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PubMed1980

Bone tissue formation within a sintered microporous glass-fiber network implanted in extraction sockets in the rat.

Implants were prepared by sintering glass-fibers into a three-dimensional network with meshes smaller than 20 micron. Oblong 5 x 2 x 0.15 mm sheets of the test material were implanted in maxillary incisor alveoli in eight white rats. The alveoli were closed with a suture in the overlying mucosa. After 3 months the animals were sacrificed and sections from the site of implantation prepared. In three animals only root remnants were found but in the remaining five the implants were wholly or partially embedded in bone tissue. Sections studied with transmitted light, microradiography, and scanning electron microscopy showed that mineralized tissue had also formed within the pores of the network. The intimate contact between the individual fibers and the bone within the network was corroborated through microchemical analysis (EDX).

Alveolar Process↗
PubMedDate not supplied

Immediate implantation of pure titanium implants into extraction sockets of Macaca fascicularis. Part II: Histologic observations.

The purpose of this study was to evaluate immediate implants with implants placed in ossified extraction (control) sites. Histologic observation of immediate and control implants showed similar levels of bone integration at the light microscopic level using ground-section and decalcified thin-section histologic methods. Both histologic methods provided similar information in relation to determination of hard and soft tissue components measured at the interface. The percentage of bone integration was similar in different anatomic regions of the oral cavity. Bone patterns peripheral to the interface region differed, suggesting that special consideration be given to implants placed in the posterior regions of the maxilla and mandible.

Alveolar Process↗
PubMed2004

Risk of osteoradionecrosis after extraction of impacted third molars in irradiated head and neck cancer patients.

PURPOSE: This study was performed to compare the risk of osteoradionecrosis (ORN) in head and neck cancer patients in whom 1 or more impacted third molars were extracted before radiotherapy with patients whose impacted third molars were left intact. PATIENTS AND METHODS: Eighty-one patients were selected from the medical records from 1989 to 1998. Patients had at least 1 impacted third molar and received radiotherapy for a head and neck cancer. These patients were divided into 2 groups on the basis of preirradiation extraction: group 1, patients who had impacted third molars extracted before radiotherapy (n = 55), and group 2, patients whose impacted third molars were left intact before radiotherapy (n = 38). In 12 patients of combined groups 1 and 2, at least 1 but not all of the impacted third molars were extracted before radiotherapy. RESULTS: Before radiotherapy, a total of 99 impacted third molars were extracted from the 55 patients in group 1 and a total of 55 impacted third molars were left intact in the 38 patients in group 2. After radiotherapy, a total of 7 impacted third molars were removed from 5 patients as treatment for infection (5 lower molars) or discomfort (2 upper molars). A total of 4 patients (2 from group 1 and 2 from group 2) developed ORN in the mandible. Of these 4 cases of ORN, 1 from group 1 appeared to be related to a dry socket that developed after preirradiation extraction of a lower impacted third molar, 1 from group 2 seemed to be related to infection of a lower impacted third molar after radiotherapy, and the remaining 2 cases appeared to be unrelated to an impacted third molar. CONCLUSION: Because few patients in this study developed ORN, the study failed to demonstrate whether preirradiation extraction versus retention of impacted third molars affects the risk for ORN.

Adolescent↗
PubMed1993

Evaluation of guided bone generation around implants placed into fresh extraction sockets: an experimental study in dogs.

Immediate placement of implants into fresh extraction sockets would have the principal advantage of decreasing the recommended period of healing. It also would result in a guided placement of the implant, and it could reduce the resorption of the alveolar bone in the extraction area. However, when an implant is placed immediately into an extraction socket, it may not engage the walls of the socket near the crest of the alveolar ridge. With the presence of a bone defect around an implant, ingrowth of soft tissue could compromise the achievement of osseointegration in the crestal bone area. The objective of this study was to evaluate the crestal bone healing response adjacent to implants placed immediately into fresh extraction sockets with and without covering membranes. Eight adult mongrel dogs had the third and fourth mandibular premolars extracted bilaterally. Thirty-two submerged titanium hollow-screw implants were inserted immediately into the extraction sockets. On the right side, the implants were covered with an expanded polytetrafluorethylene membrane, whereas the left side served as a control. One dog was killed after 2 weeks, one after 4 weeks, and six after 12 weeks. Soft tissue dehiscence developed over 10 implants (12-week dogs) covered with membranes. Dehiscence was noted histologically over three contralateral control implants. When soft tissue dehiscence occurred and the membrane was left exposed without oral hygiene during healing, the degree of bone integration was significantly less than in the control sites without membranes.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1997

The ways and wherefores of immediate placement of implants into fresh extraction sites: a literature review.

A waiting period of 12 months or longer to allow total socket healing used to be accepted protocol for placing dental implants. More than 15 years of research and clinical practice were needed for the concept of immediate endossceous implantation into fresh extraction sites to be accepted. Today the dilemma is no longer when, but which, protocol to follow. The diverse recommendations found in the literature leave the practitioner confused as to the methodology of choice. The conclusions drawn after reviewing the relevant literature on immediate dental implantation are: 1) implants placed into fresh extraction sockets have a high rate of survival, ranging between 93.9% to 100%; 2) implants must be placed 3 to 5 mm beyond the apex in order to gain a maximal degree of stability; 3) implants should be placed as close as possible to the alveolar crest level (0 to 3 mm); 4) there is no consensus regarding the need for gap filling and the best grafting material; 5) the use of membrane does not imply better results-on the contrary, membrane exposure may carry complications in its wake; and 6) the absolute need for primary closure remains to be established.

Alveolar Process↗
PubMed1996

Cast titanium dental implants for the posterior mandible.

The purpose of this paper is to present the results of the evaluation of five patients who received titanium dental implant replicas of extracted molars and pre-molars, placed in the posterior mandible. The replicas were placed in the sockets where the molars and bicuspids had been extracted. The implant replicas were fabricated in two parts, an abutment portion and a root portion connected by a titanium screw. The root portion was made of cast titanium. The abutment portion was made of a high noble metal to which porcelain could be fused, so that the crown restoration could be made directly on the abutment. The patient's ages ranged from 27 to 63 years. Four were male and one was female. The implants were placed three to six weeks after extraction. All implants integrated. The longest follow-up with the implant in function was five years.

Adult↗
PubMed1998

A two-stage resin-bonded fixed partial denture seated in conjunction with postextraction healing of the alveolar socket: a clinical report.

A patient treatment modality that involved a two-stage resin-bonded FPD was presented in this clinical report. During recovery of the alveolar socket, a direct bonded acrylic pontic was seated with an adhesive resin (Super-Bond C&B Clear). This primary prosthesis provided service for 6 months without trouble and was effective for maintaining the open space and recovery of oral functions. The secondarily seated resin-bonded FPD, which was made of silver-palladium-copper-gold alloy and bonded with a primer for noble alloys (V-Primer) and an adhesive resin (Super-Bond Opaque), has been functioning satisfactorily for more than 5 years. This two-stage procedure is useful in situations that require conservative or periodontal treatment before seating final prostheses.

Acrylic Resins↗
PubMed1980

Plasma cells and their immunoglobulins in the normal and delayed healing of the extraction wound in man.

Eight volunteer patients underwent simultaneous extraction of two diseased teeth, the sockets of which were histologically and immunohistochemically evaluated one and two weeks later with special reference to the plasma cells and their intracytoplasmic immunoglobulins, respectively. One of the sockets was allowed to heal spontaneously, the other was packed with Alvogyl (Septodont, 1974) known to induce delayed healing of extraction wounds. A small and constant number of plasma cells was found to be present in the wounds, and this number was not affected by the Alvogyl packing or the stage of wound healing process. Immunoglobulins IgA, IgG and IgM were demonstrated in the plasma cells in proportions characteristic to the plasma cells of oral mucous membranes in general, thus supporting the concept that plasma cell activity in the extraction wound is evoked also by the continuous presentation of the diversity of oral antigens, and not an essential component of the wound healing per se.

Adult↗
PubMed1995

The use of a particulate, microporous, calcified copolymer as a ridge maintenance device in dogs.

HTR polymer Synthetic Bone was found to be an osteoconductive, biocompatible, reliable nonresorbable matrix ridge maintenance material (Ridge Preservation). When used as socket implants immediately after the extraction of teeth over a one-year period in 16 beagle dogs, HTR was observed clinically and radiographically and compared with controls (unimplanted, sutured) extraction sites. As the control areas resorbed, the stability and effectiveness of the synthetic bone material in the operative sites became more clearly delineated. Quantitative analyses could not be made using radiographic techniques, but radiographs supported by subjective clinical observations as well as study casts taken of the height and width of the implanted areas, showed greater ridge retention compared with controls. Histological sections demonstrated dense laminar bone gradually forming into and around the HTR particulate material.

Alveolar Bone Loss↗
PubMed1980

Carbon, a promising material in endoprosthetics. Part 1: the carbon materials and their mechanical properties.

Progress in endoprosthetics depends to a large extent on the availability of materials. Carbon is known for its excellent biocompatibility. Carbon materials can also be manufactured with a great variety of properties. The application of carbon materials has been restricted to some special cases like heart valves or tooth roots. Construction of high-loaded endoprosthetic joints has been impossible due to insufficient mechanical strength or manufacturable size of the materials. Three new carbon materials have been developed which seem to offer new possibilities: (1) a high strength isotropic carbon, (2) a silicon carbide/carbon composite (SiC/C) and (3) a carbon fibre reinforced carbon (CFRC). The mechanical properties of these materials were investigated including size effects (length / to thickness d ratio of samples) and manufactured parameters (final heat treatment temperature, fibre volume content and fibre orientation). Flexural strength of the first two materials, which are both isotropic, increases with decreasing l/d ratio, whereas the CFRC behaves contrarily. In the latter case, failure at low l/d ratios is caused by shear failure. The Wöhler diagram of all three materials demonstrates limits of fatigue even after only 10(3) to 10(4) cycles. The fatigue strength of the isotropic C and the SiC/C is between 70 and 80% of the static strength, even in Ringer's solution. The Young's modulus of the isotropic C is comparable to that of femoral bone. The modulus of the SiC/C is still appreciably low. It follows that both isotropic materials are applicable for sliding parts like ball and socket. Their tribological properties are described in a following paper. The CFRC finally combines high fatigue strength (approximately 400 MN/m2) with a moderate Young's modulus (approximately 150 X 10(3) MN/m2). These properties indicate application for shafts and pins.

Biomechanical Phenomena↗
PubMed1999

Positioning of dental implants using computer-aided navigation and an optical tracking system: case report and presentation of a new method.

A navigation system for computer-aided surgery (Virtual Patient System, VPS) has been described in previous studies for different indications in oral and maxillofacial surgery. The aim of the system is the intraoperative transfer of preoperative planning on radiographs or CT scans on the patient, in real-time, and independent of the position of the patient's head. Until now an electromagnetic tracking system has been used for intra-operative position measurement. For placement of dental implants, the electromagnetic tracking system is not suitable since the motor of the implant drill leads to a considerable distortion of the magnetic field, thus direct visualization of drilling the implant socket was not possible. To overcome this problem, an optical tracking system which is not disturbed by conductive materials was integrated in the VPS system. The first patient operated on with this system had a posttraumatic loss of the upper incisors; three implants have been placed according to the prosthetic axis previously planned on radiographs and CT scans. The experience gained in this intervention led to the conclusion that computer-aided surgery provides a valuable tool in implant dentistry.

Adult↗
PubMed1975

Orthodontics and dentistry for the hemophilic patient.

In this presentation we have contrasted the normal blood-clotting mechanism with the failure to form blood clots in hemophiliacs due to the absence of protein factors necessary for conversion of prothrombin to thrombin. The statistics, hereditary basis, and long-term disabling consequences of hemophilia to the severely ffected patient are described. The systemic means of minimizing severe joint disabilities and serious internal bleeding hazards by employing concentrates of antihemophilic factors to reverse the bleeding defects are discussed. Availability and advantages of the types of concentrates are explained. The fatalistic attitude of hemophiliacs toward hepatitis is discussed, along with admonitions to avoid the use of aspirin, alcohol, and buttock injections. Alternative medications for pain are recommended; and injection sites for pediatric patients are suggested. The details of simplified oral surgical management of hemophilic patients without hospitalization are described, including local anesthetic injection technique, method of performing extractions, general anesthesia techniques when indicated, materials for packing of extraction sockets, regimen and precautions in use of Amicar administration for clot maintenance, postoperative diet, and postsurgical activity guidelines. Also noted is the self-administration of intravenous concentrate infusions at home in the event of hemorrhagin, so that bleeding is on the way to bein controlled even before the patient reaches the hospital. We avoided orthodontic treatment of hemophilic patients in the past; however, recently developed bracket-fixation techniques and auxiliary aids; along with an enlightened understanding that gingival bleeding is ot to be feared, have changed our attitude, and we now treat hemophilic patients in much the same manner as otherwise normal orthodontic patients...

Anesthesia, Dental↗
PubMed2002

[A clinical study on immediate implantation of particulate hydroxylapatite artificial bone after teeth extraction].

OBJECTIVE: The aim of this study is to investigate the effect and complication of immediate implantation of particulate hydroxylapatite artificial bone after teeth extraction. METHODS: Particulate hydroxylapatite artificial bone was implanted into 65 extraction sockets after teeth extraction. All patients were followed up until 3 months after the operation. They are examined with clinical examination and X-ray examination to observe the effect and complication of the implantation operation. RESULTS: The wound healed well in all cases without any complication. Compared to the alveolar ridge before teeth extraction, and the height of the alveolar ridge after teeth extraction didn't decrease. CONCLUSION: Implantation of particulate hydroxylapatite artificial bone after teeth extraction could maintain the height of the alveolar ridge and reduce the complication of teeth extraction. It would be helpful for the following prosthetic restoration. The immediate implantation of artificial bone is therefore needed further study.

Adult↗
PubMed1996

Bacteriologic findings in tonsillitis and pericoronitis.

Bacteriologic samples from 31 young men were cultured quantitatively for aerobes and anaerobes; these samples included 31 specimens of tonsils (16 infected and 15 healthy), 16 specimens from pericoronal pockets of lower third molars (11 infected and 5 symptom-free), and 6 postoperative specimens from lower-third-molar extraction sockets. Anaerobes were isolated more often from infected third molars than from infected tonsils (14.5 isolates vs. 8.4 isolates, respectively; P < .001). Infected tonsil samples contained significantly more anaerobic species if an adjacent partly erupted lower third molar was present rather than absent (10.3 isolates vs. 6.9 isolates, respectively; P < .05). Eubacterium aerofaciens, Clostridium species, Peptostreptococcus micros, and Prevotella oris were frequently isolated. Streptococcus salivarius was found more frequently in tonsillar specimens, whereas Corynebacterium species, Prevotella denticola, Capnocytophaga species, Peptostreptococcus anaerobius, and Lactobacillus species were more common in pericoronal pocket samples. Thus, partial eruption of lower third molars increases the number of anaerobic bacterial species on tonsils and many species can be isolated simultaneously from both tonsils and lower third molars.

Adolescent↗
PubMed2005

A regimen of systematic periodontal care after removal of impacted mandibular third molars manages periodontal pockets associated with the mandibular second molars.

AIM: This randomized, single-blinded control trial investigated the local effects of periodontal care on the mandibular second molar delivered during and after impacted third molar surgical extraction. METHOD: Thirty subjects (50% male, 32.1+/-7.8 years) out of 35 enrolled, with a mesio-angular impacted mandibular third molar, having probing pocket depth (PPD) >5 mm at adjacent second molar distal, and crestal radio-lucency between the two teeth, completed the study. Oral hygiene instruction, scaling and caries stabilization were performed before surgery. Controls (n=16) had their third molar extracted followed by standard socket debridement. Test group subjects (n=14) received the same treatment, except that before wound closure the operator was informed of the group allocation and ultrasonic root debridement on the second molar was performed, followed by a three-visit plaque control programme. RESULTS: Six months post-extraction, statistically significantly (p<0.007) better plaque control and shallower probing depths were observed at test second molars' distal (%plaque=21; PPD=3.2+/-1.2 mm) than at control second molars (%plaque=88; PPD=5.2+/-0.7 mm). CONCLUSIONS: The periodontal interventions investigated prevented residual pockets on periodontally involved second molars 6 months after ipsilateral impacted mandibular third molar removal.

Adult↗
PubMed1994

A comparison of demineralized freeze-dried bone and autologous bone to induce bone formation in human extraction sockets.

The purpose of this study was to test the bone-forming capacity of demineralized freeze-dried bone (DFDBA) and autologous bone grafts in extraction sockets. Seven paired sites were grafted with either DFDBA or autologous bone. The sites were reentered between 3 and 13 months for the purposes of obtaining biopsies of the grafted sites and to place endosseous implants. Biopsies from 6 of the 7 grafted sites were evaluated for new bone formation. DFDBA sites revealed the presence of dead particles of DFDBA with no evidence of bone formation on the surfaces of the implanted particles and no evidence of osteoclastic resorption of the bone particles. Biopsies from the 6 autologous sites revealed vascular channels with woven and lamellar bone. Some specimens had retained cortical, non-vital bone chips. These bone chips were undergoing active osteoclastic resorption. The results of this study questions the use of DFDBA as a bone inductive graft material.

Alveolar Process↗
PubMed1994

Guided tissue regeneration around dental implants in immediate extraction sockets: comparison of e-PTFE and a new titanium membrane.

To evaluate the efficacy of guided tissue regeneration around exposed implant threads, 16 implants were placed into fresh extraction sockets in beagle dogs. Polytetrafluoroethylene (e-PTFE) membranes and titanium membranes were used to cover the defects around implants. A control group did not receive any membranes. Results were evaluated histologically. The average gain in bone height was 2.1 mm for e-PTFE sites, 0.8 mm for titanium membranes, and 2.9 mm for control sites. The greatest gain in bone levels was seen for two sites that received e-PTFE membranes and remained covered for the entire evaluation interval. Within the limits of this study, clinical and histologic evidence demonstrated that, when primary coverage is maintained, the use of e-PTFE membranes can significantly enhance bone regeneration around implants.

Alveolar Bone Loss↗
PubMed2004

A double-blind randomized controlled trial investigating the effectiveness of topical bupivacaine in reducing distress in children following extractions under general anaesthesia.

OBJECTIVE: This study was designed to investigate the effectiveness of topical bupivacaine (0.25%) in reducing postoperative distress following extraction of teeth under general anaesthesia in children. DESIGN: The study was a double-blind randomized controlled trial. SETTING: The study was conducted in a dental hospital. SAMPLE: The sample comprised 135 children aged between 2 and 12 years of age who were undergoing outpatient general anaesthesia for simple dental extractions. METHODS: The children were randomly allocated to one of two groups: the bupivacaine group (the study group) comprised 68 children whilst the sterile water group (the control group) comprised 67. Following the extraction of their teeth, children had swabs soaked in the appropriate solution placed over the exposed teeth sockets. A five-point face scale was employed by an independent observer to evaluate the distress for each child. Evaluation of distress was made preoperatively, on recovery from the general anaesthetic, and again, 15 min following recovery from the anaesthetic. RESULTS: There were no statistically significant differences between the mean distress scores for the bupivacaine and sterile water groups preoperatively, postoperatively or 15 min postoperatively. For both groups, however, there were significant increases in distress scores between the preoperative and 15 min postoperative assessment scores. CONCLUSION: Extraction of teeth under general anaesthesia does cause distress in children. There is no evidence that topical bupivacaine reduces this distress when compared to sterile water.

Ambulatory Surgical Procedures↗