All ETDs from UAB

Advisory Committee Chair

Nicolaas C Geurs

Advisory Committee Members

Ramzi V Abou-Arraj

Maria L Geisinger

Amjad Javed

Document Type

Thesis

Date of Award

2017

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

The use of bone grafting materials in sockets after tooth extraction has become a common technique for the preservation of alveolar ridge dimensions for future dental implant placement. A number of growth factors have been used to accelerate healing and shorten the healing period between extraction and implant placement. This study presents a novel application of amniotic tissue allograft used as an adjunct to bone grafting with mineralized bone allograft after tooth extraction. Amniotic tissue contains a myriad of growth factors such as Epidermal Growth Factor (EGF), Transforming Growth Factor beta (TGF-β), Fibroblast Growth Factor (FGF), Platelet Derived Growth Factor A&B (PDGF A&B) that may act to enhance not only bone formation but also soft tissue healing. In the pilot clinical trial presented, two different post-extraction bone grafting applications, mineralized bone allograft alone and mineralized bone allograft with amniotic tissue allograft, was evaluated in twenty eligible adult subjects at day of extraction, and 1, 2, 4, and 7 weeks. This study compared the rate of soft tissue wound contraction and epithelial migration between the two groups using image analysis software and presents a histomorphometric analysis to ascertain qualitative and quantitative hard tissue differences. Data was collected by using clinical photographs to measure soft tissue wound surface area at the following time points: day of extraction, week 1, 2, 4, and 7. Bone core biopsies were taken of the alveolar healing site on the day of implant placement and histomorphometric analysis was performed. Statistical analysis consisted of repeated measures analysis of variance (rANOVA) and Wilcoxon rank sum tests. Results: The outcomes of this study revealed similar wound contraction in both groups. Wound contraction in the control group was 94.4% and in the amniotic tissue allograft group was 96.5% after 7 weeks. New bone formation was observed in the control group at 31.76% of total volume and 35.82% of total volume in the amniotic tissue allograft group. The test group, with added amniotic tissue allograft, experienced greater wound contraction and greater amount of new bone formation, though this difference was not statistically significant. Conclusion: There may be a clinical advantage to the inclusion of amniotic tissue allograft in healing extraction sockets, however, more studies and larger sample sizes are needed to confirm these claims with statistical significance.

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Dentistry Commons

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