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At least 199 records · Page 11Linked to original sources
PubMed1975

The bony residual ridge in man.

The bone which fills in the socket after tooth extractions was investigated in 120 dry skull specimens and 100 radiographs in which one or more teeth had been missing for at least three months. The bony content of the socket was of the trabecular type. This trabecular bone was well differentiated from the adjacent cortical bony plates. In buccolingual sections, the residual crest was formed by dense trabecular bone, clearly differentiated from the cortical plates as well as from the less dense trabecular bone that was deeper within the former sockets. From the occlusal aspect, the crest of the edentulous surface had shifted lingually when compared to the original position of the teeth before extractions. From the lateral aspect, the residual ridge formed a concavity or went straight between the alveolar crests of the adjacent remaining teeth. When several teeth were missing, the concavity was more pronounced than when a single tooth was missing.

Adult↗
PubMedDate not supplied

Unhealed extraction sites mimicking TMJ pain.

A case of unhealed extraction sites in the mandible is described, including clinical, radiographic, and biopsy findings. The subject was treated for TMJ disease in the past but still had related signs and symptoms and facial pain.

Adult↗
PubMed2004

Tetracycline compound placement to prevent dry socket: a postoperative study of 200 impacted mandibular third molars.

PURPOSE: Our objective was to study whether the placement of intra-alveolar tetracycline prevents dry sockets or improves the postoperative period. PATIENTS AND METHODS: A comparative clinical study of the surgical removal of 200 impacted mandibular third molars is made, with particular reference to postextraction pain, inflammation, trismus, and the incidence of dry socket. In 50% of these cases, a pharmacologic preparation that includes tetracycline was placed in the socket after removal of the impacted molar. RESULTS: Dry socket was diagnosed in 4 cases (2%), with no relation to intra-alveolar tetracycline placement being observed. The patients who were administered intra-alveolar tetracycline had less pain and trismus and consumed fewer analgesics than the patients who received no such treatment, although statistical significance was not reached. CONCLUSIONS: The intra-alveolar placement of tetracycline compound after the surgical removal of impacted mandibular third molars did not affect the incidence of dry socket.

Administration, Topical↗
PubMedDate not supplied

Immediate implants: their current status.

Immediate implants are implants placed into a prepared extraction socket following tooth removal. Short-term animal and human studies have shown these implants to be comparable to implants placed into healed bone. The advantages of the procedure include fewer surgical sessions, elimination of the waiting period for socket healing, shortened edentulous time period, reduced overall cost, as well as preservation of bone height and width. Although immediate implantation is more demanding both surgically and prosthetically compared to the conventional placement technique, the advantages make it very appealing to patients who are in need of both extractions and implant therapy.

Alveolar Bone Loss↗
PubMed2004

Histomorphometric evaluation of the effect of bovine collagen granules on bone healing. An experimental study in rats.

Collagen materials have been utilized in medicine and dentistry because of their proven biocompatibility and capability of promoting wound healing. The aim of the present experimental study was to perform a histomorphometric evaluation of the effect of bovine collagen granules on post-extraction alveolar wound healing in rats. Twenty male Wistar rats were submitted to bilateral extraction of the first lower molars under ketamine/xylazine anesthesia according to the technique previously described by Guglielmotti and Cabrini. Sterile Bovine collagen granules of approximately 80 +/- 10 microm (Membracel G, Lab. Celina, Buenos Aires) were hydrated with saline solution and placed into the right mesial socket (experimental side) with gentle pressure, completely filling the site. The contralateral sockets were considered as the control side. Sutures were not performed. After surgery neither special diet nor antibiotics were given. The rats were fed rat chow and water ad libitum. All the animals were killed on the 30th day following surgery by ether overdose. The jaws were dissected, radiographed, decalcified, and embedded in paraffin. Sections were obtained at the level of the first molar mesial socket in a buccolingual orientation and stained with hematoxylin-eosin. The trabecular area and volume density of trabecular bone were measured histomorphometrically. The trabecular area was greater in alveoli treated with collagen granules than in control alveoli (P<0.05). Values of volume density of trabecular bone were greater in experimental than in control sockets (P<0.05). This experimental study provides evidence for the use of bovine collagen granules as bone grafting material, as a therapeutic alternative to fill postextraction sockets.

Alveolar Bone Loss↗
PubMed2001

Periodontal healing after replantation of intentionally rotated teeth with healthy and denuded root surfaces.

The purpose of the study was to evaluate periodontal healing after replantation of intentionally rotated teeth with healthy and denuded root surfaces. Ten teeth with hopeless prognoses because of extensive alveolar bone loss and deep pockets extending to the apexes only on one or two surfaces, but with a healthy periodontal apparatus on the other surfaces, were selected. A mucogingival flap was elevated and the teeth were extracted carefully so as not to damage the healthy remnant of the periodontal membrane remaining on the root surfaces. Thorough extra-oral debridement was performed on the contaminated root surface and the remnant was carefully conserved. Retrofilling was also done to eliminate an endodontic cause of attachment loss. The teeth were horizontally rotated and then replanted so that the healthy root would face the connective tissue at the initially periodontally involved sites, and the root planed surfaces, which had been periodontally involved, would face the surfaces of the alveolar sockets at initially healthy sites. The teeth were splinted with adjacent teeth. Clinical parameters and radiographic examination were performed pre-operatively, and at 3 or 6 months, 1, 2, and 3 years postoperatively. One tooth was extracted 1.5 years postoperatively due to reduced support and the treatment strategy of the patient. The other nine teeth were well maintained without any discomfort for the whole maintenance period of 3 years. In all teeth, areas that previously had no pocketing but were now against denuded root surfaces maintained the previous pocket depth readings. In areas where a deep pocket was present but now had a root surface with healthy periodontium, a distinct decrease of mean pocket depth was observed at the first reexamination 3 months postoperatively. The mean radiographic alveolar bone level increased from 0.3% to 45.3% in 2 years and was thereafter maintained for the entire observation period. Loss of periodontal space and possible root resorption were observed in only one case without other ankylotic symptoms. These results suggest that the healing without ankylosis of an extensive denuded root surface may occur by mechanisms other than the maintenance of a viable periodontal ligament on the root surface.

Adult↗
PubMed2005

Are sterile gloves necessary in nonsurgical dental extractions?

PURPOSE: The aim of the study was to compare the incidence of healing complications of extraction socket with the use of sterile or clean nonsterile gloves during nonsurgical dental extractions. MATERIAL AND METHODS: This was a randomized prospective study conducted at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (Nigeria), between October 2002 and January 2003. Patients who were referred for nonsurgical extractions of permanent teeth and who satisfied the inclusion criteria into the study were randomly allocated into 2 groups. One group had their extractions performed with the surgeon wearing a pair of sterile gloves and the second group had their extractions performed with the surgeon wearing a pair of clean nonsterile gloves. Two hundred sixty-nine patients who had 301 teeth extracted and satisfied the inclusion criteria for socket healing assessment were assessed for postoperative socket healing. RESULTS: Three different types of socket healing complications were identified (dry socket, acutely inflamed socket, and acutely infected socket). A total of 32 patients (11.9%) developed socket healing complications. Nineteen of 122 patients in the sterile glove group and 13 of 147 patients in the clean nonsterile glove group developed socket healing complications (P = .09). CONCLUSION: The study confirmed that the use of sterile surgical gloves offers no advantage over clean nonsterile gloves in minimizing extraction socket healing complications following dental extraction. Therefore, nonsurgical dental extraction can be safely performed with the surgeon wearing clean nonsterile gloves.

Adolescent↗
PubMed2000

Use of hydroxyapatite cement to support implants in extraction sockets.

Bioactive cements based on calcium phosphate chemistry have been developed to serve as bone substitute materials. One such commercial product, BoneSource, is a hydroxyapatite cement (HAC) used for small bone defects in the craniofacial complex. We have investigated the possibility that HAC could be used to support bone growth adjacent to dental implants placed in immediate tooth extraction sites. Variable levels of bone contact were noted up to 3 months postimplantation. Considerable loss of HAC occurred and was thought to be because of "washout" of the cement before complete cement setting. When HAC was immobile in the surgical site, the bioactive nature of the cement led to HAC resorption and bone deposition. Efforts to maintain the HAC in situ should be expanded so that the full clinical potential of the HAC can be realized.

Absorbable Implants↗
PubMed1999

Split palatal flap. I. A surgical approach for primary soft tissue healing in ridge augmentation procedures: technique and clinical results.

This article describes a surgical procedure to predictably obtain primary closure over extraction sockets in the maxilla. The technique offers a valuable treatment approach for the achievement of primary soft tissue closure over bone grafts and/or occlusive osteopromotive membranes, although the use of an osteopromotive membrane may not always be necessary in cases of single-tooth extraction. The surgical technique is based on a split-thickness palatal flap in which the pediculated deep portion is rotated to cover the grafted alveolus or membrane. This procedure was used in a total of 40 sites in 32 consecutive patients; a barrier membrane was used in 20 sites. All treated sites allowed proper implant placement after healing. Two membranes became prematurely exposed and one was removed before implant surgery. Proper soft and hard tissue anatomy was predictably obtained prior to implant placement. This surgical procedure is useful in preserving and/or augmenting the alveolar ridge prior to or during implant placement in cases of advanced alveolar bone loss.

Adult↗
PubMed2005

Healing of extraction sockets and surgically produced - augmented and non-augmented - defects in the alveolar ridge. An experimental study in the dog.

OBJECTIVES: The current experiments had three aims (i) to determine whether the absence of the periodontal ligament (PDL) may alter features of the healing of an extraction socket, (ii) to examine if there were differences in the proportion of different tissues in resolved extraction sockets and surgically produced defects after 3 months of healing, (iii) to study the influence of different biomaterials on the healing of surgically produced bone defects. MATERIAL AND METHODS: Extraction sites: In five dogs, the 4th mandibular pre-molars were hemi-sected and the distal roots were removed. The extraction socket of one of the pre-molars was instrumented to eliminate all remnants of the PDL tissue. The socket of the contra-lateral pre-molar was left without instrumentation. The dogs were sacrificed after 3 months of healing. Defect sites: In five dogs, the pre-molars and 1st molars on both sides of the mandible were first removed and 3 months of healing allowed. After this interval three standardized cylindrical defects were prepared in each side of the mandible. The defects were 3.5 mm in diameter and 8 mm deep. In each quadrant one defect was grafted with Bio-Oss Collagen, one with Collagen Sponge and one defect was left non-grafted. The dogs were sacrificed 3 months after the grafting procedure. RESULTS: Extraction sites: The two categories of extraction sockets did not differ with respect to gross morphological features. The tissue of the extraction sites, apical of a newly formed bone bridge, was dominated by bone marrow. Few trabeculae of lamellar bone were also present. Defect sites: The non-augmented defect was sealed by a hard-tissue bridge. In the central and apical portions of the defect bone marrow made up about 61%, and mineralized bone 39% of the tissues. The invagination of the surface of this crestal bone was 0.8+/-0.3 mm. The defect augmented with Collagen Sponge was covered by a hard-tissue bridge 38% of the tissue within the defect was made up of bone marrow while the remaining 62% was occupied by mineralized bone. The invagination of the hard-tissue bridge was on the average 0.6+/-0.1 mm. In defects augmented with Bio-Oss Collagen the biomaterial occupied a substantial portion of the tissue volume. Eighty-five percent of the periphery of the Bio-Oss particles were found to be in direct contact with newly formed mineralized bone. Woven bone and bone marrow made up 47% and 26% of the newly formed tissue. The invagination of the most coronal part of the bone defect was 0.1+/-0.1 mm. CONCLUSION: Sockets that following tooth removal had their PDL tissue removed exhibited similar features of healing after 3 months as sockets which had the PDL retained. The tissues present in an extraction site appeared to be more mature than those present in a surgically produced defect of similar dimension. The Bio-Oss Collagen augmented defect exhibited less wound shrinkage than the non-augmented defect.

Alveolar Process↗
PubMed2000

The effects of local trauma to the enamel-related periodontal tissues in the eruption of the rat incisor.

The periodontal tissues related to enamel (PTE) of the rat incisor comprise a connective tissue derived from the dental follicle and the enamel organ with its successive stages of development. Localized damage to these tissues in rat lower incisors was done surgically in three ways: with an endodontic file introduced into the labial periodontal space through either (i) its basal or (ii) its incisal extremities, or (iii) by the partial removal of the mandibular lower border, at the level of the molar teeth, together with the introduction of an endodontic file into the incisal part of that space. The lesions in the molar region of the PTE produced first a variable period of retarded eruption, and, depending upon their extent or degree were followed by a cessation of the eruptive movement and, in the majority of the operated teeth, a recovery of the normal eruption rate before the end of the experiment (17 weeks after surgery). Access to the PTE through the basal portion of the socket was erratic, but when the tissues were damaged produced similar effects. Effects on eruption of lesions produced through the alveolar crest were minimal or even absent. Localized injury to the periodontal ligament of either lower or upper incisors did not produce similar effects on tooth eruption. The dental follicle and the enamel organ of teeth of limited growth when their crown is completed are similar to the PTE in the molar region of continuously growing rodent incisors. In teeth of limited growth these tissues play an essential part in the intraosseous stage of eruption. The results here suggest that the PTE may also have a role in the supraosseous stage of eruption, which is continuous in teeth such as rat incisors due to the presence of a continuously functioning odontogenic organ.

Alveolar Process↗
PubMed1993

Comparative changes in microvasculature and bone during healing of implant and extraction sites.

The acquisition and maintenance of biological fixation of dental implants are achieved by a rapid and regenerative response of the recipient tissues, especially the vascular and osseous elements. This sequential response is described from initial osteogenesis through remodeling up to 20 weeks after implantation in Macaca fuscata monkeys. The sequential changes in the microvasculature and bone formation in three-dimensional bone-vasculature microcorrosion casts are studied by means of a plastic injection method devised by the author. Micrographs derived from microcorrosion casts reveal that all soft tissues (blood vessels walls, marrow, collagen fiber cells and the like) have been digested, leaving spaces once occupied by these elements, bone, and polymeric material that filled the blood vessels at death. The effects of biomaterial choice, general implant configuration, and interface configuration and material were sequentially analyzed. The effects of one- and two-stage healing variables were not analyzed. The Macaca fuscata monkeys were used for SEM examination of both bioinert and bioactive dental implant materials. The objective of this paper is to describe osseous healing at an implant interface, and compare it with osseous healing in tooth extraction sockets by use of a similar research approach in identical animal models.

Alveolar Process↗
PubMed2001

An evaluation of complications following dental extractions using either sterile or clean gloves.

This randomized prospective study aims to evaluate any differences in the postoperative infection rate from dental extraction using either sterile or clean surgical gloves and to determine any predisposing factors that may complicate socket healing. A total of 609 patients were randomly assigned to two groups, with the operators wearing either sterile or clean gloves in performing forcep extractions. 551 patients, who had 811 extractions performed, returned for the postoperative assessment visit. There was no difference in the incidence of an acutely inflamed socket, acutely infected socket and dry socket and also no significant predisposing factors found between the sterile and clean glove groups. The pre-operative diagnosis of caries, periodontal disease or retained root had a higher tendency of producing an acute-inflamed socket, whereas an acutely infected socket only developed in the cases of retained root. On the pain intensity level, an acutely inflamed socket caused mild to moderate pain, on acutely infected socket caused moderate to severe pain; and a dry socket caused severe pain in the majority of cases. The study concluded that the use of sterile surgical gloves does not offer an advantage over clean gloves in minimizing socket inflammation, infection, as well as a dry socket following dental extraction.

Adolescent↗
PubMed2000

The clinical use of deproteinized bovine bone mineral on bone regeneration in conjunction with immediate implant installation.

Twenty-one c.p. titanium screw-shaped implants were immediately installed after extraction and thorough curettage of the alveoli in 15 patients. Granules of deproteinized bovine bone of 0.25-1.0 mm diameter were used to fill the remaining defect when the distance of the defect wall to the implant surface was > 3 mm. Dimensional measurements of the defect height and width were made with a pocket probe. Fourteen sites in the upper jaw and 7 sites in the lower jaw were thus treated. The mean defect depth varied between 7 mm vestibularly and 10 mm mesially. The mucoperiosteal flaps were hermetically closed. At re-entry, the particles were packed and firmly attached but still distinguishable from the surrounding bone. Of the 21 sites treated, 5 sites had an exposure of the implant cover screw during the healing period. An exposure of the granular material occurred in 4 sites, but loss of granules in only 3. Even in these sites no signs of infection or inflammation of the soft tissues were observed. At re-entry after 6 months, 10 sites were completely and 9 partially filled. For the partial fills, the mean remaining defect height was 1.6 mm (range: 0.6-3.0 mm). Two sites showed an increased defect of respectively 2.4 and 4.8 mm. No fixtures were lost. The present results indicate that deproteinized bovine bone is a safe filling material to fill remaining defects around implants installed in fresh extraction sockets.

Adolescent↗