Journal of Oral Implantology August 2013 - (Page 503)
CASE LETTER
Guided Bone Regeneration for Socket Preservation in
Molar Extraction Sites: Histomorphometric and 3D
Computerized Tomography Analysis
Stephen C. Wallace, DDS, MHS*
INTRODUCTION
D
eveloping ideal sites for implant
placement after tooth extraction depends on controlling the resorption
and remodeling phenomena that is
inevitably seen during healing of
extraction sites. Bone resorption, vertically and
horizontally, occurs most rapidly in the first 3
months after extractions,1 so immediate augmentation is important at the time of extraction.
Augmentation of extraction sites will prevent most
resorption, thus preventing the necessity of future
ridge augmentation procedures in order to have
optimal positioning for implant placement. Autogenous bone is the first choice for augmentation due
to the inherent osteogenic, osteoconductive, and
osteoinductive properties, but limited quantities
and a second surgery adding significant morbidity
make a substitute material highly desirable. Numerous materials have been used for socket graft
augmentation including autogenous bone, xenografts, allografts, alloplasts, and combinations of
these.2–5 Use of mineralized cancellous particulate
allograft has been reported in numerous studies for
sinus grafts, guided bone regeneration procedures,
implant defects, furcation defects, and socket
grafting.6 Placement of a barrier over grafted socket
sites has been shown to be essential to prevent soft
tissue ingrowth and encapsulation of graft particules.7,8 Barriers used over graft materials include
resorbable and nonresorbable membranes with
varying results with regard to graft retention and
regeneration.9–12
The size of an extraction site defect affects the
Stephen C. Wallace, DDS, MHS, Wilmington, NC
* Corresponding author, e-mail: scwperio@bizec.rr.com
DOI: 10.1563/AAID-JOI-D-13-00001
extent of bone regeneration that occurs, so the
combination of a socket graft with a barrier
membrane is important in larger defects such as
molar extraction sites to maximize woven bone
regeneration throughout the site.13 Complete flap
closure over a grafted socket site is important in
preventing infection and interference with maximal
bone regeneration.14
Acellular dermis matrix (ADM) is cadaveric tissue
that has had cellular components removed. Its
remaining collagen scaffold structure lends itself to
ingrowth of endothelial and fibroblast cells. Originally developed as therapy for burn patients,15
reports have demonstrated positive results with
ADM used as a guided bone regeneration barrier
membrane in combination with different graft
materials in socket preservation surgery.15–20 However, there are few reports providing histologic data
on new bone regeneration in extraction sockets
where cortical or cancellous allograft has been used
specifically with ADM for the guided bone regeneration barrier.21 A new ADM is available that does
not have to be hydrated before use. The purpose of
this case series is to obtain data showing the
histologic and clinical results of this new decellularized dermis matrix (DDM) used as a guided bone
regeneration barrier over mineralized cancellous
bone allograft (MCAB) in molar extraction sites in
preparation for implant placement.
MATERIALS
AND
METHODS
This study protocol was carried out with patient
consent following guidelines according to the
Helsinki Declaration of 1975, as revised in 2000.
Subjects were between 25 and 70 years of age.
Subjects excluded were: those with active periodontal disease, evident periapical radiolucencies or
Journal of Oral Implantology
503
Table of Contents for the Digital Edition of Journal of Oral Implantology August 2013
Literary Responsibility—Everyone Has a Role to Play
Rehabilitation of Surgically Relocated Integrated Dental Implants With and Without Bone Morphogenesis Protein-2
Erratum
Marginal Fit of Implant-Supported All-Ceramic Zirconia Frameworks
Influence of the Implant Diameter With Different Sizes of Hexagon: Analysis by 3-Dimensional Finite Element Method
Autologous Dental Pulp Stem Cells in Regeneration of Defect Created in Canine Periodontal Tissue
Histologic and Biomechanical Evaluation of 2 Resorbable-Blasting Media Implant Surfaces at Early Implantation Times
Efficacy of Guided Bone Regeneration Using Composite Bone Graft and Resorbable Collagen Membrane in Seibert’s Class I Ridge Defects: Radiological Evaluation
Minimal Iliac Bone Harvesting in Sinus Lift Surgery
Functional Load in Oblique Bicortical Implants: Parasinusal Implants and Palatine Implants
Ultrasonic Oscillations for Conservative Retrieval of a Rare Fracture of Implant Healing Abutment
Craniofacial Implant-Retained Auricular Prosthesis: A Case Report
Gingival Conditioning in an Implant-Supported Prosthesis: A Clinical Report
An Early Loaded Implant-Supported Mandibular Complete Arch Fixed Prosthesis in a Young Completely Edentulous Patient: A Case Report
Computer Guided Surgery for Implant Placement and Dental Rehabilitation in a Patient Undergoing Sub-Total Mandibulectomy and Microvascular Free Flap Reconstruction
Guided Bone Regeneration for Socket Preservation in Molar Extraction Sites: Histomorphometric and 3D Computerized Tomography Analysis
Osseointegration of Dental Implants and Osteonecrosis of the Jaw in Patients Treated With Bisphosphonate Therapy: A Systematic Review
Review of Current Literature
Journal of Oral Implantology August 2013
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