Grisi Mf

Titanium membranes in prevention of alveolar collapse after tooth extraction.

Background and Purpose:The resorption of alveolar bone following tooth extraction results in a narrowing and shortening of the residual ridge, which leads to esthetic and restorative problems, and reduces the bone volume available for implant therapy. The aim of this study was to evaluate the prevention of alveolar collapse after tooth extraction, using titanium membrane (Frios Boneshield; DENTSPLY Friadent, Mannheim, Germany), associated (or not) with autologous bone graft. Materials and Methods:A total of 10 nonsmoking healthy subjects, ranging from 35 to 60 years old, were selected for this study. Each patient had a minimum of 2 uni-radicular periodontally hopeless teeth, which were scheduled for extraction. After the procedure, 2 titanium pins were fixed on the vestibular bone surfaces that were used as references for the initial measures (depth, width, and height) of the socket. Of the sockets,1 was randomly chosen to be filled with autologous bone graft (test) removed from superior maxillary tuber, and the other one did not receive the graft (control). A titanium membrane was adapted and fixed, covering the sockets, which remained for at least 10 weeks. After a 6-month healing, the final measures were performed. Results:There was exposure of the membrane in 5 of the 10 treated subjects. Average bone filling (±standard deviation) among the 10 subjects was 8.80 ± 2.93 mm (range 4-13) in the control group and 8.40 ± 3.35 mm (range 4-13) in the test group. Average bone loss in width in both group was 1.40 ± 1.97 mm (range −4-1) in the control group and 1.40 ± 0.98 mm (range −4-0) in the test group. There was no significant statistical difference between groups considering the evaluated standards. Conclusion:The use of titanium membrane, alone or in association with autogenous bone, favored the prevention of alveolar ridge after tooth extraction. This membrane seems to be a possible and safe alternative to other nonresorbable membranes when the prevention of alveolar ridge resorption is the objective.

Acellular dermal matrix and hydroxyapatite in prevention of ridge deformities after tooth extraction.

The aim of this study was to evaluate the role of acellular dermal matrix graft (ADMG) acting as a membrane, associated with a resorbable hydroxyapatite (RHA) in bone regeneration to prevent ridge deformities after tooth extraction. Fifteen patients who had at least 2 noncontiguous, uniradicular teeth indicated for extraction were selected. In group I, the extraction sockets were covered by ADMG alone; and in group II, the alveoli were filled with RHA before the placement of the ADMG. After 6 months, re-entry surgeries and biopsies were performed. Although ridge thickness had been preserved in both groups, the means were significantly greater (P <0.05) for group II when compared to group I (6,8 ± 1.26 and 5.53 ± 1.06). The histologic analysis showed small bone formation in some samples for group II, where the presence of a highly vascularized fibrous connective tissue surrounding the particles was a common finding. Based on the results, it can be concluded that the ADMG was able to preserve ridge thickness and that the additional use of RHA favored the preservation of the ridges along with an increase in the width of keratinized tissue.

Influence of Periodontal Biotype on Buccal Bone Remodeling after Tooth Extraction Using the Flapless Approach with a Xenograft: A Histomorphometric and Fluorescence Study in Small Dogs

BACKGROUNDnSeveral approaches have been used to counteract alveolar bone resorption after tooth extraction.nnnPURPOSEnThe aim of the present study was to evaluate the influence of gingival thickness and bone grafting on buccal bone remodeling in extraction sockets with thin buccal bone, using a flapless approach.nnnMATERIALS AND METHODSnThe gingiva of 8 dogs was thinned at one side of the mandible and mandibular premolars were extracted without flaps. The sockets were randomly assigned to the test group (thin gingiva) (TG), the test group with grafting material TG + GM, the control group (normal gingiva) (CG), or the control group with grafting material CG + GM. Ground sections were prepared from 12-week healing biopsies, and histomorphometry and fluorescence analysis were performed.nnnRESULTSnIn the groups with thin gingiva, numerically greater buccal bone loss was observed, while there were no differences between grafted and nongrafted sites. A numerically higher rate of mineralization was observed for the grafted sites, as compared with the nongrafted sites, at 12 weeks.nnnCONCLUSIONSnA thin buccal bone plate leads to higher bone loss in extraction sockets, even with flapless surgery. The gingival thickness or the use of a graft material did not prevent buccal bone resorption in a naturally thin biotype, but modified the mineralization process.