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Objective To analyse the expression of BMP7 in osteoblasts and NFATc1 in osteoclasts during the bone healing process in the extraction socket and the possible relationship between the expression of BMP7 and NFATc1. Methodology This study represented a post-test only control group design consisting of four groups, namely; a control group (polyethylene glycol), an ethanol extract of propolis (EEP) group, a bovine bone graft (BBG) group, and a EEP-BBG group. 56 Cavia cobaya were split randomly into four groups. The mandibula left incisors of the subjects were extracted, treated with certain materials according to their group, and sutured. The expression of BMP7 and NFATc1 was observed on day 7 and day 14 by means of immunohistochemical staining. Statistical analysis was performed using a combination of one-way ANOVA, Games-Howell post-hoc, and Pearson tests. Results The propolis-BBG combination group showed the highest BMP7 expression, on both day 7 and day 14. With regard to NFATc1 expression, the combination group experienced the lowest expression on day 7 and day 14. The combination group showed significant differences in all expressions compared to the control group. The BMP7 and NFATc1 expressions showed a strong relationship (r = -0.598, r > 0.5) Conclusion Propolis-BBG combination increases BMP7 expression and reduces NFATc1 expression in the extraction socket. This study confirmed a strong relationship between the expressions of BMP7 and NFATc1.

Muthukumar Santhanakrishnan,1 Vedavalli Subramanian,2 Nithyakalyani Ramesh,2 R Kamaleeshwari2 1Faculty of Dental Sciences, Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India; 2Department of Periodontology, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, IndiaCorrespondence: Muthukumar Santhanakrishnan Tel +9884118681Email muthukumars@sriramachandra.edu.inObjective: The purpose of this study was assessment of the changes in soft and hard tissues in the esthetic zone of maxilla following immediate implant placement (IIP) with and without the socket shield technique (SST) and placement of implants 4 months following socket preservation (DIP) in terms of alterations in crestal bone thickness (CBT) and soft tissue changes evaluated by means of pink esthetic scores (PES) following placement of implants in the esthetic zone of maxilla.Materials and Methods: In the maxillary esthetic region, 75 dental implants were placed totally, with 25 implants each in the SST, IIP, and DIP groups. All participants were subjected to undergo CBCT for assessing the variations in thickness of crestal aspect of facial/buccal/labial alveolar bone (CBT). PES and PROMS (patient-related outcome measures) were assessed using VAS for pain threshold and esthetic satisfaction following implant placement and after 6th post-operative month.Results: The mean reduction in CBT showed a statistically significant difference between and within the groups, in comparison to IIP and DIP groups, which demonstrated an average reduction in CBT 0.4 ± 0.1 and 0.2 ± 0.1 at 6 months following implant placement, respectively. The SST group showed a significantly lesser reduction in CBT of 0.05 ± 0.02. However, the mean difference in PES within and among the groups showed no significant difference statistically at P < 0.05. On comparison of individual scores of PES between the groups, the results showed significant difference statistically at P < 0.001.Conclusion: The SST group demonstrated minimal reduction in CBT and a superior PES at the end of 6 months compared with the IIP and DIP groups.Keywords: socket shield technique, immediate implant placement, socket preservation, randomized controlled trial, pink esthetic score

Introduction: Primary closure is the most important step following tooth extraction. Primary closure using cut back incision technique helps in preserving the bone graft in socket and to preserve it in their desired position. Aim: To assess the healing outcome with and without cut back incision technique in adult population for the purpose of socket preservation at baseline, 1 week and 4 weeks. Material and Methods: In this single blinded randomized controlled trial forty-two sites were planned for extraction with bone augmentation and were randomly divided. In group 1 sockets were preserved using cutback incision technique and in group 2 sockets were grafted without cutback incision technique. Clinical standardized measurements were used to assess the dimensional alterations of the extraction socket. Various non-parametric tests have been used for comparisons. Results: Intergroup comparison showed statistical higher difference on Pain on VAS (p >0.00 6) and KGW (p 0.039) at 1 week and primary healing showed no significant results at all time intervals. Conclusion: The present finding concluded that use of cutback incision technique enhances primary closure and the socket seal of the extraction site with minimal pain, morbidity and low cost. Keywords: Cutback, Socket preservation, Primary healing, Grafting, Randomised controlled trial

Alveolar ridges usually undergo a change in shape and height due to tooth loss. This can make it difficult to install dentures or implants. Preservation of the socket post tooth extraction can maintain the height and width of the alveolar ridge. Preservation of ridges and socketscan be done with atraumatic extraction, the use of bone graft or membrane, and a combination of bone graft and membrane.

Dental implants represent the gold standard for the treatment of single edentulism, even in anterior areas. Today, the basic criteria for implant success has changed from mobility, pain, radiolucency, and peri-implant bone loss (>1.5 mm) to prosthetic level success, aesthetics, soft tissue parameters, as well as patient satisfaction. This case report documents a combination of surgical and prosthetic procedures for the treatment of gingival recessions in the anterior maxilla, appearing after tooth extraction, socket preservation, and staged guided implant placement. Prosthetic management of the temporary restoration, orthodontic treatment, and a connective tissue graft were performed. The decision-making process and step-by-step execution of the treatments are presented to describe the entire clinical and surgical management of the reported case. Finally, good aesthetic outcomes, patient satisfaction, and recovery of the soft tissue recession were observed with the combination of these techniques.

Objective: The present study was performed to evaluate the effect of addition of human serum albumin and platelet rich fibrin to xenograft bone for socket preservation. Material and Methods: 20 patients seeking treatment for badly broken teeth (lower premolars and molars) 10 patients in each group. In the first (study) group, the patients will be subjecting to extraction of badly decayed non restorable tooth then insertion of human albumin coated xenograft bone (OneGraft natural collagenated bovine bone graft 1.0 -2.0mm grain size Bioimplon, Germany) and platelet rich fibrin. In the second (controlled) group, the patients will be subjecting to extraction of badly decayed non restorable tooth without xenograft insertion. CBCT was done to evaluate; bone density, alveolar bone height at the site of extraction and bone graft addition. Bone Density and height was measured at alveolar bone crest & middle of the socket at region of interest (ROI) immediately & at 6 months post operatively. Results: In albumin coated xenograft with PRF group showed less decrease in buccal, lingual height and width , increase in bottom of socket and increase in bone density measurements. Conclusion: the use of albumin coated xenograft with PRF were effective in socket preservation , significantly minimized ridge resorption in all dimensions, accelerate the bone healing and shorting the time period for rehabilitation than the normal sequence of healing.

Aim: The study was aimed at determining the evaluation of hard and soft tissues at the extraction site when using advanced platelet rich fibrin compared to natural healing. Methodology: The present study was conducted on 30 subjects. The patients were allocated to receive either advanced platelet rich fibrin (APRF) (test group) or left for natural healing (control group). Alveolar ridge width was measured at 2 months and 4 months follow up and then it was subjected to a statistical analysis. Results: The buccolingual width result in the test group was decreased to 6.37±1.16mm while for the control groups, the values decreased to 5.95±0.53mm after 4 months with no statistical significance between the 2 groups. Both treatment protocols could not prevent bone resorption after 4 months. Conclusion: Despite the fact that ARP using APRF in our study did not totally avert bone loss, the values observed after 4 months were much lower than unassisted extraction.

espanolObjetivo: Evaluar el uso de dientes extraidos autogenos para la preservacion del alveolo tras la extraccion dental.Material y Metodos: Se realizo una busqueda en las bases de datos Cochrane, Scopus y PubMed para identificar estudios clinicos en humanos que informaban los resultados clinicos, radiograficos y / o histologicos de las tecnicas de preservacion de alveolos con dientes extraidos autogenos. Solo se incluyeron estudios publicados en ingles en los ultimos 10 anos. Resultados: En total se identificaron 82 articulos. Se incluyeron cinco articulos en la revision. Incluyeron 58 dientes que se prepararon como injerto para la preservacion del alveolo. Los injertos derivados de dientes autogenos se presentaron en tres formas: particulas, bloques y polvo. La perdida osea media oscilo entre 0,28 mm y 0,41 mm de altura y 0,15 mm de ancho. Conclusion: El diente autogeno extraido de forma inmediata utilizado como material de injerto para la conservacion del alveolo fresco es prometedor para la practica clinica diaria futura. Se necesitan mas estudios clinicos comparativos. EnglishObjectives: To evaluate the use of extracted autogenous teeth for socket preservation after tooth extraction. Material and Methods: Cochrane, Scopus, and PubMed databases search was conducted to identify human clinical studies reporting the clinical, radiographic and/or histological outcomes of socket preservation techniques with autogenous extracted tooth Only studies published in English language in the last 10 years were included in the study. Results:In total, 82 articles were identified. Five articles were included in the review. They included 58 teeth that were prepared as a graft for socket preservation. The grafts derived from autogenous teeth were presented in three forms: particles, blocks and powder. The mean bone loss ranged from 0.28 mm to 0.41mm in height and 0.15 mm in width.Conclusion: Immediate autogenous extracted tooth as a grafting material for fresh socket preservation is promising for future daily clinical practice. More clinical comparative studies are needed.

A simplified surgical technique is presented for closure and soft tissue augmentation of fresh extraction sockets that utilizes a xenogeneic collagen matrix as a substitute for a combined onlay-interpositional connective tissue graft. Ten alveoli receiving a socket preservation procedure (n = 5) or an immediate submerged implant (n = 5) were sealed with a xenogeneic collagen matrix, stabilized under small palatal and buccal full-thickness envelope flaps. Eight weeks after surgery, full wound closure was achieved in 9 out of 10 sites with satisfactory esthetic integration (mean ΔE score: 3.76). Results from this descriptive observational study suggest that this technique may represent a valuable and minimally invasive solution to simplify closure and soft tissue augmentation of fresh extraction sockets.

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

Relevance. Immediate implant placement with immediate temporisation is method of choice in case of central incisors extractions. In nowadays there are many protocols aimed on optimisation of the immediate prosthetic result. Some of them are based on using CAD/CAM technology, others stress the importance of peri-implant grafting procedures as a means of clinical success. The aim of the study is to analyse tactic of treatment in cases of immediate implant prosthetic replacement of maxilla central incisors using assessment of clinical example and elaboration of the optimal treatment option. Materials and methods. We conducted the evaluation of the 54 year old male patient with the use of clinical and paraclinical examination methods (OPG, CBCT). Implant placement in the position of the teeth 1.1, 2.1 was performed utilising new NobelParallel Conical Connection TiUltra (NobelBiocare, USA) 4.3*13 mm followed by implant supported Procera Zirconia prosthesis. We used international indices PES and it’s modification WES for the assessment of the achieved results. Results. The final result received following scores: PES index = 7, WES index = 8. Conclusion. Choice of implant design is a major influencing factor on the immediate implant placement prognosis. Utilising Nobel Active implant in the described clinical situation combining its placement with grafting of the connective tissue taken from the tuberosity area led to the decrease in total treatment time and achievement of the superior esthetic and functional result.

Aim: Successful functional and esthetic rehabilitation of edentulous jaws with implants depends on the optimal timing of placement, surgical protocol, materials used, cost-effectiveness, and satisfying patient needs. Increasing demand for shorter treatment times necessitates the immediate placement protocol. However, researchers have demonstrateda higher failure rate. A-PRF (Advanced platelet-rich fibrin) has exhibited accelerated bone regeneration potential. Early implant placement with a limited healing period, along with A-PRF, can be beneficial over conventional and immediate implant placement. Settings and Design: This prospective randomized clinical trial aims to assess the outcome of early implant placement in sockets preserved using A-PRF at six weeks and eight weeks of post-extraction. Two groups of 10 participantseach were formed. All patients underwent atraumatic extraction and socket preservation using A-PRF. Materials and Methods: A Partial-thickness pedicle graft was raised, and the extraction socket wasclosed. Implants wereplaced in at six and eight weeks of post-extraction in group A group B, respectively. The histomorphometric analysisassessedthe bone quality present at the timeof surgery. The insertion torque values were recorded during implant placement. Statistical Analysis Used: The obtained data were statistically analyzed using parametric tests, namely independent T-test for intergroup comparison. Results: T-test for torque values indicated a significantly higher torque value at eight weeks. The meanhistomorphometric value showeda significantly higher percentage of bone formation at eight weeks than at six weeks (P = 0.03). Conclusion: Within the study's limitations, early implant placement in extraction sockets preserved with A-PRF had significantly higher insertion torque values and predictable bone at eight weeks compared to six weeks.

Introduction. Extracted teeth are still considered clinical waste and therefore are being discarded. It is evident that obtained and prepared autogenous dentin graft (ADG) may be used for guided bone regeneration (GBR) due to its similar biochemical characteristics to human bone. The aim was to present a novel procedure in a clinical setting that employs freshly extracted teeth that are processed into a bacteria-free particulate dentin, and then grafted immediately into the extraction sites or bone deffects. Monitoring the clinical and radiological parameters (vertical and horizontal dimensional changes on the alveolar ridge and vertical dimension of intrabony defects at the distal aspect of the second molar after extraction of third molar) for a period of 6 months, proved rapid healing capacity of ADG on the bone and soft tissue structures in the jawbones. Material and methods. Clinical measurements were performed using a questionnaire for monitoring the postoperative clinical manifestation, bone measuring calipers for measuring horizontal changes of the alveolar ridge and graduated probe for measuring vertical dimensional changes, also paraclinical-radiological examinations to follow-up bone density. Results. During the follow up period of six months, clinical measurements of post-extraction dimensional changes of the alveolar ridges showed minimal horizontal and vertical bone resorption with preserved alveolar ridge volume, with an accelerated bone regenerative process without special postoperative complications. Conclusion. Dentin particulate grafted immediately after extractions should be considered as gold standard due to its osteogenetic, osteoinductive and osteoconductive effects on bone tissue regeneration. With the use of mineralized dentin matrix we get maximum utilization of our own biological potential without the use of other artificial graft materials.

Extraction socket preservation (ESP) is widely performed after tooth extraction for future implant placement. For successful outcome of implants after extractions, clinicians should be acquainted with the principles and indications of ESP. It is recommended that ESP be actively implemented in cases of esthetic areas, severe bone defects, and delayed implant placement. Dental implant placement is recommended at least 4 months after ESP.

The placement of immediate implants in aesthetic anterior region usually possess a challenge in implant dentistry. After tooth extraction, the buccal bone inevitably undergoes remodelling with associated resorption and diminished horizontal and vertical size of the alveolar ridge. To maintain the original buccal bone dimension after tooth extraction practitioners can choose multiple techniques like atraumatic extraction, immediate implant placement, socket preservation, socket augmentation and extensive buccal bone grafts and barrier membranes. However these techniques could partly compensate but not avoid the resorption process thus a better technique called socket shield technique have been proposed. In socket shield technique, a partial buccal root fragment is retained around an immediately placed implant with the aim of avoiding facial tissue alterations after tooth extraction. The literature related to socket shield technique reports promising solution and hold significant potential for immediate implant placement specifically in anterior aesthetic region. Keywords: Socket Shield, Atraumatic extraction, Immediate implantation Key Message: Socket Shield physiologically helps to preserve labial and buccal bone. Socket shield technique requires minimal material and is minimal invasive. Socket shield with immediate implant placement reduces the required treatment time and number of surgical procedures as compared to a delayed conventional approach

Purpose Deproteinized bovine bone mineral (DBBM) is a type of bone substitute material widely used in tooth extraction sites. However, there is a lack of evidence supporting the benefit of DBBM used for postextraction socket preservation with regard to new bone formation. This meta-analysis and systematic review was conducted to explore whether site preservation (SP) using DBBM could provide benefits with regard to new bone formation compared with natural healing. Materials and methods Studies reporting histological results for postextraction SP with DBBM and natural healing from 2000 to 2019 were identified in three databases, and a meta-analysis was conducted. Results Five studies were included. The DBBM group had a significantly lower new bone percentage than the natural healing group, with a MD of −24.75 [95% CI: −39.77, −9.73] (P = 0.001). The percentage of connective tissue in the extraction site was not significantly different between the two groups, with a MD of 0.60 [95% CI: −4.85, 6.05] (P = 0.83). Conclusions SP using DBBM provided no additional benefit with regard to postextraction new bone formation in comparison with natural healing. Due to the lack of high-quality research, further large-sample studies and standard studies are needed to confirm these conclusions.

Background The present study aimed to analyze the early soft tissue healing characteristics and Fractal Dimension (FD) of extraction sockets preserved by Leukocyte-platelet-rich fibrin (L-PRF) and titanium prepared platelet-rich fibrin (T-PRF). Materials and methods 57 single-tooth extraction sockets were included in the study, three groups were prepared: post-extraction sockets filled with L-PRF (n = 19) and T-PRF (n = 19), and control group; naturally healing sockets (n = 19). Three months after tooth extraction, FD measurement was made in the center of the healing socket. The Landry Wound Healing Index (LWHI) and H2O2 bubbling test results for the complete wound epithelization (CWE) rates were recorded 1 and 2 weeks postoperatively. All patients were asked to record a visual analog scale (VAS) value for pain and the number of analgesics taken during the 3 days after the extraction. Results CWE using H2O2 test result showed a significantly lower rate in the controls than in L-PRF and T-PRF groups at 1st week. At 2nd weeks, both of the test groups showed 100% CWE compared with only 40.7% in the control group. The VAS pain score was significantly higher in the control group than in L-PRF and T-PRF groups on the 1st day. However, no significant difference was found among the groups on 2nd day. FD value of control group was significantly lower than the L-PRF group and T-PRF group. Conclusions T-PRF and L-PRF similarly enhanced wound epithelization and reduced postoperative discomfort at extraction sockets. The T-PRF procedure resulted in higher FD compared to the L-PRF and control group.

Background: The extracted teeth have proven to be a ready source of bone substitute material and thus, they are no longer viewed as clinical leftover. Many techniques are employed to process the teeth into particles with different sizes, shapes and calcium composition. Aim: The aim of the trial is to compare autogenous tooth (AT) biomaterial and the autogenous decalcified dentin (ADD) biomaterial for their efficacy in socket preservation procedures in relation to the radiographic dentistry measured on cone beam computed tomography (CBCT) images. Methodology: A total of 12 hopeless teeth were randomly assigned into both study groups. After executing atraumatic extraction, the tooth was cleaned and milled then it was prepared into either AT or ADD with decalcification in hydrochloric acid with pH=1 then inserted in the extraction socket. Baseline CBCT and the final images taken after six months were compared for radiographic density expressed in Hounsfield units (Hu). Results: After six months, all sites achieved soft tissue closure and were filled with bone without incidents. Radiographic bone density values were 830.67±115.5 and 742.83±148.84 Hounsfield units for the AT group and the ADD group respectively without a statistical difference. Conclusions: Both types of biomaterials were similarly effective in bone healing after extraction by providing radiographic density in treated sites.

Objective: The aim of present study is to evaluate effect of using two different biomaterials, Bio-oss graft and PRF membrane for ridge preservation after tooth extraction, clinically and radiographically. Patient&Methods: This study was conducted on 20 patients indicated for extraction, from those attending the outpatient clinics of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University Hospitals. Patients were divided into two groups: Group I: Extraction socket preservation with bio-oss graft and PRF membrane (10 patients). Group II: Extraction socket without grafting (10 patients). All patients were evaluated clinically after 24-hour, one week and two weeks for pain and edema. They were also evaluated immediately and after six months for bone gain in height and width using cone beam computed tomography. Results: The bone width between the two groups was found to be statistically significant where the bone height was not statistically significant between the study and control groups. Conclusion: Post extraction alveolar ridge resorption is an inevitable process. Bio-oss placed in extraction socket give better bone quality and quantity than empty socket. The PRF membrane is used effectively as a membrane to cover the bone graft.

A bone graft may be used in a variety of clinically practiced implant surgeries, namely, guided bone regeneration, extraction socket preservation or reconstruction, ridge augmentation, and sinus membrane elevation. The bone graft is of various types depending on the material, for instance, autogenous bone graft, allograft, xenograft, alloplastic graft, and autogenous bone graft with demineralized dentin matrix, which may be used alone or with other materials. Bioactive agents that promote bone formation, such as recombinant human bone morphogenetic protein-2 (rhBMP-2), have been shown to exhibit a clinically beneficial effect on bone regeneration. Here, we intend to present surgical guidelines for bone grafts and criteria for selection of bone graft materials by referring to evidence-based studies and recent lectures on the subject of ‘bone grafts for implant dentistry’ at the Amapá society of implantodontics, 2020.

OBJECTIVE The aim of the study was to determine whether the inhibition of apoptosis via pan-caspase inhibitors can attenuate the changes in the alveolar ridge upon tooth extraction. BACKGROUND Cells undergoing apoptosis might play a central role in the onset of alveolar bone resorption and the ensuing bone atrophy following tooth extraction. Caspases are proteases that regulate apoptotic cell death. It is, therefore, reasonable to hypothesize that blocking apoptosis with pan-caspase inhibitors attenuates the changes in the alveolar ridge following tooth extraction. METHODS In 16 inbred rats, the mandibular first (M1) and second (M2) molars of one side were extracted. Following random allocation, the rats received either a cell-permeable pan-caspase inhibitor or diluent. After a healing period of 10��days, changes in shape and height of the alveolar ridge were examined using geometric morphometrics and linear measurements based on micro-computed tomography. RESULTS Geometric morphometric analysis revealed that the pan-caspase inhibitor prevented major shape changes of the alveolar ridge following M1 tooth extraction (P��

Background: Telescopic overdenture is a prosthesis consisting of a primary coping, or an inner crown, that is attached to a supporting tooth in the oral cavity, and a secondary coping, or an outer crown, attached to a denture, which must be compatible with the primary coping. Purpose: The purpose of this study was to restore function and aesthetics and uplift the psychological status of the patient by fabrication of a fixed removable prosthesis using the existing abutment teeth as a telescopic overdenture. Case: A 36-year-old female came to the Prosthodontic RSGM UNAIR speciality clinic on her own volition to make front dentures for her upper and lower jaws after a traffic accident one and a half years ago. The patient had an arch bar installed two months after the accident, which was removed after two months. The patient wanted new dentures to improve both her ability to eat and her appearance. Case Management: Preliminary treatments performed were; maxillary and mandibular scaling and root planing; crown lengthening of tooth 15; extraction of teeth 16, 41, 42, and 43; and alveolectomy of the mandibular anterior region. Before the definitive treatment to improve the aesthetic appearance could be carried out, the first step was to make maxillary and mandibular transitional dentures. These were to be used while waiting for healing to occur, following the socket preservation in the mandibular area. Then, for the definitive restoration, we used telescopic overdenture for the maxilla and a removable partial denture for the mandible. Conclusion: Telescopic overdenture is recommended for patients who need good aesthetics for anterior tooth loss. Telescopic overdenture uses double crowns as the retentive elements, which give better aesthetic results compared to clasps, thereby improving the psychological status of the patient. In addition, they have better retention and stability compared to conventional complete dentures.

Introduction: Sufficient bone volume, as well as the bone quality characteristics are necessary prerequisites to ensure optimal mechanical stability of the implants and subsequent osseointegration. Aim: The aim of the present study was to assess the correlation between bone density values obtained by cone-beam computed tomography (CBCT), the primary stability of dental implants and the histomorphometric analysis of bone quality. Materials and methods: Following tooth extraction, socket preservation with frieze-dried bone allograft or protein-rich fibrin (PRF) was performed on 30 patients with 30 maxillary teeth in the region from second premolar to second premolar. Four months after the procedure, CBCT was used to assess the bone density (Hounsfield units) in the area of extraction. Thirty bone samples were harvested from implant sites using a trephine drill. They were analyzed with Image J software. Immediately after placing the implant, the implant stability quotient was measured using the Osstell Idx device. Results: The results revealed significant correlations between bone density and primary stability along the vestibulo-oral (r=0.392, p=0.032) and mesiodistal axes (r=0.407, p=0.026). Bone density also correlated strongly with the percentage of newly formed bone (r=0.776, p Conclusion: Bone quality, in terms of bone density measured in CBCT and new bone formation are correlated to the primary stability of the dental implants and vice versa.

Aim: To compare socket bone preservation using Osteon II Collagen mixed with Hyaluronic Acid (Hy A) versus autologous concentrated growth factors enriched bone graft matrix (sticky bone) assessed by 3D cone beam computed tomography and histological evaluation. Patients and methods: 30 patients were treatment planned for extraction of mandibular first molar teeth, leaving 30 sockets for the study. Sockets were divided randomly into two equal groups. Sockets were grafted as follows: Group (I) sockets were grafted by Osteon II Collagen mixed with Hy A, Group (II) sockets were grafted by sticky bone graft. A cone beam computed tomography (CBCT) radiographs at one day, 3 and 6 months were postoperatively done to assess bone density and tooth socket dimensions. Microscopic evaluation was performed at 6 months before implant insertion. All readings were recorded and analyzed statistically. Results: There is a high statistically significant difference between study groups as regards the mean values of bone density, bone height, and percentage of volume change. In another the side, other parameters showed insignificant differences between the study groups. Histological study referred to more maturation of bone in group I than group II. Conclusion: The results clearly concluded that both Osteon II Collagen mixed with HyA and sticky bone are successful in achieving clinical and 3D volumetric socket bone preservation with superiority for Osteon II Collagen mixed with HyA .

Objective: The objective of the present study was to compare the effect of mixing simvastatin with Nanobone graft on thehealing process of extraction sockets regarding to the histological parameter.Materials and Methods: In a prospective randomized clinical study, ten patients (study group, Group II) treated by simvastatinmixed with Nanobone after tooth extraction. The other ten patients (Control group, Group I) received Nanobone only. Threemonths after tooth extraction and socket preservation, histological biopsies were taken at the time of implant placement. Thebiopsies were evaluated in the terms of the histological parameter for the identification of vascularization and bone metabolismfactors.Results: The use of simvastatin combination results in slightly higher values of mineralized area of newly formed boneandnumerous well differentiated capillary vascularization.Conclusion: Simvastatin and Nanobone combination showed improvement in socket preservation.

The management of the alveolar socket is fundamental to create conditions that would allow the positioning of dental implants in the same site, when required. A number of biomaterials were described in scientific literature to be used for alveolar socket preservation immediately after tooth extraction: autogenous grafts, allograft (of various origin), and synthetic products. Among the autogenous biomaterials, some authors proposed the use of autogenous dentin and/or enamel, retrieved from teeth, adequately managed, and purified. The present case report with two-year follow-up shows one case of alveolar socket preservation by using tooth graft material that was subsequently treated with one implant-supported rehabilitation in the same site. The paper presents clinical and histological outcomes and confirms the feasibility of adopting such autogenous biomaterial in standard procedures.

Background. Alveolar bone remodeling after tooth loss results in reduced ridge dimensions in horizontaland vertical planes. To prevent this, various authors have proposed different ridge preservationtechniques. A collagen plug is a novel material that has shown promising results in preserving thealveolar bone. PRP has also yielded favorable outcomes in wound healing and promoted osteoinductionand osteoconduction Methods. Thirty patients of both sexes with an age range of 30–18 years requiring bilateral extractionof teeth with similar tooth root anatomy in the maxilla or mandible were included in the study. Theextraction of teeth was carried out atraumatically. The patients’ arches were randomly divided andlabeled as the test or control sides. Bone width was measured on both sides. A collagen plug, with PRP,was placed, and the extraction socket was sutured on the test side. The control side was just sutured. Abaseline RVG was taken to record the apico-coronal height. The patients were recalled after 10 days forsuture removal and evaluation of wound healing. Parameters were re-evaluated at three and six monthspostoperatively. The data were subjected to t-test and one-way ANOVA. Results. The height of the crestal bone on the grafted side was more when compared to the non-graftedside three and six months after tooth extractions, and the difference was statically significant (P0.05). Conclusion. Collagen and PRP provided reasonable socket preservation as simple and inexpensiveoptions as compared to other materials.

Aim: This study was designed to evaluate the socket preservation using a synthetic nanocrystalline hydroxyapatite followed by collagen membrane. Subjects and methods: Fourteen patients were selected from Oral and Maxillofacial clinic of the Faculty of Oral and Dental Medicine, Al-Azhar University, Cairo, Boys. Extraction of tooth of lower premolar area was done to all participants. Then they were divided into 2 groups, where 7 sockets were preserved and the 7 were kept as control. After tooth extraction in the test group nanobone putty form was grafted into the socket. An additional covering was performed by a collagen membrane. A cone beam computed tomography (CBCT) radiograph at 3 and 6 months were done to assess bone density and socket dimensions. All readings were recorded and analyzed statistically. Results: Among the study group, there is a high statistically significant difference between the three measurements (soon after extraction, after 3- and 6- months from operation) as regards the mean of bone density and the three dimensions .Conclusion: Nano hydroxyapatite together with collagen membrane to seal the socket accelerates the formation of bone filling in the extracted bony socket

Background: Maintaining a good ridge is required during prosthodontic treatment. Hence, adequate alveolar bone support is considered an important factor in pursuing successful dentures. Propolis extract combined with bovine bone graft is a recent and innovative material in the process of socket preservation, as the caffeic acid phenethyl ester (CAPE) it contains can suppress the inflammatory process. Purpose: This study aims to determine the effective dose of propolis extract combined with bovine bone graft on the number of osteoblasts and osteoclasts in socket preservation. Methods: Twenty-eight Cavia cobaya animals were divided into four groups of seven. Group I was given 25 grams of PEG, while Group II were given a propolis extract at a dose of 0.5% combined with bovine bone graft. Group III were given a propolis extract at a dose of 1% combined with bovine bone graft and Group IV were given a propolis extract at a dose of 2% combined with bovine bone graft. On day 30, the lower incisor of each subject was extracted and induced with PEG and propolis (dose 0.5%, 1%, 2%). Histopathological examinations of osteoblasts and osteoclasts were measured with a 400x magnification light microscope. One-way ANOVA and Tukey HSD tests were performed to analyse data statistically. Results: The propolis extract combined with bovine bone graft not only increased the number of osteoblasts but also reduced the number of osteoclasts. The most effective dose for the propolis extract combined with bovine bone graft was 2%. Conclusion: The propolis extract combined with bovine bone graft could be effective in tooth extraction socket preservation at a dose of 2%.

After tooth extraction, the alveolar ridge is absorbed and changes shape. Recently, socket preservation has been proposed to prevent alveolar ridge absorption. However, there are few reports of socket preservation in a model without the periosteum, and alveolar bone regeneration and resorption inhibitory effects in this type of model remain unclear. Therefore, in this study, we conducted socket preservation at the bone defect without the periosteum using a canine model. Ten beagle dogs were extracted. A 5 mm × 7 mm × 4 mm bone defect was created without the periosteum. Defects were filled with beta-tricalcium phosphate (β-TCP)/collagen (Col), β-TCP, collagen, or left intact (Control). The observation periods were 4 and 8 weeks (n = 5 per group). Evaluations were made of the newly formed bone area, residual granular area, horizontal width and vertical dimensional change. The newly formed bone area at 4 weeks after surgery in TCP/Col, Collagen, β-TCP, and Control groups was 21.50%, 17.26%, 18.22%, and 17.47%. Compared to the control group, the TCP/Col group showed a significant difference in bone regeneration and horizontal width. TCP/Col is suggested to be effective for bone regeneration and suppression of alveolar ridge resorption in the bone defect periosteum removal model.

Background: Post-extraction alveolar bone height and width never reach the same dimensions as before extraction. A combination of propolis extracts and bovine bone graft (BBG) that are anti-inflammatory, antioxidant, osteoinductive and osteconductive is expected to improve bone regeneration. Purpose: Knowing the effect of the combination of propolis extracts and BBG on the number of osteoclast and osteoblast as an effort to preserve the socket after extraction of Cavia cobaya teeth. Methods: 56 Cavia cobaya was divided into eight groups : the lower left incisor was extracted, and the socket was filled with 2% poly ethylene glycol (PEG), propolis extract+PEG, BBG+PEG, and a combination of propolis extract+BBG+PEG. The incisors socket of animals models were executed on the 14 th and 30 th days. Using HE for histopathological examination, the number of osteoclasts and osteoblasts were counted with a 400x magnification light microscope with nine visual fields. The data were analysed via one-way ANOVA and Tukey HSD tests. Results: The highest mean number of osteoclasts occurred in the BBG+PEG 14 th day group and the lowest occurred in the propolis extract+BBG+PEG 14 th day group. The highest mean number of osteoblasts occurred in the propolis + BBG + PEG combination 30 th day group, the lowest occurred in the control group (PEG) on the 14 th day. Conclusion: The 2% combination of propolis extracts and BBG effectively reduces the osteoclast number and increases the osteoblast number in preserving the socket after extracting Cavia cobaya teeth.

Objective: High-intensity laser therapy (HILT) combined with photobiomodulation therapy (PBMT) using a diode or CO2 laser was administered after extraction of the left first molar in rats. Effects on socket preservation (preservation of the alveolar bone and healing time after extraction) were evaluated histopathologically. Background: Irradiation using a diode or CO2 laser has been shown to hasten wound healing, but the effects remain controversial. Methods: Five-week-old male Wistar rats that underwent extraction of the left maxillary first molar were divided into three groups: diode laser irradiation (diode group), CO2 laser irradiation (CO2 group), and no laser irradiation (control group). HILT (27 J) was performed immediately after tooth extraction to enhance blood coagulation, followed by PBMT (0.7 J) 1 day later to enhance healing. Tissues, including the extraction socket, were removed en bloc 3, 5, 7, 10, and 21 days postextraction to determine the morphological characteristics of wound healing and the distribution of myofibroblasts involved in scar formation. Results: In the diode and CO2 groups, new bone formation and cancellous bone maturation were observed at an early stage of wound healing. The number of myofibroblasts was significantly lower in the laser treatment groups than the control (p

Abstract Objective This study aims to combine natural propolis with bovine bone graft (BBG) as a means of extraction socket preservation after 3 and 7 days toward expression of heat shock protein (HSP) 70 and osteocalcin to regenerate bone. Materials and Methods The Cavia cobaya were divided into eight groups, each consisting of seven samples. Their lower left incisors were extracted and induced with PEG, propolis extract, BBG, and a combination of propolis extract BBG. The research subjects were terminated on days 3 and 7 postextraction. Immunohistochemical and histopathological examinations were subsequently performed to observe HSP 70 expression, osteocalcin expression, osteoblasts, and osteoclasts. Statistical Analysis Data obtained were then analyzed with one-way analysis of variance (ANOVA) and Tukey’s honestly significant difference (HSD) tests. Results Both the groups with the combination of propolis extract and BBG on days 3 and 7 were found to present the highest number of HSP70 expression, osteocalcin expression, and osteoblast cells as well as the lowest number of osteoclasts. Conclusion Both the groups with the combination of propolis extract and BBG on days 3 and 7 were found to present the highest number of HSP70 expression, osteocalcin expression, and osteoblast cells as well as the lowest number of osteoclasts.