Alveolar ridge preservation techniques: a systematic review and meta-analysis of histological and histomorphometrical data.

AIM: The aim of this article was to systematically review histological and histomorphometrical data from literature that provide information regarding the effect of alveolar ridge preservation procedures on healing after tooth extraction in humans. MATERIALS AND METHODS: The MEDLINE-PubMed and the Cochrane CENTRAL databases were searched up to September 2012; 38 papers were selected from 646 founded. A meta-analysis was performed regarding the variations in the mean percentage of Bone, Connective Tissue and Residual Graft Material between three different types of Procedures. RESULTS: The highest value regarding bone percentages is produced at 3 months by Procedures with Allografts (54.4%), while the lowest is obtained, at 5 months, by those using Xenografts (23.6%). Referring to connective tissue, the highest and lowest values are shown at 7 months, with Allografts (67%) and Alloplasts (27.1%), respectively. Regarding residual graft material, the lowest rates are displayed by Procedures with Allografts (12.4-21.11%), while those using Xenografts and Alloplasts showed the best results at 7 months (37.14 and 37.23%). No statistical difference was found. CONCLUSIONS: With the limitations due to the features of the selected papers, no major histological and histomorphometrical differences arose among different procedures or when compared to spontaneous healing. Thus, it might be argued that in preserved sites it is unnecessary to wait over 3 to 4 months prior to implant insertion.

Implant placement and immediate loading with fixed restorations in augmented sockets. Five-year results. A case report.

In this report, a case is presented in which a patient received eight implants 10 months after tooth extraction and socket preservation. The implants were placed in both arches (maxilla = 4, mandible = 4) and immediately loaded using fixed partial restorations; they remained functional over 5 years. No changes in bleeding on probing or plaque index were observed; however, a 1.5-mm probing attachment level loss was observed during the first 3 years (mean: 0.25 mm/year) with no subsequent changes.

Efficacy of AZM therapy in patients with gingival overgrowth induced by Cyclosporine A: a systematic review.

BACKGROUND: In daily clinical practice of a dental department it's common to find gingival overgrowth (GO) in periodontal patients under treatment with Cyclosporine A (CsA). The pathogenesis of GO and the mechanism of action of Azithromycin (AZM) are unclear. A systematic review was conducted in order to evaluate the efficacy of Azithromycin in patients with gingival overgrowth induced by assumption of Cyclosporine A. METHODS: A bibliographic search was performed using the online databases MEDLINE, EMBASE and Cochrane Central of Register Controlled Trials (CENTRAL) in the time period between 1966 and September 2008. RESULTS: The literature search retrieved 24 articles; only 5 were Randomised Controlled Trials (RCTs), published in English, fulfilled the inclusion criteria. A great heterogeneity between proposed treatments and outcomes was found, and this did not allow to conduct a quantitative meta-analysis. The systematic review revealed that a 5-day course of Azithromycin with Scaling and Root Planing reduces the degree of gingival overgrowth, while a 7-day course of metronidazole is only effective on concomitant bacterial over-infection. CONCLUSION: Few RCTs on the efficacy of systemic antibiotic therapy in case of GO were found in the literature review. A systemic antibiotic therapy without plaque and calculus removal is not able to reduce gingival overgrowth. The great heterogeneity of diagnostic data and outcomes is due to the lack of precise diagnostic methods and protocols about GO. Future studies need to improve both diagnostic methods and tools and adequate classification aimed to determine a correct prognosis and an appropriate therapy for gingival overgrowth.