OBJECTIVE: To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft.
METHODS: Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol (n = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed (n = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant.
RESULTS: Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35 mm vs. 1.60 ± 0.66 mm [p = .000] and 9.64 ± 15.39% mm3 vs. 31.45 ± 18.11% mm3 [p = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm3 vs. 5.25 ± 5.79% mm3). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance.
CONCLUSIONS: Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

OBJECTIVE: The aim of this study was to compare leukocyte and platelet-rich fibrin (L-PRF) and photobiomodulation (PBM) applications, which have been repeatedly reported to be superior to control groups, in terms of pain, soft tissue and bone healing in tooth extraction sockets.
METHODS: This double-blind, randomized clinical study was completed with 34 patients, who had an indication for extraction of their bilaterally impacted teeth. The right and left teeth of the patients were randomly divided into L-PRF and PBM groups. L-PRF group was treated with the blood product centrifuged for 12 min at 2700 rpm, and the PBM group was treated with a diode laser at different points for 60 s with a wavelength of 940 nm in repeated sessions. Postoperative pain was evaluated using Visual Analogue Scale (VAS), soft tissue healing with Landry Index (LI), tissue healing in the distal region of mandibular second molar by probing depth measurement, and bone healing via panoramic x-ray using the Image J program.
RESULTS: No statistically significant difference was found for any variable compared between the groups.
CONCLUSIONS: L-PRF and PBM applications provide similar support in the healing of extraction sockets. Nevertheless, the advantages and disadvantages of both methods determine their usage areas.
CONCLUSIONS: While L-PRF is advantageous in the early healing of extraction sockets, PBM may be preferred in terms of bone trabeculation in the long term.

OBJECTIVE: This study sought to evaluate the efficacy of cancellous bovine bone mineral granules and 10% porcine collagen (deproteinized bovine bone mineral with collagen [DBBM-C]; (OCS-B Collagen® [Straumann XenoFlex], NIBEC, Korea) in a mouldable block form, with or without socket seal, using autogenous free gingival graft (FGG).
METHODS: Fifty-four patients were included and randomly assigned to one of three groups: (1) spontaneous healing (control group), (2) alveolar ridge preservation (ARP) using DBBM-C (DBBM-C group), and (3) ARP employing DBBM-C sealed with FGG (DBBM-C/FGG group). Bone biopsy and implant fixture placement were performed 180 days after ARP. Cone-beam computed tomography, histological analysis, implant stability, and three-dimensional volumetric analysis were conducted.
RESULTS: Of the 54 patients, 4 dropped out owing to loss of follow-up and osseointegration failure. The changes in alveolar bone during follow-up were not significantly different. Between 84- and 180-day postextraction, the volume of the DBBM-C and DBBM-C/FGG groups was maintained at 3 mm below the alveolar ridge crest (0.72 ± 0.80 mm, 6.05 ± 6.69%), whereas the volume in the control group decreased (-0.37 ± 1.31 mm, -2.10% ± 8.37%) (P = .026). The DBBM-C/FGG group exhibited less horizontal ridge resorption at 1 mm below the alveolar crest (-9.19 ± 5.09 mm, -73.67% ± 32.53%) between preextraction and 84 days postextraction (P = .049). In all groups, the implant stability quotient remained above 70.
CONCLUSIONS: Within the limitations of this study, both ARP using DBBM-C with and without socket sealing effectively preserved the width dimension of the alveolar ridge, with no significant difference in alveolar bone resorption. However, socket sealing appeared to enhance the stability of the bone graft and bone quality.
CONCLUSIONS: The use of DBBM-C for ARP seems to aid in volume maintenance as compared with spontaneous healing. Gingival sealing with an FGG can help maintain the width of the alveolar ridge. This clinical trial was not registered prior to participant recruitment and randomization. This study was registered at WHO ICTRP (https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008266).

UNASSIGNED: The study aimed to ascertain how Anredera cordifolia (Ten.) Steenis Gel affects the expression of protein dentin matrix protein-1 (DMP-1) in alveolar Wistar rats after tooth extraction.
UNASSIGNED: Rats were given A. cordifolia (Ten.) Steenis gel was in the socket after tooth extraction, and then the wound was sutured. The rats were sacrificed for 8 and 15 days following tooth extraction. The results on the 8th and 15th days demonstrate that the expression of DMP-1 in the treatment group is significantly higher than in the control group.
UNASSIGNED: Expression of DMP-1 in the socket after tooth extraction on days 8 and 15 with a 400x magnification light microscope in both of the A. cordifolia (Ten.) Steenis gel treatment groups showed significant differences compared to the control group.
UNASSIGNED: The use of A. cordifolia (Ten.) Steenis gel can stimulate DMP-1 expression in alveolar bone after tooth extraction.

Background and Objectives: In socket preservation, the goal is to minimize bone resorption after tooth extraction to maintain the volume and contour of the alveolar ridge. The use of PRF in post extraction sites may reduce ridge resorption by encouraging the growth of new bone and acting as a scaffold for tissue. In addition, PRF may enhance healing and minimize postoperative pain. The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) in maintaining the ridges\' dimensions at the extraction site, in the maxilla and mandible, as well as its impact on post-extraction discomfort. Methods: The study was conducted on 60 patients presenting for extraction of posterior teeth and was randomly divided into three groups: group I PRF (n = 20), group II PRF + collagen (n = 20), and group III control (n = 20). Sockets were filled with PRF (group I) and PRF + collagen (group II). At baseline and follow-up after 3 months, CBCT was used to assess the bone dimensions. The postoperative pain evaluations were performed at 24 h, 3 days, and 7 days after the tooth extraction. The pain rate was evaluated using a numerical rating scale from the British Pain Society. Results: The study examined the effects of platelet-rich fibrin (PRF) and PRF combined with collagen on the height and width of the ridges, as well as the pain experienced by the patients following alveolar ridge preservation surgery. ANOVA and t-tests were used to evaluate and compare the ridge dimensions. Comparing the results to the control group, there were no significant differences in the height or width of the ridges. However, both the PRF and PRF + Collaplug® treatments effectively reduced the short-term postoperative pain. Conclusions: The study findings suggest that platelet-rich fibrin (PRF) and PRF combined with collagen do not exert significant effects on ridge width and height compared to the standard treatment following alveolar ridge preservation. However, it is noteworthy that both the PRF and PRF + collagen treatments demonstrated efficacy in reducing postoperative pain in the short term, offering a potential advantage over standard treatment protocols.

OBJECTIVE: This study aims to evaluate the efficacy of concentrated growth factor (CGF) membrane and collagen as barrier materials in sealing the alveolar socket in alveolar ridge preservation (ARP) in the posterior region during a one-year follow-up.
METHODS: A total of 24 patients who underwent ARP in the posterior region were selected for inclusion and randomly assigned to the CGF group (12 cases) and Collagen group (12 cases). The patients in both groups underwent extraction of posterior teeth. The extraction sockets were filled with a bone substitute to the level of the pre-extraction buccal and lingual or palatal alveolar bone plates. The wounds in the CGF group were closed with a fabricated CGF overlaying the upper edge of the bone substitute material, whereas those in the Collagen group were closed with Bio-Oss Collagen. The implants were placed after 6 months. The evaluation was based on implant retention, re-grafting rate, and vertical and horizontal alveolar ridge bone volume changes measured by cone beam computed tomography (CBCT). Data were statistically analyzed using SPSS 28.0 software.
RESULTS: No patient withdrew throughout the follow-up period. No implant failure and no severe peri-implant or mucosal soft tissue complications were observed. Six months after the operation, the degree of vertical alveolar ridge height resorption in the CGF group was lower than that in the Collagen group (P<0.05). There were no statistically difference between the groups at 1 year after the operation (P>0.05). The amount of bone reduction in horizontal alveolar ridge width showed no difference between the groups at 6 months and 1 year after surgery (P>0.05).
CONCLUSIONS: CGF membrane and Bio-Oss Collagen as barrier materials for posterior ARP inhibited reduction in alveolar ridge bone mass.
目的: 评价自体浓缩生长因子（CGF）膜和骨胶原作为屏障材料在后牙区牙槽嵴保存术（ARP）术后1年的骨组织保存效果。方法: 选取三壁及以上骨缺损需接受后牙区牙槽嵴保存术治疗的24例患者为研究对象，随机分配至CGF组（12例）和骨胶原组（Collagen组）（12例）。2组患者均拔除无法保留后牙，拔牙窝内填充异种移植物骨替代物Bio‐Oss®至拔牙前牙槽嵴顶处，CGF组将制取的CGF膜覆盖于骨替代材料上缘并封闭创口，Collagen组采用Bio-Oss® Collagen覆盖并封闭创口。牙槽峭保存术后6个月植入种植体。采用锥形束CT测量分析术后即刻、6个月和1年的垂直牙槽嵴骨高度和水平牙槽嵴骨宽度变化，评估种植术中再植骨率和植体存留率。采用SPSS 28.0软件对数据进行统计学分析。结果: 24例患者均完成术后1年随访，无1例退出试验或失访，无1例出现术后感染、出血和种植体周病等。术后6个月CGF组的垂直牙槽嵴骨高度减少量低于Collagen组，差异有统计学意义（P<0.05）；术后1年CGF组和Collagen组垂直牙槽嵴骨高度的减少量差异无统计学意义（P>0.05）。术后6个月、术后1年CGF组和Collagen组水平牙槽嵴骨宽度的减少量差异均无统计学意义（P>0.05）。2组种植术中再植骨率均为16.7%，植体存留率为100%。结论: CGF膜和Bio-Oss® Collagen作为后牙区牙槽嵴保存术的屏障材料，均能有效减少拔牙后牙槽骨吸收，保存牙槽骨。.

BACKGROUND: The healing process after tooth removal involves bone remodelling which implies some loss of alveolar bone volume. Among materials proposed for minimising this remodelling and preserving the bone, autologous dental tissue is a promising option, but more data are needed. In this context, we evaluated size and density changes using cone beam computed tomography in autologous dental material (ADM)-preserved sockets compared to controls, and assessed biological responses by histological analysis.
METHODS: A split-mouth study was conducted including 22 patients, who underwent removal of ≥ 2 single-rooted teeth with intact sockets, assigning one socket to the experimental group which received ADM for alveolar preservation and another to the control group, which only underwent blood clot stabilisation. Cone beam computed tomography was performed postoperatively (week 0) and at weeks 8 and 16 to assess socket size and bone density. Histological analysis was carried out on trephine biopsies taken (Ø4 × 4.5 mm) from the experimental group.
RESULTS: Less horizontal shrinkage was observed in the ADM group, especially at week 16 considering the group-by-time interaction for the following variables: difference in height between the lingual and buccal alveolar crests (-1.00; p < .01; 95% CI: -0.28 - -1.73), and half-widths, measured as the distance from the long axis of the missing tooth to the buccal alveolar crest at 1 mm (-0.61; p < .01; 95% CI: -0.18 - -1.04) and at 3 mm (-0.56; p < .01; 95% CI: -0.15 - -0.97) below the crest, with mean decreases of 1.07 and 2.14 mm in height difference, 0.66 and 1.32 mm in half-width at 1 mm and 0.43 and 1.02 mm in half-width at 3 mm in ADM and control groups respectively. Densitometry analysis showed higher bone densities in Hounsfield units in the ADM group considering all factors analysed regardless of time point and socket third (coronal, middle, or apical). Histologically, there were no signs of inflammation or foreign body reaction, and dentin particles were surrounded by and in close contact with bone tissue.
CONCLUSIONS: These results add to the evidence that dentin can be used successfully as a material for alveolar socket preservation, given its desirable mechanical and biological properties, and warrant larger studies.

Immediate implant placement in the anterior maxilla remains complex, particularly when the labial cortical plate of the socket is deficient and there is an associated class IV ridge defect with both hard- and soft-tissue deficiencies. This case report describes a novel combination of polydioxanone (PDS) suture tenting to support a synthetic bone graft with simultaneous implant placement with implants featuring a body-shift design and subcrestal internal angle correction. In addition, the implants were immediately loaded with a four-unit provisional bridge at the time of surgery, thus reducing morbidity, costs, and total treatment time.

The socket-shield technique is a clinical procedure aimed at preventing both hard- and soft-tissue collapse following immediate implant placement. The technique can be challenging as multiple factors influence the precision of this treatment. Selective preservation of tooth (SPOT) is a standardized, reproducible tooth-guided preparation protocol for achieving a socket shield and for immediate post-extraction implant site preparation and placement. SPOT emphasizes the utilization of osseodensification burs in both forward (ie, clockwise) rotation, to allow for simultaneous precise root apex removal and shield preparation, and reverse (ie, counterclockwise) rotation, to allow for implant site preparation with further compaction-autografting of bone and dentin, thereby improving implant primary stability and its subsequent early healing. This article presents SPOT in a step-by-step protocol for socket-shield and implant site preparation with immediate post-extraction implant placement. The article describes the stepwise application for single-rooted teeth.

The placement of immediate dental implants in the esthetic zone is a highly successful procedure, however it requires careful case selection. Depending on the structural integrity of the alveolar socket and the gingival level, either an implant can be placed immediately and provisionalized or its insertion may need to be delayed. If the extraction site is compromised, implant placement should be deferred to allow bone or soft-tissue grafting or a combination of both to facilitate esthetic implant placement. In addition, two other treatment factors need to be considered with regard to immediate placement: (1) if the implant has low primary stability (ie, low insertion torque value), a custom healing abutment should be fabricated to maintain tissue contour and retain bone placed into the buccal gap; (2) if there is high primary stability (ie, high insertion torque value), fabrication of an immediate fixed provisional will preserve tissue contour, hold a buccal gap bone graft in place, and provide an esthetic result. At sites where the implant will be placed, factors favoring immediate placement include the following: coronal position of the gingiva compared to adjacent teeth, a type I socket classification, and class I or II sagittal root position. The purpose of this article is to present clinical guidelines that can aid in the decision-making process for delayed versus immediate implant placement.