Single Tooth Extraction Research Articles

The influence of intra-alveolar application of honey versus Chlorhexidine rinse on the incidence of Alveolar Osteitis following molar teeth extraction. A randomized clinical parallel trial.

BackgroundAlveolar Osteitis (AO) is a complication occurs on the post-extraction days that includes pain and disintegrated blood clot. Chlorhexidine (CHX) rinse after extraction is an effective method for decreasing the incidence of AO. Honey has natural antibacterial properties and effectiveness when it is used as a dressing on burns and wounds. However, the effect of intraoral honey dressings on healing is still not adequately studied. This study aimed to compare pain and AO after extraction of a molar tooth in a group of patients who received the intra-alveolar application of Manuka Honey post-operatively with another group who used 0.2% CHX rinse.Material and MethodsA randomized clinical trial of parallel groups was carried out on 100 patients who had a single molar tooth extraction. They were randomly divided into two groups. Group1 (G1) used 0.2 % CHX twice daily for 7 days. In Group2 (G2), Manuka Honey applied topically by a cotton swab into the socket directly after extraction and on Day3. Re-evaluation, including pain assessment, empty socket, and halitosis was done on day 3 and day 7.ResultsG1 included 43 patients and G2 included 57 patients. Higher grades of pain, more empty sockets, and halitosis were found in G2 than in G1 on day3 and day7 without significant differences. Four cases of AO were found in G1 (9.3%) and 7 cases in G2 (12.3%), without significant difference between the two groups according to Chi-squared tests (p=0.753).ConclusionsThe application of Manuka honey in the extraction socket directly after extraction and on day 3 has been found to be insignificantly less efficient in the prevention of AO than CHX rinse twice daily for seven days. However, honey is promising as natural dressing material and further studies are recommended. Key words:Manuka honey, Chlorhexidine, Alveolar Osteitis, extraction, dry socket.

Should we fear direct oral anticoagulants more than vitamin K antagonists in simple single tooth extraction? A prospective comparative study.

The aim of this prospective comparative clinical study was to evaluate the effect of oral anticoagulants on peri- and post-operative bleeding during simple single tooth extractions, comparing patients in treatment with vitamin K antagonists (VKAs) and patients assuming direct oral anticoagulants (DOACs). Patients under oral anticoagulant therapy needing dental extraction were eligible for entering the study; patientswere enrolled following inclusion and exclusion criteria and divided into VKAs and DOAC group according to the anticoagulation therapy. Included patients underwent a simple single dental extraction with elevators and forceps with a maximum surgical time of 15 minutes, without anticoagulation therapy discontinuation. All participants were assessed pre-operatively, during surgery, 30min minutes and 7days after surgery. Biological complications were registered and post-extraction bleeding was clinically defined according to Iwabuchi classification. Parametric and non-parametric tests were used to evaluate the variables between the groups. Sixty-five patients per group were enrolled and 130 teeth were extracted. The two groups were comparable for pre-, peri-, and post-operative variables. Only 1 patient of DOAC group and 2 patients for VKA group needed medical evaluation for post-extractive bleeding. No statistically significant difference resulted in post-operative bleeding events between the groups (p = 0.425). DOAC and VKA patients showed the same incidence of bleeding complications after simple single tooth extraction. Bleeding events were not statistically significant and not clinically relevant. Patients assuming DOACs can be treated similarly to patients in VKAs therapy with INR index between 2 and 3. Non-ceasing of DOAC therapy seems to be appropriate for simple single dental extractions.

Osseodensification for implant site preparation in the maxilla‐ a prospective study of 97 implants

Background Osseodensification (OD) is an innovative surgical technique for implant site preparation that avoids bone sacrifice, contrary to the conventional drilling protocols. This is possible because of special burs designed to rotate in counter-clockwise direction. It is a nonextraction technique that creates a layer of compacted bone along the surface of an osteotomy, while simultaneously plastically expanding the bony ridge, which can bring many advantages in clinical practice. Aim/Hypothesis To investigate the outcome of osseodensification technique for implant site preparation in the maxilla in different clinical situations. Material and Methods Ninety-seven implants were placed in 41 patients (all of them in the maxilla with OD technique for implant site preparation, except the first pilot drill which was used in clockwise rotation). The implants placed were divided into four different groups. In group A, 60 implants were placed in 24 patients (10 males and 14 females) with reduced bone ridge width (range 3.2–5.1 mm) – in all cases, after expanding the ridge with OD, guided bone regeneration procedure was performed for contour augmentation. In group B, 15 implants were placed in 14 patients (6 males and 8 females) simultaneously with sinus augmentation by crestal approach (initial bone height ranging from 2.9 to 6.1 mm). In group C, 3 implants were placed in 3 male patients immediately after single tooth extraction. In group D, 19 implants were placed in 3 female patients with immediate loading for full-arch rehabilitation. Outcome measures were success rate of osseointegration and gain in bone width and height after site preparation. Results The success rate of osseointegration was 96.9%. Three implants (2 from group A and 1 from group D) in three patients were removed before final impressions because of non-integration. All implants placed had insertion torque values ≥45 N cm at the time of placement. Greater bone expansion occurred at the coronal position compared to the apical. Group A showed a mean ridge expansion of 1.6 mm (range from 1.1 to 2.4 mm). The greatest amount of bone expansion was recorded on initially narrower ridges compared to wider ridges. In group B (sinus lift group), the mean gain in bone height was 5.8 mm (range from 4.2–6.3 mm). Osseodensification clearly helped to optimize the site for the immediate post-extraction implants (group C) and to achieve great values of implant stability and insertion torque for the immediate loading full-arch cases from group D. Conclusions and Clinical Implications Osseodensification is a biomechanical site preparation technique that preserves bone bulk and allows to avoid bone sacrifice. This study validated the bone expansion capacity of OD for predictable ridge expansion with enhanced primary stability and higher insertion torque values. This may be clinically relevant in minimizing implant dehiscences or fenestrations, as was noted in this study. OD can also be used for crestal sinus lift in a simple, safe and predictable way with reduced morbidity.

Gingival Perfusion and Tissue Biomarkers During Early Healing of Postextraction Regenerative Procedures: A Prospective Case Series.

Postextraction alveolar bone loss, mostly affecting the buccal plate, occurs despite regenerative procedures. To better understand possible determinants, this prospective case series assesses gingival blood perfusion and tissue molecular responses in relation to postextraction regenerative outcomes. Adults scheduled to receive bone grafting in maxillary, non-molar, single-tooth extraction sites were recruited. Clinical documentation included the following: 1) probing depth (PD); 2) keratinized tissue width (KT); 3) tissue biotype (TB); and 4) plaque level. Wound closure was clinically evaluated. Gingival blood perfusion was measured by laser Doppler flowmetry (LDF). Wound fluid (WF) and gingival biopsies were analyzed for protein levels and gene expression, respectively, of relevant molecular markers. Bone healing outcomes were determined radiographically (cone-beam computed tomography). Healing was followed for 4 months. Data from 15 patients are reported. Postoperatively, neither complications nor changes in PD, KT, or TB were observed. LDF revealed decreased perfusion followed by hyperemia that persisted for 1 month (P ≤0.05). WF levels of angiopoietin-2, interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α), and vascular endothelial growth factor peaked on day 6 (P ≤0.05) and decreased thereafter. Only IL-8 and TNF-α exhibited increased gene expression. Linear bone changes were negligible. Volumetric bone changes were minimal but statistically significant, with more bone loss when membrane was used (P = 0.05). Gingival blood perfusion after postextraction bone regenerative procedures follows an ischemia-reperfusion model. Transient increases in angiogenic factor levels and prolonged hyperemia characterize the soft tissue response. These soft tissue responses do not determine radiographic bone changes.

Immediate versus delayed loading of a new conical connection implant in the esthetic zone: a randomized study with 2-year follow-up

Aim The aim of this study is to compare immediate versus delayed loading protocol of a new conical connection implant in the esthetic zone. Materials and methods Patients requiring single-tooth extraction for root fractures or periodontal disease in the maxillary or mandibular anterior or premolar areas were selected for the present study. After extraction, implants were placed immediately in fresh sockets. After randomization process, in group A immediate loading was performed while in group B a delayed loading protocol was followed. In both groups mean marginal bone loss was measured through intraoral digital radiographs at 3, 6, 12 and 24-month follow-up. Results At 24-month, a survival rate of 100% was reported. For group A a mean marginal bone loss of 0.10 ± 0.09 mm was found, while for group B a value of 0.11 ± 0.08 mm was measured. No statistically significant differences between groups were found at each time point (P>0.05). Conclusion When used in postextraction immediate and delayed loading implant rehabilitation, the new conical connection implant showed a good clinical outcome at 24-month follow-up.

Periodontal ligament injection versus routine local infiltration for nonsurgical single posterior maxillary permanent tooth extraction: comparative double-blinded randomized clinical study.

AimThe aim of this study was to evaluate the efficacy of, and patients’ subjective responses to, periodontal ligament (PDL) anesthetic injection compared to traditional local-anesthetic infiltration injection for the nonsurgical extraction of one posterior maxillary permanent tooth.Materials and methodsAll patients scheduled for nonsurgical symmetrical maxillary posterior permanent tooth extraction in the Department of Oral and Maxillofacial Surgery at the University of Jordan Hospital, Amman, Jordan over a 7-month period were invited to participate in this prospective randomized double-blinded split-mouth study. Every patient received the recommended volume of 2% lidocaine with 1:100,000 epinephrine for PDL injection on the experimental side and for local infiltration on the control side. A visual analog scale (VAS) and verbal rating scale (VRS) were used to describe pain felt during injection and extraction, respectively. Statistical significance was based on probability values <0.05 and measured using χ2 and Student t-tests and nonparametric Mann–Whitney and Kruskal–Wallis tests.ResultsOf the 73 patients eligible for this study, 55 met the inclusion criteria: 32 males and 23 females, with a mean age of 34.87±14.93 years. Differences in VAS scores and VRS data between the two techniques were statistically significant (P<0.001) and in favor of the infiltration injection.ConclusionThe PDL injection may not be the alternative anesthetic technique of choice to routine local infiltration for the nonsurgical extraction of one posterior maxillary permanent tooth.

Extraction Socket Preservation Using Porcine-Derived Collagen Membrane Alone or Associated with Porcine-Derived Bone. Clinical Results of Randomized Controlled Study.

ABSTRACTObjectivesThe aim of present randomized controlled clinical trial was to clinically evaluate hard tissue changes after extraction socket preservation procedures compared to natural spontaneous healing.Material and MethodsThirty patients were enrolled in the present study and underwent single-tooth extraction in the premolar/molar areas. Ten sites were grafted with porcine-derived bone covered by collagen membrane, 10 covered by porcine-derived collagen membrane alone, and 10 underwent natural spontaneous healing. Vertical and horizontal bone changes after 3-month were evaluated at implant placement.ResultsThe vertical and horizontal bone changes at the extraction sockets treated with collagen membrane alone (vertical: -0.55 [SD 0.11] mm, and horizontal: -1.21 [SD 0.69] mm) and collagen membrane plus porcine-derived bone (vertical: -0.37 [SD 0.7] mm, and horizontal: -0.91 [SD 0.53] mm) were found significantly lower (P < 0.001), when compared to non-grafted sockets (vertical: -2.09 [SD 0.19] mm, and horizontal: -3.96 [SD 0.87] mm).In type 1 extraction sockets, in premolar sites, and in presence of vestibular bone thicknesses ≥ 1.5 mm, the use of collagen membrane alone revealed similar outcomes to those with additional graft material.ConclusionsAt the re-entry surgery, extraction sockets grafted with porcine-derived bone and covered by collagen membrane, and extraction sockets covered by porcine-derived collagen membrane alone, showed significantly lower vertical and horizontal bone changes, compared to extraction sockets sites underwent natural spontaneous healing. However, a complete prevention of remodelling is not achievable, irrespective of the technique used.

Case Selection is Critical for Successful Outcomes Following Immediate Implant Placement in the Esthetic Zone

Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial. Tonetti MS, Cortellini P, Graziani F, Cairo F, Lang NP, Abundo R, Conforti GP, Marquardt S, Rasperini G, Silvestri M, Wallkamm B, Wetzel A. Journal of Clinical Periodontology 2017;44(2):215-24. Nonprofit, Foundations: European Research Group on Periodontology, Genova, Italy Industry: Thommen Medical AG, Switzerland and Geistlich AG, Switzerland (biomaterials). Randomized controlled trial.

RELATIONSHIP BETWEEN DENTAL ANXIETY AND PAIN EXPERIENCE DURING DENTAL EXTRACTIONS

ABSTRACTObjective: To assess the effects of anxiety on pain experienced during dental extractions.Methods: A prospective study was conducted during the academic year July-September 2016, randomly among 60 dental patients who visited theoutpatient Department of Oral and Maxillofacial Surgery, Saveetha Dental College, Saveetha University, Chennai, for single tooth extraction. Anxietywas measured using the Hamilton anxiety rating scale. The pain was measured using the pain visual analog scale (VAS) for the level of pain perceivedduring extraction. Data collected were analyzed with Statistical Package for Social Sciences for Windows, Version 16.0 (SPSS Inc., Chicago, IL, USA)and results obtained.Results: From regression analysis, R2=0.605 which meant that the independent variable (anxiety) explained 60.50% of the variability of the dependentvariable (pain) with significant t-value. There was a statistically significant correlation between VAS and total anxiety score (p&lt;0.05). This stronglysuggests that an increase in pain level is associated with an increase in anxiety level.Conclusion: Pre-operative dental anxiety is a major predictor of pain experienced by patients during dental extractions. Hence, it is an important toreduce anxiety before treatment to reduce pain during the treatment. Pharmacologic modalities like sedation can be used for reducing anxiety andpain related to the treatment in indicated patients.Keywords: Dental anxiety, Sedation, Anesthesia, Pain, Tooth extraction.

Single-Tooth Implant Restorations in Fresh Extraction Sockets of the Maxillary Esthetic Zone: Two-Year Results of a Prospective Cohort Study.

In this prospective study, 15 patients received 15 variable-thread tapered implants placed in fresh extraction sites in the maxillary esthetic zone and immediately were provisionalized out of occlusion. Of the 15 patients, 11 completed their 2-year follow-up. At 2 years, the success and cumulative survival rates were both 100%, and the mean bone level gain was 0.83 mm. Soft tissue assessment showed no zero esthetic scores, improved papilla indices, and low bleeding on probing and plaque accumulation. Overall, the study implants showed excellent hard tissue, soft tissue, and esthetic outcomes, indicating a healthy tissue response in single-tooth extraction sites in the maxillary esthetic zone.

Platelet-rich fibrin application in immediate implant placement

The dental rehabilitation of a patient following single-tooth extraction in the esthetic zone is often clinically challenging. The treatment option for this is implant-supported single crown which has the advantage that adjacent teeth do not have to be prepared, as in a fixed prosthesis. This article presents a case of immediate implant placement in relation to 22 and a guided bone regeneration approach with platelet-rich fibrin (PRF) and bone graft. After immediate implant placement, to compensate for the gap (jumping distance) between the implant surface and bone walls of the socket, we used bone grafts and PRF clot as well as PRF membrane to achieve guided bone regeneration. PRF, which is the second generation platelet concentrate, offers the surgeon an access to growth factors with a simple and available technology. These growth factors, which are autologous, nontoxic, and nonimmunogenic, enhance and accelerate the normal bone regeneration pathways. The case presented showed successful outcome with a 1 year follow-up period.

Evaluation of role of antiplatelet therapy on bleeding after dental extraction

Aims and Objectives: Antiplatelet therapy results in altered platelet function and increased bleeding time (BT). The present study was done to evaluate antiplatelet therapy on bleeding after dental extraction. Materials and Methods: In this prospective case–control study, a total of 150 patients requiring dental extraction were divided into two equal groups; Group I: with 75 patients on antiplatelet therapy and Group II: with 75 patients who have discontinued antiplatelet therapy 5 days before the dental extraction. Informed consent was obtained from the participants, and ethical approval was obtained from the Institutional Ethical Committee. Prior to extraction, BT of all the participants was recorded. Simple extraction for single-molar tooth was done in both the groups under local anesthesia. Suturing followed by pressure pack was placed after extraction. BT after extraction was statistically compared between the groups after 1 h and 24 h using Chi-square test with P < 0.05. Results: None of the patients in both the groups showed active bleeding 1 h and 24 h postoperatively. No bleeding was seen in 71 patients in Group I and 74 patients in Group II after 24 h. Conclusion: The present study showed no significant difference in BT in both the groups. Hence, single-tooth extraction can be done in patients on long-term antiplatelet therapy without discontinuation or alteration of medication.

Ex Vivo Scanning Electron Microscopy Evaluation of Cleaning Efficacy Following In Vivo Endodontic Treatment: A Report of 2 Cases

In endodontic therapy, thorough cleaning of the root canal system which results in the complete or near elimination of diseased or necrotic pulp tissue and resident microorganisms is the most critical factor in ensuring a favorable outcome. Removal of both debris and the smear layer from the canals is important, since organic matter from these materials may promote bacterial growth and inhibit obturation materials from having proper contact with the canal wall. This report of two cases is the first known presentation of teeth receiving in vivo treatment and then analyzed post extraction via ex vivo scanning electron microscopy (SEM). The two cases describe patients with similar clinical presentation and diagnoses who required single-tooth extractions. The treating clinician provided in vivo chairside endodontic therapy using two different available treatment modalities: standard root canal treatment and the GentleWave® Procedure. The teeth were then extracted and underwent ex vivo SEM analyses as part of an ongoing clinical study. Similarities and differences in the level of debridement in the root canal systems were observed between the two cases, with greater reduction in accumulated debris and smear layer scores present in the tooth treated with the GentleWave Procedure. Further research is ongoing to provide additional evidence-based data regarding outcomes related to the cleaning efficacy of different endodontic therapies.

Esthetic Outcome of Implants Placed in Fresh Extraction Sockets by Clinicians with or without Experience: A Medium-Term Retrospective Evaluation.

This study discussed a 3-year retrospective survey of clinical and esthetic outcomes of immediate implants placed by experienced senior surgeons and residents in implant dentistry. The retrospective chart review included patients who received single-tooth extraction and immediate implant placement at the Tuscan Stomatology Institute between 2009 and 2011. Treated independent postextraction areas were divided into two groups according to the operator's experience: expert versus nonexpert group. Patient satisfaction with the esthetic aspect, chewing, speaking, comfort, self-esteem, and ease of cleaning were assessed by visual analog scales. Changes in the marginal bone level and parameters describing the changes of the facial soft tissue and in papilla index were assessed. Proper pairwise comparison tests were applied with a significant level α = .05. Of the 60 selected patients, 31 were in the expert group and 29 in the nonexpert group. At the 3-year follow-up, findings attested to a significantly higher bone loss in the nonexpert group (1.74 ± 0.59 mm) than those registered in the expert group (1.34 ± 0.45 mm), with a P value of .0044. The papilla index (PI) appeared very stable in the group of experts, whereas it showed a significant loss throughout the study in patients in the nonexpert group (PI = 2 at 1 year and PI = 1.5 at 3 years). Moreover, significant recessions at the buccal soft tissue were registered for all groups at both check-ups; however, in the expert group, slight soft tissue recession was evident 3 years later (0.58 ± 0.72 mm), whereas the nonexpert group showed greater recession (1.52 ± 0.74 mm). Patients reported higher overall satisfaction when treated by the group of experts (85.2%) than when treated by the nonexperts (81.1%) with P < .0001. The findings from this study suggested that immediate implant procedures could be considered a successful and satisfying treatment strategy when strict selection criteria together with a high level of surgical expertise are applied.

Regenerative Needs Following Alveolar Ridge Preservation Procedures in Compromised and Noncompromised Extraction Sockets: A Cone Beam Computed Tomography Study.

The aim of this study was to evaluate the necessity for additional regenerative procedures following healing of compromised and noncompromised extraction sockets with alveolar ridge preservation procedures through the use of virtual implant imaging software. The cohort was comprised of 87 consecutive patients subjected to a single maxillary tooth extraction with an alveolar ridge preservation procedure for subsequent implant placement. Patients were divided into two main groups based on the integrity of the buccal bone plate following teeth extraction. Patients in the compromised socket (CS) group (n = 52) had partial or complete buccal bone plate loss, and patients in the noncompromised socket (NCS) group (n = 35) exhibited no bone loss of their socket walls following tooth extraction. Following 4 to 6 months of healing, all patients had a cone beam computed tomography (CBCT) study. Root-formed implants were placed virtually in an ideal prosthetic position. The number of implants per group and location (anterior, premolar, molar) exhibiting exposed buccal implant surface was calculated. In the CS group, 5 out of 19 anterior implants (26.3%), 4 out of 14 premolar implants (28.5%), and 7 out of 19 molar implants (36.8%) had exposed buccal surfaces. In the NCS group, 4 out of 9 anterior implants (44.4%), 2 out of 9 premolar implants (22.2%), and 4 out of 17 molar implants (23.5%) had exposed buccal surfaces. There were no statistically significant differences for intragroup and intergroup comparisons (χ² test, P > .05). This study failed to find statistically significant differences in the frequency of implants with exposed buccal surfaces placed virtually, following treatment of compromised and noncompromised sockets. A high proportion (22% to 44%) of sites had implants that potentially needed additional regenerative procedures.

PT131 Bleeding Evaluation During Single Tooth Extraction in Patients With Coronary Artery Disease and Acetylsalicylic Acid Therapy Suspension: A Prospective, Double-Blinded, and Randomized Study

PT131 Bleeding Evaluation During Single Tooth Extraction in Patients With Coronary Artery Disease and Acetylsalicylic Acid Therapy Suspension: A Prospective, Double-Blinded, and Randomized Study

A retrospective analysis of episodes of single tooth extraction under general anaesthesia for adults.

To investigate the provision of adult dental extraction under general anaesthesia (DGA) at the Royal Cornwall Hospitals NHS Trust (RCHT)-- specifically adult single tooth DGA episodes in regards to numbers, demographics, justifications, and appropriateness regarding the use of resources. Data were collected retrospectively from the patient case notes and electronic records for the complete study cohort. This study included all episodes of adult single tooth DGA in all RCHT sites during 2014, except for mandibular third molar and impacted teeth. Each case was tested against the DGA case selection criteria empirically devised for this study. In 2014, 106 episodes of adult single tooth DGA were carried out in RCHT that met the inclusion criteria. Younger females from more socio-economically deprived areas of Cornwall were increasingly likely to have this procedure. Mental disorders were the most prevalent co-morbidity (21.7%) in this cohort. The vast majority of patients (93.4%) had previously tolerated dental treatment without the need for general anaesthesia (GA). Many referrals (46.2%) and listings (30.2%) specifically stated patient demand-driven reasons. None of the cohort had DGA due to failure of sedation. There were potentially 11 episodes that met the DGA case selection criteria. Patients waited for 126 days (median) from the referral date for an operation which took seven minutes (median) to complete. The majority (83%) of the cases were simple exodontia. Twenty patients (18.9%) had previous DGA. Potentially a considerable proportion of GA prescription appeared to be driven by patient demand rather than clinical need. This study poses a fundamental question--what drives the demand for DGA? National data collection and specific DGA case selection criteria are recommended.

The effect of light emitting diode phototherapy on rate of orthodontic tooth movement: a split mouth, controlled clinical trial.

Increasing the rate of orthodontic tooth movement (OTM) can reduce risks such as periodontal disease and caries. This split-mouth randomized controlled clinical trial investigated whether light emitting diode (LED) phototherapy could accelerate the rate of OTM. The study was conducted at the Graduate Orthodontics Clinic at the University of Toronto, Faculty of Dentistry. 17 dental arches from 11 orthodontic participants with bilaterally symmetrical extraction of premolars were included. During space closure of single tooth extraction sites, LED phototherapy was applied to one side of the dental arch for a specified time and the contralateral side acted as the control. Space closure was measured immediately prior to, during and later in space closure. All participants were compliant with LED application. Our results revealed no significant changes in the rate of OTM with LED phototherapy over 3 months of extraction space closure. Our findings were contrary to previous findings of the effect of laser phototherapy on regulating the rate of OTM. Further investigations are warranted to analyse whether the duration or method of LED delivery would have an effect on the rate of OTM. Toronto. This trial was registered at clinicaltrials.gov (NCT01490385).

Ridge preservation surgery after single and multiple adjacent tooth extractions: a microcomputed tomography study in dogs.

The aim of this study was to determine, before implant placement, the outcome of ridge preservation surgery after extractions of one or more adjacent teeth on the dimensions of the edentulous ridge. Nineteen extraction sites in four dogs were randomly divided into three groups: group 1 = single premolars (n = 7 sites); group 2 = two adjacent premolars (n = 6 sites); group 3 = three adjacent premolars (n = 6 sites). Extraction was followed by ridge preservation surgery using a combination of xenograft and collagen membrane after full-thickness flap reflection. All animals were sacrificed 4 months later, and each extraction site was sectioned in the sagittal plane so that alveolar bone measurements could be made in both the buccolingual and apicocoronal directions using microcomputed tomography. Mean buccolingual width of the ridges postsurgery was 4.80 ± 2.78 mm, 4.98 ± 2.65 mm, and 4.79 ± 2.79 mm in groups 1, 2, and 3, respectively. The mean vertical distance from the cementoenamel junction to the crest of the ridge was 1.94 ± 0.42 mm, 2.05 ± 0.48 mm, and 2.60 ± 0.67 mm in groups 1, 2, and 3, respectively. No statistically significant difference was seen between single and multiple extraction sites. Ridge preservation surgery results in a similar pattern of bone remodeling in the horizontal and vertical dimensions of the edentulous ridge after single and multiple adjacent tooth extractions.

Associations between bacteremia from oral sources and distant-site infections: tooth brushing versus single tooth extraction

To determine the impact of antibiotic prophylaxis (AP) on the incidence of bacteremia caused by oral bacterial species associated with infective endocarditis (IE) and prosthetic joint infections (PJIs) and to compare the incidence of following tooth brushing versus single tooth extraction. Bacterial species in blood following single tooth extraction, with or without AP, and tooth brushing(1) were compared with IE- and PJI-associated bacteria reported in the literature. Of the 98 bacterial species identified in blood following single tooth extraction and tooth brushing, 32(1) and 12 were species were associated with IE and PJI, respectively. AP decreased the frequency of IE- and PJI-causing oral bacterial species in blood; however, single tooth extraction versus brushing resulted in bacteremia with IE- and PJI-causing species with similar frequencies: 65% versus 56% for IE, and 31% versus 28% for PJI. Although AP significantly decreased the incidence of bacteremia, the similarity between the incidence of bacteremia following brushing and extraction undermines AP as an effective strategy for the prevention of these distant-site infections.