Midterm outcomes of autogenous mature third molars transplantation into surgically created sockets: A retrospective cohort study.

BACKGROUND/AIMS: The purpose of this study was to observe the outcome of mature third molars transplantation into surgically created sockets with the assistance of computer designed three dimensional (3-D) printed replicas and compare its outcome with the conventional fresh socket autotransplantation. MATERIAL AND METHODS: This study included total of 96 mature third molars autotransplanted in 96 cases with the guidance of computer designed 3-D printed replicas. Forty-eight teeth autotransplanted into surgically created sockets were enrolled into the surgically created socket group and 48 teeth conventionally autotransplanted into fresh sockets were enrolled into the fresh socket group. In the surgically created socket group, mature third molars were autotransplanted into surgically prepared sockets at the site of previously missed or extracted molars in the alveolar bone and in the fresh socket group, autotransplantation of mature third molars were performed in fresh sockets of extracted diseased molars simultaneously. After transplantation, the visual analogue scale (VAS) score, Landry Wound Healing Index (LWHI), mobility and probing depth (PD) of the transplanted teeth were measured and the patient satisfaction questionnaire were held in both group. All patients underwent clinical and radiographic examinations during the follow-up. RESULTS: During the mean follow-up period of 47.63 ± 16.78 months (range 18-78 months), 92 out of 96 teeth remained in situ without clinical or radiographic complications with overall success rate of 95.83%. No statistically significant differences were found in success and survival rates between the two group. The average extra-oral time of the donor teeth were 60.76 ± 22.41 s and mean positioning trials of the donor teeth were 2.43 ± 1.19. The VAS score at Day 1 in the surgically created socket group was higher than the fresh socket group (p < .05). LWHI scores in the surgically created group were lower than the fresh socket group during the first 2 weeks (p < .05). The degree of mobility of the transplanted teeth in both group showed no statistically significant difference during the first 3 months. PD in the surgically created group were higher than the fresh socket group in the first month but there were no statistically significant difference after 1 month. Twenty-six out of 48 cases in the surgically created group needed crown restoration while only 10 cases went through crown restoration in the fresh socket group. Most patients in both group were satisfied with the treatment. CONCLUSIONS: Autogenous mature third molars transplantation into surgically created sockets is as effective as conventional fresh socket transplantation. This technique is worth recommending in carefully selected cases and optimistic results can be achieved.

A clinical study of the piezosurgery, high-speed contra-angle handpiece, and the combined application of both for extraction of embedded supernumerary teeth.

OBJECTIVES: To compare the effectiveness of three methods: high-speed contra-angle handpiece (HSCAH), piezosurgery, and combined in the extraction of different locations and types of embedded supernumerary teeth. METHODS: Sixty cases with different locations and different types of embedded supernumerary teeth were randomly divided into three groups for extraction by HSCAH, piezosurgery, and the combination of both, and the intraoperative and postoperative conditions of the three groups were compared and analyzed. RESULTS: In the extraction of embedded supernumerary teeth in the inverted, horizontal, and root tip positions, the piezosurgery group required significantly longer operative time and reduced intraoperative bleeding compared with the HSCAH and the piezosurgery combined with the HSCAH; it could effectively relieve postoperative pain and facial swelling. In the extraction of oblique, orthodontic, middle, and crown segments of embedded supernumerary teeth, the use of a piezosurgery combined with an HSCAH can effectively reduce the operative time, while the factors of bleeding, postoperative pain, and facial swelling not statistically significant when compared with a piezosurgery. Compared with the HSCAH and combined piezosurgery, piezosurgery can significantly reduce the fear of patients. CONCLUSION: Piezosurgery is effective in extracting embedded supernumerary teeth in inverted, horizontal, and apical positions, effectively reducing intraoperative and postoperative trauma and shortening the time required for healing. The piezosurgery combined with an HSCAH can effectively reduce intraoperative and postoperative trauma when extracting embedded supernumerary teeth in oblique, orthodontic, middle, and crown positions. piezosurgery is a technique suitable for the treatment of patients with fear.

Clinical application of concentrate growth factors combined with bone substitute in Alveolar ridge preservation of anterior teeth.

OBJECTIVE: To investigate the clinical effect of concentrated growth factors (CGF) combined with deproteinized bovine bone mineral (DBBM) on Alveolar ridge preservation during implantology. METHODS: A total of 38 patients were selected and randomly divided into 2 groups, with 19 cases in each group. The extraction sockets were filled with DBBM with or without CGF. Visual analogue scale (VAS) pain score was recorded within1 week and Landry wound healing index (LWHI) was recorded at 1, 2 and 3 weeks after operation. CBCT was taken preoperatively and 3 and 6 months postoperatively to measure and compare the changes of vertical height, width and gray value of alveolar bone at extraction site. The changes of alveolar bone contour were observed clinically and compared between the two groups. RESULTS: The VAS score of CGF group was lower than control group on the 1st and 3rd day after operation (P < 0.05). The LWHI of CGF group was higher than control group 1 week after operation (P < 0.05). The absorption of the labial and palatal plates height and the width in the CGF group was significantly less than the control group at 3 months (P < 0.05). The gray value of alveolar bone in CGF group was significantly higher than control group at 3 months (P < 0.05). There was no significant difference in new bone contour between the two groups (P > 0.05). 94.7% cases in CGF group did not undergo bone grafting, which was significantly higher than control group (78.9%). CONCLUSIONS: The use of CGF combined with DBBM can help to reduce postoperative pain at the early stage of healing, form sufficient keratinized gingival tissue, effectively maintain the height and width of alveolar bone in the three-dimensional direction and provide good conditions for implant repair in the future.

Application of concentrated growth factor to autotransplantation with inflammation in recipient area.

OBJECTIVE: The purpose of this study was to apply concentrated growth factor (CGF) to the transplanted area with inflammation, to observe the clinical effects of CGF on the inflammation area assisted by 3D printing technology. METHODS: A total of 52 compromised mandibular first or second molar with chronic periapical lesions were transplanted with mature third molars. The patients were divided into CGF group (n = 26) and control group (n = 26) and transplanted into fresh extraction sockets with or without CGF. All the patients underwent clinical and radiographic examinations during the follow-up. RESULTS: Average surgery and extra-oral time were 39 min (± 7.8) and 42 s (± 10.2). The success rates of CGF group and control group were 100% and 92.3% respectively. Most of the periapical lesions in CGF group healed completely within 3 months, which was significantly faster than control group. The initial stability of CGF group was better than control group immediately after operation, and the degree of pain in CGF group was lower than control group on the 1st and 3rd day after operation. CONCLUSIONS: The application of CGF in recipient site with chronic periapical lesions can accelerate the regeneration of alveolar bone and the healing of inflammation, greatly shorten the healing period. Meanwhile, CGF help to reduce postoperative pain and reaction at the early stage of healing and increase the success rate of autogenous tooth transplantation (ATT). Additionally, the use of 3D printing model can greatly reduce the extra-oral time of donor teeth.