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Ridge preservation of compromised extraction sockets applying a soft cortical membrane: A canine proof-of-principle evaluation


Fischer, Kai R; Götz, Werner; Kauffmann, Frederic; Schmidlin, Patrick R; Friedmann, Anton (2020). Ridge preservation of compromised extraction sockets applying a soft cortical membrane: A canine proof-of-principle evaluation. Annals of Anatomy - Anatomischer Anzeiger, 231:151524.

Abstract

Objectives: To explore whether placement of a soft cortical membrane can restore and regenerate the original alveolar ridge contour in deficient sockets.

Materials and methods: One Beagle dog was used in this proof-of-principle evaluation. In a first intervention, a standardized buccal dehiscence defect was artificially created at the distal roots of the 3rd and 4th mandibular premolars. Four weeks later, following endodontic treatment of the mesial roots, teeth were hemisected and the distal roots were extracted without raising a flap. A cortical membrane (Lamina®, Osteobiol) was placed outside of the bony envelope of the extraction socket to rebuild the buccal bone contour. Afterwards, sockets were filled with a collagen-modified porcine bone graft material (Gen-Os®, Osteobiol) to the level of the surrounding bone height. The socket orifice was closed with a porcine dermal matrix (Derma®). After four months, block specimens containing the socket-sites and remaining roots were retrieved, histologically processed and analyzed.

Results: Surgery and post-operative healing were uneventful. Histologically, bone formation under the membrane was found, i.e. bony protrusions and ossicles by osteoblasts could be identified. Concomitantly, the membrane showed clear signs of degradation. Bone substitute was well integrated in newly formed bone and resorption of particles was found.

Conclusion: Three major observations were made in the present proof-of-principle study: (i) regeneration of a compromised socket seems possible when applying the presented approach, (ii) the soft cortical membrane was sufficiently stable to allow for the establishment of the contour and to inhibit soft tissue invasion and (iii) the applied xenogenic graft material was undergoing remodelling processes while allowing adequate bone regeneration.

Keywords: Compromised socket; Cortical lamina; Extraction socket; Porcine bone substitute; Ridge preservation.

Abstract

Objectives: To explore whether placement of a soft cortical membrane can restore and regenerate the original alveolar ridge contour in deficient sockets.

Materials and methods: One Beagle dog was used in this proof-of-principle evaluation. In a first intervention, a standardized buccal dehiscence defect was artificially created at the distal roots of the 3rd and 4th mandibular premolars. Four weeks later, following endodontic treatment of the mesial roots, teeth were hemisected and the distal roots were extracted without raising a flap. A cortical membrane (Lamina®, Osteobiol) was placed outside of the bony envelope of the extraction socket to rebuild the buccal bone contour. Afterwards, sockets were filled with a collagen-modified porcine bone graft material (Gen-Os®, Osteobiol) to the level of the surrounding bone height. The socket orifice was closed with a porcine dermal matrix (Derma®). After four months, block specimens containing the socket-sites and remaining roots were retrieved, histologically processed and analyzed.

Results: Surgery and post-operative healing were uneventful. Histologically, bone formation under the membrane was found, i.e. bony protrusions and ossicles by osteoblasts could be identified. Concomitantly, the membrane showed clear signs of degradation. Bone substitute was well integrated in newly formed bone and resorption of particles was found.

Conclusion: Three major observations were made in the present proof-of-principle study: (i) regeneration of a compromised socket seems possible when applying the presented approach, (ii) the soft cortical membrane was sufficiently stable to allow for the establishment of the contour and to inhibit soft tissue invasion and (iii) the applied xenogenic graft material was undergoing remodelling processes while allowing adequate bone regeneration.

Keywords: Compromised socket; Cortical lamina; Extraction socket; Porcine bone substitute; Ridge preservation.

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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 Conservative and Preventive Dentistry
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Anatomy
Life Sciences > Developmental Biology
Uncontrolled Keywords:Anatomy, Developmental Biology, General Medicine
Language:English
Date:1 September 2020
Deposited On:15 Jan 2021 07:38
Last Modified:25 May 2024 01:41
Publisher:Elsevier
ISSN:0940-9602
OA Status:Green
Publisher DOI:https://doi.org/10.1016/j.aanat.2020.151524
PubMed ID:32376298
  • Content: Accepted Version
  • Language: English
  • Licence: Creative Commons: Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)