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  • 1.
    Bertl, Kristina
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Heimel, Patrick
    Rökl-Riegler, Michaela
    Hirtler, Lena
    Ulm, Christian
    Zechner, Werner
    MicroCT-based evaluation of the trabecular bone quality of different implant anchorage sites for masticatory rehabilitation of the maxilla2015In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 43, no 6, p. 961-968Article in journal (Refereed)
    Abstract [en]

    In the severely atrophied maxilla, implant anchorage in the zygomatic bone is considered a viable alternative to conventional dental implants with preceding bone augmentation procedures. The present microCT-based study compared the trabecular bone quality of the maxilla and zygomatic bone. MicroCT scanning was conducted in 12 halves of cadaver heads (5 male, 7 female) with edentulous, atrophied maxillae. Relevant trabecular bone quality parameters were determined in the anterior and posterior maxilla and in the zygomatic bone and compared by region and sex. Any difference in mean values between the anterior maxilla and the zygomatic bone was insignificant. Comparison of both with the posterior maxilla presented significantly higher values for bone volume fraction, surface density, and trabecular thickness and number, and significantly lower values for specific bone surface, structure model index, and trabecular separation. A significant sex-specific difference was not detected. The present microCT-based analysis is, to the best of our knowledge, the first intra-individual comparison of different implant anchorage sites for masticatory rehabilitation of the maxilla. The trabecular compartment of the zygomatic bone offered bone quality and, thus, an implant bed comparable with those of the anterior maxilla, and both were superior to the posterior maxilla.

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  • 2.
    Chrcanovic, Bruno
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Dental implants in patients with ectodermal dysplasia: a systematic review2018In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 46, no 8, p. 1211-1217Article, review/survey (Refereed)
    Abstract [en]

    Purpose. To assess the clinical outcome and survival rate of oral implants placed in individuals with ectodermal dysplasia (ED), based on previously published studies. Methods. An electronic search without time restrictions was undertaken in 5 databases (PubMed/Medline, Web of Science, ScienceDirect, J-Stage, Lilacs). Descriptive statistics, Kaplan Meier estimator and implant failure probability were calculated. Results. 90 publications included, reporting 228 ED patients that received 1472 implants (1392 conventional, 47 zygomatic, 33 mini-implants). Mean age of the patients was 20.2±6.8 years (2-56). Patients had a mean of 3.2±2.5 maxillary and 2.1±2.6 mandibular permanent teeth (min-max, 0-14). Patients received a mean of 8.2±3.8 implants (1-20). Most implants were placed in the third decade of life, 24.6% of the implants were placed in children (0-17 years of age). 1391 implants had information on follow-up (72 failures, 5.2%). The 20-year CSR was 84.6%. The probability of failure was 4.5% (95%CI 3.5%-5.6%, p<0.001). Additional treatments performed: Le Fort I (99 implants, 20 patients, 3.5% failed), grafting (497 implants, 77 patients, 5.2% failed), distraction osteogenesis (79 implants, 16 patients, 10.1% failed). Mean follow-up 42.9±41.9 months (min-max, 2-240). Conclusions. Dental implants placed in ED patients, either infants or adults, present a high survival rate (20-year CSR 84.6%).

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  • 3.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Nilsson, Johanna
    Thor, Andreas
    Survival and complications of implants to support craniofacial prosthesis: a systematic review2016In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 44, no 10, p. 1536-1552Article, review/survey (Refereed)
    Abstract [en]

    Objective: To assess the survival rate of craniofacial implants (CIs) to support facial prosthesis/epithesis and the prevalence of surgical/biological complications based on previously published studies. Methods: An electronic search was undertaken in March/2016. Only studies with a minimum of 5 patients were included. Untransformed proportions of implant failures for different regions were calculated. A meta-analysis evaluated the influence of radiotherapy on the failure rates. A meta-regression was performed considering the follow-up period as covariate. Results: Seventy publications included 2355 patients and 8184 CIs (545 failures). The probability of a failure was 5.5% for all CIs (95%CI 4.5-6.5, P<0.001), 1.2% for CIs in the auricular region (95%CI 0.8-1.5, P<0.001), 12.2% for the nasal region (95%CI 9.0-15.5, P=0.017), and 12.1% for the orbital region (95%CI 9.3-15.0, P<0.001). Radiotherapy statistically affected the CIs rates (OR 5.80, 95%CI 3.77-8.92, P<0.00001). There was no statistically significant influence of the follow-up time on the proportion of implant failures (P=0.814). Soft tissue adverse reactions were the most common complications. Conclusions: Implants placed in the auricular region have a lower probability of failure than those in the nasal and orbital regions. Soft tissue adverse reactions were the most common complications. Radiotherapy significantly affected the CIs failure rates.

  • 4.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Santiago Gomez, Ricardo
    Calcifying epithelial odontogenic tumor: An updated analysis of 339 cases reported in the literature2017In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 45, no 8, p. 1117-1123Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to integrate the available data published on calcifying epithelial odontogenic tumors (CEOT) into a comprehensive analysis of its clinical and radiologic features. Materials and Methods: An electronic search was undertaken in May 2016. Eligibility criteria were publications having enough clinical, radiological and/or histological information to confirm definite diagnosis. Results: A total of 362 lesions were found, 339 with enough information were analyzed. Variants clear cells (n=33) and Langerhans cells (n=10) were rarely described in the literature, as well as lesions with malignant transformation (n=8). Central lesions (n=264) were more prevalent than their peripheral counterparts (n=24). A higher prevalence characterized the mandible, posterior region, and third and fourth decades. About 40% of the peripheral lesions showed signs of underlying bone erosion, and about half of the central ones showed signs of cortical bone perforation. Recurrence was found in all lesions (12.6%), peripheral lesions (18.8%), central lesions (11.6%), clear cell (10.7%), Langerhans cell (0%), and those with malignant transformation (42.9%). Excision or curettage was associated with the highest recurrence rate. None of the variables showed a statistically significant influence on the recurrence rate. Conclusions: The possible locally aggressive behavior of the lesions recommends a less conservative management than simple curettage. The clear cell variant shows similar demographic data and biological behavior compared to the non-variant lesions, suggesting that the presence of clear cells does not have an important clinical significance.

  • 5.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Santiago Gomez, Ricardo
    Cementoblastoma: an updated analysis of 258 cases reported in the literature2017In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 45, no 10, p. 1759-1766Article, review/survey (Refereed)
    Abstract [en]

    Purpose: To investigate the recurrence rate of cementoblastomas for different variables aside from the clinical/radiologic features. Methods: An electronic search was undertaken in November/2016. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm the diagnosis. Results: 141 publications (258 cementoblastomas) were included. There was an equal sex distribution. There was a high prevalence in the second/third decades of life, in the posterior regions, and in mandibular first molars. Lesions were commonly associated with bone expansion (74.9%), presence of clinical symptoms (70.2%), vital teeth (78%), root resorption (59.8%). Observations not as frequent: cortical bone perforation (16.3%), inferior displacement of the mandibular canal (23.6%). Treatment was reported for 229 cases. Twenty (11.8%) out of 170 recurred. Preservation of the involved teeth and location seem to not influence the recurrence rate, but there was a 687% higher probability (odds ratio 7.875; p=0.048) of recurrence for lesions associated with bone expansion, and a 217% higher probability (odds ratio 3.173; p=0.023) of recurrence for lesions presenting cortical bone perforation. Conclusions: Although the recurrence rate of cementoblastomas is not as high as previously believed, it is a relevant phenomenon (11.8%). The presence of bone expansion and cortical bone perforation seem to influence the recurrence rate.

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  • 6.
    Chrcanovic, Bruno
    et al.
    Malmö högskola, Faculty of Odontology (OD).
    Santiago Gomez, Ricardo
    Recurrence probability for keratocystic odontogenic tumors: An analysis of 6,427 cases2017In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 45, no 2, p. 244-251Article in journal (Refereed)
    Abstract [en]

    Purpose. To investigate and compare the probability of recurrence of keratocystic odontogenic tumors (KCOTs) for different variables and treatment protocols. Materials and Methods. An electronic search was undertaken in April 2016 that included clinical series of KCOTs reporting recurrences. Untransformed proportions and meta-analyses were performed to estimate the probability/risk of recurrence, according to several variables. Results. A total of 94 publications were included (6,427 KCOTs, 1,464 recurrences). Probability of recurrence: all lesions, 21.1%; nevoid basal cell carcinoma syndrome, 35.4%; males, 20.3%; females, 19.3%; maxilla, 15.3%; mandible, 21.5%; unilocular, 14.7%; multilocular, 24.4%; marsupialization/decompression, 28.7%; decompression+enucleation±additional therapy, 18.6%; enucleation/curettage, 22.5%; enucleation+peripheral ostectomy, 18.6%; enucleation+Carnoy’s solution, 5.3%; enucleation+cryotherapy, 20.9%; marginal/segmental resection, 2.2%. The recurrence was not statistically significantly affected by lesion location (maxilla vs. mandible, risk ratio [RR] 0.92, P=0.32) or patient’s sex (male vs. female, RR 0.94,P=0.44), but by locularity (unilocular vs. multilocular, RR 0.67, P=0.007). Recurrence risk for surgical managements: marsupialization vs. enucleation (RR 1.65,P=0.0006), marsupialization vs. resection (RR 3.17, P=0.009), enucleation alone vs. enucleation+peripheral ostectomy (RR 1.66, P=0.05), enucleation alone vs. enucleation+Carnoy’s solution (RR 1.94, P=0.03), enucleation alone vs. enucleation+cryotherapy (RR 0.88, P=0.56). Conclusions. KCOTs have a considerable rate of recurrence, which varies significantly according to some clinical, radiographic, and histopathological features, as well as surgical management.

  • 7.
    Chrcanovic, Bruno
    et al.
    Malmö University, Faculty of Odontology (OD).
    Santiago Gomez, Ricardo
    Squamous odontogenic tumor and squamous odontogenic tumor-like proliferations in odontogenic cysts: an updated analysis of 170 cases reported in the literature2018In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 46, no 3, p. 504-510Article, review/survey (Refereed)
    Abstract [en]

    Purpose. To integrate the available data published on squamous odontogenic tumors (SOT) and squamous odontogenic tumor-like proliferations in odontogenic cysts (SOT-LPOC) into a comprehensive analysis of their clinical/radiologic features. Materials and Methods. An electronic search was undertaken in January 2017. Eligibility criteria included publications having enough clinical/radiological/histological information to confirm a definite diagnosis. Results. A total of 74 publications reporting 110 SOTs (102 central, 8 peripheral) and 60 SOT-LPOC were included. Compared to SOT-LPOC, SOT showed lower mean age, no preference regarding maxilla or mandible localization, significant association with cortical bone perforation, multilocular radiographic appearance, and mobility of the tooth/teeth associated with the lesion. While 5 recurrent SOT were reported after enucleation, no recurrent SOT-LPOC was found. Conclusions. SOT shows a more aggressive biologic behavior than SOT-LPOC, which supports the hypothesis that the two lesions are distinct clinicopathological conditions.

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  • 8. Englesson-Sahlström, Lotta
    et al.
    Ekberg, EwaCarin
    Malmö högskola, Faculty of Odontology (OD).
    List, Thomas
    Malmö högskola, Faculty of Odontology (OD).
    Petersson, Arne
    Malmö högskola, Faculty of Odontology (OD).
    Eriksson, Lars
    Malmö högskola, Faculty of Odontology (OD).
    Lavage question in treatment of painful reduced mouth opening capacity2008In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 36, no Suppl 1, p. 162-163Article in journal (Other academic)
    Abstract [en]

    OBJECTIVES: To compare treatment with local anaesthetics and local anaesthetics and lavage in patients with temporomandibular joint (TMJ) pain and reduced mouth opening in a randomized controlled trial. METHODS: Forty-one women and four men (mean age 35 years) participated. All patients had had TMJ pain för more than 3 months, had reduced mouth opening capacity, and had non-reducin disc displacement confirmed by magnetic resonance imaging. The patient were randomized to treatment with extra-articular local anaesthetics alone (control) or with extra-articular local anaesthetics and lavage (treatment). All patients were examined at basline and at 1 and 3 months by an examiner blind to treatment. Successful treatment was determined as 30% or more pain reduction on a 100-mm visual analog scale (VAS). RESULTS: At baseline, mean pain intensity (VAS) on movement of the TMJ was 58 among the controls and 61 in the treatment group. At the 3-month folow-up, treatment was considered succesful in 76% of the controls and 50% of the treatment group. Mouth opening capacity without assistance was 34 mm and 33 mm at baseline and 43 mm and 38 mm after 3 months among the controls and in the treatment group, respectively. These differences between groups in median pain intesity, successful treatment outcome, and mouth opening capacity with assistance were nonsignificant. CONLUSIONS: Use of lavage to supplement extra-articular local anaesthetic treatment of painful reduced mouth opening at non-reducing discs does not appear to improve treatment outcome.

  • 9. Strbac, Georg D.
    et al.
    Giannis, Katharina
    Mittlböck, Martina
    Fuerst, Gabor
    Zechner, Werner
    Stavropoulos, Andreas
    Malmö högskola, Faculty of Odontology (OD).
    Ulm, Christian
    Survival rate of autotransplanted teeth after 5 years: A retrospective cohort study2017In: Journal of Cranio-Maxillofacial Surgery, ISSN 1010-5182, E-ISSN 1878-4119, Vol. 45, no 8, p. 1143-1149Article in journal (Refereed)
    Abstract [en]

    Background: Autotransplantation of teeth (TX) is a predictable treatment option, although this type of therapy is often overlooked compared to other types of restorations. Purpose: As current literature contains few long-term studies concerning the outcome of auto-transplanted immature molars, the aim was to evaluate results after a follow-up period of 5 years. Material and methods: This retrospective study enrolled all patients treated with immature auto-transplanted molars after a follow-up period of 5 years. In order to ensure comparable results, survival rate was investigated as well as clinical and radiological parameters. Contralateral teeth (TC) were used as controls for further assessments and for ensuring comparable future results. Results: 52 patients with 66 TX were examined. Mean age at the time of surgery was 19.64 years. Tooth survival rate after 5 years was 89.39%. The results for parameters such as PPD, BOP, mobility, dental caries, periapical pathologies and endodontic treatments showed no differences. In contrast, dental restorations (p < 0.001), occlusal contacts (p = 0.003) and sensitivity (p < 0.001) differed significantly between TX and TC. Conclusions: The current findings clearly confirm that TX is an effective alternative treatment option to fixed prosthodontic restorations and dental implants, and provides for results equivalent to those with the patients' natural teeth. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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