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PubMedDate not supplied

Immediate implantation of pure titanium implants into extraction sockets of Macaca fascicularis. Part I: Clinical and radiographic assessment.

Immediate implants have the advantages of few surgical exposures, short treatment time, and maintenance of alveolar bone height and width. The purpose of this study was to compare immediate implants with conventional implants (implants placed into ossified extraction sites) in adult monkeys. Forty-eight implants were placed and allowed to heal for a 6-month period. Following a 7-month loading period, the monkeys were sacrificed, and implant sections were evaluated histologically. Clinical and radiographic measurements showed few significant differences between immediate and control implants.

Alveolar Process↗
PubMed1985

Healing following reimplantation of teeth subjected to root planing and citric acid treatment.

The aim of the present study was to examine the effect of citric acid treatment on periodontal healing around teeth which were extracted, root planed and then reimplanted. Maxillary incisors and mandibular incisors, premolars and molars of 5 monkeys were used. The teeth were divided into 3 experimental groups. In 1 group, the teeth were extracted and immediately reimplanted into their own sockets. In a 2nd group, the teeth were extracted, root planed to a level corresponding to 50-75% of the root length and then reimplanted. In the 3rd group, periodontal breakdown extending to 50-75% of the root length was first induced by placing orthodontic elastic ligatures around the teeth. They were then extracted and root planed and transplanted into the sockets of the contralateral, periodontally healthy teeth which had just been extracted. Half the number of the teeth of groups 2 and 3 were treated with citric acid before reimplantation or transplantation. The animals were sacrificed after 6 months of healing. The jaws were removed and histological specimens prepared for microscopic examination. With the exception of a limited coronal regrowth of new cementum in the apical part of the planed portion of a few roots, connective tissue attachment failed to reform on most root surfaces deprived of their periodontal ligament tissue. Healing was most frequently characterized by root resorption and ankylosis. These were the most predominant features of healing both on root surfaces which had been deprived of the ligament tissue by mechanical means or during a course of experimentally-induced periodontal disease, and occurred in citric acid as well as non-citric acid treated roots. The findings imply that the result of healing following tooth reimplantation or transplantation is determined by the type of cells that repopulate the wound area adjacent to the denuded root surface.

Animals↗
PubMed1995

The use of a connective tissue graft for closure over an immediate implant covered with occlusive membrane.

Complete wound closure over an immediate implant is considered to be a desirable goal. This case report describes for the first time the use of a connective tissue autograft placed under the existing flap margins of an extraction socket to successfully achieve closure over an immediate implant covered with an occlusive membrane. The rationale of the method is described. Healing was uneventful and epithelization of the graft surface from surrounding tissues was achieved. This technique created an increased width of keratinized tissue and avoided the need to disrupt the normal anatomical relationships of the surrounding buccal tissues, in contrast to current techniques. The advantages of the technique, together with factors that may influence healing and predictability, are discussed.

Connective Tissue↗
PubMed1987

Identification of cellulose fibers in oral biopsies.

Oral biopsies comprising five periapical cysts, three cases of exuberant granulation tissue in extraction sockets and one case of a mandibular radiopaque structure, all displaying material consistent with cellulose fibers on routine histologic examination, were subjected to histochemical, polarization, fluorescence and scanning electron microscopical, energy dispersive X-ray and chemical investigations. Routine screening of periapical lesions with polarization microscopy and identification of possible cellulose fibers with Calcofluor White is advocated. Further, attention is drawn to endodontic paper point material as an etiologic factor in postendodontic periapical inflammatory processes.

Adolescent↗
PubMed1996

Connective tissue grafting for primary closure of extraction sockets treated with an osteopromotive membrane technique: surgical technique and clinical results.

This article describes a grafting technique using connective tissue to predictably obtain primary closure of extraction sockets treated with an osteopromotive membrane technique. This technique was used for a total of 24 sites in 22 consecutive patients to regenerate alveolar bone in severely damaged ridges and in conjunction with implants immediately installed into extraction sites. Two sites (8.3%) were complicated by premature membrane exposure that necessitated early removal. In the remaining 22 sites, membranes remained completely covered for a mean period of 23.75 weeks (SD = 8.21 weeks; range = 10 to 38 weeks).

Adult↗
PubMed1979

Correlative transmission and scanning electron microscopy of the initial mineralization of healing alveolar bone in rats.

Primary mineralization in healing sockets after extraction of molar teeth was studied in rats. The observations obtained by scanning electron microscopy were correlated by transmission electron microscopy. The process is characterized by abundance of extracellular matrix vesicles distributed between the forming cells and the calcifying fronts. The occurrence of osmiophilic material and solitary hydroxyapatitte crystals within the vesicles was followed by accumulation of hydroxyapatite crystals, disappearance of the vesicular membrane and formation of calcospherites that conglomerate into calcified fronts. The process described here in bone healing is essentially similar to primary mineralization in other normal and pathological calcified tissues.

Alveolar Process↗
PubMed1992

Healing-in of root analogue titanium implants placed in extraction sockets. An experimental study in the beagle dog.

The aim of these animal experiments was to characterize and evaluate the healing-in of root analogue titanium implants fitting with high precision to the alveolar wall. Four beagle dogs were used in the study. The roots of the 3rd and 4th mandibular premolars in both quadrants of 3 dogs and in 1 quadrant of 1 dog (dog 4) were extracted after hemisection. Each root was machine-copied to 1 titanium analogue. In dog 4, however, 2 titanium analogues were fabricated from each of the 4 extracted roots. This enabled insertion of analogues also into the contralateral sockets obtained by extraction of the corresponding roots immediately before implant installation, which was undertaken 2 weeks after the first extractions. Thus, in all, 32 analogues were implanted in their respective (or contralateral) sockets following ridge incision and elevation of mucoperiosteal flaps. The analogues were carefully covered by the repositioned flaps. In dog 4, 2 analogues from the immediate sockets and 2 from the 2-week sockets were surgically exposed and supplied with titanium crowns after a healing period of 2 months. The healing after implantation was evaluated by clinical, radiographic and histological measures after 2, 12 or 36 months. Two analogues (6%) were lost due to early (during the 1st week) exposure to the oral cavity. Another 2 analogues (6%) were, although not exposed, encapsulated by soft tissue and were easily removed with a surgical forceps. Twenty-eight analogues (88%) were healed-in by contact between bone and implant (osseointegration).(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed2001

Endothelin-1 expression in the microvasculature of normal and 3-hour continuously loaded rat molar periodontal ligament.

Endothelin-1 (ET-1) distribution is described in the microvascular bed (MVB) of normal rat molar periodontal ligament (PDL). Five male Sprague-Dawley rats, aged 90 days, were anaesthetized and an external pressure of 100 +/- 20 g, maintained for 3 hours, was transmitted occlusally to randomly allocated left or right molars. The controls were the contralateral molars. Rats were perfused for 5 minutes with 5 per cent paraformaldehyde, and the mandibles post-fixed and stored in 30 per cent sucrose. Sagittal, undemineralized, mandibular jaw sections, approximately 150 microns thick, were immunolabelled with ET-1 and alpha-smooth muscle actin (alpha-SMA) primary antibodies, and IgG/CY5 and IgG/CY3 secondary antibodies, respectively. Serial images were captured with a Bio-Rad MRC-1000 UV confocal laser scanning microscope (CLSM). In the control PDL, the ET-1 immunolabelling occurred sporadically in all categories of PDL blood vessels. ET-1 showed a punctate distribution within endothelial cells, producing longitudinal and circumferential pan-endothelial labelling. Immunoreactivity to the ET-1 antibody occurred at or adjacent to vessel branching sites, and affected blood vessels with and lacking alpha-SMA immunolabelling. Treatment effects on ET-1 immunofluorescence were analysed for vascular endothelium, socket bone surface cells, cementum surface cells and PDL background in the cervical, inter-radicular and apical regions. Significant (P < 0.05) region by treatment interactions occurred for the endothelium and bone. Cementum showed a significant (P < 0.05) region effect and a significant (P < 0.05) treatment effect. However, the region by treatment interaction was not significant. Background immunofluorescence showed significant (P < 0.05) region by treatment effects for the endothelium and bone. ET-1 activity is the default state for normal PDL vascular endothelium.

Alveolar Process↗
PubMed1998

Dental extractions in patients on warfarin: is alteration of anticoagulant regime necessary?

Various clinical protocols for the management of warfarinised patients needing dental extractions have been suggested. This study was designed to compare two approaches in the management of these patients. A control group of 32 patients had their warfarin treatment stopped for 2-3 days prior to having dental extractions, resulting in a reduction in the average preoperative international normalised ratio (INR) from 2.6 to 1.6. The study group of 33 patients did not have their anticoagulant treatment altered before extractions, and had an average preoperative INR of 2.7. All patients were treated under local analgesia on an outpatient basis, and local measures-consisting of Surgicel pack and sutures-were used in all cases to control postoperative bleeding from extraction sockets. None of the patients had any immediate postoperative bleeding, and only 1 patient from each group had mild delayed haemorrhage, which was easily controlled with local measures. It is proposed that, provided the INR is within the therapeutic range of 2.0 to 4.0 and local measures are used to control postoperative bleeding, there is no justification in altering warfarin treatment prior to dental extractions in these patients, and thereby exposing them to the risk of thromboembolism.

Adult↗
PubMed1998

Bone wound healing after maxillary molar extraction in ovariectomized aged rats.

We studied bone wound healing processes after maxillary molar extraction in ovariectomized (OVX) aged rats, as an experimental model of postmenopausal osteoporosis, by means of scanning electron microscopy. Six-month-old female rats were either sham-operated or bilaterally OVX; and at 60 days postoperatively, the maxillary first molars were extracted. On postextraction days 4, 7, 30 and 60, the dissected maxillae were fixed and the alveolar bone surfaces around the extracted alveolar sockets were examined. In sham-operated controls, new bone formation was recognized on the buccal-side bone surfaces on day 4 and then increased in extent daily through day 60 mainly on the buccal and mesial sides. On day 60, the extracted sockets were filled with new bone mass and the surrounding alveolar bone surfaces had become smooth, indicating decreased bone metabolism. Bone resorption was prominent throughout the bone surfaces around and within the extracted sockets, increased in extent through day 7, but had decreased by day 60. In comparison to sham-operated controls, new bone formation in OVX rats was slightly increased in the early phase but subsequently showed a marked decrease. Bone resorption in OVX rats was greatly stimulated and was comparatively long-lasting. These results suggest that, under the present experimental conditions, in bone wound healing after maxillary molar extraction, (i) ovariectomy stimulates sustained bone resorption and (ii) bone formation and resorption both take place at specific sites on alveolar bone surfaces.

Aging↗
PubMed1980

Relationship between bacterial contamination and alveolitis after third molar surgery.

The frequency of alveolitis after third molar surgery was studied in three groups of 40 patients each. One group was premedicated with penicillin V, another with scopolamine, and the third group received no premedication. The respective frequencies of alveolitis were 5, 2.5 and 32.5 % (P less than 0.01 and P less than 0.001). The aerobic flora in blood sampled from the socket before suturing was significantly reduced (P less than 0.05) in the penicillin group as compared with the controls. In alveolar blood clot sampled 48 h postoperatively, both aerobes and anaerobes were significantly diminished (P less than 0.01). The concentration of penicillin V in alveolar blood ranged from 0.8 to 9.5 mg/l. The total bacterial content in alveolar blood before suturing showed poor correlation with the development of alveolitis. Abundant growth of aerobes was found, however, in 75 % of the patients with alveolitis, but in only 47 % of those without this complication.

Adolescent↗
PubMed1991

A histological study of tissue response to simulated cleft palate surgery at different ages in beagle dogs.

The response of maxillary tissues to mucoperiosteal manipulation at different ages was studied microscopically early after operation and at maturity. Thirty-two Beagles were divided into three experimental groups, a sham-operated group and a control group. At the age of 6, 16 or 25 weeks in the experimental groups an elliptical mucoperiosteal flap was excised in the midsagittal region of the palate, relaxation incisions were made and the mucoperiosteum was elevated and closed in the midline leaving two areas of denuded bone adjacent to the teeth. The animals were killed 1, 2 or 3 weeks after the operation or at the age of 37 weeks and serial sections of the jaw tissues were examined. Two weeks after the operation, scar had formed, its lack of elastic fibres indicating a more rigid type of tissue. The palatal bone showed rapid trabecular deposition. Cervico-palatal and apico-buccal bone resorption in the alveolar socket indicated medial tipping of the teeth. The different soft tissue composition persisted until maturity. In the areas where scar tissue had developed, attachment by means of Sharpey's fibres from the mucoperiosteum to the palatal bone was found at the age of 37 weeks. Thus the different mechanical properties of scar tissue adjacent to the teeth and its attachment to the palatal bone may influence the growth and development of dento-alveolar structures.

Alveolar Process↗
PubMed2004

Self-extraction of teeth involving gamma-hydroxybutyric acid.

A case involving self-extraction of teeth linked to the abuse of gamma-hydroxybutyric acid (GHB) is reported. A 28-year-old woman and her 29-year-old boyfriend were discovered by paramedics following an extensive period of GHB use. The paramedics were alerted by a neighbor who had heard screaming from the house. On presentation to the accident and emergency department, it was noted that the female had 18 fresh extraction sockets visible intra-orally. At the scene, a mirror, a pair of pliers, and a bowl containing human teeth were found. Charges of assault were taken to the courts against the boyfriend who was subsequently acquitted. Odontological evidence centered on whether or not it was possible to self-extract the teeth using the pliers found. This case is the first to describe possible oral self-mutilation under the influence of GHB and odontologists should always consider self-injury as an explanation for intra- and perio-oral injuries of unknown origin.

Adjuvants, Anesthesia↗
PubMed1997

[Establishment of immediate implant animal model in mongrel dog's fresh extraction socket].

The purpose of the study was to establish the animal models which had clinical characteristics in bone defect sizes around immediate implants. The mesial region of dogs' fresh extraction sockets were made with 3 mm x 3 mm x 5 mm size bone defects around implants with a round bur, then observed their osseous changes at 2 weeks, 4 weeks, 8 weeks, 12 weeks with and without demineralized freeze-dried bone allograft (DFDBA) filled. The results showed that the bone defects in DFDBA grafted group were substituted by new bone, but the defects in ungrafted group were only substituted to 3/5. Such animal models had the advantages of simple preparations and similar clinical characteristics, so they were beneficial to investigation of the immediate implantation.

Animals↗
PubMed2003

A randomized, double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery.

AIMS: To evaluate the effect of a 3-day regimen of ibuprofen 600 mg x 4 on acute postoperative swelling and pain and other inflammatory events after third molar surgery compared with a traditional regimen of paracetamol 1000 mg x 4. METHODS: A controlled, randomized, double-blind, cross-over study where 36 patients (26 females, 10 males) with mean age 23 (range 19-27) years acted as their own controls. All patients were subjected to surgical removal of bilateral third molars. After one operation the patients received tablets of ibuprofen 600 mg x 4 for 3 days. After the other operation they received an identical regimen of paracetamol 1000 mg tablets. Swelling was objectively measured (mm) with a standardized face bow and the patients scored their pain intensity (PI) on a 100-mm visual analogue scale. RESULTS: There was no statistically significant difference between paracetamol and ibuprofen treatment with respect to effect on acute postoperative swelling. Swelling after paracetamol on the third postoperative day was 1.8% less than that after ibuprofen. Mean (95% CI) difference between treatments was -0.3 (-4.7, 4.1) mm. On the sixth postoperative day swelling after ibuprofen was 2.3% less than that after paracetamol. Mean (95% CI) between treatments was 0.2 (-2.4, 2.8) mm. There was no statistically significant difference in pain intensity between the paracetamol and the ibuprofen regimen on the day of surgery. The mean (95% CI) difference between the treatments for summed pain intensity on the day of surgery (SUMPI 3.5-11) was 3.31 (-47.7, 54.3) mm. Two patients developed fibrinolysis of the blood clot (dry socket) after receiving ibuprofen while none did this after paracetamol treatment. There was no noticeable difference between treatments with respect to appearance of haematomas/ecchymoses or adverse effects which all were classified as mild to moderate. CONCLUSIONS: A 3-day regimen of ibuprofen 600 mg x 4 daily does not offer any clinical advantages compared with a traditional paracetamol regimen 1000 mg x 4 daily with respect to alleviation of acute postoperative swelling and pain after third molar surgery.

Acetaminophen↗
PubMed1980

Analysis of pathogenesis and topography of replacement root resorption (ankylosis) after replantation of mature permanent incisors in monkeys.

The pathogenesis and topography of replacement root resorption (ankylosis) after replantation of incisors was examined in green Vervet monkeys (Cercopithecus aethiops). Incisors were replanted after 0,18 or 120 min. storage and examined histometrically for replacement resorption after 2, 4 and 8 weeks. There was a significant preference for certain locations upon the root surface. Thus, ankylosis was found significantly more often on the rounded labial and lingual surfaces than on the flat or concave proximal surfaces, and on the apical portion of the root in contrast to the coronal portion. At two-weeks' observation periods, two types of initial ankylosis were seen after 120 min. dry storage. In the cervical areas and on the labial and lingual surfaces, the most common finding was a complete mineralization of the entire periodontal ligament, while on the remaining parts of the root surface, the initial ankylosis area consisted of a layer of bone deposited upon the root surface and socket wall with an intervening soft connective tissue zone. These two zones were in some areas united by bony bridges formed along the Sharpey's fiber bundles. It is suggested that the first type of initial ankylosis represents areas where both the cemental and alveolar parts of the periodontal ligament are avital; whereas the second type represents areas where only the cemental part of the periodontal ligament is avital (i.e., from dry storage). It is concluded that ankylosis after replantation is presumably a response in the periodontium to areas of the periodontal ligament and/or the root surface damaged by the extraction procedure or storage conditions prior to replantation.

Animals↗
PubMed1993

A randomised double blind comparative study of low level laser therapy following surgical extraction of lower third molar teeth.

A randomised, double blind comparative study was undertaken to assess the efficacy of low level laser therapy in the reduction of postoperative pain and swelling in patients undergoing the extraction of bilaterally impacted mandibular third molar teeth. Healing of the sockets was also compared after 1 week. A group of 64 patients had one randomly-selected operation side treated with a semi-conductor laser and the other side with an apparently identical but non-operating model. Complete data were obtained from 52 of the 64 patients. The results showed that there was no evidence of a difference in pain and swelling on the third day after operation between laser and placebo sides. There was no difference between the two sides when they were assessed for healing 7 days after surgery.

Adolescent↗
PubMed2002

The effect of swabs soaked in bupivacaine and epinephrine for pain relief following simple dental extractions in children.

We studied 133, ASA I or II children, aged 5-12 years undergoing general anaesthesia for simple dental extractions. Induction and maintenance of anaesthesia were achieved using sevoflurane in nitrous oxide and oxygen. At the end of surgery, patients had swabs soaked in a trial solution placed over the exposed teeth sockets. The bupivacaine group had swabs soaked in bupivacaine 0.25% with epinephrine 1:200 000, the saline group had swabs soaked in saline. Pain scores were recorded on a 4-point scale as follows: 0 = I don't hurt at all; 1 = I hurt a bit; 2 = I hurt a lot; 3 = I hurt the most. Nurse pain assessments and the patient's own scores were recorded at 15 and 30 min following recovery from anaesthesia. The median pain scores (2 at 15 min and 1 at 30 min postoperatively) were the same in both groups.

Administration, Topical↗