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  3. Examining the dimensional changes of hard and soft tissue after placing an immediate implant compared to a newly extracted tooth

Examining the dimensional changes of hard and soft tissue after placing an immediate implant compared to a newly extracted tooth

Number of pages: 65 File Format: word File Code: 32068
Year: Not Specified University Degree: Master's degree Category: Medical Sciences
Tags/Keywords: Dimensional changes of Ridge Eloel - Freshly extracted tooth - hard texture - Immediate implant - Restoring silent teeth - silent restoration - teeth - Tooth extraction - tooth extraction
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  • Summary of Examining the dimensional changes of hard and soft tissue after placing an immediate implant compared to a newly extracted tooth

    Dissertation to obtain a doctorate degree in general dentistry

    Findings:

    The vertical changes of the soft tissue in all the measured points were lower in the test group compared to the control group, and this difference was not significant only in the midbuccal area and it is significant in other places.

    Changes The horizontal dimensions of the soft tissue were also less than the control group at 1, 3, and 7 mm from the CEJ of the adjacent teeth in the test group.

    The vertical changes of the hard tissue were also less in all the measured points in the test group than the control group. Of course, these changes were significant in the midbuccal and midpalatal areas.

    Horizontal changes in the hard tissue were also less in the 1, 3, and 7 mm areas of the CEJ of the adjacent teeth in the test group, which was not significant in the 7 mm area.

    Conclusion:

    Based on the findings of the present study, It can be concluded that placing an immediate implant in the quiet place of a newly extracted tooth is effective for reducing the vertical and horizontal changes of the bone and also for reducing the vertical and horizontal changes of the soft tissue of the area.

    Key words:

    immediate implant - tooth extraction - alveolar ridge dimensional changes

    Chapter One

    Review of texts and articles

    Overview

    The silent restoration process of extracted teeth:

    restoration of extracted teeth is characterized by a series of internal changes that lead to the formation of bone inside the socket and a series of external changes that lead to the loss of the width and height of the alveolar ridge. After the extraction of the tooth, bleeding occurs, followed by the formation of a silent clot, and with the start of the inflammatory reaction of the stimulated cells, granulation is created. Within 48 to 72 hours, as the germ tissue grows, the clot begins to disappear, the place of the clot forms, and immature connective tissue is formed.

    After seven days, the germinal tissue has completely replaced the blood clot, at this stage, the presence of osteoid in the silent base is evident as pieces of non-calcified bone. Two weeks after tooth extraction, woven bone (newly formed primary bone) is formed in the lateral and apical areas. While the central parts and margins are filled with connective tissue, a large number of osteoclasts can be seen in the margin and outer parts of the silent wall, and in many parts of the silent wall of the woven bone, Bondle bone is replaced.

    During the next 2-3 weeks and 3-4 weeks after tooth extraction, non-calcified bone pieces begin to form. Mineralization takes place from the base of the bone to the coronal side, at this time, all the bone is filled with woven bone and a large number of osteoclasts are seen in the outer walls and margins of the hard tissue, and the osteoclasts are lined up in the center and around the woven bone present in the bone, and in other words, the woven bone is replaced by mature bone. This process continues with re-epithelization, which finally completely covers the socket up to 6 weeks after tooth extraction. At the eighth week, a layer of cortical bone covers the entry. The woven bone formed in the fourth week is replaced by bone marrow and some lamellar bone trabeculae in the eighth week. On the upper and outer surface of the buccal and lingual walls, there are signs of hard tissue degeneration. The crest of the buccal wall of the bone is more apical than the lingual crest. The surface of the margin of the lingual wall remains unchanged. While the buccal wall shifts several millimeters towards the apical side.

    A series of factors may affect the silent restoration process.The size of the socket is important, a wider socket will take more time to fill the existing defect than a narrower socket. Silent teeth with horizontal bone loss are repaired sooner. Because the decrease in the volume of the alveolar bone means the decrease in the volume of the cavity to be filled, the bone will not be regenerated more coronally than its horizontal limit or the border of the bone crest of the adjacent teeth, which means that the tooth will never be filled with bone 100% silently (1). or the alveolar ridge shrinks, maintaining bone volume during tooth extraction is a desirable goal. Maximum bone loss after tooth extraction occurs in the first 6 to 24 months.

    Therefore, when the clinician has the possibility to intervene in tooth extraction, alveolar bone preservation should be considered. Conservative preservation of the tissues around the extracted tooth can eliminate or significantly reduce the need for advanced bone surgery methods.

    When a tooth is extracted and ready to place an implant, prevention of alveolar bone loss is very desirable.

    The time of implant placement compared to the time of tooth extraction is still discussed by many clinicians
    , depending on the quantity and quality and support of the existing bone as well as the ability of the clinicians and the patient, implant placement after tooth extraction can be immediate, delayed or staged. According to the definition, the immediate placement of the implant is done at the time of tooth extraction. Delayed placement of the implant is done about 2 months after tooth extraction to allow soft tissue restoration. Step-by-step placement of the implant in order to fully restore the bone in the areas of tooth extraction usually requires 4-6 more months.

    Tooth extraction is performed non-traumatically using a narrow and wide device such as Periotome. This device is inserted deep into the sulcus and tears the periodontal ligament and slightly expands the adjacent periodontal tissues. The tooth is lifted and removed by forceps using a slow, rotating motion. Applying buccolingual forces should be avoided to prevent damage to the labial bone.

    Using surgical curettes, the soft tissue on the bone in the extraction area is completely debrided. After debridement, the extraction area is completely washed with sterile saline. At this stage, after evaluating the bone and its support, the clinician decides whether or not to fill the area with bone graft and when to place the implant in the area. (immediate, delayed, phased) (2).

    Different times of implant placement:

    Type 1) Implant placement immediately following tooth extraction,

    Advantages: reducing the number of surgeries, reducing the length of the treatment period, optimal bone amount the remainder Disadvantages: the morphology of the area may complicate the placement of the implant, the potential lack of soft tissue for matching the flap, auxiliary surgical procedures and the sensitivity of this method.

    Type 2) Soft tissue completely covers the socket, approximately 4-8 weeks after extraction.

    Advantages: increasing the amount of soft tissue in the area and, of course, making it easier to match the flap, allowing the removal of pathologies local area.

    Disadvantages: the morphology of the area may complicate the placement of the implant, increase the length of the treatment period, different analysis of the socket walls, the possibility of needing auxiliary surgical methods and the sensitivity of this method.

    Type 3) The implant is placed in the socket of the tooth, which has a significant amount of new bone formed inside it.

    Advantages: the amount of bone formed in the sac makes it easier to place the implant, and also the developed soft tissue makes it easier to match the flap.

    Disadvantages: longer treatment period, different analysis of the sac wall and the possibility of needing auxiliary surgical methods.

  • Contents & References of Examining the dimensional changes of hard and soft tissue after placing an immediate implant compared to a newly extracted tooth

    List:

    The first chapter: review of texts and articles. 1

    General.. 2

    The silent restoration process of extracted teeth. 2

    Measures after tooth extraction. 4

    Different implant placement times. 6

    immediate implant placement. 7

    Ridge correction in relation to implant placement. 8

    A review of the articles.. 14

    Statement of the problem and the necessity of doing research. 23

    Objectives and hypotheses.. 24

    Chapter two: materials and methods. 26

    Materials and work methods.. 27

    Method of data analysis and statistical analysis. 41

    Chapter Three: Findings. 42

    Findings.. 43

    Examination of soft tissue.. 44

    Examination of hard tissue. 50

    Chapter Four: Discussion. 57

    Discussion.. 58

    Chapter five: conclusions and suggestions. 62

    Conclusion .. 63

    Suggestions .. 63

    Resources .. 64

     

     

    Source:

     

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    Klokvold RP. Localized bone augmentation and implant site development. In: Newman MG, Takel HH, Klokkevold PR. Caranza's clinical periodontology, 10th ed. Philadelphia: W. B. Saunders; 2008. P: 1141-45.

    Hanmerle CH, Araujo M, Lindhe J. Timing of implant placement. In: Lindhe J, Lang NP, Karring TH. Clinical periodontology and implant dentistry, 5th ed.          : Black Well; 2008. P. 1054-61.

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    Abstract :

    Introduction :

    Immediate implantation in single-root teeth possesses some benefits, especially bone preservation. The aim of this study was to evaluate the ridge changes after immediate implantation in comparison with tooth extraction and natural dental socket healing.

Examining the dimensional changes of hard and soft tissue after placing an immediate implant compared to a newly extracted tooth
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