After tooth extraction, alveolar ridge loss due to resorption is almost inevitable. Most of this bone loss occurs during the first six months after the extraction procedure. Many studies have indicated that applying socket-filling biomaterials after extraction can effectively reduce the resorption rate of the alveolar ridge. The purpose of this study was to investigate the clinical efficacy of the application of a hydroxyapatite/β-tricalcium plus collagen (HA/β-TCP + collagen) dental bone graft in dental sockets immediately after tooth extraction, so as to prevent socket resorption. The study was conducted on 57 extraction sockets located in the mandible and maxilla posterior regions in 51 patients. HA/β-TCP + collagen was inserted into all of the dental sockets immediately after extraction, and was covered with a flap. Follow-up was performed for three months after extraction, using radiographs and stents for the vertical and horizontal alveolar ridge measurements. A minimal alveolar bone width reduction of 1.03 ± 2.43 mm (p < 0.05) was observed. The height reduction showed a slight decrease to 0.62 ± 1.46 mm (p < 0.05). Radiographically, the bone height was maintained after three months, indicating a good HA/β-TCP + collagen graft performance in preserving alveolar bone. In conclusion, the HA/β-TCP + collagen graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction.

Preserving the marginal bone level (MBL) is essential for the long-term success of dental implant therapy, and bone remodeling around dental implants is considered to vary with time. Numerous studies comparing the platform-switching (PS) and platform-matching (PM) dental implants have indicated that PS dental implants showed a lesser reduction for the MBL, and the majority of them had a relatively short period. This study aimed to evaluate vertical and horizontal bone defects by using digital periapical radiographs to examine the changes in MBL around PM and PS dental implants over 5 years after functional loading. The vertical MBL (vMBL) was measured from the implant–abutment junction to the first bone-to-implant contact. The horizontal MBL (hMBL) was measured from the implant–abutment junction to the bone crest. All data were presented as means ± standard errors. Paired and independent t-tests with Welch’s correction were used to analyze the data. A total of 61 dental implants in 38 patients after 5 years of functional loading were evaluated. Over time, PS dental implants were more likely to gain bone; by contrast, PM dental implants were more likely to lose bone during the observation time. Changes in vMBL for PS dental implants were significantly less than those for PM dental implants at 1-year (p = 0.045), 3-year (p = 0.021), and 5-year (p = 0.010) loading. Likewise, changes in hMBL for PS dental implants were significantly smaller than in those for PM dental implants at 3-year (p = 0.021) and 5-year (p = 0.006) loading; however, the changes were minimal in both approaches. PS dental implants had a significant increment in the percentage of bone integration, whereas that for PM dental implants dropped over time, with no significance. In PS dental implants that occlude with natural teeth, vertical and horizontal bone gain was observed, and it was significant at 3 years (p = 0.023). A significant horizontal bone gain was observed in the opposing natural teeth at 3-year (p = 0.002) and 5-year loading (p = 0.002). The PS concept appears to preserve more MBL around dental implants by stabilizing the vMBL and hMBL over a 5-year period. A minimal marginal bone change was detected in both concepts. The opposing natural teeth at PS dental implants showed a favorable effect on marginal bone tissues.

Few studies have compared marginal bone loss (MBL) around implant-retaining overdentures (IODs) vs. implant-supported fixed prostheses (FPs). This study evaluated the mean MBL and radiographic bone-implant interface contact (r-BIIC) around IODs and implant-supported FPs. We also investigated osseointegration and MBL around non-submerged dental implants. We measured the changes between the MBL in the mesial and distal sites immediately after prosthetic delivery and after one year. The mean MBL and its changes in the IOD group were significantly higher. The mean percentage of r-BIIC was significantly higher in the FP group. MBL and its changes in males were significantly higher in the IOD group. The percentage of r-BIIC was significantly higher in the FP group. MBL in the lower site in the IOD group was significantly higher. Regarding MBL, the location of the implant was the only significant factor in the IOD group, while gender was the only significant predictor in the FP group. Regarding the r-BIIC percentage, gender was a significant factor in the FP group. We concluded that non-submerged dental implants restored with FPs and IODs maintained stable bone remodeling one year after prosthetic delivery.

Background: The objective of this study was to evaluate the effects of opposite tooth conditions on change in marginal bone level (MBL) around submerged dental implants. Materials and methods: The study included healthy patients with one or two implants. Structures opposite implants were either natural teeth (NT) or fixed restorations (FRs). MBLs were measured on digital periapical radiographs at the mesial and distal aspects of each implant. Results: Sixty implants were inserted by the 3-year follow-up. Mean MBLs for NT were 0.21 ± 0.33 mm before prosthetic loading and 0.30 ± 0.41 mm 3 years later (p = 0.001). Mean MBLs with FRs were 0.36 ± 0.45 mm before loading and 0.53 ± 0.50 mm 3 years later (p < 0.001). Changes in mean MBL from the 6-month follow-up to the 1- and 3-year follow-ups were statistically significant (p < 0.01) for implants opposite NT. However, changes in mean MBL from the 6-month follow-up to the 1-year (p = 0.161) and 3-year follow-ups (p = 1.000) were not significant for implants opposite FRs. Between baseline and the 3-year follow-up, MBL change was relatively small and did not differ regarding NT and FRs. Conclusion: Bone loss was greater if submerged dental implants were opposed by FRs. MBLs around submerged implants continued to change after 3 years if NT opposed implants.

Background: Alveolar osteitis (AO) may occur after molar extraction. Chlorhexidine (CHX) rinse and CHX gel are widely used to prevent AO. Although previous meta-analyses support the effectiveness of both CHX rinse and CHX gel in preventing AO, important issues regarding these two formulations have not been addressed adequately in the literature. Purpose: A systematic review and meta-analysis of randomized controlled trials was conducted to determine the effectiveness of CHX rinse and CHX gel in preventing AO. Methods: PubMed, EMBASE, SCOPUS, and Cochrane databases were searched for randomized controlled trials published before June 2018. The risk ratio (RR) was used to estimate the pooled effect of AO incidence using a random-effect model. Results: The RRs of AO in patients treated with 0.12% CHX rinse (RR = 0.54, 95% CI [0.41, 0.72]) and 0.2% CHX rinse (RR = 0.84, 95% CI [0.52, 1.35]) were significantly lower than in those treated with the control. Moreover, a significantly lower RR was identified in patients treated with 0.2% CHX gel (RR = 0.47, 95% CI [0.34, 0.64]) than in those treated with the control. When CHX products of different concentrations were grouped together, patients treated with CHX rinse showed an RR of AO of 0.61 (95% CI [0.48, 0.78]) and those treated with CHX gel showed an RR of AO of 0.44 (95% CI [0.43, 0.65]). On the other hand, a meta-analysis of three trials that compared CHX rinse and CHX gel directly showed a significantly lower RR of AO in patients treated with CHX rinse than in those treated with CHX gel (RR = 0.56, 95% CI [0.34, 0.96]). Conclusions/Implications for Practice: The results support the effectiveness of both CHX rinse and gel in reducing the risk of AO after molar extraction. Each formulation provides unique benefits in terms of ease of application and cost. On the basis of the results of this study, the authors recommend that CHX gel be used immediately after molar extraction because of the convenience and cost-effectiveness of this treatment and that CHX rinse be used by the patient after discharge at home in combination with appropriate health education and case management.