Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP) granules coated with poly(lactic-co-glycolic acid) (PLGA) were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone) in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material) while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques.

A randomised clinical trial to assess maintenance of gingival health by a novel dentifrice containing 0.1%w⁄w o-cymen-5-ol and 0.6%w⁄w zinc chloride Objectives: To assess the ability of 0.1%w ⁄ w o-cymen-5-ol ⁄ 0.6%w ⁄ w zinc chloride dentifrice to maintain gingival health compared to a sodium fluoride control dentifrice. Design: Following a baseline examination, subjects went through a regimen to bring them to a high level of gingival health. This included a professional prophylaxis supported by oral hygiene instruction prior to commencing study treatment. Subjects brushed twice daily for 12 weeks with either the test or control dentifrice. Examinations for gingival inflammation (MGI), bleeding and plaque were performed after 6 and 12 weeks. Results: 224 subjects were included in the efficacy analysis. Relative to the sodium fluoride ⁄ silica control dentifrice group the o-cymen-5-ol ⁄ zinc chloride dentifrice exhibited statistically significant reductions (p < 0.0001) in MGI, bleeding and plaque of 12.3%, 18.5% and 13.2% respectively after six weeks and 38.1%, 37.8% and 24.2% after 12 weeks. Conclusion: The results of the present clinical study demonstrate that the use of the 0.1%w ⁄ w o-cymen-5-ol ⁄ 0.6%w ⁄ w zinc chloride dentifrice over a 12 week period provides a statistically significant benefit in maintaining gingival health compared to a sodium fluoride control dentifrice.

A randomised clinical trial to assess maintenance of gingival health by a novel gel to foam dentifrice containing 0.1%w⁄w o-cymen-5-ol, 0.6%w⁄w zinc chloride Objectives: To assess the ability of 0.1%w ⁄ w o-cymen-5-ol ⁄ 0.6%w ⁄ w zinc chloride gel to foam dentifrice to maintain gingival health compared to a sodium fluoride control dentifrice. Design: Following a baseline examination, subjects went through a regimen to bring them to a high level of gingival health. This involved a professional dental prophylaxis supported by oral hygiene instruction prior to commencing study treatment. Subjects brushed twice daily for 12 weeks with either the test or control dentifrice. Examinations for gingival inflammation (MGI), bleeding and plaque were performed after 12 weeks. Results: 205 subjects were included in the efficacy analysis. Relative to the sodium fluoride ⁄ silica control dentifrice group the o-cymen-5-ol ⁄ zinc chloride gel to foam dentifrice exhibited statistically significant reductions (p < 0.0001) in MGI, bleeding and plaque of 32.2%, 26.3% and 20.7% respectively after 12 weeks. Conclusion: The results of the present clinical study demonstrate that the use of the 0.1%w ⁄ w o-cymen-5-ol ⁄ 0.6%w ⁄ w zinc chloride gel to foam dentifrice over a 12 week period provides a statistically significant benefit in maintaining gingival health compared to a sodium fluoride control dentifrice.

BackgroundPost-Extraction ridge preservation using bone graft substitutes is a conservative technique to maintain the width of the alveolar ridge. The objective of the present study was to evaluate an in situ hardening biphasic (HA/β-TCP) bone graft substitutes for ridge preservation without primary wound closure or a dental membrane.MethodsA total of 15 patients reported for tooth extraction were enrolled in this study. Implants were placed in average 5.2 ± 2 months after socket grafting. At this visit, Cone Beam CT (CBCT) images and core biopsies were taken. Implant stability (ISQ) was assessed at the insertion as well as at the day of final restoration.ResultsCBCT data revealed 0.79 ± 0.73 mm ridge width reduction from grafting to implant placement. Histomorphometric analysis of core biopsy samples revealed in average 21.34 ± 9.14% of new bone in the grafted sites. Primary implant stability was high (ISQ levels 70.3 ± 9.6) and further increased until final restoration.ConclusionsThe results of this study show that grafting of intact post-extraction sockets using a biphasic in situ hardening bone graft substitute results in an effective preservation of the ridge contour and sufficient new bone formation in the grafted sites, which is imperative for successful implant placement.

Introduction: Immediate placement of implants in a fresh post-extraction socket is an increasingly popular and established treatment option. However, active infection in the extraction site may adversely affect the outcome of this procedure. This study was designed to assess the clinical results of immediate placement of dental implants in infected extraction sockets using a standardized protocol, which included (a) the use of an Er,Cr:YSGG laser for the decontamination of the infected socket prior to implant insertion, and (b) the utilization of an in situ hardening alloplastic bone graft substitute to augment the gap between the implant surface and the labial plate of bone. Patients and Methods: A retrospective record review was used to identify 68 patients who had implants placed as per the described protocol. A total of 126 implants were placed in 68 patients (65 implants in the maxilla, 61 implants in the mandible). The implants were loaded 136 ± 73 days (mean ± standard deviation; range: 37–400 days) after implant placement. Eight patients (16 implants) were subsequently lost to follow up. Results: 105 of the 110 implants (95.45%) placed immediately in the infected sites using the described protocol survived after prosthetic loading. Conclusion: Immediate implant placement in previously infected sites using the protocols mentioned in our study with laser decontamination of the socket, grafting with an in situ hardening alloplastic bone graft material and non-submerged healing shows a similar survival rate to the published success rates for immediate implants placed in non-infected sites.