OBJECTIVE: To evaluate the clinical and radiographic efficacy of micro crestal flap-alveolar ridge preservation following extraction of mandibular molars with severe periodontitis compared with natural healing, and to preliminarily propose the surgical indication. METHODS: A retrospective analysis was conducted on clinical data from patients with mandibular molars with severe periodontitis either receiving micro crestal flap-alveolar ridge preservation (MCF-ARP group) or undergoing natural healing in department of periodontology, Peking University School and Hospital of Stomatology from September 2013 to June 2021. Cone-beam computed tomography scannings performed before/immediately after extraction (as baseline) and repeated before implantation (after the extraction socket healing) were used to measure the ridge width, height and volumetric changes of the sockets, and the proportion of guided bone regeneration (GBR) during implant therapy were compared between the two groups. RESULTS: Between baseline and healing, significant differences in changes of MCF-ARP group [(8.34±2.81) mm] and natural healing group [(3.82±3.58) mm] in the distances from mandibular canal to center of the tooth socket were recorded (P < 0.001). The ridge width at 1 mm below the most coronal aspect of the crest increased by (3.50±4.88) mm in the MCF-ARP group but decreased by (0.16±5.70) mm in the natural healing group, respectively (P=0.019). After healing, the MCF-ARP group showed the distances from mandibular canal to center of the tooth socket >8 mm in all the cases, with 97.1% exceeding 10 mm. Natural healing group displayed 23.1% of the cases with center bone height < 8 mm and 61.5% exceeding 10 mm. Volume changes at the buccal and lingual aspect as well as the total socket were significantly greater in the MCF-ARP group compared with natural healing group (P < 0.001).At the time of implantation, GBR was performed in 5 out of 68 subjects (8.3%) in the MCF-ARP group, whereas 8 out of 26 subjects (30.8%) in the natural healing group required GBR, reflecting significant difference (P=0.003). CONCLUSION In the sites of mandibular molars with severe periodontitis, when the distances from mandibular canal to center of the tooth socket was not enough (less than 7 mm), clinicians could consider performing the micro crestal flap-alveolar ridge preservation to achieve augmentation for alveolar ridge and reduce the proportion of guided bone regeneration during implant therapy to reduce the difficulty and risk of injuries during implant therapy.
Humans ; Tooth Extraction ; Retrospective Studies ; Surgical Flaps ; Molar/surgery* ; Mandible/surgery* ; Female ; Periodontitis/surgery* ; Male ; Adult ; Middle Aged ; Cone-Beam Computed Tomography ; Alveolar Ridge Augmentation/methods* ; Alveolar Process/surgery* ; Tooth Socket/diagnostic imaging* ; Dental Implantation, Endosseous/methods*

OBJECTIVES: To compare the clinical effects of concentrated growth factor (CGF) membrane and Bio-Gide ^® collagen membrane, combined with Bio-Oss ^® sticky bone respectively in alveolar ridge preservation (ARP) of maxillary anterior teeth. METHODS: Thirty patients who needed alveolar ridge preservation after maxillary anterior tooth extraction were selected and randomly assigned to the Bio-Gide group and the CGF group. In both groups, the extraction sockets were tightly filled with the Bio-Oss^® sticky bone. In the Bio-Gide group used Bio-Gide^® collagen membrane to cover the upper edge of the Bio-Oss^® sticky bone and closed the wound. The CGF group, the CGF membrane was covered on the upper edge of the Bio-Oss^® sticky bone and the wound was closed. The soft tissue wound healing status at 10 days after ARP, the changes in alveolar ridge height and width immediately after ARP and at 6 months after ARP, and the doctor-patient satisfaction at 6 months after ARP were compared and evaluated between the two groups. RESULTS: At 6 months after ARP, there was no statistically significant difference in the changes of alveolar bone width and height between the two groups (P>0.05). However, the CGF group showed better performance in soft tissue healing after ARP and doctor-patient satisfaction, and the differences were statistically significant (P<0.05). CONCLUSIONS Compared with the Bio-Gide^® collagen membrane, the combined application of CGF membrane and Bio-Oss^® sticky bone can lead to better soft tissue healing after ARP of maxillary anterior teeth and higher doctor-patient satisfaction, showing obvious advantages in ARP of maxillary anterior teeth.
Humans ; Maxilla/surgery* ; Tooth Extraction ; Alveolar Process/surgery* ; Membranes, Artificial ; Alveolar Ridge Augmentation/methods* ; Intercellular Signaling Peptides and Proteins/therapeutic use* ; Minerals/therapeutic use* ; Collagen ; Wound Healing ; Tooth Socket/surgery* ; Bone Substitutes/therapeutic use* ; Male ; Female ; Middle Aged ; Alveolar Bone Loss/prevention & control* ; Adult

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Esthetics, Dental ; Alveolar Ridge Augmentation/methods* ; Osseointegration ; Maxilla/surgery* ; Dental Implants, Single-Tooth

Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Dental Implantation ; methods ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged

Alveolar Bone Loss ; surgery ; Alveolar Ridge Augmentation ; Dental Implantation, Endosseous ; methods ; Guided Tissue Regeneration ; methods ; Humans ; Membranes, Artificial ; Polytetrafluoroethylene ; therapeutic use ; Reconstructive Surgical Procedures ; methods ; Tooth Loss ; surgery

AIMTo evaluate the effects of maxillary sinus floor elevation by a tissue-engineered bone complex of beta-tricalcium phosphate (beta-TCP) and autologous osteoblasts in dogs.

METHODOLOGYAutologous osteoblasts from adult Beagle dogs were cultured in vitro. They were further combined with beta-TCP to construct the tissue-engineered bone complex. 12 cases of maxillary sinus floor elevation surgery were made bilaterally in 6 animals and randomly repaired with the following 3 groups of materials: Group A (osteoblasts/beta-TCP); Group B (beta-TCP); Group C (autogenous bone) (n=4 per group). A polychrome sequential fluorescent labeling was performed post-operatively and the animals were sacrificed 24 weeks after operation for histological observation.

RESULTSOur results showed that autologous osteoblasts were successfully expanded and the osteoblastic phenol-types were confirmed by ALP and Alizarin red staining. The cells could attach and proliferate well on the surface of the beta-TCP scaffold. The fluorescent and histological observation showed that the tissue-engineered bone complex had an earlier mineralization and more bone formation inside the scaffold than beta-TCP along or even autologous bone. It had also maximally maintained the elevated sinus height than both control groups.

CONCLUSIONPorous beta-TCP has served as a good scaffold for autologous osteoblasts seeding. The tissue-engineered bone complex with beta-TCP and autologous osteoblasts might be a better alternative to autologous bone for the clinical edentulous maxillary sinus augmentation.

Alkaline Phosphatase ; analysis ; Alveolar Ridge Augmentation ; methods ; Animals ; Anthraquinones ; Biocompatible Materials ; therapeutic use ; Biomarkers ; analysis ; Bone Substitutes ; therapeutic use ; Bone Transplantation ; pathology ; Calcification, Physiologic ; physiology ; Calcium Phosphates ; therapeutic use ; Cell Adhesion ; physiology ; Cell Proliferation ; Dogs ; Fluorescent Dyes ; Guided Tissue Regeneration, Periodontal ; methods ; Maxilla ; surgery ; Maxillary Sinus ; surgery ; Models, Animal ; Osteoblasts ; transplantation ; Osteogenesis ; physiology ; Random Allocation ; Tissue Engineering ; methods ; Tissue Scaffolds ; Transplantation, Autologous

OBJECTIVETo evaluate the use of acellular dermal matrix (ADM) to improve esthetic effects of alveolar ridge in dental implantology.

METHODSFifty patients with similar single missing tooth in the anterior maxilla were randomly divided into two groups: the ADM group was treated with dental implant therapy plus ADM transplantation; the control group was treated with dental implant therapy alone. The periodontal parameters and the changes of horizontal width of alveolar crest at implant zones were evaluated before surgery and 12 weeks after surgery.

RESULTSAll operated sites healed uneventfully. Mean horizontal width of alveolar crest in ADM group increased by (3.10 +/- 0.64) mm at 12 weeks and the control group increased by (0.30 +/- 0.50) mm, The volume increase showed a significant difference groups (P < 0.05). Mean horizontal width of alveolar crest in ADM group was (11.50 +/- 1.48) mm and the contralateral alveolar crest was (11.60 +/- 1.60) mm (P > 0.05).

CONCLUSIONSADM is a suitable material for the treatment of soft tissue deformities due to its biocompatibility and horizontal gain of soft tissue.

Adult ; Alveolar Bone Loss ; surgery ; Alveolar Ridge Augmentation ; methods ; Dental Implants, Single-Tooth ; Dermis ; cytology ; transplantation ; Extracellular Matrix ; transplantation ; Female ; Humans ; Male ; Skin, Artificial

OBJECTIVETo evaluate the quality of the alveolar ridge augmented by Ti-Ni shape memory alloy (Ti-Ni SMA) distractor.

METHODSAll of the mandibular premolars and the first molars were extracted from 12 adult mongrel canines. One month later, box-shaped osteotomy was carried out in the left mandibles and Ti-Ni SMA distractors were imbedded. The right sides served as blank control. The canines were killed 3 or 6 months later and specimens were taken from corresponding area of the experiment sides and the control. Bone mineral density and biomechanical function were measured.

RESULTSBone mineral density, ultimate compressive strength and Young's Modules of the augmented ridge were lower than the blank control three months after distraction. But the indexes increased and showed no significant difference with the control six months after distraction.

CONCLUSIONSThe canines mandibular posterior alveolar ridge could be augmented by distraction osteogenesis using Ti-Ni SMA distractor, and the new bone is strong enough for implant placement.

Alveolar Ridge Augmentation ; methods ; Animals ; Bone Density ; Bone Regeneration ; physiology ; Compressive Strength ; Dogs ; Male ; Mandible ; physiology ; Nickel ; Osteogenesis, Distraction ; Titanium

To investigate the biomechanical influences on two different cleft maxillary 3D finite element models pre- and post-alveolar bone graft, we developed a cleft palate bony model from a 17 year cleft palate male CT scan data and built an alveolar bone-grafted cleft maxillary 3D finite element model through gluing the graft model. Apply vector lip force on the anterior face of the models. Study the press (including S3 principal, S1 principal, von Mises and shear) distribution properties and localized area. The results suggested that the press principal spreads along the alveolar ridge and formed several focused areas. After bone grafted, the shear stress tends to be evenly. The grafted alveolar could resist the medially deformation of alveolar crest and the shear stress to the nasal base bony structure. The conclusions from results demonstrated that the deformation of alveolar ridge is possibly due to the lip pressure after the lip repair. The shear stress along the alveolar ridge could cause the severity of the dentition. The grafted bony structure could even the shear stress distribution evenly other than the distribution properties.
Adolescent ; Alveolar Process ; surgery ; Alveolar Ridge Augmentation ; methods ; Biomechanical Phenomena ; Bone Transplantation ; Cleft Palate ; diagnostic imaging ; physiopathology ; surgery ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; Male ; Maxilla ; diagnostic imaging ; physiopathology ; surgery ; Models, Biological ; Tomography, Spiral Computed

Alveolar Ridge Augmentation ; methods ; Humans ; Osteogenesis, Distraction