| PURPOSE: Due to the remodeling of the alveolar ridge after tooth extraction,its contour and surrounding tissues both change.Extraction-site preservation refers to implanting bone materials into extraction sockets after tooth extraction,in order to preserve the alveolar ridge,which has a significant impact on future denture restoration.The purpose of the present study was to research the natural heal process of extraction socket and extraction-site preservation with biomaterial to preserve the alveolar ridge.METHODS: 1.The accuracy of Mimics Software for three-dimensional imaging of measurement: select adult skull,missing 22 teeth,were measured with a vernier caliper,the lowest point of connection with lateral buccal-lingual bone plate(D1)and the highest point of connection with proximal and distal alveolar bone of(D2),and measured D1 ’,D2’ with Mimics after three-dimensional reconstruction,compare the two methods.2.The comparative study on reaction after surgery between extraction site preservation and natural healing of extraction sockets: 91 cases with posterior or anterior teeth in patients who were treated in Shanghai Ninth People’s Hospital Department of Oral Surgery from March 2011 to Sep 2015,including 43 males and 48 females,aged from 19 to 57 years old,mean 38 years old.53 cases of the test group and the control group of 38 patients.In the test group,we immediate implant Bio-oss into extraction sockets and covered by coverage colloidal silver gelatin hemostatic sponge.In the control group of patients,we clean or suture the sockets after tooth extraction.Patients come back after 3 and 7 days.Compare pain,limited mouth opening and facial swelling,record postoperative adverse reactions.3.The comparative study on soft and hard tissue changes and follow-up after implant surgery between extraction site preservation and natural healing of extraction sockets: papilla index(PIS)scoring and CT were taken before and 6 months after surgery,using Mimics to measure the width and height changes in alveolar after three-dimensional reconstruction,compare the difference between the two groups.After the implant restoration we followed up 6 months or more,evaluate the implant movement,implant loss and(BOP),compare the difference between the two groups.RESULTS: 1.Vernier caliper measured D1 was 8.33 ± 1.37 mm,D2 was 6.65 ± 2.57 mm.Mimics software measured D1 ’was 8.54 ± 1.85 mm,D2’ of 6.79 ± 2.68 mm.Difference between the two was 0.185 ± 0.152 mm.Error range from 0.31 to 4.8%.Two measures has no significant difference(P> 0.05).2.After 3 days and 7 days,two groups of patients have no significant difference on the degree of pain,limited mouth opening and the degree of swelling of the face.Two groups of patients healed well,with no infection,bleeding and other abnormalities.In the experimental group,three patients had Bio-oss overflow.A week after the referral.3 patients healed,no more Bio-oss overflow.3.The PIS score have no difference before and after surgery in the experimental group(P> 0.05).The PIS score have difference before and after surgery in the control group(P <0.05).In experimental group alveolar width bone absorption(W)is 0.29 ± 1.01 mm,absorption rate is 2.28 ± 6.99%,the absorption heighte(H)is 0.41 ± 0.55 mm,absorption rate is 3.56 ± 4.78%;In control group W ’value was 1.65 ± 0.78 mm,the absorption rate of 14.66 ± 6.68%,H ’value of 1.88 ± 1.19 mm,the absorption rate of 7.42 ± 4.25%.Experimental group and control group alveolar bone width and height of alveolar bone absorption were significantly different(P <0.01).Experimental group,42 patients completed implant surgery,including 1 patients did bone graft,with a ratio of 2.4%;in the control group,33 patients completed implant surgery,including 6 patients did bone graft,with a ratio of 18.2%.There are differences between the two groups(P <0.05).Two groups of patients have no implant loosening,implant survival rate was 100%,CT display around the implant exists no transmission Movies,planting crowns can function normally during follow-up(6-48 months).In the experimental group 2 occurred bleeding probe,with a ratio of 4.8%;in the control group 4 had bleeding probe,the ratio was 12.1%.Two patients had no difference(P> 0.05).CONCLUSION: 1.Mimics is reliable with three-dimensional reconstruction of alveolar bone measurement.2.The extraction site preservation technique does not increase the reaction after surgery,with no difference in natural healing extraction sockets.3.The extraction site preservation technique can reduce the absorption of soft and hard tissue,so that the alveolar bone and gingival papilla can be preserved.4.Bone grafting ratio reduced during the implantation surgery after extraction site preservation. |
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