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  • 1. Bougas, Kostas
    et al.
    Franke Stenport, Victoria
    Currie, Fredrik
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    In vitro Evaluation of Calcium Phosphate Precipitation on Possibly Bioactive Titanium Surfaces in the Presence of Laminin2011In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 2, no 3, article id e3Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the present study was to evaluate calcium phosphate precipitation and the amount of precipitated protein on three potentially bioactive surfaces when adding laminin in simulated body fluid. Material and Methods: Blasted titanium discs were prepared by three different techniques claimed to provide bioactivity: alkali and heat treatment (AH), anodic oxidation (AO) or hydroxyapatite coating (HA). A blasted surface incubated in laminin-containing simulated body fuid served as a positive control (B) while a blasted surface incubated in non laminin-containing simulated body fuid served as a negative control (B-). The immersion time was 1 hour, 24 hours, 72 hours and 1 week. Surface topography was investigated by interferometry and morphology by Scanning Electron Microscopy (SEM). Analysis of the precipitated calcium and phosphorous was performed by Energy Dispersive X-ray Spectroscopy (EDX) and the adsorbed laminin was quantified by iodine (125I) labeling. Results: SEM demonstrated that all specimens except for the negative control were totally covered with calcium phosphate (CaP) after 1 week. EDX revealed that B- demonstrated lower sum of Ca and P levels compared to the other groups after 1 week. Iodine labeling demonstrated that laminin precipitated in a similar manner on the possibly bioactive surfaces as on the positive control surface. Conclusions: Our results indicate that laminin precipitates equally on all tested titanium surfaces and may function as a nucleation center thus locally elevating the calcium concentration. Nevertheless further studies are required to clarify the role of laminin in the interaction of biomaterials with the host bone tissue.

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  • 2. Bougas, Kostas
    et al.
    Franke Stenport, Victoria
    Tengvall, Pentti
    Currie, Fredrik
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    Laminin coating promotes calcium phosphate precipitation on titanium discs in vitro2011In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 2, no 4, article id e5Article in journal (Refereed)
    Abstract [en]

    Objectives: The objective of this study was to investigate the effect of a laminin coating on calcium phosphate precipitation on three potentially bioactive titanium surfaces in simulated body fluid. Material and Methods: Blasted titanium discs were prepared by alkali and heat treatment (AH), anodic oxidation (AO) or hydroxyapatite coating (HA) and subsequently coated with laminin. A laminin coated blasted surface (B) served as a positive control while a blasted non coated (B-) served as a negative control. Surface morphology was examined by Scanning Electron Microscopy (SEM). The analysis of the precipitated calcium and phosphorous was performed by Energy Dispersive X-ray Spectroscopy (EDX). Results: The thickness of the laminin coating was estimated at 26 Å by ellipsometry. Interferometry revealed that the coating process did not affect any of the tested topographical parameters on μm level when comparing B to B-. After 2 weeks of incubation in SBF, the alkali-heat treated discs displayed the highest calcium phosphate deposition and the B group showed higher levels of calcium phosphate than the B- group. Conclusions: Our results suggest that laminin may have the potential to be used as a coating agent in order to enhance the osseoinductive performance of biomaterial surfaces, with the protein molecules possibly functioning as nucleation centres for apatite formation. Nevertheless, in vivo studies are required in order to clarify the longevity of the coating and its performance in the complex biological environment.

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  • 3. Edén Strindberg, Jerker
    et al.
    Hol, Caroline
    Torgersen, Gerald
    Møystad, Anne
    Nilsson, Mats
    Malmö högskola, Faculty of Odontology (OD).
    Näsström, Karin
    Hellén-Halme, Kristina
    Malmö högskola, Faculty of Odontology (OD).
    Comparison of Swedish and Norwegian Use of Cone-Beam Computed Tomography: a Questionnaire Study2015In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 6, no 4, article id e2Article in journal (Refereed)
    Abstract [en]

    Objectives: Cone-beam computed tomography in dentistry can be used in some countries by other dentists than specialists in radiology. The frequency of buying cone-beam computed tomography to examine patients is rapidly growing, thus knowledge of how to use it is very important. The aim was to compare the outcome of an investigation on the use of cone-beam computed tomography in Sweden with a previous Norwegian study, regarding specifically technical aspects. Material and Methods: The questionnaire contained 45 questions, including 35 comparable questions to Norwegian clinics one year previous. Results were based on inter-comparison of the outcome from each of the two questionnaire studies. Results: Responses rate was 71% in Sweden. There, most of cone-beam computed tomography (CBCT) examinations performed by dental nurses, while in Norway by specialists. More than two-thirds of the CBCT units had a scout image function, regularly used in both Sweden (79%) and Norway (75%). In Sweden 4% and in Norway 41% of the respondents did not wait for the report from the radiographic specialist before initiating treatment. Conclusions: The bilateral comparison showed an overall similarity between the two countries. The survey gave explicit and important knowledge of the need for education and training of the whole team, since radiation dose to the patient could vary a lot for the same kind of radiographic examination. It is essential to establish quality assurance protocols with defined responsibilities in the team in order to maintain high diagnostic accuracy for all examinations when using cone-beam computed tomography for patient examinations.

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  • 4.
    Ekberg, Ewacarin
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Hansson, Lars-Göran
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Sahlström, Lotta
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Can MRI Observations Predict Treatment Outcome of Lavage in Patients with Painful TMJ Disc Displacement without Reduction?2015In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 30, no 1, article id e5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The purpose of this study was to examine magnetic resonance imaging findings in patients with painful disc displacement without reduction of the temporomandibular joint to determine whether the findings were able to predict treatment outcome of lavage and a control group treated with local anaesthesia without lavage in a short-term: 3-month perspective. MATERIAL AND METHODS: Bilateral magnetic resonance images were taken of 37 patients with the clinical diagnosis of painful disc displacement without reduction. Twenty-three patients received unilateral extra-articular local anaesthetics and 14 unilateral lavage and extra-articular local anaesthetics. The primary treatment outcome defining success was reduction in pain intensity of at least 30% during jaw movement at the 3-month follow-up. RESULTS: Bilateral disc displacement was found in 30 patients. In 31 patients the disc on the treated side was deformed, and bilaterally in 19 patients. Osteoarthritis was observed in 28 patients, and 13 patients had bilateral changes. Thirty patients responded to treatment and 7 did not, with no difference between the two treated groups. In neither the treated nor the contralateral temporomandibular joint did treatment outcome depend on disc diagnosis, disc shape, joint effusion, or osseous diagnoses. Magnetic resonance imaging findings of disc position, disc shape, joint effusion or osseous diagnosis on the treated or contralateral side did not give information of treatment outcome. CONCLUSIONS: Magnetic resonance imaging findings could not predict treatment outcome in patients treated with either local anaesthetics or local anaesthetics and lavage.

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  • 5. Gudac, Jelena
    et al.
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    Venskutonis, Tadas
    Puisys, Algirdas
    Machiulskiene, Vita
    Comparison of Selected Anatomical and Treatment-related Diagnostic Parameters Estimated by Cone-Beam Computed Tomography and Digital Periapical Radiography in Teeth with Apical Periodontitis2020In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 11, no 2, article id e4Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare selected anatomical and treatment-related diagnostic parameters estimated by cone-beam computed tomography and by digital periapical radiography in teeth with apical periodontitis, and to evaluate reliability of different examiners in interpretation of images obtained by both methods.

    Material and Methods: Teeth with apical periodontitis were evaluated independently by 2 endodontists and 1 radiologist based on 128 cone-beam computed tomography (CBCT) and 162 digital periapical radiography (DPR) images. Anatomical (size, relation with root, location of periapical radiolucency) and treatment-related (canal obturation length, homogeneity, coronal seal) parameters were assessed. Fleiss kappa reflected inter-observer agreement while intra-examiner agreement was estimated by Cohen's kappa. McNemar and McNemar-Bowker tests served for evaluation of differences between CBCT- and DPR-based estimates.

    Results: Cohen's kappa ranged from 0.62 to 1 for all examiners. Fleiss kappa values were nearly perfect for majority of parameters. Diagnostic discrepancy between methods was found for size of radiolucency that in 15 - 17% cases was larger, and in 25 - 28% smaller in DPR than in CBCT images. DPR revealed 20% of root canals scored as non-obturated while in CBCT - obturation present. Canal obturation was rated as homogenous by CBCT, while absent or non-homogenous by DPR, in 17 - 23%, and 11 - 14% of cases, respectively. Radiologist detected more root perforations in CBCT than in DPR images.

    Conclusions: Good intra- and inter-examiner agreement for anatomical and treatment-related diagnostic parameters was achieved using cone-beam computed tomography and digital periapical radiography methods and demonstrated similar diagnostic capability, although variation regarding root perforations and canal obturation quality was observed.

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  • 6.
    Hellén-Halme, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Kristina
    The Effects on Absorbed Dose Distribution in Intraoral X-ray Imaging When Using Tube Voltages of 60 and 70 kV for Bitewing Imaging2013In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 4, no 3, article id e2Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Efforts are made in radiographic examinations to obtain the best image quality with the lowest possible absorbed dose to the patient. In dental radiography, the absorbed dose to patients is very low, but exposures are relatively frequent. It has been suggested that frequent low-dose exposures can pose a risk for development of future cancer. It has previously been reported that there was no significant difference in the diagnostic accuracy of approximal carious lesions in radiographs obtained using tube voltages of 60 and 70 kV. The aim of this study was, therefore, to evaluate the patient dose resulting from exposures at these tube voltages to obtain intraoral bitewing radiographs. MATERIAL AND METHODS: The absorbed dose distributions resulting from two bitewing exposures were measured at tube voltages of 60 and 70 kV using Gafchromic(®) film and an anatomical head phantom. The dose was measured in the occlusal plane, and ± 50 mm cranially and caudally to evaluate the amount of scattered radiation. The same entrance dose to the phantom was used. The absorbed dose was expressed as the ratio of the maximal doses, the mean doses and the integral doses at tube voltages of 70 and 60 kV. RESULTS: The patient receives approximately 40 - 50% higher (mean and integral) absorbed dose when a tube voltage of 70 kV is used. CONCLUSIONS: The results of this study clearly indicate that 60 kV should be used for dental intraoral radiographic examinations for approximal caries detection.

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  • 7. Henmi, Yoko
    et al.
    Naito, Yoshihito
    Oral Implant Center, Tokushima University Hospital, Tokushima Japan.
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Jinno, Yohei
    Malmö högskola, Faculty of Odontology (OD).
    Sekine, Kazumitsu
    Hamada, Kenichi
    Bone Ingrowth to Ti Fibre Knit Block with High Deformability2016In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 7, no 4, article id e2Article in journal (Refereed)
    Abstract [en]

    Objectives The objective of this study is to develop a Ti fibre knit block without sintering, and to evaluate its deformability and new bone formation in vivo. Material and Methods A Ti fibre with a diameter of 150 μm was knitted to fabricate a Ti mesh tube. The mesh tube was compressed in a metal mould to fabricate porous Ti fibre knit blocks with three different porosities of 88%, 69%, and 50%. The elastic modulus and deformability were evaluated using a compression test. The knit block was implanted into bone defects of a rabbit’s hind limb, and new bone formation was evaluated using micro computed tomography (micro-CT) analysis and histological analysis. Results The knit blocks with 88% porosity showed excellent deformability, indicating potential appropriateness for bone defect filling. Although the porosities of the knit block were different, they indicated similar elastic modulus smaller than 1 GPa. The elastic modulus after deformation increased linearly as the applied compression stress increased. The micro-CT analysis indicated that in the block with 50% porosity new bone filled nearly all of the pore volume four weeks after implantation. In contrast, in the block with 88% porosity, new bone filled less than half of the pore volume even 12 weeks after implantation. The histological analysis also indicated new bone formation in the block. Conclusions The titanium fibre knit block with high porosity is potentially appropriate for bone defect filling, indicating good bone ingrowth after porosity reduction with applied compression.

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  • 8.
    Johansson, Krister
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Oral & Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden.
    Lindström, Martin
    Malmö University, Faculty of Odontology (OD).
    Alhabshi, Manaf
    Malmö University, Faculty of Odontology (OD).
    Ahmad, Marianne
    Malmö University, Faculty of Odontology (OD).
    Svensson, Peter J.
    Department of Translational Medicine, Clinical Coagulation Research Unit, Skåne University Hospital, Malmö, Sweden.
    Becktor, Jonas P
    Malmö University, Faculty of Odontology (OD).
    Estimation of Blood Loss in Oral and Maxillofacial Surgery by Measurements of Low Haemoglobin Levels in Mixtures of Blood, Saliva and Saline: a Laboratory Study2021In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 12, no 2Article in journal (Refereed)
    Abstract [en]

    Objectives: Estimating blood loss is an important factor in several surgical procedures. The accuracy of blood loss measurements in situations where blood is mixed with saliva and saline is however uncertain. The purpose of this laboratory study was to ascertain if blood loss measurements in mixtures of blood, saline, and saliva are reliable and could be applicable in a clinical setting.

    Material and Methods: Venous blood and resting saliva were collected from six volunteers. Saliva, saline, and combinations thereof were mixed with blood to obtain different concentrations. A portable spectrophotometer was first used to measure the haemoglobin concentration in undiluted venous blood followed by measurements of the haemoglobin concentration after each dilution. To examine the strength of linear relationships, linear regression and Pearson correlations were used.

    Results: The measurements of haemoglobin concentrations in mixtures of blood, saline, and saliva were proven to be accurate for haemoglobin measurements > 0.3 g/dl (correlation = 0.986 to 1). For haemoglobin measurements < 0.3 g/dl, a small increase in haemoglobin values were reported, which was directly associated to the saliva concentration in the solution (correlation = 0.983 to 1). This interference of saliva was significantly eliminated by diluting the samples with saline, mimicking the clinical situation.

    Conclusions: The results suggest that a portable spectrophotometer can be used clinically to preoperatively measure the haemoglobin value of a venous blood sample and postoperatively measure the haemoglobin value of the collected liquids, including shed blood, thereby achieving a highly accurate method of measuring blood loss during oral and maxillofacial surgery.

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  • 9.
    Naito, Yoshihito
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Vandeweghe, Stefan
    Chrcanovic, Bruno
    Malmö högskola, Faculty of Odontology (OD).
    Tovar, Nick
    Bryington, Matthew
    Ichikawa, Tetsuo
    Coelho, Paulo
    Wennerberg, Ann
    Malmö högskola, Faculty of Odontology (OD).
    The influence of 1α.25-dihydroxyvitamin d3 coating on implant osseointegration in the rabbit tibia2014In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 5, no 3, article id e3Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study aims to evaluate bone response to an implant surface modified by 1α,25-dihydroxyvitamin D3 [1.25-(OH)2D3] in vivo and the potential link between 1.25-(OH) 2D3 surface concentration and bone response. MATERIAL AND METHODS: Twenty-eight implants were divided into 4 groups (1 uncoated control, 3 groups coated with 1.25-(OH)2D3 in concentrations of 10(-8), 10(-7) and 10(-6) M respectively), placed in the rabbit tibia for 6 weeks. Topographical analyses were carried out on coated and uncoated discs using interferometer and atomic-force-microscope (AFM). Twenty-eight implants were histologically observed (bone-to-implant-contact [BIC] and new-bone-area [NBA]). RESULTS: The results showed that the 1.25-(OH)2D3 coated implants presented a tendency to osseointegrate better than the non-coated surfaces, the differences were not significant (P > 0.05). CONCLUSIONS: The effect of 1.25-(OH)2D3 coating to implants suggested possible dose dependent effects, however no statistical differences could be found. It is thought that the base substrate topography (turned) could not sustain sufficient amount of 1.25-(OH)2D3 enough to present significant biologic responses. Thus, development a base substrate that can sustain 1.25-(OH)2D3 for a long period is necessary in future studies.

  • 10. Pranskunas, Mindaugas
    et al.
    Poskevicius, Lukas
    Juodzbalys, Gintaras
    Kubilius, Ricardas
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Influence of Peri-Implant Soft Tissue Condition and Plaque Accumulation on Peri-Implantitis: a Systematic Review2016In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 7, no 3:e2, article id e2Article, review/survey (Refereed)
    Abstract [en]

    Objectives To systematically examine influence of soft tissue condition and plaque accumulation around dental implants on peri-implantitis development. Material and Methods An electronic literature search was conducted of two databases - MEDLINE (Ovid) and EMBASE from 2011 to 2016. Sequential screenings at the title, abstract, and full-text levels were performed. Clinical human studies in the English language that had reported soft tissue condition or plaque accumulation influence on peri-implantitis development were included. The resulting articles were independently subjected to clear inclusion and exclusion criteria by two reviewers as follows. Results The search resulted in 8 articles meeting the inclusion criteria. These studies reported gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index for sites with “adequate” (≥ 2 mm) and “inadequate” (< 2 mm) width of keratinized mucosa. Results demonstrated that the amount of keratinized mucosa has little influence on soft-tissue inflammation in the presence of good oral hygiene. However, suboptimal oral hygiene due to difficulty in access for plaque control in the areas of minimal keratinized mucosa may lead to greater tissue damage. Conclusions In cases with insufficient keratinized gingiva in the vicinity of implants, the insufficiency does not necessarily mediate adverse effects on the hygiene management and soft tissue health condition. Nonetheless, the risk of the increase of gingival index, plaque index, pocket depth, bleeding on probing/modified bleeding index is present. Therefore, the presence of an appropriate amount of keratinized gingiva is required.

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  • 11. Sonnesen, Liselotte
    et al.
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Berg, Soren
    Svanholt, Palle
    Pharyngeal Airway Dimensions and Head Posture in Obstructive Sleep Apnea Patients with and without Morphological Deviations in the Upper Cervical Spine2017In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 8, no 3, article id e4Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of the study was to analyse differences in pharyngeal airway dimensions and head posture between obstructive sleep apnea patients with and without morphological deviations in the upper cervical spine and to analyse associations between pharyngeal airway dimensions and head posture in the total sample. Material and Methods: The sample comprised 53 obstructive sleep apnea (OSA) patients of which 32.1% had upper spine morphological deviations. Accordingly two groups were defined: 17 OSA patients with morphological deviations in the upper spine and 36 without upper spine deviations. Pharyngeal airway dimensions in terms of distances, cross-sectional areas and volume and upper spine morphological deviations were evaluated on cone-beam computed tomography. Head posture was evaluated on two-dimensional generated lateral cephalograms. Differences were analysed and adjusted for age and gender by multiple linear regression analysis. Results: OSA patients with upper spine morphological deviations had a significantly more backward and curved neck posture (OPT/HOR, P < 0.01; OPT/CVT, P < 0.05) compared to OSA patients without spine deviations. No significant differences were found in airway dimensions between patients with and without upper spine deviations. In the total group significant associations were found between head posture and pharyngeal airway distances and cross-sectional area at the nasal floor, epiglottis and hyoid bone level (P < 0.05, P < 0.01, P < 0.001). No significant association was found between head posture and airway volume. Conclusions: The results may contribute to differentiate obstructive sleep apnea patients and thereby may prove valuable in diagnosis and treatment planning of obstructive sleep apnea patients.

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  • 12. Stacchi, Claudio
    et al.
    Andolsek, Francesca
    Astramskaite, Inesa
    Berton, Federico
    Lenarda, Roberto Di
    Fernandes, Maria Helena
    Frassetto, Andrea
    Gomes, Pedro de Sousa
    Guobis, Zygimantas
    Jimbo, Ryo
    Malmö högskola, Faculty of Odontology (OD).
    Juodzbalys, Gintaras
    Khoury, Aiman
    Kubilius, Ricardas
    Kuoppala, Ritva
    Lombardi, Teresa
    Maminskas, Julius
    Pacauskiene, Ingrida
    Perinetti, Giuseppe
    Poskevicius, Lukas
    Pranskunas, Mindaugas
    Puisys, Algirdas
    Raustia, Aune
    The 1st Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2016. Summary and Consensus Statements: Group I - Peri-Implantitis Aetiology, Risk Factors and Pathogenesis2016In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 7, no 3:e7, article id e7Article, review/survey (Other academic)
    Abstract [en]

    Introduction: The task of Group 1 was to review and update the existing data concerning aetiology, risk factors and pathogenesis of peri-implantitis. Previous history of periodontitis, poor oral hygiene, smoking and presence of general diseases have been considered among the aetiological risk factors for the onset of peri-implant pathologies, while late dental implant failures are commonly associated with peri-implantitis and/or with the application of incorrect biomechanical forces. Special interest was paid to the bone cells dynamics as part of the pathogenesis of peri-implantitis. Material and Methods: The main areas indagated by this group were as follows: in uence of smoking, history of periodontitis and general diseases on peri-implantitis development, bio-mechanics of implant loading and its in uence on peri-implant bone and cellular dynamics related to the pathogenesis of peri-implantitis. The systematic reviews and/or meta- analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york. ac.uk/PROSPERO/. The literature in the corresponding areas of interest was screened and reported following the PRISMA (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in Preface chapter. Results: The results and conclusions of the review process are presented in the respective papers. One systematic review with meta-analysis, three systematic reviews and one theoretical analysis were performed. The group′s general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.

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  • 13. Starch-Jensen, Thomas
    et al.
    Becktor, Jonas Peter
    Malmö University, Faculty of Odontology (OD).
    Maxillary Alveolar Ridge Expansion with Split-Crest Technique Compared with Lateral Ridge Augmentation with Autogenous Bone Block Graft: a Systematic Review2019In: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 10, no 4, article id e2Article, review/survey (Refereed)
    Abstract [en]

    Objectives: The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after maxillary alveolar ridge expansion with split-crest technique compared with lateral ridge augmentation with autogenous bone block graft.

    Material and Methods: A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until 8th of February, 2018 were included.

    Results: One comparative and four noncomparative studies fulfilled the inclusion criteria. Both treatment modalities disclosed high survival rate of implants with few complications. High survival rate of prosthesis, implant stability values, limited peri-implant marginal bone loss and gain in maxillary alveolar ridge width were reported with the split-crest technique. Patient-reported outcome measure and length of patient treatment time was not assessed in any of the included studies.

    Conclusions: The split-crest technique seems to be useful for horizontal augmentation of maxillary alveolar deficiencies with high survival rate of prosthesis and implants. However, further long-term randomized controlled trials with larger patient sample as well as assessment of patient-reported outcome measures and patient treatment time are needed before well-defined conclusions can be provided about the two treatment modalities.

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