Immediate Bone Augmentation After Infected Tooth Extraction Using Titanium Membranes

Abstract

Infectious process frequently results in extensive bone resorption and defect, periradicular or periapical lesions, or vertical fracture with infected sinus tract. When tooth extraction is mandated it typically results in additional bone loss in the buccal or lingual cortical plate. Immediate guided bone regeneration (GBR) and implant fixation at an infected site is frequently complicated by soft-tissue dehiscence, membrane exposure, and implant failure. The objective of this research is to assess the feasibility of immediate bone augmentation (IBA) after purulent tooth extraction, employing a dedicated titanium membrane. An intrasulcular incision was made around the tooth to be extracted and extended to 2 adjacent teeth while maintaining the papillae. Vertical releasing incisions were made to mobilize the mucoperiosteal flap. Cautious tooth extraction was executed utilizing conventional measures and was followed by meticulous curettage of the infected and granulated tissue in the socket. Titanium membranes were applied to the socket walls followed by socket filling with autologous platelet-rich fibrin and primary closure. Eight or more weeks later membrane removal and implant placement were performed. Of the 15 patients who underwent this procedure, 7 patients (47%) had early membrane exposure (between weeks 2 and 6), which was treated conservatively. No infection or early membrane removal was reported. All patients achieved sufficient bone augmentation, and 8 patients received implants without any additional GBR. IBA after infected tooth extraction, using titanium membrane application was feasible and safe and yielded adequate bone filling to support implant fixation at > or =8 weeks. Further studies need to evaluate if the titanium membrane helped in any way to inhibit plaque accumulation or resist infection in cases of early membrane exposure.

Evolution, current status and advances in application of platelet concentrate in periodontics and implantology

“…PRF plugs can also be indicated in management of residual extraction sockets[95]. A technique in which autologous PRF is used in extracted socket after immediate bone augmentation using titanium membranes applied to the socket walls and achieving primary closure, was found to be feasible and safe with adequate bone filling after 8 wk or above for implant fixation[96]. Hafez et al[97] in 2015 demonstrated that PRF membrane maintains particulate autogenous bone graft and help achieve primary coverage over immediately placed implants.…”

Role of Platelet rich fibrin in wound healing: A critical review

“…[15] Use of autologous PRF in extracted socket filling after immediate bone augmentation using titanium membranes applied to the socket walls and primary closure was found to be feasible and safe with adequate bone filling after 8 weeks or above for implant fixation. [16]…”

Efectividad del Plasma Rico en Plaquetas en la Cicatrización de Implantes Dentales: Una Revisión Sistemática

“…En odontología se ha utilizado para la regeneración de tejidos posterior a alguna intervención (Blus et al, 2008), incluyendo tejido blando y hueso (Consolo et al, 2007), con resultados clínicamente significativos, aunque en ciertos tipos de cirugías su uso no está tan evidenciado (Kfir et al, 2007) o que simplemente demuestran resultados contradictorios o negativos en lo que ha cicatrización se refiere (Torres et al, 2009) lo que permite establecer la discusión sobre la real efectividad de este procedimiento e contextos clínicos.…”

“…En odontología se ha utilizado para la regeneración de tejidos posterior a alguna intervención (Blus et al, 2008), incluyendo tejido blando y hueso (Consolo et al, 2007), con resultados clínicamente significativos, aunque en ciertos tipos de cirugías su uso no está tan evidenciado (Kfir et al, 2007) Por lo cual, el objetivo de este estudio radica en evaluar la efectividad del plasma rico en plaquetas en la cicatrización de implantes dentales mediante un procedimiento de revisión sistemática que deriva en un metaanálisis permitiendo generar una recomendación clínica basada en la evidencia.…”