Taxonomy and classification of a disease contributes to facilitating the diagnosis and treatment planning process and simplifies communication between clinicians. The aim of this study was to provide a critical appraisal based on a systematic review of the single-rooted extraction socket (ES) classifications and subsequently, introduce a new classification system combining the cornerstones of the previously proposed systems and based on the latest consensus in implant dentistry. Following the systematic search process in PubMed, EMBASE, and SCOPUS databases 13 ES classifications were detected. The most repeated hard and soft tissue factors in the previous classifications were buccal bone dehiscence, interproximal bone, gingival recession, and soft tissue phenotype. However, there was minimal attention to patient-related factors such as systemic conditions and smoking. Therefore, a new classification system based on the combination of patient-related factors, clinical and radiographical parameters was proposed. This divides an ES into three types. Class I and II sockets are candidates for receiving immediate implant placement and conversely, a class III socket includes a compromised condition that requires multiplestage reconstruction mostly suitable for standard delayed implant placement with alveolar ridge preservation. Within the limitations of this study, the new classification system not only provides comprehensive inclusion of various crucial parameters in implant placement (such as prediction of future implant position and osteotomy difficulty, etc.) but also, in contrast to the previously introduced systems, is able to classify the ES prior to extraction and also, takes into the account the patient-related factors as the class modifiers following the extraction.
Oro‐antral communication (OAC) is an opening between the maxillary sinus and the oral cavity, which can provide a pathway to cause an infection of the maxillary sinus. Although surgical techniques propose many advantages, several drawbacks have been reported in the previous studies. Bioactive modifiers such as platelet‐rich fibrin (PRF) are widely being used in oral surgery. Various studies have been conducted for closure of OACs using PRF. Due to the heterogeneity of the techniques found, we opted for a literature review to highlight the variety of techniques discussed in the literature. A comprehensive search of the PubMed, Google Scholar and Cochrane databases was performed for published articles between 2014 and 2021. Keywords for OAC management and repair and inclusion criteria were used to screen articles for final review. Out of 195 articles found, 12 articles were included to the study. Eight studies performed simple direct application of PRF clots, 2 studies used PRF in combination with collagen membrane and in 2 studies the treatment plan was to use buccal advancement flap reinforced by PRF. There were several variations among approaches to the closure of OAC using PRF in terms of treatment planning, pre‐ and post‐operative medication and preparation of PRF. Despite the mentioned variations, review of recent studies showed that all of the cases experienced full epithelialisation of OAC. This technique, without manipulation of any additional flaps and auto‐grafts, has several advantages. However, further research, both experimental and clinical, is necessary to unravel the success rate of using PRF in the management of OACs.
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