RESUMO
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.
Assuntos
Perda do Osso Alveolar , Terapia com Luz de Baixa Intensidade , Humanos , Processo Alveolar/diagnóstico por imagem , Processo Alveolar/cirurgia , Processo Alveolar/patologia , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Alvéolo Dental/patologia , Lasers Semicondutores/uso terapêutico , Osteocalcina , Extração Dentária/métodos , Perda do Osso Alveolar/patologiaRESUMO
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.
Assuntos
Aumento do Rebordo Alveolar , Substitutos Ósseos , Humanos , Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Minerais , Processo Alveolar/cirurgia , Dentina , Alvéolo Dental/cirurgia , Extração DentáriaRESUMO
The present study evaluated the quantitative effects of platelet-rich fibrin (PRF) for the repair of extraction socket in Sprague Dawley (SD) rat model by assessing several key clinical parameters. Seventy two male SD rats were subjected to surgical extraction of the maxillary right incisor. Rats were randomly divided into four groups with eighteen rats in each group based on the treatment received: extraction socket without treatment of PRF was taken as control (group I). Extraction socket implanted with 0.1, 0.2, and 0.4 mL of PRF was taken as study groups (groups II, III, and IV). The obtained results demonstrated that, low dose of PRF efficiently enhanced the natural healing cascade. Whereas, high dose interfered with native tissue contribution and altered the natural healing process. The beneficial effects of quantity-based application of PRF may raise the possibility of a new approach as complementary therapy besides conventional treatment.
Assuntos
Fibrina Rica em Plaquetas , Masculino , Animais , Ratos , Alvéolo Dental/cirurgia , Extração Dentária , Ratos Sprague-DawleyRESUMO
The objective was to evaluate the effect of photobiomodulation (PBM) using 980 nm diode laser therapy (0.60 W, 0.77 W cm-2 , 36 J, 46 J cm-2 , 60 s) irradiated in continuous wave mode by flat-top hand-piece on socket healing in the maxilla and mandible. A split-mouth experimental design was performed on 6 dogs. The 3rd premolar tooth was extracted from the maxilla and mandibles for both sides. The right-sided sockets were irradiated (PBM group), and the left-sided sockets were kept as control. Irradiation was done after extraction and at 48-h interval for 14 days. Both the buccal and lingual sides were irradiated to reach a total irradiation time of 120 s. Bone density was evaluated at 3, 4 and 5 weeks using cone beam computed tomography. We showed that maxillary sockets in the PBM group had higher bone density compared to control one at 3, 4, 5 weeks (P = 0.029, <0.001, <0.001), respectively. Mandibular sockets revealed no significant difference between PBM and control at 3 weeks (P = 0.347), while at 4 and 5 weeks PBM group showed higher bone density (P = 0.004, <0.001). In both groups, there was a significant increase (P < 0.001) in bone density by time which was higher in the PBM group. We concluded that PBM using a flat-top hand-piece of 980-nm improved the bone density of extraction sockets.
Assuntos
Lasers Semicondutores , Terapia com Luz de Baixa Intensidade , Animais , Cães , Modelos Teóricos , Alvéolo Dental/cirurgia , CicatrizaçãoRESUMO
The management of patients under treatment with Direct Oral Anticoagulants (DOACs) has led clinicians to deal with two clinical issues, such as the hemorrhagic risk in case of non-interruption or the risk of thromboembolism in case of suspension of the treatment. The primary aim of this retrospective study was to evaluate the incidence of perioperative bleeding events and healing complications in patients who were under treatment with Rivaroxaban and who received dental implants and immediate prosthetic restoration. Patients treated with Rivaroxaban (Xarelto 20 mg daily) and who needed implant rehabilitation were selected. Four to six implants were placed in mandibular healed sites or fresh extraction sockets. All patients, in agreement with their physicians, interrupted the medication for 24 h and received implants and immediate restorations. Twelve patients and 57 implants were analyzed in the study. No major postoperative bleeding events were reported. Three patients (25%) presented slight immediate postoperative bleeding controlled with compression only. The implant and prosthetic survival rate were both 100% after 1 year. Within the limitations of this study, multiple implant placement with an immediate loading can be performed without any significant complication with a 24 h discontinuation of Rivaroxaban, in conjunction with the patient's physician.
Assuntos
Carga Imediata em Implante Dentário , Rivaroxabana/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Falha de Restauração Dentária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Rivaroxabana/efeitos adversos , Extração Dentária , Alvéolo Dental/cirurgia , Resultado do TratamentoRESUMO
The aim of this randomized, controlled animal exploratory trial was to investigate the influence of local application of aminobisphosphonate pamidronate during the socket preservation procedure. Mandibular premolars were extracted in five Göttingen minipigs. Two animals underwent socket preservation using BEGO OSS (n = 8 sockets) and three animals using BEGO OSS + Pamifos (15 mg) (n = 12 sockets). After jaw impression, cast models (baseline, eight weeks postoperative) were digitized using an inLab X5 scanner (Dentsply Sirona) and the generated STL data were superimposed and analyzed with GOM Inspect 2018 (GOM, Braunschweig). After 16 weeks, the lower jaws were prepared and examined using standard histological methods. In the test group (BEGO OSS + pamidronate), buccooral dimensional loss was significantly lower, both vestibulary (0.80 ± 0.57 mm vs. 1.92 ± 0.63 mm; p = 0.00298) and lingually (1.36 ± 0.58 mm vs. 2.56 ± 0.65 mm; p = 0.00104) compared with the control group (BEGO OSS). The test group showed a significant difference between vestibular and lingual dimensional loss (p = 0.04036). Histology showed cortical and cancellous bone in the alveolar sockets without signs of local inflammation. Adjuvant application of pamidronate during socket preservation reduces alveolar dimensional loss significantly. Further investigations with regard to dose-response relationships, volume effects, side effects, and a verification of the suitability in combination with other bone substitute materials (BSMs) are necessary.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Conservadores da Densidade Óssea/uso terapêutico , Pamidronato/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Extração Dentária/métodos , Perda do Osso Alveolar/etiologia , Animais , Conservadores da Densidade Óssea/administração & dosagem , Regeneração Óssea , Modelos Anatômicos , Pamidronato/administração & dosagem , Distribuição Aleatória , Suínos , Porco Miniatura , Extração Dentária/efeitos adversos , Alvéolo Dental/patologia , Alvéolo Dental/cirurgiaRESUMO
BACKGROUND: Low-level laser therapy (LLLT) has been suggested to improve primary stability at the early stages of osseointegration in animal models. However, there is still scarce evidence about its influence on implant stability in humans. PURPOSE: To assess the influence of LLLT on implant stability in implants placed in fresh extraction sockets. MATERIAL AND METHODS: A randomized controlled trial was designed according to the SPIRIT guidelines and is reported following the CONSORT. Patients were randomly allocated according to control or LLLT groups. LLLT consisted in the application of GaAlAs laser (808 nm, avg. power density: 50 mW, circular spot diameter and area: 0.71 cm/0.4cm2 ) applied in six points in contact mode with peri-implant soft tissue (1.23 minutes in each point of application; dose per point 11 J) before bone perforation and after suturing. The total dose resulted in 66 J per application moment. This LLLT protocol was applied only in the dental implant placement session. Implant stability was by ISQ at implant placement (T0 ) and the abutment selection (Ta ). Digital radiographs for T0 and Ta were used to assess the distance between the implant platform and alveolar bone crest, in millimeters. T-test and Shapiro-Wilk test were used to analyze data between groups using the implant as a unit of analysis. RESULTS: Fifty implants were placed in 44 patients. The insertion torque ranged from 15 to 60 N.cm (mean 35.64 ± 13.34). Two implants of the LLLT and one of the control groups were lost to follow-up and one implant of the control group failed to osseointegrate (4.3%). ISQ at T0 ranged from 17 to 79 (mean 59.33 ± 13.05) and from 40 to 89 (mean 66.46 SD ± 11.56) at Ta . No differences were observed when comparing the groups with ISQ difference (P = .433) or radiographical peri-implant alterations (P = .261). CONCLUSIONS: LLLT did not influence implant stability in implants placed in fresh extraction sockets when assessed at healing abutment installation.
Assuntos
Implantes Dentários , Terapia com Luz de Baixa Intensidade , Processo Alveolar , Animais , Implantação Dentária Endóssea , Humanos , Osseointegração , Alvéolo Dental/cirurgiaRESUMO
BACKGROUNDS: This paper describes an additional benefit in double anterior segmental osteotomy to correct severe anterior protrusion in adult patients with extremely thin mandibular alveolus and ankylosed tooth. For the optimal anterior segmental retraction, an ankylosed posterior tooth needed surgical inclination reposition. During anterior segmental osteotomy surgery under local anesthesia, additional single tooth osteotomy was performed without challenge. METHODS: For anterior segment retraction, osteotomy cuts were made by the surgeon to define a block of bone embedding 6 mandibular anterior teeth. First premolars were extracted during initial orthodontic treatment period. But the ankylosed lower left lateral incisor and lower right second premolar root which remains mesially with uprighted crown hindered further anterior segment retraction. The authors removed cortical bone around second premolar root and repositioned to be upright. Anterior segment was retracted to proper position utilizing the space gained. RESULT: Thin alveolar mandibular anterior segment retraction and the second premolar uprighting were managed effectively with additional single tooth segmental osteotomy during anterior segmental osteotomy. CONCLUSION: Double anterior segmental osteotomy can be an effective alternative to conventional orthognathic surgery in selected adult patients.
Assuntos
Anestesia Local/métodos , Dente Canino/cirurgia , Mandíbula/cirurgia , Osteotomia/métodos , Anquilose Dental/cirurgia , Técnicas de Movimentação Dentária/métodos , Alvéolo Dental/cirurgia , Adulto , Dente Pré-Molar , Humanos , Incisivo , Masculino , Anquilose Dental/diagnóstico , Anquilose Dental/etiologiaRESUMO
The aim of the present study was to evaluate the feasibility of SEM and EDX microanalysis on evaluating the effect of porcine xenografts (MP3®) supplemented with pamidronate during socket healing. Mandibular second premolars (P2) and first molars (M1) were extracted from six Beagle dogs. P2 were categorized as small defects (SD) and M1 as large defects (LD). Four random groups were created: SC (small control defects with MP3®), ST (small test defects MP3®+pamidronate), LC (large control defects with MP3®), and LT (large test defects MP3®+pamidronate). At four and eight weeks of healing the samples were evaluated fisically through scanning electron microscopy (SEM), and chemical element mapping was carried out by Energy dispersive X-ray spectroscopy (EDX). After four weeks of healing, SEM and EDX analysis revealed more mineralized bone in ST and LT groups compared with control groups (p<0.05). After eight weeks, Ca/P ratios were slightly higher for small defects (groups SC and ST); in SEM description, in both control and test groups, trabecular bone density was similar to the adjacent mineralized cortical bone. Within the limitations of this experimental study, SEM description and EDX elemental microanalysis have demonstrated to be useful techniques to assess bone remodelling of small and large defects. Both techniques show increased bone formation in test groups (MP3® modified with pamidronate) after four and eight weeks of healing.
Assuntos
Aumento do Rebordo Alveolar/métodos , Difosfonatos/administração & dosagem , Microscopia Eletrônica de Varredura/métodos , Alvéolo Dental/cirurgia , Alvéolo Dental/ultraestrutura , Animais , Conservadores da Densidade Óssea/administração & dosagem , Transplante Ósseo/métodos , Terapia Combinada/métodos , Cães , Xenoenxertos/transplante , Xenoenxertos/ultraestrutura , Masculino , Pamidronato , Projetos Piloto , Suínos , Extração Dentária , Alvéolo Dental/efeitos dos fármacos , Transplante Heterólogo , Resultado do Tratamento , CicatrizaçãoRESUMO
OBJECTIVES: The aim of the study was to compare the effects of porcine xenografts (MP3(®)) with or without pamindronate for the healing of small and large defects of postextraction sockets. MATERIALS AND METHODS: Six beagle dogs were used in the study; second premolars and first molars of the mandible were extracted, small defects (SD) and large defects (LD) were identified. Each defect was measured and randomly filled as follows: SC (small control defects filled with MP3(®) alone), ST (small test defects filled with MP3(®) modified with pamindronate), LC (large control defects filled with MP3(®) alone), LT (large test defects filled with MP3(®) modified with pamindronate). After 4 and 8 weeks, the animals were euthanized and the percentages of new bone formation (NB), residual graft (RG) and connective tissue (CT) were analysed by histology and histomorphometry of undecalcified samples. RESULTS: After 4 weeks, NB formation was higher for ST compared to all groups and for LT compared to LC (P < 0.05); RG was significantly higher in both control groups compared to tests (P < 0.05); and CT was higher in large defects (LC and LT) compared to small defects. After 8 weeks, NB formation was higher for test groups (ST and LT) compared to controls (P < 0.05); RG was significantly higher in both control groups compared to tests (P < 0.05); and CT was higher in large defects (LC and LT) compared to small defects (P < 0.05). CONCLUSIONS: Within the limitations of this experimental study, the findings suggest that porcine xenografts modified with pamindronate favours the new bone formation and increased the porcine xenograft substitution/replacement after 4 and 8 weeks of healing.
Assuntos
Perda do Osso Alveolar/prevenção & controle , Substitutos Ósseos/farmacologia , Difosfonatos/farmacologia , Alvéolo Dental/efeitos dos fármacos , Animais , Dente Pré-Molar/cirurgia , Cães , Xenoenxertos , Masculino , Mandíbula/cirurgia , Dente Molar/cirurgia , Pamidronato , Distribuição Aleatória , Retalhos Cirúrgicos , Suínos , Extração Dentária , Alvéolo Dental/cirurgiaRESUMO
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.
Assuntos
Processo Alveolar/efeitos da radiação , Transplante Ósseo/métodos , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Doenças Maxilares/radioterapia , Técnicas de Movimentação Dentária/métodos , Processo Alveolar/cirurgia , Animais , Densidade Óssea/efeitos da radiação , Matriz Óssea/transplante , Regeneração Óssea/efeitos da radiação , Remodelação Óssea/efeitos da radiação , Substitutos Ósseos/uso terapêutico , Cães , Corantes Fluorescentes , Masculino , Doenças Maxilares/cirurgia , Osteogênese/efeitos da radiação , Distribuição Aleatória , Alvéolo Dental/efeitos da radiação , Alvéolo Dental/cirurgia , Microtomografia por Raio-X/métodosRESUMO
PURPOSE: To evaluate the effects of low-level laser therapy (LLLT) on peri-implant bone regeneration by means of resonance frequency analysis and histologic analysis of bone-to-implant contact (BIC). MATERIALS AND METHODS: Thirty-two male New Zealand rabbits were randomly divided into four groups of eight animals each, one control group (nonirradiated animals) and three experimental groups that received LLLT (group E5 = 5 J per session; group E10 = 10 J per session; group E20 = 20 J per session). The mandibular left incisor was surgically extracted in all animals, and a nanoparticle-treated-surface osseointegrated implant was placed immediately afterward. The experimental groups were irradiated with aluminum-gallium-arsenide laser diode every 48 hours over a 13-day period for a total of seven sessions. Implant stability quotients (ISQs) were measured at the time of implant placement and 30 days after the last LLLT session. The animals were then euthanized and dissected, and histologic slides of the implant region were obtained for BIC evaluation. RESULTS: Significant differences in ISQ were detected between groups before and after LLLT, with group E20 showing significantly higher values than controls. The percentage of BIC was also significantly higher in group E20 than in control animals. CONCLUSION: Laser therapy at a dose of 20 J per treatment session, based on the irradiation protocol used in this study, was able to significantly increase ISQ values and BIC after implant placement, indicating that laser irradiation effected an improvement in peri-implant bone healing.
Assuntos
Implantes Dentários , Terapia com Luz de Baixa Intensidade/métodos , Mandíbula/efeitos da radiação , Osseointegração/efeitos da radiação , Animais , Interface Osso-Implante/anatomia & histologia , Interface Osso-Implante/efeitos da radiação , Implantação Dentária Endóssea/métodos , Planejamento de Prótese Dentária , Retenção em Prótese Dentária , Lasers de Estado Sólido/uso terapêutico , Masculino , Mandíbula/anatomia & histologia , Mandíbula/cirurgia , Nanopartículas/química , Osteogênese/efeitos da radiação , Coelhos , Distribuição Aleatória , Propriedades de Superfície , Alvéolo Dental/anatomia & histologia , Alvéolo Dental/efeitos da radiação , Alvéolo Dental/cirurgia , VibraçãoRESUMO
This case report describes the treatment of a skeletal Class III malocclusion with autotransplantation of a cryopreserved tooth. To gain an esthetic facial profile and good occlusion, extraction of bimaxillary premolars and surgical therapy were chosen. The patient had chronic apical periodontitis on the lower left first molar. Although she did not feel any pain in that region, the tooth was considered to have a poor prognosis. Therefore, we cryopreserved the extracted premolars to prepare for autotransplantation in the lower first molar area because the tooth would probably need to be removed in the future. The teeth were frozen by a programmed freezer with a magnetic field (CAS freezer) that was developed for tissue cryopreservation and were cryopreserved in -150°C deep freezer. After 1.5 years of presurgical orthodontic treatment, bilateral sagittal split ramus osteotomy was performed for mandible setback. Improvement of the facial profile and the occlusion were achieved in the retention phase. Six years after the initial visit, the patient had pain on the lower left first molar, and discharge of pus was observed, so we extracted the lower left first molar and autotransplanted the cryopreserved premolar. Three years later, healthy periodontium was observed at the autotransplanted tooth. This case report suggests that long-term cryopreservation of teeth by a CAS freezer is useful for later autotransplantation, and this can be a viable technique to replace missing teeth.
Assuntos
Autoenxertos/transplante , Dente Pré-Molar/transplante , Criopreservação/métodos , Feminino , Seguimentos , Humanos , Magnetoterapia/métodos , Má Oclusão Classe III de Angle/cirurgia , Má Oclusão Classe III de Angle/terapia , Dente Molar/cirurgia , Mordida Aberta/terapia , Osteotomia de Le Fort/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Planejamento de Assistência ao Paciente , Periodontite Periapical/cirurgia , Cisto Radicular/cirurgia , Tratamento do Canal Radicular/métodos , Extração Dentária/métodos , Alvéolo Dental/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
The extraction of teeth results in rapid bone resorption both vertically and horizontally in the first month. The loss of alveolar ridge reduces the chance of implant rehabilitation. The atraumatic extraction, implant placement in extraction socket, and an immediate prosthesis have been proposed as alternative therapies to maintain the volume and contours tissue and reduce time and cost of treatment. Thus, this paper aims to present a clinical case where the extraction was performed using interradicular septum as guide for pilot drill in postextractive implantology with implant placement and immediate provisionalization in a inferior molar. The advantages of this technique are to place the implant exactly in the center of the alveolar ridge, to mantain the edges of the alveolar ridge and reduce postextractive bone resorption, and has great advantages in final prosthetic rehabilitation.
Assuntos
Implantação Dentária Endóssea/métodos , Implantes Dentários para Um Único Dente , Carga Imediata em Implante Dentário , Extração Dentária/métodos , Alvéolo Dental/cirurgia , Cárie Dentária/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Granuloma Periapical/cirurgia , Pulpectomia/métodos , Fraturas dos Dentes/cirurgia , Raiz Dentária/cirurgiaRESUMO
The aim of the study was to assess the rate of neoangiogenesis in extraction wound healing following exposure to biostimulating laser therapy and to analyze the correlation between parameters of neoangiogenesis as reflected by the number and surface area of newly formed blood vessels and clinical parameters such as gender, position of a tooth in the oral cavity, and CD4 lymphocyte count. Twenty-seven patients with confirmed HIV infection were enrolled in the study (6 women, 21 men). Eighty-nine teeth were extracted; 45 sockets were exposed to 6 J laser radiation (laser parameters were set as follows: wavelength, 820 nm; output, 200 mW; dose, 6 J/cm(2); spot size, 38 mm(2); continuous radiation) for five consecutive days following tooth extraction, and the remaining extraction wounds were left to heal spontaneously without laser irradiation. Antigen CD34 was assessed by immunohistochemistry as a marker of angiogenesis, and its expression was examined by computer-assisted histomorphometric image analysis. As a result, we report that biostimulating laser therapy in HIV-infected patients of varying degrees of immunodeficiency greatly accelerated post-extraction neoangiogenesis, regardless of the patient's gender, tooth position, number of roots, or number of CD4 lymphocytes in the blood. Application of low-level laser therapy for the treatment of tooth extraction wounds in HIV(+) patients greatly enhanced the formation of new blood vessels, which in turn promoted wound healing.
Assuntos
Infecções por HIV/cirurgia , Terapia com Luz de Baixa Intensidade/métodos , Neovascularização Fisiológica , Extração Dentária , Cicatrização/fisiologia , Adulto , Antígenos CD34/metabolismo , Linfócitos T CD4-Positivos/efeitos da radiação , Feminino , Humanos , Lasers , Masculino , Pessoa de Meia-Idade , Alvéolo Dental/cirurgiaRESUMO
Previous studies have reported positive effects of low-level laser therapy (LLLT) on bone healing. This study evaluated the effects of LLLT on peri-implant healing in vivo. Thirty-two rabbits had their mandibular left incisors removed, followed by immediate insertion of a dental implant into the fresh socket. Animals were assigned randomly to four groups: control (non-irradiated) or LLLT at three different doses per session: 5J/cm(2), 10J/cm(2), and 20J/cm(2). A GaAlAs laser (830nm, 50mW) was applied every 48h for 13 days, starting immediately after surgery. The implant stability quotient (ISQ) was measured using resonance frequency analysis upon implant insertion and immediately after death, 30 days after the last application. Tissues were prepared for scanning electron microscopy (SEM) and stereology. Variables measured were bone-implant contact (BIC) and bone neoformation within implant threads at three different sites. The results showed better ISQ for the 20J/cm(2) group (P=0.003). BIC values were significantly higher (P<0.05) in the 20J/cm(2) group, on both SEM and stereology. Bone area values were better in the 10J/cm(2) (P=0.036) and 20J/cm(2) (P=0.016) groups compared to the control group. Under these conditions, LLLT enhanced peri-implant bone repair, improving stability, BIC, and bone neoformation. The findings support and suggest parameters for the design of clinical trials using LLLT after implant placement.
Assuntos
Implantação Dentária Endóssea/métodos , Implantes Dentários , Terapia com Luz de Baixa Intensidade/métodos , Osteogênese/efeitos da radiação , Cicatrização/efeitos da radiação , Animais , Masculino , Mandíbula/cirurgia , Microscopia Eletrônica de Varredura , Coelhos , Alvéolo Dental/cirurgiaRESUMO
BACKGROUND: Grafting a fresh extraction socket is essential for successful regeneration of bone and maximizing volume preservation. Various synthetic grafts have been used to simulate bone formation. The purpose of the present study was to evaluate clinical, histomorphometric, and radiographic healing at 1-month, 3-month, and 4-month time points after tooth extraction with placement of calcium sulfate hemihydrate putty bone grafts NanoGen and DentoGen to determine their efficacy in ridge preservation following tooth extraction. METHOD: Sixty subjects who were in need of extraction were recruited. The subjects were randomly assigned their group based on computer software for both the test groups (NanoGen and DentoGen). DentoGen is a medical-grade calcium sulfate hemihydrate with particle of 30 µm, and NanoGen is a nanocrystalline version of DentoGen with particle size 400 µm to 800 µm. Data were recorded at 1, 3, and 4 months after extraction socket grafting. Bone biopsies were taken at 4 months for histomorphometric analysis. RESULTS: The mean percentage of bone formed by NanoGen was 51.19 ± 9.53% and by DentoGen 50.67 ± 16.16% after 4 months. No statistically significant difference was noted in the mean bone formation by NanoGen and DentoGen at various time intervals; no bone graft remnants of DentoGen were found at 4 months. The mean percentage of bone graft remnants left after 4 months for NanoGen was 6.83 ± 16% in the maxilla and 7.38 ± 21% in the mandible. The mean percentage of soft tissue formed was significantly higher with DentoGen in mandibular socket sites. On radiographic evaluation the mean percentage of socket fill with DenoGen was found to be 23.1 ± 11.65%, 50 ± 9.6%, and 76.7 ± 11% and with NanoGen was 29.2 ± 12.8%, 52.8 ± 15.6%, and 76.47 ± 12.43% at 1 month, 3 months, and 4 months postoperative intervals, respectively. CONCLUSION: Both the materials investigated in the study showed excellent bone forming capacity, but the nanocrystalline version (NanoGen) of calcium sulfate was found to have clinical and biologic advantages over DentoGen.
Assuntos
Substitutos Ósseos/uso terapêutico , Sulfato de Cálcio/uso terapêutico , Nanopartículas/uso terapêutico , Alvéolo Dental/cirurgia , Adolescente , Adulto , Aumento do Rebordo Alveolar/métodos , Biópsia/métodos , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/patologia , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Osteogênese/efeitos dos fármacos , Tamanho da Partícula , Radiografia Interproximal , Extração Dentária , Resultado do Tratamento , Adulto JovemRESUMO
The aim of this study was to evaluate the use of calcium sulfate (CaS) as a hemostatic agent after tooth extraction in patients with anticoagulant drug therapy. A total of 30 patients undergoing anticoagulant therapy (22 women and 8 men) with a mean age of 54.6 years (SD = 9.2 years), needing dental extractions, were selected for this study. They were divided into 2 groups, control (group 1) and test (group 2), in a randomized way. In group 1 patients, the postextraction socket was managed with obliterative suture only. Group 2 patients were treated with CaS placed into the postextraction sockets. All the patients did not interrupt the anticoagulant therapy during the dental treatment. The healing pattern was found to be approximately similar in all treatment groups, showing significant improvement at each consecutive visit. However, a statistically significant difference in the adequate hemostasis was evident between groups 1 and 2 (P = 0.0056). The use of CaS helped to control the bleeding from inside the socket, producing instantly a very good hemostasis. Further studies are necessary to confirm the simplicity, possibilities, and limits of the proposed procedure.
Assuntos
Anticoagulantes/uso terapêutico , Sulfato de Cálcio/uso terapêutico , Hemostasia Cirúrgica/métodos , Extração Dentária , Administração Oral , Anticoagulantes/administração & dosagem , Coagulação Sanguínea/efeitos dos fármacos , Feminino , Hemostáticos/uso terapêutico , Humanos , Coeficiente Internacional Normatizado , Masculino , Pessoa de Meia-Idade , Hemorragia Bucal/prevenção & controle , Hemorragia Pós-Operatória/prevenção & controle , Extração Dentária/efeitos adversos , Alvéolo Dental/cirurgia , Varfarina/administração & dosagem , Varfarina/uso terapêutico , Técnicas de Fechamento de Ferimentos , Cicatrização/fisiologiaRESUMO
Evaluar y comparar de forma clínica, tomográfica e histológica el proceso de reparación ósea y la conservación del reborde alveolar en dos alveolos post-extracción de paredes intactas, con y sin la utilización de un material sustituto óseo regenerativo a base de sulfato de calcio hemihidratado como relleno y barrera, antes de la colocación de implantes a cuatro meses.
To evaluate and compare clinically, tomographic and histological the bone repair process and the preservation of the alveolar walls of two sockets intact, with and without the use of a bone substitute material based regenerative calcium sulfate hemihydrate as a filler and barrier before implant placement to four months.
Assuntos
Humanos , Masculino , Adulto , Alvéolo Dental/cirurgia , Perda do Osso Alveolar/prevenção & controle , Regeneração Óssea/fisiologia , Sulfato de Cálcio/uso terapêutico , Extração Dentária , Cicatrização/fisiologia , Substitutos Ósseos/uso terapêuticoRESUMO
OBJECTIVE: The aim of this report was to clinically and radiographically evaluate changes to the hard and soft tissues around implants placed in extraction sockets grafted with medical grade calcium sulfate hemihydrate (MGCSH) mixed with platelet-rich plasma (PRP) and a collagen resorbable plug after one year of function. METHODS: This evaluation was part of a previous study conducted to evaluate extraction socket grafts. Fourteen subjects out of 16 were evaluated. After tooth extraction, eight subjects received MGCSH mixed with PRP in the extraction sockets (test group), and six subjects received collagen resorbable plug dressing material (control group). After three months of bone healing, dental implants were placed. Three months after implant installation, provisional restorations were placed and implants were loaded in function for one month followed by definitive restorations. Follow-up examinations and intraoral digital radiographs were made at baseline and one year after definitive restorations to evaluate the marginal bone level in each subject. RESULTS: At the one-year follow-up, the survival and success rate was 100% for all implants. There was no statistically significant difference in the amount of vertical bone loss between groups after 1 year (p > 0.05). For the test group, there was a mean mesial bone loss of -0.8 +/- 0.6mm and a mean distal bone loss of -0.5 +/- 0.4mm. For the control group, there was a mean mesial bone loss of -1.1 +/- 0.7mm and a mean distal bone loss of -0.6 +/- 0.6mm. CONCLUSIONS: At the one-year follow-up, the implant placement in grafted sockets was not affected by the type of the graft material. Implants placed in sockets grafted with MGCSH mixed with PRP showed less marginal bone loss after one year in comparison to those with collagen resorbable grafts.