Biology and innovation. Keys to success in fixed prosthesis<\/strong><\/h2>\n<\/div>Recently, a new modality in alveolar ridge preservation favoring the biological bases of bone healing has been described (Pramstraller et al. 2020). To discuss this technique, we talked to Prof. Leonardo Trombelli, director of research in periodontology at the University of Ferrara.<\/span><\/h3>\n<\/div><\/div><\/div><\/div><\/div>In the last decade, a multitude of techniques and materials for socket preservation have been introduced and published. In your opinion why haven\u2019t we found a consensus about the best technique for ridge preservation?<\/strong><\/p>\n![\"\"](\"https:\/\/botiss.com\/wp-content\/uploads\/2023\/02\/cerabone_porenetwork-300x200.jpg\")
Prof. Trombelli: Although a recent meta-analysis showed a significantly reduction in horizontal ridge dimension when a combination of a graft material (bovine bone particulate) plus socket sealing by a collagen membrane\/sponge was used, the available data did not allow ranking the efficacy of different alveolar ridge preservation (ARP) approaches. This may at least in part be due to a wide heterogeneity of proposed techniques and devices used including flap management at suturing, chemical-physical characteristics of graft material, and additional socket sealing.<\/p>\n
What are the short comings of the current commonly performed ARP approaches? <\/strong><\/p>\nProf. Trombelli: Although ARP procedures based on socket grafting can prevent up to a 30% of volume reduction in the coronal third, a limited effect was observed in the remaining middle-apical thirds. Moreover, grafting of the alveolus often results in the persistence of residual graft particles embedded into the newly formed bone with a delay in the rate of bone deposition and mineralization.<\/p>\n<\/div><\/div><\/div>
Recently you published a case report about a novel ARP modality. What is BARP? And what<\/strong> distinguishes this technique from other established ARP approaches?<\/strong><\/p>\nProf. Trombelli: Based on the previous considerations, we recently proposed a novel, simplified technique, namely the Biologically oriented Alveolar Ridge Preservation (BARP), that restricts socket grafting to the coronal portion of the socket (Fig. 1). Briefly, BARP is based on three layers of materials placed in the extraction socket: First a deep collagen layer filling the socket up to \u22484 to 5 mm from the most coronal extensions of the buccal and lingual crest to create a support for the coronal graft; Second a graft layer, placed on top of the apical collagen layer to fill the coronal part of the socket and third a superficial collagen layer, used to obtain socket sealing.<\/p>\n<\/div><\/div><\/div>
![\"\"](\"https:\/\/botiss.com\/wp-content\/uploads\/2023\/02\/graf2-1024x683.jpg\")
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Fig. 1<\/strong> modified from “A Simplified Procedure for Biologically-oriented Alveolar Ridge Preservation: Clinical and Histological Findings from a Case Report\u201d. Pramstraller M, Farina R, Simonelli A, G\u00f6tz W, Trombelli L., Clinical Advance in Periodontics. 2020.<\/p>\n<\/div><\/div><\/div><\/div>![\"\"](\"https:\/\/botiss.com\/wp-content\/uploads\/2023\/02\/trombelli_1.jpg\" "\\"trombelli_1.jpg\\"")
<\/div><\/a><\/div><\/div>![\"\"](\"https:\/\/botiss.com\/wp-content\/uploads\/2023\/02\/trombelli_2-e1617881054749.jpg\" "\\"trombelli_2-e1617881054749.jpg\\"")
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Recently, a new modality in alveolar ridge preservation favoring the biological bases of bone healing has been described (Pramstraller et al. 2020). To discuss this technique, we talked to Prof. Leonardo Trombelli, director of research in periodontology at the University of Ferrara.<\/span><\/h3>\n<\/div><\/div><\/div><\/div><\/div>In the last decade, a multitude of techniques and materials for socket preservation have been introduced and published. In your opinion why haven\u2019t we found a consensus about the best technique for ridge preservation?<\/strong><\/p>\nProf. Trombelli: Although a recent meta-analysis showed a significantly reduction in horizontal ridge dimension when a combination of a graft material (bovine bone particulate) plus socket sealing by a collagen membrane\/sponge was used, the available data did not allow ranking the efficacy of different alveolar ridge preservation (ARP) approaches. This may at least in part be due to a wide heterogeneity of proposed techniques and devices used including flap management at suturing, chemical-physical characteristics of graft material, and additional socket sealing.<\/p>\n
What are the short comings of the current commonly performed ARP approaches? <\/strong><\/p>\nProf. Trombelli: Although ARP procedures based on socket grafting can prevent up to a 30% of volume reduction in the coronal third, a limited effect was observed in the remaining middle-apical thirds. Moreover, grafting of the alveolus often results in the persistence of residual graft particles embedded into the newly formed bone with a delay in the rate of bone deposition and mineralization.<\/p>\n<\/div><\/div><\/div>
Recently you published a case report about a novel ARP modality. What is BARP? And what<\/strong> distinguishes this technique from other established ARP approaches?<\/strong><\/p>\nProf. Trombelli: Based on the previous considerations, we recently proposed a novel, simplified technique, namely the Biologically oriented Alveolar Ridge Preservation (BARP), that restricts socket grafting to the coronal portion of the socket (Fig. 1). Briefly, BARP is based on three layers of materials placed in the extraction socket: First a deep collagen layer filling the socket up to \u22484 to 5 mm from the most coronal extensions of the buccal and lingual crest to create a support for the coronal graft; Second a graft layer, placed on top of the apical collagen layer to fill the coronal part of the socket and third a superficial collagen layer, used to obtain socket sealing.<\/p>\n<\/div><\/div><\/div>
<\/p>\n
Fig. 1<\/strong> modified from “A Simplified Procedure for Biologically-oriented Alveolar Ridge Preservation: Clinical and Histological Findings from a Case Report\u201d. Pramstraller M, Farina R, Simonelli A, G\u00f6tz W, Trombelli L., Clinical Advance in Periodontics. 2020.<\/p>\n<\/div><\/div><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div>
In the last decade, a multitude of techniques and materials for socket preservation have been introduced and published. In your opinion why haven\u2019t we found a consensus about the best technique for ridge preservation?<\/strong><\/p>\n What are the short comings of the current commonly performed ARP approaches? <\/strong><\/p>\n Prof. Trombelli: Although ARP procedures based on socket grafting can prevent up to a 30% of volume reduction in the coronal third, a limited effect was observed in the remaining middle-apical thirds. Moreover, grafting of the alveolus often results in the persistence of residual graft particles embedded into the newly formed bone with a delay in the rate of bone deposition and mineralization.<\/p>\n<\/div><\/div><\/div> Recently you published a case report about a novel ARP modality. What is BARP? And what<\/strong> distinguishes this technique from other established ARP approaches?<\/strong><\/p>\n Prof. Trombelli: Based on the previous considerations, we recently proposed a novel, simplified technique, namely the Biologically oriented Alveolar Ridge Preservation (BARP), that restricts socket grafting to the coronal portion of the socket (Fig. 1). Briefly, BARP is based on three layers of materials placed in the extraction socket: First a deep collagen layer filling the socket up to \u22484 to 5 mm from the most coronal extensions of the buccal and lingual crest to create a support for the coronal graft; Second a graft layer, placed on top of the apical collagen layer to fill the coronal part of the socket and third a superficial collagen layer, used to obtain socket sealing.<\/p>\n<\/div><\/div><\/div> Fig. 1<\/strong> modified from “A Simplified Procedure for Biologically-oriented Alveolar Ridge Preservation: Clinical and Histological Findings from a Case Report\u201d. Pramstraller M, Farina R, Simonelli A, G\u00f6tz W, Trombelli L., Clinical Advance in Periodontics. 2020.<\/p>\n<\/div><\/div><\/div>Prof. Trombelli: Although a recent meta-analysis showed a significantly reduction in horizontal ridge dimension when a combination of a graft material (bovine bone particulate) plus socket sealing by a collagen membrane\/sponge was used, the available data did not allow ranking the efficacy of different alveolar ridge preservation (ARP) approaches. This may at least in part be due to a wide heterogeneity of proposed techniques and devices used including flap management at suturing, chemical-physical characteristics of graft material, and additional socket sealing.<\/p>\n<\/p>\n<\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div><\/div><\/a><\/div><\/div>