Hanan Hassan Fouad

n/a

PURPOSE: This randomized clinical trial aimed to assess esthetic and soft and hard tissue outcomes 6 months after immediate implant placement using vestibular socket therapy (VST) (test) versus partial extraction therapy (comparator) in intact thin-walled fresh extraction sockets in the esthetic zone.

MATERIALS AND METHODS: Twenty-four patients with hopeless maxillary anterior teeth requiring immediate implant placement were randomly assigned to two equal groups to receive either VST or partial extraction therapy. Definitive restorations were delivered after 3 months. Pink esthetic scores (PESs) and vertical soft tissue alterations in millimeters were measured 6 months after restoration using intraoral digital scans of the distal papilla, midfacial gingival margin, and mesial papilla. Facial bone thickness was measured using CBCT scans at baseline and after 6 months. Implant survival and peri-implant pocket depth were assessed.

RESULTS: Both groups showed 100% implant survival after 6 months. The overall PESs after 6 months were 12.67 (± 1.3) in the VST group, while the partial extraction therapy group score was 13.17 (± 1.19), with no significant difference between them ( = .02). The mean (± SD) vertical soft tissue measurements for the VST group were 0.08 (± 0.55), 0.01 (± 0.73), and -0.03 (± 0.52) mm, and for the partial extraction therapy group, they were -0.24 (± 0.25) mm, -0.20 (± 0.10) mm, and -0.34 (± 0.13) mm for the mesial papilla, midfacial gingival margin, and distal papilla, respectively. No significant differences were observed between the groups at any of the reference points ( ± .05). Both techniques demonstrated a significant gain in millimeters of labial bone thickness after 6 months compared to baseline (P ± .05). Regarding VST, the apical, middle, and crestal mean bone gain was 1.68 (±± 2.73), 1.62 (±± 1.35), and 1.33 (±± 1.22) mm, respectively, while partial extraction therapy showed 0.58 (± 0.62), 1.27 (± 1.22), and 1.53 (± 1.24) mm, respectively, with no significant difference detected between them ( ≥ .05). Additionally, the mean (± SD) peri-implant pocket depth after 6 months for VST was 2.16 (± 0.44) and 2.08 (± 1.02) mm for partial extraction therapy with no significant difference between them ( = .79).

CONCLUSION: This investigation suggests that both VST and partial extraction therapy preserved alveolar bone structure and peri-implant tissues following immediate implants. The novel VST might be considered a predictable alternative treatment approach for immediate implant placement in intact thin-walled fresh extraction sockets in the esthetic zone. Int J Oral Maxillofac Implants 2023;38:468-478. doi: 10.11607/jomi.9973.

Obesity affects oocyte mitochondrial functions and reduces oocyte quality and fertility. Obesity may also increase the risk of metabolic disorders in the offspring. Children are likely to follow their parents lifestyle and diet, which also contributes to the increased prevelance of obesity across generations. We hypothesise that the impact of obesogenic (OB) diet and obesity on oocyte mitochondrial functions is different in offspring born to obese mothers compared to those born to healthy mothers. To test this hypothesis, we fed a control (C, 10% fat, 7% sugar) or an OB diet (60% fat, 20% sugar) to female mice (for 7 weeks (w)) and then to their female offspring (for 7w after weaning) in a 2 × 2 factorial design (C » C, n = 35, C » OB, n = 35, OB » C n = 49 and OB » OB, n = 50). Unlike many other studies, we used an outbred Swiss mouse model to increase the human pathophysiological relevance. Offspring were sacrificed at 10w and their oocytes were collected. Offspring OB diet increased oocyte lipid droplet content, mitochondrial activity and reactive oxygen species (ROS) levels, altered mitochondrial ultrastructure and reduced oocyte pyruvate consumption. Mitochondrial DNA copy numbers and lactate production remained unaffected. Mitochondrial ultrastructure was the only factor where a significant interaction between maternal and offspring diet effect was detected. The maternal OB background resulted in a small but significant increase in offspring's oocyte mitochondrial ultrastructural abnormalities without altering mitochondrial inner membrane potential, active mitochondrial distribution, mitochondrial DNA copy numbers, or ROS production. This was associated with reduced mitochondrial complex III and V expression and reduced pyruvate consumption which may be compensatory mechanisms to control mitochondrial inner membrane potential and ROS levels. Therefore, in this Swiss outbred model, while offspring OB diet had the largest functional impact on oocyte mitochondrial features, the mitochondrial changes due to the maternal background appear to be adaptive and compensatory rather than dysfunctional.