Procedure - Incision in region 22 - Flap Design - Preparation of the Implant Bed - Implant Placement - Suture - Extraction of tooth 12 - Curretage - Implant Placement Materials Implant System: 3I, Osseotite, Ø 4mm Region 12: 15mm length Region 22: 13mm length

Clinical steps for the fabrication of implant-supported restorations - Single-tooth restoration - Fixed partial denture - Electroplated cone-retained restoration - Conical copings using a pre-fabricated abutment matrix system

Objectives: The aim of this study was to examine the efficacy of antibody-mediated osseous regeneration (AMOR) in conjunction with two novel extraction devices, namely a SocketKAP™ (for obturation of socket orifices) and SocketKAGE™ (for providing space in sites with facial dehiscence for ridge preservation and augmentation procedures following tooth extraction). Methods: In this prospective controlled study, 8–12-year-old macaques (Macaca fascicularis; n = 6) underwent removal of both maxillary and mandibular second left and right premolars (ULPM2, URPM2, LLPM2, LRPM2), both maxillary and mandibular second left and right molars (ULM2, URM2, LLM2, and LRM2) on each side. This was followed by resection of the entire facial alveolar wall. They were randomly assigned to the following intervention groups: dehiscence socket unfilled and uncovered (group A; negative control); dehiscence socket reconstructed with SocketKAGE™ and covered with SocketKAP™ (group B); dehiscence socket reconstructed with SocketKAGE™ and ABBM and covered with SocketKAP™(group C); dehiscence socket reconstructed with SocketKAGE™ and chimeric anti-BMP-2 monoclonal antibody (mAb) and covered with SocketKAP™(group D); dehiscence socket reconstructed with SocketKAGE™ and iso-type-matched control mAb (Iso-mAb) and covered with SocketKAP™ (group E). At 6 and 12 weeks post-extraction, cone beam CT imaging was performed. All files were imported to Simplant TM/® software (for linear measurement of remaining bone width and height at 1mm, 2mm, 3mm and 5mm from alveolar crest) and to reverse engineering Geomagic ControlTM/®software (for volumetric analysis of alveolar bone). Histologic evaluation was also made of the dimensional changes in dehiscence defects after ridge preservation using different materials. Non-parametric analysis of variance was conducted using the methods of Brunnner and Langer. Results: The result from linear and volumetric analyses demonstrated that group D (chimeric mAb +SocketKAP™ + SocketKAGE™) was associated with significantly greater percentages of remaining bone width and height at the buccal point, and remaining bone volume at 6 and 12 weeks when compared to group A (negative control), group B (SocketKAP™ + SocketKAGE™) and group E (Iso-mAb); the latter lost approximately 70% of crestal bone width at the crestal 1 mm point, and ABBM failed to prove more effective in preserving alveolar bone width at crestal 1mm (36%). When anti-BMP-2 mAB was used, the percentage of bone width was as good as those with ABBM at crestal 2mm, 3mm and 5mm areas. However, the most important finding was that the data demonstrated that bone remodelling using chimeric mAb was not only limited to the crestal 2–5-mm zone, but also the crestal 1-mm area, with mean remaining bone widths of 52% and 68% at 6 weeks and 12 weeks, respectively. Both CB-CT and volumetric analysis revealed more active and extensive bone regeneration of marginal bone with chimeric mAb compared to other groups. Histologic analysis showed the knife-edge of alveolar crest following tooth extraction in groups A, B, C and E, as well as statistically significant more bone remodelling in chimeric mAb, including a higher percentage of bone formation within newly generated tissue together with signs of osteogenic cell activity. Conclusions: These results suggest that chimeric anti-BMP-2 mAb, in conjunction with SocketKAPTM/® and SocketKAGETM/® was effective in the reconstruction of the alveolar bone in extraction sockets with facial dehiscence defects. These favourable results may be attributed to advantageous nature of AMOR, such as using endogenous BMP-2 captured by chimeric mAb enhance osteogenesis, with higher biological activity of endogenous BMP and a longer half-life of captured BMP compared to ABBM (which only exhibits osteoconductivity).