This study utilized radiographic comparative analysis in order to evaluate dimensional ridge changes four months after tooth extraction and immediate grafting with mineralized dentin particulate autograft and chopped platelet-rich fibrin. Fifty-eight extraction sockets with up to 2 mm of missing buccal bone in the coronal aspect compared to the lingual bone were included. Graft material was covered with either a platelet-rich fibrin membrane or collagen sponge with no effort to achieve primary closure. The dimensional changes of the ridge were assessed on cone-beam computed tomography (CBCT) images acquired prior to extraction and four months later. The reduction in the buccal bone plate thickness 1 mm, 3 mm, and 5 mm below the buccal crest was −0.87 ± 0.84 mm, −0.60 ± 0.70 mm, and −0.41 ± 0.55 mm, respectively. The mean ridge width changes 1 mm, 3 mm, and 5 mm below the crest were −1.38 ± 1.24 mm, −0.82 ± 1.13 mm, and −0.43 ± 0.89 mm, respectively. The average mid-buccal bone height gain was +1.1%, while the mid-lingual height gain was 5.6%. A mineralized dentin autograft with platelet-rich fibrin is effective in preserving post-extraction alveolar ridge dimensions.
Failure of a natural tooth may not permit placement of an implant at the time of extraction due to insufficiency in available bone to house the implant. Reconstruction of the extraction socket frequently involves both hard and soft tissue augmentation to provide a site that can house the implant and ridge contours that mimic the adjacent natural anatomy. The modified IVAN technique achieves those goals and may be used in both delayed and immediate placement situations. The technique will be discussed as well as long-term follow-up on 20 cases treated by the author.
D ear Editor, We have read with great interest the article published in the August 2017 edition of the journal, titled ''Current-Evidence on the Socket-Shield Technique: A Systematic Review.'' The article appears to present the technique mostly in a negative light, supported by a review of the literature that in its selection of content and methodology is fraught with error. The authors claim to have conducted this systematic review ''in line with the recommendations of the PRISMA statement.'' Of the 23 studies (although 2 are listed twice) tabulated by the authors to review ''complications and adverse effects,'' 4 are not the socket shield (
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