Piezosurgical treatment of crestal bone: quantitative comparison of post‐extractive socket outcomes with those of traditional treatment

Spinato, Sergio; Rebaudi, Alberto; Bernardello, Fabio; Bertoldi, Carlo; Zaffe, Davide

doi:10.1111/clr.12555

Cited by 7 publications

(9 citation statements)

References 30 publications

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“…However, all of these options are associated with significant rate of complications, increased morbidity, high costs, and prolonged time of therapy [ 11 – 13 ]. In the attempt to reduce the need for advanced surgical procedures and to simplify the treatment plan, specific surgical techniques were developed to reduce postextractive ridge resorption [ 14 , 15 ]. Alveolar ridge preservation (ARP), with the application of different biomaterials, is the most common procedure aiming to control crestal bone resorption following dental extractions [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Alveolar Ridge Preservation after Maxillary Molar Extraction in Reducing Crestal Bone Resorption and Sinus Pneumatization: A Multicenter Prospective Case-Control Study

Lombardi¹,

Bernardello²,

Berton

et al. 2018

BioMed Research International

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Aim To evaluate, with three-dimensional analysis, the effectiveness of alveolar ridge preservation (ARP) after maxillary molar extraction in reducing alveolar bone resorption and maxillary sinus pneumatization when compared to unassisted socket healing. Methods Patients were included in the study following inclusion criteria and underwent minimally traumatic maxillary molar extraction followed by ARP using synthetic nanohydroxyapatite (Fisiograft Bone, Ghimas, Italy) (test group) or unassisted socket healing (control group). Cone-beam computerized tomographies (CBCT) were performed immediately after tooth extraction (T0) and 6 months postoperatively (T1). CBCTs were superimposed by using a specific software (Amira, Thermo Fisher Scientific, USA) and the following items were analyzed in both groups: (i) postextractive maxillary sinus floor expansion in coronal direction and (ii) postextractive alveolar bone dimensional changes (both vertical and horizontal). All data were tested for normality and equality of variance and subsequently analyzed by independent samples T-test and Mann–Whitney test. Results Thirty patients were treated by three centers and twenty-six (test n=13; control n=13) were included in the final analysis. Mean sinus pneumatization at T1 was 0.69±0.48 mm in the test group and 1.04±0.67 mm in the control group (p=0.15). Mean vertical reduction of the alveolar bone at T1 was 1.62±0.49 mm in the test group and 2.01±0.84 mm in the control group (p=0.08). Mean horizontal resorption of crestal bone at T1 was 2.73±1.68 mm in test group and 3.63±2.24 mm in control group (p=0.24). Conclusions It could be suggested that ARP performed after maxillary molar extraction may reduce the entity of sinus pneumatization and alveolar bone resorption, compared to unassisted socket healing. This technique could decrease the necessity of advanced regenerative procedures prior to dental implant placement in posterior maxilla.

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Section: Introductionmentioning

confidence: 99%

Efficacy of Alveolar Ridge Preservation after Maxillary Molar Extraction in Reducing Crestal Bone Resorption and Sinus Pneumatization: A Multicenter Prospective Case-Control Study

Lombardi¹,

Bernardello²,

Berton

et al. 2018

BioMed Research International

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“…22 Bone healing probably related to various factors including searching methods, the size of the bone defect, and timing in histopathological examination. 23,24 Furthermore, Gomes et al, 13 in their study on animals found that healing was delayed as shown by histological follow-up, in the group that used only the hAM. The reason for higher bone building levels in the conventional surgery on 21 st day likely that the hAM maintains its tissue integrity by performing its barrier function in the present study.…”

Section: Discussionmentioning

confidence: 97%

Histopathological assessment of healing process using an amniotic membrane in osteotomy defects caused by piezosurgery and conventional surgery in rats

Ilker¹,

Ilker

Sivrikaya

2020

Preprint

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There is a paucity of studies aimed to compare the healing process of piezosurgery with conventional surgery. This study evaluated the histopathological assessment of healing process in osteotomy defects caused by these surgical methods in rats using an amniotic membrane (hAM). In this randomized controlled experimental study, there were 2 main groups: group 1 (Piezosurgery method-right tibia) and group 2 (Conventional surgery method-left tibia) and subgroups determined by the sacrification periods on the 7th (n = 20) and 21st days (n = 20). hAM was used in all groups. The primary outcome variable was new bone formation, while inflammation, necrosis, fibrotic tissue formation in the defective zone were secondary outcomes. 40 male Sprague Dawley rats were used. The 7th day fibrosis levels and the 7th new bone-building level of the group who underwent piezosurgery were found to be significantly higher than those of the group undergoing conventional surgery (p < 0.05) and the 21st new bone-building level was significantly lower than conventional surgery. In all rats, on the 21st day, there were statistically significant decreases in inflammation, fibrosis, and increases in the healing score (p < 0.05). Also, there was no statistically difference in new bone formation between 7st and 21st days (p > 0.05). The choice of conventional surgery when applying with hAM increases the new bone building in the late period.

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“…Complicated extractions, such as the removal of ankylosed and endodontically treated teeth, can cause excessive bleeding, if the surgical procedures of flapping and deboning are conducted [5,6]. Given that such aggressive procedures may further increase the bleeding risk in DAPT patients, the flapless approach serves as an ideal alternative owing to its less traumatic nature, and turbine handpieces (TH) with burs specially designed to create dento-alveolar spaces are commonly used instruments [7,8]. Although the cutting action of TH is highly efficient, the rotating working mode of the bur and the high operational pressure limit the cutting precision and intraoperative control, thereby causing unwanted adjacent tissue injuries and subsequent prolongation of intra-alveolar clotting [7,9].…”

Section: Introductionmentioning

confidence: 99%

“…Given that such aggressive procedures may further increase the bleeding risk in DAPT patients, the flapless approach serves as an ideal alternative owing to its less traumatic nature, and turbine handpieces (TH) with burs specially designed to create dento-alveolar spaces are commonly used instruments [7,8]. Although the cutting action of TH is highly efficient, the rotating working mode of the bur and the high operational pressure limit the cutting precision and intraoperative control, thereby causing unwanted adjacent tissue injuries and subsequent prolongation of intra-alveolar clotting [7,9]. It is worth noting that, although the flapless extraction using TH (FET) is less invasive, the rough cutting characteristic of the instrument may amplify the adverse effect of DAPT on the post-extraction clotting process [6].…”

Section: Introductionmentioning

confidence: 99%

“…Since complicated extraction using PI has exhibited advantages in the alleviation of postoperative sequelae and acceleration of tissue healing [14,15], the instrument has been introduced in the flapless approach to improve operation quality [8]. Currently, flapless extraction using PI (FEP) has been proven to be highly effective in soft tissue sparing and preservation of alveolar bone during the operation [7,8]. Given the less intrusive characteristic of PI, it is considered that FEP may better promote immediate postoperative clotting than FET.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of immediate clotting after flapless extraction using piezosurgery or turbine handpiece in patients receiving dual antiplatelet therapy

et al. 2022

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Purpose: This study aimed to investigate the efficacy of piezosurgery (PI) in promoting immediate clotting after flapless extraction in patients undergoing dual antiplatelet therapy (DAPT). Methods: In this randomized controlled trial, 80 DAPT patients were equally divided into the PI and turbine handpiece (TH) groups. Accordingly, flapless extraction of a single tooth using PI or TH was performed on each patient, and the immediate clotting status was evaluated. The results of the preoperative hematological examinations, surgery-related variables and postoperative complications were recorded for analysis. Results: Both groups presented with low platelet aggregation and similar coagulation functions. The PI group exhibited a higher proportion of patients with normal intra-alveolar clotting (≤30 min) (70% vs. 40%, P = 0.007) and fewer intraoperative complications (25% vs. 47.5%, P = 0.036) than that in the TH group. Logistic regression analysis indicated that the applied instrument was an independent risk factor for prolonged immediate bleeding (odds ratio = 3.10, 95% confidence interval: 1.20-8.00, P = 0.019). Intergroup differences were insignificant in terms of the other surgery-related variables and postoperative complications, except for the longer surgical duration in the PI group. Conclusion:The application of PI may contribute to better immediate clotting in DAPT patients after flapless extraction compared with the use of TH.

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Piezosurgical treatment of crestal bone: quantitative comparison of post‐extractive socket outcomes with those of traditional treatment

Cited by 7 publications

References 30 publications

Efficacy of Alveolar Ridge Preservation after Maxillary Molar Extraction in Reducing Crestal Bone Resorption and Sinus Pneumatization: A Multicenter Prospective Case-Control Study

Efficacy of Alveolar Ridge Preservation after Maxillary Molar Extraction in Reducing Crestal Bone Resorption and Sinus Pneumatization: A Multicenter Prospective Case-Control Study

Histopathological assessment of healing process using an amniotic membrane in osteotomy defects caused by piezosurgery and conventional surgery in rats

Assessment of immediate clotting after flapless extraction using piezosurgery or turbine handpiece in patients receiving dual antiplatelet therapy

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