Post-extraction Alveoli Research Articles

Peri-implant tissue behavior around non-titanium material: Experimental study in dogs

The aim of this study is to assess the effectiveness of using non-titanium abutments for better establishment of peri-implant biological width and to assess the stability of the soft tissue. Forty-eight tapered dental titanium implants with internal connection of 3.5mm in diameter and 10mm length were implanted in post extraction alveoli of 6 dogs. Twenty-four abutments made in a reinforced polyetheretherketone (PEEK) formed the test group, and 24 titanium abutments, the control group. The groups were randomized. Histological, histomorphometric, ISQ and radiological analyses were performed. Greatest differences (control group vs. test group) were found at PM-Lc (Mucosa to lingual bone contact) (2.91±0.03 vs. 3.71±0.18), and to PM Lingual-IS (2.65±0.43 vs. 3.57±0.38). Reinforced PEEK constitutes an effective alternative to conventional titanium abutments, given its high rate of biocompatibility, preservation of bone height and soft tissue stability.

Valutazione della guarigione dei siti postestrattivi mediante l’utilizzo di un gel a base di aminoacidi e sodio ialuronato

ObjectivesThe aim of this study was to compare both oral soft and hard tissue wound healing with and without use of a compound gel containing amino acids and sodium hyaluronate and to evaluate post-operative pain after tooth extraction. Materials and methods46 patients were divided into two groups (study group 23 patients and control group 23 patients). In the first group, the gel containing amino acids and sodium hyaluronate (Aminogam®, Errekappa Euroterapici SpA, Milano, Italy) was administered for the whole healing period, while in the second group, no topical substances were applied.Numeric Rating Scale (NRS, 0-10) was used to evaluate pain experienced after surgery.Using millimeter grid paper as a benchmark and a graphic software, Adobe Photoshop®, it was possible to measure the whole surgical wound area, immediately after tooth extraction (Timing 0), at 7 (Timing 1), 30 (Timing 2) and 60 days (Timing 3). ResultsThe cases treated with the compound gel (study group) showed a higher average percentage of healing than the control group, with regard to both soft and hard tissue. NRS pain scale did not show any significant differences between the two groups. ConclusionsThe use of a gel containing amino acids and sodium hyaluronate promoted a better and faster healing, both of the oral soft tissues, by reducing the surgical wound area in the first week after tooth extraction, and of the hard tissues, through the progressive filling of post-extraction alveoli.

Efficacy of platelet-rich plasma applied to post-extraction retained lower third molar alveoli. A systematic review

Dental retentions have a high prevalence among the general population and their removal can involve multiple complications. The use of platelet rich plasma has been proposed in an attempt to avoid these complications, as it contains high growth factors and stimulates diverse biological functions that facilitate the healing of soft and hard tissues. Objectives: To evaluate the available scientific evidence related to the application of platelet-rich plasma in the post-extraction alveoli of a retained lower third molars. Material and Methods: A systematic review of published literature registered in the Medline, EMBASE, Cochrane and NIH databases. The following categories were included: human randomized clinical studies. Key search words were: platelet rich plasma; platelet rich plasma and oral surgery; platelet rich in growth factors and third molar. Results: Of 101 potentially valid articles, seven were selected, of which four were rejected as they failed to meet quality criteria. Three studies fulfilled all selection and quality criteria: Ogundipe et al.; Rutkowski et al.; Haraji et al. The studies all measured osteoblast activity by means of sintigraphy, and also registered pain, bleeding, inflammation, temperature, numbness as perceived by the patients, radiological bone density and the incidence of alveolar osteitis. Conclusions: Scientific evidence for the use of PRP in retained third molar surgery is poor. For this reason randomized clinical trials are needed before recommendations for the clinical application of PRP can be made. Key words:Platelet rich plasma, lower third molar surgery, postoperative.

Evaluation of physicochemical and mechanical properties of polymeric formulations for use in the oral cavity

The aim of this research was to create and investigate a formulation that could be placed within post-extraction alveolus. The main material used in this work is a natural polymer, known as microcrystalline chitosan (MCCh). It was formulated as an aqueous hydrogel with the addition of the cross-linking agent (CaCl2) and various plasticizers (propylene glycol, glycerol and sorbitol). The swelling of the preparations was tested by three different methods under completely different acceptor fluids such as distilled water, phosphate buffer and simulated saliva. The pH was measured on the surfaces of each formulation, as well as the pH of the acceptor fluids; evidently, both of them had a similar pH to that of the oral cavity. Additionally, mechanical properties of the tested materials such as hardness, springiness and cohesiveness were evaluated. Based on research, the best compositions of materials were chosen to obtain preparations of the desired geometry and mechanical characteristics. The results from the study are able to prove that MCCh not only creates a neutral environment within the oral cavity but also, due to its significant absorptive properties, can reduce exu date and po ten tially be considered as a new carrier for medicinal substances used in dental implantation and management.

Evaluation of safety and efficacy of radiation-sterilized bone allografts in reconstructive oral surgery

Bone grafting allows reconstruction of the atrophied or destroyed alveolar process. In orthopaedics and traumatology allogeneic grafting has been used to restore defects of osseous tissue for over 60 years. In order to improve safety of the graft recipient, sterilized allogeneic grafts have been use. The aim of the study was to assess the direct and long-term outcomes following augmentation of atrophied alveolar processes with the use of radiation-sterilized allogeneic bone grafts. Sixty-eight patients were surgically treated between 2004 and 2011: 29 underwent open sinus floor elevation, post-extraction alveoli augmentation was performed in 16 subjects and 23 underwent reconstruction of the atrophied alveolar process. Augmentation of bone defects used bone granulate in 63 patients and bone blocks stabilized with titanium screws in 5 patients. PRF membranes collected from the patient’s blood were also used in all the procedures. In each of the cases optimal dimensions of the alveolar process were obtained allowing embedment of BIOMET 3I dental implant/-s. In all the patients the defects were successfully restored with implant-supported prostheses. Radiation-sterilized allogeneic bone grafts proved to be safe and effective for the patients and manageable for the surgeon constituting a good alternative to autogeneic material.

Clinical Use of Allogeneic Bone Granulates to Reconstruct Maxillary and Mandibular Alveolar Processes

Introduction Lack of adequate mass of a patient's own bone is still a clinical problem in dental implantology; it precludes dental embedment. Surgical widening of an atrophied alveolar process with the use of an allogeneic bone granulate to fill the bone defect constitutes a first-line method to prepare for implant-prosthetic treatment. Transplantation of allogeneic material allows reconstruction of optimal height, thickness, and width of the alveolar process facilitating a procedure with a good long-term outcome. The study assessed outcomes following augmentation of atrophied alveolar processes before intraosseous implantation. Materials and Methods Filling bone defects in the maxilla and mandible as an introductory measure for implant-prosthetic treatment was performed in 59 patients (24 females and 35 males of age range 22–65 years). Bone granulate was used for maxillary sinus floor elevation (n = 29), augmentation of the postextraction alveoli (n = 12), and filling of defects in the outer table of the compact bone formed following inflammatory conditions (n = 18). The bone grafts were covered with plasma-rich fibrin (PRF) obtained from the patient's blood to accelerate the formation of synostoses and prevent epithelial penetration between the patients' own bone and the bone graft. Results In all of the patients normal union was observed, as confirmed by radiological images as well as intraprocedural assessment. Sufficient height and width as well as thickness of the alveolar process was obtained, which allowed embedment. Conclusions Allogeneic bone granulate constitutes a good material to reconstruct maxillary and mandibular alveolar processes in out-patient care.

Evaluation of bone height and bone density after tooth extraction: an experimental study in minipigs

The objective of this study was to radiographically quantify bone density and bone height preservation in tooth extraction alveolus filled with xenograft. The maxillary and mandibular fourth deciduous molars and fourth premolars of 6 minipigs were removed. Randomly, in 3 animals the right side was used as the test side and in the other 3 animals the left side was the test side. Intraoral radiographs were performed to compare the condition at the initial time and 3 months later. Measurements of bone height and bone density were performed using KS300 (Zeiss) software. After 3 months, there was a statistically significant smaller bone height loss for the test group. The test group presented a statistically greater bone density immediately after tooth extraction. However, after 3 months there was no statistically significant difference between the groups. The results suggest that treatment of postextraction alveolus with xenograft can preserve bone height initially but differences in bone density compared to when no xenograft is used are not sustained.

Clinical Evaluation of Post-Extraction Site Wound Healing

The aim of this prospective study was to evaluate the clinical pattern of post-extraction wound healing with a view to identify the types, incidence, and pattern of healing complications following non-surgical tooth extraction. A total of 311 patients, who were referred for non-surgical (intra-alveolar) extractions, were included in the study. The relevant pre-operative information recorded for each patient included age and gender of the patient, indications for extraction, and tooth/teeth removed. Extractions were performed under local anesthesia with dental forceps, elevators, or both. Patients were evaluated on the third and seventh postoperative days for alveolus healing assessment. Data recorded were: biodata, day of presentation for alveolus healing assessment, day of onset of any symptoms, body temperature (degrees C) in cases of alveolus infection, and presence or absence of pain. Two hundred eighty-two patients (282) with 318 extraction sites were evaluated for alveolus healing. Healing was uneventful in 283 alveoli (89%), while 35 alveoli (11%) developed healing complications. These complications were: localized osteitis 26 (8.2%); acutely infected alveolus 5 (1.6%); and an acutely inflamed alveolus 4 (1.2%). Females developed more complications than males (p=0.003). Most complications were found in molars (60%) and premolars (37.1%). Localized osteitis caused severe pain in all cases, while infected and inflamed alveolus caused mild or no pain. Thirty patients (12%) among those without healing complications experienced mild pain. Most of the post-extraction alveoli healed uneventfully. Apart from alveolar osteitis (AO), post-extraction alveolus healing was also complicated by acutely infected alveoli and acutely inflamed alveoli. This study also demonstrated a painful alveolus is not necessarily a disturbance of post-extraction site wound healing; a thorough clinical examination must, therefore, be made to exclude any of the complications.

Osseous repair of the postextraction alveolus in man

Osseous repair of the postextraction alveolus in man