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  • 1. Abrahamssom, Peter
    et al.
    Isaksson, Sten
    Gordh, Monica
    Andersson, Gunilla
    Malmö högskola, Faculty of Odontology (OD).
    Onlay bone grafting of the mandible after periosteal expansion with an osmotic tissue expander: an experimental study in rabbits2010In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 12, p. 1404-1410Article in journal (Refereed)
    Abstract [en]

    Abstract Objectives: To evaluate the space-maintaining capacity of a titanium mesh or a bioresorbable mesh after periosteal expansion and to assess bone formation under a titanium mesh or a bioresorbable mesh on the lateral border of the mandible by qualitative and quantitative histological analysis. Material and methods: In 13 rabbits, a self-inflatable soft tissue expander was placed intraorally, bilaterally under the mandibular periosteum via an extra oral approach. After 2 weeks, the expanders were removed and a particulated onlay bone graft was placed and covered by a titanium mesh or a bioresorbable mesh. After 3 months, the animals were sacrificed and specimens were collected for histology. Results: The osmotic soft tissue expander created a subperiosteal pocket and a ridge of new bone had formed at the edges of the expanded periosteum in all sites. After the healing period of 3 months, soft tissue dehiscence was recorded in two of the sites with bioresorbable meshes. The mean bone fill was 65% under the titanium mesh and 85% under the bioresorbable mesh (P<0.05). There was no significant difference between the titanium mesh and the bioresorbable mesh regarding the height of the meshes, mesh area and mineralized bone area. Scanning electron microscopy shows that new bone is growing in direct contact with the resorbable mesh and the titanium mesh. Conclusion: This study confirms that an osmotic soft tissue expander creates a surplus of periosteum and soft tissue and that new bone can be generated under a titanium mesh or bioresorbable mesh.

  • 2. Abrahamsson, Peter
    et al.
    Isaksson, Sten
    Andersson, Gunilla
    Malmö högskola, Faculty of Odontology (OD).
    Guided bone generation in a rabbit mandible model after periosteal expansion with an osmotic tissue expander.2011In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 22, no 11, p. 1282-8Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the space-maintaining capacity of titanium mesh covered by a collagen membrane after soft tissue expansion on the lateral border of the mandible in rabbits, and to assess bone quantity and quality using autogenous particulate bone or bone-substitute (Bio-Oss(®) ), and if soft tissue ingrowth can be avoided by covering the mesh with a collagen membrane.

    MATERIAL AND METHODS: In 11 rabbits, a self-inflatable soft tissue expander was placed under the lateral mandibular periosteum via an extra-oral approach. After 2 weeks, the expanders were removed and a particulated onlay bone graft and deproteinized bovine bone mineral (DBBM) (Bio-Oss(®) ) were placed in the expanded area and covered by a titanium mesh. The bone and DBBM were separated in two compartments under the mesh with a collagen membrane in between. The mesh was then covered with a collagen membrane. After 3 months, the animals were sacrificed and specimens were collected for histology.

    RESULTS: The osmotic soft tissue expander created a subperiosteal pocket and a ridge of new bone formed at the edges of the expanded periosteum in all sites. After the healing period of 3 months, no soft tissue dehiscence was recorded. The mean bone fill was 58.1±18% in the bone grafted area and 56.9±13.7% in the DBBM area. There was no significant difference between the autologous bone graft and the DDBM under the titanium mesh with regard to the total bone area or the mineralized bone area. Scanning electron microscopy showed that new bone was growing in direct contact with the DBBM particles and the titanium mesh. There is a soft tissue ingrowth even after soft tissue expansion and protection of the titanium mesh with a collagen membrane.

    CONCLUSION: This study confirms that an osmotic soft tissue expander creates a surplus of periosteum and soft tissue, and that new bone can subsequently be generated under a titanium mesh with the use of an autologous bone graft or DBBM.

  • 3.
    Aghazadeh, Ahmad
    et al.
    Tand & Implantat Specialistkliniken, Solna, Sweden.
    Persson, G Rutger
    Department of Periodontics and Oral Medicine, University of Washington USA; .
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Regenerative Dental Medicine and Periodontology, CUMD, University of Geneva, Geneva, Switzerland.
    Renvert, Stefan
    Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China.
    Reconstructive treatment of peri-implant defects- Results after three and five years.2022In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 33, no 11, p. 1114-1124Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to assess the long-term efficacy of reconstructive treatment of peri-implantitis intraosseous defects.

    MATERIAL AND METHODS: Peri-implant intraosseous defects were augmented using either an autogenous bone graft (AB) or a bovine-derived xenograft (BDX) in combination with a collagen membrane. Maintenance was provided every third month.

    RESULTS: In the AB group, 16 patients with 25 implants remained at year five. In the BDX group, 23 patients with 38 implants remained. Between baseline and year 5, bleeding on probing (BOP) and probing pocket depth (PPD) scores were reduced in both groups (p < .001). In the AB and BDX groups, mean PPD between baseline and year five was reduced by 1.7 and 2.8 mm, respectively. The difference between groups was significant (p < .001). In the AB group, the mean bone level change at implant level between baseline and years three and five was-0,2 and -0.7 mm, respectively. In the BDX group, the mean bone level change at implant level between baseline and years three and five was 1.6 and 1.6 mm, respectively. The difference between the groups was significant (p < .001). Successful treatment (no bone loss, no probing pocket depth (PPD) > 5 mm, no suppuration, maximum one implant surface with bleeding on probing (BOP) at year five) was obtained in 9/25 implants (36%) in the AB group and in 29/37 implants (78.3%) in the BDX group.

    CONCLUSIONS: Reconstructive surgical treatment of peri-implant defects using BDX resulted in more predictable outcomes than using autogenous bone over 5 years.

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  • 4.
    Albrektsson, Tomas
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Donos, N.
    Working group 1,
    Implant survival and complications: The Third EAO consensus conference 20122012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no s6, p. 63-65Article in journal (Refereed)
    Abstract [en]

    Objectives The task of this working group was to analyze biological, technical and aesthetic complications of single crowns on implants and fixed dental prostheses with or without cantilevers on implants over 5 years or more. In addition, the group analyzed economic aspects on such implant treatment. Materials and methods A systematic search of the relevant literature was conducted and critically reviewed. Four manuscripts were presented to cover the topics. Results The consensus statements prepared by the group and later accepted at the plenary session as well as suggestions for future research are presented in this article. The four reviews by Jung et al., Pjetursson et al., Romeo & Storelli and Scheuber et al. are printed separately and present detailed analyses of the research topics.

  • 5.
    Anderud, Jonas
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Abrahamsson, Peter
    Adolfsson, Erik
    Malmström, Johan
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    The impact of surface roughness and permeability in hydroxyapatite bone regeneration membranes2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 27, no 8, p. 1047-1054Article in journal (Refereed)
    Abstract [en]

    Background One of the crucial aspects in guided bone regeneration is the space maintenance. This is normally created by a membrane, which should primarily be accepted by the surrounding tissues without causing any adverse reactions. The impact of surface topography, biological acceptance as well as permeability of these membranes has been carefully discussed in the literature. Purpose The purpose of this study was to evaluate histologically the bone forming properties inside of hollow hydroxyapatite space-maintaining devices with different inner surfaces and different permeabilities in an animal calvaria model in vivo. Materials and methods A total of 36 hollow domes with three different designs made of hydroxyapatite were surgically attached to the skulls of rabbits. Group 1 had a moderately rough inner surface. Group 2 had a smooth inner surface. Group 3 had the same properties as Group 1 but had macroscopic holes on the top. The domes were left to heal for 12 weeks and were then processed for undecalcified ground sectioning. Histological evaluations were performed using a light microscope and scanning electron microscopy. The bone–implant contact (BIC) percentage along the device was calculated. Results The median percentage of BIC was higher for Group 1 compared with Group 2 (P = 0.004). Group 1 produced a larger median BIC compared with Group 3 (P < 0.0001). Conclusions Within the limits of this preclinical study, these findings suggest that a moderately rough inner surface of a ceramic membrane along with a non-permeable device produces more bone than a smooth inner surface.

  • 6. Batas, Leonidas
    et al.
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Koumpias, Sokrates
    Kostantinidis, Antonios
    Histological evaluation of PRGF as adjunct to DBB in maxillary sinus floor augmentation: preliminary results of a split-mouth study2013In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 24, no s9, p. 193-193, article id 394Article in journal (Other academic)
    Abstract [en]

    Background: Autologous growth factors are currently evaluated for their potential to enhance bone formation in association with maxillary sinus floor augmentation (MSFA). Aim/Hypothesis: To evaluate histologically whether chair-side prepared autologous platelet rich growth factor (PRGF) in combination with deproteinized bovine bone (DBB) enhances bone formation when compared with DBB alone as graft material in MSFA. Material and methods: Six partially edentulous patients with ≤3 mm residual bone height bilaterally in the posterior maxilla were subjected to MSFA with DBB in combination with PRGF in one side or DBB alone in the contralateral side. PRGF was prepared by collecting 20 ml of peripheral blood from each patient into tubes containing 3.8% (wt/vol) sodium citrate as anticoagulant and centrifugation at 1400 rpm for 8 min at room temperature (PRGF System1, Vitoria, Spain). From the separated blood, the 0.5 ml plasma fraction located just above the red cell fraction, but not including the buffy coat, was then collected and deposited in an eppendorf tube, and activated with the addition of PRGF activator (50 ll calcium chloride solution 10%w/v). The resulting PRGF was then mixed with deproteinized bovine bone (DBB) in a glass dish. After 5–8 min, the material attained a viscous consistency and was ready for application. MSFA was performed with the lateral window technique. Trephine biopsies were obtained during oral implant site preparation approximately 6 months after MSFA and processed for decalcified or non-decalcified histological and histomorphometrical evaluation. Non-parametric statistics, with P set at 0.05, were performed. Results: The collected biopsies varied in length (range: 3.5– 9.9 mm); consequently, the portion of the biopsy representing augmented tissues also varied (range 2.3–14.6 mm2). New bone formation with a trabecular appearance and numerous DBB particles in contact with the new bone or with loose connective tissue were observed. No differences in the relative volumes of bone formation were found in sinuses augmented with DBB+PRGF or DBB alone 6 months after MSFA (35.6 8.26 mm and 37.8 3.15 mm, respectively). Conclusions and clinical implications: Based on these preliminary results, PRGF as an adjunct to DBB does not enhance bone formation inside the human sinus when implant installation is planned several months after MSFA.

  • 7. Batas, Leonidas
    et al.
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Papadimitriou, Serafim
    Nyengaard, Jens R.
    Konstantinidis, Antonios
    Evaluation of autogenous PRGF+β-TCP with or without a collagen membrane on bone formation and implant osseointegration in large size bone defects: A preclinical in vivo study2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 27, no 8, p. 981-987Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to evaluate whether the adjunctive use of a collagen membrane enhances bone formation and implant osseointegration in non-contained defects grafted with chair-side prepared autologous platelet-rich growth factor (PRGF) adsorbed on a β-TCP particulate carrier. MATERIALS AND METHODS: Large box-type defects (10 × 6 mm; W × D) were prepared in the edentulated and completely healed mandibles of six Beagles dogs. An implant with moderately rough surface was placed in the center of each defect leaving the coronal 6 mm of the implant not covered with bone. The remaining defect space was then filled out with chair-side prepared autologous PRGF adsorbed on β-TCP particles and either covered with a collagen membrane (PRGF/β-TCP+CM) (6 defects) or left without a membrane (PRGF/β-TCP) (5 defects). RESULTS: Histology 4 months post-op showed new lamellar and woven bone formation encompassing almost entirely the defect and limited residual β-TCP particles. Extent of osseointegration of the previously exposed portion of the implants varied, but in general was limited. Within the defect, new mineralized bone (%) averaged 43.2 ± 9.86 vs. 39.9 ± 13.7 in the PRGF/β-TCP+CM and PRGF/β-TCP group (P = 0.22) and relative mineralized bone-to-implant contact (%) averaged 26.2 ± 16.45 vs. 35.91 ± 24.45, respectively (P = 0.5). First, bone-to-implant contact from the implant top was 4.1 ± 1.5 and 3.2 ± 2.3 (P = 0.9), in the PRGF/β-TCP+CM and PRGF/β-TCP group, respectively. CONCLUSIONS: Implantation of chair-side prepared autologous PRGF adsorbed on a β-TCP carrier in non-contained peri-implant defects resulted in large amounts of bone regeneration, but osseointegration was limited. Provisions for GBR with a collagen membrane did not significantly enhance bone regeneration or implant osseointegration.

  • 8. Becker, Kathrin
    et al.
    Brunello, Giulia
    Gurzawska-Comis, Katarzyna
    Becker, Jürgen
    Sivolella, Stefano
    Schwarz, Frank
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Dental care during COVID-19 pandemic: survey of experts' opinion.2020In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 31, no 12, p. 1253-1260Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The current COVID-19 outbreak in conjunction with the need to provide safe dental treatments, and the limited knowledge on the efficacy of protective measures has posed dentists into a challenging situation. Therefore, the present article aimed at collecting experiences and recommendations of front-line clinical experts on critical aspects of dental treatment provision during pandemic.

    MATERIAL & METHODS: , 2020.

    RESULTS: A total of 27 experts from different European countries completed the survey. The transmission risk of SARS-CoV-2 in dental settings for aerosol generating procedures was considered high by all experts except two. For aerosol-free and aerosol generating procedures, more than 80% of the experts recommended face protection and caps for every single treatment. For aerosol-generating procedures, additional measures (FFP2/FFP3 masks and gowns) were suggested by the vast majority of the experts. To reduce transmission risk, all experts recommended limiting aerosol-generating procedures and reducing the number of patients in waiting areas as well as hand hygiene for the patients.

    CONCLUSION: The limitation of aerosol-generating procedures along with the usage of adequate personal protection equipment was considered to be crucial to protect dental health care providers and patients, thus reducing the transmission risk of COVID-19.

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  • 9.
    Becker, Kathrin
    et al.
    Universitätsklinikum Düsseldorf.
    Gurzawska-Comis, Katarzyna
    University of Birmingham, UK; Birmingham Dental Hospital, UK.
    Brunello, Giulia
    Universitätsklinikum Düsseldorf.
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Karolinska Institutet.
    Summary of European guidelines on infection control and prevention during COVID-19 pandemic2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no S21, p. 353-381Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The current COVID-19 pandemic highlighted the need for a review of guidelines on infection control and prevention to ensure safe delivery of dental care. However, it is not clear to what extent the rapidly published European guidelines reflect the current evidence and thus provide homogeneous recommendations.

    MATERIAL & METHODS: Guidelines from all European Union countries, Scotland, Switzerland and United Kingdom were retrieved. Information on triage, mouth rinse, personal protective equipment (PPE) for aerosol free/ generating procedures (non-AGP/AGP) and treatment of potentially infectious patients were summarised, and compared with recommendations from international organizations (WHO, ECDC, CDC).

    RESULTS: All included countries (30/30) published COVID-19 guidelines in 2020. All countries recommended triage and to postpone non-urgent treatment of potentially infectious patients. Hydrogen peroxide (1-1.5%) was the most frequently recommended antiseptic mouth rinse to reduce viral load (24/30). PPE for non-AGP treatments included mainly surgical masks (21/30) or FFP2/FFP3/N95 masks (16/30), whereas FFP2/FFP3 masks (25/30) and face shields (24/30) were recommended for AGP by the vast majority of guidelines. For high-risk/COVID positive patients, most countries recommended maximum protection, and treatment in specialised dental clinics (22/30).

    CONCLUSION: There was general agreement among recommendations for triage, mouth rinse, and PPE during AGP and treatment of potentially infectious patients. In contrast, recommendations on PPE for non-AGP treatment varied considerably among the European countries possibly due to limited scientific evidence regarding transmission risk during non-AGP treatments.

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  • 10. Bergkvist, Göran
    et al.
    Sahlholm, Sten
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Implant-supported Fixed Prostheses in the Edentulous Maxilla. A 2-year Clinical and Radiological Follow-up of Treatment with Non-submerged ITI Implants2004In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 15, no 3, p. 351-359Article in journal (Other academic)
    Abstract [en]

    OBJECTIVES: To evaluate the survival rate of non-submerged solid-screw ITI dental implants with a rough (titanium plasma sprayed, TPS) surface in the edentulous maxilla after 1 and 2 years of loading. MATERIAL AND METHOD: Twentyfive patients (mean age 64 years) with edentulous upper jaws received five-seven implants and, after a mean healing time of 6.9 months, screw-retained implant-supported fixed prostheses. A total of 146 ITI solid screw TPS implants were inserted. The diameter of 56% of the implants was smaller (3.3 mm) than the standard (4.1 mm) and the diameter of the rest (44%) was standard. The bone quantity of the majority of the patients was low and the bone quality poor. Clinical parameters were registered at baseline and at two annual follow-ups. Radiological examinations and assessments were also made at these times. RESULTS: Mean marginal bone level at baseline was measured at a point 4.52 mm (range 1.45-7.70, SD 1.2) apical of the reference point. Mean bone loss from baseline to 1 year of loading was 0.24 mm (SD 0.9, P=0.002) and from 1 year to 2 years of loading 0.15 mm (SD 0.4, P<0.001). Five implants failed, four of which were early failures prior to loading. One implant failed shortly after bridge installation. The cumulative survival rate was 96.6% after 1 and 2 years. CONCLUSION: ITI TPS solid-screw implants in combination with fixed prostheses had successful survival rates and were found to be a viable treatment alternative in the edentulous maxilla.

  • 11.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bertl, Michael H.
    Heimel, Patrick
    Burt, Maria
    Gahleitner, André
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Ulm, Christian
    Alveolar bone resorption after primary tooth loss has a negative impact on straightforward implant installation in patients with agenesis of the lower second premolar2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 2, p. 155-163Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare the alveolar bone dimensions in patients with lower second premolar (P2) agenesis prior to and after primary molar loss on CT scans, and assess the possibility for straightforward implant placement. Methods: Alveolar bone dimensions were evaluated on 150 mandibular CT scans in three groups: (i) agenesis of P2, with the primary tooth in situ, and regularly erupted first premolar (P1) and molar (M1) (AW); (ii) agenesis of P2, without the primary tooth in situ for ≥3m, but regularly erupted P1 and M1 (AWO); and (iii) P1, P2, and M1 regularly erupted (CTR). The possibility of straightforward placement of an implant 3.5 or 4.3 mm in Ø × 10 mm long was digitally simulated and compared to the actually performed treatment. Results: Buccolingual width (7.3 ± 2.0 mm) at the coronal aspect of the ridge in the AWO group was statistically significantly smaller comparing with both the AW (9.2 ± 1.4 mm) and the CTR (9.5 ± 1.1 mm) group; width reduction appeared to be mainly due to “collapse” of the buccal aspect of the ridge. Simulated straightforward placement of implants with a diameter of 3.5 or 4.3 mm was possible in 62% and 56% of the cases in the AWO vs. 86% and 84% in the AW group (p = .006 and .002, respectively). Straightforward implant placement was actually possible in all patients (22) in the AW group, while 28% (11 of 39) of the patients in the AWO group needed additional hard tissue augmentation. Conclusions: Significant dimensional differences exist in the alveolar ridge, especially in the coronal part, at lower P2 agenesis sites missing the primary tooth for ≥3m, when compared to P2 agenesis sites with the primary tooth in situ. It seems thus reasonable to advise that the primary second molar should be kept as long as possible, in order to facilitate straightforward implant installation and reduce the probability of additional bone augmentation procedures.

  • 12.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Gotfredsen, Klaus
    Jensen, Simon
    Bruckmann, Corinna
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Adverse reaction after hyaluronan injection for minimally invasive papilla volume augmentation: A report on two cases2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 7, p. 871-876Article in journal (Refereed)
    Abstract [en]

    Objectives: To report two cases of adverse reaction after mucosal hyaluronan (HY) injection around implant-supported crowns, with the aim to augment the missing interdental papilla. Material and Methods: Two patients with single, non-neighbouring, implants in the anterior maxilla, who were treated within the frames of a randomized controlled clinical trial testing the effectiveness of HY gel injection to reconstruct missing papilla volume at single implants, presented an adverse reaction. Injection of HY was performed bilaterally using a 3-step technique: (i) creation of a reservoir in the mucosa directly above the mucogingival junction, (ii) injection into the attached gingiva/mucosa below the missing papilla, and (iii) injection 2–3 mm apically to the papilla tip. The whole-injection session was repeated once after approximately 4 weeks. Results: Both patients presented with swelling and extreme tenderness with a burning sensation on the lip next to the injection area, after the second injection session. In one of the cases, a net- like skin discoloration (livedo reticularis) was also noted. The symptoms lasted for up to 7 days, and in both cases, symptoms resolved without any signs of skin or mucosal necrosis or any permanent damage. Conclusion: Most likely, water attraction over time by the highly hygroscopic HY, exerted progressively an external vascular compression and at least partial occlusion of neighbouring blood vessels. An infection or an allergic reaction seems unlikely, since all symptoms gradually disappeared within a week irrespective use of antimicrobials, while an allergic reaction most likely would not have been restricted to one side.

  • 13.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Gotfredsen, Klaus
    Jensen, Simon
    Bruckmann, Corinna
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Can hyaluronan injections augment deficient papillae at implant-supported crowns in the anterior maxilla? A randomized controlled clinical trial with 6 months follow-up2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 9, p. 1054-1061Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next to an implant-supported crown were randomly assigned to receive twice either HY (test) or saline solution (control) injection. The following parameters were recorded prior to injection (baseline) and 3 and 6 months after injection: distance between the papilla tip and contact point (PT-CP), modified papilla index score (MPIS), and standard clinical periodontal parameters. Pain level after injection was recorded on a visual analogue scale (VAS). The deficient area was evaluated on clinical photographs, and the esthetic appearance was recorded on a VAS. Differences in mucosal volume were assessed after 3 months by intraoral scans. The bone level was assessed on periapical radiographs. RESULTS: No differences were observed between groups, neither at baseline nor at 3 and 6 months post-treatment. Mean PT-CP ranged between 1.8 mm and 2.3 mm without significant differences between groups or over time within groups; MPIS was 2 for all patients at all time points. Similarly, insignificant differences between groups or time points were observed for deficient area, gingival volume changes, bone level, and esthetic appearance. There were no differences in pain level between groups during injection, but discomfort after injection lasted longer in the test group. CONCLUSIONS: Injection of HY adjacent to maxillary anterior implant-supported crowns did not result in any clinical conspicuous volume augmentation of deficient papillae.

  • 14.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Kukla, Edmund Benjamin
    Albugami, Rajaa
    Malmö högskola, Faculty of Odontology (OD).
    Beck, Florian
    Gahleitner, André
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Timeframe of socket cortication after tooth extraction: A retrospective radiographic study.2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 1, p. 130-138Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To assess the timeframe between tooth extraction and radiographically detectable socket cortication in humans. METHODS: Two hundred and fifty patients with a CT scan ≤36 months after tooth extraction were included. First, three orthoradial multiplanar reconstruction slices, representing the major part of the extraction socket, were scored regarding the degree of bone healing as (i) healed, that is, complete/continuous cortication of the socket entrance, or (ii) non-healed. Thereafter, based on the results of all three slices, the stage of cortication of the extraction socket, as one unit, was classified as (i) non-corticated, that is, all three slices judged as non-healed, (ii) partially corticated, that is, 1 or 2 slices judged as non-healed, or (iii) completely corticated, that is, all three slices judged as healed. The possible effect of several independent parameters, that is, age, gender, timeframe between tooth extraction and CT scan, tooth type, extent of radiographic bone loss of the extracted tooth, tooth-gap type, smoking status, presence of any systemic disease, and medication intake, on cortication status was statistically evaluated. RESULTS: Three to 6 months after tooth extraction, 27% of the sockets were judged as non-corticated and 53% were judged as partially corticated. After 9-12 months, >80% of the sockets were corticated, while some incompletely corticated sockets were detected up to 15 months after extraction. Each additional month after tooth extraction contributed significantly to a higher likelihood of a more advanced stage of cortication, while radiographic bone loss ≥75% significantly prolonged cortication time; no other independent variable had a significant effect. CONCLUSIONS: The results indicate a considerably long timeframe until complete cortication of an extraction socket, that is, 3-6 months after tooth extraction 3 of 4 sockets were still not completely corticated, and only after 9-12 months, complete cortication was observed in about 80% of the sockets.

  • 15.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Mick, René-Bernard
    Heimel, Patrick
    Gahleitner, André
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Ulm, Christian
    Is a simple rational classification of maxillary sinus dimensions applicable?2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no S14, p. 65-65Article in journal (Other academic)
    Abstract [en]

    Background Maxillary sinus floor augmentation (MSFA) with autologous bone and/or bone substitutes is a reliable procedure to develop an implant site. Loss of augmentation volume during the healing period seems to be dependent on the type of graft material and possibly on the sinus dimensions/morphology, e.g. a larger distance between the buccal and palatal sinus wall (i.e. “wide” sinus) might delay graft consolidation due to a longer distance angiogenic/osteogenic factors and cells need to cover to populate the graft. Aim/Hypothesis To assess the bucco-palatal width of the maxillary sinus in the premolar and molar region and any possible differences due to tooth region, gender, tooth-gap extent, and residual alveolar bone dimensions. Further, to attempt a rational, simple sinus classification based on its bucco-palatal width. Material and Methods CTs of the posterior maxilla were divided depending on tooth-gap extent into (a) edentulous, and (b) 1- or 2-tooth gap. Sites presenting on the CT >5 mm of the maxillary sinus, no previous augmentation procedures and/or oro-antral communication were included. A central orthoradial multiplanar reconstruction slice from each edentulous tooth site was chosen by a calibrated examiner to record the following parameters: (i) alveolar bone height (ABH), (ii) alveolar bone area (ABA), (iii) alveolar bone width (ABW) 2 mm apical to the alveolar crest (ABW2), (iv) ABW at the sinus floor (ABWS), (v) bucco-palatal sinus width (SW) and (vi) sinus area (SA) at a level 2, 4, 6, 8 and 10 mm above the sinus floor (SW2/SA2, SW4/SA4, etc.) (Figure 1). Based on mean values (i.e. <25th, 25–75th, >75th percentile and <33rd, 33–67th, >67th percentile) the sinus was classified as narrow, average, and wide, respectively, to attempt a simple sinus classification. Results Eighty-six partially dentate and 76 edentulous quadrants contributed with 383 tooth sites (58 first and 97 second premolars, 129 first and 99 second molars). Alveolar bone and sinus parameters did not differ depending on tooth-gap extent and gender, but differed significantly depending on tooth site, i.e. ABH and ABA was smallest at the first molar, and ABW, ABWS, SW, and SA were significantly larger at the molars. Further, ABW correlated significantly with SW and SA. High variability in SW among the various levels within the same tooth site, as well as high variability among tooth sites within the same person was observed, i.e. in >50% of the cases, sinus classification (i.e., narrow, average, or wide) varied depending on SW height level (Table 1) and among tooth sites within each patient. Conclusions and Clinical Implications Maxillary sinus bucco-palatal width varies significantly among the various height levels within the same tooth site and among tooth sites within the same person. A rational, simple classification of each sinus as narrow, average, or wide was not applicable.

  • 16.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Mick, René-Bernard
    Heimel, Patrick
    Gahleitner, André
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Ulm, Christian
    Variation in bucco-palatal maxillary sinus width does not permit a meaningful sinus classification2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 12, p. 1220-1229Article in journal (Refereed)
    Abstract [en]

    Objectives The bucco-palatal sinus width (SW) appears as relevant factor for graft consolidation after maxillary sinus (MS) floor augmentation. The present study aimed to assess a) SW at different height levels of posterior teeth, b) possible factors influencing SW, and c) whether a simple/meaningful sinus classification based on SW is possible. Methods The following parameters were recorded on computed tomographies of 76 edentulous and 86 partially edentulous maxillary quadrants displaying 383 tooth sites in total: i) alveolar ridge height, ii) -area, iii) -width 2mm apical to the alveolar crest, iv) -width at the sinus floor, and v) SW and sinus area at a level 2, 4, 6, 8, and 10mm above the sinus floor. The possible influence of gender, tooth position [i.e., premolar (PM); molar (M)], tooth-gap extent, and residual alveolar ridge dimensions on SW was assessed. Further, based on percentiles of average values or on the frequency distribution of SW <10, 10-15, or >15mm, it was attempted to classify the sinus at each given site into narrow, average, or wide. Results Gender and tooth-gap extent presented no relevant impact on MS dimensions; however, significant differences were observed among the various tooth positions regarding all evaluated parameters. The lower the residual alveolar ridge, the wider the MS at 4-10mm height, while the wider the residual alveolar ridge, the wider the MS. Large variation in SW classes among the different height levels within the same tooth position and among tooth positions within the same person was observed, irrespective of the threshold applied. Further, at a MS height of 10mm at PM1, PM2, M1, and M2, SW was <10mm in 68%, 33%, 0%, and 7% of the cases, respectively, while in 3%, 21%, 65%, and 57%, respectively, SW was >15mm. Conclusions There is a large variation in SW depending on the height level within the sinus and on tooth position, which does not permit a simple/meaningful classification of each sinus as “narrow”, “average”, or “wide”. Nevertheless, narrow sinuses (<10mm) are rather prevalent in the premolar region, while wide sinuses (>15mm) in the molar region; further, a wider and shorter residual alveolar ridge is associated with a wider SW.

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  • 17.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Schulze Grotthoff, Verena
    Bertl, Michael H
    Malmö högskola, Faculty of Odontology (OD).
    Heimel, Patrick
    Gahleitner, Andre
    Ulm, Christian
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    A Wide Mesio-Distal Gap Distance in Sites of Congenitally Missing Maxillary Lateral Incisors Is Related to a Thin Bucco-Palatal Alveolar Ridge Width2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 27, no S13 : Abstracts of the EAO Congress, p. 218-219Article in journal (Other academic)
    Abstract [en]

    Background: In cases of a missing maxillary lateral incisor, an implant-supported crown is often the treatment of choice in order to avoid affecting intact adjacent teeth; however, proper implant placement requires a specific minimum amount of alveolar ridge bone volume. In general, alveolar ridge development is depended on tooth development and eruption; consequently, tooth loss has major impact on alveolar ridge dimensions and tooth agenesis seems to impair proper alveolar ridge development. It seems thus reasonable to consider that the impact of tooth agenesis on alveolar ridge development might depend on the gap width, i.e. the distance between the neighboring – regularly erupted – teeth. In particular, the influence from the adjacent teeth on alveolar ridge development would be diminished with an increasing mesio-distal gap distance, which in turn might result in deficient alveolar ridge dimensions, i.e. reduced height and bucco-palatal width in the center of the edentulous alveolar ridge. Aim/Hypothesis: This study aimed (a) to evaluate whether there is a correlation between the mesio-distal gap size and alveolar ridge dimension in patients missing the maxillary lateral incisor either due to agenesis or loss; (b) to determine the edentulous alveolar ridge dimension in the region of the missing maxillary lateral incisor and simulate straightforward implant placement; and (c) to assess any effect of tooth agenesis on the alveolar ridge dimension at the adjacent teeth (i.e. central incisor, canine). Material and Methods: Per protocol, 3 groups (n = 40 per group) were planned, including patients (1) with agenesis of one permanent maxillary lateral incisor (TA); (2) with the maxillary permanent lateral incisors regularly erupted but lost >3 months prior to the CT scan (TL); and (3) with the maxillary permanent lateral incisors regularly erupted and in situ (control; C). The following parameters were manually recorded by a single calibrated examiner: (1) mesio-distal gap width between the central incisor and the canine; (2) average bucco-palatal alveolar ridge width in the coronal (1st to 5th mm) and apical (6th to 10th mm) part of the alveolar ridge; (3) alveolar ridge bone area from a level 1 mm below the top of the alveolar ridge and 10 mm apically; (4) alveolar ridge height; and (5) possibility of straightforward implant placement (10 mm long x 3 or 3.5 mm in diameter). Further, clinical data regarding the actual treatment performed, i.e. bone grafting prior to- or in association with implant installation, were retrieved from the dental records of the patients of TA. Differences in alveolar ridge dimensions (i.e., bucco-palatal width, area, height) among groups [TA vs. TL vs. C) groups were assessed by One-way-ANOVA with LSD post-hoc test; correlations between the alveolar ridge dimension and the mesio-distal gap width were tested by the Spearman correlation coefficient. Results: Altogether 104 maxillary CT-scans were evaluated; the intended sample size of 40 was not achieved for TL due to frequently uncertain history of tooth loss. The area and bucco-palatal width of the alveolar ridge at the lateral incisor and at the adjacent teeth was significantly reduced in TA compared to TL and C (Table 1). Further, in TA, but not TL, an increasing mesio-distal distance between the adjacent teeth resulted in a significantly reduced bucco-palatal width of the coronal part of the edentulous alveolar ridge (r = −0.464, P = 0.003). This impeded simulated straightforward implant placement in >50% of the cases in TA, even with a reduced implant diameter of 3 mm. This simulation had good agreement with the actual treatment performed. Based on clinical data from 26 patients of the TA group, straightforward implant placement was not possible in 58% of the cases. Conclusions and Clinical Implications: The present results indicate that the wider the mesio-distal gap is in maxillary lateral incisor agenesis sites, the thinner bucco-palatally should the alveolar ridge be expected to be. In particular, a mesio-distal gap of >6 mm precluded straightforward implant placement in 60–80% of the cases. These results are relevant for treatment planning, since additional hard and/or soft tissue augmentation procedures should be frequently expected for optimal functional and aesthetic outcomes.

  • 18.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Schulze Grotthoff, Verena
    Bertl, Michael
    Malmö högskola, Faculty of Odontology (OD).
    Heimel, Patrick
    Gahleitner, Andreas
    Ulm, Christian
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    A wide mesio-distal gap in sites of congenitally missing maxillary lateral incisors is related to a thin alveolar ridge2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 9, p. 1038-1045Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate (i) a possible correlation between the mesio-distal gap width and the alveolar ridge (AR) dimensions in patients missing the maxillary lateral incisor (I2) either due to agenesis or loss and (ii) the possibility of straightforward implant placement based on simulation. METHODS: The bucco-palatal width, area, and height of the AR at the position of I2, and the mesio-distal gap width between the central incisor and the canine, were assessed in maxillary CT scans of three groups: Patients with (i) agenesis of I2 (TA ; n = 40); (ii) I2 regularly erupted but extracted (TL ; n = 24); (iii) I2 regularly erupted and in situ (C; n = 40). Further, the possibility of straightforward placement of an implant 3 or 3.5 mm in diameter ×10 mm in length, with 1 mm distance from the buccal and palatal plate of the alveolar ridge was simulated and compared to the actual treatment delivered. RESULTS: Bucco-palatal width and area of the AR at I2 and the adjacent teeth was significantly reduced in TA compared to TL and C. Further, in TA , but not TL , an increasing mesio-distal gap width between the central incisor and canine resulted in a significantly reduced bucco-palatal width of the edentulous AR. This impeded a simulated straightforward implant placement in >50% of the cases in TA , even with a reduced implant diameter. CONCLUSIONS: In patients congenitally missing I2, an increased mesio-distal gap width correlates significantly with reduced edentulous AR dimensions. A mesio-distal gap of >6 mm was associated with thin bucco-palatal alveolar ridges, precluding straightforward implant placement in 60-80% of the cases.

  • 19.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Subotic, M
    Heimel, P
    Schwarze, UY
    Tangl, S
    Ulm, C
    Morphometric characteristics of cortical and trabecular bone in atrophic edentulous mandibles2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 7, p. 780-787Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Adaptations of the alveolar ridge after tooth loss have been well described. However, studies on the morphometric characteristics of cortical bone are rare; hence, this study of human atrophic edentulous mandibles was undertaken. MATERIAL AND METHODS: Total cortical area, porosity, and thickness, and the percentage of cortical area in the complete mandibular area as well as in an area (height, 10 mm) starting at the most caudal point of the trabecular compartment and extending in the coronal direction were determined in 185 thin ground sections of edentulous mandibles (incisor region, 49; premolar region, 76; molar region, 60; 95 from females and 90 from males; mean age, 78.2 years, SD ± 7.8 years; Caucasian donors; cause of death: cardiovascular disease). Further, mandibular height and width and degree of residual ridge resorption (RRR) were recorded. RESULTS: The percentage of cortical area in the complete mandibular area increased with increasing RRR. Yet, evaluation of the 10-mm caudal portion corresponding to the basal part of the mandibular body did not confirm these changes in cortical bone. Cortical porosity and thickness decreased from the mesial to the distal region. Cortical porosity was unaffected by RRR, while cortical thickness increased, mainly at lingual aspects. CONCLUSIONS: In conclusion, cortical bone remained stable in different degrees of RRR except for some modulations in the lingual aspects. Changes in the relative composition between cortical and trabecular bone are due to loss of height and total area, mainly at expense of trabecular bone area, but not to adaptations of the cortical bone.

  • 20. Browaeys, Hilde
    et al.
    Vandeweghe, Stefan
    Malmö högskola, Faculty of Odontology (OD).
    Johansson, Carina B.
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Deschepper, Ellen
    de Bruyn, Hugo
    Malmö högskola, Faculty of Odontology (OD).
    The histological evaluation of osseointegration of surface enhanced microimplants immediately loaded in conjunction with sinuslifting in humans2013In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 24, no 1, p. 36-44Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim was to investigate histomorphometrically whether or not implant surface nanotopography improves the bone response under immediate loading simultaneous to sinus grafting. MATERIALS AND METHODS: Dual acid-etched titanium microimplants with/without crystalline surface deposition of calcium phosphate particles were placed in bilateral sinuslift areas grafted with a mixture of iliac crest bone and BioOss. Surface topography of microimplants was characterized using interferometry. Loaded microimplants (MsL) were immobilized in a provisional bridge supported by four normal size implants. Some patients had unloaded microimplants as controls (MsU). Biopsies were trephined after 2 or 4 months and histomorphometric analysis of bone area (BA) and bone-to-implant contact (BC) was performed. Nonparametric methods for dependent data were used to compare effect of surface modification, and healing time (2 vs. 4 months). RESULTS: A total of 53 biopsies were available from 13 patients. A total of 4/28 and 1/11 MsL failed after resp. 2 and 4 months vs. 0/6 and 1/5 MsU. Many loaded biopsies were damaged at the apical portion and showed no bone adhesion. MsL decreased in BA from coronal to apical from 2 to 4 months; Coronal > Middle (P = 0.047), Coronal > Apical (P < 0.001) and Middle > Apical (P < 0.001). This gradual decrease was not observed for BC; Coronal < Middle and Middle > Apical (P < 0.001). Only the middle part showed significant bone contact after 2 months. For MsL there was no statistically significant difference between surface or time indicating that improvement of osseointegration over time due to maturation of the graft was poor. The MsU did not show any difference between Osseotite and Nanotite for BIC and BA (P > 0.05) but doubled both their BA and BIC (P < 0.05) between 2 and 4 months. CONCLUSIONS: Osseointegration in sinus-grafted bone mixed with BioOss was poor irrespective of healing time or nanotopographical surface modification. The apex of MsL showed minimal bone contact suggesting that the graft does not add to the loading capacity. Surface enhancement was not beneficial despite the enlarged surface area. Overloading, most critical coronally of an implant, increases risks for implant failure and jeopardizes bone healing especially under immediate loading conditions with high load.

  • 21.
    Brunello, Giulia
    et al.
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany; University of Padova, Padova, Italy.
    Gurzawska-Comis, Katarzyna
    University of Birmingham, Birmingham, United Kingdom.
    Becker, Kathrin
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
    Becker, Jürgen
    Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
    Sivolella, Stefano
    University of Padova, Padova, Italy.
    Schwarz, Frank
    Goethe University, Frankfurt, Frankfurt am Main, Germany.
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Karolinska Institutet.
    Dental care during COVID-19 pandemic: follow-up survey of experts' opinion2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no S21, p. 342-352Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of the present survey is to give an update of European experts' opinion on infection control and prevention in dentistry during second wave of pandemic. The secondary aim was to analyse how experts' opinion changed in the light of the new scientific evidence since the first wave.

    MATERIAL & METHODS: An anonymous online 14-item questionnaire was sent to a total of 27 leading academic experts in Oral (and Maxillofacial) Surgery from different European countries, who had completed a previous survey in April-May 2020. The questionnaire covered the topics of dental setting safety, personal protective equipment (PPE), and patient-related measures to minimise transmission risk. Data collection took place in November-February 2020/21.

    RESULTS: 26 experts participated in the follow-up survey. The overall transmission risk in dental settings was scored significantly lower compared to the initial survey (P<0.05), though the risk associated with aerosol generating procedures (AGP) was still considered to be high. Maximum PPE was less frequently recommended for non-AGP (P<0.05), whereas the majority of experts still recommended FFP2/FFP3 masks (80.8%), face shields or goggles (88.5%), gowns (61.5%), and caps (57.7%) for AGP. Most of the experts also found mouth rinse relevant (73.1%) and reported to be using it prior to treatment (76.9%). No uniform opinion was found regarding the relevance of COVID-19 testing of staff and patients.

    CONCLUSION: With the continuation of dental care provision, transmission risk has been scored lower compared to the first wave of pandemic. However, high risk is still assumed for AGP, and maximum PPE remained advised for the respective treatments.

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  • 22. Campos, Felipe E. B.
    et al.
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Bonfante, Estevam A.
    Barbosa, Darceny Z.
    Oliveira, Maiolino T. F.
    Janal, Malvin N.
    Coelho, Paulo G.
    Are insertion torque and early osseointegration proportional?: A histologicevaluation2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 11, p. 1256-1260Article in journal (Refereed)
    Abstract [en]

    ObjectivesThe objective of this histologic study was to determine the effect of three drilling protocols (oversized, intermediate, and undersized) on biologic responses to a single implant type at early healing periods (2weeks in vivo) in a beagle dog model. Materials and methodsTen beagle dogs were acquired and subjected to surgeries in the tibia 2weeks before euthanasia. During surgery, each dog received three Unitite implants, 4mm in diameter by 10mm in length, in bone sites drilled to 3.5, 3.75, and 4.0mm in final diameter. The insertion torque was recorded during surgery, and bone-to-implant contact (BIC), and bone area fraction occupied (BAFO) measured from the histology. Each outcome measure was compared between treatment conditions with the Wilcoxon signed-rank test. Bonferroni-corrected statistical significance was set to 95%. ResultsInsertion torque increased as an inverse function of drilling diameter, as indicated by significant differences in torque levels between each pair of conditions (P=0.005). BIC and BAFO levels were highest and statistically similar in the recommended and undersized conditions and significantly reduced in the oversized condition (P<0.01). ConclusionsReduced drilling dimensions resulted in increased insertion torque (primary stability). While BIC and BAFO were maximized when drilling the recommended diameter hole, only the oversized hole resulted in evidence of statistically reduced integration.

  • 23. Cecchinato, Denis
    et al.
    Bressan, Eriberto A
    Toia, Marco
    Institute Franci, Padova, Italy.
    Araújo, Mauricio G
    Liljenberg, Birgitta
    Lindhe, Jan
    Osseointegration in periodontitis susceptible individuals2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 1, p. 1-4Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to examine tissue integration of implants placed (i) in subjects who had lost teeth because of advanced periodontal disease or for other reasons, (ii) in the posterior maxilla exhibiting varying amounts of mineralized bone. Material and methods: Thirty‐six subjects were enrolled; 19 had lost teeth because of advanced periodontitis (group P) while the remaining 17 subjects had suffered tooth loss from other reasons (group NP). As part of site preparation for implant placement, a 3 mm trephine drill was used to remove one or more 2 mm wide and 5–6 mm long block of hard tissue [biopsy site; Lindhe et al. (2011). Clinical of Oral Implants Research, DOI: 10.1111/j.1600-0501.2011.02205.x]. Lateral to the biopsy site a twist drill (diameter 2 mm) was used to prepare the hard tissue in the posterior maxilla for the placement of a screw‐shaped, self‐tapping micro‐implant (implant site). The implants used were 5 mm long, had a diameter of 2.2 mm. After 3 months of healing, the micro‐implants with surrounding hard tissue cores were retrieved using a trephine drill. The tissue was processed for ground sectioning. The blocks were cut parallel to the long axis of the implant and reduced to a thickness of about 20 μm and stained in toluidine blue. The percentage of (i) implant surface that was in contact with mineralized bone as well as (ii) the amount of bone present within the threads of the micro‐implants (percentage bone area) was determined. Results: Healing including hard tissue formation around implants placed in the posterior maxilla was similar in periodontitis susceptible and non‐susceptible subjects. Thus, the degree of bone‐to‐implant contact (about 59%) as well as the amount of mineralized bone within threads of the micro‐implant (about 45–50%) was similar in the two groups of subjects. Pearson's coefficient disclosed that there was a weak negative correlation (−0.49; P < 0.05) between volume of fibrous tissue (biopsy sites) and the length of bone to implant contact (BIC) while there was a weak positive correlation (0.51; P < 0.05) between the volume of bone marrow and BIC.

  • 24. Cecchinato, Denis
    et al.
    Marino, Massimiliano
    Toia, Marco
    Malmö University, Faculty of Odontology (OD).
    Cecchinato, Francesca
    Lindhe, Jan
    Bone loss at implants and teeth in the same inter-proximal unit: A radiographic study2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 4, p. 375-380Article in journal (Refereed)
    Abstract [en]

    ObjectiveThis study was performed to determine whether the distance between an implant and a tooth present in an inter-proximal unit influenced the amount of marginal bone loss that occurred at the two facing (adjacent) surfaces. Materials and methodsOne hundred and eighty patients with a total of 278 inter-proximal units were included. Radiographs of implants that also included adjacent (facing) natural tooth/teeth were digitalized, and various linear measurements were performed using a software program. The marginal bone level and the bone level change that had occurred during a mean of 5.8years were assessed as well as distance between the implant and the adjacent tooth/teeth. ResultsThe mean amount of additional marginal bone loss that took place during the observation period was about 0.4mm at both implants and adjacent tooth surfaces. The horizontal distance between an implant and the facing tooth did not influence the amount of marginal bone loss that had occurred. In most inter-proximal units, more advanced bone loss (>1mm, >2mm) had ensued either at the implant or at the facing tooth surface. Advanced additional bone loss occurred at both the implant and the tooth in only about 3% of the examined subjects. ConclusionBone loss at implants and teeth appears to be a site-specific phenomenon and not dependent on the inter-proximal distance.

  • 25.
    Chowdhary, Ramesh
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Thomsen, C S
    Carlsson, L
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    The osseointegration stimulatory effect of macrogeometry-modified implants: a study in the rabbit2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 9, p. 1051-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the bone stimulatory effect of compression forces through histomorphometric analyses of macrothreaded implants with microthreads in between.

    MATERIAL AND METHODS: Two sets of turned implants with different macrogeometries were prepared. The test group possessed microthreads in between macrothreads, and the control group had macrothreads only. The two-implant groups were placed in both the femur and the tibiae of 10 rabbits. After 4 weeks, the animals were sacrificed and were subjected to histologic processing and histomorphometry. On the prepared stained sections, the total bone area (BA), new BA and bone-to-implant (BIC) were calculated.

    RESULTS: The mean new BA% (SD) for the test group in the femur presented significantly higher values compared with the control group, being 32.84 (32.5) ± 6.04 and 27.31 (28.19) ± 5.66, respectively (P = 0.04). There were no differences for the new BA in the tibia or the total BA% for both bone types (P = 0.86, P = 0.131, and P = 0.131, respectively). The mean BIC% (SD) in the femur was 13.66 (11.49) ± 6.86 for the test group and 8.48 (7.92) ± 3.31 for the control group and in the tibia, 11.4 (11.88) ± 4.21 for the test group and 13.91 (12.06) ± 6.07 for the control group, respectively. There was no statistical significance among the groups tested.

    CONCLUSION: The modified implant macrogeometry with microthreads in between promoted effect in the femur. However, no statistical differences could be seen in the tibia, suggesting that the modification may be more effective in bone with poor bone quality, such as in the maxillary bone.

  • 26.
    Chowdhary, Ramesh
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Thomsen, Christian
    Carlsson, Lennart
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Biomechanical evaluation of macro and micro designed screw-type implants: an insertion torque and removal torque study in rabbits2013In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 24, no 3, p. 342-346Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the combined effect of macro and pitch shortened threads on primary and secondary stability during healing, but before dynamic loading. MATERIALS AND METHODS: Two sets of turned implants with different macro geometry were prepared. The test group possessed pitch shortened threads in between the large threads and the control group did not have thread alterations. The two implant groups were placed in both femur and tibiae of 10 lop-eared rabbits, and at the time of implant insertion, insertion torques were recorded. After 4 weeks, all implants were subjected to removal torque tests. RESULTS: The insertion torque values for the control and test groups for the tibia were 15.7 and 20.6 Ncm, respectively, and for the femur, 11.8, and 12.8 Ncm respectively. The removal torque values for the control and test groups in the tibia were 7.9 and 9.1 Ncm, respectively, and for the femur, 7.9 and 7.7 Ncm respectively. There was no statistically significant difference between the control and test groups. CONCLUSION: Under limited dynamic load, the addition of pitch shortened threads did not significantly improve either the primary or the secondary stability of the implants in bone.

  • 27.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Kisch, Jenö
    Albrektsson, Tomas
    Malmö högskola, Faculty of Odontology (OD).
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Bruxism and dental implant treatment complications: a retrospective comparative study of 98 bruxer patients and a matched group2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 7, p. e1-e9Article in journal (Refereed)
    Abstract [en]

    Objectives. To analyze the complications of dental implant treatment in a group of patients with bruxism in comparison with a matched group of non-bruxers. Material and methods. Patients being diagnosed as bruxers were identified within a group of patients consecutively treated with implant-supported prostheses at one specialist clinic, based on the most recent listed sign and symptoms of bruxism according to the International Classification of Sleep Disorders. A diagnostic grading system of “possible,” “probable,” and “definite” sleep or awake bruxism was used, according to a recent published international consensus. A case–control matching model was used to match the bruxers with a group of non-bruxers, based on five variables. Implant-, prosthetic-, and patient-related data were collected, as well as 14 mechanical complications, and compared between groups. Results. Ninety-eight of 2670 patients were identified as bruxers. The odds ratio of implant failure in bruxers in relation to non-bruxers was 2.71 (95% CI 1.25, 5.88). Considering the same number of patients with the same total number of implants equally distributed between groups, the bruxers group had a higher prevalence of mechanical complications in comparison with the non-bruxers group. Conclusions. This study suggests that bruxism may significantly increase both the implant failure rate and the rate of mechanical and technical complications of implant-supported restorations. Other risk factors may also have influenced the results.

  • 28.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Kisch, Jenö
    Albrektsson, Tomas
    Malmö högskola, Faculty of Odontology (OD).
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Survival of dental implants placed in sites of previously failed implants2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 11, p. 1348-1353Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the survival of dental implants placed in sites of previously failed implants and to explore the possible factors that might affect the outcome of this reimplantation procedure. Materials and methods: Patients that had failed dental implants, which were replaced with the same implant type at the same site, were included. Descriptive statistics were used to describe the patients and implants; survival analysis was also performed. The effect of systemic, environmental, and local factors on the survival of the reoperated implants was evaluated. Results: 175 of 10,096 implants in 98 patients were replaced by another implant at the same location (159, 14, and 2 implants at second, third, and fourth surgeries, respectively). Newly replaced implants were generally of similar diameter but of shorter length compared to the previously placed fixtures. A statistically significant greater percentage of lost implants were placed in sites with low bone quantity. There was a statistically significant difference (P = 0.032) in the survival rates between implants that were inserted for the first time (94%) and implants that replaced the ones lost (73%). There was a statistically higher failure rate of the reoperated implants for patients taking antidepressants and antithrombotic agents. Conclusions: Dental implants replacing failed implants had lower survival rates than the rates reported for the previous attempts of implant placement. It is suggested that a site-specific negative effect may possibly be associated with this phenomenon, as well as the intake of antidepressants and antithrombotic agents.

  • 29.
    Chrcanovic, Bruno R.
    et al.
    Malmö University, Faculty of Odontology (OD).
    Kisch, Jenö
    Malmö University, Faculty of Odontology (OD).
    Larsson, Christel
    Malmö University, Faculty of Odontology (OD).
    Retrospective evaluation of implant-supported full-arch fixed dental prostheses after a mean follow-up of 10 years.2020In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 31, no 7, p. 634-645Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the outcomes of implant-supported full-arch fixed dental prostheses (ISFAFDPs) and the supporting implants.

    MATERIAL AND METHODS: This retrospective study included patients treated with ISFAFDPs at one specialist clinic. Implant/prosthesis failure and complications were the outcomes analyzed. Survival analysis methods were used.

    RESULTS: A total of 709 patients with 869 ISFAFDPs (4,797 implants) were included, with a mean ± SD follow-up of 10.7 ± 7.2 years. A total of 353 implants and 62 prostheses failed. Estimated cumulative survival rates were as follows: 93.3% (95% CI 91.3, 95.3) after 10 years and 87.1% (95% CI 83.4, 90.8) after 20 years. Implants installed in bruxers, smokers, and maxilla had a lower survival than implants installed in non-bruxers, non-smokers, and mandible, respectively. A total of 415 ISFAFDPs (47.8%) presented technical complications, of which 67 (7.7%) presented only occurrences of loss/fracture of implant access hole sealing. Bruxism was a factor to exert a higher risk of screw loosening (HR 3.302; also in younger patients), screw fracture (HR 4.956), ceramic chipping/fracture (HR 5.685), and loss/fracture of acrylic teeth (HR 2.125; this last complication with higher risk also in men, in maxillae, and when the opposing jaw presented natural dentition or fixed prostheses). Patients with bruxism had a statistically significant higher risk of prosthesis failure than non-bruxers (HR 3.276).

    CONCLUSIONS: ISFAFDPs presented good long-term prognosis. Failure of several supporting implants was the main reason for failure. The results of the present study strongly suggest that bruxism is an important contributor to implant and prosthesis failure, as well as to an increased prevalence of technical complications in ISFAFDPs.

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  • 30.
    Chrcanovic, Bruno Ramos
    et al.
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Kisch, Jenö
    Malmö University, Faculty of Odontology (OD).
    Larsson, Christel
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Retrospective clinical evaluation of implant‐supported single crowns: mean follow‐up of 15 years2019In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 30, no 7Article in journal (Refereed)
    Abstract [en]

    Objective: To retrospectively assess the clinical outcomes of implant‐supported single crowns and the supporting implants. Material and Methods: This retrospective study included all patients treated with implant‐supported single crowns at one specialist clinic. Implant and prosthesis failure, and mechanical/technical complications (ceramic fracture/chipping; crown loss of retention/mobility; crown failure/fracture; loosening/loss/fracture of prosthetic screw; implant failure/fracture) were the outcomes analyzed. Any condition/situation that led to the removal/replacement of crowns was considered prosthesis failure. Results: 438 patients with 567 crowns were included. Mean±SD follow‐up of 183.4±69.3 months. 37 implants (6.5%) and 54 crowns (9.5%) failed. If only technical problems were considered, the crown failure rate decreased to 4.1% (23/567). Most common reasons for crown failure: esthetic issue (n=12), crown constantly mobile (n=9), change to another type of prosthesis together with other implants (n=8), crown fracture (n=7), crown in infraposition in comparison to adjacent teeth (n=7). The odds of crown failure were shown to be statistically significantly higher for the following factors: younger patients, maxillary crowns, and screw‐retained crowns. Loose prosthetic screw was much more prevalent in screw‐retained than in cemented crowns. Ceramic fracture/chipping was more prevalent in screw‐retained crowns, maxillae, females. Crown fracture was more prevalent in ceramic crowns, screw‐retained crowns, maxillae, posterior region, females. However, these differences were statistically significant only for crown fractures in females. Conclusions: The odds of crown failure were significant for some factors, but one must keep in mind that non‐technical complications are as common as technical ones as reasons for the replacement of implant‐supported single crowns.

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  • 31. Coelho, Paulo G
    et al.
    Granato, Rodrigo
    Marin, Charles
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Lin, Siyan
    Witek, Lukasz
    Suzuki, Marcel
    Bonfante, Estevam Augusto
    Effect of Si addition on Ca- and P-impregnated implant surfaces with nanometer-scale roughness: an experimental study in dogs2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 3, p. 373-378Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To investigate the effect of Si addition on a nanometer-scale roughness Ca and P implant surfaces in a canine tibia model by biomechanical and histomorphometric evaluations. MATERIAL AND METHODS: The implant surfaces comprised a resorbable media CaP microblasted (control) and a CaP resorbable media+silica-boost microblasted (experimental) surfaces. Surfaces were characterized by scanning electron microscopy (SEM), X-ray photoelectron spectroscopy (XPS), and optical interferometry (IFM) down to the nanometric level. The animal model involved the bilateral placement of control (n=24) and experimental surface (n=24) implants along the proximal tibiae of six dogs, remaining in vivo for 2 or 4 weeks. After euthanization, half of the specimens were torqued-to-interface failure, and the other half was subjected to histomorphologic and bone-to-implant contact (BIC) evaluation. Torque and BIC statistical evaluation was performed by the Friedman test at 95% level of significance, and comparisons between groups was performed by the Dunn test. RESULTS: IFM and SEM observations depicted comparable roughness parameters for both implant surfaces on the micrometer and nanometer scales. XPS analysis revealed similar chemical composition, except for the addition of Si on the experimental group. Torque-to-interface failure and BIC mean values showed no significant differences (P=0.25 and 0.51, respectively) at both 2- and 4-week evaluation points for experimental and control groups. Early bone healing histomorphologic events were similar between groups. CONCLUSIONS: The experimental surface resulted in not significantly different biomechanical fixation and BIC relative to control. Both surfaces were biocompatible and osseoconductive.

  • 32. Correa, Leticia
    et al.
    Spin-Neto, Rubens
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Schropp, Lars
    da Silveira, Heloísa
    Wenzel, Ann
    Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 6, p. 690-695Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To compare the implant size (width and length) planned with digital panoramic radiographs, cone beam computed tomography (CBCT)-generated panoramic views, or CBCT cross-sectional images, in four implant systems. MATERIAL AND METHODS: Seventy-one patients with a total of 103 implant sites in the upper premolar and/or lower molar regions were examined with digital panoramic radiography (D-PAN) and (CBCT). A metal ball 5 mm in diameter was placed in the edentulous area for the D-PAN. CBCT data sets were reformatted to a 10-mm thick CBCT panoramic view (CBCT-pan) and 1-mm cross-sections (CBCT-cross). Measurements were performed in the images using dedicated software. All images were displayed on a monitor and assessed by three observers who outlined a dental implant by placing four reference points in the site of the implant-to-be. Differences in width and length of the implant-to-be from the three modalities were analyzed. The implant size selected in the CBCT-cross images was then compared to that selected in the other two modalities (D-PAN and CBCT-pan) for each of the implant systems separately. RESULTS: The implant-to-be (average measurements among observers) was narrower when measured in CBCT-cross compared with both D-PAN and CBCT-Pan. For premolar sites, the width also differed significantly between D-PAN and CBCT-pan modalities. The implant-to-be was also significantly shorter when recorded in CBCT-cross than in D-PAN. In premolar sites, there were no significant differences in implant length among the three image modalities. It mattered very little for the change in implant step sizes whether CBCT-cross was compared to D-PAN or CBCT-pan images. CONCLUSION: Our results show that the selected implant size differs when planned on panoramic or cross-section CBCT images. In most cases, implant size measured in cross-section images was narrower and shorter than implant size measured in a panoramic image or CBCT-based panoramic view

  • 33.
    De Bruyn, Hugo
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Raes, Filiep
    Cooper, Lyndon F.
    Reside, Glenn
    Garriga, Joan S.
    Tarrida, Luís G.
    Wiltfang, Jörg
    Kern, Matthias
    Three-years clinical outcome of immediate provisionalization of single Osseospeed™ implants in extraction sockets and healed ridges2013In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 24, no 2, p. 217-223Article in journal (Refereed)
    Abstract [en]

    Aim The purpose of this prospective multicenter clinical study was to compare 3 years implant survival, bone and soft tissue changes following immediate loading using single Osseospeed™ implants (Astra Tech AB, Mölndal, Sweden) installed in healed ridges or extraction sockets. Material and methods Implants were provisionally restored the day of surgery using cemented acrylic crowns out of full occlusion. The provisional crowns were replaced after 12 weeks by full-ceramic crowns. Implant survival, bone levels, soft tissue levels and peri-implant health were monitored up to 3 years. Results 55 patients (22 men, 33 women; mean age 45) had the implant installed in extraction sockets and 58 patients (25 men, 33 women; mean age 42) received conventional implant treatment in healed ridges. Three implants failed in the extraction group and one implant failed in the healed group, all failures occurred before the final crown placement. No further losses occurred during 3 years, giving a statistically comparable survival rate of 94.6% and 98.3%, respectively. The total bone loss after 3 years, compared to implant placement was 0.4 mm (SD 1.5) in healed sites, whilst the immediate sites showed a bone gain of 1.6 mm (SD 2.4) due to bone fill in the alveolus. Papillae retracted with 0.3 and 0.0 mm in the period of provisionalization, but grew back after final crown was placed with 0.3 and 0.5 mm in extraction and healed sites respectively after 3 years. Plaque and inflammation scores were very low throughout the study time, irrespective of treatment modality. Conclusions Immediate implants restored at the day of surgery show comparable risk for implant failure, bone loss and midfacial soft tissue recession compared to conventionally installed implants. The 3-years results suggest both hard and soft tissue stability.

  • 34.
    De Bruyn, Hugo
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Raes, Stefanie
    Matthys, Carine
    Cosyn, Jan
    The current use of patient-centered/reported outcomes in implant dentistry: a systematic review2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no S11, p. 45-56Article, review/survey (Refereed)
    Abstract [en]

    Aim: To provide an update on the use of Patient-Reported Outcome Measures (PROMs) in the field of implant dentistry (1); to compare PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition (2). Materials and methods: The dental literature was searched on PubMed until December 31, 2014, using a general search algorithm. An overall quantitative analysis was performed, and a qualitative appraisal was made on the output of the last 6 years. Per type of edentulism and prosthetic treatment, the general search algorithm was refined in order to select controlled studies comparing PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition. Results: With nearly half of the output (300 of 635) published in the last 6 years, there is a growing interest in PROMs by the scientific community. When scrutinizing the 300 most recent publications, only 84 controlled studies could be identified among which 38 RCTs and 31 cohort studies. An "ad hoc" approach is commonly employed using non-standardized questions and different scoring methods, which may compromise validity and reliability. Overall, 39 eligible papers related to fully edentulous patients treated with an implant overdenture (IOD) and 9 to fully edentulous patients treated with a fixed implant prosthesis (FIP). There is plenty of evidence from well-controlled studies showing that fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a conventional denture (CD). This may not hold true for fully edentulous patients in the maxilla. In general, fully edentulous patients seem to opt for a fixed or removable rehabilitation on implants for specific reasons. Data pertaining to partially edentulous patients were limited (FIP: n = 6; single implants: n = 16). In these patients, the timing of implant placement does not seem to affect patient satisfaction. Patients seem to prefer straightforward implant surgery over complex surgery that includes bone grafting. Conclusion: There is an urgent need for standardized reporting of PROMs in the field of implant dentistry. Fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a CD. All other types of prostheses have been underexposed to research.

  • 35. Derks, Jan
    et al.
    Håkansson, Jan
    Wennström, Jan L
    Klinge, Björn
    Malmö högskola, Faculty of Odontology (OD).
    Berglundh, Tord
    Patient-reported outcomes of dental implant therapy in a large randomly selected sample2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 5, p. 586-591Article in journal (Refereed)
    Abstract [en]

    BackgroundIn addition to traditional clinical parameters, the need to include patient-reported assessments into dental implant research has been emphasized. AimThe aim of this study was to evaluate patient-reported outcomes following implant-supported restorative therapy in a randomly selected patient sample. Material and MethodsFour thousand seven hundred and sixteen patients were randomly selected from the data register of the Swedish Social Insurance Agency. A questionnaire containing 10 questions related to implant-supported restorative therapy was mailed to each of the individuals about 6years after therapy. Associations between questionnaire data, and (i) patient-related, (ii) clinician-related and (iii) therapy-related variables were identified by multivariate analyses. ResultsThree thousand eight hundred and twenty-seven patients (81%) responded to the questionnaire. It was demonstrated that the overall satisfaction among patients was high. Older patients presented with an overall more positive perception of the results of the therapy than younger patients and males were more frequently satisfied in terms of esthetics than females. While clinical setting did not influence results, patients treated by specialist dentists as opposed to general practitioners reported a higher frequency of esthetic satisfaction and improved chewing ability. In addition, patients who had received extensive implant-supported reconstructions, in contrast to those with small reconstructive units, reported more frequently on improved chewing ability and self-confidence but also to a larger extent on implant-related complications. ConclusionIt is suggested that patient-perceived outcomes of implant-supported restorative therapy are related to (i) age and gender of the patient, (ii) the extent of restorative therapy and (iii) the clinician performing the treatment.

  • 36. Dias, Danilo R.
    et al.
    Leles, Claudio R.
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane F.
    The effect of marginal bone level changes on the stability of dental implants in a short-term evaluation2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 10, p. 1185-1190Article in journal (Refereed)
    Abstract [en]

    ObjectivesTo evaluate whether changes in marginal bone level (MBL) around implants, in sites with different bone types, affect the over time implant stability measured by resonance frequency analysis (RFA). Material and methodsSeventy-eight implants were inserted into jawbones of 32 patients using a two-stage surgical protocol, and implant bone sites were grouped according to the Lekholm and Zarb bone classification. The implant stability quotient (ISQ) was measured by RFA at four time points: implant placement, uncovering, rehabilitation, and at 1-year follow-up after loading. The MBL was measured on periapical radiographs at uncovering and at 1-year follow-up. Percent change in bone level was calculated based on the difference between the implant length and height from the crestal bone level to the implant apex. Descriptive statistics, Pearson's correlation, and repeated-measures ANOVA were used for data analysis. ResultsSignificant improvement of ISQ was found between implant insertion and uncovering surgery (P<0.001), while no significant changes were detected throughout the remaining follow-up period. The greatest improvement of ISQ was observed for bone type 4, compared with the other groups (P<0.001). Percent change in bone level had no effect on longitudinal measures of ISQ (P=0.337). The ISQ difference between uncovering and 1year after loading was not correlated with percent change in bone level (r=0.16; P=0.157). ConclusionThere was increased implant stability after implant placement, but it was not affected by changes in marginal bone level during the first year of loading.

  • 37. Dias, Danilo Rocha
    et al.
    Leles, Claudio Rodrigues
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Marginal bone level changes and implant stability after loading are not influenced by baseline microstructural bone characteristics: 1-year follow-up2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 27, no 10, p. 1212-1220Article in journal (Refereed)
    Abstract [en]

    ObjectiveThe aim of this study was to investigate the influence of different bone tissue characteristics of implant sites on changes in marginal bone level and implant stability over time. Material and methodsOne hundred and one implants were inserted in 41 patients. Cortical bone thickness of the alveolar ridge was measured on computed tomography (CT) images. Histomorphometric and microtomographic analyses (microCT) were performed in bone specimens obtained by using a trephine bur, at first drilling. Implant stability quotient (ISQ) measured by resonance frequency analysis (RFA) was registered at implant insertion. Implant stability quotient was measured also at the stages of uncovering, loading and at the 1-year follow-up, when standardized periapical radiographs were taken to measure the marginal bone level (MBL). Descriptive statistics, Spearman's rho correlation and multiple linear regression were used for data analysis (P<0.05). ResultsComparison between groups of higher and lower values of ISQ changes and between groups of higher and lower values of MBL changes revealed no differences in histomorphometric and microtomographic parameters, according to non-parametric comparison tests, (P>0.05). Bivariate correlation also showed no association among these microstructural parameters and the outcomes evaluated. There was no correlation between cortical thickness and MBL changes (r=-0.029; P=0.832) and between cortical thickness and ISQ changes (r=0.145; P=0.292). ConclusionMicrostructural bone characteristics of implant sites have no effect on changes in marginal bone level and implant stability as measured by RFA. Bone morphology cannot predict implant treatment success over time.

  • 38. Dierens, M.
    et al.
    Vandeweghe, Stefan
    Malmö högskola, Faculty of Odontology (OD).
    Kisch, J.
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    Cosyn, J.
    De Bruyn, Hugo
    Malmö högskola, Faculty of Odontology (OD).
    Cost estimation of single-implant treatment in the periodontally healthy patient after 16-22 years of follow-up2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 11, p. 1288-1296Article in journal (Refereed)
    Abstract [en]

    Background: Costs for single-implant treatment are mostly described for the initial treatment. Information on the additional cost related to aftercare is scarce. Objective: To make an estimation of complication costs of single implants in periodontally healthy patients after 16-22years and to compare costs for various prosthetic designs. Materials and methods: Patients with a single implant were recalled for a clinical examination and file investigation. Prosthetic designs included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Costs related to failures or technical, biologic, and aesthetic complications were retrieved from patient's records. Total and yearly additional complication costs were calculated as a percentage relative to the initial cost. Chair time needed to solve the complication was recorded and prosthetic designs were compared by Kruskal-Wallis tests. Results: Fifty patients with 59 surviving implants were clinically investigated. Additional complication costs after a mean follow-up of 18.5years amounted to 23% (range 0-110%) of the initial treatment cost. In total, 39% of implants presented with no costs, whereas 22% and 8% encountered additional costs over 50% and 75%, respectively. In 2%, the complication costs exceeded the initial cost. The mean yearly additional cost was 1.2% (range 0-6%) and mean complication time per implant was 67min (range 0-345min). Differences between prosthetic designs (CO, ST-PFM, ST-ACR) were statistically significant for total cost (P=0.011), yearly cost (P=0.023), and time (P=0.023). Pairwise comparison revealed significant lower costs for CO compared with ST-ACR reconstructions. Conclusion: Patients should be informed about additional costs related to complications with single implants. The mean additional cost spent on complications was almost one-quarter of the initial treatment price. A majority of implants presented with lower additional costs, whereas the highest complication costs were related to a smaller group with 22% of the implants needing more than half of the initial cost for complication management. Expenses were significantly different for various prosthetic designs.

  • 39. Dierens, M.
    et al.
    Vandeweghe, Stefan
    Malmö högskola, Faculty of Odontology (OD).
    Kisch, Jenö
    Malmö högskola, Faculty of Odontology (OD).
    Nilner, Krister
    Malmö högskola, Faculty of Odontology (OD).
    De Bruyn, Hugo
    Malmö högskola, Faculty of Odontology (OD).
    Long-term follow-up of turned single implants placed in periodontally healthy patients after 16–22 years: radiographic and peri-implant outcome2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 2, p. 197-204Article in journal (Refereed)
    Abstract [en]

    Objectives: Retrospectively evaluate the survival, radiographic and peri-implant outcome of single turned Brånemark™ implants after at least 16 years. Materials and methods: From 134 patients (C-group), 101 could be contacted concerning implant survival and 50 (59 remaining implants) were clinically examined (I-group). Marginal bone level was radiographically measured from the implant–abutment junction at baseline (=within 6 months after abutment connection) and 1–4, 5–8 and 16–22 years post-operatively. Probing depth, gingival and plaque index were measured. Marginal bone-level changes were analyzed using Friedman's and Wilcoxon's signed ranks tests. Spearman's correlations between radiographic and clinical parameters were calculated. Results: In the C-group, 13 out of 166 implants in 11 out of 134 patients failed (CSR=91.5%). In the I-group (28 males–22 females; mean age 23.9 years at baseline; range 14–57), the mean follow-up was 18.4 years (range 16–22). The mean bone level was 1.7±0.88 mm (range −0.8 to 5) after 16–22 years. Changes in the mean marginal bone level were statistically significant between baseline and the second measuring interval (1–4 years). Thereafter, no significant differences could be demonstrated. The mean interproximal probing depth, gingival and plaque indices were 3.9±1.27 mm, 1.2±0.81 and 0.2±0.48, respectively. Probing depth was moderately correlated with gingival inflammation (r=0.6; P<0.001) but not with bone level (P>0.05). 81.4% of the implants had a bone level ≤2nd thread and 91.5% had a probing depth ≤5 mm. 76.3% had both bone level ≤2nd thread and probing depth ≤5 mm. Conclusions and clinical implications: The single turned Brånemark™ implant is a predictable solution with high clinical survival and success rates. In general, a steady-state bone level can be expected over decades, with minimal signs of peri-implant disease. A minority (5%), however, presents with progressive bone loss.

  • 40.
    Donos, Nikos
    et al.
    Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry Queen Mary University of London (QMUL London UK.
    Asche, Nele Van
    Centre for Periodontology and Oral Implants KULeuven Leuven Belgium.
    Naim Akbar, Aron
    Malmö University, Faculty of Odontology (OD).
    Francisco, Helena
    Departamento de Cirurgia Oral e Implantologia Faculdade de Medicina Dentária Universidade de Lisboa Lisbon Portugal.
    Gonzales, Oscar
    Department of Periodontology Complutense University of Madrid Madrid Spain;Department of Periodontology and Periodontal‐Prosthesis School of Dental Medicine University of Pennsylvania Philadelphia PA USA.
    Gotfredsen, Klaus
    Oral Rehabilitation Copenhagen University Hospital Copenhagen Denmark.
    Haas, Robert
    Academy for Oral Implantology Vienna Austria.
    Happe, Arndt
    Department of Prosthetic Dentistry University Ulm Center of Dentistry Germany and Private Practice Münster Germany.
    Leow, Natalie
    Periodontology Unit UCL‐Eastman Dental Institute London UK.
    Navarro, Jose Manuel
    Private Practice Harley Street London UK.
    Ornekol, Turker
    Cosmodent Center for Dentistry and Dental Implants Istanbul Turkey.
    Payer, Michael
    Department of Oral Surgery and Orthodontics University Clinic of Dental Medicine &amp; Oral Health Medical University of Graz Graz Austria.
    Renouard, Franck
    Private Practice Paris France.
    Schliephake, Henning
    Department of Oral &amp; Maxillofacial Surgery University Medicine‐Augusta‐University Göttingen Germany.
    Impact of timing of dental implant placement and loading: Summary and consensus statements of group 1—The 6th EAO Consensus Conference 20212021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no S21, p. 85-92Article in journal (Refereed)
    Abstract [en]

    Objectives: This publication reports on the EAO workshop group 1 summaries, discussions and consensus statements based on four systematic reviews evaluating the impact of timing of dental implant placement and loading.

    Materials and methods: The first of the systematic reviews was on the influence of the timing of implant placement and loading in the biological outcomes of implant-supported fixed partial dentures. The second systematic review evaluated the influence of the timing of implant placement and loading on the aesthetic outcomes in single-tooth implants. The third systematic review was on the long-term outcomes of maxillary single-tooth implants in relation to timing protocols of implant placement and loading and the fourth on patient's perception of timing concepts in implant dentistry. The group evaluated these systematic reviews, provided comments and additions as required and agreed on the relevant consensus statements as well as on clinical and research recommendations.

    Results: Different timings of implant placement/loading presented with high implant survival rates. The systematic reviews evaluated from this working group provided a number of conclusions based on the available/current literature. However, the specific topic of timing is an area that further research is required in order to provide detailed guidelines for the different protocols to be employed.

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  • 41.
    Etöz, Onur
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Periodontology, Gazi University, Turkey .
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Kukla, Edmund
    Comprehensive Center Unit, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Ulm, Christian
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Ozmeric, Nurdan
    Department of Periodontology, Gazi University, Turkey .
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    How old is old for implant therapy in terms of implant survival and marginal bone levels after 5-11 years?2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no 3, p. 337-348Article in journal (Refereed)
    Abstract [en]

    Aim

    To evaluate implant survival and marginal bone levels (MBLevel) at least 5 years after implant installation in patients ≥ 65 years old.

    Methods

    Patient records were screened retrospectively for the following inclusion criteria: (1) ≥ 65 years of age at the time of implant installation, and (2) ≥ 5‐year radiographic follow‐up or registered implant loss. Association between patient‐ and implant‐related data with radiographically assessed data [i.e., implant survival, mean MBLevel (i.e., average of mesial and distal level), maximum marginal bone loss (i.e., either mesial or distal loss; maximum MBLoss)] were statistically evaluated by mixed effects multi‐level regression models.

    Results

    Two‐hundred‐eighteen implants in 74 patients were included with a mean follow‐up of 6.2 years (range: 5 to 10.7 years); 4 early and 6 late implant losses have been registered (implant survival rate: 95.4%). Mean MBLevel and maximum MBLoss was 1.24 ± 0.9 mm and 1.48 ± 1.0 mm, respectively. Maximum MBLoss < 2 mm, 2 to 5 mm, and ≥ 5 mm was found in 70.7, 28.8, and 0.5% of the implants, respectively. For both, mean MBLevel and maximum MBLoss, age presented a slightly protective effect (mean MBLevel: Coef. ‐0.041, p = 0.016; maximum MBLoss: Coef. ‐0.045, p = 0.014).

    Conclusion

    The high implant survival rate (95.4%), low mean MBLevel (1.24 mm), and low frequency of maximum MBLoss ≥ 5 mm (0.5%) observed herein after 5 to 11 years follow‐up, suggest that older age should not be considered as a limiting factor for implant treatment.

  • 42. Fischer, K
    et al.
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Calvo Guirado, J
    Schneider, D
    Fickl, S
    Influence of local administration of pamidronate on extraction socket healing: a histomorphometric proof-of-principle preclinical in vivo evaluation2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no Suppl 10, p. 148-148, article id 142Article in journal (Other academic)
    Abstract [en]

    Background: Tooth extraction is conventionally performed without any additional tissue manipulation and left for healing by secondary intention. Maintaining hard and soft tissue volume after tooth extraction may be crucial to achieve a highly aesthetic restoration and it may also facilitate stability of the results on the long-term. Therefor, different approaches have been proposed to eliminate post-extraction ridge reduction. Today, however, no technique seems to be able to preserve the entire socket volume. Aim/Hypothesis: To evaluate histomorphometrically the influence of local administration of pamidronate, adsorbed on a deproteinized porcine bone substitute, on extraction socket healing. Material and methods: Two American Fox-hound dogs were used within this proof-of-principle study. Following endodontic treatment of the distal root of the three lower premolars, the teeth were hemisected and the mesial roots were extracted flapless. The sockets were then loosely filled, in a split-mouth fashion, with a deproteinized porcine bone substitute in particulate form (Osteobiol Gen-Os; DPB), rehydrated either with sterile saline (control) or 90 mg/ml pamidronic acid solution (Aredia ; test). Extraction sockets were sealed with connective tissue punches obtained from the palate and secured with sutures. After 4 months of healing, specimens containing the sockets sites and remaining roots were retrieved and histomorphometrically evaluated. Vertical and horizontal ridge changes were evaluated comparing the section containing the remaining root and the corresponding extraction sites. Results: Histological evaluation of the sections revealed significant differences in healing patterns between test and controls. While the latter group presented complete closure of the sockets with newly formed bone, pamidronate treated sites presented with open socket entrances, only sealed with soft connective tissue. Within the socket, control sites presented with various amounts of newly formed bone and no evidence of DPB; limited amounts of bone healing were observed within test sites, that were filled with DPB mainly embedded in connective tissue. Socket (bone) wall loss in a vertical dimension showed only minor differences between tests and controls sites (buccal: – 1.01 vs – 1.15 mm; lingual: – 0.92 vs – 1.15 mm;). Horizontal bone loss, measured at a level corresponding to 3 mm below the cemento-enamel-junction (CEJ), was nearly three times higher in control sites ( 2.19 1.81 mm vs. – 0.80 0.91 mm;), while no differences were observed between groups at a level corresponding to 5 mm below the CEJ. Conclusion and clinical implications: Local administration of pamidronate adsorbed on a deproteinized porcine bone substitute in particulate form appeared to delay extraction socket healing, but may also reduce post-extraction dimensional changes in the alveolar ridge, in terms of horizontal bone loss. Additionally, pamidronate appears to obstruct resorption of the porcine bone substitute.

  • 43. Fischer, Kai R.
    et al.
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Calvo-Guirado, Jose-Luis
    Schneider, David
    Fickl, Stefan
    Influence of local administration of pamidronate on extraction socket healing: a histomorphometric proof-of-principle pre-clinical in vivo evaluation2015In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 26, no 10, p. 1135-1142Article in journal (Refereed)
    Abstract [en]

    Objectives:To evaluate the influence of local administration of pamidronate histomorphometrically, adsorbed on a collagenated porcine bone substitute, on extraction socket healing.

    Material and methods:Two American Fox-hound dogs were used within this proof-of-principle study. Following endodontic treatment of the distal root of the three lower premolars, the teeth were hemisected, and the mesial roots were extracted flapless. The sockets were then loosely filled, in a split-mouth fashion, with a collagenated porcine bone substitute (Osteobiol Gen-Os; CPB), rehydrated either with 90mg/ml pamidronate (Aredia((R)); test) or with sterile saline (control). Extraction sockets were sealed with connective tissue punches obtained from the palate and secured with sutures. After 4months of healing, specimens containing the socket sites and remaining roots were retrieved and histomorphometrically examined.

    Results:Histological evaluation of the sections revealed substantial differences in healing patterns. Control sites presented with various amounts of newly formed bone and no evidence of CPB inside the socket; in contrast, limited amounts of bone were observed at test sites, which were filled with CPB mainly embedded in connective tissue. Only minor differences were observed between test and control sites regarding vertical bone loss (buccal bone: -1.01mm vs. -1.15mm; lingual bone: -0.92mm vs. -1.15mm). Horizontal bone loss was nearly three times higher in control sites comparing to sites treated with pamidronate (-2.191.81mm vs. -0.80 +/- 0.91mm) at a level corresponding to 3mm below the cemento-enamel junction (CEJ).

    Conclusion:Local administration of pamidronate adsorbed on a collagenated porcine bone substitute in particulate form appeared to delay extraction socket healing, but may also reduce post-extraction dimensional changes in terms of horizontal bone width. Additionally, pamidronate appears to obstruct resorption of the porcine bone substitute.

  • 44. Franke Stenport, Victoria
    et al.
    Roos-Jansåker, Ann-Marie
    Renvert, S
    Kuboki, Y
    Irwin, C
    Albrektsson, Tomas
    Malmö högskola, Faculty of Odontology (OD).
    Claffey, N
    Failure to induce supracrestal bone growth between and around partially inserted titanium implants using bone morphogenetic protein (BMP): an experimental study in dogs2003In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 14, no 2, p. 219-225Article in journal (Other academic)
    Abstract [en]

    The effect of bone morphogenetic protein on supracrestal bone growth around partially inserted implants in a dog model is described. The lower premolar teeth (P1, P2, P3 and P4) were extracted on both sides of the mandible in six dogs. At a surgical exposure 12 weeks later, two 10 mm turned titanium implants were partially inserted, approximately 15 mm apart, in areas of P1 and P3 in each side of the mandible, allowing five threads to protrude from the bone crest. A titanium mesh was fastened to the coronal aspect of the two fixtures and the space beneath was filled with bone morphogenetic protein (S300 BMP) in combination with an inssoluble bone matrix carrier, or with carrier alone. The mesh was covered with an ePTFE membrane. Thus, a space for potential bone formation was created between the two implants. The surgical flaps were coronally positioned and secured with vertical mattress sutures. After 16 weeks of healing, biopsy specimens were retrived and examined histologically. Bone was not formed around the protruding implants or in the created space between the implants in any case. The carrier was completely resorbed. We conclude that supracrestal bone growth beyond the crestal limit with or without BMP in such a large space as in the experimental design may not be possible.

  • 45. Galindo-Moreno, Pablo
    et al.
    Nilsson, Peter
    King, Paul
    Becktor, Jonas P
    Malmö högskola, Faculty of Odontology (OD).
    Speroni, Stefano
    Schramm, Alexander
    Maiorana, Carlo
    Clinical and radiographic evaluation of early loaded narrow diameter implants - 1-year follow-up2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 5, p. 609-616Article in journal (Refereed)
    Abstract [en]

    Objective: To evaluate the clinical performance of Astra Tech OsseoSpeed™ TX 3.0S implants using one‐stage surgical procedure and early loading in the anterior region. Material and methods: This is a prospective, single arm, multi‐centre study. Patients missing teeth at positions 12, 22 and 32–42 were eligible to enter the study. The implants (OsseoSpeed™ TX 3.0S) used in the study were of 3 mm diameter and of different lengths. One‐stage surgery was performed, and healing abutments were used during the 6–10 weeks healing period. Clinical and radiographic examinations were assessed at implant installation, loading and at the 6‐ and 12‐month follow‐up visits. Results: Ninety‐seven implants were placed in 69 patients at six different study centres in Denmark, Germany, Italy, Spain, Sweden and the United Kingdom. The survival rate was 95.9%. No implants have been lost after loading (100% survival rate after loading). Mean marginal bone loss 1 year after installation was 0.065 mm (SD = 1.018). The frequency of bone loss ≥1 mm was 6.6% and 51.3% of the implants demonstrated no bone loss or even bone gain from the surgical visit to the first year follow‐up visit. Mean probing pocket depth and gingival zenith score were stable from crown placement to the 6‐ and 1‐year follow‐up visits. Conclusion: Treatment with OsseoSpeed™ TX 3.0S implants is a safe and predictable option in the anterior region where physical space is limited. Minimal marginal bone loss was observed during the first year follow‐up.

  • 46.
    Galli, Silvia
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Naito, Yoshihito
    Malmö högskola, Faculty of Odontology (OD).
    Berner, Simon
    Dard, Michel
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Chemically modified titanium-zirconium implants in comparison with commercially pure titanium controls stimulate the early molecular pathways of bone healing2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 10, p. 1234-1240Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Titanium-zirconium (TiZr) has been proposed as a mechanically stronger alternative to commercially pure titanium for oral and orthopaedic implants. However, not much is known on the osseointegration kinetics of TiZr surfaces. In this study, we aimed to identify the genetic response of bone around TiZr implants compared to pure Ti. MATERIAL AND METHODS: Microtextured and hydrophilic TiZr implants (tests) and cpTi implants grade IV (controls) were placed in the tibia of 30 New Zealand white rabbits. At 2, 4 and 12 weeks, the implants were subjected to removal torque test (RTQ). The expression of a panel of genes involved in the process of osseointegration was measured in the bone around the test and control implants by means of quantitative real-time polymerase chain reaction (PCR) and compared to the control samples. RESULTS: The controls yielded statistically significant higher RTQ at 4 weeks, but the RTQ of the tests had a larger increase between 4 and 12 weeks, when both groups reached similar values. The gene expression analysis showed that all selected markers for bone formation, bone remodelling and cytokines were significantly upregulated around TiZr implants after 2 weeks. After 4 weeks of healing, two bone formation markers were significantly more expressed in the test samples, while at 12 weeks, the expression of all genes was similar in the two groups. CONCLUSIONS: TiZr implants showed comparable biomechanical outcomes to cpTi up to 12 weeks of healing. However, at early healing stages, they showed a significant upregulation of osteogenesis and osteoclastogenesis markers.

  • 47. Gomes de Oliveria, Rubelisa Candido
    et al.
    Leles, Cláudio Rodrigues
    Lindh, Christina
    Malmö högskola, Faculty of Odontology (OD).
    Ribeiro-Rotta, Rejane Faria
    Bone tissue microarchitectural characteristics at dental implant sites. Part I: Identification of clinical-related parameters2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no 8, p. 981-986Article in journal (Refereed)
    Abstract [en]

    Abstract Objective: To identify the characteristics of bone tissue microarchitecture by microCT at dental implant bone sites, describing them in terms of clinical parameters. Material and methods: Forty-six bone implant sites of the maxilla and mandible from 32 volunteers were evaluated by conventional radiographs and CT scans. During the installation of each implant, bone biopsies were removed using a trephine bur at the first drilling to prepare the socket implant. Each sample was evaluated by microCT and dimensional parameters measured. Results: Factor analysis summarized the microparameters into four components, which accounted for 92.8% of the total variance. The identified factors were (1) architecture - variables affecting 3D trabecular bone configuration and organization, (2) density - variables relating to surface/volume ratios and volume/volume ratios, (3) bulk - variables relating to the amount of bone and (4) spacing - variable related to the distance between trabeculae and the quantity and organization of marrow spaces. Conclusion: These four summarized factors correspond to clinical and radiographically recognizable parameters used for routine bone quality evaluation for implant treatment planning, which can potentially influence the primary stability of dental implants. The understanding of factors related to bone microarchitecture might reveal important aspects of its mechanical properties, essential for implant success. To cite this article: De Oliveira RCG, Leles CR, Lindh C, Ribeiro-Rotta RF. Bone tissue microarchitectural characteristics at dental implant sites. Part 1: Identification of clinical related parameters. Clin. Oral Impl. Res. xx, 2011; 000-000. doi: 10.1111/j.1600-0501.2011.02243.x. © 2011 John Wiley & Sons A/S.

  • 48. Gracis, Stefano
    et al.
    Michalakis, Konstantinos
    Vigolo, Paolo
    Vult von Steyern, Per
    Malmö högskola, Faculty of Odontology (OD).
    Zwahlen, Marcel
    Sailer, Irena
    Internal vs. external connections for abutments/reconstructions: a systematic review2012In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, no Suppl 6, p. 202-216Article, review/survey (Other academic)
    Abstract [en]

    OBJECTIVES: The objectives of the review were (1) to evaluate the accuracy of implant-level impressions in cases with internal and external connection abutments/reconstructions, and (2) to evaluate the incidence of technical complications of internal and external connection metal- or zirconia-based abutments and single-implant reconstructions. MATERIALS AND METHODS: A MEDLINE electronic search was conducted to identify English language publications in dental journals related to each of the two topics by inserting the appropriate keywords. These electronic searches were complemented by a hand search of the January 2009 to January 2012 issues of the following journals: Clinical Oral Implants Research, The Journal of Prosthetic Dentistry, The International Journal of Prosthodontics, The International Journal of Periodontics and Restorative Dentistry, The International Journal of Oral Maxillofacial Implants, Clinical Implant Dentistry and Related Research. RESULTS: Seven in vitro studies were included in the review to evaluate the accuracy of implant-level accuracy. No clinical study was found. There was no study that directly compared the influence of internal and external implant connections for abutments/reconstructions on the accuracy of implant-level impressions. All in vitro studies reported separately on the two connection designs and they did not use same protocol and, therefore, the data could not be compared. Fourteen clinical studies on metal-based abutments/reconstructions and five clinical studies on zirconia-based abutments/reconstructions satisfied the inclusion criteria and, therefore, were included in the review to evaluate the incidence of technical complications. The most frequent mechanical complication found in both implant connection design when employing metal abutments/reconstructions was screw loosening. CONCLUSIONS: Implant-level impression accuracy may be influenced by a number of variables (implant connection type, connection design, disparallelism between multiple implants, impression material and technique employed). Implant divergence appears to affect negatively impression accuracy when using internal connection implants. Based on the sparse literature evaluating the incidence of technical complications of metal or zirconia abutments/reconstructions, it was concluded that: The incidence of fracture of metal-based and zirconia-based abutments and that of abutment screws does not seem to be influenced by the type of connection. Loosening of abutment screws was the most frequently occurring technical complication. The type of connection seems to have an influence on the incidence of the screw loosening: more loose screws were reported for externally connected implant systems for both types of materials. However, proper preload may decrease the incidence of such a complication.

  • 49.
    Gurzawska-Comis, Katarzyna
    et al.
    University of Birmingham, UK.
    Becker, Kathrin
    Universitätsklinikum Düsseldorf, Germany.
    Brunello, Giulia
    University of Padova, Italy; Universitätsklinikum Düsseldorf, Germany.
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Karolinska Institutet.
    COVID-19: Review of European recommendations and experts' opinion on dental care. Summary and consensus statements of group 5. The 6th EAO Consensus Conference 2021.2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no S21, p. 382-388Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The present work reports the EAO Workshop group 5 and consensus plenary discussions and statements based on two reviews summarising European guidelines and experts' opinion on infection control and prevention (ICP) in dentistry during the pandemic.

    MATERIAL: Two manuscripts were presented at the 6th EAO Consensus Conference. The first study compared the most recent national guidelines/recommendations of European countries. The second paper was an experts' opinion-based survey on application of ICP regulation during the second wave. The outcome of COVID-19 group discussion was presented to all participants of the consensus to come to an agreement about the consensus statements and clinical recommendation.

    RESULTS: The dynamic of the pandemic had an impact on rapidly published and frequently updated national guidelines in Europe. As guidelines were not based on solid evidence, they were supplemented by experts' opinion on ICP in dentistry. The dental care should be guaranteed during the pandemic, however in case of suspected or confirmed COVID-19 disease, the treatment should be postponed if possible. Remote triage and patient-related measures (i.e., social distancing, hand hygiene and mask wearing) were recommended to be the most efficient to reduce SARS-CoV-2 transmission. The type of personal protective equipment for dental staff should be adequate to the procedure and infection risk.

    CONCLUSIONS: Adequate infection control protocols have to be followed by healthcare professionals and patients to minimise the spreading of COVID-19. We foresee the importance of continuously updating the national dental guidelines, considering the evolution of the pandemic and new scientific evidence becoming available.

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  • 50.
    Halldin, Anders
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Johansson, Carina B
    Gretzer, Christina
    Jacobsson, Magnus
    Malmö högskola, Faculty of Odontology (OD).
    Improved osseointegration and interlocking capacity with dual acid-treated implants: a rabbit study2016In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 27, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate how osseointegration is affected by different nano-and microstructures. The hypothesis was that the surface structure created by dual acid treatment (AT-1), applied on a reduced topography, might achieve equivalent biomechanical performance as a rougher surface treated with hydrofluoric acid (HF). Materials and methods: In a preclinical rabbit study, three groups (I, II, and III) comprised of test and control implants were inserted in 30 rabbits. The microstructures of the test implants were either produced by blasting with coarse (I) or fine (II) titanium particles or remained turned (III). All test implants were thereafter treated with AT-1 resulting in three different test surfaces. The microstructure of the control implants was produced by blasting with coarse titanium particles thereafter treated with HF. The surface topography was characterized by interferometry. Biomechanical (removal torque) and histomorphometric (bone-implant contact; bone area) performances were measured after 4 or 12 weeks of healing Results: Removal torque measurement demonstrated that test implants in group I had an enhanced biomechanical performance compared to that of the control despite similar surface roughness value (Sa). At 4 weeks of healing, group II test implants showed equivalent biomechanical performance to that of the control, despite a decreased Sa value. Group III test implants showed decreased biomechanical performance to that of the control Conclusions: The results of the present study suggest that nano-and microstructure alteration by AT-1 on a blasted implant might enhance the initial biomechanical performance, while for longer healing time, the surface interlocking capacity seems to be more important

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