Autologous Tooth Granulometry and Specific Surface Area with Three Grinding Methods: An In Vitro Study.

A postextraction socket becomes a clinical challenge due to the fact that a series of changes associated with bone remodelling and resorption of the socket that occur after extraction, which limits the aesthetic and functional prognosis of implant-supported rehabilitations. It has been studied that the use of the autologous tooth-derived graft (ATDG) has regenerative properties and could therefore be useful for solving this type of problem. There is no consensus in the scientific literature on a standardized protocol for the use of the autologous tooth. Therefore, the aim of the present study was to evaluate the most relevant parameters to achieve the best properties of ground ATDG using three methods, namely Gouge forceps, electric grinder, and manual, that made up the study group (SG) and compared with the control group (CG) consisting of Bio-Oss®. The sample obtained by the electric grinder had the highest value of specific surface area (2.4025 ± 0.0218 m2/g), while the particle size as average diameter (751.9 µm) was the lowest and most homogeneous of the three groups. Therefore, the electric grinder allowed for obtaining ATDG with more regenerative properties due to its specific surface-area value and particle size in accordance with the xenograft with the greatest bibliographical support (Bio-Oss®). The higher specific surface increases the reaction with the physiological media, producing faster biological mechanisms.

Alveolar ridge preservation: A review of concepts and controversies.

The loss of thickness and height of the alveolar process after tooth extraction is a significant impediment to implant placement, which limits the aesthetic results of many restorative treatments. Alveolar ridge preservation can reduce bone resorption. Knowing how beneficial this procedure is can help clinicians decide if it is worth doing. The purpose of this article is to present a contemporary review of the different approaches to preserving the dimensions of the alveolar ridge. We analyze the alveolar healing process, atraumatic extraction techniques, graft materials, and controversies.

Preservación alveolar con colgajo vs sin colgajo. Revisión bibliográfica / Socket preservation with flap versus flapless. A literature review

Introducción: La extracción dentaria desencadena una serie de cambios di mensionales en la altura y anchura de la cresta alveolar que se traducen en la pérdida de tejidos blandos y duros, afec tando de forma directa a la calidad de vida de los pacientes. Por ello, se han estudiado diferentes técnicas para la pre servación de la cresta alveolar (PCA) tras las extracciones, con el fin de optimizar los resultados funcionales y estéticos de la futura rehabilitación prostodóncica. El objetivo fue evaluar los resultados de la PCA utilizando un enfoque con colgajo en comparación con un enfoque sin colgajo en términos de cambios óseos en anchu ra y altura. Material y Métodos: Se realizó una búsqueda bibliográfica en tres bases de datos The National Library of Medicine (MEDLINE/PubMed), Scielo y Cochrane Library. Se incluyeron ensayos clínicos aleatorizados en humanos que compara ran la PCA con colgajo y sin colgajo, en los que se analizaran pacientes sanos, mayores de edad, sin hábitos nocivos, en los que era necesaria la exodoncia de un diente mandibular o maxilar. Resultados: Se incluyeron 5 ensayos clí nicos de los últimos 15 años en los que se realizó un total de 74 procedimientos quirúrgicos de PCA con colgajo y 77 sin colgajo en 138 pacientes entre 18 y 75 años, cuyo género sólo se describió en 3 estudios. Los cambios óseos en anchu ra al realizar una PCA con colgajo varían entre –4,18 mm y 3 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 1,74 mm y 3,42 mm. Por otro lado, los cambios óseos en altura al realizar una PCA con colgajo varían entre –0,99 mm y 0,8 mm, mientras que al realizar una PCA sin colgajo los cambios son entre 0,3 mm y 1,42 mm (AU)

Introduction: Tooth extraction triggers a series of dimensional changes in the height and width of the alveolar ridge, which result in the loss of soft and hard tissues, directly affecting patients’ quality of life. Therefore, different techniques for the preservation of the alveolar ridge (PCA) after extractions have been studied in order to optimize the functional and esthetic results of future prosthodontic rehabilitation. The aim was to evaluate the results of PCA using a flap approach compared to a flapless approach in terms of bone changes in width and height. Material and Methods: A literature search was performed in three databases The National Library of Medicine (MEDLINE/ PubMed), Scielo and Cochrane Library. Randomized human clinical trials comparing flap and flapless PCA were included in which healthy patients, over the age of majority, without harmful habits, who needed to have a mandibular or maxillary tooth extraction, were analyzed. Results: A total of 5 clinical trials from the last 15 years were included in which a total of 74 flap and 77 flapless PCA surgical procedures were performed in 138 patients between 18 and 75 years of age and whose gender was only described in 3 studies. Bone changes in width when performing a flapless PCA varied between –4.18 mm and 3 mm, while when performing a flapless PCA the changes were between 1.74 mm and 3.42 mm. On the other hand, bone changes in height when performing a PCA with flap vary between –0.99 mm and 0.8 mm, while when performing a PCA without flap the changes are between 0.3 mm and 1.42 mm (AU)

The use of autogenous tooth bone graft is an efficient method of alveolar ridge preservation - meta-analysis and systematic review.

BACKGROUND: Ridge resorption following tooth extraction may be reduced by alveolar ridge preservation (ARP). Previous randomized clinical trials and systematic reviews have suggested that autogenous tooth bone graft (ATB) can be an effective alternative material for ARP. However, the results are heterogeneous. Therefore, our research aimed to evaluate the efficacy of ATB in ARP. METHODS: A systematic search was conducted in Cochrane Library, Embase, MEDLINE and Scopus for studies published from inception to 31 November 2021. We searched searched for randomized, non-randomized controlled trials and case series reporting on ATB use for ARP. The primary outcome was the ridge width difference pre- and post-surgery, measured in millimetres (mm) measured on CBCT (cone beam computed tomography). The secondary outcomes were the histological results. We followed the PRISMA2020 recommendations for reporting our systematic review and meta-analysis. RESULTS: The analysis included eight studies for the primary and six for the secondary outcomes. The meta-analysis revealed a positive ridge preservation effect with a pooled mean difference ridge width change of -0.72 mm. The pooled mean residual graft proportion was 11.61%, and the newly formed bone proportion was 40.23%. The pooled mean of newly formed bone proportion was higher in the group where ATB originated from both the root and crown of the tooth. CONCLUSIONS: ATB is an effective particulate graft material in ARP. Complete demineralization of the ATB tends to decrease the proportion of newly formed bone. ATB can be an attractive option for ARP. TRIAL REGISTRATION: The study protocol was registered on PROSPERO (CRD42021287890).

Randomized clinical study of injectable dextrin-based hydrogel as a carrier of a synthetic bone substitute.

OBJECTIVES: This study aimed to improve the performance and mode of administration of a glass-reinforced hydroxyapatite synthetic bone substitute, Bonelike by Biosckin® (BL®), by association with a dextrin-based hydrogel, DEXGEL, to achieve an injectable and moldable device named DEXGEL Bone. METHODS: Twelve participants requiring pre-molar tooth extraction and implant placement were enrolled in this study. BL® granules (250-500 µm) were administered to 6 randomized participants whereas the other 6 received DEXGEL Bone. After 6 months, a bone biopsy of the grafted area was collected for histological and histomorphometric evaluation, prior to implant placement. The performance of DEXGEL Bone and BL® treatments on alveolar preservation were further analyzed by computed tomography and Hounsfield density analysis. Primary implant stability was analyzed by implant stability coefficient technique. RESULTS: The healing of defects was free of any local or systemic complications. Both treatments showed good osseointegration with no signs of adverse reaction. DEXGEL Bone exhibited increased granule resorption (p = 0.029) accompanied by a tendency for more new bone ingrowth (although not statistically significant) compared to the BL® group. The addition of DEXGEL to BL® granules did not compromise bone volume or density, being even beneficial for implant primary stability (p = 0.017). CONCLUSIONS: The hydrogel-reinforced biomaterial exhibited an easier handling, a better defect filling, and benefits in implant stability. CLINICAL RELEVANCE: This study validates DEXGEL Bone safety and performance as an injectable carrier of granular bone substitutes for alveolar ridge preservation. TRIAL REGISTRATION: European Databank on Medical Devices (EUDAMED) No. CIV-PT-18-01-02,705; Registo Nacional de Estudos Clínicos, RNEC, No. 30122.

Uso de dentina particulada en procedimientos de preservación alveolar / Use of particulate dentin in alveolar preservation procedures: systematic review of the literature

Introducción: Los procesos biológicos que acontecen tras las exodoncias dentales provocan defectos en los tejidos blandos y duros de los maxilares, lo que dificulta las técnicas rehabilitadoras con implantes. Los procedimientos de preservación alveolar han sido propuestos para disminuir estos cambios dimensionales. A pesar de que el hueso autógeno se presenta como el material con mejores propiedades, también conlleva un aumento de la morbilidad en el paciente. Por ello, el propio diente se presenta como alternativa. Los objetivos de esta revisión fueron analizar los cambios dimensionales en la altura/anchura de la cresta alveolar tras los procedimientos de preservación alveolar con dentina particulada, además de las posibles complicaciones intra y postoperatorias, formación de hueso nuevo y tiempo de reentrada en la zona injertada. Material y método: Se realizó una revisión de la literatura relevante a través de PubMed en la base de datos MEDLINE, identificando los estudios en los que se evaluaran los procedimientos de preservación alveolar con dentina particulada en pacientes humanos y se registrara su seguimiento. Resultados: Un total de 12 estudios se incluyeron en el análisis sistemático. Los cambios dimensionales, tras el injerto con dentina particulada, fue comparable al de otros biomateriales y menor que en los grupos control. La aparición de complicaciones fue baja. La formación de hueso nuevo y el tiempo de reentrada fue similar al de otros biomateriales. Conclusiones: El uso de dentina particulada en procedimientos de preservación alveolar se presenta como una opción prometedora respecto a otros materiales de relleno y superior a la ausencia de preservación alveolar. (AU)

Introduction: The biological processes that take place following dental extractions cause defects in the soft and hard tissues of the jaw, which hinders rehabilitation techniques with implants. Alveolar preservation procedures have been proposed to decrease these dimensional changes. Although autogenous bone is presented as the material with the best properties, it also leads to an increase in morbidity in the patient. Therefore, the tooth itself is presented as an alternative. The objectives of this review were to analyse the dimensional changes in alveolar ridge height/width after alveolar preservation procedures using particulate dentin, as well as possible intraoperative and postoperative complications, new bone formation and re-entry time in the grafted area. Material and method: A review of the relevant literature in the PubMed and MEDLINE databases was carried out, identifying studies evaluating alveolar preservation procedures with particulate dentin in human patients with recorded follow-up. Results: A total of 12 studies were included in the systematic analysis. The dimensional changes, after grafting with particulate dentin, were comparable to those of other biomaterials and lower than in the control groups. The occurrence of complications was low. New bone formation and re-entry time was similar to that of other biomaterials. Conclusions: The use of particulate dentin in alveolar preservation procedures is presented as a promising option compared with other filling materials and superior to the absence of alveolar preservation. (AU)

Calcium Phosphate Modified with Silicon vs. Bovine Hydroxyapatite for Alveolar Ridge Preservation: Densitometric Evaluation, Morphological Changes and Histomorphometric Study.

After tooth extraction, the alveolar bone undergoes a physiological resorption that may compromise the future placement of the implant in its ideal position. This study evaluated bone density, morphological changes, and histomorphometric results undergone by alveolar bone after applying a new biomaterial composed of calcium phosphate modified with silicon (CAPO-Si) compared with hydroxyapatite of bovine origin (BHA). Alveolar ridge preservation (ARP) was performed in 24 alveoli, divided into a test group filled with CAPO-Si and a control group filled with BHA. Three months later, the mineral bone density obtained by the biomaterials, horizontal and vertical bone loss, the degree of alveolar corticalization, and histomorphometric results were evaluated. Both biomaterials presented similar behavior in terms of densitometric results, vertical bone loss, and degree of alveolar corticalization. Alveoli treated with CAPO-Si showed less horizontal bone loss in comparison with alveoli treated with BHA (0.99 ± 0.2 mm vs. 1.3 ± 0.3 mm), with statistically significant difference (p = 0.017). Histomorphometric results showed greater bone neoformation in the test group than the control group (23 ± 15% vs. 11 ± 7%) (p = 0.039) and less residual biomaterial (5 ± 10% vs. 17 ± 13%) (p = 0.043) with statistically significant differences. In conclusion, the ARP technique obtains better results with CAPO-Si than with BHA.

The effect of post-extraction socket preservation laser treatment on bone density 4 months after extraction: Randomized controlled trial.

BACKGROUND: Post-extraction bone resorption may affect the outcome of ensuing restorations. PURPOSE: This study aimed to evaluate a comprehensive laser post-extraction protocol by comparing resulting alveolar bone regeneration with that obtained after standard extraction procedure. MATERIALS AND METHODS: About 53 simple extractions were randomized to either laser or control group. In the laser group, erbium (Er:YAG; 2940 nm) and neodymium (Nd:YAG; 1064 nm) lasers were used for degranulation, disinfection, de-epithelialization of the surrounding gingiva, clot stabilization, and photobiomodulation. The primary outcome measure was change in bone density in the extraction area between day 1 and 4 months after extraction. Patients were monitored for potential side effects. RESULTS: Increase in bone density at the follow-up CBCT was significantly higher in laser than in control group (p < 0.001). No post-operative pain, bleeding, or swelling was present in the laser group. In the control group, one patient had bleeding 3-5 days after extraction, two patients had swelling and three patients reported post-operative pain rated 3-5 on a 0-10 pain scale up to 3 days after extraction. CONCLUSIONS: The proposed laser post-extraction procedure is a safe and effective method to improve post-extraction bone healing.

Use of particulate dentin in alveolar preservation procedures: a systematic review

Introduction: The biological processes that take place following dental extractions cause defects in the soft and hard tissues of the jaw, which hinder rehabilitation techniques with implants. Alveolar preservation procedures have been proposed to decrease these dimensional changes. Although autogenous bone is considered the material with the best properties, it also leads to an increase in patient morbidity. Therefore, the tooth itself is considered as an alternative. The objectives of this review were to analyse the dimensional changes in alveolar ridge height/width after alveolar preservation procedures using particulate dentin, as well as possible intraoperative and postoperative complications, new bone formation and re-entry time in the grafted area. Materials and method: A review of the relevant literature in the PubMed and MEDLINE databases was carried out, identifying studies evaluating alveolar preservation procedures with particulate dentin in human patients with recorded follow-up. Results: A total of 12 studies were included in the systematic analysis. The dimensional changes, after grafting with particulate dentin, were comparable to those of other biomaterials and fewer than in the control groups. The occurrence of complications was low. New bone formation and re-entry time were similar to other biomaterials. (AU)

Topographic characterization and in vitro biofilm adhesion to titanium and polypropylene membranes used for alveolar preservation.

BACKGROUND: Nonresorbable membranes have been widely used in guided bone regeneration (GBR) procedures in posttooth extraction alveoli. In this context, one of the properties suggested by the GBR technique is that these barriers, when exposed to the oral environment, control or prevent the infiltration of connective and epithelial tissue cells, favoring the proliferation of bone cells inside the alveolus, without the growth of biofilm. MATERIALS AND METHODS: This in vitro study evaluated the topographic characteristics and in vitro biofilm adhesion on membranes used for alveolar preservation, bone Heal™ and Titanium Seal™. Fragments of these membranes (5 mm × 5 mm) were used for all experiments. The topographical morphology and chemical characterization of the membranes were analyzed by scanning electron microscope and dispersive energy X-ray spectroscopy, respectively. For the in vitro biofilm adhesion assay, samples were immersed in Candida albicans (American Type Culture Collection [ATCC] 10231) and Staphylococcus aureus (ATCC 25923) mixed biofilm for 7 and 14 days. Biofilm formation was measured by quantitative analysis with crystal violet aqueous solution, in a spectrophotometer, with a wavelength of 590 nm. RESULTS: The ultrastructural images showed a rough surface for the titanium membrane, without homogeneity in the surface structure, while the polypropylene membrane presented a smoother surface without depressions. The chemical composition of the membranes by Ehlers-Danlos syndrome has identified the presence of copolymer and traces of zinc for the polypropylene membrane; in contrast, the titanium membrane revealed the unique presence of titanium. In addition, there was a decrease in biofilm formation on the surface of the titanium membrane compared to polypropylene (P < 0.05), at both evaluated times. CONCLUSIONS: It can be concluded that despite the greater heterogeneity of the titanium membrane surface, the results showed less biofilm formation on this membrane (P < 0.05), which may be indicated in cases of oral cavity exposure.

Safety and Efficacy of a New Synthetic Material Based on Monetite, Silica Gel, PS-Wallastonite, and a Hydroxyapatite Calcium Deficient: A Randomized Comparative Clinic Trial.

Background and Objectives: Maxillary bone defects related to post-extraction alveolar ridge resorption are usual. These defects may lead to failure in further surgical implant phases given the lack of bone volume to perform the dental implant. The objective of this clinical assay was to evaluate the safety and efficacy of an experimental synthetic bone substitute in the preservation of post-extraction maxillary alveoli. Materials and Methods: 33 voluntary patients who had at least one maxillary premolar tooth that was a candidate for exodontia (n = 39) and subsequent implant rehabilitation participated. The regenerated alveoli were monitored by means of periodic clinical examinations (days 9 ± 1, 21 ± 4, 42 ± 6, and 84 ± 6), measuring the height and width of the alveolar crest (days 0 and 180 ± 5), measurement of radiodensity using tomographic techniques (days 0-5 and 175 ± 5), and histological examination of biopsies collected at 180 ± 5 days. Results: No significant differences were observed during the entire follow-up period between the two groups with respect to the safety variables studied. A variation in width of -0.9 ± 1.3 mm and -0.6 ± 1.5 mm, and a variation in height of -0.1 ± 0.9 mm and -0.3 ± 0.7 mm was observed for experimental material Sil-Oss® and Bio-Oss®, respectively. The radiodensity of the alveoli regenerated with the experimental material was significantly lower than that corresponding to Bio-Oss®. However, the histological study showed greater osteoid matrix and replacement of the material with newformed bone in the implanted beds with the experimental material. Conclusions: Both materials can be used safely and proved equally effective in maintaining alveolar flange dimensions, they are also histologically biocompatible, bioactive and osteoconductive. The experimental material showed the advantage of being resorbable and replaced with newformed bone, in addition to promoting bone regeneration.

Tomographic and histomorphometric evaluation of socket healing after tooth extraction using leukocyte- and platelet-rich fibrin: A randomized, single-blind, controlled clinical trial.

The use of platelet concentrate in alveolar ridge preservation has been broadly studied. However, no randomized clinical trials with histomorphometric analysis and low risk of bias are available in the literature. We conducted a prospective, single-blind, parallel, randomized, controlled clinical trial to evaluate the efficacy of leukocyte- and platelet-rich fibrin (L-PRF) in socket preservation after tooth extraction. Additionally, the effect of L-PRF on bone formation was analyzed histologically using bone biopsy specimens obtained during implant placement. A total of 48 subjects who underwent a non-molar tooth extraction were randomly assigned to the L-PRF group (n = 24) or the control group (n = 24). Cone-beam computed tomographies were performed immediately after tooth extraction and at 3 months after tooth extraction, prior to implant surgery. A significant difference in bone resorption was registered 1 mm below the crest: 0.93 ± 0.9 mm for the L-PRF group and 2.27 ± 1.2 mm for the control group (p = 0.0001). Histomorphometric analysis showed a higher percentage of new bone formation in the L-PRF group compared with the control group. The values were 55.96 ± 11.97% and 39.69 ± 11.13%, respectively (p = 0.00001). These findings indicate that the administration of L-PRF should always be considered when socket preservation is planned (Clinicaltrials.gov NCT03408418).

Extração dental minimamente invasiva ­ primeiro passo para a preservação alveolar e garantia de manutenção do contorno gengival / Minimally invasive dental extraction ­ first step for alveolar preservation and maintenance of the gingival contour

O objetivo deste trabalho foi relatar o uso de instrumentos para exodontia minimente invasiva, visando à manutenção da integridade dos tecidos peri-implantares. Foi utilizado, neste relato de caso, o uso de periótomo e extrator de raiz mecânico para a remoção de um elemento dental fraturado, seguido de instalação imediata do implante, associado à reconstrução tecidual e temporização imediata. Após as sessões de acompanhamento clínico e radiográfico de até dois anos, verificamos uma satisfatória manutenção ótica e volumétrica do rebordo alveolar e da sua relação com a prótese dentária. Dessa forma, concluiu-se que, dentre os vários passos para a preservação alveolar, a extração atraumática possui um espaço determinante deste processo, garantindo a viabilidade das estruturas que permitirão a confecção de uma restauração estética e funcional previsíveis (AU).

The aim of this paper was to report instruments use for minimally invasive tooth extraction, in order to maintain peri-implant tissues integrity. It was used in this case report periotome and mechanical root extractor for fractured dental element removal, followed by immediate implantation, associated with tissue reconstruction and immediate provizionalization. After clinical and radiographic monitoring follow-up of two years, we verified a satisfactory optical and volumetric maintenance of the alveolar ridge and of its relationship with the dental prosthesis. Thus we concluded that among several steps for alveolar preservation, atraumatic extraction has a determinant space of this process, assuring the viability of the structures that will allow the production of an aesthetic and functionally predictable restoration (AU).

Aplicaciones del cianoacrilato en periodoncia: serie de casos / Applications of cyanoacrylate in periodontics: a series of cases

Introducción: Actualmente el uso de adhesivos tisulares como el cianoacrilato ha sido beneficioso en el área odontológica, reduciendo el tiempo del acto quirúrgico, disminuyendo el tiempo de cicatrización y la cicatriz postoperatoria, así también el dolor postoperatorio. Objetivo: El objetivo de este artículo es reportar diversas aplicaciones del cianoacrilato en tratamientos quirúrgicos periodontales, como recontorneo estético, gingivectomía, colgajo posicionado apical y preservación alveolar. Materiales y métodos/Presentación de casos: Los protocolos de tratamiento utilizados fueron los tradicionales para cada caso en particular más la adición de tres capas de cianoacrilato, con lapso de aplicación de 30 segundos entre cada capa. Conclusión: Los resultados clínicos de los casos presentados muestran una eficacia en la cicatrización al utilizar cianoacrilato, sin embargo, no sustituye los métodos tradicionales de los protocolos de cada tratamiento (AU)

Introduction: Currently, the use of tissue adhesives such as cyanoacrylate has been beneficial in the dental area, reducing the time of the surgical act, decreasing the time of healing and the postoperative scar, as well as the postoperative pain. Objective: The objective of this article is to report various applications of cyanoacrylate in periodontal surgical treatments, such as aesthetic crown lengthening, gingivectomy, apically positioned flap, and alveolar preservation. Materials and methods/Case presentation: The treatment protocols were the traditional ones for each particular case plus the addition of three layers of cyanoacrylate, with application time of 30 seconds between each layer. Conclusion: The clinical results of the presented cases show an efficacy in the cicatrization when using cyanoacrylate adhesives, nevertheless it does not substitute the traditional methods of the protocols of each treatment (AU)

Peri-Implant Bone Loss at Implants Placed in Preserved Alveolar Bone Versus Implants Placed in Native Bone: A Retrospective Radiographic Study.

OBJECTIVES: The aim of our study was to compare peri-implant bone loss at implants placed in alveolar sockets filled with a particulate allogenous bone graft (DFDBA 300-500 µm) and platelet concentrates versus at implants placed in the native bone. MATERIALS AND METHODS: A retrospective clinical study was performed. A total of 84 patients were included with 247 implants for the restoration of mono and pluri-radicular teeth: 169 implants in native bone and 78 in socket-grafted bone. The peri-implant bone loss was measured by 2 independent operators at 6 and 12 months. RESULTS: The overall mesial and distal peri-implant bone losses were 0.9 ± 0.7 mm and 0.9 ± 0.8 mm at 6 months, respectively, and 1 ± 0.65 mm and 1.2 ± 0.9 mm at 12 months, respectively. In the tested group, the bone loss was 0.8 ± 0.8 mm at 6 months and 1.2 ± 0.9 mm at 12 months. In the control group, the bone loss was 1.0 ± 0.7 mm at 6 months and 0.95 ± 0.6 mm at 12 months. There were no statistically significant differences in bone loss between the two groups. Taking both groups together, there were no statistically significant difference in bone loss between patients with or without histories of periodontitis, but there was a statistically significant difference in bone loss between the mandible and maxilla as well as between unitary and total edentations and between partially and total edentulous patients. CONCLUSION: At 6 and 12 months, the peri-implant bone loss in sockets preserved with DFDBA and platelet concentrates was similar to the peri-implant bone loss in native bone.

Colocación de implante mediante la técnica de raíz sumergida: reporte de un caso / Implant placement through submerged root technique: report of a case

Introducción: Actualmente la técnica de raíz sumergida para colocación de implantes está pobremente descrita en la literatura; sin embargo, se ha encontrado gran beneficio clínico para el aumento de encía queratinizada. Reporte del caso: Paciente masculino de 61 años de edad diagnosticado con periodontitis crónica moderada generalizada y caries en el órgano dental 3.7 comprometiendo su restauración, por lo cual se colocó un implante dental mediante la técnica de raíz sumergida y la colocación del tornillo de cicatrización inmediatamente, evitando la fase II de cicatrización, por lo cual se obtuvo un resultado gingival satisfactorio y sin evidencia de pérdida ósea a los tres meses. Conclusión: Hoy en día existen múltiples alternativas para la colocación de implantes dentales unitarios; sin embargo, existen pocos reportes acerca de la colocación de implantes mediante la técnica de raíz sumergida, la cual logró aumentar la cantidad de encía queratinizada y obtener un cierre primario durante el acto quirúrgico (AU)

Introduction: Currently, the submerged root technique for implant placement is poorly described in the literature, however great clinical benefi t has been found for the increase of keratinized gingiva. Case report: A 61-year-old male patient diagnosed with moderate generalized chronic periodontitis and dental caries in piece 3.7 compromising its restoration, whereby a dental implant was placed using the submerged root technique and the placement of the healing screw immediately avoiding stage II of healing, for which a satisfactory gingival result was obtained and without evidence of bone loss at three months. Conclusion: Today there are multiple alternatives for the placement of unitary dental implants, however there are few reports about implant placement using the submerged root technique, which managed to increase the amount of keratinized gum and obtain a primary closure during the surgical act (AU)

Clinical Safety of a New Synthetic Resorbable Dental Membrane: A Case Series Study.

Dental membranes are commonly used in oral and maxillofacial surgery for the regeneration of small osseous defects. A new synthetic resorbable membrane has recently demonstrated its biocompatibility and bone regeneration capacity in preclinical studies. This membrane is made of poly(D,L-lactic/glycolic acid 85/15), has a bi-layered structure with a dense film to prevent gingival epithelial cell invasion, and a microfibrous layer to support osteogenic cells and bone healing. This membrane completely degrades by hydrolysis in 4 to 6 months without signs of inflammation. Based on this research, a clinical study was conducted to evaluate the safety of the new membrane in guided tissue regeneration (GTR). In total, 26 patients (age: 50.5 ± 12.4, min-max 31-72 years; male/female 42/58%) were operated on at 7 independent private dental practices. Dental surgeons used the membrane together with various bone fillers in GTR for immediate and delayed implant placement (23 cases, 88%) and, to a lesser extent, socket preservation (2 cases, 8%) and alveolar crest augmentation (1 case, 4%). Surgeons reported an easy placement of the membrane (satisfaction index: 3.8/5). Fourteen days postsurgery, 15 patients had no pain while the others declared minimal pain (verbal rating scale: 2.2/10), and none had minor or serious complications related to the membrane. Exposure of the membrane without loosening the biomaterial granules was observed in 3 cases while mucosa healed normally over time. At 4 months postimplantation, no infection or mucosal inflammation was reported, and the overall dentist satisfaction with the clinical performance of the membrane was 4.5/5 on average. This clinical study demonstrated that the new synthetic resorbable membrane is safe for guided bone tissue regeneration in various dental surgery indications.