scholarly journals Extraction socket preservation using a collagen plug combined withplatelet-rich plasma (PRP): A comparative clinico-radiographic study

2020 ◽  
Vol 14 (2) ◽  
pp. 139-145
Author(s):  
Numaan Nisar ◽  
Kumar Nilesh ◽  
Mushtaq Ishaq Parkar ◽  
Prashant Punde

Background. Alveolar bone remodeling after tooth loss results in reduced ridge dimensions in horizontaland vertical planes. To prevent this, various authors have proposed different ridge preservationtechniques. A collagen plug is a novel material that has shown promising results in preserving thealveolar bone. PRP has also yielded favorable outcomes in wound healing and promoted osteoinductionand osteoconduction Methods. Thirty patients of both sexes with an age range of 30–18 years requiring bilateral extractionof teeth with similar tooth root anatomy in the maxilla or mandible were included in the study. Theextraction of teeth was carried out atraumatically. The patients’ arches were randomly divided andlabeled as the test or control sides. Bone width was measured on both sides. A collagen plug, with PRP,was placed, and the extraction socket was sutured on the test side. The control side was just sutured. Abaseline RVG was taken to record the apico-coronal height. The patients were recalled after 10 days forsuture removal and evaluation of wound healing. Parameters were re-evaluated at three and six monthspostoperatively. The data were subjected to t-test and one-way ANOVA. Results. The height of the crestal bone on the grafted side was more when compared to the non-graftedside three and six months after tooth extractions, and the difference was statically significant (P<0.001).No statistically significant difference was seen in the width of the alveolar bone three and six monthsafter tooth extraction (P>0.05). Conclusion. Collagen and PRP provided reasonable socket preservation as simple and inexpensiveoptions as compared to other materials.

Scanning ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Jin-Hyun Kim ◽  
Puneet Wadhwa ◽  
HongXin Cai ◽  
Dong-Hyung Kim ◽  
Bing Cheng Zhao ◽  
...  

This study is aimed at assessing the dimensional alterations occurring in the alveolar bone after premolar extraction in dogs with histomorphometric and histological analysis. After atraumatic premolar extraction, tooth-derived bone graft material was grafted in the extraction socket of the premolar region in the lower jaws of six dogs in two experimental groups. In the second experimental group, BM-MSCs were added together with the graft. The control was left untreated on the opposite side. After twelve weeks, all six animals were sacrificed. Differences in alveolar bone height crests lingually and buccally, and alveolar bone width at 1, 3, and 5 mm infracrestally, were examined. Histologic study revealed osteoconductive properties of tooth biomaterial. A statistically significant difference was detected between the test and control groups. In the test groups, a reduced loss of vertical and horizontal alveolar bone dimensions compared with the control group was observed. Tooth bone graft material may be considered useful for alveolar ridge preservation after tooth extraction, as it could limit the natural bone resorption process.


2018 ◽  
Vol 1 (2) ◽  
pp. 1-17
Author(s):  
Fahcreza ◽  
Elsa Iskandar ◽  
Rachmat Hidayat ◽  
Petty Purwanita ◽  
Anang Tribowo ◽  
...  

Abstract Background: Chemical trauma to the cornea is an emergency condition of the eye that requires early diagnosis and good treatment. Alkaline have ability to saponify fatty acids in cells and cell membranes which can make penetration into the stroma and destroy proteoglycans and collagen in cells. Aloe vera (AV) contains several active substances that are reported to have anti-inflammatory, immunomodulatory, and wound healing effects. AV has been reported to accelerate the healing process of corneal epithelial defects by increasing fibroblast proliferation, collagen production and growth factor production. This study aims to determine the difference between the effect of aloe vera extract with a concentration of 10%, 20%, 40% and BSS on the healing of extensive corneal lesions in white wistar rats alkaline trauma models. Method: This study was an experimental study with a pre and posttest only with control group design in vivo approach to 30 Wistar white rats which were divided into 5 treatment groups for 3 days. Comparative analysis of effectiveness using the ANNOVA test or the Kruskal Wallis test and continued by the post hoc test. Results: Based on the one way ANOVA test there was a statistically significant difference in effectiveness between the five treatment groups on the percentage of corneal wound healing area and TGF-β expression with an assessment of p = 0,000 each. The administration of alloevera (AV) concentration of 20% had a significant difference in percentage of healing of corneal lesions and TGF-β expression compared with other treatment groups with p = 0,000 each. Large differences in the area of corneal lesions in the 40% AV group were -0.45 in the BBS group, 0.146 in the 10% AV group, 0.493 in the 20% AV group. The difference in the AV group 10% was 0.30 in the BBS group, -064 in the AV group 20%, and -0.14 in the AV group 40%. However, TGFβ expression in the normal control group that did not receive treatment was 54.94 (53.21-56-12). TGFβ levels in the BSS group were 10.44, the 10% aloe vera group was 25.43, 47.99 for the 20% aloe vera group and 37.95 for the 40% aloe vera group. Conclusion: There is a difference between the effect of aloe vera extract with concentrations of 10%, 20%, 40% and BSS on the extensive healing of corneal lesions in white wistar rats with alkaline chemical trauma models.


e-GIGI ◽  
2019 ◽  
Vol 7 (2) ◽  
Author(s):  
Lidia A. Kewo ◽  
Damajanty H.C. Pangemanan ◽  
Aurelia Supit

Abstract: To date, there are lots of documentations about the adverse effects of smoking on the oral cavity. Albeit, smoking is still considered as a casual thing in our community. Chemicals contained in the cigarette smoke can irritate the gums and soft tissues of the mouth, thus inhibiting wound healing after tooth extraction. This study was aimed to determine the difference in post-extraction dental wound healing between smokers and non-smokers. This was a comparative analytical study with a cross sectional design. Samples were obtained by using total sampling method. Subjects consisted of 16 smokers and 16 non-smokers that fulfilled the study eligibility criteria. Their oral cavities were examined to check the signs of inflammation (calor, dolor, rubor, tumor, and functio laesa). The results showed that there was a difference in post-extraction wound healing in inflammatory phase between smokers and non-smokers. As many as 9.4% of smoker patients and 34.4% of non-smoker patients recovered at 7 days post extraction. The Mann Whitney U test showed a p-value of 0.005. In conclusion, there was a significant difference in post-extraction wound healing between smokers and non-smokers.Keywords: smokers, non-smokers tooth extraction, wound healing Abstrak: Kebiasaan merokok bukan merupakan hal asing di masyarakat walaupun banyak dokumentasi mengenai akibat buruk dari merokok terhadap rongga mulut. Bahan kimia yang terdapat dalam asap rokok dapat mengiritasi gusi dan jaringan lunak mulut sehingga menghambat penyembuhan luka pasca ekstraksi gigi. Penelitian ini bertujuan untuk mengetahui perbedaan penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan bukan perokok. Jenis penelitian ialah analitik komparatif dengan desain potong lintang. Pengambilan sampel menggunakan total sampling yang memenuhi kriteria penelitian. Terdapat sebanyak 16 orang perokok dan 16 orang bukan perokok sebagai subyek penelitian. Pemeriksaan rongga mulut dilakukan untuk melihat tanda-tanda inflamasi (kalor, dolor, rubor, tumor, dan fungsio laesa). Hasil penelitian menunjukkan terdapat perbedaan penyembuhan luka 7 hari pasca ekstraksi gigi pada fase inflamasi antara pasien perokok dengan yang bukan perokok; sebanyak 9,4% pasien perokok dan 34,4% pasien bukan perokok yang sudah sembuh. Hasil uji Mann Whitney U mendapatkan nilai p=0,005. Simpulan penelitian ini ialah terdapat perbedaan bermakna dalam penyembuhan luka pasca ekstraksi gigi antara pasien perokok dengan yang bukan perokokKata kunci: perokok, bukan perokok, ekstraksi gigi, penyembuhan luka


2019 ◽  
Vol 52 (1) ◽  
pp. 13
Author(s):  
Amiyatun Naini ◽  
I Ketut Sudiana ◽  
Mohammad Rubianto ◽  
Utari Kresnoadi ◽  
Faurier Dzar Eljabbar Latief

Background: Damage to bone tissue resulting from tooth extraction will cause alveolar bone resorption. Therefore, a material for preserving alveolar sockets capable of maintaining bone is required. Hydroxyapatite Gypsum Puger (HAGP) is a bio-ceramic material that can be used as an alternative material for alveolar socket preservation. The porous and rough surface of HAGP renders it a good medium for osteoblast cells to penetrate and attach themselves to. In general, bone mass is regulated through a remodeling process consisting of two phases, namely; bone formation by osteoblasts and bone resorption by osteoclasts. Purpose: This research aims to identify the effects of HAGP scaffold application on the number of osteoblasts and osteoclasts, as well as on the width of trabecular bone area in the alveolar sockets of rats. Methods: This research used Posttest Only Control Group Design. There were three research groups, namely: a group with 2.5% HAGP scaffold, a group with 5% HAGP scaffold and a group with 10% HAGP scaffold. The number of samples in each group was six. HAGP scaffold at concentrations of 2.5%, 5% and 10% was then mixed with PEG (Polyethylene Glycol). The Wistar rats were anesthetized intra-muscularly with 100 mg/ml of ketamine and 20 mg/ml of xylazine base at a ratio of 1:1 with a dose of 0.08-0.2 ml/kgBB. Extraction of the left mandibular incisor was performed before 0.1 ml preservation of HAGP scaffold + PEG material was introduced into the extraction sockets and suturing was performed. 7 days after preparation of the rat bone tissue, an Hematoxilin Eosin staining process was conducted in order that observation under a microscope could be performed. Results: There were significant differences in both the number of osteoclasts and osteoblasts between the 2.5% HAGP group, the 5% HAGP group and the 10% HAGP group (p = 0.000). Similarly, significant differences in the width of the trabecular bone area existed between the 5% HAGP group and the 10% HAGP group, as well as between the 2.5% HAGP group and the 10% HAGP group (p=0.000). In contrast, there was no significant difference in the width of the trabecular bone area between the 2.5% HAGP group and the 5% HAGP group. Conclusion: The application of HAGP scaffold can reduce osteoclasts, increase osteoblasts and extend the trabecular area in the alveolar bone sockets of rats.


Author(s):  
Alessandra Impellizzeri ◽  
Martina Horodynski ◽  
Riccardo Fusco ◽  
Gaspare Palaia ◽  
Antonella Polimeni ◽  
...  

This study aimed to investigate the effectiveness of photobiomodulation therapy (PBMT) on the acceleration of orthodontic movements, deriving from its biostimulating and regenerative capacity on soft tissues, consequent to the increase in differentiation, proliferation, and activity of cells that are involved with alveolar bone remodeling. The present randomized controlled trial was conducted on six patients who required extractive orthodontic therapy because their ectopic canines had erupted. A total of eight canines were analyzed, four of which received laser irradiation (i.e., experimental group). Two weeks after the extractions, all canines of the experimental and placebo groups were distalized simultaneously and symmetrically with the laceback retraction technique. The PBMT protocol consisted of four cycles of laser applications, one each on days 0, 3, 7, and 14 of the study, with session treatment durations of 2–4 min. The results of the descriptive analysis on the distal displacement speed of the canines after 1 month of follow-up indicate an average displacement of 1.35 mm for the non-irradiated group and 1.98 mm for the irradiated group. Through inferential analysis, a statistically significant difference (p < 0.05) was found between the average speed of the irradiated canines and the control canines. The low energy density laser used in this study, with the parameters set, was found to be a tool capable of statistically significantly accelerating the distal displacement of canines.


Materials ◽  
2021 ◽  
Vol 14 (16) ◽  
pp. 4457
Author(s):  
Xiaoxu Zhang ◽  
Ikiru Atsuta ◽  
Ikue Narimatsu ◽  
Nobuyuki Ueda ◽  
Ryosuke Takahashi ◽  
...  

The objective of this study was to investigate a bone graft substitute containing carbonate apatite (CO3Ap) to analyze bone replacement and the state of bone formation in vitro and in vivo compared with autogenous bone (AB) or control. An osteoclast precursor cell line was cultured with AB or CO3Ap, and morphological analysis using scanning electron microscopy and a tartrate-resistant acid phosphatase activity assay were performed. The right maxillary first and second molars of Wistar rats were extracted and compensated by AB or CO3Ap granules. Following implantation, the bone formation state was evaluated after 3, 5, 7, 14, and 28 days of surgery by micro-computed tomography and immunohistostaining. The osteoclast-like cell morphology was typical with many cell protrusions in the AB and CO3Ap groups. Additionally, the number of osteoclast-like cells formed in the culture increased in each group; however, there was no significant difference between the AB and CO3Ap groups. Five days after tooth extraction, osteoclasts were observed near CO3Ap. The bone thickness in the CO3Ap group was significantly increased than that in the control group and the bone formation in the CO3Ap group increased by the same level as that in the AB group. CO3Ap is gradually absorbed by osteoclasts in the extraction socket and is easily replaced by alveolar bone. The process of bone replacement by osteoclasts is similar to that of autologous bone. By observing the process of bone replacement in more detail, it may be possible to gain a better understanding of the bone formation and control the amount of bone after surgery.


Materials ◽  
2019 ◽  
Vol 12 (18) ◽  
pp. 2902 ◽  
Author(s):  
Márcio de Carvalho Formiga ◽  
Ulisses Ribeiro Campos Dayube ◽  
Cristiane Kern Chiapetti ◽  
Daniela de Rossi Figueiredo ◽  
Jamil Awad Shibli

When alveolar preservation procedures are not performed after tooth extraction, aesthetic and functional impairment could occur. Guided bone regeneration using polytetrafluoroethylene (PTFE) membranes has proven to be a simple alternative treatment that results in good maintenance of the alveolar bone for mediate/late implant placement. Therefore, this study compared the effect of alveolar preservation with the use of dense PTFE membranes, with and without xenograft material by Computerized tomography-based body composition (CTBC) analysis, after four months of the socket preservation procedure. A total of 29 teeth indicated for extraction. In the test group, the sockets were filled with bone graft biomaterial and subsequently coated with a dense PTFE membrane. In the control group, the sockets were filled with the blood clots and subsequently coated with a dense PTFE membrane. The results we found on the changes of the bone width and height after the procedures were: buccal plate: control group 0.46 mm, test group 0.91 mm; alveolar height: control group −0.41 mm, test group 0.35 mm; cervical third: control group −0.89 mm, test group −0.11 mm; middle third: control group −0.64, test group −0.50; and apical third: control group 0.09 mm, test group −0.14 mm. The use of a xenograft in conjunction with d-PTFE membranes proved to be superior to the use of the same membrane and blood clot only in regions of the crest, middle third, and alveolar height.


2020 ◽  
Vol 99 (8) ◽  
pp. 930-937 ◽  
Author(s):  
C.W. Wang ◽  
S.H. Yu ◽  
T. Fretwurst ◽  
L. Larsson ◽  
J.V. Sugai ◽  
...  

Tooth extraction results in alveolar bone resorption and is accompanied by postoperative swelling and pain. Maresin 1 (MaR1) is a proresolving lipid mediator produced by macrophages during the resolution phase of inflammation, bridging healing and tissue regeneration. The aim of this study was to examine the effects of MaR1 on tooth extraction socket wound healing in a preclinical rat model. The maxillary right first molars of Sprague-Dawley rats were extracted, and gelatin scaffolds were placed into the sockets with or without MaR1. Topical application was also given twice a week until complete socket wound closure up to 14 d. Immediate postoperative pain was assessed by 3 scores. Histology and microcomputed tomography were used to assess socket bone fill and alveolar ridge dimensional changes at selected dates. The assessments of coded specimens were performed by masked, calibrated examiners. Local application of MaR1 potently accelerated extraction socket healing. Macroscopic and histologic analysis revealed a reduced soft tissue wound opening and more rapid re-epithelialization with MaR1 delivery versus vehicle on socket healing. Under micro–computed tomography analysis, MaR1 (especially at 0.05 μg/μL) stimulated greater socket bone fill at day 10 as compared with the vehicle-treated animals, resulting in less buccal plate resorption and a wider alveolar ridge by day 21. Interestingly, an increased ratio of CD206+:CD68+ macrophages was identified in the sockets with MaR1 application under immunohistochemistry and immunofluorescence analysis. As compared with the vehicle therapy, local delivery of MaR1 reduced immediate postoperative surrogate pain score panels. In summary, MaR1 accelerated extraction wound healing, promoted socket bone fill, preserved alveolar ridge bone, and reduced postoperative pain in vivo with a rodent preclinical model. Local administration of MaR1 offers clinical potential to accelerate extraction socket wound healing for more predictable dental implant reconstruction.


Author(s):  
Hsi Kuei Lin ◽  
Yu Hwa Pan ◽  
Eisner Salamanca ◽  
Yu Te Lin ◽  
Wei Jen Chang

After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.


Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 216 ◽  
Author(s):  
Gregor-Georg Zafiropoulos ◽  
Zeljka Kačarević ◽  
Syed Qasim ◽  
Branko Trajkovski

Background and objectives: Non-resorbable dense polytetrafluoroethylene (dPTFE) membranes are widely used for regeneration procedures, alone or in combination with particulate materials. The aim of this work was to examine the efficacy of a newly developed dPTFE membrane in the management of extraction socket healing. Materials and Methods: The extraction premolar sockets of 44 patients (20 men and 24 women) were preserved. One group received prosthetic rehabilitation with a fixed partial denture (FPD) (PROS group, N = 19) and a second group received immediate implant placement (IMPL group, N = 25). The PROS group sockets were augmented with a bovine derived xenograft and covered with a newly developed dPTFE membrane prior to FPD rehabilitation. Results: In the IMPL group, socket preservation was combined with immediate implant placement. Before (T0) and 6 months after surgery (T1), horizontal and vertical dimensions were measured with customized stents. No significant differences in alveolar bone loss from T0 to T1 were observed between the PROS and IMPL groups in the horizontal dimension for any tooth type. There was a significant difference in alveolar bone loss from T0 to T1 between the two groups for only single-rooted maxillary premolars in the vertical dimension. Conclusions: The use of the examined new dPTFE membrane consistently led to the preservation of hard tissue in the extraction sites.


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