A radiographic and histological study to compare red (650 nm) versus near infrared (810 nm) diode lasers photobiomodulation for alveolar socket preservation.

Previous findings indicated that the laser photobiomodulation is more effective than the control or placebo in preserving the alveolar socket. This study aimed to compare two different lasers regarding their effectiveness in aiding alveolar socket preservation. Twenty extraction sockets were selected then divided into two equal groups. Group A was exposed to 650 nm Diode laser, and Group B to 810 nm Diode laser following the same protocol and parameters after a standard alveolar socket preservation procedure with collagen plug. Radiographic analysis with cone beam computed tomography was done to compare the alveolar bone surface area immediately after extraction and three months post-operatively, while bone samples collected before implant drilling were histologically examined for newly formed bone evaluation and histomorphometric analysis in terms of percentage of new bone surface area, percentage of unmineralized bone and finally, immunohistochemical analysis of Osteocalcin reaction surface area as well as optical density. Radiographically, infrared (810 nm) Diode effect on alveolar bone surface area has significantly exceeded the red laser, while histologically, red (650 nm) Diode has demonstrated statistical significance regarding all parameters; newly formed bone surface area percentage, unmineralized bone area percentage and finally Osteocalcin bone marker reaction surface area percentage and optical density. Under the specified conditions and laser parameters, photobiomodulation using the 810 nm Diode got the upper hand radiographically, yet histologically, the red 650 nm Diode managed to dominate all histological parameters when both employed as an adjunct to alveolar socket preservation procedures.

Autogenous particulated dentin for alveolar ridge preservation. A systematic review.

PURPOSE: This review aimed to investigate the clinical outcomes of autogenous particulated dentin (APD) used for alveolar ridge preservation (ARP), evaluating volume gain, histologic/histomorphometric data, and associated complications. MATERIAL AND METHODS: The review followed PRISMA guidelines and was registered in the International Prospective Register of Systematic Reviews (PROSPERO). An automated search was made in four databases (Medline/Pubmed, Scopus, Web of Science, and Cochrane Library) supplemented by a manual search for relevant clinical articles published before March 10th, 2022. The review included human studies of at least four patients in which extraction and subsequent ARP were performed in a single surgery. Both comparative studies and studies that assessed ARP with APD exclusively were admitted. The quality of evidence was assessed with the Cochrane bias assessment tool, the Newcastle-Ottawa Quality Assessment Scale, and the Joanna Briggs Institute Critical Appraisal tool. RESULTS: Eleven studies fulfilled the inclusion criteria and were included for descriptive analysis, with a total of 215 patients, and 337 alveoli preserved by APD, spontaneous healing (blood clot), or other bone substitutes, obtaining comparatively less vertical and horizontal resorption when APD was used. CONCLUSIONS: After dental extraction, autogenous dentin was effective in terms of volume maintenance, showing promising results in histologic/histomorphometric analysis, and a low complication rate. Nevertheless, few comparative studies with comparable parameters have been published and so more research providing long-term data is needed to confirm these findings.

Técnica de disyunción horizontal del reborde alveolar con bisturí piezoeléctrico y colocación de implantes en el maxilar inferior: informe de casos clínicos / Horizontal split crest technique using a piezoelectric scalpel and immediate implant placement in the jaw: report of clinical cases

Objetivo: Presentar una técnica quirúrgica de disyunción con bisturí piezoeléctrico y expansión de rebordes delgados en maxilar inferior que permita la colocación de implantes en la posición tridimensional correcta en el mismo acto quirúrgico. Casos clínicos: Se presenta la resolución de dos casos clínicos de pacientes que acudieron a la Cátedra de Odontología Integral Adultos de la Facultad de Odontología de la Universidad de Buenos Aires. Ambos requerían la colocación de implantes en sectores posteroinferiores. Las imágenes tomográficas mostraban adecuada altura del reborde alveolar pero deficiente espesor para la colocación de implantes en la posición tridimensional correcta. Se decidió realizar una técnica de disyunción horizontal del reborde alveolar con bisturí piezoeléctrico, expansión del reborde y colocación de implantes e injerto óseo particulado de forma simultánea. Luego de 3 meses, se efectuó la segunda cirugía para iniciar la rehabilitación protésica. Conclusión: La técnica de disyunción horizontal del reborde alveolar mediante el uso del bisturí piezoeléctrico permitió ubicar al implante en la posición tridimensional correcta dentro del tejido óseo nativo sin la necesidad de realizar regeneraciones complejas en rebordes alveolares delgados (AU)

Aim: Present the horizontal split crest technique with a piezoelectric scalpel and the immediate implant placement in the correct tridimensional position, in thin mandibular alveolar ridges. Cases report: The surgical resolutions of 2 clinical cases of patients who attended the Adult Integral Dentistry Chair of the Faculty of Dentistry of the UBA, are presented. Both patients required implant placement in posterior madibular residual ridge. The tomographic images showed adequate height of the alveolar ridge but poor thickness for implants placement in a correct three-dimensional position. It was decided to perform a horizontal split crest technique of the alveolar ridge with piezoelectric scalpel, ridge expansion, and immediate implant placement with xenograft. After 3 months, the second surgery was performed to start with the prosthetic rehabilitation. Conclusion: The horizontal split crest technique using a piezoelectric scalpel, allowed immediate implant placement in the correct tridimensional position within native bone tissue, avoiding a guided bone regeneration technique, in these cases with thin alveolar ridges (AU)

Methods of accelerating orthodontic tooth movement: A review of contemporary literature.

Technological progress and the introduction of modern therapeutic methods are constantly changing contemporary orthodontics. More and more orthodontic patients are working adults, who expect satisfactory therapeutic effects as soon as possible, increasing the importance of methods accelerating tooth movement. The aim of this study was to review the current literature regarding methods of accelerating tooth movement and reducing the duration of the active phase of therapy. The literature was collected from the PubMed and EBSCO databases using "accelerated orthodontic tooth movement" as the search key words. The methods described were categorized as conservative and surgical. The pharmacological agents used in conservative treatment, such as growth hormone, parathyroid hormone, thyroxine, and vitamin D, are especially worth mentioning. They stimulate osteoclasts to increase resorption through a variety of mechanisms. Effective methods also include physical stimuli, e.g., vibrations or photobiomodulation. Most studies describing the effects of pharmacological agents were based on animal subjects and they may therefore lack clinical relevancy. Corticotomy and its modifications based on the regional acceleratory phenomenon (RAP) might prove to be a useful augmentation of orthodontic treatment, especially in adults, including patients with periodontal disease.

The Radiological and Stereological Analysis of the Effect of Low-Level Laser Therapy on the Mandibular Midline Distraction Osteogenesis.

OBJECTIVE: The aim of this study was to evaluate the effect of low level laser therapy (LLLT) on bone mineral density by using high-resolution computerized tomography (HR-CT) and stereology in patients subjected to mandibular midline distraction. METHODS: Nine patients between the ages of 13 and 16 years with mandibular transverse deficiency (>5 mm) were evaluated. Mandibular midline distraction osteogenesis was performed for all the patients. The patients were divided into 2 groups: the control group (n = 4) and the laser group (n = 5). GaAlAs, 830 nm wavelength, power of 40 mW, energy of 8.4 J/cm2 dose per spot, was directly applied from 2 points on the mandibular midline. The laser was applied in 8 treatment sessions at 48-hour intervals. Bone mineral density and volume of the newly formed bone were analyzed using HR-CT and stereological methods. RESULTS: A higher bone mineral density rate was found in the laser group (P < 0.05). A higher newly formed immature bone rate was found in the control group (P < 0.001). These findings suggest that more mature bone may also have a greater mineral organization than that of immature newly formed bone, which is shown by HR-CT and stereological results. CONCLUSIONS: The retention period can be shortened and mineralization may be increased by using LLLT in mandibular distraction osteogenesis.

Effect of low-level laser therapy on orthodontic tooth movement into bone-grafted alveolar defects.

INTRODUCTION: The objective of this study was to investigate the effect of low-level laser therapy (LLLT) on the rate of orthodontic tooth movement (OTM) into bone-grafted alveolar defects based on different healing states. METHODS: Ten male beagles were randomly allocated to 3 groups: group C, OTM alone as a control; group G, OTM into the grafted defects; group GL, OTM into the grafted defects with LLLT. The maxillary second premolars were protracted into the defects for 6 weeks, immediately (G-0 and GL-0) and at 2 weeks (G-2 and GL-2) after surgery. The defects were irradiated with a diode laser (dose, 4.5 J/cm(2)) every other day for 2 weeks. The rates of OTM and alveolar bone apposition, and maturational states of the defects were analyzed by histomorphometry, microcomputed tomography, and histology. RESULTS: The total amounts of OTM and new bone apposition rates were decreased by LLLT, with increased bone mineral density and trabecular maturation in the defects. Group GL-2 had the slowest movement with root resorption in relation to less woven bone in the hypermatured defect. CONCLUSIONS: LLLT significantly decreased the rate of OTM into the bone-grafted surgical defects by accelerating defect healing and maturation, particularly when the start of postoperative OTM was delayed.

Association of vitamin D3 with alveolar bone regeneration in dogs.

Designed sockets prepared on the mandibles of nine Beagle dogs were divided into three groups: Calcitriol +Alloplast, Alloplast and Empty. Five of the nine dogs received Vit.D3 and calcium supplement (Vit.D/Ca group), while the other four dogs without supplements were assigned to Non-Vit.D/Ca group. After 4 weeks, the extent of vertical ridge resorption (VRR), bone density (density), new bone formation (NBF) and implant stability quotient (ISQ) were measured. Following systemic Vit.D/Ca administration, the Empty subgroup showed significant differences from the Calcitriol + Alloplast subgroup on variants NBF/Density/VRR and the Alloplast subgroup on items NBF/Density/ISQ/VRR. Alternatively, the Calcitriol + Alloplast subgroup revealed higher values of NBF/Density/ISQ (P < 0.001) and a lower VRR value (P = 0.001) than the Alloplast subgroup. Although there were no significant differences in NBF (P = 0.349), density (P = 0.796), ISQ (P = 0.577) and VRR (0.979) comparisons on alloplast treatment between the Vit.D/Ca and Non-Vit.D/Ca groups, local application with Calcitriol + Alloplast demonstrated better NBF/Density/ISQ (P = 0.02 to <0.001) effects than which of Alloplast subgroups. Consequently, the results showed that both systemic and local vitamin D3 treatment might accelerate bone regeneration in dogs. Within the using dose, systemic vitamin D3 treatment displayed a superior stimulating effect than local vitamin D3 application did.

Effect of frequent application of low-level laser therapy on corticotomized tooth movement in dogs: a pilot study.

PURPOSE: The purposes of the present study were to evaluate the effects of frequent applications of low-level laser therapy (LLLT) on corticotomy-assisted tooth movement in a beagle dog model and to compare the effects in the mandible and maxilla. MATERIALS AND METHODS: In 4 male beagles, the maxillary and mandibular second premolars were extracted. The third premolars were corticotomized and then protracted from the canines with a continuous force of 200 g. Daily LLLT (using an aluminum gallium indium phosphide [AlGaInP] diode) was applied at the buccal mucosa of the corticotomized premolars on 1 side only. The tooth movement was measured for 8 weeks. Fluorochromes were injected intravenously at the start of the experiment (T0) and after 2 (T2), 4 (T4), and 8 (T8) weeks to evaluate new bone formation on the tension sides. Histomorphometric and immunohistologic evaluations were performed. RESULTS: In the mandible, the movement of the corticotomized premolars in the LLLT plus corticotomy group was less than that in the corticotomy-only group, although the difference was not statistically significant. In the maxilla, no significant differences between the 2 groups were found. Osteoclastic and proliferating cell activities and the amount of new bone formation were greater in the mandibular LLLT plus corticotomy group than in the corticotomy-only group. CONCLUSIONS: The frequent application of LLLT showed no significant effect on the corticotomized tooth movement.

Horizontal augmentation through the ridge-split procedure: a predictable surgical modality in implant reconstruction.

Among alveolar ridge augmentation techniques, the ridge-split procedure demonstrates many benefits, including no need for a second (donor) surgical site, rare risk of inferior alveolar nerve injury, and less pain and swelling, and others. Lateral bone augmentation through the ridge-split works best in a localized lateral bony defect intended for 1 or 2 implants and where the ridge is vertically intact. In this article, the authors present a detailed description of the implant-driven technique of alveolar ridge-split procedure in small and large bone deficiencies, in maxilla and mandible, supplemented by multiple photographs. The authors emphasize the need for careful manipulation of the thin ridge based on knowledge of precise surgical principles and stress that a practitioner needs specialized training and experience to perform this type of alveolar bone augmentation.

Clinical and histomorphometric evaluation of extraction sockets treated with an autologous bone marrow graft.

PURPOSE: The aim of this study was to evaluate the potential of an autologous bone marrow graft in preserving the alveolar ridges following tooth extraction. MATERIALS: Thirteen patients requiring extractions of 30 upper anterior teeth were enrolled in this study. They were randomized into two groups: seven patients with 15 teeth to be extracted in the test group and six patients with 15 teeth to be extracted in the control group. Hematologists collected 5 ml of bone marrow from the iliac crest of the patients in the test group immediately before the extractions. Following tooth extraction and elevation of a buccal full-thickness flap, titanium screws were positioned throughout the buccal to the lingual plate and were used as reference points for measurement purposes. The sockets were grafted with an autologous bone marrow in the test sites and nothing was grafted in the control sites. After 6 months, the sites were re-opened and bone loss measurements for thickness and height were taken. Additionally, before implant placement, bone cores were harvested and prepared for histologic and histomorphometric evaluation. RESULTS: The test group showed better results (P<0.05) in preserving alveolar ridges for thickness, with 1.14+/-0.87 mm (median 1) of bone loss, compared with the control group, which had 2.46+/-0.4 mm (median 2.5) of bone loss. The height of bone loss on the buccal plate was also greater in the control group than in the test group (P<0.05), 1.17+/-0.26 mm (median 1) and 0.62+0.51 (median 0.5), respectively. In five locations in the control group, expansion or bone grafting complementary procedures were required to install implants while these procedures were not required for any of the locations in the test group. The histomorphometric analysis showed similar amounts of mineralized bone in both the control and the test groups, 42.87+/-11.33% (median 43.75%) and 45.47+/-7.21% (median 45%), respectively. CONCLUSION: These findings suggest that the autologous bone marrow graft can contribute to alveolar bone repair after tooth extraction.

Influence of low-level laser therapy on biomaterial osseointegration: a mini-review.

The aim of this paper is to provide an overview of the available literature on low-level laser therapy (LLLT) and its influence on bone repair and the osseointegration of biomaterials. Extensive studies of alveolar bone repair, a common problem in periodontal therapy, have been conduced worldwide. The utility of LLLT in biomaterial osseointegration is still unanswered, due to lack of literature and poorly understood mechanisms. It is still difficult for one to compare studies about the action of LLLT on the osseointegration of biomaterials because the experimental models and duration of treatments are very distinct. However, it could be concluded that LLLT may offer advantages in terms of periodontal and bone functional recovery and biomaterial osseointegration.

Alveolar ridge preservation prior to implant placement with surgical-grade calcium sulfate and platelet-rich plasma: a pilot study in a canine model.

PURPOSE: To evaluate the combination of surgical-grade calcium sulfate (SGCS) and platelet-rich plasma (PRP) for alveolar ridge preservation prior to implant placement. MATERIALS AND METHODS: Five mongrel dogs were used as subjects. Four enlarged mandibular extraction sockets, 2 on each side, were created in each dog. According to a split-mouth design, the 2 anterior sockets received either SGCS/PRP (SGCS/PRPant) or were left unfilled, while the 2 posterior sockets received either SGCS/PRP (SGCS/PRPpost) or SGCS. Computerized tomographic (CT) scans were conducted at 1 day and 8 weeks postextraction to detect the change in ridge height. Bone scintigraphy was performed at 2, 4, and 6 weeks to investigate new bone formation activity. At 8 weeks, 1 dog was sacrificed for histologic and histomorphometric study. Meanwhile, implants were placed in the remaining 4 dogs. These 4 dogs were sacrificed after 3 months. RESULTS: Less ridge resorption was observed in the anterior SGCS/PRP-filled sites compared to unfilled sites (P = .001), while no significant difference was found between the SGCS/PRPpost and SGCS groups (P = .544). Bone scintigraphy showed that sites filled with SGCS/PRP showed significantly higher count/pixel at 2 (P = .028), 4 (P = .009), and 6 weeks (P = .037) than the unfilled sites. Nevertheless, the SGCS/PRPpost group achieved significantly higher values than the SGSC group only at 2 weeks (P = .036). Histomorphometrically, the SGCS/PRPant group showed a significantly higher percentage of bone-implant contact than the unfilled group (P = .024), but no significant difference was detected between the SGCS/PRPpost and SGCS groups (P = .979). CONCLUSION: Grafting SGCS/PRP in fresh extraction sockets reduced alveolar ridge resorption and promoted the bone formation in this canine model. The addition of PRP to SGCS resulted in the enhancement of bone regeneration in the early phase of healing.

Case report: surgeon and orthodontist work together from patient's birth.

This case report presents one of the initial participants of a new treatment protocol started in 1965 for children born with complete clefts of the lip, alveolus, and palate at Children's Memorial Hospital, Chicago, USA. The surgeon and orthodontist worked together and in tandem from the time of the patient's birth. The protocol involves lip and palate closure, along with the placement of a passive maxillary prosthesis and minimal primary osteoplasty to the alveolus to help stabilize the maxillary segments. This case is noteworthy in that the patient had a number of congenitally missing teeth, and treatment required moving a tooth into and through an area originally cleft. The patient is now 40 years of age. Intra- and extraoral photographs, cephalometric radiographs, occlusal dental radiographs, and dental casts through the treatment stages are presented.

[An experimental study on alveolar ridge preservation prior to dental implant placement].

OBJECTIVE: To evaluate the combination of surgical grade calcium sulfate hemihydrate (SGCS) and platelet-rich plasma (PRP) for alveolar ridge preservation prior to implant placement. METHODS: Changes of bone quantity and quality in extraction sites following the SGCS/PRP and SGCS implantations were investigated by spiral computer tomography scan, bone scintigraphy, radiographic, histological and histomorphometric examinations. RESULTS: The placement of SGCS/PRP reduced the resorption of the alveolar ridge. It also promoted bone metabolism and bone-to-implant contact. The addition of PRP to SGCS achieved the enhancement of the bone metabolism only at the early healing phase. CONCLUSIONS: In this animal experiment, SGCS/PRP may be used as fresh extraction sockets graft for alveolar ridge preservation prior to implant placement.

Evaluation of healing with use of an internal matrix to repair furcation perforations.

AIM: The purpose of this study was to evaluate healing responses following repair of furcation perforations, with and without an internal matrix. Two matrix materials, HAPSET (65% non-resorbable hydroxyapatite and 35% plaster of paris) and hydroxyapatite were compared. METHODOLOGY: Four adult female baboons (Papio anubis) served as experimental models. Furcation perforations were made in the molar and premolar teeth, which were then randomly assigned to one of the five groups, according to the method of perforation repair: 1 Experimental group 1 (16 teeth): The matrix material was HAPSET and the sealing material, amalgam. 2 Experimental group 2 (16 teeth): The matrix material was hydroxyapatite and the sealing material, amalgam. 3 Experimental group 3 (16 teeth): No matrix was placed. The sealing material was amalgam. 4 Positive control group (16 teeth): The perforation was not sealed. 5 Negative control group (16 teeth): No perforation was made. The animals were sacrificed at 1 week and 1, 3 and 7 months. Specimens were prepared for examination with light microscopy. RESULTS: The data revealed that when amalgam was used alone without a matrix, there was marked extrusion of the material into the underlying bone with an associated severe inflammatory response, which continued throughout the observational period. When an internal matrix was used, there was an initial acute inflammatory response that diminished with time such that at 7 months, 75% of these specimens were free of inflammation. There was no difference in the tissue response to the different matrix materials. HAPSET and hydroxyapatite underwent connective tissue encapsulation in the early stages followed by new bone deposition in direct contact with the materials. CONCLUSIONS: Within this animal model healing responses are better when an internal matrix, whether HAPSET or hydroxyapatite, is used in the repair of furcation perforations.

Alveolar ridge repair in a canine model using rhTGF-beta 1 with barrier membranes.

In both normal and membrane-assisted situations, healing events are modulated by the activity of endogenous protein molecules known as cytokines. Due to its mitogenic and chemotactic characteristics, the addition of rhTGF-beta 1 should increase the rate of osteogenesis or increase the potential for bone regeneration in oral osseous defects. This study evaluates the effects of an osteoconductive biodegradable matrix incorporating human recombinant transforming growth factor beta 1 (rhTGF-beta 1) in conjunction with barrier membranes on bone regeneration in canine alveolar ridge defects. A matrix of calcium carbonate and hydroxyethyl starch served as the carrier for test concentrations of 2.0 micrograms/0.8 ml and 20.0 micrograms/0.8 ml of rhTGF-beta 1. One surgically prepared site in each of 13 adult male fox-hounds received 1 of 4 experimental treatment regimens, with 6 sites utilizing barrier membranes. Four sites in each of 2 additional animals, two containing carrier matrix only and 2 with the additional barrier membrane, served as controls. Specimens were retrieved after 2 months of healing and processed for routine light microscopy. The quantity and composition of regenerated bone was examined. Analysis of variance revealed a statistically significant increase (P < 0.05) in the development of bone with the use of rhTGF-beta 1. Likewise, a statistically significant increase in regeneration was found in membrane-protected sites over nonmembrane-protected sites. No statistically significant difference was noted between the low and high dose treatments. The authors conclude that the use of rhTGF-beta 1 in conjunction with a barrier membrane greatly enhances bone regeneration in osseous oral defects.

[Comparative evaluation of biomaterials use in surgical treatment of periodontitis]. / Ocena porównawcza zastosowania biomaterialów w chirurgicznym leczeniu zapalen przyzebia.

Clinical and radiological evaluation of three biomaterials--HA-Biocer, Bio-Gran and Bio-Oss was carried out two years after their grafting in parodontium. The tests were carried out for 91 patients with parodontis. Comparative clinical results (remission of the inflammatory state of parodontium tissues, essential reduction of gingival pockets and rebuilding of alveolar process bone on aimed X-ray pictures) were noted. The carried out observations show that biomaterials application for filling vertical alveoral process bone defects for patients with parodontis gives satisfactory clinical results.