Alveolar ridge preservation with guided bone regeneration and a synthetic bone substitute or a bovine-derived xenograft: a randomized, controlled clinical trial: Alveolar ridge preservation (original) (raw)
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Clinical Oral Implants Research, 2010
The aim of this randomized, controlled clinical trial was to compare the potential of a synthetic bone substitute or a bovine-derived xenograft combined with a collagen membrane to preserve the alveolar ridge dimensions following tooth extraction. Methods: Twenty-seven patients were randomized into two treatment groups following single tooth extraction in the incisor, canine and premolar area. In the test group, the alveolar socket was grafted with Straumann Bone Ceramic s (SBC), while in the control group, Bio-Oss s deproteinized bovine bone mineral (DBBM) was applied. In both groups, a collagen barrier was used to cover the grafting material. Complete soft tissue coverage of the barriers was not achieved. After 8 months, during re-entry procedures and before implant placement, the horizontal and vertical dimensions of the residual ridge were re-evaluated and trephine biopsies were performed for histological analysis in all patients. Results: Twenty-six patients completed the study. The bucco-lingual dimension of the alveolar ridge decreased by 1.1 AE 1 mm in the SBC group and by 2.1 AE 1 in the DBBM group (Po0.05). Both materials preserved the mesio-distal bone height of the ridge. No differences in the width of buccal and palatal bone plate were observed between the two groups. The histological analysis showed new bone formation in the apical part of the biopsies, which, in some instances, was in direct contact with both SBC and DBBM particles. The coronal part of the biopsies was occupied by a dense fibrous connective tissue surrounding the SBC and DBBM particles. Conclusion: Both biomaterials partially preserved the width and the interproximal bone height of the alveolar ridge.
Dental Research Journal, 2016
Background: Alveolar ridge preservation could be performed immediately following tooth extraction to limit dimensional changes of alveolar process due to bone resorption. The aim of this study was to compare the clinical and histologic outcomes of socket preservation using two different graft materials; deproteinized bovine bone mineral (DBBM) and demineralized freeze-dried bone allograft (DFDBA) with absorbable collagen membrane. Materials and Methods: Twenty extraction sockets in 20 patients were randomly divided into 2 treatment groups: 10 sockets were augmented with DBBM and collagen membrane whereas 10 sockets were filled with DFDBA and covered by collagen membrane. Primary closure was achieved over extraction sockets by flap advancement. Horizontal and vertical ridge dimensional changes were assessed at baseline and after 4-6 months at the time of implant placement. For histological and histomorphometrical analysis, bone samples were harvested from the augmented sites with trephine during implant surgery. All data were analyzed using SPSS version 18 (α=0.05). Results: Clinical measurements revealed that average horizontal reduction was 2.3 ± 0.64 mm for DFDBA and 2.26 ± 0.51 mm for DBBM. Mean vertical ridge resorption at buccal side was 1.29 ± 0.68 mm for DFDBA and 1.1 ± 0.17 mm for DBBM. Moreover, mean vertical ridge reduction at lingual site was 0.41 ± 0.38 mm and 0.35 ± 0.34 mm for DFDBA and DBBM, respectively. No significant differences were seen between two groups in any of those clinical parameters. Histologic analysis showed statistically significant more new bone deposition for DFDBA compared to DBBM (34.49 ± 3.19 vs. 18.76 ± 3.54) (P < 0.01). Residual graft particles were identified significantly more in DBBM (12.77 ± 1.85) than DFDBA (6.06 ± 1.02). Conclusion: Based on the findings of this study, both materials have positive effect on alveolar ridge preservation after tooth extraction, but there was more new bone formation and less residual graft particles in DFDBA group than in DBBM group.
Radiographic alveolar bone changes following ridge preservation with two different biomaterials
Clinical Oral Implants Research, 2011
Objectives: The aim of this randomized controlled trial was to evaluate radiographical bone changes following alveolar ridge preservation with a synthetic bone substitute or a bovine xenograft. Methods: Alveolar ridge preservation was performed in 27 patients randomized in two groups. In the test group (n ¼ 14), the extraction socket was treated with Straumann bone ceramic s (SBC) and a collagen barrier membrane (Bio-Gide s ), whereas in the control group (n ¼ 13) with deproteinized bovine bone mineral and the same barrier. Standardized periapical X-rays were taken at 4 time points, BL: after tooth extraction, GR: immediately after socket grafting, 4M: 16 weeks, 8M: 32 weeks postoperatively. The levels of the alveolar bone crest at the mesial (Mh), and distal (Dh) and central aspects of the socket were measured at all time points. All the radiographs obtained were subtracted from the follow-up images. The gain, loss and unchanged areas in terms of grey values were tested for significant difference between the two groups. Results: In the test group, the Mh and Dh showed a mean difference (AE standard deviation) of 0.9 AE 1.2 and 0.7 AE 1.8 mm, respectively, among BL-8M. In the control group, the Mh and Dh showed a mean difference of 0.4 AE 1.3 and 0.7 AE 1.3 mm, respectively (P40.05). Both treatments presented similar gain in grey values between BL-GR, BL-4M and BL-8M. The SBC presented less loss in grey values between BL-4M and BL-8M (Po0.05). Radiographic assessment underestimated the intrasurgical measurements (mesial and distal) of an average 0.3 mm (95% CI, 0.02-0.6).
2020
Radiographic and Histomorphometric assessment of Autogenous and Anorganic bovine bone graft mixture (Auto/ABB) vs Anorganic Bovine Bone (ABB) vs Absorbable gelatin sponge in alveolar socket preservation. Materials and Methods: 30 patients, 1/group required extraction of mandibular molar tooth. Immediate and 6 months post grafting CBCT radiographs. Crestal flaps, followed by core biopsy. Histomorphometric analysis of mean bone/area and residual percent and radiographical evaluation of bone loss. Results: Auto/ABB loss buccally 2.64 ± 1.48 mm, lingually 1.59 ± 0.86 mm, width 1.63 ± 0.97mm. Mean bone area percent 42.34% residual material percent 32.19%. The ABB loss buccally 1.62mm, lingually 0.48mm and width 1.55mm. Bone area percent was 48.42% and residual percent of 20.87%. The AGS recorded a buccal loss of 1.29mm, lingual 1.44mm and horizontal 0.89mm. The Bone area percent 58.88% and a residual of 20.36%. Conclusion: The Auto/ABB loss was highest in all the radiographical dimensions with the least bone area percent and the highest residual material present giving rise to questioning its effectiveness in socket preservation. ABB had the significant least amount of lingual loss of bone. The AGS showed promising results with the bone area percent recorded the most and the least residual material percent. Alveolar bone atrophy post-extraction has been well documented in the past years. Normal healing event results in a minimal loss of vertical height (around 1 mm), but a substantial loss of width in the buccal-lingual plane (4-6 mm) [1]. Clinical measurements show a three-dimensional loss of alveolar ridge volume of approx. 35 per cent in the first three months and 50 per cent in the first six months. An additional negative side-effect of this resorption process is the simultaneous reduction and shift of the crestal keratinized gingiva [1]. With the expanding literature documentation about the immediate implant installation in fresh extraction sockets, the loss of 57
Journal of Materials Science: Materials in Medicine, 2006
The aim of the present study was to assess the efficacy of a ready-to-use injectable bone substitute on the prevention of alveolar ridge resorption after tooth extraction. Maxillary and mandibular premolars were extracted from 3 Beagle dogs with preservation of alveolar bone. Thereafter, distal sockets were filled with an injectable bone substitute (IBS), obtained by combining a polymer solution and granules of a biphasic calcium phosphate (BCP) ceramic. As a control, the mesial sockets were left unfilled. After a 3 months healing period, specimens were removed and prepared for histomorphometric evaluation with image analysis. Histomorphometric study allowed to measure the mean and the maximal heights of alveolar crest modifications. Results always showed an alveolar bone resorption in unfilled sockets. Resorption in filled maxillary sites was significantly lower than in control sites. Interestingly, an alveolar ridge augmentation was measured in mandibular filled sockets including 30 % of newly-formed bone. It was concluded that an injectable bone substitute composed of a polymeric carrier and calcium phosphate can significantly increase alveolar ridge preservation after tooth extraction.
The Journal of Prosthetic Dentistry, 2003
Statement of problem. No study provides human histologic evidence regarding the use of resorbable collagen membrane for a 2-stage localized alveolar augmentation procedure. Purpose. The purpose of this pilot study was to evaluate the potential of use of a resorbable collagen membrane in conjunction with an autogenous bone graft and inorganic bovine mineral (IBM) for labial/buccal alveolar ridge augmentation prior to placing dental implants. Material and methods. Seven consecutively treated human patients participated in the study. All patients received labial/buccal alveolar ridge augmentation. An autogenous block graft was secured at the recipient site with fixation screws and a mixture of autogenous particulate with IBM was placed at the periphery. Resorbable collagen membrane was used as a barrier. Radiographic and laboratory measurements were made to quantify ridge augmentation and resorption rate. Preoperative and postoperative stone casts were used to quantify alveolar ridge augmentation. Volumetric evaluation was measured in mL whereas linear laboratory evaluation was measured in millimeters. Measurements were made 1 and 6 months after bone grafting. Histologic and histomorphometric analysis from the grafted area evaluated new bone formation, and osteoconductivity of IBM. Results. For all patients Type II to III bone quality was achieved at the augmented sites. The implant survival rate was 100% at second-stage surgery. No complication was observed at the recipient sites. Radiographic evaluation revealed 4.65 mm labial/lingual augmentation, whereas laboratory analysis revealed 4.57 mm. Volumetric laboratory analysis demonstrated 1.00 (Ϯ 0.29) mL alveolar ridge augmentation 6 months after bone grafting and 13.79% resorption between months 1 and 6. Histomorphometric analysis revealed that on average, the area occupied by bone was 34.28% (range 24 to 50; Ϯ9.05),] soft tissue 46.00% (Ϯ9.20%; range 30% to 55%), and IBM particles 19.71% (Ϯ11.74%, range 3% to 42%). The proportion of the surface of the IBM particles in contact with bone was 47.14% (range 15% to 64%; SD 17.21%). Conclusions. Resorbable collagen membranes may be used as barriers for labial/buccal alveolar ridge augmentation procedures. (J Prosthet Dent 2003;90:530-8.) CLINICAL IMPLICATIONS This pilot study demonstrated that resorbable collagen membranes may be used as barriers for labial/buccal alveolar ridge augmentation procedures rather than nonresorbable barriers that require a separate surgical procedure for removal.
International Journal of Implant Dentistry
Purpose The aim of this study was to longitudinally evaluate changes in alveolar bone crest (ABC) levels and differences in resorption rates (RR) between the tested grafting materials following alveolar ridge preservation (ARP) after tooth extraction after 1, 2, and 3 years (T1–T8) of clinical function. Methods Patients were randomly assigned to two different bone allografts (group 1 maxgraft®, group 2 Puros®) for ARP. Non-restorable teeth were minimal traumatically extracted. Sockets were augmented with the tested materials and covered with a pericardium membrane. After 4 months of healing, 36 implants were placed and sites were clinically and radiographically monitored in the mesial (ABC-M), the distal (ABC-D, T1–T8), the bucco-lingual (ABC-BL), buccal (ABC-B) and oral (ABC-O) aspect (T1–T4). Results Changes in (ABC-M), (ABC-D), (ABC-BL), (ABC-B), and (ABC-O) levels showed statistically highly significant differences between T1 and T2 for both bone allografts (p
Alveolar Ridge Preservation Using Xenogeneic Collagen Matrix and Bone Allograft
International Journal of Dentistry, 2014
Alveolar ridge preservation (ARP) has been shown to prevent postextraction bone loss. The aim of this report is to highlight the clinical, radiographic, and histological outcomes following use of a bilayer xenogeneic collagen matrix (XCM) in combination with freeze-dried bone allograft (FDBA) for ARP. Nine patients were treated after extraction of 18 teeth. Following minimal flap elevation and atraumatic extraction, sockets were filled with FDBA. The XCM was adapted to cover the defect and 2-3 mm of adjacent bone and flaps were repositioned. Healing was uneventful in all cases, the XCM remained in place, and any matrix exposure was devoid of further complications. Exposed matrix portions were slowly vascularized and replaced by mature keratinized tissue within 2-3 months. Radiographic and clinical assessment indicated adequate volume of bone for implant placement, with all planned implants placed in acceptable positions. When fixed partial dentures were placed, restorations fulfille...
Journal of Oral Implantology, 2015
Following tooth extraction, ridge preservation procedures are employed to regenerate bone in the extraction socket, limit consequent ridge resorption, and provide a stable base for implant placement. The purpose of this study is to histologically evaluate and compare bone regeneration in extraction sockets grafted with either a putty alloplastic bone substitute or particulate anorganic bovine xenograft utilizing the socket-plug technique. Nineteen patients underwent 20 tooth extractions and ridge preservation following a standardized protocol. Ten sites were grafted with calcium phosphosilicate putty (CPS group) and the remaining 10 with anorganic bovine bone substitute (BO group). Patients were recalled after 4–6 months to evaluate the bone regeneration and to proceed with implant placement. A bone core was obtained during the implant procedure from each site and was used for histologic analysis. Histomorphometry revealed that residual graft values were significantly higher in the ...