing in rat maxillary first molar extraction sockets.

Class II malocclusion with severe overjet treated with maxillary second molar extractions and bone screws

Class II malocclusion with severe overjet treated with maxillary second molar extractions and bone screws

The Palatal Elevation Technique (PET) for Intra-alveolar Extraction of Grossly Decayed Maxillary Third Molars.

Intra-alveolar extraction of maxillary third molars always poses a challenge to dental practitioners owing to limited accessibility and minimal space for dental forceps application. Dental elevators facilitate the extraction of such teeth. In the traditional technique as described in the literature, the elevator is always introduced from the mesiobuccal aspect of the tooth to engage the space between the interdental bone and the offending tooth to use it as a fulcrum. However, certain situations prevent proper application of the elevator from the buccal aspect of the offending tooth to bring about luxation. One such situation is a grossly decayed third molar tooth, especially from the mesiobuccal aspect with destruction of the tooth substance extending below the cementoenamel junction.Another such situation is observed in patients presenting with thick and inextensible cheeks but a good interincisal opening. In either situation, it becomes very challenging to achieve a good purchase for luxation of the offending third molar. The authors have therefore described a modified technique of tooth elevation, the palatal elevation technique (PET), using the palatal bone instead of the buccal bone as the fulcrum which was observed to be effective in such situations. In the authors' view, PET is simple and quick and can effectively be employed as an alternative to the traditional technique of tooth elevation in all cases that require an intra-alveolar extraction of maxillary third molars.

Evaluation of Bolton’s Class II Patients Treated with EXT Premolars with Appropriate Finishes in Orthodontic Treatment

Background and aim: One of the requirements for orthodontic treatment is, making appropriate final occlusion and Finishing correctly. More frequently in Class II patients with maxillary pre molar extraction, to make the final occlusion is impossible, This is due to the disruption of Bolton rate by Extraction maxillary premolars, because the mean mesiodistal width of the premolar tooth is greater than the migration rate of the maxillary first molar tooth from the buccal groove mandibular first molar to the embrasure between the fifth and sixth teeth. For these reasons, to make an appropriate final occlusion, more frequently we need the TIPR (total inter proximal reduction) in mandible. in this study, we examined patients with Class II who were treated with extraction of maxillary first pre molars and its treatment with selective TIPR reached to the appropriate final occlusion, to we’ve got the ultimate good of Bolton is calculated.

Radiographic evaluation before surgical extraction of impacted third molar to reduce the maxillary sinus related complication.

Surgical extraction of maxillary third molars is routine in departments devoted to oral and maxillofacial surgery. Because maxillary third molars are anatomically adjacent to the maxillary sinus, complications such as oroantral fistula and maxillary sinusitis can occur. Here we explore the factors that can cause radiographic postoperative swelling of the maxillary sinus mucosa after surgical extraction. This retrospective study reviewed the clinical records and radiographs of patients who underwent maxillary third-molar extraction. Preoperative panoramas, Waters views, and cone-beam computed tomography were performed for all patients. The patients were divided into two groups; those with and those without swelling of the sinus mucosa swelling or air-fluid level in a postoperative Waters view. We analyzed the age and sex of patients, vertical position, angulation, number of roots, and relation to the maxillary sinus between groups. Statistical analysis used logistic regression and P<0.05 was considered statistically significant. A total of 91 patients with 153 maxillary third molars were enrolled in the study. Variables significantly related to swelling of the maxillary sinus mucosa after surgical extraction were the age and the distance between the palatal cementoenamel junction (CEJ) and the maxillary sinus floor (P<0.05). Results of the analysis show that the relationship between the CEJ and sinus floor was likely to affect postoperative swelling of the maxillary sinus mucosa. Maxillary third molars are anatomically adjacent to the maxillary sinus and require careful handling when the maxillary sinus is pneumatized to the CEJ of teeth.

Comparison of posterior superior alveolar and greater palatine nerve block with local infiltration for extraction of maxillary molars in oral surgery – A randomized controlled trial

Administration of local anesthetic drug that prevents pain during dental treatment is of absolute importance. Act of injecting local anesthetic should be nonpainful and atraumatic. The maxilla is very porous and highly vascular. Therefore, anesthesia of maxillary teeth can be accomplished more easily than with mandibular teeth. The aim of this study is to determine the anesthetic efficacy of the conventional technique of posterior superior alveolar (PSA) and greater palatine nerve(GP) block anesthesia as compared to the buccal and palatal technique in terms of pain during injection, after extraction, after 15mins of the procedure and quality of anesthesia during the extraction procedure. The study also intends to determine the incidence of positive aspiration in the infiltration technique. This randomized clinical study was carried out on 154 patients who reported to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences &amp; Hospital Bangalore, requiring extraction of maxillary second and third molar teeth. The patients received anesthesia using the conventional nerve block technique and infiltration technique randomly on each side of the mouth. Patients were assessed for pain during the injection, after extraction, and after 15mins of the procedure with each technique using Visual Analog Scale (VAS). The patients were also assessed for pain using the Verbal Response Scale (VRS). The positive aspiration was assessed for each technique. During tooth extraction, quality of anesthesia was assessed using an eight-point category rating scale. The results obtained were analyzed using Chi-square test. It was concluded that the buccal infiltration technique is less painful for the patient as compared to the posterior superior alveolar nerve block. This technique has a lower frequency of positive aspiration as compared with the PSA nerve block. However, the PSA nerve block technique provides better-quality of anesthesia. It can be concluded that the infiltration technique appears to be a successful alternative with additional advantages, as compared to the nerve block technique.

Role of CBCT in Prediction of Oro-antral Communication Post Third Molar Extraction: A Retrospective Study.

Oro-antral communication (OAC) is one of the most frequently encountered complications during third molar extraction. Various radiographic factors, like excessive maxillary sinus pneumatization, long periods of edentulism, periapical lesions, etc., have been considered high-risk factors for OAC. However, a panoramic radiograph has not proven to be accurate in predicting the chances of OAC. Through this retrospective study, we evaluated the efficacy of a CBCT in predicting the incidence of OAC after maxillary third molar extraction. We conducted a retrospective study in our department, which included the patients who had undergone extraction of a maxillary third molar over five years with the presence of panoramic X-rays and/or CBCT scans prior to extraction. Primary outcomes assessed from the case files were intra-operative complications like OAC, root fracture, tuberosity fracture, pterygoid plate fracture, etc. The incidence of these complications was correlated with the presence or absence of CBCT before extraction. Out of 920 extracted maxillary third molar, only 148 teeth (16.1%) had a CBCT record before extraction. The most commonly encountered complication was broken inaccessible root piece/s (4.9%), followed by OAC (3.5%). An inter-group comparison showed that a significantly higher percentage of patients (p < 0.001) with CBCT records had an incidence of OAC (11.5%) as against the group of patients with no CBCT record (1.9%). A CBCT scan prior to cases with high-risk factors for OAC can be a valuable tool in accurately predicting the chances of OAC after maxillary third molar extraction.

Factors influencing the successful eruption of the maxillary third molar after extraction of the maxillary second molar

This study evaluated the occlusal status of the maxillary third molars that erupted spontaneously after extraction of the maxillary second molars and investigated the factors that influenced the occlusal status of the maxillary third molars. We assessed 136 maxillary third molars in 87 patients. Alignment, marginal ridge discrepancy, occlusal contact, interproximal contact, and buccal overjet were used to score the occlusal status. Occlusal status was classified as good (G group), acceptable (A group), and poor (P group) for the maxillary third molar at its full eruption (T1). The Nolla's stage, long axis angle, the vertical and horizontal position of the maxillary third molar, and the maxillary tuberosity space were assessed at the time of maxillary second molar extraction (T0) and T1 to identify factors influencing the eruption of the maxillary third molar. G, A, and P groups comprised 47.8%, 17.6,% and 34.6% of the sample, respectively. Age was the lowest in the G group at both T0 and T1. The maxillary tuberosity space at T1 and the amount of the change of maxillary tuberosity space were the largest in the G group. There was a significant difference in the distribution of the Nolla's stage at T0. The proportions of the G group were 60.0% in stage 4, 46.8% in stages 5 and 6, 70.4% in stage 7, and 15.0% in stages 8-10. According to multiple logistic regression analysis, stages 8-10 for the maxillary third molar at T0 and the amount of the change of maxillary tuberosity were negatively associated with the G group. Good-to-acceptable occlusion was seen in 65.4% of the maxillary third molars after maxillary second molar extraction. Insufficient increase in the maxillary tuberosity space and Nolla stage 8 or higher at T0 negatively influenced the maxillary third molar eruption.

Comparative evaluation of efficacy of physics forcep and conventional forceps for extraction of maxillary molars.

Tooth extraction is one of the most commonly performed procedures in dentistry. It is usually a traumatic procedure often resulting in immediate destruction and loss of alveolar bone and surrounding soft tissues. It is the only dental procedure which was carried out by dentists in the previous centuries and various instruments have evolved for this procedure over time. Atraumatic extraction is one of the essential dental procedures, as atraumatic extraction leads to proper wound healing and appropriate bone healing. Physics forceps have got a new role in extraction technique, that it makes just one contact point with the tooth as a unique benefit. Physics forceps depends on the physics of rotational power, lever and torque much like a bottle top removal. A study was conducted to evaluate the efficacy of physics forceps and conventional forces in the extraction of maxillary molar. Eligible participants were adults aged 18-50 diagnosed with grossly decayed maxillary molars with poor endodontic prognosis and willing to participate in the study. Exclusion criteria were as follows: patients with dilacerate roots; patients with systemic diseases like hypertension, diabetes mellitus, thyroid, tuberculosis, epilepsy seizures, COVID-19 positive; patients' non-acceptance to voluntarily participate in research a refusal to sign the informed consent. Parameters such as a crown fracture or root fracture; buccal bone fracture; time taken for extraction and operator ease on the VAS scale are assessed. Results showed that with the use of physics forces, there was very less incidence of crown fracture and no incidence of buccal bone fracture, whereas with the conventional forceps the result showed that in almost all the time taken for extraction was much more in conventional forcep and the operator ease rating was more with conventional forceps. Hence, oral surgeons as well as general practitioner should adapt the use of physics forceps in routine extractions.

Long-Term Capsaicin Administration Ameliorates the Dysfunction and Astrogliosis of the Brain in Aged Mice with Missing Maxillary Molars.

Tooth loss and decreased masticatory function reportedly affect cognitive function; tooth loss allegedly induces astrogliosis and aging of astrocytes in the hippocampus and hypothalamus, which is a response specific to the central nervous system owing to homeostasis in different brain regions. Capsaicin, a component of red peppers, has positive effects on brain disorders in mice. Decreased expression of transient receptor potential vanilloid 1, a receptor of capsaicin, is associated with the development of dementia. In this study, we investigated the effect of capsaicin administration in aged mice (C57BL/6N mice) with reduced masticatory function owing to the extraction of maxillary molars to investigate preventive/therapeutic methods for cognitive decline attributed to age-related masticatory function loss. The results demonstrated that mice with impaired masticatory function showed decreased motor and cognitive function at the behavioral level. At the genetic level, neuroinflammation, microglial activity, and astrogliosis, such as increased glial fibrillary acidic protein levels, were observed in the mouse brain. The mice with extracted molars fed on a diet containing capsaicin for 3 months demonstrated improved behavioral levels and astrogliosis, which suggest that capsaicin is useful in maintaining brain function in cases of poor oral function and prosthetic difficulties.

Surgical-Orthodontic Treatment of Class III Malocclusion with Anterior Open Bite

A 21-year-old female came with chief complaints of inability to incise food and poor esthetics. The patient presented with a concave facial profile, long face with a steep mandibular angle, incompetent lip closure, and acute nasolabial angle. Intraorally, she had negative 6 mm overjet, 3 mm open bite and dental crowding. She was diagnosed as severe skeletal Class III malocclusion and anterior open bite. The treatment plan included orthodontic treatment with orthognathic surgery and extraction of maxillary second molars, which were supra-erupted and tipped buccally. The pre-operative orthodontic alignment took 11 months. The surgical correction included maxillary Le Fort I osteotomy with 4 mm advancement, mandibular intraoral vertical ramus osteotomy with 6.5 mm setback and genioplasty. The total surgical-orthodontic treatment time was 16 months. The final result presented a straight profile with stable occlusion. The patient’s facial and dental esthetics, masticatory function, and quality of life were all significantly improved after surgical-orthodontic treatment.

Comparative treatment outcomes after bilateral extractions of maxillary second molars or first premolars in patients with class II malocclusion: a retrospective study

BackgroundThis retrospective cohort study aimed to compare treatment results between bilateral extraction of upper second molars (M2) and first premolars (P1) in terms of treatment timing, cephalometry, upper third molar alignment and relapse in the long-term.MethodsFifty-three consecutively treated Caucasian patients with a brachyfacial pattern, skeletal class I and dental class II requiring extraction in the maxilla due to crowding were retrospectively divided into group I (M2 extracted; N = 31) and II (P1 extracted; N = 22). Fixed appliances were inserted after extraction and after distalisation of the first molars in group I. Post-treatment lateral cephalograms were digitally analysed and compared between groups. Six to seven years later relapse and success of upper third molar alignment were clinically evaluated as well as orthodontic treatment duration, pre-treatment age and gender recorded.ResultsAfter debonding patients with second molar extraction showed significantly smaller values for the Wits-appraisal, but higher values for index and facial axis. Extracting first premolars caused significantly more retroinclination/−position of anterior teeth and an increased profile concavity, more relapse and less successful alignment of upper third molars. Orthodontic treatment duration, pre-treatment age and gender were not significantly different between groups.ConclusionsBilateral extraction of upper first premolars or second molars may solve dental crowding in skeletal class I dental class II patients with a brachyfacial growth pattern. Upper second molar extraction seems to affect maxillary third molar alignment, long-term stability and dental and soft-tissue cephalometric parameters positively, but no intervention proved to be clearly superior.

Zoledronate/Anti-VEGF Neutralizing Antibody Combination Administration Increases Osteal Macrophages in a Murine Model of MRONJ Stage 0-like Lesions

The pathophysiology, pathogenesis, histopathology, and immunopathology of medication-related osteonecrosis of the jaw (MRONJ) Stage 0 remain unclear, although 50% of MRONJ Stage 0 cases could progress to higher stages. The aim of this study was to investigate the effects of zoledronate (Zol) and anti-vascular endothelial cell growth factor A (VEGFA) neutralizing antibody (Vab) administration on polarization shifting of macrophage subsets in tooth extraction sockets by creating a murine model of MRONJ Stage 0-like lesions. Eight-week-old, female C57BL/6J mice were randomly divided into 4 groups: Zol, Vab, Zol/Vab combination, and vehicle control (VC). Subcutaneous Zol and intraperitoneal Vab administration were performed for 5 weeks with extraction of both maxillary first molars 3 weeks after drug administration. Euthanasia was conducted 2 weeks after tooth extraction. Maxillae, tibiae, femora, tongues, and sera were collected. Structural, histological, immunohistochemical, and biochemical analyses were comprehensively performed. Tooth extraction sites appeared to be completely healed in all groups. However, osseous healing and soft tissue healing of tooth extraction sites were quite different. The Zol/Vab combination significantly induced abnormal epithelial healing, and delayed connective tissue healing due to decreased rete ridge length and thickness of the stratum granulosum and due to decreased collagen production, respectively. Moreover, Zol/Vab significantly increased necrotic bone area with increased numbers of empty lacunae compared with Vab and VC. Most interestingly, Zol/Vab significantly increased the number of CD169+ osteal macrophages (osteomacs) in the bone marrow and decreased F4/80+ macrophages, with a slightly increased ratio of F4/80+CD38+ M1 macrophages compared to VC. These findings are the first to provide new evidence of the involvement of osteal macrophages in the immunopathology of MRONJ Stage 0-like lesions.

Alpha-ketoglutarate up-regulates autophagic activity in peri-implant environment and enhances dental implant osseointegration in osteoporotic mice.

The osseointegration of dental implants is impaired in patients with osteoporosis, leading to significantly higher failure rates. This study set out to investigate the potential effects of alpha-ketoglutarate (α-KG) on implant osseointegration in an osteoporotic mouse model. Female C57BL/6 mice received ovariectomy and bilateral first maxillary molar extraction at the age of 7 weeks. Dental implants were inserted 8 weeks after tooth extraction. In one of the groups, α-KG was administered via drinking water throughout the experimental period. Specimens were collected on post-implant days (PIDs) 3, 7, 14, and 21 for micro-CT, histological, and immunohistochemical analyses. At the same time, bone-marrow-derived mesenchymal stem cells (BMMSCs) treated with α-KG were interrogated for osteogenic differentiation, autophagic activity, and apoptosis. α-KG supplementation in drinking water resulted in enhanced dental implant osseointegration in ovariectomized mice, with up-regulated osteogenic and autophagic activity and down-regulated osteoclast differentiation and cell apoptosis. α-KG-treated BMMSCs showed enhanced activity in proliferation, survival, colony formation, and osteogenic differentiation, as well as autophagic activity. Systemic α-KG supplementation effectively prevents the failure of dental implant osseointegration in mice under an osteoporotic state.

Influence of mineralized and demineralized xenograft bone on the repair of intraoral bone defect in rats.

Introduction: Mineralized bovine bone grafts have been widely used as substitutes for bone losses in dental clinics. Studies have shown that exposing the organic components of the bone matrix at surgical sites accelerates bone deposition. Objective: The present study evaluated the bone repair progress of an intraoral bone defect in rats after grafting with mineralized (MBB) and demineralized bovine bone (DBB). Materials and Methods: An intraoral bone defect was created after extraction of the right maxillary first molar, drilling the area of the alveoli of the four distal roots using a diamond tip. The defect was filled with the MBB or DBB graft. Grafting effects were evaluated after 1, 7, 14, 21, and 49 days, using radiographic and histological data. Results: After 14 days, all groups showed full mucosa epithelialization at the surgical site. Radiographic data showed an improvement in bone deposition in defects grafted with the organic matrix. This data was confirmed by histological analysis. A higher level of bone maturation of the neoformed trabeculae and a faster reabsorption rate were also observed to be a feature of the DBB graft. Conclusion: The present in vivo data revealed that the DBB graft may represent an alternative to mineralized biomaterials.

Buccal rotation for wholly impacted maxillary third molar extraction

BackgroundExtracting wholly impacted maxillary 3rd molars faces difficulty due to the narrow surgical field, adjacent teeth resistances and risk of oroantral communication. This study is designed to introduce and evaluate the applicability of a novel method-buccal rotation to extract maxillary 3rd molars.Materials and methodsIn this cohort study, from October 1st 2020 to September 30th 2021, 72 wholly impacted maxillary 3rd molars were included. Based on the crowns with coronal 1/3, middle 1/3, apical 1/3 of the adjacent teeth roots, teeth were classified into position I, II, III. Based on the angles < 30°, ≥ 30°but < 60°, ≥ 60° to the adjacent teeth, teeth were classified into angulation A, B, C. Traditional method and novel method-buccal rotation were applied based on the surgical simulations. Surgical results were recorded. To analyze the data, Chi-square test was applied.Results82.00% of teeth in position I and 50.00% in position II were designed to use traditional method, 83.33% in position III were using the novel method (p < 0.05). 81.25% of teeth in angulation A and 52.63% in angulation B were designed to use traditional method, 80.00% in angulation C were using the novel method (p < 0.05). Four cases got temporary complications.ConclusionBuccal rotation was applicable to extract the deep impacted maxillary third molars with large angles towards the adjacent teeth.

Low-level laser therapy prevents medication-related osteonecrosis of the jaw-like lesions via IL-1RA-mediated primary gingival wound healing

BackgroundMedication-related osteonecrosis of the jaw (MRONJ) is a serious debilitating disease caused by anti-resorption and anti-angiogenesis drugs, significantly affecting patients' quality of life. Recent studies suggested that primary gingival wound healing may effectively prevent the development of MRONJ. This study aimed to evaluate the effects of low-level light therapy (LLLT) on promoting gingival wound healing in extraction sockets of MRONJ-like mice and preventing the occurrence of MRONJ. Furthermore, we explored underlying mechanisms.MethodsMice were randomly divided into the Ctrl, Zol, and Zol + LLLT groups. Administration of zoledronate and tooth extraction of bilateral maxillary second molars were used to build the MRONJ model, and LLLT was locally administered into the tooth sockets to examine the effect of LLLT. Next, to explore the function of IL-1RA, we performed LLLT with interleukin-1 receptor antagonist (IL-1RA) neutralizing antibody (named Zol + LLLT + IL-1RA NAb group) or negative control antibodies for tooth extraction in subsequent rescue animal experiments. Stereoscope observations, micro-computed tomography, and histological examination were conducted to evaluate gingival wound healing and bone regeneration in tooth sockets. The effects of LLLT on the migration capacities of zoledronate-treated epithelial cells were assessed in vitro.ResultsLLLT promoted primary gingival wound healing without exposed necrotic bone. Micro-computed tomography results showed higher bone volume and mineral density of the tooth sockets after LLLT. Histology analysis showed complete gingival coverage, obvious bone regeneration, and reduced soft tissue inflammation, with down-regulated pro-inflammation cytokines, like interleukin-1 beta (IL-1β) and tumor necrosis factor-α (TNF-α), and up-regulated IL-1RA expression in the gingival tissue in the LLLT group. The rescue assay further showed that the effects of LLLT promoting gingival wound healing and preventing MRONJ might be partially abolished by IL-1RA neutralizing antibodies. In vitro studies demonstrated that LLLT accelerated zoledronate-treated epithelial cell migration.ConclusionsLLLT might promote primary gingival wound healing and contribute to subsequent bone regeneration of the tooth extractions in MRONJ-like lesions via IL-1RA-mediated pro-inflammation signaling suppression.