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Evaluation of Healing at Molar Extraction Sites With Ridge Preservation Using Freeze Dried Bone Allograft and a Collagen Wound Dressing

2017-06-20 02:08:21 | BioPortfolio

Summary

Currently, it is not known what the dimensional changes might be following a molar site extraction which has been grafted with FDBA and covered with a collagen wound dressing. The purpose of the proposed study is to examine the clinical healing following ridge preservation using freeze dried bone allograft (FDBA) with a collagen wound dressing barrier (CollaPlug®) in a molar extraction site.

I

Description

It is well known that a tooth socket will undergo significant resorption and remodeling following tooth extraction. Pietrokovsky and Massler documented alveolar bone dimension changes subsequent to tooth extraction forty-five years ago. Schropp et al. evaluated tissue changes on models following premolar and molar extractions and concluded that 50% of the ridge width was lost within one year following extraction. Two thirds of this resorption happened during the first 3 months.

In addition to alveolar ridge resorption in a horizontal dimension (decrease in width), changes in the vertical dimension of the ridge have been documented following tooth extraction in a canine model (Araújo & Lindhe 2005). The healing pattern of the extraction socket observed in the preclinical setting was further confirmed in human investigations (Iasella et al. 2003, Barone et al. 2008, Oghli et al. 2010). A systematic review (Van der Weijden et al. 2009) concluded that greater loss of ridge width is to be expected following extraction compared to loss of ridge height. Clinical mean reductions of 3.87mm and 1.87mm in ridge width and height, respectively, were reported. Radiographically, the mean reduction amounted 1.21mm and 1.53mm for ridge width and height, respectively. These results were confirmed by another systematic review (Tan et al. 2012).

If the extracted tooth is to be replaced, the unfavorable dimensional changes resulting from this healing process may necessitate advanced and technique sensitive guided bone regeneration (GBR) procedures prior to dental implant placement. In order to avoid GBR and limit these dimensional changes, grafting of the extraction socket with or without membrane coverage, also called ridge preservation procedure, have been advocated (Araújo & Lindhe 2009, Iasella et al. 2003, Darby et al. 2009, Vignoletti et al. 2012). In order to perform ridge preservation, typically, a graft material and some sort of a barrier (e.g. non-resorbable and resorbable membranes or collagen wound dressing) are used. A large variety of materials are available on the market for the purpose of ridge preservation. No material gold standard has yet been identified to date, which would ensure the best dimensional stability of the alveolar ridge (Darby et a. 2009, Vignoletti et al. 2012).

Current materials used as part of standard care in clinical practice include freeze dried bone allograft (FDBA) as a grafting material and a dense polytetrafluroethylene (dPTFE) non-resorbable membrane or a collagen wound dressing (Collaplug®, Zimmer Dental, Carlsbad, CA) to protect the extraction grafted site. It is currently now known how the use of a collagen wound dressing would compare to a non-resorbable membrane (which has been documented) and if any would lead to any substantial clinical advantages.

Therefore, the proposed research project will answer the following question:

What are the dimensional changes of the hard and soft tissues encountered following molar extractions with ridge preservation using FDBA and a collagen wound dressing?

Study Design

Conditions

Tooth Extraction

Intervention

Ridge preservation

Status

Active, not recruiting

Source

The University of Texas Health Science Center at San Antonio

Results (where available)

View Results

Links

Published on BioPortfolio: 2017-06-20T02:08:21-0400

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Medical and Biotech [MESH] Definitions

The surgical removal of a tooth. (Dorland, 28th ed)

A condition sometimes occurring after tooth extraction, particularly after traumatic extraction, resulting in a dry appearance of the exposed bone in the socket, due to disintegration or loss of the blood clot. It is basically a focal osteomyelitis without suppuration and is accompanied by severe pain (alveolalgia) and foul odor. (Dorland, 28th ed)

Use of various chemical separation and extraction methods, such as SOLID PHASE EXTRACTION; CHROMATOGRAPHY; and SUPERCRITICAL FLUID EXTRACTION; to prepare samples for analytical measurement of components.

Preprosthetic surgery involving rib, cartilage, or iliac crest bone grafts, usually autologous, or synthetic implants for rebuilding the alveolar ridge.

The pathologic wearing away of the tooth substance by brushing, bruxism, clenching, and other mechanical causes. It is differentiated from TOOTH ATTRITION in that this type of wearing away is the result of tooth-to-tooth contact, as in mastication, occurring only on the occlusal, incisal, and proximal surfaces. It differs also from TOOTH EROSION, the progressive loss of the hard substance of a tooth by chemical processes not involving bacterial action. (From Jablonski, Dictionary of Dentistry, 1992, p2)

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