• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.3
• /
• pp.281-290
• /
• 2021

Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.34 no.3
• /
• pp.167-174
• /
• 2018

Purpose: The purpose of present study was to retrospectively analyze the survival rate of implant placed after alveolar ridge preservation by initial stability and radiographic measurements. Materials and Methods: In total, 19 patients who received 21 sandblasted, large-grit, acid-etched (SLA) implants were enrolled in this retrospective study. Implants placed after alveolar ridge preservation technique (ARP) 2 - 3 months healing period, Periotest value (PTV) measured at implant placement and before placed prosthodontics. Marginal bone level (MBL) was measured at implant placement and final recall check. Results: Overall survival rate of implant was 100%. Mean PTV at implant placement was $-0.06{\pm}8.33$ and mean PTV before placed prosthodontics was $-5.75{\pm}1.7$. The range of MBL change was from -0.55 mm to 1.6 mm (Mean: $0.19{\pm}0.58mm$). Conclusion: The findings of present study suggest that the implant paced after alveolar ridge preservation appear high survival rates and stable MBL.

• Journal of the Korean Academy of Esthetic Dentistry
• /
• v.32 no.1
• /
• pp.16-22
• /
• 2023

Esthetic factors are very important in the success of maxillary anterior implant restoration. However, achieving esthetic results is difficult, especially in cases where periodontitis has resulted in severe alveolar bone loss. In the case of maxillary anterior teeth, the alveolar ridge resorption that begins immediately after tooth extraction interferes with the esthetic implant restoration. Therefore immediate implant placement can be performed to minimize the alveolar ridge resorption. However, in severe bone loss cases, immediate implant placement could result in esthetic failure, and this result might cause irreparable problems. We can also perform alveolar ridge preservation and then place implants later. On JCP published in 2019, there is the consensus of European academy of periodontology on the extraction socket management and the timing of implant placement. This consensus states that alveolar ridge preservation should be considered when there is severe labial bone loss in an esthetically important area such as maxillary anterior region. On performing the alveolar ridge preservation, we cannot obtain the primary wound closure, so secondary wound healing is induced with open membrane technique or soft tissue grafting should be performed for primary wound closure. However, the secondary wound healing can have a negative impact on bone regeneration, and soft tissue grafting such as FGG or CT graft can be burdensome for both patients and dentists. On the other hand, by using the granulation tissue in the extraction socket, primary closure can be achieved without soft tissue grafting. Also some studies have shown that granulation tissue in periodontal defects contains stem cells that may help in tissue regeneration. Based on this, implant restorations were performed on maxillary anterior teeth with severe alveolar bone loss by alveolar ridge preservation using granulation tissue. In spite of the severe bone defect of the extraction socket, relatively esthetic results could be obtained in implant restorations.

• Journal of Periodontal and Implant Science
• /
• v.47 no.1
• /
• pp.51-63
• /
• 2017

Purpose: Following tooth extraction, alveolar ridge preservation (ARP) can maintain the dimensions of ridge height and width. Although previous studies have demonstrated the effects of ARP, few if any studies have investigated the compressive force applied during grafting. The aim of this study was to determine the effects of different compressive forces on the graft materials during ARP. Methods: After tooth extraction, sockets were filled with deproteinized bovine bone mineral with 10% porcine collagen and covered by a resorbable collagen membrane in a double-layered fashion. The graft materials were compressed using a force of 5 N in the test group (n=12) and a force of 30 N in the control group (n=12). A hidden X suture was performed to secure the graft without primary closure. Cone-beam computed tomography (CBCT) was performed immediately after grafting and 4 months later, just before implant surgery. Tissue samples were retrieved using a trephine bur from the grafted sites during implant surgery for histologic and histomorphometric evaluations. Periotest values (PTVs) were measured to assess the initial stability of the dental implants. Results: Four patients dropped out from the control group and 20 patients finished the study. Both groups healed without any complications. The CBCT measurements showed that the ridge volume was comparably preserved vertically and horizontally in both groups (P>0.05). Histomorphometric analysis demonstrated that the ratio of new bone formation was significantly greater in the test group (P<0.05). The PTVs showed no significant differences between the 2 groups (P>0.05). Conclusions: The application of a greater compressive force on biomaterials during ARP significantly enhanced new bone formation while preserving the horizontal and vertical dimensions of the alveolar ridge. Further studies are required to identity the optimal compressive force for ARP.

• 대한치주과학회:학술대회논문집
• /
• 2006.11a
• /
• pp.168-168
• /
• 2006

• 대한치주과학회:학술대회논문집
• /
• 2004.05a
• /
• pp.16-16
• /
• 2004

• Journal of Periodontal and Implant Science
• /
• v.48 no.4
• /
• pp.236-250
• /
• 2018

Purpose: Resorption of the alveolar bone is an unavoidable consequence of tooth extraction when appropriate alveolar ridge preservation (ARP) measures are not taken. The objective of this trial was to test the hypothesis that dimensional changes in the alveolar bone after tooth extraction would be reduced by inserting an equine collagen membrane and a collagen cone to fill and seal the alveolus (as ARP), in comparison to extraction with untreated alveoli. Methods: In this randomized clinical trial, 31 patients were directly treated with the collagen material after extraction of a tooth from the maxilla (the ARP group). Twenty-nine patients served as the control group. After extraction, no further treatment (i.e., no socket preservation measures) was performed in the control group. Changes in the alveolar process immediately after extraction and after an 8 (${\pm}1$)-week healing period were evaluated 3-dimensionally. Blinded analyses were performed after superimposing the data from the digitalized impressions and surfaces generated by cone-beam computed tomography. Results: Both the ARP and control groups showed a reduction of bone in the alveolar area after tooth extraction. However, significantly less bone resorption was detected in the clinically relevant buccal region in the ARP group. The median bone reduction was 1.18 mm in the ARP group and 5.06 mm in the control group (P=0.03). Conclusions: The proposed hypothesis that inserting a combination material comprising a collagen cone and membrane would lead to a difference in alveolar bone preservation can be accepted for the clinically relevant buccal distance. In this area, implantation of the collagen material led to significantly less alveolar bone resorption. German Clinical Trials Register at www.drks.de, DRKS00004769.

• Journal of Periodontal and Implant Science
• /
• v.47 no.4
• /
• pp.194-210
• /
• 2017

Purpose: The aim of the present study was to evaluate the healing of post-extraction sockets following alveolar ridge preservation clinically, radiologically, and histologically. Methods: Overall, 7 extraction sockets in 7 patients were grafted with demineralised bovine bone mineral and covered with a porcine-derived non-crosslinked collagen matrix (CM). Soft tissue healing was clinically evaluated on the basis of a specific healing index. Horizontal and vertical ridge dimensional changes were assessed clinically and radiographically at baseline and 6 months after implant placement. For histological and histomorphometric analysis, bone biopsies were harvested from the augmented sites during implant surgery 6 months after the socket preservation procedure. Results: Clinically, healing proceeded uneventfully in all the sockets. A trend towards reduced horizontal and vertical socket dimensions was observed from baseline to the final examination. The mean width and height of resorption were 1.21 mm (P=0.005) and 0.46 mm (P=0.004), respectively. Histologically, residual xenograft particles ($31.97%{\pm}3.52%$) were surrounded by either newly formed bone ($16.02%{\pm}7.06%$) or connective tissue ($50.67%{\pm}8.42%$) without fibrous encapsulation. The CM underwent a physiological substitution process in favour of well-vascularised collagen-rich connective tissue. Conclusions: Socket preservation using demineralised bovine bone mineral in combination with CM provided stable dimensional changes of the alveolar ridge associated with good reepithelialisation of the soft tissues during a 6-month healing period.

• Imaging Science in Dentistry
• /
• v.44 no.2
• /
• pp.143-148
• /
• 2014

Purpose: This study evaluated the efficacy of alveolar ridge preservation methods with and without primary wound closure and the relationship between histometric and micro-computed tomographic (CT) data. Materials and Methods: Porcine hydroxyapatite with polytetrafluoroethylene membrane was implanted into a canine extraction socket. The density of the total mineralized tissue, remaining hydroxyapatite, and new bone was analyzed by histometry and micro-CT. The statistical association between these methods was evaluated. Results: Histometry and micro-CT showed that the group which underwent alveolar preservation without primary wound closure had significantly higher new bone density than the group with primary wound closure (P<0.05). However, there was no significant association between the data from histometry and micro-CT analysis. Conclusion: These results suggest that alveolar ridge preservation without primary wound closure enhanced new bone formation more effectively than that with primary wound closure. Further investigation is needed with respect to the comparison of histometry and micro-CT analysis.

• Journal of Periodontal and Implant Science
• /
• v.28 no.3
• /
• pp.409-418
• /
• 1998

The socket preservation technique is very effective in preventing alveolar ridge collapse after tooth extraction. Many technigues have been proposed for the primary closure of the flap and we tested a new graft design, "wing graft", which is a modification of free connective tissue graft in this case report. With this technique, primary closure was achieved without shallowing the vestibule. Additionally some vertical ridge augmentation effect could be observed and therefore good esthetic and functional results were obtained from this technique even in the case where severe bone loss and gingival recession was present. Finally we observed good healing appearance in the donor site after 2weeks. The results from this report suggest that this "wing graft" can be used successfully as an adjunctive procedure with socket preservation technique.