Lateral alveolar ridge augmentation procedure using subperiosteal tunneling technique: a pilot study.

BACKGROUND: In this research article, we evaluate the use of sub-periosteal tunneling (tunnel technique) combined with alloplastic in situ hardening biphasic calcium phosphate (BCP, a compound of ß-tricalcium phosphate and hydroxyapatite) bone graft for lateral augmentation of a deficient alveolar ridge. METHODS: A total of 9 patients with deficient mandibular alveolar ridges were included in the present pilot study. Ten lateral ridge augmentation were carried out using the sub-periosteal tunneling technique, including a bilateral procedure in one patient. The increase in ridge width was assessed using CBCT evaluation of the ridge preoperatively and at 4 months postoperatively. Histological assessment of the quality of bone formation was also carried out with bone cores obtained at the implant placement re-entry in one patient. RESULTS: The mean bucco-lingual ridge width increased in average from 4.17 ± 0.99 mm to 8.56 ± 1.93 mm after lateral bone augmentation with easy-graft CRYSTAL using the tunneling technique. The gain in ridge width was statistically highly significant (p = 0.0019). Histomorphometric assessment of two bone cores obtained at the time of implant placement from one patient revealed 27.6% new bone and an overall mineralized fraction of 72.3% in the grafted area 4 months after the bone grafting was carried out. CONCLUSIONS: Within the limits of this pilot study, it can be concluded that sub-periosteal tunneling technique using in situ hardening biphasic calcium phosphate is a valuable option for lateral ridge augmentation to allow implant placement in deficient alveolar ridges. Further prospective randomized clinical trials will be necessary to assess its performance in comparison to conventional ridge augmentation procedures.

Ridge preservation using an in situ hardening biphasic calcium phosphate (ß-TCP/HA) bone graft substitute-a clinical, radiological, and histological study.

BACKGROUND: Post-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/ß-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane. METHODS: A total of 15 patients reported for tooth extraction were enrolled in this study. Implants were placed in average 5.2 ± 2 months after socket grafting. At this visit, Cone Beam CT (CBCT) images and core biopsies were taken. Implant stability (ISQ) was assessed at the insertion as well as at the day of final restoration. RESULTS: CBCT data revealed 0.79 ± 0.73 mm ridge width reduction from grafting to implant placement. Histomorphometric analysis of core biopsy samples revealed in average 21.34 ± 9.14% of new bone in the grafted sites. Primary implant stability was high (ISQ levels 70.3 ± 9.6) and further increased until final restoration. CONCLUSIONS: The results of this study show that grafting of intact post-extraction sockets using a biphasic in situ hardening bone graft substitute results in an effective preservation of the ridge contour and sufficient new bone formation in the grafted sites, which is imperative for successful implant placement.

A clinical investigation of the tooth whitening efficacy of a new hydrogen peroxide-containing dentifrice.

OBJECTIVE: The objective of this four-week, double-blind clinical study was to assess the tooth whitening efficacy of a new dentifrice delivering 1.0% hydrogen peroxide, 0.243% sodium fluoride, and sodium tripolyphosphate in a high-cleaning silica base (Test Dentifrice), relative to that of a control dentifrice containing 0.243% sodium fluoride in a silica base (Control Dentifrice). METHODOLOGY: Following a baseline oral soft tissue examination and tooth shade assessment using the Vita Shade Guide, qualifying adult male and female subjects from the New Delhi, India area were randomized into either the Test or Control Dentifrice group. The two groups were balanced for baseline mean Vita Shade Guide rank scores. All subjects were provided with their assigned dentifrice and a soft-bristled adult toothbrush for home use. Subjects were instructed to brush their teeth for two minutes twice daily (morning and evening), using only the dentifrice provided, and to refrain from using any other oral hygiene products for the entire four weeks of the study. There were no restrictions regarding diet or smoking habits during the course of the study. Oral soft tissue and tooth shade evaluations for each subject were repeated after two and four weeks of product use. RESULTS: Forty-four (44) subjects complied with the protocol and completed the entire study. At the two- and four-week examinations, the Test Dentifrice group had statistically significant mean shade rank score reductions of 4.04 and 5.17, respectively, compared to baseline (p < 0.05), while the Control Dentifrice had respective reductions of 0.41 and 0.53, which were also statistically significant. The mean shade rank reductions in the Test group compared to those in the Control group at two and four weeks were 3.63 and 4.64, respectively, and were statistically significant (p < 0.05). CONCLUSION: A new whitening dentifrice delivering 1.0% hydrogen peroxide, 0.243% sodium fluoride and sodium tripolyphosphate has significant tooth whitening effectiveness, producing a mean shade rank score reduction from baseline of 5.17 after four weeks' use.