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


Naenni, Nadja; Bienz, Stefan P; Jung, Ronald E; Hämmerle, Christoph H F; Thoma, Daniel S (2019). Histologic analyses of flapless ridge preservation in sockets with buccal dehiscence defects using two alloplastic bone graft substitutes. Clinical Oral Investigations, 23(9):3589-3599.

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.

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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic of Reconstructive Dentistry
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 September 2019
Deposited On:26 Apr 2019 12:37
Last Modified:09 Jan 2020 01:00
Publisher:Springer
ISSN:1432-6981
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00784-018-2784-4
PubMed ID:30617661

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