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Preservation of Alveolar Dimensions at the Time of Tooth Extraction

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Implant Aesthetics
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Abstract

Our patients lose teeth due to advanced periodontal disease, endodontic issues, restorative problems, and trauma. The goal of the dental team that is treating the patient, should be to have the best procedures and materials used to maximize the functional and aesthetic benefits of each and every step of the process. From choosing the appropriate surgical technique to the proper materials will enable the regeneration of an ideal site with vital bone and covered with keratinized tissue. In this way an ideal implant can be placed to support a restoration which is easy to maintain in a clean and healthy state for the rest of the patient’s lifetime. This chapter will demonstrate different surgical approaches and biomaterials to help the surgeon make the best educated choice to yield an optimal biologically based, cosmetic outcome. The reader will see clinical cases, histologic validation, and literature source to justify the treatment modalities shown. These are predictable and will assist you in the choices you must make on a daily basis.

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References

  • Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986) The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1(1):11–25

    PubMed  Google Scholar 

  • al Ruhaimi KA (2000) Effect of adding resorbable calcium sulfate to grafting materials on early bone regeneration in osseous defects in rabbits. Int J Oral Maxillofac Implants 15(6):859–864

    PubMed  Google Scholar 

  • Amler MH, Johnson PL, Salman I (1960) Histological and histochemical investigation of human alveolar socket healing in undisturbed extraction wounds. J Am Dent Assoc 6:46–48

    Google Scholar 

  • Anson D (2002) Maxillary anterior esthetic extractions with delayed single-stage implant placement. Compend Contin Educ Dent 23(9):829–830 833–6

    PubMed  Google Scholar 

  • Anson D (2009) CE 2-The changing treatment planning paradigm: save the tooth or place an implant. Compend Contin Educ Dent 30(8):506

    PubMed  Google Scholar 

  • Arnett T (2003) Regulation of bone cell function by acid–base balance. Proc Nutr Soc 62(02):511–520

    Article  Google Scholar 

  • Artzi Z, Tal H, Dayan D (2000) Porous bovine bone mineral in healing of human extraction sockets. Part 1: histomorphometric evaluations at 9 months. J Periodontol 71:1015–1023

    Article  Google Scholar 

  • Artzi Z, Givol N, Rohrer MD et al (2003) Qualitative and quantitative expression of bovine bone mineral in experimental bone defects. Part 2: morphometric analysis. J Periodontol 74(8):1153–1160

    Article  Google Scholar 

  • Artzi Z, Weinreb M, Givol N, Rohrer MD, Nemcovsky CE, Prasad HS, Tal H (2004) Biomaterial resorption rate and healing site morphology of inorganic bovine bone and beta-tricalcium phosphate in the canine: a 24-month longitudinal histologic study and morphometric analysis. Int J Oral Maxillofac Implants 19(3):357–368

    PubMed  Google Scholar 

  • Barone A, Aldini NN, Fini M, Giardino R, Calvo Guirado JL, Covani U (2008) Xenograft versus extraction alone for ridge preservation after tooth removal: a clinical and histomorphometric study. J Periodontol 79:1370–1377

    Article  Google Scholar 

  • Bartee B (1995) The use of high-density polytetrafluoroethylene membrane to treat osseous defects: clinical reports. Implant Dent 4(1):21–26

    Article  Google Scholar 

  • Becker W, Dahlin C, Becker B, Lekholm U, van Steenberghe D, Higuchi K, Kultje C (1994) The use of e-PTFE barrier membranes for bone promotion around titanium implants placed into extraction sockets: a prospective multicenter study. Int J O Ral Maxillofac Implants 9:31–40

    Google Scholar 

  • Botticelli D, Berglundh T, Lindhe J (2004) Hard-tissue alterations following immediate implant placement in extraction sites. J Clin Periodontol 31:820–828

    Article  Google Scholar 

  • Boyne PJ, Lilly LC, Marx RE et al (2005) De novo bone induction by recombinant human bone morphogenetic protein-2 (rhBMP-2) in maxillary sinus floor augmentation. J Oral Maxillofac Surg 63:1693–1707

    Article  Google Scholar 

  • BrĂ¥nemark PI, Adell R, Breine U, Hansson BO, Lindström J, Ohlsson A (1969) Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 3(2):81–100

    Article  Google Scholar 

  • Buser D, Bragger U, Lang NB, Nyman S (1990) Regeneration and enlargement of jaw bone using guided tissue regeneration. Clin Oral Implants Res 1:22–30

    Article  Google Scholar 

  • Bushinsky DA (2001) Acid-base imbalance and the skeleton. Eur J Nutr 40(5):238–244

    Article  Google Scholar 

  • Carlsson GE, Thilander H, Hedegard B (1967) Histologic changes in the upper alveolar process after extractions with or without insertion of an immediate full denture. Acta Odontol Scand 25:1

    Google Scholar 

  • Coppa A, Bondioli L, Cucina A, Frayer DW, Jarrige C, Jarrige JF et al (2006) Palaeontology: early neolithic tradition of dentistry. Nature 440:755–756

    Article  Google Scholar 

  • Crespi R, Capparè P, Gherlone E (2010) Immediate loading of dental implants placed in periodontally infected and non-infected sites: a 4-year follow-up clinical study. J Periodontol 81(8):1140–1146

    Article  Google Scholar 

  • Del Corso M, Sammartino G, Dohan Ehrenfest DM (2009) Choukroun’s platelet-rich fibrin (PRF) membranes in periodontal surgery: understanding the biomaterial or believing into the magic of growth factors? J Periodontol 80(11):1694–1697

    Article  Google Scholar 

  • Dohan DM, Choukroun J, Diss A, Dohan SL, Dohan AJ, Mouhyi J, Gogly B (2006) Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 101(3):37–44

    Article  Google Scholar 

  • Dohan Ehrenfest DM, de Peppo GM, Doglioli P, Sammartino G (2009a) Slow release of growth factors and thrombospondin-1 in Choukroun’s platelet-rich fibrin (PRF): a gold standard to achieve for all surgical platelet concentrates technologies. Growth Factors 27:63–69

    Article  Google Scholar 

  • Dohan Ehrenfest DM, Diss A, Odin G, Doglioli P, Hippolyte MP, Charrier JB (2009b) In vitro effects of Choukroun’s PRF (platelet rich fibrin) on human gingival fibroblasts, dermal prekeratinocytes, preadipocytes and maxillofacial osteoblasts in primary cultures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108(3):341–352

    Article  Google Scholar 

  • Fickl S, Zuhr O, Wachtel H, Bolz W, Hurzeler M (2008) Tissue alterations after tooth extraction with and without surgical trauma: a volumetric study in the beagle dog. J Clin Periodontol 35:356–363

    Article  Google Scholar 

  • Friedmann A, Strietzel FP, Maretzki B, Pitaru S, Bernimoulin JP (2002) Histological assessment of augmented jaw bone utilizing a new collagen barrier membrane compared to a standard barrier membrane to protect a granular bone substitute material. Clin Oral Implants Res 13(6):587–594

    Article  Google Scholar 

  • Ganz SD (2001) CT Scan technology—an evolving tool for predictable implant placement and restoration. Int Mag Oral Implantol 1:6–13

    Google Scholar 

  • He L, Lin Y, Hu X, Zhang Y, Wu HA (2009) Comparative study of platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) on the effect of proliferation and differentiation of rat osteoblasts in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108(5):707–713

    Article  Google Scholar 

  • Hirschfeld L, Wasserman BA (1978) Long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol 49:225–237

    Article  Google Scholar 

  • Hoffmann O, Bartee BK, Beaumont C, Kasaj A, Deli G, Zafiropoulos GG (2008) Alveolar bone preservation in extraction sockets using non-resorbable dPTFE membranes: a retrospective non-randomized study. J Periodontol 79(8):1355–1369

    Article  Google Scholar 

  • Holtzclaw D, Toscano N (2012) Amnion chorion allograft barrier: indications and techniques update. J Imp Adv Clin Dent 4(2):25–38

    Google Scholar 

  • Holtzclaw D, Hinze F, Toscano N (2012) Gingival flap attachment healing with amnion-chorion allograft membrane: a controlled, split mouth case report replication of the classic 1968 Hiatt study. J Imp Adv Clin Dent 4(5):19–25

    Google Scholar 

  • Holtzclaw D, Toscano N (2013) Amnion–chorion allograft barrier used for guided tissue regeneration treatment of periodontal intrabony defects: a retrospective observational report of 64 patients. Clin Adv Perio 3(3):131–137

    Article  Google Scholar 

  • Horowitz RA (2003) Case acceptance – increasing profitability through digital photography. Contemp Esthet Restor Pract 2:2–5

    Google Scholar 

  • Horowitz RA (2005) Extraction environment Enhancementâ„¢ – Critical evaluation of early socket healing in long-term barrier protected extraction sockets. Comp Cont Ed Dent 26(10):619–630

    Google Scholar 

  • Horowitz RA, Mazor Z (2010) Atraumatic extraction: advantages and implementation. Insid Dent 6(7):420–428

    Google Scholar 

  • Horowitz RA, Rohrer MD, Prasad HS, Tovar N, Mazor Z (2012) Enhancing extraction socket therapy with a biphasic calcium sulfate. Compend Contin Educ Dent 33(6):420–426

    PubMed  Google Scholar 

  • Howell TH, Fiorellini J, Jones A et al (1997) A feasibility study evaluating rhBMP-2/absorbable collagen sponge device for local alveolar ridge preservation or augmentation. Int J Periodontics Restorative Dent 17:124–139

    PubMed  Google Scholar 

  • Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA et al (2003) Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol 74(7):990–999

    Article  Google Scholar 

  • Kaigler D, Avila G, Wisner-Lynch L et al (2011) Platelet-derived growth factor applications in periodontal and peri-implant bone regeneration. Expert Opin Biol Ther 11:375–385

    Article  Google Scholar 

  • Kfir E, Kfir V, Kaluski E (2007) Immediate bone augmentation after infected tooth extraction using titanium membranes. J Oral Implantol 33(3):133–138

    Article  Google Scholar 

  • Koob T, Rennert R, Zabek N et al (2013) Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. doi:10.1111/iwj.12140

    Article  PubMed  PubMed Central  Google Scholar 

  • Koob T, Lim J, Zabek N (2014a) Cytokines in single layer amnion allografts compared to multilayer amnion/chorion allografts for wound healing. J Biomed Mater Res B. doi:10.1002/jbm.b.33265

    Article  Google Scholar 

  • Koob T, Li W, Gurtner G et al (2014b) Angiogenic properties of dehydrated human amnion/chorion allografts: therapeutic potential for soft tissue repair and regeneration. Vas Cell 4(10):6–10

    Google Scholar 

  • Leek FE (1967) The practice of dentistry in ancient egypt. J Egypt Archaeol 53:51

    Article  Google Scholar 

  • Linkow LI, Chercheve R (1970) Theories and techniques of oral implantology. C.V. Mosby Co., St. Louis, pp 1–154

    Google Scholar 

  • Lynch SE, Williams RC, Polson AM, Howell TH, Reddy MS, Zappa Antoniades HN (1989) A combination of platelet-derived and insulin-like growth factor enhanced periodontal regeneration. J Clin Periodontol 16:545–548

    Article  Google Scholar 

  • Machtei EE (2001) The effect of membrane exposure on the outcome of regenerative procedures in humans: a meta-analysis. J Periodontol 72:512–516

    Article  Google Scholar 

  • Mazor Z, Horowitz RA, Del Corso M, Prasad HS, Rohrer MD, Dohan Ehrenfest DM (2009) Sinus floor augmentation with simultaneous implant placement using Choukroun’s PRF (platelet-rich fibrin) as sole grafting material: a radiological and histological study at 6 months. J Periodontol 80(12):2056–2064

    Article  Google Scholar 

  • Mecall RA, Rosenfeld AL (1991) Influence of residual ridge resorption patterns on implant fixture placement and tooth position. Int J Period RestDent 11(1):8–23

    Google Scholar 

  • Moghaddas H, Stahl SS (1980) Alveolar bone remodeling following osseous surgery. A clinical study. J Periodontol 51(7):376–381

    Article  Google Scholar 

  • Nekoofar MH, Namazikhah MS, Sheykhrezae MS, Mohammadi MM, Kazemi A, Aseeley Z, Dummer PMH (2009) pH of pus collected from periapical abscesses. Int Endod J 42(6):534–538

    Article  Google Scholar 

  • Nevins M, Kirker-Head C, Nevins M, Wozney JA, Palmer R, Graham D (1996) Bone formation in the goat maxillary sinus induced by absorbable collagen sponge implants impregnated with recombinant human bone morphogenetic protein-2. Int J Periodontics Restor Dent 16:8–19

    Google Scholar 

  • Niknejad H, Peirovi H, Jorjani M et al (2008) Properties of the amniotic membrane for potential use in tissue engineering. Euro Cells Mat 15:88–89

    Article  Google Scholar 

  • Nyman S, Lindhe J, Karring T, Rylander H (1982) New attachment following surgical treatment of human periodontal disease. J Clin Periodontol 9:290–296

    Article  Google Scholar 

  • Pietrokovski J, Massler M (1967) Alveolar ridge resorption following tooth extraction. J Prosthet Dent 17:21–27

    Article  Google Scholar 

  • Quarles LD, Hartle JE, Siddhanti SR, Guo R, Hinson TK (1997) A distinct cation-sensing mechanism in MC3T3-E1 osteoblasts functionally related to the calcium receptor. J Bone Miner Res 12(3):393–402

    Article  Google Scholar 

  • Rosen PS, Toscano N, Holtzclaw D, Reynolds M (2011) A retrospective consecutive case series using mineralized allograft with recombinant human platelet-derived growth factor BB to treat moderate to severe osseous lesions. Int J Periodontics Restor Dent 31:335–341

    Google Scholar 

  • Rosen PS, Rosen AD (2013) Purposeful exposure of a polylactic acid barrier to achieve socket preservation for placement of dental implants: case series report. Compend Contin Educ Dent 34(1):34–38

    PubMed  Google Scholar 

  • Simion M, Baldoni M, Rossi P et al (1994) A comparative study of the effectiveness of e-PTFE membranes with and without early exposure during the healing period. Int J Periodontics Restor Dent 14:166–180

    Google Scholar 

  • Simion M, Tinti C, Wagenberg B (2006a) A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Int J Periodontics Restor Dent 26:19–29

    Google Scholar 

  • Simion M, Rocchietta I, Kim D, Nevins M, Fiorellini J (2006b) Vertical ridge augmentation by means of deproteinized bovine bone block and recombinant human platelet derived growth factor-BB: a histologic study in a dog model. Int J Periodontics Restor Dent 2:415–423

    Google Scholar 

  • Sottosanti JS (1997) Calcium sulfate: a valuable addition to the implant/bone regeneration complex. Dent Implantol Updat 8(4):25–29

    Google Scholar 

  • Strocchi R, Orsini G, Iezzi G, Scarano A, Rubini C, Pecora G, Piattelli A (2002) Bone regeneration with calcium sulfate: evidence for increased angiogenesis in rabbits. J Oral Implantol 28(6):273–278

    Article  Google Scholar 

  • Sussman HI (2004) Periapical infections adjacent to freshly placed implants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98(2):136

    Article  Google Scholar 

  • Tarnow DP, Chu SJ, Salama MA, Stappert CF, Salama H, Garber DA, Sarnachiaro GO, Sarnachiaro E, Gotta SL, Saito H (2014) Flapless postextraction socket implant placement in the esthetic zone: part 1. The effect of bone grafting and/or provisional restoration on facial-palatal ridge dimensional change-a retrospective cohort study. Int J Periodontics Restor Dent 34(3):323–331

    Article  Google Scholar 

  • Urist MR (1965) Bone: formation by autoinduction. Science 150:893–899

    Article  Google Scholar 

  • Vance GS, Greenwell H, Miller RL, Hill M, Johnston H, Scheetz JP (2004) Comparison of an allograft in an experimental putty carrier and a bovine-derived xenograft used in ridge preservation: a clinical and histologic study in human. Int J Oral Maxillofac Implants 19(4):491–497

    PubMed  Google Scholar 

  • Vignoletti F, Discepoli N, Muller A, de Sanctis M, Muñoz F, Sanz M (2012) Bone modelling at fresh extraction sockets: immediate implant placement versus spontaneous healing. An experimental study in the beagle dog. J Clin Periodontol 39:91–97

    Article  Google Scholar 

  • Wang HL, Kiyonobu K, Neiva RF (2004) Socket augmentation: rationale and technique. Implant Dent 13(4):286–296

    Article  Google Scholar 

  • Zubery Y, Goldlust A, Alves A, Nir E (2007) Ossification of a novel cross-linked porcine collagen barrier in guided bone regeneration in dogs. J Periodontol 78(1):112–121

    Article  Google Scholar 

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Correspondence to Robert A. Horowitz DDS .

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Horowitz, R.A. (2017). Preservation of Alveolar Dimensions at the Time of Tooth Extraction. In: Karateew, E. (eds) Implant Aesthetics. Springer, Cham. https://doi.org/10.1007/978-3-319-50706-4_11

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