Investigation of novel methods to facilitate dental implant osseointegration in areas of deficient bone and in areas of recent tooth extraction
Citation:
Haitham Bashara, 'Investigation of novel methods to facilitate dental implant osseointegration in areas of deficient bone and in areas of recent tooth extraction', [thesis], Trinity College (Dublin, Ireland). School of Dental Science, 2013, pp 194Download Item:
Abstract:
The aim of this this series of studies was to identify methods to prevent alveolar ridge resorption following tooth extractions and also to invesigate conservative methods of providing anchorage in areas of deficient bone using titanium. The healing of an extraction socket following tooth removal has been studied in animal models. These studies demonstrated that during the process of healing a series of events occurred, such as the formation and maturation of a blood clot, infiltration of fibroblasts replacing the coagulum and the establishment of a provisional matrix that allowed for bone formation. In dog studies, researchers studied bone tissue reactions to tooth extraction using observations from both within the alveolus and in the surrounding tissues. It was observed that the intra-alveolar portion of the extraction site became occupied by woven bone which, following the formation of a cortical hard tissue ridge, became replaced mainly by bone marrow. Both the lingual and the buccal hard tissue walls underwent a marked change. Thus, through the combined effect of surface resorption and loss of bundle bone, the buccal bone wall in particular was reduced in thickness as well as in height. These changes have obvious implications for any subsequent implant placement, particularly in the aesthetic zone. Although it has been suggested that the placement of implants in fresh extraction sockets may serve to maintain the original shape of the ridge, remodelling in the later stages of healing was found to result in the loss of a significant amount of buccal bone. Furthermore, it was found that while the placement of biomaterials into sockets immediately following extraction failed to prevent resorption and loss of height of the buccal bone crest, the profile of the ridge was better preserved. The aim of the first study herein was to evaluate the effects of a novel bone substitute system (Natix®, Tigran Technologies AB, Malmo, Sweden), consisting of porous titanium granules (PTG), and a bovine-derived xenograft (Bio-Oss®, Geistlich Pharma AG, Wolhusen, Switzerland), on hard tissue remodelling following their placement into fresh extraction sockets in dogs. Histological observation revealed that while bone formed around both the xenograft and the titanium particles, bone was also noted within titanium granules. Of the five modalities of ridge preservation techniques used in this study, no one technique proved to be superior. Overall, the titanium granules were observed to have promising osseoconductive properties.
Author: Bashara, Haitham
Advisor:
Claffey, NoelQualification name:
Doctor of Philosophy (Ph.D.)Publisher:
Trinity College (Dublin, Ireland). School of Dental ScienceNote:
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