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: 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
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