OBJECTIVE: To evaluate and to compare dimensional alterations of hard and soft tissues in molar extraction sites with irregular deficiency of bone plates due to advanced periodontitis receiving two different procedures, namely the flapped and flapless techniques with Bio-Gide membrane covering the Bio-Oss material for ridge preservation. METHODS: Twenty-three patients with 24 infected-molar extraction sites received ridge preservation procedure, the first consecutive 12 sites belonged to the flap group (a full thickness mucoperiosteal flap and primary soft tissue closure) and the following 12 sites belonged to the flapless group (minimal flap with a collagen sponge and a secondary soft tissue closure). Width of keratinized tissue was evaluated before tooth extraction and after 6-month healing. Parallel periapical radiographs were taken immediately and 6 months after extraction to evaluate vertical bone changes. The width of the ridge was measured in the center of the ridge at the time of tooth extraction and after 6 months at implant placement. RESULTS: After 6 months, width of keratinized tissue decreased (1.6±1.5) mm in the flap group (P=0.004) when compared with (0.3±1.6) mm in the flapless group (P>0.05). Both groups showed increases in ridge height from the central aspect, (5.53±4.20) mm for flap group and (7.70±4.35) mm for flapless group. These differences between the groups were not statistically significant (P=0.226). The ridge widths were (9.5±2.2) mm for flap group and (9.3±1.0) mm for flapless group at the time of implant insertion, and no statistical significance was observed between the flap and flapless groups. CONCLUSION The study points out that both ridge preservation techniques were effective in increasing ridge height and minimizing ridge resorption after tooth extraction, and the ridge width allowed the placement of implants 6 months after ridge preservation. The flapless technique gave positive outcome in terms of the keratinized gingival width than that of the flap technique.
Alveolar Process ; Humans ; Molar ; Periodontitis ; Tooth Extraction ; Tooth Socket

Resorption of alveolar bone that occurs following tooth extraction is irreversible, it may compromise the restoration of implants or conventional prostheses. Ridge preservation can minimize ridge resorption after tooth extraction. In this article, healing features of socket after tooth extraction, factors influencing ridge remodeling, and the use of bioma-terials were reviewed.
Alveolar Bone Loss ; Alveolar Process ; Alveolar Ridge Augmentation ; Humans ; Tooth Extraction ; Tooth Socket ; Wound Healing

OBJECTIVE: This study aimed to provide foundation for interproximal bone preservation to improve esthetic effects of inter-implant papillar by alveolar ridge preservation following tooth extraction of maxillary single anterior teeth. METHODS: A total of 30 patients requiring maxillary single anterior teeth extraction were randomly divided into test and control groups (15 cases in each group). The test group underwent alveolar ridge preservation after tooth extraction (Bio-Oss bone powder was implanted in alveolar fossa and fixed with surface free gingival graft suture). No other treatment was performed on the control group after tooth extraction. All patients were scanned using cone beam computed tomography with personalized digital radiographic template at 7 days and 6 months after tooth extraction. Then, measurement of height changes at the interproximal and middle buccal was performed. RESULTS: At the mesial and distal interproximal site, ridge height reduction in the test group measured (0.358±0.151) mm, (0.322±0.180) mm, whereas that of control group reached (0.653±0.260) mm, (0.667±0.274) mm, indicating statistical significance (P<0.05). At the middle buccal site, the ridge height reduction of test group amounted to (0.826±0.307) mm, whereas that of control group totaled (1.510±0.625) mm, also presenting statistical significance (P<0.05). CONCLUSIONS Alveolar ridge preservation can reduce absorption of alveolar crest height after tooth extraction, which could improve esthetic effects of inter-implant papillae gingiva.
Alveolar Bone Loss ; Alveolar Process ; Cone-Beam Computed Tomography ; Esthetics, Dental ; Humans ; Tooth Extraction ; Tooth Socket

PURPOSE: Following tooth extraction caused by severe periodontitis, alveolar ridge dimension lose their original volume. To reduce the alveolar ridge dimension, the ridge preservation technique has been introduced and tested in many clinical studies with membrane alone or membrane plus graft, achieving reduced ridge loss compared to extraction only. The aim of the present clinical study was to compare the post-extraction dimensional changes in the membrane exposure group to non-exposure group during healing period following ridge preservation technique. METHODS: Ridge preservation was performed in 44 extraction sites. After extraction, deproteinized bovine bone mineral coated with synthetic oligopeptide (Ossgen-X15(R)) or deproteinized bovine bone mineral (Bio-Oss(R)) was implanted into the socket. A collagen membrane (Bio-Gide(R)) was trimmed to cover the socket completely and applied to the entrance of the socket. Four clinical parameters were compared between baseline and 6 months. RESULTS: During healing period, membrane exposure was observed at 19 sites. At the re-entry, hard newly formed tissue were observed at the ridge preservation site. The grafted socket sites were well preserved in their volume dimension. In both groups, horizontal ridge width was reduced and vertical height was increased. There were not statistically significant differences in horizontal (-1.32 mm vs -1.00 mm) and vertical ridge change (2.24 mm vs 2.37 mm at buccal crest, 1.36 mm vs. 1.53 mm at lingual crest) between two groups. CONCLUSIONS: The ridge preservation approach after tooth extraction effectively prevented resorption of hard tissue ridge in spite of membrane exposure during healing period.
Alveolar Process ; Bone Substitutes ; Collagen ; Membranes ; Periodontitis ; Tooth Extraction ; Tooth Socket ; Transplants

PURPOSE: The healing process following tooth extraction apparently results in a pronounced resorption of the alveolar ridge. As a result, the width of alveolar ridge is reduced and severe alveolar bone resorption occurs. The purpose of this experiment is to clinically and histologically evaluate the results of using horse-derived bone mineral for socket preservation. METHODS: The study comprised 4 patients who were scheduled for extraction as a consequence of severe chronic periodontitis or apical lesion. The extraction was followed by socket preservation using horse-derived bone minerals. Clinical parameters included buccal-palatal width, mid-buccal crest height, and mid-palatal crest height. A histologic examination was conducted. RESULTS: The surgical sites healed uneventfully. The mean ridge width was 7.75 +/- 2.75 mm at baseline and 7.00 +/- 2.45 mm at 6 months. The ridge width exhibited no significant difference between baseline and 6 months. The mean buccal crest height at baseline was 7.5 +/- 5.20 mm, and at 6 months, 3.50 +/- 0.58 mm. The mean palatal crest height at baseline was 7.75 +/- 3.10 mm, and at 6 months, 5.00 +/- 0.82 mm. There were no significant differences between baseline and 6 months regarding buccal and palatal crest heights. The amount of newly formed bone was 9.88 +/- 2.90%, the amount of graft particles was 42.62 +/- 6.57%, and the amount of soft tissue was 47.50 +/- 9.28%. CONCLUSIONS: Socket preservation using horse-derived bone mineral can effectively maintain ridge dimensions following tooth extraction and can promote new bone formation through osteoconductive activities.
Alveolar Process ; Bone Resorption ; Bone Substitutes ; Chronic Periodontitis ; Humans ; Minerals ; Osteogenesis ; Tooth Extraction ; Tooth Socket ; Transplants

PURPOSE: The aim of this study was to radiographically and clinically compare the effect of extracellular matrix (ECM) membranes on dimensional alterations following a ridge preservation procedure. METHODS: One of 2 different ECM membranes was applied during a ridge preservation procedure. A widely used ECM membrane (WEM; Bio-Gide, Geistlich Biomaterials, Wolhusen, Switzerland) was applied in the treatment group and a newly developed ECM membrane (NEM; Lyso-Gide, Oscotec Inc., Seongnam, Korea) was applied in the control group. Cone-beam computed tomography (CBCT) scans and alginate impressions were obtained 1 week and 6 months after the ridge preservation procedure. Results were analyzed using the independent t-test and the nonparametric Mann-Whitney U test. RESULTS: There were no significant differences between the ECM membranes in the changes in the dimension, width, and height of the extraction socket or the quantity of bone tissue. CONCLUSIONS: The NEM showed comparable clinical and radiographic results to the WEM following the ridge preservation procedure.
Alveolar Bone Grafting ; Alveolar Process* ; Biocompatible Materials ; Bone and Bones ; Bone Regeneration ; Clinical Study* ; Cone-Beam Computed Tomography ; Extracellular Matrix ; Gyeonggi-do ; Imaging, Three-Dimensional ; Membranes* ; Tooth Socket

PURPOSE: The purpose of this study was to provide an actual guideline in determining the shape, diameter, and position of the implant in immediate implantation by the measurement of the thickness of facial and palatal plate, the thickness of cortical bone on the facial and palatal plate, the diameter of the root, and the distance between the roots in the cadavers. MATERIALS AND METHODS: The horizontal sections of 20 maxillae were measured and analyzed to obtain the average values. Resin blocks were produced and cut serially at 1 mm intervals from the cervical line to the root apex. Images of each section were obtained and the following measurements were performed: The thickness of the facial and palatal residual bone at each root surface, the thickness of the facial and palatal cortical bone at the interdental region, the diameter of all roots of each section on the faciopalatal and mesiodistal diameter, and the interroot distance. Three specimens with measurements close to the average values were chosen and 3-dimensional images were reconstructed. RESULTS: The thickness of the facial and palatal cortical bone at the interdental region in the maxilla, the buccal cortical bone was thicker in the posterior region compared to the anterior region. The interroot distance of the alveolar bone thickness between the roots increased from anterior to posterior region and from coronal to apical in the maxilla. CONCLUSION: In this study, the limited results of the morphometric analysis of the alveolar ridge using the sections of maxilla in the cadavers may offer the useful information when planning and selecting optimal implant for immediate implantation in the maxilla.
Alveolar Process ; Cadaver ; Maxilla

alveolar ridge and allows the surgeon to widein the ridge in routine office procedure. Therefore, it is the treatment of choice to implant the maxilla with narrow alveolar ridge This article presents clinical cases and discusses the advantage, rationale and surgical protocol of REO technique.]]>
Alveolar Process ; Maxilla ; Osteotomy

< 0.05). Also significant difference is on volume resorption on two groups (P < 0.05). CONCLUSION: We found that more bone resorption occurred with iliac(endochondral) bone and when we use intraoral bone, that bone can maintain their vitality for alveolar ridge augmentation.
Alveolar Process* ; Alveolar Ridge Augmentation* ; Bone Resorption*

Alveolar Bone Loss ; diagnosis ; Alveolar Process ; Humans