Alveolar ridge preservation in inflammatory extraction sites and implant surgery

doi:10.12337/zgkqzzxzz.2024.10.010

Abstract

Abstract: Alveolar ridge preservation after tooth extraction can reduce or even prevent alveolar bone resorption and soft tissue collapse during the healing process. This helps avoid complex soft and hard tissue augmentation procedures and provides good soft and hard tissue conditions for implant surgery. While conventional alveolar ridge preservation techniques have been widely applied and have shown predictable outcomes, there is still no standardized protocol for alveolar ridge preservation in cases where teeth are extracted due to periodontitis or periapical inflammation. To improve the success rate of alveolar ridge preservation in these inflammatory extraction sites, it is necessary to understand the various influencing factors of alveolar ridge preservation. This review discusses the indications for alveolar ridge preservation in inflammatory extraction sites, the impact of inflammation on alveolar ridge preservation, the key steps of this technique, and the timing of implant placement. It also shares experiences and techniques to optimize treatment outcomes.

Key words: Alveolar ridge preservation in inflammatory extraction sites, Periodontitis, Periapical diseases, Bone regeneration

Shao Zhiwen, Zhu Hanjiu, Song Yingliang. Alveolar ridge preservation in inflammatory extraction sites and implant surgery[J]. Chinese Journal of Oral Implantology, 2024, 29(5): 453-458.

References

[1] Zhao L, Xu T, Hu W, et al.Preservation and augmentation of molar extraction sites affected by severe bone defect due to advanced periodontitis: a prospective clinical trial[J]. Clin Implant Dent Relat Res, 2018,20(3):333-344. DOI: 10.1111/cid.12585.
[2] 李佩仪, 张新春. 微环境酸碱度在组织工程骨再生中作用的研究进展[J].国际口腔医学杂志,2021,48(1):64-70. DOI: 10.7518/gjkq.2021005.
[3] Ahn JJ, Shin HI.Bone tissue formation in extraction sockets from sites with advanced periodontal disease: a histomorphometric study in humans[J]. Int J Oral Maxillofac Implants, 2008,23(6):1133-1138.
[4] Feller L, Jadwat Y, Chandran R, et al.Radiolucent inflammatory implant periapical lesions: a review of the literature[J]. Implant Dent, 2014,23(6):745-752. DOI: 10.1097/ID.0000000000000140.
[5] 常雨丝,赖光云,汪俊.乳牙根尖周病相关微生物研究进展[J].中国实用口腔科杂志,2019,12(6):368-371.DOI:10.19538/j.kq.2019.06.012.
[6] 王彦雪, 傅靖菲, 刘怡. 白细胞介素-33在牙周炎方面的研究进展[J].北京口腔医学,2023,31(5):374-377. DOI: 10.20049/j.bjkqyx.1006-673X.2023.05.016.
[7] Quirynen M, Gijbels F, Jacobs R.An infected jawbone site compromising successful osseointegration[J]. Periodontol 2000, 2003,33(1):129-144. DOI: 10.1046/j.0906-6713.2002.03311.x.
[8] Hita-Iglesias C, Sánchez-Sánchez FJ, Montero J, et al.Immediate implants placed in fresh sockets associated with periapical pathology: a split-mouth design and survival evaluation after 1-year follow-up[J]. Clin Implant Dent Relat Res, 2016,18(6):1075-1083. DOI: 10.1111/cid.12387.
[9] Cosyn J, De Lat L, Seyssens L, et al.The effectiveness of immediate implant placement for single tooth replacement compared to delayed implant placement: a systematic review and meta-analysis[J]. J Clin Periodontol, 2019,46(Suppl 21):S224-S241. DOI: 10.1111/jcpe.13054.
[10] Bell CL, Diehl D, Bell BM, et al.The immediate placement of dental implants into extraction sites with periapical lesions: a retrospective chart review[J]. J Oral Maxillofac Surg, 2011,69(6):1623-1627. DOI: 10.1016/j.joms.2011.01.022.
[11] 彭晓花. 根管治疗结合牙周翻瓣术应用于牙髓-牙周综合征患者的临床疗效观察[J].现代医学与健康研究(电子版), 2022,6(18):61-64.
[12] 申丁, 李婧, 张爱凤. 牙周炎患者种植牙同期行引导骨组织再生术的美学修复效果及对牙槽骨吸收的影响研究[J]. 中国美容医学, 2024,33(4):136-139. DOI:10.15909/j.cnki.cn61-1347/r.006235.
[13] Kumar D, Sivaram G, Shivakumar B, et al.Comparative evaluation of soft and hard tissue changes following endosseous implant placement using flap and flapless techniques in the posterior edentulous areas of the mandible-a randomized controlled trial[J]. Oral Maxillofac Surg, 2018,22(2):215-223. DOI: 10.1007/s10006-018-0695-9.
[14] Al-Juboori MJ.Conservative socket regeneration with buccal wall defect using guided tissue[J]. Open Dent J, 2016,10(1):561-567. DOI: 10.2174/1874210601610010561.
[15] 胡晴. 单颗上前牙唇侧骨壁部分缺损拔牙窝的即刻种植效果的临床研究及病例报告[D].武汉:武汉大学, 2020. DOI:10.27379/d.cnki.gwhdu.2020.000820.
[16] Ragucci GM, Elnayef B, Criado-Cámara E, et al.Immediate implant placement in molar extraction sockets: a systematic review and meta-analysis[J]. Int J Implant Dent, 2020,6(1):40. DOI: 10.1186/s40729-020-00235-5.
[17] Kotsakis G, Chrepa V, Marcou N, et al.Flapless alveolar ridge preservation utilizing the "socket-plug" technique: clinical technique and review of the literature[J]. J Oral Implantol, 2014,40(6):690-698. DOI: 10.1563/AAID-JOI-D-12-00028.
[18] 徐涛, 胡文杰, 毕小成, 等. 针对罹患重度牙周病变磨牙实施微创拔牙和位点保存术的初步探索(附1例报告)[J].中国实用口腔科杂志,2018,11(1):37-43. DOI: 10.19538/j.kq.2018.01.008.
[19] Maeda H, Wada N, Nakamuta H, et al.Human periapical granulation tissue contains osteogenic cells[J]. Cell Tissue Res, 2004,315(2):203-208. DOI: 10.1007/s00441-003-0832-z.
[20] Couto de Carvalho LA, Tosta Dos Santos SL, Sacramento LV, et al. Mesenchymal stem cell markers in periodontal tissues and periapical lesions[J]. Acta Histochem, 2020,122(8):151636. DOI: 10.1016/j.acthis.2020.151636.
[21] Jaiswara C, Srivastava VK, Dhiman N.Autotransplantation of a strange positioned impacted central incisor in a surgically prepared socket: a miracle esthetic concept[J]. Int J Clin Pediatr Dent, 2016,9(3):269-272. DOI: 10.5005/jp-journals-10005-1375.
[22] Casap N, Zeltser C, Wexler A, et al.Immediate placement of dental implants into debrided infected dentoalveolar sockets[J]. J Oral Maxillofac Surg, 2007,65(3):384-392. DOI: 10.1016/j.joms.2006.02.031.
[23] 邱立新. 拔牙窝植骨-拔牙位点保存技术要点[J].中国口腔种植学杂志, 2021,26(1):2-6. DOI: 10.12337/zgkqzzxzz. 2021.02.002.
[24] Blus C, Szmukler-Moncler S, Khoury P, et al.Immediate implants placed in infected and noninfected sites after atraumatic tooth extraction and placement with ultrasonic bone surgery[J]. Clin Implant Dent Relat Res, 2015,17(Suppl 1):e287-e297. DOI: 10.1111/cid.12126.
[25] 钱为民, 曹良菊, 蒋愉, 等. 光活化消毒辅助治疗慢性牙周炎的疗效[J].昆明医科大学学报,2024,45(1):136-142. DOI: 10.12259/j.issn.2095-610X.S20240123.
[26] Sawabe M, Aoki A, Komaki M, et al.Gingival tissue healing following Er:YAG laser ablation compared to electrosurgery in rats[J]. Lasers Med Sci, 2015,30(2):875-883. DOI: 10.1007/s10103-013-1478-z.
[27] van der Meer WJ, Jansma J, Delli K, et al. Computer-aided planning and surgical guiding system fabrication in premolar autotransplantation: a 12-month follow up[J]. Dent Traumatol, 2016,32(4):336-340. DOI: 10.1111/edt.12253.
[28] Pellegrini G, Rasperini G, Obot G, et al.Soft tissue healing in alveolar socket preservation technique: histologic evaluations[J]. Int J Periodontics Restorative Dent, 2014,34(4):531-539. DOI: 10.11607/prd.1857.
[29] 张荷馨, 李新月. 重度牙周炎拔牙后位点保存不同膜覆盖技术的疗效评价[J].口腔医学研究,2020,36(10):962-967. DOI: 10.13701/j.cnki.kqyxyj.2020.10.017.
[30] Lindhe J, Cecchinato D, Donati M, et al.Ridge preservation with the use of deproteinized bovine bone mineral[J]. Clin Oral Implants Res, 2014,25(7):786-790. DOI: 10.1111/clr.12170.
[31] 罗晓丁. PRF用于口腔种植GBR手术组织愈合效果初步研究[D].天津:天津医科大学, 2012. DOI:10.7666/d.Y2232385.
[32] Mardinger O, Vered M, Chaushu G, et al.Histomorphometrical analysis following augmentation of infected extraction sites exhibiting severe bone loss and primarily closed by intrasocket reactive soft tissue[J]. Clin Implant Dent Relat Res, 2012,14(3):359-365. DOI: 10.1111/j.1708-8208.2010.00281.x.
[33] Qazi TH, Berkmann JC, Schoon J, et al.Dosage and composition of bioactive glasses differentially regulate angiogenic and osteogenic response of human MSCs[J]. J Biomed Mater Res A, 2018,106(11):2827-2837. DOI: 10.1002/jbm.a.36470.
[34] 孙徐麟, 戴安娜, 黄佳萍, 等. 牙槽嵴保存术在牙周感染位点中的应用:从软硬组织再生到后续种植修复[J].口腔医学,2024,44(2):130-138. DOI: 10.13591/j.cnki.kqyx.2024.02.010.
[35] 周永敏, 徐燕, 王晓静, 等. 重度慢性牙周炎患者上颌磨牙区拔牙后即刻种植与位点保存术后延期种植短期疗效观察[J].口腔医学研究,2017, 33(1):78-82. DOI: 10.13701/j.cnki.kqyxyj.2017.01.018.
[36] 毕小成, 危伊萍, 胡文杰, 等. 罹患重度牙周病变磨牙拔牙后位点保存与自然愈合后种植治疗效果对比研究[J].中国实用口腔科杂志,2017,10(10):598-604. DOI:10.19538/j.kq.2017.10.006.
[37] Jung RE, Ioannidis A, Hämmerle C, et al.Alveolar ridge preservation in the esthetic zone[J]. Periodontol 2000, 2018,77(1):165-175. DOI: 10.1111/prd.12209.