Accelerating Socket Repair via WNT3A Curtails Alveolar Ridge Resorption

Abstract

Tooth extraction triggers alveolar ridge resorption, and when this resorption is extensive, it can complicate subsequent reconstructive procedures that use dental implants. Clinical data demonstrate that the most significant dimensional changes in the ridge occur soon after tooth extraction. Here, we sought to understand whether a correlation existed between the rate at which an extraction socket heals and the extent of alveolar ridge resorption. Maxillary molars were extracted from young and osteoporotic rodents, and quantitative micro–computed tomographic imaging, histology, and immunohistochemistry were used to simultaneously follow socket repair and alveolar ridge resorption. Extraction sockets rapidly filled with new bone via the proliferation and differentiation of Wnt-responsive osteoprogenitor cells and their progeny. At the same time that new bone was being deposited in the socket, tartrate-resistant acid phosphatase–expressing osteoclasts were resorbing the ridge. Significantly faster socket repair in young animals was associated with significantly more Wnt-responsive osteoprogenitor cells and their progeny as compared with osteoporotic animals. Delivery of WNT3A to the extraction sockets of osteoporotic animals restored the number of Wnt-responsive cells and their progeny back to levels seen in young healthy animals and accelerated socket repair in osteoporotic animals back to rates seen in the young. In cases where the extraction socket was treated with WNT3A, alveolar ridge resorption was significantly reduced. These data demonstrate a causal link between enhancing socket repair via WNT3A and preserving alveolar ridge dimensions following tooth extraction.

Recombinant bone matrix maintains the graft space, induces vascularized bone regeneration and preserves canine tooth extraction socket structure

“…The importance of space maintenance for bone regeneration has been proposed in guided bone regeneration (Briguglio et al, 2019). Recently, Arioka et al (2022)demonstrated a causal link between enhancing socket repair and preserving alveolar ridge dimensions following tooth extraction. Hence, RBM may have promoted bone regeneration in the extraction socket, which may also have contributed to the space maintenance and suppressed alveolar ridge absorption.…”

Ridge preservation using octacalcium phosphate collagen to induce new bone containing a vascular network of mainly Type H vessels

“…Schropp et al reported that, in most cases in humans, decreases in alveolar bone height and width both occurred immediately after extraction [7]. According to Arioka et al, alveolar bone resorption also occurs immediately after tooth extraction in rodents [29], and RP is considered to be effective for protection of the alveolar ridge after tooth extraction. In the present study, the post-extraction alveolar bone resorption rate was lower in both groups that underwent RP than in the CTL group, with the reduction in width in particular being signi cantly lower, demonstrating the effectiveness of RP.…”

Periodontal Wound Healing and Regeneration: Insights for Engineering New Therapeutic Approaches

“…Lineage tracing has also been used to investigate the osteogenic potential of periodontal cell populations in tooth extraction sites. Wnt-responsive cells, indicated by expression of Axin2, were present in small numbers in healthy periodontal tissues (70,71). After tooth extraction, Axin2-lineage cells that remained in the residual PDL proliferated and migrated into the socket.…”