Hopeless Prognosis Research Articles

The use of mineral trioxide aggregate for treatment of children with complications of dental trauma

Jf the study was to assess the efficacy of mineral trioxide aggregate for treatment of children with complicated permanent teeth trauma. The study comprised 29 children aged 6-13 years (mean age 8.6±1.7 years) with 36 injured constant teeth, from which 30 had immature roots, 27 (75%) teeth had necrotic pulp at baseline examination, 12 (33.3%) teeth showed radiological signs of external imflammatory root resorbtion, 2 teeth were diagnosed with of the root fracture (5.6%). MTA was used for pulp regeneration procedure in 25 (69.5%) teeth, external closure of resorbtion site in 3 (8.3%) teeth, root canal filling in 4 (11.1%) teeth, apical plug creation in 4 teeth (11.1%). The patients were folowed up for 1 to 9 years. From 36 teeth only one was extracted 9 years after regenerative endodontic procedure because of cervical root fracture. In 2 teeth with external imflammatory resorbtion progession of replacement resorption took place, in 1 tooth necrosis of regenerated pulp tissue occurred 2 years after the procedure because of restoration marginal seal failure. In 25 teeth favorable outcome was registered with stabilisation of external root resorbtion, continous root growth in 24 teeth and radioluscent lesions healing in 6 teeht showing them at baseline examination. Change of external imflammator root resorbtion to replacement resorption was detected in 1 teeth from 3 with external closure of resorbtion site. Root calan filling with MTA was performed in 3 avulsed teeth with replantation delayed for more than 1 day and in 1 tooth with root fracture. All teeth were clinically asymptomatic during more than 5 years follow-up. Favorable outcome was received in all cases of apicl plug formation. MTA is highly effective for preservation of constant teeth in children with clinically complicated situations. In many cases with hopeless long-term prognosis for a teeth MTA allows stabilization of dental tissue level with the teeth being an object for guided tissue regeneration.

Prevalence of Tooth Loss due to Periodontitis in Patients Visiting Tertiary Care Hospital

Introduction: Epidemiological studies have been showing that caries is the main reason for tooth loss. But nowadays, it seems to show an increasing trend of tooth loss due to periodontal reasons rather than caries. The retention of natural teeth can improve the quality of life by maintaining the ability to chew and digest food. Thus, directly or indirectly periodontitis leading to tooth loss affects quality of life.
 Objective: To determine the prevalence of tooth loss in periodontitis patients.
 Methods: A cross-sectional study was done in Department of Periodontology and Oral Implantology from June 2023 to September 2023 after obtaining ethical clearance from institutional review committee. Study participants were patients diagnosed as periodontitis according to world workshop in periodontics 2017 classification and prevalence of tooth loss was recorded according to the history of mobile tooth. Poor prognosis and hopeless prognosis were counted as to be extracted tooth in the study. Collected data were entered into the excel sheet and further statistical analysis was done using SPSS v.20.
 Results: Mean of tooth loss due to periodontitis was found to be 3.74±3.285 and tooth to be extracted is 1.94±1.884. 
 Conclusion: As the age increases number of tooth loss increases, likewise current smokers have more amount of tooth loss than that of former and nonsmokers. Likewise, mandibular anterior region was most common for prevalence for tooth loss.

Treatment with Viscum album potencies induces reduction of MCP-1 and ROs levels in murine melanoma cells.

Melanoma is responsible for most skin cancer deaths. It has a high metastatic potential, complex treatment, and a hopeless prognosis. Viscum album extract (Va) is a complementary treatment in cancer, with in vitro and in vivo cytotoxic effects on different tumor types. However, its ultra-diluted homeopathic preparations' effects and mechanisms on cancer cells need further study. Thus, the aim of present work was to investigate cytokine profile and ROs production of melanoma cells after treatment with ultradiluted VA collected from host tree Abies alba (VaAa) and Quercus rubur (VaQr)during Swiss summer. For this, potencies of Va in different homeopathic scales were prepared using mother tincture (MT) from VaAa and VaQr submitted to homeopathic ethanolic maceration and then a subsequent dynamization process. Then, B16F0 melanoma cells cultivated in 24-well plates were treated with MT or 12DH, 200CH or 5LM potencies of VaAa or VaQr for 24, 48 or 72 hours. After these periods, culture supernatants were collected to assess the levels of MCP-1, INF-γ, TNF-α, IL-10, IL-12p70 and IL-6 cytokines and, ROs production. Results demonstrated significant reduction of MCP-1 and ROs levels in B16F10 melanoma cells treated with Va (VaQr, preferentially) at 12DH or 5LM potencies when compared to untreated or carboplatin-treated cells. In conclusion, we demonstrated for the first time, the in vitro effects of Va potencies prepared in different homeopathic scales in relation to cytokines and ROs production in cell melanoma cells.

A 30-year retrospective cohort outcome study of periodontal treatment of stages III and IV patients in a private practice.

Tooth loss studies show that periodontal treatment is effective. However, it is not known whether these results can be projected into a lifetime of treatment. The aim of the study was to study all patients with stages III/IV of periodontitis over 30 years in a private practice. All patients referred between 1986 and 1990 were monitored for 30 years for tooth loss and prognostic factors. All dropouts were accounted for. In all, 386 patients were followed, of whom 283 patients dropped out, leaving 103 patients (67 females and 36 males, average age 40.1 years) monitored over 30 years. Tooth loss was stable until 16 years, when the population was divided into groups of low (n = 65), moderate (n = 18) and high (n = 20) tooth loss, losing 1.05 (SD 1.27), 4.83 (SD 0.96) and 11.90 (SD 4.25) teeth, respectively. The strongest prognostic factors were first-degree relatives with periodontitis, periodontal treatment before the age of 35 years, diabetes and patients with teeth with initial hopeless prognosis. The majority of patients with stages III and IV periodontitis could be successfully treated with conventional periodontal treatment over a period of 30 years. The findings suggest that retrospective studies with shorter observation times cannot automatically be projected onto the outcome of a lifetime of periodontal treatment.

Root surface changes following manual and ultrasonic instrumentation - a scanning electron microscopic study.

The aim of this study is to assess the efficacy of hand and ultrasonic scaling and to evaluate the surface roughness on the root surface of periodontally involved teeth using a scanning electron microscope. A sample of 90 single-rooted teeth with a hopeless prognosis was selected for the study and divided into three separate groups. Group I consist of no treatment. In Group II, hand scaling was done using Gracey curettes, and in Group III, ultrasonic scaling was done. The teeth were then extracted and fixed in 10% formaldehyde solution for 24-48 hours and subjected to scanning electron microscopic (SEM) evaluation. The SEM analysis revealed that the remaining calculus index was found to be similar in the ultrasonic group and the hand scaling group, whereas the surface roughness was found to be the least in the ultrasonic group. Hand instrumentation has resulted in more surface roughness as compared to ultrasonic instruments.

A surgical procedure for re-implanting a tooth that has been rendered hopeless because of periodontitis: a case report

Aim and methodology: This article describes a periodontally compromised, hopeless incisor tooth that was purposefully replanted, along with the results after six months. This entails the deliberate removal of the tooth and its subsequent correct manipulation and endodontic restoration before reinserting it into the socket. Results: Hopeless lower incisors with periodontal involvement were transplanted utilizing an implant surgical drilling approach after receiving root canal therapy and tetracycline-HCI conditioning. Bone graft material was added and the procedure was monitored for six months. The tooth was observed to be asymptomatic, functioning normally, and showing no pathologic radiological changes. With minimal bleeding during probing and no growth of pathological pockets, the periodontal condition was within normal limits. Alveolar bone support was seen to be adequate. The results may suggest that, in some circumstances, purposeful replantation is a viable strategy of treatment for maintaining native dentition. Conclusion: Intentional tooth reimplantation can be an alternative treatment option for periodontally involved teeth with poor or hopeless prognoses.

Türkiye’de Hospiz Bakım Sisteminin Kurulması için Bir Model Önerisi

Hastalığının son evresinde olduğu öngörülen hastalar ve onların yakınları, hospiz olarak bilinen kurumlarda çok disiplinli bir ekip tarafından takip edilmeye ihtiyaç duyarlar.Bu derlemenin amacı son yıllarda dünyada ve ülkemizde etik bir sorun haline gelen prognozu ümitsiz hastaların ölüme yaklaşması ve ötanaziye alternatif bir yöntem olarak benimsenen hospiz kurumsallaşması ile ilgili ülkemizin sosyo-kültürel yapısına özgü bir model önerisi sunmaktır. Türkiye için hospiz modeli önerisi çalışması bir doktora tezi kapsamında gerçekleştirildi. Kronik seyirli, prognozu ümitsiz bir hastalık neticesinde hastalığının son evresinde olduğu düşünülen hastalar için kullanılan onurlu ölme hakkı ifadesi bir taraftan ötanazi ile eşleştirilirken diğer yandan hastaya tıbbi bakım ve özenin üst düzeyde sunulması şeklinde algılanmaktadır. Bu çalışmada ölümün doğal sürecinde hasta ve hasta yakınlarının yaşam kalitesini koruma, kabullenilen ölümü insanca yaşama ve ölümden sonra yas sürecinde hasta yakınlarına gerekli fizyolojik ve psikososyal desteği sağlamak felsefesiyle kurulmuş hospiz kuruluşlarının Almanya’daki bazı örnekleri incelenerek, ülkemize özgü bir hospiz modeli önerisinde bulunulmuştur.

Retention of periodontally hopeless tooth and the clinical effect on the adjacent tooth at maintenance phase: A retrospective study

Previous research has shown that periodontal maintenance therapy can keep teeth healthy for a long time. However, only a few studies have been conducted on the periodontal hopeless tooth that is retained during the maintenance phase. The purpose of this study was to evaluate if retaining a periodontal hopeless tooth had an effect on the periodontal conditions in the adjacent tooth at maintenance. A retrospective analysis was conducted on the periodontal status of periodontitis patients who presented with retained hopeless tooth. Hopeless prognosis is based on the mean percentage of the mesial and distal radiographic bone loss ? 65%. The periodontal status consists of periodontal pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BoP), which were evaluated at baseline (T0), after active therapy (T1) and at the last examination (T2) for both the hopeless tooth and the tooth/teeth adjacent to it. Compliance toward maintenance and reason for hopeless tooth extraction were also evaluated at maintenance (T1-T2). A total of 65 patients with 121 hopeless teeth and 187 adjacent teeth were included. Significant improvement of all periodontal parameters for both hopeless and adjacent teeth at T1 and T2 from T0 were observed within 5.05±2.58 years of observation, except for the CAL during maintenance. In conclusion, a low risk of disease progression on the tooth adjacent to the retained periodontal hopeless tooth can be achieved following active treatment with strict maintenance care.

Prosthetic Rehabilitation With Immediate Denture for Periodontally Hopeless Teeth: A Case Report

Background: Patient with poor oral hygiene may have periodontally diseased teeth with hopeless prognosis. The treatment is usually teeth extraction, which may be unpleasant to the patient because it can affect their appearance, speech and stomatognathic systems. It can be prevented by prosthetic rehabilitations with immediate denture. Immediate denture is a prosthodontic appliance to replace teeth and its subsequent structures which is inserted after tooth extractions.
 Objectives: To observe immediate denture as a prosthetic rehabilitation treatment to replace periodontally hopeless teeth.
 Case Report: We report a case of a 48-year-old woman with poor oral hygiene and elongated and mobile teeth which affected her chewing, speaking and appearance. The patient denied edentulous period. Patient management included subjective and objective examinations, preprosthetic treatment, impressions taking, diagnostic cast and working cast fabrications. Since try-in was impossible, midline position, tooth size and shade were taken in the early visit. Maxillomandibular relationship was determined and transferred to articulators. Cast modification with spatial modeling method, tooth set-up, wax modelling and insertion was done. Immediate denture was inserted right after the teeth extraction. Post-insertion control was done after one day, one week and one month.
 Results: The results were esthetically satisfactory with acceptable occlusion, speech, retention and stabilization.
 Conclusion: Immediate denture can be considered as a predictable treatment to replace hopeless teeth, which will restore esthetics, occlusions and speech with satisfactory retention and stabilization.
 Keywords: immediate denture, periodontally hopeless teeth, prosthetic rehabilitation

Prevalence of endo-perio lesions according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease in a university hospital.

Teeth with combined endodontic-periodontal lesions (EPLs) have favorable to hopeless prognoses. The new classification system was developed by the World Workshop on the Classification of Periodontal and Peri-Implant Disease in 2017 and suitable epidemiologic data related to this new system are currently lacking. This study aims to contribute data about the prevalence of EPLs according to the new system. A total of 1,008 panoramic views taken in 2019 were analyzed, recording the presence of an EPL and other periodontic parameters. Radiographs of bad quality and of the same person were excluded. Additionally, the EPLs' radiographic patterns were rated by two raters according to their shape (j-shaped vs cone-shaped). Descriptive statistical methods as well as t tests for continuous and chi-squared tests for categorical variables were used. Overall, 866 patients (with 18,963 teeth) were included. Prevalence of EPLs was 4.9% (n = 43) (patient-related)/0.4% (n = 71) (tooth-related). Mean age (62.3 years vs 51.5 years), mean maximal percentage of bone loss (60% vs 30%), and mean age-adjusted bone-loss index (1.0 vs 0.6) were considerably higher compared to patients without EPL. A total of 67 EPLs were found in patients with stage III/IV periodontitis and 4 in patients with stage II periodontitis. This is the first study showing prevalence of EPLs (4.9%/0.4%) according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease. Patients with EPLs have a substantially higher maximal percentage of bone loss and a higher age-adjusted bone-loss index at residual teeth, excluding teeth with EPLs. All patients have at least stage II periodontitis.

Clinical and Radio Graphical Evaluation of Implants Placed in Ridge Preserved Sites versus Naturally Healed Sites

Introduction: Dental implant has proved to be a pioneer in prosthetic rehabilitation overcoming the disadvantage of a removable or a fixed partial denture. The aim of the study was to clinically and radiographically evaluate and compare changes of hard and soft tissues around the implants which will be placed in ridge preserved sites with implant placed in naturally healed extraction sites.
 Materials and Methods: In this study 10 Patients having tooth with hopeless prognosis requiring tooth extraction followed by implant placement were enrolled. These patients were randomly divided in to two groups. Group I: Socket preservation with demineralized bone matrix putty group. Group II: Naturally healed socket after extraction, followed by implant placement in both groups.
 Results: The results of the current study indicated that demineralisedbone matrix putty, when used in patients for dental augmentation in either mandibular or maxillary sites, resulted in replacement of the graft material with bone by as early as 4-6 months, there upon enabling implant placement and subsequent prosthetic reconstruction.
 Conclusion: Bucco lingual ridge width and width of keratinized gingiva can be preserved by ridge preservation after extraction. Short-term survival rates and clinical outcomes of both groups were similar and were comparable. Further clinical trials with longer duration follow up with larger sample size should be done to get more affirmative and conclusive results.

ASSESSMENT OF BONE REGENERATION AFTER PLACEMENT OF IMMEDIATE IMPLANTS USING STICKY BONE AND CGF MEMBRANE

Aim: Assessment Of Bone Regeneration After Placement Of Immediate Implants Using Sticky Bone And CGF Membrane. Materials And Methods: The study was performed in a series of 10 patients aged 25- 40 years with hopeless prognosis of tooth and needing immediate implant replacement. After placement of implants, the sites were augmented with sticky bone and CGF membrane. The bone regeneration was assessed radiologicaly in 3, 6 and 12 months. The results were recorded. Results: There was statistical significance comparative with intraoperative and 3,6,12 months postoperative was (p=0.001),(p=0.002),(p=0.004) suggesting there was significant difference there. Conclusion: It was concluded thatImmediate implant placement along with sticky bone grafting provides good implant success with bone regeneration surrounding the implant.

Hard tissue dimensional changes following implant removal due to peri-implantitis: A retrospective study.

The current evidence regarding the alterations experienced by the alveolar ridge (hard tissue changes) after implant removal due to peri-implantitis is limited. To assess the hard tissue dimensional changes following implant removal due to peri-implantitis. Clinical records were examined to identify patients with implants that had to be removed due to a hopeless prognosis secondary to peri-implantitis due to expendability of peri-implantitis implants for functional reasons. Patients with preoperative and postoperative cone-beam computed tomography (CBCT) scans were included. Patient-related, implant-related, and surgery-related factors were assessed based on the clinical records. Linear measurements were made to evaluate the influence of bone plate thickness (BPT), ridge width (RW), and ridge height (RH) at various levels upon the outcome of implant removal. A descriptive statistical analysis of the quantitative and qualitative variables was performed. Correlations of the variables with the primary outcome (dimensional changes) were tested using univariate and multivariate analyses (multinomial random intercept mixed model linear regressions). A total of 26 patients (nimplants = 79) met the eligibility criteria. The mean decrease in RW at 1 and 3 mm below the crest was 11.3% and 4.4%, respectively (P < 0.001). Buccal and lingual RH was significantly reduced by 2.2% and 6.3%, respectively (P < 0.001). Few patient-related, implant-related, and surgery-related factors appeared to have an impact upon the hard tissue dimensional changes. Bone regeneration simultaneous to implant removal minimized the dimensional changes of the ridge both vertically (5% lesser buccal RH reduction) and horizontally (12% lesser RW reduction) when compared with spontaneous healing. The use of a reverse-torque removal kit seemed to be critical in limiting the dimensional changes of the ridge. Minimal hard tissue changes can be expected following implant removal due to peri-implantitis. Simultaneous bone regeneration procedures and the use of a removal kit may considerably reduce the impact upon the dimensional changes (NCT04534361).

Evidence revealing the role of T cell regulators (Tregs) in periodontal diseases: A review.

Periodontitis is an inflammatory disease of the periodontium, which is a reflection of the overgrowth of oral commensals. This alteration in the oral microbiota initiates inflammation of the gingiva, which when left untreated, terminates with the resorption of the alveolar bone that may lead to a poor and hopeless prognosis. With upcoming trends in modulating the host's immunity, the role of regulatory T-cells has gained importance. These T-cells defend against inflammation and autoimmunity as they suppress both. However, in both the conditions, the regulatory cells are invariably reduced in number. Novel methods to enhance the function of Tregs have made their way in dentistry, as a promising approach to cure periodontitis. This article discusses various significant tests and trials of Tregs in the recent years.

Histopathological Investigation of Dental Pulp Reactions Related to Periodontitis.

Objective:Since the 1960s, there has been contradictory evidence regarding the association between periodontal pathology and the status of the pulp. The purpose of this study was to evaluate the histopathological changes of pulp tissue with severe periodontal disease, including vertical bone loss involving the major apical foramen, and compared them with the histological pulpal status of teeth with healthy periodontium.Methods:This case-controlled study included 35 intact teeth with severe periodontitis of hopeless prognosis (test group) and 35 teeth without periodontitis extracted for orthodontic reasons (control group). For each tooth, periodontal and endodontic parameters such as probing depth and pulpal vitality were recorded, and the pulp tissue was evaluated histologically. The data were analysed with a significance level of 0.05.Results:Vital pulp was observed in all specimens of both groups (P=1). Pulpal inflammation in the apical portion was observed in 81.71% of the severe periodontitis group, whereas all teeth in the control group demonstrated no signs of pulpal inflammation. Dystrophic calcification and pulp stones were observed in 7.5% of the periodontitis group and 5.7% of the healthy group (P>0.05). Pulp fibrosis was observed in 22.8% of the periodontitis group and 2.8% of the control group (P=0.012). Pulpal necrosis was not noted in either group. In the periodontitis group, internal resorption was present in 22.8% of cases (P=0.005) and external resorption was present in 80% of cases (P<0.001). In the control group, no internal or external resorption was observed in any of the specimens. No differences were noted in the study patients with regard to sex or age.Conclusion:Periodontal disease does not significantly affect pulp vitality and pulpal calcifications. However internal and/or external resorption was significantly different between the two groups as well as apical inflammation and pulp fibrosis.

Effect of citric acid on periodontally involved root surface after mechanical debridement as root conditioning agent– A SEM study

Periodontitis-affected root surfaces are hypermineralized and contaminated with cytotoxic and other biologically active substances. Chemical root conditioner are playing important role in decontaminating root surface as well as enlarge dentinal tubules into which healing connective tissue can enter. The various root conditioning agents used are citric acid, tetracycline, doxycycline, phosphoric acid, ethylene diamine tetra acetic acid etc. The present study was aimed to compare the efficacy of citric acid as root conditioner with scaling and root planing scaling and root planing alone by observing the change in root surface under SEM. For the present study 40 samples were obtained from 20 single rooted anterior teeth indicated for extraction having hopeless prognosis. The obtained samples are scaled and root planed properly then tooth root are divided in two parts and. One part of each root sample were treated with saline and other with citric acid. Scanning photomicrographs of the root surfaces were taken at 3000X. Photomicrography analysis of SEM samples revealed that removal of smear layer and opening of dentinal tubules was more in samples treated by citric acid with SRP than the SRP alone.

Analyzing the predictability of the Kwok and Caton periodontal prognosis system: A retrospective study.

The aim of this study was to analyze the predictability of the Kwok and Caton periodontal prognosis system by investigating tooth survival within a 64-month period and to compare this to other well-established prognosis systems. This retrospective study included the records of patients who had a minimum of two dental exams at least 12 months apart at a single University-affiliated Dental Center. Data including patients' age, sex, length of follow-up period, initial tooth prognosis, revised tooth prognosis, tooth type, and number of teeth lost at the latest exam were recorded. Descriptive analysis was used for data interpretation. A total of 4,046 teeth from 174 patients qualified for the study. Teeth with initial poorer prognosis had a higher chance of being extracted compared with those with a better initial prognosis. Tooth survival rate at the latest follow-up for those with an initial favorable, questionable, unfavorable, and hopeless prognosis was 97.9%, 90.7%, 62.5%, and 17.7%, respectively. Teeth initially assigned to a poorer prognosis category had a higher proportion that changed to a worse prognosis at the latest periodontal exam. The Kwok and Caton prognosis system can predictably determine tooth survivability within a 5-year period. The defined categories of this prognosis system are more reliable than that of other systems in the short-term. However, long-term (>5 years) prediction accuracy of this prognosis system needs further investigation.

Effect of 940 nm Diode Laser as Adjunct Treatment to Mechanical Instrumentation on Root Surface Gingival Fibroblast Adhesion in Periodontally Compromised Extracted Teeth : An in vitro Study

Introduction: Mechanical debridement of diseased root surfaces produces a smear layer that encompass microorganisms and residual cementum which may interfere with periodontal healing and regeneration of connective tissue attachment. Accordingly, this study aimed to determine impact of 940nm diode laser on adhesion of fibroblasts to root surface of extracted teeth from patients with chronic periodontitis. Methods: Twenty extracted single-rooted teeth with hopeless prognosis were collected and debrided with hand curettes. Afterward, two specimens were obtained from each tooth by splitting them with a sterile diamond disk. Samples were submerged in fibroblast suspension and randomly divided into two groups. Group A comprised of 20 specimens subjected to scaling and root planing only and group B included 20 specimens which received SRP and and 940 nm diode laser irradiation. The adhesion of fibroblasts was investigated by MTT and cell morphology was assessed with scanning electron microscopy (SEM). Results: The extent of adhesion was higher in group B compared with group A, though this difference was not statistically significant. In the laser group, fibroblast cells showed more elongated morphology and a smaller number of rounded forms was found. But no significant difference was observed between the two groups. Conclusion: A diode laser with a wavelength of 940 nm has a negligible effect on adhesion of fibroblasts to the root surface of teeth extracted because of chronic periodontitis

Combined Sinus Floor and Alveolar Ridge Augmentation Simultaneously Performed with Extraction of Ankylosed Maxillary Molar: A Case Report

This is a case report of combined sinus floor augmentation and alveolar ridge augmentation using a titanium mesh simultaneously performed with extraction of an ankylosed maxillary molar. An 18-year-old male presented with discomfort in the upper right molar. The maxillary right first molar was diagnosed with chronic apical periodontitis, ankylosis, and secondary dental caries. It was determined as hopeless prognosis due to the extensive secondary caries so we planned extraction of the tooth. Due to the pneumatization of the maxillary sinus and the vertical defects of the alveolar ridge, the bone dimension was insufficient for future implant placement. Sinus floor augmentation and alveolar ridge augmentation were performed simultaneously with extraction. Buccal flap was elevated for approach to the ankylosed root and the sinus. Piezosurgery was used for atraumatic removal of ankylosed tooth and the sinus window formation without the Schneiderian membrane perforation. Demineralized bone matrix and bovine bone mineral were grafted into the sinus and on the defected ridge. The sinus window was covered with a collagen membrane and a titanium mesh was installed at the ridge. Primary closure was achieved with buccal advanced flap and palatal rotational flap. Though there was titanium mesh exposure during the healing process, but sufficient bone formation was achieved. And the implant placement and the restoration procedures were successfully completed.

Immediate Ridge Augmentation Using Autogenous Tooth Root as a Block Graft in a Periodontally Hopeless Extraction Site: A Pilot Study.

The aim of the our study was to assess the efficacy of autogenous tooth root as a block bone graft in reconstructing the vertical and horizontal dimensions at periodontally hopeless extraction sites both clinically and radiographically. A total of 13 patients having a tooth with periodontally hopeless prognosis and indicated for extraction were included in the study. Following atraumatic extraction, the tooth was processed to create a decoronated cementum-free dentin block which was used to augment the extraction socket. The augmentation of periodontally hopeless socket with tooth block autograft resulted in a gain of clinical ridge width of 5.9 mm radiographically, the apico-coronal defect depth reduced up to 8.2 mm (P = .001), and a gain in ridge width of 5.8 mm postoperatively after 6 months (P = .001). The present study demonstrated the effectiveness of using tooth root as a block graft for ridge augmentation in the periodontally hopeless extraction site making it suitable for implant placement in future.