Master of Science, The Ohio State University, 2014, Dentistry

Abstract Background: The combination of membranes and bone grafting materials has been shown to preserve the post-extraction dimensions of the alveolar ridge and constitutes the currently accepted protocol for socket preservation. However, the use of bone grafting materials in extraction sockets has been questioned because of possible interference with bone formation in the wound sites; particles of graft material have been found in alveolar sockets more than 6 months after placement. Histologic examination of extraction sockets filled with allograft bone revealed the presence of graft particles with no evidence of bone formation on the particle surface, suggesting that the allograft bone may delay healing and affect the quality of regenerated bone. The purpose of this preliminary study is to determine whether use of a polylactic acid (PLA) membrane alone (without bone graft) after tooth extraction results in sufficient bone formation for implant placement and to determine the quality of the newly formed bone. Methods: Patients with single rooted non-esthetic teeth deemed hopeless for various reasons and in need of extraction, socket preservation and implant placement were recruited at the Graduate Periodontology Clinic, College of Dentistry, The Ohio State University. Extraction sites were randomly assigned to either control group (extraction alone) or test group (extraction + PLA membrane). Clinical measurements, including relative ridge height and soft tissue level, were recorded using a pre-fabricated plastic stent before and immediately after extraction, and pre-implant placement. Clinical parameter measurements were recorded at six different positions (MB, B, DB, ML, L, and DL) per extraction site. Bone cores (2 x 6 mm) were retrieved with a trephine immediately before implant placement and subjected to micro-computed tomography (micro-CT) and cone beam CT (CBCT) scans followed by histomorphometric analysis. Results: A total of 18 subjects fulfil (open full item for complete abstract)

Committee: Hua-Hong Chien (Advisor); Dimitris Tatakis (Committee Member); Do-Gyoon Kim (Committee Member) Subjects: Dentistry

Master of Science, The Ohio State University, 2009, Dentistry

Background: Alveolar ridge preservation (ARP) is a surgical technique designed to prevent naturally occurring post-extraction bone resorption.. The purpose of this study was to investigate clinical and histological healing outcomes following ARP performed on molar and premolar sites by using freeze-dried bone allograft (FDBA) together with a collagen membrane. Maxillary and mandibular sextants were compared for clinical and histological parameters. Methods: Inclusion criteria were single tooth extraction with intact mesial and distal adjacent teeth. Exclusion criteria were smokers, patients with ystemic health problems and acute infection. A stent was prepared from clear acrylic. Pre-operative clinical measurements included the amount of keratinized gingiva and clinical attachment level at tooth scheduled for extraction and at adjacent teeth were taken. The thickness of buccal and lingual plate, the length and diameter of the extracted tooth, buccal-lingual and mesial-distal defect size and, the distance from stent in place-occlusal plate to alveolar crest were measured. FDBA and collagen membrane were placed and flap was sutured. A re-entry surgery was performed following approximately 140 days healing period. Clinical measurements were repeated. A bone core was obtained and immediately frozen in liquid nitrogen. Frozen bone cores were analyzed with micro-CT scan for bone volume density and bone trabecular connectivity. Following micro-CT scan, cores were fixed in formalin, decalcified, embedded in paraffin and sectioned. Slides obtained from the mid-portion of the bone core were stained with trichrome and analyzed under light microscopy. Results: Twenty-one patients were completed the study. Following ARP, ridge height loss change was negligible (a loss of 0.4±0.3 mm in maxilla and a gain of 1.3±0.3 mm in mandible). However, average ridge width loss was 2.4±0.8 mm and 2.5±0.5 mm in maxilla and in mandible, respectively. In maxilla, initial CAL at mesial surface of (open full item for complete abstract)

Committee: Binnaz Leblebicioglu (Advisor); Dimitris Tatakis (Other); Suda Agarwal (Other); Do-Gyoon Kim (Other) Subjects: Dental Care

Master of Science, The Ohio State University, 2024, Dentistry

Background and objective: Socket preservation is a bone regeneration procedure indicated immediately following tooth extraction to preserve existing alveolar ridge height and to control alveolar ridge width. Primary wound closure following socket preservation is not indicated since it is a flapless procedure and wound edges cannot be proximated to close the bone graft through suturing. Instead, a collagen plug and/or a resorbable membrane is generally used to stabilize bone graft and seal the orifice of the socket. The purpose of this approach is to allocate time for soft tissue granulation and complete epithelization. To our knowledge the indications for these two types of biomaterials are not well-established and there are no clinical studies in the literature comparing clinical outcomes in relation to the use of these wound management approaches. Thus, the purpose of this study was to evaluate and compare the early clinical outcomes following socket preservation procedures performed by using collagen plug (CP) or collagen membrane (CM) as a sealing material. In addition, soft tissue phenotype was evaluated as a variable possibly affecting clinical healing outcomes. Material and Methods: Patients who need single tooth extraction (surrounded with mesial and distal intact teeth) and socket preservation procedures for a future implant placement procedure were recruited (IRB protocol #2022H0277). Impressions (digital) were obtained prior to surgery and at 3-6 months to study ridge dimensional changes. Soft tissue phenotype was determined prior to extraction by probing and buccal tissue thickness was determined by using a surgical caliper. Buccal bone integrity was determined by probing immediately after extraction. FDBA was used as bone graft material. Decision to use a collagen plug or collagen membrane was clinician's choice based on the case and site anatomy. The membrane and plug were stabilized via simple interrupted and cross matrix suture using a resorbab (open full item for complete abstract)

Committee: Binnaz Leblebicioglu (Advisor); Guo-Liang Cheng (Committee Member); Hanin Hammoudeh (Committee Member); Luiz Meirelles (Committee Member) Subjects: Dentistry