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Published in: Clinical Oral Investigations 9/2019

01-09-2019 | Original Article

Histologic analyses of flapless ridge preservation in sockets with buccal dehiscence defects using two alloplastic bone graft substitutes

Authors: Nadja Naenni, Stefan P. Bienz, Ronald E. Jung, Christoph H.F. Hämmerle, Daniel S. Thoma

Published in: Clinical Oral Investigations | Issue 9/2019

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Abstract

Objectives

To investigate whether one of two synthetic bone substitute materials used for ridge preservation in the extraction sockets with buccal dehiscence defects was superior regarding new bone formation and ridge preservation and to compare it to sites left for spontaneous healing.

Materials and methods

In sixteen dogs, P3 and P4 were hemi-sectioned and the respective distal roots were extracted. Following the preparation of a mucoperiosteal flap without vertical releasing incisions, 50% of the buccal bone was carefully removed. The extraction sites were randomly assigned either to a ridge preservation procedure (alloplastic bone substitute material (two test groups)) or to spontaneous healing (control group). Descriptive histology and histomorphometric analyses were performed at healing times of 4, 8, and 16 weeks. In case of homogeneous variances, the results were analyzed by one-way ANOVA, followed by Tukey’s post-hoc test. If inhomogeneous, the data was analyzed using Welch-type ANOVA, followed by the Games–Howell post-hoc test.

Results

The use of bone substitute material led to significantly greater horizontal dimensions amounting to 3.3 mm (SD = 0.67; test 1) and 3.5 mm (SD = 0.72; test 2) compared to spontaneous healing (1.7 mm, SD = 0.23) at 16 weeks of healing (p < 0.0001). A significant difference was observed between spontaneous healing and the test groups in terms of newly formed bone tissue at 4, 8, and 16 weeks (p = 0.001), with values reaching 7.9, 21.8, and 36.8% (test 1), 5.0, 10.4, and 29% (test 2), and 26.2, 43.5, and 56.4% (control), but there were no significant differences between the test groups (p > 0.05). The final ridge profile was more favorable after ridge preservation (p < 0.001) as demonstrated by a loss of 28.8% (spontaneous healing) and an increase in both test groups at 16 weeks (test 1 = 60.5% and test 2 = 31.2%).

Conclusions

The use of alloplastic materials rendered greater horizontal dimensions and a more favorable maintenance of the ridge profile.

Clinical relevance

Alloplastic bone substitute materials can successfully be used for ridge preservation procedures.
Literature
1.
go back to reference Al Salamah L, Babay N, Anil S, Al Rasheed A, Bukhary M (2012) Guided bone regeneration using resorbable and non-resorbable membranes: a histological study in dogs. Odonto-Stomatol Trop 35:43–50 Al Salamah L, Babay N, Anil S, Al Rasheed A, Bukhary M (2012) Guided bone regeneration using resorbable and non-resorbable membranes: a histological study in dogs. Odonto-Stomatol Trop 35:43–50
2.
go back to reference Araujo M, Linder E, Wennstrom J, Lindhe J (2008) The influence of Bio-Oss collagen on healing of an extraction socket: an experimental study in the dog. Int J Periodontics Restorative Dent 28:123–135PubMed Araujo M, Linder E, Wennstrom J, Lindhe J (2008) The influence of Bio-Oss collagen on healing of an extraction socket: an experimental study in the dog. Int J Periodontics Restorative Dent 28:123–135PubMed
10.
11.
go back to reference de Barros RRM, Novaes AB Jr, de Carvalho JP, de Almeida ALG (2017) The effect of a flapless alveolar ridge preservation procedure with or without a xenograft on buccal bone crest remodeling compared by histomorphometric and microcomputed tomographic analysis. Clin Oral Implants Res 28:938–945. https://doi.org/10.1111/clr.12900 CrossRefPubMed de Barros RRM, Novaes AB Jr, de Carvalho JP, de Almeida ALG (2017) The effect of a flapless alveolar ridge preservation procedure with or without a xenograft on buccal bone crest remodeling compared by histomorphometric and microcomputed tomographic analysis. Clin Oral Implants Res 28:938–945. https://​doi.​org/​10.​1111/​clr.​12900 CrossRefPubMed
15.
go back to reference Jung RE, Sapata VM, Hämmerle CHF, Wu H, Hu XL, Lin Y (2018) Combined use of xenogeneic bone substitute material covered with a native bilayer collagen membrane for alveolar ridge preservation: a randomized controlled clinical trial. Clin Oral Implants Res 29(5):522–529. https://doi.org/10.1111/clr.13149 Jung RE, Sapata VM, Hämmerle CHF, Wu H, Hu XL, Lin Y (2018) Combined use of xenogeneic bone substitute material covered with a native bilayer collagen membrane for alveolar ridge preservation: a randomized controlled clinical trial. Clin Oral Implants Res 29(5):522–529. https://​doi.​org/​10.​1111/​clr.​13149
21.
go back to reference Naenni N, Sapata V, Bienz SP, Leventis M, Jung RE, Hammerle CH, Thoma DS (2017) Effect of flapless ridge preservation with two different alloplastic materials in sockets with buccal dehiscence defects—volumetric and linear changes. Clin Oral Inv. https://doi.org/10.1007/s00784-017-2309-6 Naenni N, Sapata V, Bienz SP, Leventis M, Jung RE, Hammerle CH, Thoma DS (2017) Effect of flapless ridge preservation with two different alloplastic materials in sockets with buccal dehiscence defects—volumetric and linear changes. Clin Oral Inv. https://​doi.​org/​10.​1007/​s00784-017-2309-6
24.
go back to reference Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 23:313–323PubMed Schropp L, Wenzel A, Kostopoulos L, Karring T (2003) Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent 23:313–323PubMed
27.
go back to reference Wildburger A, Bubalo V, Magyar M, Nagursky H, Jakse N, Schmelzeisen R, Sauerbier S (2017) Sinus floor augmentation comparing an in situ hardening biphasic calcium phosphate (hydroxyapatite/beta-tricalcium phosphate) bone graft substitute with a particulate biphasic calcium phosphate (hydroxyapatite/beta-tricalcium phosphate) bone graft substitute: an experimental study in sheep. Tissue Eng Part C Methods 23:404–411. https://doi.org/10.1089/ten.TEC.2016.0549 CrossRefPubMed Wildburger A, Bubalo V, Magyar M, Nagursky H, Jakse N, Schmelzeisen R, Sauerbier S (2017) Sinus floor augmentation comparing an in situ hardening biphasic calcium phosphate (hydroxyapatite/beta-tricalcium phosphate) bone graft substitute with a particulate biphasic calcium phosphate (hydroxyapatite/beta-tricalcium phosphate) bone graft substitute: an experimental study in sheep. Tissue Eng Part C Methods 23:404–411. https://​doi.​org/​10.​1089/​ten.​TEC.​2016.​0549 CrossRefPubMed
Metadata
Title
Histologic analyses of flapless ridge preservation in sockets with buccal dehiscence defects using two alloplastic bone graft substitutes
Authors
Nadja Naenni
Stefan P. Bienz
Ronald E. Jung
Christoph H.F. Hämmerle
Daniel S. Thoma
Publication date
01-09-2019
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 9/2019
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-018-2784-4

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