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      Prevention of Bone Resorption by HA/β-TCP + Collagen Composite after Tooth Extraction: A Case Series

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          Abstract

          After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm ( p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm ( p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.

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          Most cited references29

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          Bone substitutes: an update.

          Autograft is considered ideal for grafting procedures, providing osteoinductive growth factors, osteogenic cells, and an osteoconductive scaffold. Limitations, however, exist regarding donor site morbidity and graft availability. Allograft on the other hand, posses the risk of disease transmission. Synthetic graft substitutes lack osteoinductive or osteogenic properties. Composite grafts combine scaffolding properties with biological elements to stimulate cell proliferation and differentiation and eventually osteogenesis. We present here an overview of bone grafts and graft substitutes available for clinical applications.
            • Record: found
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            • Article: not found

            Dimensional ridge alterations following tooth extraction. An experimental study in the dog.

            To study dimensional alterations of the alveolar ridge that occurred following tooth extraction as well as processes of bone modelling and remodelling associated with such change. Twelve mongrel dogs were included in the study. In both quadrants of the mandible incisions were made in the crevice region of the 3rd and 4th premolars. Minute buccal and lingual full thickness flaps were elevated. The four premolars were hemi-sected. The distal roots were removed. The extraction sites were covered with the mobilized gingival tissue. The extractions of the roots and the sacrifice of the dogs were staggered in such a manner that all dogs contributed with sockets representing 1, 2, 4 and 8 weeks of healing. The animals were sacrificed and tissue blocks containing the extraction socket were dissected, decalcified in EDTA, embedded in paraffin and cut in the buccal-lingual plane. The sections were stained in haematoxyline-eosine and examined in the microscope. It was demonstrated that marked dimensional alterations occurred during the first 8 weeks following the extraction of mandibular premolars. Thus, in this interval there was a marked osteoclastic activity resulting in resorption of the crestal region of both the buccal and the lingual bone wall. The reduction of the height of the walls was more pronounced at the buccal than at the lingual aspect of the extraction socket. The height reduction was accompanied by a "horizontal" bone loss that was caused by osteoclasts present in lacunae on the surface of both the buccal and the lingual bone wall. The resorption of the buccal/lingual walls of the extraction site occurred in two overlapping phases. During phase 1, the bundle bone was resorbed and replaced with woven bone. Since the crest of the buccal bone wall was comprised solely of bundle this modelling resulted in substantial vertical reduction of the buccal crest. Phase 2 included resorption that occurred from the outer surfaces of both bone walls. The reason for this additional bone loss is presently not understood. (c) Blackwell Munksgaard, 2005.
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              • Abstract: found
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              Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study.

              Preservation of alveolar bone volume following tooth extraction facilitates subsequent placement of dental implants and leads to an improved esthetic and functional prosthodontic result. The aim of the present study was to assess bone formation in the alveolus and the contour changes of the alveolar process following tooth extraction. The tissue changes after removal of a premolar or molar in 46 patients were evaluated in a 12-month period by means of measurements on study casts, linear radiographic analyses, and subtraction radiography. The results demonstrated that major changes of an extraction site occurred during 1 year after tooth extraction.

                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                21 November 2019
                December 2019
                : 16
                : 23
                : 4616
                Affiliations
                [1 ]School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei 110 Taiwan; linhsikuei38@ 123456gmail.com (H.K.L.); shalom.dc@ 123456msa.hinet.net (Y.H.P.); d204103004@ 123456tmu.edu.tw (E.S.)
                [2 ]Dental Department, Taipei Medical University, Shuang-Ho hospital, Taipei 235, Taiwan
                [3 ]Department of General Dentistry, Chang Gung Memorial Hospital, Taipei 105, Taiwan
                [4 ]Graduate Institute of Dental & Craniofacial Science, Chang Gung University, Taoyuan 333, Taiwan
                [5 ]Sunmax Biotech Co. Ltd., Tainan 744, Taiwan; lud32@ 123456msn.com
                Author notes
                [* ]Correspondence: cweijen1@ 123456tmu.edu.tw
                [†]

                The authors are equal contributors to this study for the study operation.

                Article
                ijerph-16-04616
                10.3390/ijerph16234616
                6926561
                31766327
                0a12ee3b-0e0b-48f0-b42c-3ea3cc7e0acf
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 11 October 2019
                : 17 November 2019
                Categories
                Article

                Public health
                ha/β-tcp + collagen composite,periodontal bone loss,dental sockets preservation,tooth extraction

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