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Two Clinical Studies

1.) "Alveolar Resorption after tooth Extraction with two different Extraction Methods A Comparison Study"

2.) "The Ögram System - a Contribution to Minimize Trauma for Tooth Extraction"


First Clinical Study

Translated from the German language, Die Quintessenz [Quintessence] Volume 52,
pages 863-868 September 2001 Berlin, Germany.
Excerpts from the Study -

 "Alveolar Resorption after tooth Extraction

with two different Extraction Methods

A Comparison Study"


Javier M. Herrera, Dr. med. dent.

Joachim E. Zöller, Prof. Dr. med. Dr. med. dent.

University Clinic and Outpatient Department for Oral and Maxillofacial Surgery

Dept. of Oral and Maxillofacial Surgery University of Köln

Köln, Germany


Helmut Steveling, Dr. med. dent.

University Clinic and Outpatient Department for Oral and Maxillofacial Surgery

Dept. of Oral and Maxillofacial Surgery University of Heidelberg

Heidelberg, Germany



Zusammenfassung (Synopsis, page 863)

 An important goal in modern dental medicine is the retention of alveolar bone after tooth loss. Therefore the dental arch can provide esthetic and sound clinical results for implants. The goal of this report is to present two different tooth removal possibilities: the standard method for tooth removal and a new extraction method (Ögram) which is a far less invasive technique and uses instruments that are anatomically correct to the tooth's morphology. This clinical will show, that with the Ögram System the operation yields minimal trauma and that bone resorption can be greatly reduced. So that better results for future implants can be better accomplished.

 Patienten, Material and Methoden (Patients, Material and Methods, page 864)

 At the beginning of 1997 until mid 1998 170 patients had 198 teeth extracted. Patients were only accepted with the understanding that a 3-month post extraction assessment was required of each patient for the control group. Patients that did not return for the 3-month post extraction assessment were not included. The clinical study therefore was based on 166 extractions from 125 patients.

The 62 female and 63 male patients were between the ages of 15 to 87 years old (average age was 49 years old). The selection process for our patients in this study had the following requirements:

 - no local or altogether bone disease for either dental arch so that bone loss values could be properly observed;

 - no horizontal bone resorption in the apical third of the root;

 - no periodontal pockets;

 - no loose teeth.

  The planned conclusion to this study is to assess the difference between two tooth extraction methods, with the distribution of the patients into two groups:

 - Group A encompasses patient treatment with conventional extraction methods.

 - Group B represents patients that received the Ögram System extractions.

 The patient base for both study groups were categorized and divided into three Classes with relationship of adjoining teeth:

  - Class I: The extracted tooth had mesial and distal neighboring teeth.

 - Class II: The extracted tooth had mesial or distal a neighboring tooth (one tooth adjoining only).

 - Class III: The extracted tooth had mesial or distal no neighboring tooth

 Ergebnisse (Results, page 866, last paragraph)

 The results of alveolar resorption 3 months post extraction by the conventional extraction and extractions with the Ögram System shows an average value loss of 2.6 mm in Group A and 0.2 mm in Group B (Table 1). The minimum value of bone resorption in both Group A and Group B showed 0.0 mm., the maximum value exhibited a significant difference between Group A with 8 mm bone loss, and Group B with 1 mm bone loss. The average of the T-Test proves an important significant statistical difference (p=4.73E-24) and can be confirmed between both Groups.

 Conventional tooth extractions           (Group A)  53 patients

The Ögram System extractions           (Group B)  72 patients


                                         Bone Loss 3 Months Post Extraction


                  Conventional Extractions                                     Ögram Extractions

                   Group A                                                          Group B

                 53 patients                                                       72 patients


0.0  mm loss *              4                                                                     54

1.0  mm loss                 4                                                                     18

2.0  mm loss                 22                                                                   0

3.0  mm loss                 10                                                                   0

4.0  mm loss                 8                                                                     0

5.0  mm loss                 4                                                                     0

6.0  mm loss                 0                                                                     0

7.0  mm loss                 0                                                                     0

8.0  mm loss                 1                                                                     0

 Average bone loss for Group A Conventional Extraction:  2.6 mm w/sd of +/- 1.48 mm

Average bone loss for Group B Ögram Extraction: 0.2 mm w/sd of +/- 0.45 mm

 *Measurements are values for vertical buccal bone loss.
*Bone loss values were rounded to nearest whole millimeters.

 Diskussion (Discussion, page 867)

 It is commonly known, that with tooth removal almost always more or less alveolar bone is resorbed, where as with less invasive extraction technique alveolar resorption can be reduced and even eliminated. The regeneration of bone in the upper arch is slower than the lower arch. While the anatomical change in the lower arch requires a wait of 2 months, one must wait 3 months for the upper arch before continuing with dental treatment.

 The here described study of the new tooth removal system shows after our clinical experiences that this new surgery possibility offers far greater results. The observation using both tooth removal possibilities clearly shows the advantage in bone retention.  The retention in bone clearly shows for better overall implant results. The new method can for this reason be highly recommended.

 The results of this study show, that patient bone loss or bone resorption after tooth removal by traditional methods is substantially higher, than compared with the Ögram System.  The presented surgical methods of noninvasive and greater bone retention possibilities clearly shows that this new removal system offers the best prognoses for future prosthetic procedures or implant prosthetic treatments. With complex tooth removals (non-impacted) the Ögram technique is an absolute must as it reduces the need of an osteotomy by 70%!


  Second Clinical Study 

 Translated from the German language, Die Quintessenz Volume 47, pages 693-705 May 1996 Berlin, Germany

 Excerpts from the Study -

 "The Ögram System - a Contribution

to Minimize Trauma for Tooth Extraction"


by Prof. Frank Peter Strietzel, Dr. med.

Dept. of Oral Surgery and Dental Radiography

Humboldt Medical University

Berlin, Germany


Gunnar Philipp, Bioengineer

Denton, Texas

 Zusammenfassung (Synopsis, page 693)

 The extraction of teeth or the removal of roots in a modern dental practice is often a traumatic experience for patients. The contribution of The Ögram System establishes with instrumentation and extraction methodology that trauma for tooth removal is minimized. This report of a Clinical Study is the implementation of this System based on 65 tooth removals of 34 patients with varied clinical situations. In not one case was there a post extraction wound healing disorder. The precedence is a non-invasive extraction technique.

Resümee (Summation, page 704)

 The Ögram System offers new possibilities for dentists to reduce trauma for procedures of tooth, root, or root fragment removals. This is accomplished by no longer requiring an osteotomy or the need for surgical reflection of gingival tissues and the preservation of the cortical alveolus (for non-impacted removals), through exact technic and the proper manipulation of exact instrumentation for each specific situation. Tooth removal trauma is minimized for each specific situation with reduced extraction times, by application of exact technique and instruments used in the Ögram System, also the elimination of profound hand forces by the practioner, and at the same time reducing stress for the practioner and the patient. With the implementation of The Ögram System, the provision of tooth saving partial hemi-section is far less traumatic. Due to attainable minimizing of trauma in tooth removal using exact instrumentation and easy to apply techniques, adequate alveolar and crestal bone retention will allow for preferable future prosthetics and will also have a special meaning for implants.