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  • 1.
    Liu, Chun Ching
    et al.
    Univ Zurich, Ctr Dent Med, Div Periodontol & Periimplant Dis, Clin Conservat & Prevent Dent, Zurich, Switzerland.;Univ Zurich, Ctr Dent Med, Div Periodontol & Periimplant Dis, Clin Conservat & Prevent Dent, Plattenstr 11, CH-8032 Zurich, Switzerland..
    Dixit, Neha
    Electro Med Syst SA, Dept Clin Affairs & Med Educ, Nyon, Switzerland..
    Hatz, Christian R.
    Univ Zurich, Ctr Dent Med, Div Periodontol & Periimplant Dis, Clin Conservat & Prevent Dent, Zurich, Switzerland..
    Janson, Tobias M.
    Univ Zurich, Ctr Dent Med, Div Periodontol & Periimplant Dis, Clin Conservat & Prevent Dent, Zurich, Switzerland..
    Bastendorf, Klaus-Dieter
    Dr Strafela Bastendorf Dent Practice, Eislingen, Germany..
    Belibasakis, Georgios N.
    Karolinska Inst, Dept Dent Med, Div Oral Dis, Stockholm, Sweden..
    Cosgarea, Raluca
    Univ Bonn, Dept Periodontol Cariol & Prevent Dent, Bonn, Germany..
    Karoussis, Ioannis K.
    Natl & Kapodistrian Univ Athens, Fac Dent, Dept Periodontol, Athens, Greece..
    Mensi, Magda
    Univ Brescia, Sch Dent, Dept Surg Special Radiol Sci & Publ Hlth, Sect Periodont, Brescia, Italy..
    O'Neill, Jessica
    Univ Sydney, Fac Med & Hlth, Sch Dent, Discipline Periodont, Sydney, NSW, Australia..
    Spahr, Axel
    Univ Sydney, Fac Med & Hlth, Sch Dent, Discipline Periodont, Sydney, NSW, Australia..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Schmidlin, Patrick R.
    Univ Zurich, Ctr Dent Med, Div Periodontol & Periimplant Dis, Clin Conservat & Prevent Dent, Zurich, Switzerland..
    Air powder waterjet technology using erythritol or glycine powders in periodontal or peri-implant prophylaxis and therapy: A consensus report of an expert meeting2024In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 10, no 1, article id e855Article in journal (Refereed)
    Abstract [en]

    Objectives: To attain a collective expert opinion on the use of air powder waterjet technology (APWT) with erythritol and glycine powders in the prophylaxis and therapy of periodontal and peri-implant diseases.

    Material and methods: In the first step, a modified one-round online Delphi survey including 44 five-point Likert scale questions was conducted among a group of 10 expert clinicians and researchers with thorough knowledge and experience in this topic. In the second step, the single questions and the survey results were discussed during a meeting, and consensus statements were formulated, respectively.

    Results: An agreement was reached on most items, especially opinions supporting glycine and erythritol powders as favorable with respect to efficiency, safety, and comfort. More scientific evidence is needed to support the improvement in clinical attachment on teeth and implants, especially when APWT with erythritol is used. In addition, APWT needs more long-term evaluation and studies in terms of microbiome/microbiological effects as well as effects on the inflammatory response on natural teeth and implants, also in light of a guided biofilm therapy concept.

    Conclusions: In line with the expert opinions and supported by the evidence, it was concluded that the use of APWT with erythritol and glycine powders in nonsurgical periodontal and peri-implant therapy and prophylaxis is patient compliant and efficient.

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  • 2.
    Isler, Sila Cagri
    et al.
    Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland;Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey.
    Bellon, Benjamin
    Preclinical & Translational Research, Institut Straumann AG Basel Switzerland;Department of Periodontology, Faculty of Dentistry University of Zurich Zurich Switzerland.
    Foss, Morten
    iNANO and Department of Physics and Astronomy Science and Technology Aarhus Denmark.
    Pippenger, Benjamin
    Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland;Preclinical & Translational Research, Institut Straumann AG Basel Switzerland.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland;Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry Medical University of Vienna Vienna Austria.
    Andersen, Ole Zoffmann
    Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland;Preclinical & Translational Research, Institut Straumann AG Basel Switzerland.
    Assessing the osseointegration potential of a strontium releasing nanostructured titanium oxide surface: A biomechanical study in the rabbit tibia plateau model2024In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 10, no 1Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the impact of a Ti-Sr-O technology, applied to either a turned surface or an SLA surface, on the mechanical robustness of osseointegration, benchmarked against the SLActive surface.

    Material and methods: Ti discs (6.25-mm-diameter and 2-mm-thick) with three different surfaces were inserted on the proximal-anterior part of the tibial plateau of adult Swedish loop rabbits: (I) turned surface modified with Ti-Sr-O (turned + Ti-Sr-O), (II) SLA surface modified with Ti-Sr-O (SLA + Ti-Sr-O), and (III) SLActive surface (SLActive). Following a healing period of 2 weeks and 4 weeks, the pull-out (PO) force needed to detach the discs from the bone was assessed, as a surrogate of osseointegration.

    Results: The SLActive surface exhibited statistically significant higher median PO forces, compared with the SLA + Ti-Sr-O surfaces at both 2- and 4 weeks post-op (p > .05). In this study, no single turned + Ti-Sr-O surface disk was integrated.

    Conclusions: The tested Ti-Sr-O technology failed to enhance osseointegration; however, this finding may be related to the inappropriateness of the rabbit tibia plateau model for assessing third-generation implant surface technologies, due to the limited diffusion and clearance at the disk-bone interface.

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  • 3.
    Figuero, Elena
    et al.
    Univ Complutense Madrid, Fac Dent, ETEP Etiol & Therapy Periodontal & Periimplant Di, Res Grp, Madrid, Spain..
    Gursoy, Mervi
    Univ Turku, Inst Dent, Dept Periodontol, Lemminkaisenkatu 2, Turku 20520, Finland.;Wellbeing Serv Cty Southwest Finland, Oral Hlth Care, Turku, Finland..
    Monnet-Corti, Virginie
    Aix Marseille Univ, Dept Periodontol, Marseille, France..
    Iniesta, Margarita
    Univ Complutense Madrid, Fac Dent, ETEP Etiol & Therapy Periodontal & Periimplant Di, Res Grp, Madrid, Spain..
    Antezack, Angeline
    Aix Marseille Univ, Dept Periodontol, Marseille, France..
    Kapferer-Seebacher, Ines
    Med Univ Innsbruck, Univ Hosp Conservat Dent & Periodontol, Innsbruck, Austria..
    Graetz, Christian
    Univ Kiel, Clin Conservat Dent & Periodontol, Kiel, Germany..
    Vered, Yuval
    Hebrew Univ Jerusalem, Fac Dent Med, Hadassah Med Ctr, Dept Community Dent, Jerusalem, Israel..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Wilensky, Asaf
    Hebrew Univ Jerusalem, Hadassah Med Ctr, Fac Dent Med, Dept Periodontol, Jerusalem, Israel..
    Eickholz, Peter
    Goethe Univ Frankfurt, Ctr Dent & Oral Med Carolinum, Dept Periodontol, Theodor Stern Kai 7,Haus 29, D-60596 Frankfurt, Germany..
    Sanz, Mariano
    Univ Complutense Madrid, Fac Dent, ETEP Etiol & Therapy Periodontal & Periimplant Di, Res Grp, Madrid, Spain..
    Domains, competences and learning outcomes for undergraduate education in periodontology2024In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051XArticle in journal (Refereed)
    Abstract [en]

    Aim: This review is intended to adapt the current conceptual framework in dental education based on four domains to propose a set of competences, learning outcomes and methods of teaching, learning and assessment for undergraduate education in periodontology.

    Review: Based on the current framework of competences and learning outcomes recommended by the Association for Dental Education in Europe (ADEE), undergraduate education in periodontology has been updated using the classification and clinical practice guidelines for the diagnosis and treatment of periodontal and peri-implant diseases.

    Conclusions: Specific learning outcomes have been proposed within each competence area, that is in Domain I (n = 10), Domain II (n = 13), Domain III (n = 33) and Domain IV (n = 12). Teaching methods and learning activities based on the different dimensions of the cognitive process have been proposed. Additionally, 10 key learning outcomes have been proposed as exit outcomes, which implies their accomplishment within the final assessment of any graduating student.

  • 4.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Sigmund Freud Univ Vienna, Fac Med, Dept Periodontol, Dent Clin, Vienna, Austria.
    Burisch, Johan
    Copenhagen Univ Hosp Amager & Hvidovre, Med Div, Gastrounit, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ado, Hvidovre, Denmark..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD). Karolinska Inst, Dept Dent Med, Div Oral Dis, Stockholm, Sweden..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls: The Periodontitis Prevalence in ulcerative Colitis and Crohn disease (PPCC) case-control study2024In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 95, no 2, p. 159-174Article in journal (Refereed)
    Abstract [en]

    Background: To describe the frequency and impact of oral lesions and professional dental care costs in patients with inflammatory bowel disease (IBD) (i.e., Crohn disease [CD] or ulcerative colitis [UC]) compared to matched controls).

    Methods: IBD patients and matched controls were surveyed on general anamnestic information, eating and drinking habits, and oral health- and dental care-related questions; IBD patients were additionally surveyed on oral lesions. Problems related to oral lesions and the amount of money spent for professional dental care in the past 12 months were defined as primary outcome parameters.

    Results: Answers from 1108 IBD patients and 3429 controls were analyzed. About 30% of the patients indicated having had problems with oral lesions, with CD patients having 46% higher odds and having them more often in a generalized form compared to UC patients. Further, self-reported severe periodontitis increased the odds of having oral lesions by almost 2.3-times. However, only about 12.5% of IBD patients were informed by their physician about oral lesions and about 10% indicated receiving treatment for them. Compared to controls, IBD patients required more often dental treatment and spent more money; specifically, UC and CD patients had 27 and 89% higher odds, respectively, for having spent ≥3000 DKK (ca. 440 USD) at the dentist compared to controls.

    Conclusions: IBD patients have more often oral health problems and higher expenses for professional dental care compared to matched controls. This included problems with IBD-related oral lesions, but these are rarely addressed by the medical or dental team.Keywords: Crohn disease; case-control studies; colitis; dental care; inflammatory bowel diseases; surveys and questionnaires; ulcerative.

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  • 5.
    Bertl, Kristina
    et al.
    Sigmund Freud Univ Vienna, Fac Med, Dept Periodontol, Dent Clin, Freudpl 3, A-1020 Vienna, Austria.;Blekinge Hosp, Dept Periodontol, HalsovagenByggnad 13, S-37141 Karlskrona, Sweden..
    Vlachou, Stefania
    Univ Geneva, Div Regenerat Dent Med & Periodontol, CUMD, Rue Michel Servet 1, CH-1211 Geneva 4, Switzerland..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Freiburgstr 7, CH-3010 Bern, Switzerland..
    Zampelis, Antonios
    Drottninggatan 27, S-65225 Gotene, Sweden.;Publ Dent Hlth Serv, Specialist Clin Endodont & Periodontol, Hagagatan 6, S-65220 Karlstad, Varmland, Sweden..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Blekinge Hosp, Dept Periodontol, HalsovagenByggnad 13, S-37141 Karlskrona, Sweden.; Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Sensengasse 2a, A-1090 Vienna, Austria.;Univ Bern, Sch Dent Med, Dept Periodontol, Freiburgstr 7, CH-3010 Bern, Switzerland..
    Repeated local delivery of hyaluronic acid gel as adjunctive treatment of residual pockets in periodontitis patients undergoing supportive periodontal care. A randomized controlled clinical trial2024In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 28, no 2, article id 158Article in journal (Refereed)
    Abstract [en]

    Objectives To assess the effect of hyaluronic acid (HyA) application as adjunct to re-instrumentation of residual pockets in patients undergoing regular supportive periodontal care (SPC). Methods Chronic periodontitis patients (stage III and IV, grade B and C) with 4 interproximal residual pockets were randomly assigned to the test (HyA gel) or control (saline) group. After subgingival instrumentation, test or control substance was applied subgingivally, then daily supragingivally for 3 months, and if required a second time after subgingival re-instrumentation after 3 months. Clinical and patient reported outcome parameters were recorded every 3 months for 12 months. Pocket closure [probing pocket depth (PPD) <= 4mm with absence of bleeding on probing (BoP) at PPD = 4mm] was the main outcome parameter. Results Fifty-six patients (221 experimental sites) were analysed. Pocket closure was achieved in 56.8 and 46.6% of the experimental sites in the test and control group, respectively (p > 0.05), while median PPD and PPD distribution (< 5mm/5mm/ > 5mm) differed significantly between groups in favour of the test group, at 12 months. Further, significantly fewer sites in the HyA group required re-instrumentation at 3 months, and sites in the HyA group showed a tendency for lower odds to remain diseased compared to the control group (OR 0.48, 95%CI 0.22-1.06). The odds for a site to remain diseased after 12 months increased significantly in the presence of plaque (OR 7.94, 95%CI 4.12-15.28), but in general, decreased significantly over time (OR 0.48, 95%CI 0.28-0.81). Conclusion Re-instrumentation of residual pockets in SPC patients, per se, leads to a significant increase in pocket closure over time; this was impeded by poor plaque control. Repeated local application of HyA results in fewer sites requiring re-instrumentation and might slightly improve the rate of pocket closure. (clinicaltrials.gov registration nr. NCT04792541). Clinical relevance HyA gel is easy to apply, well accepted by patients, and may have some positive effect in terms of fewer sites requiring re-instrumentation at 3 months and higher pocket closure rate at 12 months.

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  • 6.
    Madsen, G. R.
    et al.
    Copenhagen Univ Hosp Amager & Hvidovre, Gastrounit Med Sect, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ad, Hvidovre, Denmark..
    Bertl, K.
    Sigmund Freud Univ Vienna, Dent Clin, Fac Med, Vienna, Austria.;Blekinge Hosp, Dept Periodontol, Karlskrona, Sweden..
    Pandis, N.
    Univ Bern, Dept Orthodont & Dentofacial Orthoped, Sch Dent Med, Bern, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Div Conservat Dent & Periodontol, Univ Clin Dent, Vienna, Austria..
    Burisch, J.
    Copenhagen Univ Hosp Amager & Hvidovre, Gastrounit Med Sect, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ad, Hvidovre, Denmark..
    The link between periodontitis and disease activity in inflammatory bowel disease2024In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 18, no Suppl 1, p. I788-I788, article id P378Article in journal (Other academic)
  • 7.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Vienna, Austria..
    Kogelnik, Sophie Livia
    Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Vienna, Austria..
    Kukla, Edmund
    Med Univ Vienna, Univ Clin Dent, Comprehens Ctr Unit, Vienna, Austria..
    Herrmann, Harald
    Med Univ Vienna, Dept Radiat Oncol, Vienna, Austria..
    Schneider, Steffen
    Med Univ Vienna, Dept Maxillofacial Surg, Vienna, Austria..
    Altorjai, Gabriela
    Med Univ Vienna, Dept Radiat Oncol, Vienna, Austria..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    A survey on oral health-related standard of care for head and neck cancer patients in the EU2023In: Oral Diseases, ISSN 1354-523X, E-ISSN 1601-0825Article in journal (Refereed)
    Abstract [en]

    Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).

    Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.

    Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.

    Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care.

    Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.

  • 8.
    de Waal, Yvonne C. M.
    et al.
    Univ Groningen, Univ Med Ctr Groningen, Ctr Dent & Oral Hyg, Groningen, Netherlands..
    Winning, Lewis
    Trinity Coll Dublin, Dublin Dent Univ Hosp, Dublin, Ireland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Univ Clin Dent, Med Univ Vienna, Div Conservat Dent & Periodontol, Vienna, Austria..
    Polyzois, Ioannis
    Trinity Coll Dublin, Dublin Dent Univ Hosp, Dublin, Ireland..
    Efficacy of chemical approaches for implant surface decontamination in conjunction with sub-marginal instrumentation, in the non-surgical treatment of peri-implantitis: A systematic review2023In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 50, no S26, p. 212-223Article, review/survey (Refereed)
    Abstract [en]

    Aim: To answer the following PICOS question: In adult patients with peri-implantitis, what is the efficacy of sub-marginal instrumentation combined with chemical surface decontamination in comparison with sub-marginal instrumentation with or without placebo, in terms of changes in probing depth (PD) and/or bleeding on probing, as reported in prospective randomized controlled trials, non-randomized controlled trials, or prospective cohort studies, with a minimum of 6-month "follow-up".

    Materials and Methods: A systematic literature search was performed in PubMed, Web of Science, Embase, Scopus, Ovid Medline, and The Cochrane Library of the Cochrane Collaboration (CENTRAL) for articles published until March 2022. Data addressing the primary and secondary outcomes were extracted.

    Results: The search gave 2033 results of which 3 fulfilled the inclusion criteria. Two studies investigated the use of anti-microbial photodynamic therapy as adjunct to sub-marginal instrumentation and the third study assessed the adjunctive use of a desiccant material. A meta-analysis was not deemed meaningful because of the large heterogeneity among the studies. All three studies showed favourable results in terms of PD reduction for chemical surface decontamination over control approaches, but were inconsistent or showed no differences for the other outcome variables.

    Conclusions: Adjunctive chemical approaches for implant surface decontamination may offer an advantage over sub-marginal instrumentation alone, in terms of improved PD.

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  • 9.
    Edlund Johansson, Pia
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Vienna, Austria..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Efficacy of power-driven interdental cleaning tools: A systematic review and meta-analysis2023In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 9, no 1, p. 3-16Article in journal (Refereed)
    Abstract [en]

    Objectives: To summarize the available evidence on the efficacy of power-driven interdental cleaning tools (PDICTs) as an adjunct to tooth brushing compared to tooth brushing alone or tooth brushing combined with any other non-PDICT in terms of interproximal plaque and gingival bleeding reduction in gingivitis patients. Material and Methods: A systematic literature search was performed in three databases until March 20, 2022 with the following main eligibility criteria: (1) randomized controlled clinical trials (RCTs) with (2) at least 28 days of follow-up in (3) gingivitis patients. Interproximal plaque and bleeding values were defined as the primary outcome variables and used for pair-wise meta-analyses. Results: Sixteen RCTs were identified including data from 1258 participants at the final evaluation. Eight studies each investigated the effect of either a liquid-based or mechanical PDICT; one of these studies tested additionally a combined liquid-based and mechanical PDICT. Tooth brushing combined with a liquid-based PDICT compared to tooth brushing alone did not result in better interproximal plaque values but in significantly lower interproximal bleeding values. Tooth brushing combined with either a liquid-based PDICT or with a mechanical PDICT compared to tooth brushing and flossing achieved comparable interproximal plaque and bleeding values. The majority of studies reporting on patient compliance/preference favored the use of a PDICT, and except for a single study, which was reporting soft tissue trauma in two subjects from improper use of a mechanical PDICT, none of the studies reported adverse events. Conclusions: Daily use of PDICT as an adjunct to tooth brushing significantly reduces interproximal bleeding. This effect appears comparable to that of flossing, while PDICT may achieve higher patient acceptance/compliance.

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  • 10.
    Stavropoulos, Andreas
    et al.
    Malmö University, Faculty of Odontology (OD). Univ Clin Dent, Med Univ Vienna, Div Conservat Dent & Periodontol, Vienna, Austria.;Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland..
    Marcantonio, Camila Chierici
    Univ Estadual Paulista, Surg Sch Dent Araraquara, Dept Diag, Araraquara, SP, Brazil..
    de Oliveira, Vithor Xavier Resende
    Univ Fed Uberlandia, Sch Dent, Dept Periodontol Implantodontol, Uberlandia, MG, Brazil..
    Marcantonio Jr, Elcio
    Univ Estadual Paulista, Surg Sch Dent Araraquara, Dept Diag, Araraquara, SP, Brazil..
    de Oliveira, Guilherme Jose Pimentel Lopes
    Univ Fed Uberlandia, Sch Dent, Dept Periodontol Implantodontol, Uberlandia, MG, Brazil..
    Fresh-frozen allogeneic bone blocks grafts for alveolar ridge augmentation: Biological and clinical aspects2023In: Periodontology 2000, ISSN 0906-6713, E-ISSN 1600-0757, Vol. 93, no 1, p. 139-152Article, review/survey (Refereed)
    Abstract [en]

    The possibilities for oral bone regeneration procedures vary depending on the type of bone defect to be treated, which in turn dictate the type of graft to be used. Atrophic alveolar ridges are non-contained defects and pose a challenging defect morphology for bone regeneration/augmentation. Successful results are regularly obtained with the use of particulate grafts in combination with barrier membranes. In cases of very narrow ridges with need of larger amount of bone augmentation, block grafts are often used. Fresh-frozen allogeneic bone block grafts have been proposed as an alternative to autogenous (AT) bone blocks. Based on a systematic appraisal of pre-clinical in vivo studies and clinical trials including a direct comparison of fresh-frozen bone (FFB) blocks versus AT bone blocks it can be concluded that a FFB block graft: (a) cannot be considered as a reliable replacement of a AT bone block, and (b) should only be considered in cases where the amount of necessary augmentation-in a lateral direction-is relatively limited, so that the main portion of the body of the implant lies within the inner (i.e., the vital) aspect of the block.

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  • 11.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Sigmund Freud Univ Vienna, Fac Med, Dept Periodontol, Dent Clin, Vienna, Austria..
    Tsakos, Georgios
    Univ London Univ Coll, Dept Epidemiol & Publ Hlth, London, England..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Bogren, Anna
    Umeå Univ, Dept Odontol, Sect Mol Periodontol, Umeå, Sweden..
    Burisch, Johan
    Copenhagen Univ Hosp Amager Hvidovre, Med Div, Gastrounit, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ado, Hvidovre, Denmark..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Health-related quality of life aspects of the 'Periodontitis prevalence in ulcerative colitis and Crohn's disease' (PPCC) cohort2023In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 50, no 12, p. 1601-1620Article in journal (Refereed)
    Abstract [en]

    Aim: To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL. Materials and Methods: Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses. Results: Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBDspecific, health-related QoL. Conclusions: The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.

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  • 12.
    Domic, Danijel
    et al.
    Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Sensengasse 2a, A-1090 Vienna, Austria..
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Sigmund Freud Univ, Fac Med, Dept Periodontol, Dent Clin, Freud pl 3, A-1020 Vienna, Austria..
    Lang, Tobias
    Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Sensengasse 2a, A-1090 Vienna, Austria..
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Freiburg str 7, CH-3010 Bern, Switzerland..
    Ulm, Christian
    Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Sensengasse 2a, A-1090 Vienna, Austria..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Sensengasse 2a, A-1090 Vienna, Austria.;Univ Bern, Sch Dent Med, Dept Periodontol, Freiburg str 7, CH-3010 Bern, Switzerland..
    Hyaluronic acid in tooth extraction: a systematic review and meta-analysis of preclinical and clinical trials2023In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 27, no 12, p. 7209-7229Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess whether in animals or patients with ≥ 1 tooth extracted, hyaluronic acid (HyA) application results in superior healing and/or improved complication management compared to any other treatment or no treatment.

    Materials and methods: Three databases were searched until April 2022. The most relevant eligibility criteria were (1) local application of HyA as adjunct to tooth extraction or as treatment of alveolar osteitis, and (2) reporting of clinical, radiographic, histological, or patient-reported data. New bone formation and/or quality were considered main outcome parameters in preclinical studies, while pain, swelling, and trismus were defined as main outcome parameters in clinical studies.

    Results: Five preclinical and 22 clinical studies (1062 patients at final evaluation) were included. In preclinical trials, HyA was applied into the extraction socket. Although a positive effect of HyA was seen in all individual studies on bone formation, this effect was not confirmed by meta-analysis. In clinical studies, HyA was applied into the extraction socket or used as spray or mouthwash. HyA application after non-surgical extraction of normally erupted teeth may have a positive effect on soft tissue healing. Based on meta-analyses, HyA application after surgical removal of lower third molars (LM3) resulted in significant reduction in pain perception 7 days postoperatively compared to either no additional wound manipulation or the application of a placebo/carrier. Early post-operative pain, trismus, and extent of swelling were unaffected.

    Conclusions: HyA application may have a positive effect in pain reduction after LM3 removal, but not after extraction of normally erupted teeth.

    Clinical relevance: HyA application may have a positive effect in pain reduction after surgical LM3 removal, but it does not seem to have any impact on other complications or after extraction of normally erupted teeth. Furthermore, it seems not to reduce post-extraction alveolar ridge modeling, even though preclinical studies show enhanced bone formation.

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  • 13.
    Kloukos, Dimitrios
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital, Athens, Greece.
    Kalimeri, Eleni
    Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force Hospital, Athens, Greece.
    Gkourtsogianni, Sofia
    Department of Paediatric Dentistry, Athens School of Dentistry, National and Kapodistrian University of Athens, Greece.
    Kantarci, Alpdogan
    The Forsyth Institute, Cambridge, Mass.
    Katsaros, Christos
    Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Impact of fixed orthodontic appliances on blood count and high-sensitivity C-reactive protein levels: A prospective cohort study2023In: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 164, no 3, p. 351-356, article id S0889-5406(23)00107-5Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: The aim was to elucidate the magnitude of alterations in systemic blood counts in healthy patients during the first 14 days after fixed orthodontic appliance placement.

    METHODS: This prospective cohort study consecutively included 35 White Caucasian patients starting orthodontic treatment with fixed appliances. The mean age was 24.48 ± 6.68 years. All patients were physically and periodontally healthy. Blood samples were collected at 3 time points: (1) baseline (exactly before the placement of appliances), (2) 5 days after bonding, and (3) 14 days after baseline. Whole blood and erythrocyte sedimentation rates were analyzed in automated hematology and erythrocyte sedimentation rate analyzer. Serum high-sensitivity C-reactive protein levels were measured by the nephelometric method. Standardized sample handling and patient preparation procedures were adopted to reduce preanalytical variability.

    RESULTS: A total of 105 samples were analyzed. All clinical and orthodontic procedures were performed without complications or side effects during the study period. All laboratory procedures were performed per protocol. Significantly lower white blood cell counts were detected 5 days after bracket bonding, compared with baseline (P <0.05). Hemoglobin levels were lower at 14 days than baseline (P <0.05). No other significant shifts or alteration patterns were observed over time.

    CONCLUSIONS: Orthodontic fixed appliances led to a limited and transient change in white blood cell counts and hemoglobin levels during the first days after bracket placement. The fluctuation of high-sensitivity C-reactive protein levels was not significant, demonstrating a lack of association between systemic inflammation and orthodontic treatment.

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  • 14.
    Stavropoulos, Andreas
    et al.
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Sigmund Freud Univ Vienna, Fac Med, Dept Periodontol, Dent Clin, Vienna, Austria..
    Isidor, Flemming
    Aarhus Univ, Dept Dent & Oral Hlth, Sect Prosthet Dent, Aarhus, Denmark..
    Vult von Steyern, Per
    Malmö University, Faculty of Odontology (OD). Nord Inst Dent Mat, NIOM, Oslo, Norway..
    Implantoplasty and the risk of fracture of narrow implants with advanced bone loss: A laboratory study2023In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 34, no 10, p. 1038-1046Article in journal (Refereed)
    Abstract [en]

    Objectives: To assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss.

    Materials and Methods: Narrow, parallel-walled implants (3.3 mm in diameter x 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium-Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subjected to IP in their coronal 5 mm; the remaining were used as controls (seven implants per group). Dynamic loading prior to maximum load strength testing was included.

    Results: During dynamic loading, the fracture rate of BL implants was low and independent of IP, while that of TL implants increased significantly with IP compared with controls (p = .001). Maximum implant failure strength reduction (in %) due to IP, was 1.3%-25.4%; TiZr BL implants were least affected. Implants subjected to IP compared to those without IP as well as TL implants compared to BL implants showed a significantly lower maximum implant failure strength (p < .002); implant material was not significant (p = .845).

    Conclusions: Based on data from implants of one specific manufacturer, IP has a significant negative impact on the fracture strength of narrow implants suffering from advanced peri-implantitis. TL implants have been more severely affected compared to BL implants and presented an increased risk for failure during normal chewing forces. In addition, this negative impact of IP on TL implants was independent of the implant material (i.e., Ti or TiZr).

    Clinical Relevance: Narrow single TL implants with advanced horizontal bone loss (e.g., 5 mm), when subjected to IP, appear to have an increased fracture risk during normal function.

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  • 15.
    Shanbhag, Siddharth
    et al.
    Univ Bergen, Fac Med, Ctr Translat Oral Res TOR, Dept Clin Dent, N-5009 Bergen, Norway.;Haukeland Hosp, Dept Immunol & Transfus Med, N-5021 Bergen, Norway..
    Rana, Neha
    Univ Bergen, Fac Med, Ctr Translat Oral Res TOR, Dept Clin Dent, N-5009 Bergen, Norway..
    Suliman, Salwa
    Univ Bergen, Fac Med, Ctr Translat Oral Res TOR, Dept Clin Dent, N-5009 Bergen, Norway..
    Idris, Shaza Bushra
    Voss Tannspesialist Team, N-5700 Voss, Norway..
    Mustafa, Kamal
    Univ Bergen, Fac Med, Ctr Translat Oral Res TOR, Dept Clin Dent, N-5009 Bergen, Norway..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Univ Clin Dent, Med Univ Vienna, Div Conservat Dent & Periodontol, A-1090 Vienna, Austria..
    Influence of Bone Substitutes on Mesenchymal Stromal Cells in an Inflammatory Microenvironment2023In: International Journal of Molecular Sciences, ISSN 1661-6596, E-ISSN 1422-0067, Vol. 24, no 1, article id 438Article in journal (Refereed)
    Abstract [en]

    Bone regeneration is driven by mesenchymal stromal cells (MSCs) via their interactions with immune cells, such as macrophages (MPs). Bone substitutes, e.g., bi-calcium phosphates (BCPs), are commonly used to treat bone defects. However, little research has focused on MSC responses to BCPs in the context of inflammation. The objective of this study was to investigate whether BCPs influence MSC responses and MSC-MP interactions, at the gene and protein levels, in an inflammatory microenvironment. In setup A, human bone marrow MSCs combined with two different BCP granules (BCP 60/40 or BCP 20/80) were cultured with or without cytokine stimulation (IL1 beta + TNF alpha) to mimic acute inflammation. In setup B, U937 cell-line-derived MPs were introduced via transwell cocultures to setup A. Monolayer MSCs with and without cytokine stimulation served as controls. After 72 h, the expressions of genes related to osteogenesis, healing, inflammation and remodeling were assessed in the MSCs via quantitative polymerase chain reactions. Additionally, MSC-secreted cytokines related to healing, inflammation and chemotaxis were assessed via multiplex immunoassays. Overall, the results indicate that, under both inflammatory and non-inflammatory conditions, the BCP granules significantly regulated the MSC gene expressions towards a pro-healing genotype but had relatively little effect on the MSC secretory profiles. In the presence of the MPs (coculture), the BCPs positively regulated both the gene expression and cytokine secretion of the MSCs. Overall, similar trends in MSC responses were observed with BCP 60/40 and BCP 20/80. In summary, within the limits of in vitro models, these findings suggest that the presence of BCP granules at a surgical site may not necessarily have a detrimental effect on MSC-mediated wound healing, even in the event of inflammation.

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  • 16.
    Parvini, P
    et al.
    Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany.
    Buser, D
    Buser Consulting Services, Gümligen, Switzerland.
    Pippenger, B E
    Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland Department of Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland.
    Imber, J C
    Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Bellón, B
    Department of Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland.
    Jarry, C
    Department of Global Medical Education, Institut Straumann AG, Basel, Switzerland Department of Implantology, Faculdade São Leopoldo Mandic, Campinas, Brazil.
    Schwarz, F
    Department of Oral Surgery and Implantology, Carolinum, Goethe University, Frankfurt, Germany.
    Influence of loading and grafting on hard- and soft tissue healing at immediately placed implants: An experimental study in minipigs2023In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 50, no 2, p. 232-241Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To histologically evaluate the influence of i) loading and ii) grafting on osseointegration and peri-implant soft tissue healing at immediately placed, self- cutting progressive tissue- level implants (TLX) in a minipig model.

    MATERIAL & METHODS: TLX implants (n=56) were immediately placed following the extraction of the mandibular first and second premolars, bilaterally, in a total of n=14 minipigs. In each animal, the implant sites were allocated to the following four groups: 1. unloaded with simultaneous grafting using a bovine bone mineral; 2. unloaded without grafting; 3. loaded with simultaneous grafting; 4. loaded without grafting. Histomorphometrical assessments at 4 and 12 weeks (n=7 animals each) included primary (i.e. bone-to-implant contact - BIC) and secondary outcome measures (e.g. first bone-to-implant contact - fBIC, junctional epithelium length- JE, connective tissue contact length - CTC, biological width - BW = JE + CTC).

    RESULTS: At 4 weeks, mean BIC values ranged from 74.5 ± 11.6% in group 2 to 83.8 ± 13.3% in group 1, and, at 12 weeks, from 75.5% ± 7.9% in group 2 to 79.9 ± 8.6% in group 1, respectively. Multivariate linear mixed regression did not reveal any associations between BIC and implant loading or grafting at 4 and 12 weeks. At 12 weeks, significantly higher fBIC values were noted in group 2 when compared with group 1. All groups showed comparable JE, CTC and BW values.

    CONCLUSIONS: Implant loading and grafting had no major effects on osseointegration and peri-implant soft tissue healing at TLX implants.

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  • 17.
    Serino, Giovanni
    et al.
    Clinic of Periodontology, Public Dental Service, Borås, Region Västra Götaland, Sweden; Research and Development Unit, Public Dental Service, Borås, Region Västra Götaland, Sweden.
    Wada, Masahiro
    Clinic of Periodontology, Public Dental Service, Borås, Region Västra Götaland, Sweden; Research and Development Unit, Public Dental Service, Borås, Region Västra Götaland, Sweden; Department of Removable Prosthodontics and Gerodontology, Graduated School of Dentistry, Osaka University, Osaka, Japan.
    Mameno, Tomoaki
    Department of Removable Prosthodontics and Gerodontology, Graduated School of Dentistry, Osaka University, Osaka, Japan.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria; Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Radiographic bone level and soft tissue dimensional changes following explantation of implants affected by peri-implantitis: A retrospective exploratory evaluation2023In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 9, no 6, p. 945-953Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: While the dimensional alteration of alveolar bone following tooth extraction have been extensively descripted in the literature, no information is available regarding potential hard and soft tissues changes following implant explantation.

    AIM: To evaluate the radiographic bone healing and the horizontal and vertical soft tissue dimensional alterations at implant extraction alveoli, 6 months following implant explantation.

    MATERIAL AND METHODS: Data from 31 patients scheduled for extraction of one implant with persisting peri-implantitis despite treatment were analysed. Bone crest level changes and the extent of bone healing at the apical aspect of the implant socket were assessed on the radiographs prior and 6 months following explantation. Regression analyses assessed the impact of various predictors (e.g., bone crest level, presence/absence of buccal bone) on bone level changes. Fisher's exact probability test was applied to assess the difference in probability to have mucosa recession of ≥2 mm in the presence or absence of alveolar buccal bone.

    RESULTS: A vertical bone loss of 0.8 mm (standard deviation [SD] = 1.3) of the peri-implant bone crest and a gain of 0.8 mm (SD = 1.1) from the bottom of the peri-implant defect were recorded. Complete healing was noted in the intact implant extraction socket (i.e., the part of the implant not affected by peri-implantitis). A reduction of 0.4 mm (SD = 0.7) of the alveolar mucosa height was recorded in concomitant with a decrease of 0.7 mm (SD = 0.8) of the mucosa width. These alterations were more pronounced in the absence of the alveolar buccal bone.

    CONCLUSION: The results of the present explorative study indicated a decrease in the height and width of the alveolar soft and hard tissues following explantation of peri-implantitis affected implants, and these changes were more pronounced in the absence of the buccal bone wall. Nevertheless, the apical portion of the implant alveolus (the intact implant socket) tend to heal with no further bone loss.

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  • 18.
    Stähli, Alexandra
    et al.
    Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
    Párkányi, László
    Department of Periodontology, Faculty of Dentistry, University of Szeged, 6720 Tisza Lajos Körút 64, Szeged, Hungary.
    Aroca, Sofia
    Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Schwarz, Frank
    Department of Oral Surgery and Implantology, Goethe University, Theodor-Stern-Kai 7, 60596, Frankfurt, Germany.
    Sculean, Anton
    Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
    Bosshardt, Dieter D
    Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland; Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Freiburgstrasse 3, 3010, Bern, Switzerland.
    The effect of connective tissue graft or a collagen matrix on epithelial differentiation around teeth and implants: a preclinical study in minipigs2023In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 27, no 8, p. 4553-4566Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: This study aimed to histologically evaluate the healing at 8 weeks after coronally advanced flap (CAF) with either a superficial (SCTG) or deep palatal connective tissue graft (DCTG), or a collagen matrix (CM) to cover recession defects at teeth and implants.

    MATERIAL AND METHODS: One mandibular side of 6 miniature pigs received each 3 titanium implants 12 weeks after extraction. Eight weeks later, recession defects were created around implants and contralateral premolars and 4 weeks later randomly subjected to CAF + SCTG, CAF + DCTG, or CAF + CM. After 8 weeks, block biopsies were histologically analyzed.

    RESULTS: For the primary outcome, i.e., keratinization of the epithelium, all teeth and implants exhibited a keratinized epithelium with no histological differences among them also not in terms of statistically significant differences in length (SCTG 0.86 ± 0.92 mm, DCTG 1.13 ± 0.62 mm, and Cm, 1.44 ± 0.76 mm). Pocket formation was histologically seen at all teeth, around most implants with SCTG and DCTG, however not in the CM implant group. The connective tissue grafts showed hardly signs of degradation, whereas the CM was partly degraded and integrated in connective tissue. The mean gain in gingival height was similar in all experimental groups (SCTG 3.89 ± 0.80 mm, DCTG 4.01 ± 1.40 mm, CM 4.21 ± 0.64 mm). Statistically significant differences were found in the height of the junctional epithelium between the control teeth and the connective tissue groups (p = 0.009 and 0.044).

    CONCLUSIONS: In this animal model, the use of either a superficial or deep connective tissue graft or a collagen membrane did not seem to have any impact on the epithelial keratinization around both teeth and implants. All procedures (CAF + SCTG/DCTG/CM) resulted in a long JE that was even longer at implants.

    CLINICAL RELEVANCE: Deep/superficial palatal connective tissue graft yielded similar keratinization around teeth/implants. Given the absence of pocket formation and inflammatory processes at implants when using a CM, CAF + CM might bear potential clinical benefits.

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  • 19.
    Madsen, Gorm Roager
    et al.
    Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ad, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Med Div, Gastrounit, Kettegaard Allee 30, DK-2650 Hvidovre, Denmark..
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Pandis, Nikolaos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria.
    Burisch, Johan
    Copenhagen Univ Hosp Amager & Hvidovre, Copenhagen Ctr Inflammatory Bowel Dis Children Ad, Hvidovre, Denmark.;Copenhagen Univ Hosp Amager & Hvidovre, Med Div, Gastrounit, Kettegaard Allee 30, DK-2650 Hvidovre, Denmark..
    The Impact of Periodontitis on Inflammatory Bowel Disease Activity2023In: Inflammatory Bowel Diseases, ISSN 1078-0998, E-ISSN 1536-4844, Vol. 29, no 3, p. 396-404Article in journal (Refereed)
    Abstract [en]

    Background Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarly complex pathogeneses that involve an interplay between dysbiotic microbiota and dysregulated immune-inflammatory responses. However, whether the presence of periodontitis is associated with IBD activity and/or its severity remains unknown. Methods An online, questionnaire-based study was answered by 1093 patients with IBD, comprising 527 patients with Crohn's disease and 566 patients with ulcerative colitis. The survey included questions on social demographics; oral health, including the Periodontal Screening Score (PESS); and IBD-related characteristics, including validated disease indices. Results Irrespective of disease subtype, patients with a reduced number of teeth and those with self-reported severe periodontitis scored significantly higher on the IBD disability index (number of teeth: coefficient, 4.93 [95% confidence interval {CI}, 1.21-8.66; P = .010]; periodontitis: coefficient, 3.54 [95% CI, 0.27-6.80; P = .034]) and reported increased disease activity in the preceding 12 months (number of teeth: odds ratio [OR], 1.91 [95% CI, 1.36-2.69; P < .001]; periodontitis: OR, 1.71 [95% CI, 1.27-2.31; P < .001]). There was also evidence of a weak association between self-reported severe periodontitis and current disease activity (OR, 1.33; 95% CI, 0.95-1.86; P = .099). However, IBD severity, as a composite parameter of a history of surgery due to IBD and/or treatment with biological therapy, was not associated with possessing a reduced number of teeth (OR, 1.18; 95% CI, 0.77-1.80; P = .451), nor with self-reported severe periodontitis (OR, 1.15; 95% CI, 0.79-1.66; P = .467). Conclusions Periodontitis and tooth loss were significantly associated with increased IBD-related disability and more disease activity in the preceding 12 months. Our results suggest that greater attention should be paid to IBD patients' oral health. Lay Summary In this questionnaire-based study among 1093 patients with inflammatory bowel disease (IBD), we demonstrated a significant association between the presence of periodontitis and more IBD disease activity in the last 12 months, as well as increased IBD disability.

  • 20.
    Stavropoulos, Andreas
    et al.
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria; Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
    Bellon, Benjamin
    Department of Periodontology, Faculty of Dentistry, University of Zurich, Zurich, Switzerland; Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland.
    Pipenger, Benjamin
    Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland.
    Andersen, Ole Z
    Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Preclinical & Translational Research, Institut Straumann AG, Basel, Switzerland.
    Two- and three-piece implants to boost data generation in preclinical in vivo research: A short technical report2023In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 9, no 6, p. 1004-1008Article in journal (Refereed)
    Abstract [en]

    The purpose of this technical report is to present two novel experimental implant designs to boost data generation in preclinical in vivo research. Specifically, the report describes the rationale and the components of (1) a two-piece experimental implant suitable for a small animal platform (e.g., the rabbit femur/tibial epiphysis model), consisting of a threaded apical- and a coronal cylindrical piece, which is intended for collecting two types of biomechanical data, and (2) a three-piece experimental implant suitable for a large animal platform (e.g., the mini-pig mandible model), consisting of an apical "wound chamber", which allows the collection of histological/histomorphometrical data, and a middle threaded and coronal cylindrical piece, which also allow the collection of two types of biomechanical data. The increased volume of information generated from a single experiment in a small animal platform, using the proposed two-piece implant design, may assist in a more qualified decision-making process, on whether it is relevant to proceed to further assessment using a large animal platform. Furthermore, the increased volume of information generated in a single animal experiment either in a small or large animal platform, using the proposed two- and three-piece implants, respectively, likely decreases the number of animals otherwise needed for collecting the same information with standard one-piece implants and, thus, contributes to the reduction/refinement elements of the 3R principle.

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  • 21.
    Gardelis, Panagiotis
    et al.
    Univ Geneva, Univ Clin Dent Med, Div Regenerat Dent Med & Periodontol, 1 Rue Michel Servet, CH-1211 Geneva 4, Switzerland..
    Zekeridou, Alkisti
    Univ Geneva, Univ Clin Dent Med, Div Regenerat Dent Med & Periodontol, 1 Rue Michel Servet, CH-1211 Geneva 4, Switzerland..
    Suh, Noemie
    Univ Hosp Geneva, Dept Acute Med, Intens Care Unit, Geneva, Switzerland..
    Le Terrier, Christophe
    Univ Hosp Geneva, Dept Acute Med, Intens Care Unit, Geneva, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria..
    Giannopoulou, Catherine
    Univ Geneva, Univ Clin Dent Med, Div Regenerat Dent Med & Periodontol, 1 Rue Michel Servet, CH-1211 Geneva 4, Switzerland..
    A pilot clinical and radiographic study on the association between periodontitis and serious COVID-19 infection2022In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 5, p. 1021-1027Article in journal (Refereed)
    Abstract [en]

    Background: During the pandemic of COVID-19, the scientific community tried to identify the risk factors that aggravate the viral infection. Oral health and specifically periodontitis have been shown to have a significant impact on overall health. Current, yet limited, evidence suggests a link between periodontal status and severity of COVID-19 infection. Objectives: The present pilot study aimed to assess whether younger patients (560 years) that have been hospitalized in the intensive care unit (ICU) for severe COVID-19 infection were susceptible to severe periodontitis. Material and Methods: All dentate patients <= 60 years of age diagnosed with COVID-19 and surviving hospitalization in the ICU were considered for inclusion. Susceptibility to periodontitis was determined by assessing radiographic bone loss (RBL) in recent dental radiographs (posterior bitewings, periapical, and panoramic X-rays). RBL in % was obtained from the most affected tooth and patients were classified into: Stage I, RBL 15%; Stage II, RBL 15%-33% and Stage III/IV, RBL >= 33%. The grade was defined using the RBL to age ratio on the most severely affected tooth. Patients were attributed to: Grade A, ratio <0.25; Grade B, ratio 0.25-1 and Grade C, ratio >1. Patients classified into Stage III/IV and Grade C were considered highly susceptible to periodontitis. Results: Of 87 eligible patients, 30 patients were finally assessed radiographically and/or clinically; from the remaining 57 patients, 16 refused participation for various reasons and 41 could not be reached. Based on the radiographic assessment, all patients were periodontally compromised. Half of them were classified with Stage III/IV and Grade B or C; 26.7% were classified with Stage III/IV and Grade C. Conclusions: The present pilot study showed that about half of the patients suffering from severe forms of COVID-19 infection in need of ICU admission suffered also from severe periodontitis, and about one-fourth of them were highly susceptible to it.

  • 22.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Vienna, Austria.
    Al-Hotheiry, Mehdi
    Malmö University, Faculty of Odontology (OD).
    Sun, David
    Malmö University, Faculty of Odontology (OD).
    Olofsson, John
    Malmö University, Faculty of Odontology (OD).
    Lettner, Stefan
    Karl Donath Laboratory for Hard Tissue and Biomaterial Research, Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Gotfredsen, Klaus
    Department of Oral Rehabilitation, School of Dentistry, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria; Univ Geneva, Univ Clin Dent Med CUMD, Div Regenerat Dent Med & Periodontol, Geneva, Switzerland.
    Are colored periodontal probes reliable to classify the gingival phenotype in terms of gingival thickness?2022In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 93, no 3, p. 412-422Article in journal (Refereed)
    Abstract [en]

    Background: This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT).

    Methods: Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed.

    Results: GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 88% of the cases being ≤1mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤1mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively.

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  • 23.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Geissberger, Chiarra
    Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland..
    Zinndorf, David
    Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland..
    Edlund Johansson, Pia
    Malmö University, Faculty of Odontology (OD).
    Al-Shammari, Hatem
    Malmö University, Faculty of Odontology (OD).
    Eick, Sigrun
    Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 1903-1913Article in journal (Refereed)
    Abstract [en]

    Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19-56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU.

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  • 24.
    Kloukos, Dimitrios
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland; Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.
    Mavrogonatou, Eleni
    Laboratory of Cell Proliferation and Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research “Demokritos”, Athens, Greece.
    Kletsas, Dimitris
    Laboratory of Cell Proliferation and Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research “Demokritos”, Athens, Greece.
    Makras, Polyzois
    Department of Endocrinology and Diabetes, 251 Hellenic Air Force & VA General Hospital, Athens, Greece; Department of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.
    Koukos, George
    Department of Periodontology, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Katsaros, Christos
    Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.
    Bone turnover markers in gingival crevicular fluid and blood serum of patients with fixed orthodontic appliances2022In: European Journal of Orthodontics, ISSN 0141-5387, E-ISSN 1460-2210, Vol. 44, no 4, article id cjab077Article in journal (Refereed)
    Abstract [en]

    AIM: Bone remodelling can be followed through the bone turnover markers (BTMs). Aim of the present study was to record the fluctuation of an osteoclastic and an osteoblastic BTM [C-terminal telopeptide of type I collagen (CTX) and N-terminal pro-peptide of type I pro-collagen (PINP), respectively] in both the gingival crevicular fluid (GCF) and the serum of orthodontic patients before and after the initial application of orthodontic forces.

    MATERIALS AND METHODS: Twenty-one Caucasian patients were prospectively evaluated. GCF and blood samples were collected in order to measure the selected biomarkers by ELISA at three time-points: exactly before, 5 days, and 14 days after bonding of the appliances. Standardized sample handling and patient preparation procedures were adopted in order to reduce pre-analytical variability.

    RESULTS: GCF and serum CTX levels were found to be independent of age, although higher in the serum of female subjects. PINP levels were found higher in the serum of patients ≥25 years old, as well as in the GCF of males. A positive correlation between serum and GCF baseline PINP levels was observed.

    LIMITATIONS: The effect of orthodontic treatment on bone remodelling might not be absolutely representative of the local bone microenvironment as the levels of the specific BTMs where measured within the GCF of the lower front teeth.

    CONCLUSIONS: This is the first time PINP and CTX have been evaluated in the GCF and serum of orthodontic patients with fixed appliances. No statistically significant alterations of CTX and PINP levels in the GCF and the serum of patients were recorded over time during the initial stages of orthodontic treatment.

  • 25.
    Gotfredsen, Klaus
    et al.
    Univ Copenhagen, Fac Hlth Sci, Dept Odontol, Sect Oral Rehabil, Copenhagen, Denmark..
    Rimborg, Susie
    Copenhagen Univ Lib, Copenhagen Univ, Fac Lib Nat & Hlth Sci, Copenhagen, Denmark..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Univ Geneva, Univ Clin Dent Med CUMD, Div Regenerat Dent Med & Periodontol, Geneva, Switzerland..
    Efficacy and risks of removable partial prosthesis in periodontitis patients: A systematic review2022In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 49, no 24, p. 167-181Article in journal (Refereed)
    Abstract [en]

    Aim The aim of this systematic review was to answer the following focused question: "In partially edentulous patients with periodontitis, are removable dental prostheses (RDPs) more efficacious than no prosthetic treatment, treatment to a shortened dental arch (SDA), or tooth-supported fixed dental prostheses (FDPs)?" Materials and methods A systematic literature search was performed electronically for the period 1966-2020. Two authors independently assessed the studies for eligibility according to the PRISMA guidelines. Risk assessment was performed using RoB 2.0 and the Newcastle-Ottawa Scale. Results Two retrospective studies indicated that RDPs increased the risk of tooth loss compared to FDPs in patients with a history of periodontitis. Prospective studies found that RDPs could be maintained without any significant periodontal destruction on a long-term basis. Owing to the heterogeneity of the data, no meta-analysis could be performed. Several studies indicated that RDP increased plaque accumulation. RDPs had only a limited effect on masticatory efficiency and nutritional status. RDPs may improve oral-health-related quality of life (OHRQoL), but to a lesser extent compared with that of patients treated to an SDA. Conclusions There is no strong evidence that RDPs per se will cause periodontal destruction including tooth loss. RDPs do not inevitably improve masticatory efficiency but improve OHRQoL, although less than for patients treated with FDPs including resin-bonded FDPs.

  • 26.
    Ulm, Christian
    et al.
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Strbac, Georg D
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Esfandeyari, Azadeh
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Dobsak, Toni
    Core Facility Hard Tissue and Biomaterial Research, Karl Donath Laboratory, School of Dentistry, Medical University of Vienna, Austria.
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Improved Access to the Bone Marrow Space by Multiple Perforations of the Alveolar Bundle Bone after Tooth Extraction: A case report2022In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 1, p. 3-8Article in journal (Refereed)
    Abstract [en]

    Objectives. The dental alveolus is lined by a thin cortical layer (“bundle bone”, “alveolar bone proper”, “cribriform plate”, “lamina dura”), that can impede access to the bone marrow and its vasculature. During unassisted socket healing, the alveolar bundle bone is gradually resorbed allowing tissue resources from the bone marrow to enter into the socket space. An optimized wound healing process, either during unassisted socket healing or during ridge preservation procedures, with autogenous bone and/or any bone/collagen substitute material, depends at least partly on an adequate vascularization of the socket space. This ensures sufficient recruitment of osteoblast and osteoclast precursor cells and facilitates fast bone regeneration and/or uneventful integration of the augmentation material.

    Methods. The present technical note describes an easy treatment step after tooth extraction aiming to improve socket healing with or without any ridge preservation procedure, by facilitating an increased blood inflow into the dental alveolus. Specifically, after tooth extraction the alveolar bundle bone is perforated several times – mainly in a palatally/lingually – by a small round bur (diameter < 1 mm) extending into the trabecular bone.

    Results and conclusions. By means of this relatively simple treatment step, an increased blood inflow into the alveolus is achieved after tooth extraction, which might enhance socket healing and corticalization of the entrance, and in turn result in a lower complication rate (e.g., dry socket), in an enhanced graft incorporation, and/or in a reduced loss of alveolar ridge volume.

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  • 27.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Savvidis, Philippe
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Kukla, Edmund Benjamin
    Comprehensive Center Unit, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Schneider, Steffen
    Department of Cranio-, Macillofacial and Oral Surgery, Medical University of Vienna.
    Zauza, Konstantin
    Comprehensive Center Unit, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Bruckmann, Corinna
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status2022In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 26, p. 2937-2948Article in journal (Refereed)
    Abstract [en]

    Objective

    To assess in a cross-sectional study the impact of including dental professionals in the multidisciplinary treatment team of head and neck squamous cell carcinoma (HNSCC) patients on the long-term oral health status.

    Materials and methods

    Oral health status, dental care behaviours, and oral health-related quality of life were assessed based on a clinical and radiographic examination, interview, and medical records in patients treated for HNSCC ≥ 6 months ago. This patient group (‘cohort 2’) was treated in a multidisciplinary treatment team including dental professionals and compared to a group of HNSCC patients previously treated at the same university, but without dental professionals included in the multidisciplinary treatment team (‘cohort 1’).

    Results

    Cohort 2 consisted of 34 patients, who had received a dental check-up and if necessary, treatment by dental profes- sionals prior to the initiation of cancer treatment. This cohort showed significantly improved oral hygiene habits and a better periodontal health status compared to cohort 1. However, cohort 2 still presented high demand for treatment due to active carious lesions; only a few, statistically insignificant improvements were detected compared to cohort 1.

    Conclusion

    Including dental professionals in the multidisciplinary treatment team of HNSCC patients has a positive impact on patient oral health status — primarily in terms of periodontal disease — 6 months and longer after finishing cancer therapy.

    Clinical relevance

    A team-based approach including dental professionals specialised in head and neck cancer improves oral health status.

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  • 28.
    Attauabi, Mohamed
    et al.
    Department of Gastroenterology and Hepatology, Herlev Hospital, Herlev, Denmark.
    Madsen, Gorm Roager
    Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, Hvidovre, Denmark.
    Bendtsen, Flemming
    Gastrounit, Medical Section, Hvidovre Hospital, Hvidovre, Denmark.
    Wewer, Anne Vibeke
    The Paediatric Department, Hvidovre Hospital, Hvidovre, Denmark.
    Wilkens, Rune
    Gastrounit, Medical Section, Hvidovre Hospital, Hvidovre, Denmark.
    Ilvemark, Johan
    Department of Gastroenterology and Hepatology, Herlev Hospital, Herlev, Denmark.
    Vladimirova, Nora
    Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen, Denmark.
    Jensen, Annette Bøjer
    Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Hvidovre, Denmark.
    Jensen, Frank Krieger
    Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Hvidovre, Denmark.
    Hansen, Sanja Bay
    Department of Radiology, Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Hvidovre, Denmark.
    Siebner, Hartwig Roman
    Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Hvidovre Hospital, Hvidovre, Denmark.
    Nielsen, Yousef Jesper Wirenfeldt
    Department of Radiology, Herlev Hospital, Herlev, Denmark.
    Møller, Jakob M
    Department of Radiology, Herlev Hospital, Herlev, Denmark.
    Thomsen, Henrik S
    Department of Radiology, Herlev Hospital, Herlev, Denmark.
    Thomsen, Simon Francis
    Department of Dermatology, Bispebjerg Hospital, Kobenhavn, Denmark.
    Ingels, Helene Andrea Sinclair
    Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital, Kobenhavn, Denmark.
    Theede, Klaus
    Gastrounit, Medical Section, Hvidovre Hospital, Hvidovre, Denmark.
    Boysen, Trine
    Gastrounit, Medical Section, Hvidovre Hospital, Hvidovre, Denmark.
    Bjerrum, Jacob T
    Department of Gastroenterology and Hepatology, Herlev Hospital, Herlev, Denmark.
    Jakobsen, Christian
    Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, Hvidovre, Denmark.
    Dorn-Rasmussen, Maria
    Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, Hvidovre, Denmark.
    Jansson, Sabine
    Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, Hvidovre, Denmark.
    Yao, Yiqiu
    Department of Dermatology, Bispebjerg Hospital, Kobenhavn, Denmark.
    Burian, Ewa Anna
    Department of Dermatology, Bispebjerg Hospital, Kobenhavn, Denmark.
    Møller, Frederik Trier
    Department of Infectious Disease Epidemiology and Prevention, Statens Serum Institut, Kobenhavn, Denmark.
    Fana, Viktoria
    Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Kobenhavn, Denmark.
    Wiell, Charlotte
    Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Kobenhavn, Denmark.
    Terslev, Lene
    Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet Glostrup, Glostrup, Denmark.
    Østergaard, Mikkel
    Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Kobenhavn, Denmark.
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Seidelin, Jakob B
    Department of Gastroenterology and Hepatology, Herlev Hospital, Herlev, Denmark.
    Burisch, Johan
    Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Hvidovre Hospital, Hvidovre, Denmark.
    Influence of Genetics, Immunity and the Microbiome on the Prognosis of Inflammatory Bowel Disease (IBD Prognosis Study): the protocol for a Copenhagen IBD Inception Cohort Study2022In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 6, p. e055779-e055779Article in journal (Refereed)
    Abstract [en]

    Introduction: Inflammatory bowel diseases (IBD), encompassing Crohn's disease and ulcerative colitis, are chronic, inflammatory diseases of the gastrointestinal tract. We have initiated a Danish population-based inception cohort study aiming to investigate the underlying mechanisms for the heterogeneous course of IBD, including need for, and response to, treatment.

    Methods and analysis: IBD Prognosis Study is a prospective, population-based inception cohort study of unselected, newly diagnosed adult, adolescent and paediatric patients with IBD within the uptake area of Hvidovre University Hospital and Herlev University Hospital, Denmark, which covers approximately 1 050 000 inhabitants (~20% of the Danish population). The diagnosis of IBD will be according to the Porto diagnostic criteria in paediatric and adolescent patients or the Copenhagen diagnostic criteria in adult patients. All patients will be followed prospectively with regular clinical examinations including ileocolonoscopies, MRI of the small intestine, validated patient-reported measures and objective examinations with intestinal ultrasound. In addition, intestinal biopsies from ileocolonoscopies, stool, rectal swabs, saliva samples, swabs of the oral cavity and blood samples will be collected systematically for the analysis of biomarkers, microbiome and genetic profiles. Environmental factors and quality of life will be assessed using questionnaires and, when available, automatic registration of purchase data. The occurrence and course of extraintestinal manifestations will be evaluated by rheumatologists, dermatologists and dentists, and assessed by MR cholangiopancreatography, MR of the spine and sacroiliac joints, ultrasonography of peripheral joints and entheses, clinical oral examination, as well as panoramic radiograph of the jaws. Fibroscans and dual-energy X-ray absorptiometry scans will be performed to monitor occurrence and course of chronic liver diseases, osteopenia and osteoporosis.

    Ethics and dissemination: This study has been approved by Ethics Committee of the Capital Region of Denmark (approval number: H-20065831). Study results will be disseminated through publication in international scientific journals and presentation at (inter)national conferences.

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  • 29.
    Kantarci, A.
    et al.
    Forsyth Institute 245 First Street Cambridge, MA 02142, USA Author links open overlay panel.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Sculean, A.
    University of Bern Freiburgstrasse 7 Bern 3010, Switzerland.
    Introduction: Vision of Regenerative Periodontology2022In: Dental Clinics of North America, ISSN 0011-8532, Vol. 66, no 1, p. xi-xiiiArticle in journal (Other academic)
  • 30.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Burisch, Johan
    Gastrounit, Medical Division, Copenhagen University Hospital ‐ Amager and Hvidovre Hvidovre Denmark;Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital ‐ Amager and Hvidovre Hvidovre Denmark.
    Pandis, Nikolaos
    Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine University of Bern Switzerland.
    Bruckmann, Corinna
    Division of Conservative Dentistry and Periodontology University Clinic of Dentistry, Medical University of Vienna Vienna Austria.
    Klinge, Björn
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Periodontitis prevalence in patients with ulcerative colitis and Crohn's disease - PPCC: a case–control study2022In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 49, no 12, p. 1262-1274Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this questionnaire-based, case-control study was to assess whether self-reported oral health and periodontitis in ulcerative colitis (UC) and Crohn's disease (CD) patients differ from that in matched controls without inflammatory bowel disease (IBD).

    Methods: A survey including questions on general anamnestic information, IBD diagnosis, and oral health was distributed online. Self-perceived overall health of teeth and gums, severe periodontitis, and tooth loss were defined as outcome parameters.

    Results: Analyses were based on answers from 1108 IBD patients and 3429 controls. IBD patients reported significantly worse oral health and more periodontal problems compared to controls. Regression analyses corrected for relevant confounders showed for UC and CD patients significantly increased odds for fair or poor self-perceived overall health of teeth and gums (OR 2.147 and 2.736, respectively) and for severe periodontitis (OR 1.739 and 2.574, respectively) compared to controls; CD patients presented additionally 91% higher odds for having <20 remaining teeth.

    Conclusions: UC and CD patients have significantly increased odds for worse self-perceived oral health and severe periodontitis compared to controls, with CD patients being more severely affected and losing more teeth. It is strongly recommended that IBD patients are kept under close surveillance to prevent periodontitis development and/or mitigate its progression.

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  • 31.
    Bruckmann, Corinna
    et al.
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Bruckmann, Lukas
    Neurosurgical Department, Klinik Landstrasse, Vienna, Austria.
    Gahleitner, André
    Department of Biomedical Imaging and Image‐Guided Therapy, Medical University of Vienna, Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Bertl, Kristina
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Pneumocephalus as result of nonsurgical peri‐implantitis treatment with an air‐polishing device for submucosal debridement: a case report2022In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 3, p. 632-639Article in journal (Refereed)
    Abstract [en]

    Background: A subcutaneous emphysema is an infrequent but potentially life‐ threatening complication after dental treatment involving instruments functioning with pressurized air. Emphysemata after the use of high‐speed handpieces and air‐ syringes are well documented, however, more recently several reports on emphysemata produced by air‐polishing devices during management of peri‐ implant biological complications have appeared. To the best of our knowledge, direct development of pneumocephalus after a dental procedure has never been reported before. Introduction of air likely contaminated with oral bacteria to the intracranial space bares the risk of developing meningitis.

    Case Presentation: This case report describes the spreading of a subcutaneous emphysema into the intracranial space (i.e., development of a pneumocephalus) after treatment of a peri‐implantitis lesion with an air‐polishing device equipped with the nozzle for submucosal debridement. A subcutaneous emphysema was noticed during the use of an air‐polishing device and the subsequent computed tomogra- phy (CT) examination revealed a quite unexpected spreading of the emphysema into the intracranial space. The patient was admitted to the hospital for close surveillance, CT follow‐up, and intravenous antibiotics to prevent the development of meningitis due to the introduction of air—likely contaminated with oral bacteria— into the intracranial space. After 3 days, the patient was discharged in good condition without any further complications.

    Conclusion: In case of an extensive subcutaneous emphysema as result of a dental procedure, a more extended radiographic examination including the mediastinal and cranial space should be considered, to assess the risk for potentially life‐threatening complications.

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  • 32.
    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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  • 33.
    Stavropoulos, Andreas
    et al.
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Sculean, Anton
    Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland.
    Kantarci, Alpdogan
    Forsyth Institute, Cambridge, USA.
    Regenerative Periodontal Therapy in Intrabony Defects and Long-Term Tooth Prognosis2022In: Dental Clinics of North America, ISSN 0011-8532, Vol. 66, no 1, p. 103-109Article in journal (Refereed)
    Abstract [en]

    Periodontal regenerative procedures, in particular combination approaches including grafting, result in significantly better clinical outcomes in intrabony defects, compared with OFD, on a medium to long term. This, in turn, translates into higher tooth retention in the long term, and therefore, periodontal regenerative/reconstructive therapy is strongly recommended for the treatment of intrabony defects.

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  • 34.
    Cosgarea, Raluca
    et al.
    Department of Periodontology, Operative and Preventive Dentistry, University of Welschnonnenstr. 17, 53125 Bonn, Bonn, Germany; Department of Periodontology and Peri-Implant Diseases, Philipps University of Marburg, Georg-Voigt. Str. 3, Marburg 35039, Germany; Department of Prosthetic Dentistry, University Iuliu Hatieganu Cluj-Napoca, Str. Clinicilor nr 32, Cluj-Napoca 400056, Romania.
    Kantarci, Alpdogan
    Forsyth Institute, 245 First Street, Cambridge, MA 02142, US.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Arweiler, Nicole
    Department of Periodontology and Peri-Implant Diseases, Philipps University of Marburg, Georg-Voigt. Str. 3, Marburg 35039, Germany.
    Sculean, Anton
    Department of Periodontology, University of Bern, Freiburgstrasse, 7, Bern CH-3010, Switzerland.
    Soft Tissue Regeneration at Natural Teeth2022In: Dental Clinics of North America, ISSN 0011-8532, Vol. 66, no 1, p. 87-101Article in journal (Refereed)
  • 35.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Austria.
    Pandis, Nikolaos
    Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine University of Bern, Switzerland.
    Stopfer, Nikolaus
    Division of Oral Surgery, University Clinic of Dentistry Medical University of Vienna, Austria.
    Haririan, Hady
    Department of Periodontology, Medical Faculty Sigmund Freud University Vienna, Austria.
    Bruckmann, Corinna
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry Medical University of Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Austria.
    The impact of a “successfully treated stable periodontitis patient status” on patient‐related outcome parameters during long‐term supportive periodontal care2022In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 49, no 2, p. 101-110Article in journal (Refereed)
    Abstract [en]

    Aim: To assess the importance of achieving a successfully treated stable periodontitis patient status (PPS) during long-term supportive periodontal care (SPC).

    Methods: This retrospective cohort study included 100 periodontitis patients, who continued for ≥ 7.5 years after active periodontal treatment with SPC and were judged as overall adherent. The effect of various predictors on 3 patient-related outcome parameters was assessed: number of 1) diseased teeth at last SPC, 2) teeth lost due to periodontitis, and 3) teeth lost due to any reason.

    Results: One fifth of the patients were classified as stable after active periodontal treatment. After a mean follow-up of 10.77 years, 24 patients lost 38 teeth due to periodontitis. An unstable PPS and a higher number of diseased teeth per patient at first SPC, and inadequate oral hygiene levels over time significantly increased the risk for a higher number of diseased teeth per patient at last SPC and for more lost teeth due to periodontitis. However, high adherence to SPC appeared to mitigate the negative effect of an unstable PPS, especially regarding tooth loss due to periodontitis. Further, tooth loss due to any reason was about 3-times higher than tooth loss due to periodontitis and was affected by a larger number of predictors.

    Conclusions: Successfully treated patients with a stable PPS maintained a low number of diseased teeth and barely lost teeth during long-term SPC compared to patients not achieving a stable PPS after active periodontal therapy.

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  • 36.
    Madsen, G. R.
    et al.
    Univ Copenhagen, Gastrounit, Hvidovre Hosp, Hvidovre, Denmark..
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Burisch, J.
    Univ Copenhagen, Gastrounit, Hvidovre Hosp, Hvidovre, Denmark..
    The impact of periodontitis on IBD disease activity2022In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 16, no S1, p. I568-I569Article in journal (Other academic)
    Abstract [en]

    Background Inflammatory bowel disease (IBD) and periodontitis are chronic, progressive, inflammatory diseases with similarities in their respective pathogenesis, which involve a complex interplay between a dysbiotic microbiota and a dysregulated immune-inflammatory response. Periodontitis has been associated with an adverse impact on other inflammatory diseases and the general health. Whether presence of periodontitis is associated with IBD disease activity is uncertain. Methods A questionnaire-based survey was conducted in Denmark. A total of 1,093 patients with IBD, i.e., 527 patients with Crohn’s disease (CD) and 566 patients with Ulcerative colitis (UC), answered the questionnaire. The survey included questions on social demographics, oral health, as well as IBD-related characteristics. Oral health was assessed by the number of teeth, the state of teeth and gums, and the Periodontal Screening Score (PESS) which is a validated instrument to screen for severe periodontitis. Disease activity in patients with UC and CD was assessed by the Simple Clinical Colitis Index (SCCAI) and the Harvey & Bradshaw’s Activity Index (HBI), respectively. Disease related disability was assessed by the Inflammatory bowel disease disability index (IBD-DI). Univariate and multivariate statistical analyses were performed to assess each variable. Results Patients with CD reported significantly fewer remaining teeth (p=0.004) and poorer state of teeth and gums (p=0.001) in comparison to patients with UC. Irrespective of IBD disease subtype, patients with a reduced number of teeth scored significantly higher on the IBD disability index (p=0.001) and reported an increased disease activity in the last 12 months (p=0.001). Patients with self-reported severe periodontitis scored significantly higher on the IBD disability index (p=0.041) and reported an increased disease activity in the last 12 months (p=0.001). For patients with UC, self-reported severe periodontitis was associated with a higher SCCAI score (p=0.031). Likewise, patients with CD who had a reduced number of teeth scored significantly higher on the HBI (p=0.017). Conclusion Periodontitis was significantly associated with increased IBD disease activity as well as increased IBD disease related disability. CD patients had significantly poorer oral health compared with UC patients. Our results highlight a need for an increased focus on oral health in patients with IBD.

  • 37.
    Yildiz, Hulya
    et al.
    Department of Periodontology, Faculty of Dentistry, Istanbul Aydın University, Istanbul, Turkey.
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry Medical University of Vienna Vienna Austria.
    Titanium implant surface roughness after different implantoplasty protocols: A laboratory study2022In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 8, no 6, p. 1315-1321Article in journal (Refereed)
    Abstract [en]

    Objective: To compare the surface roughness of sandblasted, large grit, acid‐etched (SLA) surfaced titanium discs, after implantoplasty (IP) with different combinations of rotating instruments without or with the subsequent use of a silicone polisher.

    Methods: Titanium discs (n = 12 per group) with an SLA surface were treated with the following IP protocols: (1) Tungsten carbide bur sequence from company 1 (Komet Dental) without or with polishing (P) with a silicone polisher (Brownie®), (2) tungsten carbide bur sequence from company 2 (Hager & Meisinger GmbH) without or with P, and (3) diamond bur sequence (125, 40, 15‐μm grit) without or with P. Pristine turned (T) and SLA titanium discs were used as negative and positive controls, respectively. Surface roughness measurements were taken with a contact profilometer rendering Ra and Rz values.

    Results: All IP protocols, even without P, resulted in significantly reduced surface roughness compared to the SLA group. The tungsten carbide bur protocols, even without P, resulted in a surface roughness similar to or significantly lower than that in the T group in terms of Ra and Rz, respectively. IP with the diamond bur sequence resulted in a significantly rougher surface compared to that achieved with the carbide burs. In all IP groups, P with a silicone polisher resulted in a significantly smoother surface.

    Conclusions: IP with dedicated tungsten carbide burs without or with the subsequent use of a silicone polisher resulted in a surface roughness similar to or significantly lower than that of commercially available turned surfaces. IP with a diamond bur sequence required additional polishing to achieve a comparable surface roughness to that of commercially available turned surfaces.

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  • 38.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Regenerative Dentistry and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.
    A mini review on non-augmentative surgical therapy of peri-implantitis: What is known and what are the future challenges?2021In: Frontiers in Dental Medicine (Section Periodontics), E-ISSN 2673-4915, Vol. 2, article id 659361Article in journal (Refereed)
    Abstract [en]

    Non-augmentative surgical therapy of peri-implantitis is indicated for cases with primarily horizontal bone loss or wide defects with limited potential for bone regeneration and/or re-osseointegration. This treatment approach includes a variety of different techniques (e.g., open flap debridement, resection of peri-implant mucosa, apically positioned flaps, bone re-contouring, implantoplasty, etc.) and various relevant aspects should be considered during treatment planning. The present mini review provides an overview on what is known for the following components of non-augmentative surgical treatment of peri-implantitis and on potential future research challenges: (1) decontamination of the implant surface, (2) need of implantoplasty, (3) prescription of antibiotics, and (4) extent of resective measures.

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  • 39.
    Domic, Danijel
    et al.
    Malmö University, Faculty of Odontology (OD).
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD).
    Ahmad, Salman
    Malmö University, Faculty of Odontology (OD).
    Schropp, Lars
    Aarhus University.
    Hellén-Halme, Kristina
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Accuracy of cone beam computed tomography is limited at implant sites with a thin buccal bone: A laboratory study2021In: Journal of Periodontology, ISSN 0022-3492, E-ISSN 1943-3670, Vol. 92, no 4, p. 592-601Article in journal (Refereed)
    Abstract [en]

    Background: To evaluate whether buccal bone thickness (BBT), implant diameter, and abutment/crown material influence the accuracy of cone beam computed tomography (CBCT) to determine the buccal bone level at titanium implants.

    Methods: Two implant beds (i.e., narrow and standard diameter) were prepared in each of 36 porcine bone blocks. The implant beds were positioned at a variable distance from the buccal bone surface, thus resulting in 3 BBT groups (i.e., > 0.5-1.0; > 1.0-1.5; > 1.5-2.0 mm). In half of the blocks, a buccal bone dehiscence of random extent ("depth") was created and implants were mounted with different abutment/crown material (i.e., titanium abutments with a metal-ceramic crown and zirconia abutments with an all-ceramic zirconia crown). The distance from the implant shoulder to the buccal bone crest was measured on cross-sectional CBCT images and compared to the direct measurements at the bone blocks.

    Results: While abutment/crown material and implant diameter had no effect on the detection accuracy of the buccal bone level at dental implants in CBCT scans, BBT had a significant effect. Specifically, when BBT was ≤ 1.0 mm, a dehiscence was often diagnosed although not present, i.e., the sensitivity was high (95.8%), but the specificity (12.5%) and the detection accuracy (54.2%) were low. Further, the average measurement error of the distance from the implant shoulder to the buccal bone crest was 1.6 mm.

    Conclusions: Based on the present laboratory study, BBT has a major impact on the correct diagnosis of the buccal bone level at dental titanium implants in CBCT images; in cases where the buccal bone is ≤ 1 mm thick, detection of the buccal bone level is largely inaccurate. This article is protected by copyright. All rights reserved.

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  • 40.
    Alshammari, Hatem
    et al.
    Malmö University, Faculty of Odontology (OD).
    Neilands, Jessica
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Svensäter, Gunnel
    Malmö University, Faculty of Odontology (OD). Malmö University, Biofilms Research Center for Biointerfaces.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). University of Geneva, Switzerland.
    Antimicrobial Potential of Strontium Hydroxide on Bacteria Associated with Peri-Implantitis2021In: Antibiotics, ISSN 0066-4774, E-ISSN 2079-6382, Vol. 10, no 2, article id 150Article in journal (Refereed)
    Abstract [en]

    Background: Peri-implantitis due to infection of dental implants is a common complication that may cause significant patient morbidity. In this study, we investigated the antimicrobial potential of Sr(OH)2 against different bacteria associated with peri-implantitis. Methods: The antimicrobial potential of five concentrations of Sr(OH)2 (100, 10, 1, 0.1, and 0.01 mM) was assessed with agar diffusion test, minimal inhibitory concentration (MIC), and biofilm viability assays against six bacteria commonly associated with biomaterial infections: Streptococcus mitis, Staphylococcus epidermidis, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Escherichia coli, and Fusobacterium nucleatum. Results: Zones of inhibition were only observed for, 0.01, 0.1, and 1 mM of Sr(OH)2 tested against P. gingivalis, in the agar diffusion test. Growth inhibition in planktonic cultures was achieved at 10 mM for all species tested (p < 0.001). In biofilm viability assay, 10 and 100 mM Sr(OH)2 showed potent bactericidal affect against S. mitis, S. epidermidis, A. actinomycetemcomitans, E. coli, and P. gingivalis. Conclusions: The findings of this study indicate that Sr(OH)2 has antimicrobial properties against bacteria associated with peri-implantitis. 

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  • 41.
    Alshammari, Hatem
    et al.
    Malmö University, Faculty of Odontology (OD). University of Hail, Saudi Arabia.
    Bakitian, Fahad
    Umm Al-Qura University, Saudi Arabia.
    Neilands, Jessica
    Malmö University, Faculty of Odontology (OD).
    Andersen, Ole Zoffmann
    Elos Medtech, Denmark..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). University of Geneva, Switzerland.
    Antimicrobial Properties of Strontium Functionalized Titanium Surfaces for Oral Applications, A Systematic Review2021In: Coatings, ISSN 2079-6412, Vol. 11, no 7, article id 810Article, review/survey (Refereed)
    Abstract [en]

    The aim of this systematic review was to assess the current scientific evidence of the antimicrobial potential of strontium (Sr) when used to functionalize titanium (Ti) for oral applications. Out of an initial list of 1081 potentially relevant publications identified in three electronic databases (MEDLINE via PubMed, Scopus, and Cochrane) up to 1 February 2021, nine publications based on in vitro studies met the inclusion criteria. The antimicrobial potential of Sr was investigated on different types of functionalized Ti substrates, employing different application methods. Nine studies reported on the early, i.e., 6-24 h, and two studies on the late, i.e., 7-28 days, antimicrobial effect of Sr, primarily against Staphylococcus aureus (S. aureus) and/or Escherichia coli (E. coli). Sr-modified samples demonstrated relevant early antimicrobial potential against S. aureus in three studies; only one of which presented statistical significance values, while the other two presented only the percentage of antimicrobial rate and biofilm inhibition. A relevant late biofilm inhibition potential against S. aureus of 40% and 10%-after 7 and 14 days, respectively-was reported in one study. Combining Sr with other metal ions, i.e., silver (Ag), zinc (Zn), and fluorine (F), demonstrated a significant antimicrobial effect and biofilm inhibition against both S. aureus and E. coli. Sr ion release within the first 24 h was generally low, i.e., below 50 mu g/L and 0.6 ppm; however, sustained Sr ion release for up to 30 days, while maintaining up to 90% of its original content, was also demonstrated. Thus, in most studies included herein, Sr-functionalized Ti showed a limited immediate (i.e., 24 h) antimicrobial effect, likely due to a low Sr ion release; however, with an adequate Sr ion release, a relevant antimicrobial effect, as well as a biofilm inhibition potential against S. aureus-but not E. coli-was observed at both early and late timepoints. Future studies should assess the antimicrobial potential of Ti functionalized with Sr against multispecies biofilms associated with peri-implantitis.

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  • 42.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD). Medical University of Vienna, Vienna, Austria.
    Edlund Johansson, Pia
    Malmö University, Faculty of Odontology (OD).
    Bruckmann, Corinna
    Medical University of Vienna, Vienna, Austria.
    Leonhard, Matthias
    Medical University of Vienna, Vienna, Austria.
    Davies, Julia R
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Medical University of Vienna, Vienna, Austria; University of Geneva, Geneva, Switzerland.
    Bacterial colonization of a power-driven water flosser during regular use: A proof-of-principle study2021In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 7, no 5, p. 656-663Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The present proof-of-principle study assessed whether daily use of a power-driven water flosser (Sonicare AirFloss; SAF) leads to bacterial colonization in the nozzle and/or the device, resulting in contaminated water-jet.

    MATERIAL AND METHODS: In five participants, saliva samples at baseline and water-jet samples of devices used daily with bottled water for 3 weeks (test) were collected. Additionally, water-jet samples from devices used daily with bottled water extra-orally for 3 weeks (positive control) and from brand new devices (negative control), as well as samples from newly opened and 1- and 3-week opened water bottles were collected. Colony forming units (CFU) were recorded after 48 h culturing and 20 oral pathogens were assessed by polymerase chain reaction-based analysis.

    RESULTS: Distinct inter-individual differences regarding the number of detected bacteria were observed; water-jet samples of test devices included both aerobic and anaerobic bacterial species, with some similarities to the saliva sample of the user. Water-jet samples from positive control devices showed limited number of aerobic and anaerobic bacterial species, while the samples from negative control devices did not show any bacterial species. Very few aerobic bacteria were detected only in the 3-week-old bottled water samples, while samples of newly and 1-week opened water bottles did not show any bacterial growth.

    CONCLUSIONS: The present proof-of-principle study showed that daily use of a power-driven water flosser for 3 weeks resulted in bacterial colonization in the nozzle and/or device with both aerobic and anaerobic, not only oral, species, that are transmitted via the water-jet.

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  • 43.
    Wehner, Christian
    et al.
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Durstberger, Gerlinde
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Arnhart, Christoph
    Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Rausch-Fan, Xiaohui
    Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria; Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Geneva, Switzerland.
    Characteristics and frequency distribution of bone defect configurations in peri-implantitis lesions: A series of 193 cases2021In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 23, no 2, p. 178-188Article in journal (Refereed)
    Abstract [en]

    Background:

    Knowledge on peri‐implantitis bone defect characteristics and predictors is still limited.

    Purpose:

    To describe peri‐implantitis bone defect characteristics and identify possible predictors.

    Methods:

    Various parameters at patient‐ (age, gender, smoking, and supra‐structure), implant‐ (surface, type, connection, platform, and misfit), and site level (region, alveolar ridge position, defect characteristics, neighboring structure) were recorded retrospectively.

    Results:

    Among 193 implants, the most prevalent defects were class Ic (25.4%), and Id (23.8%); a previously non‐described category “class Id with only one bone wall” was frequently observed (11.9%). Mean intrabony defect depth and width ranged from 4.5 to 6.2 mm and from 2.7 to 2.9 mm, respectively; mean dehiscence extent ranged from 2.8 to 7.0 mm. A total of 37.8% of the defects presented horizontal bone loss and an intrabony component; in 52.7% of the implants, total defect extent was >6 mm. Jaw region, implant position within the alveolar ridge, and implant/abutment misfit showed significant associations either to defect configuration and/or defect extent.

    Conclusion:

    (a) Most common peri‐implantitis defects exhibited a combination of intrabony component and a buccal/oral dehiscence, while purely circumferential defects were relatively seldom; (b) implants with defects with bone dehiscence were placed more frequently closer to the lateral aspect of the ridge harboring the dehiscence; (c) implants placed in the lower anterior region had the highest risk for more severe peri‐implant bone loss; and (d) peri‐implant bone defects with only a single bone wall appropriate for regenerative procedure were relatively frequent.

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  • 44.
    Lee, Won-Ho
    et al.
    Yonsei University College of Dentistry, Seoul, Korea.
    Kuchler, Ulrike
    Medical University of Vienna, Vienna, Austria..
    Cha, Jae-Kook
    Yonsei University College of Dentistry, Seoul, Korea.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). University of Geneva, Geneva, Switzerland.
    Lee, Jung-Seok
    Yonsei University College of Dentistry, Seoul, Korea.
    Distance of insertion points in a mattress suture from the wound margin for ideal primary closure in alveolar mucosa: an in vitro experimental study2021In: JOURNAL OF PERIODONTAL AND IMPLANT SCIENCE, ISSN 2093-2278, Vol. 51, no 3, p. 189-198Article in journal (Refereed)
    Abstract [en]

    Purpose: This study was conducted to determine how the distance of the near insertion points in a vertical mattress suture from the wound margin influences the pattern of primary closure in an in vitro experimental model. Methods: Pairs of 180 porcine gingival and alveolar mucosa samples were harvested from 90 pig jaws and fixed to a specially designed model. A vertical mattress suture was performed with the near insertion point at 3 different distances from the wound margin (1-, 3-, and 5-mm) on both the gingival and mucosal samples (6 groups; n=30 for each group). The margin discrepancy and the presence of epithelium between the wound margins were measured on histologic slides. Results: The margin discrepancy decreased significantly as the near insertion point became closer to the wound margin both in mucosal tissue (0.241 +/- 0.169 mm, 0.945 +/- 0.497 mm, and 1.306 +/- 0.773 mm for the 1-, 3-, and 5-mm groups, respectively) and in gingival tissue (0.373 +/- 0.304 mm, 0.698 +/- 0.431 mm, and 0.713 +/- 0.691 mm, respectively). The frequency of complications of wound margin adaptation reduced as the distance of the near insertion point from the wound margin decreased both in the mucosal and gingival tissues. Conclusions: Placing the near insertion point close to the wound margin enhances the precision of wound margin approximation/adaptation using a vertical mattress suture.

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  • 45.
    Bertl, Kristina
    et al.
    Malmö University, Faculty of Odontology (OD).
    Isidor, Flemming
    Section of Prosthetic Dentistry, Department of Dentistry, Aarhus University.
    Vult von Steyern, Per
    Malmö University, Faculty of Odontology (OD).
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Does implantoplasty affect the failure strength of narrow and regular diameter implants?: A laboratory study2021In: Clinical Oral Investigations, ISSN 1432-6981, E-ISSN 1436-3771, Vol. 25, p. 2203-2211Article in journal (Refereed)
    Abstract [en]

    Objective

    To assess whether the impact of implantoplasty (IP) on the maximum implant failure strength depends on implant type/design, diameter, or material.

    Methods

    Fourteen implants each of different type/design [bone (BL) and tissue level (TL)], diameter [narrow (3.3 mm) and regular (4.1 mm)], and material [titanium grade IV (Ti) and titanium-zirconium alloy (TiZr)] of one company were used. Half of the implants were subjected to IP in a computerized torn. All implants were subjected to dynamic loading prior to loading until failure to simulate regular mastication. Multiple linear regression analyses were performed with maximum implant failure strength as dependent variable and IP, implant type/design, diameter, and material as predictors.

    Results

    Implants subjected to IP and TL implants showed statistically significant reduced implant failure strength irrespective of the diameter compared with implants without IP and BL implants, respectively. Implant material had a significant impact for TL implants and for regular diameter implants, with TiZr being stronger than Ti. During dynamic loading, 1 narrow Ti TL implant without IP, 4 narrow Ti TL implants subjected to IP, and 1 narrow TiZr TL implant subjected to IP were fractured.

    Conclusion

    IP significantly reduced the maximum implant failure strength, irrespective implant type/design, diameter, or mate- rial, but the maximum implant failure strength of regular diameter implants and of narrow BL implants remained high.

    Clinical Relevance

    IP seems to have no clinically relevant impact on the majority of cases, except from those of single narrow Ti TL implants, which may have an increased risk for mechanical complications. This should be considered for peri-implantitis treatment planning (e.g., communication of potential complications to the patient), but also in the planning of implant installation (e.g., choosing TiZr instead of Ti for narrow implants).

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  • 46.
    Shanbhag, S.
    et al.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway; Department of Immunology and Transfusion Medicine, Haukeland University Hospital, Bergen, Norway.
    Kampleitner, C.
    Ludwig Boltzmann Institute for Traumatology, The Research Center in Cooperation With AUVA, Vienna, Austria; Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria.
    Mohamed-Ahmed, S.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
    Yassin, M. A.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
    Dongre, H.
    Gade Laboratory for Pathology, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Centre for Cancer Biomarkers (CCBIO), Faculty of Medicine, University of Bergen, Bergen, Norway.
    Costea, D. E.
    Gade Laboratory for Pathology, Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway; Centre for Cancer Biomarkers (CCBIO), Faculty of Medicine, University of Bergen, Bergen, Norway.
    Tangl, S.
    Karl Donath Laboratory for Hard Tissue and Biomaterial Research, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria; Austrian Cluster for Tissue Regeneration, Vienna, Austria.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria.
    Bolstad, A. I.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
    Suliman, S.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
    Mustafa, K.
    Center for Translational Oral Research (TOR), Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.
    Ectopic Bone Tissue Engineering in Mice Using Human Gingiva or Bone Marrow-Derived Stromal/Progenitor Cells in Scaffold-Hydrogel Constructs2021In: Frontiers in Bioengineering and Biotechnology, E-ISSN 2296-4185, Vol. 9, article id 783468Article in journal (Refereed)
    Abstract [en]

    Three-dimensional (3D) spheroid culture can promote the osteogenic differentiation and bone regeneration capacity of mesenchymal stromal cells (MSC). Gingiva-derived progenitor cells (GPC) represent a less invasive alternative to bone marrow MSC (BMSC) for clinical applications. The aim of this study was to test the in vivo bone forming potential of human GPC and BMSC cultured as 3D spheroids or dissociated cells (2D). 2D and 3D cells encapsulated in constructs of human platelet lysate hydrogels (HPLG) and 3D-printed poly (L-lactide-co-trimethylene carbonate) scaffolds (HPLG-PLATMC) were implanted subcutaneously in nude mice; cell-free HPLG-PLATMC constructs served as a control. Mineralization was assessed using micro-computed tomography (µCT), histology, scanning electron microscopy (SEM) and in situ hybridization (ISH). After 4–8 weeks, µCT revealed greater mineralization in 3D-BMSC vs. 2D-BMSC and 3D-GPC (p < 0.05), and a similar trend in 2D-GPC vs. 2D-BMSC (p > 0.05). After 8 weeks, greater mineralization was observed in cell-free constructs vs. all 2D- and 3D-cell groups (p < 0.05). Histology and SEM revealed an irregular but similar mineralization pattern in all groups. ISH revealed similar numbers of 2D and 3D BMSC/GPC within and/or surrounding the mineralized areas. In summary, spheroid culture promoted ectopic mineralization in constructs of BMSC, while constructs of dissociated GPC and BMSC performed similarly. The combination of HPLG and PLATMC represents a promising scaffold for bone tissue engineering applications. 

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  • 47.
    Kloukos, Dimitrios
    et al.
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland.;251 Hellen Air Force & VA Gen Hosp, Dept Orthodont & Dentofacial Orthoped, Athens, Greece..
    Kakali, Lydia
    251 Hellen Air Force & VA Gen Hosp, Dept Orthodont & Dentofacial Orthoped, Athens, Greece..
    Koukos, George
    251 Hellen Air Force & VA Gen Hosp, Dept Periodontol, Athens, Greece..
    Sculean, Anton
    Univ Bern, Sch Dent Med, Dept Periodontol, Bern, Switzerland..
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD).
    Katsaros, Christos
    Univ Bern, Sch Dent Med, Dept Orthodont & Dentofacial Orthoped, Bern, Switzerland..
    Gingival Thickness Assessment at Mandibular Incisors of Orthodontic Patients with Ultrasound and Cone-beam CT: A Cross-sectional Study2021In: Oral Health & Preventive Dentistry, ISSN 1602-1622, E-ISSN 1757-9996, Vol. 19, no 1, p. 263-270Article in journal (Refereed)
    Abstract [en]

    Purpose: To use and evaluate two methods for measuring gingival thickness (GT) at mandibular incisors of orthodontic patients and compare their performance in assessing periodontal anatomy through soft tissue thickness. Materials and Methods: The sample consisted of 40 consecutive adult orthodontic patients. GT was measured just before bracket placement at both central mandibular incisors, mid-facially on the buccal aspect, 2 mm apically to the free gingival margin with two methods: clinically with an ultrasound device (USD) and radiographically with cone beam computed tomography (CBCT). Results: CBCT measurements were consistently higher than USD measurements, with the difference ranging from 0.13 mm to 0.21 mm. No statistically significant difference was noted between the repeated CBCT measurements at the right central incisor (bias = 0.05 mm; 95% CI =-0.01, 0.11; p = 0.104). Although the respective results for the left incisor statistically indicated that the measurements were not exactly replicated, the magnitude of the point estimate was small and not clinically significant (bias = 0.06 mm; 95% CI = 0.01, 0.11; p = 0.014). Small differences between CBCT measurements made by the 2 examiners at the left central incisor (bias = 0.06 mm; 95% CI = 0.01, 0.11; p = 0.014) were detected. However, this difference was minor and also not clinically significant. The respective analysis on the right incisor showed no statistically significant difference (bias = 0.05 mm; 95% CI =-0.01, 0.11; p = 0.246). Conclusions: Based on reproducibility, CBCT imaging for gingival thickness assessment proved to be as reliable as ultrasound determination. However, CBCT consistently yielded higher values, albeit at a marginal level, than did the ultrasound device.

  • 48.
    Stavropoulos, Andreas
    et al.
    Malmö University, Faculty of Odontology (OD). University of Geneva, Switzerland; Medical University of Vienna, Austria.
    Sandgren, Rebecca
    Lund University.
    Bellon, Benjamin
    Institut Straumann, Switzerland; University of Zurich, Switzerland.
    Sculean, Anton
    University of Bern, Switzerland.
    Pippenger, Benjamin E
    Institut Straumann, Switzerland; University of Bern, Switzerland.
    Greater Osseointegration Potential with Nanostructured Surfaces on TiZr: Accelerated vs. Real-Time Ageing2021In: Materials, ISSN 1996-1944, E-ISSN 1996-1944, Vol. 14, no 7, article id 1678Article in journal (Refereed)
    Abstract [en]

    Surface chemistry and nanotopography of dental implants can have a substantial impact on osseointegration. The aim of this investigation was to evaluate the effects of surface chemistry and nanotopography on the osseointegration of titanium-zirconium (TiZr; Roxolid®) discs, using a biomechanical pull-out model in rabbits. Two discs each were placed in both the right and left tibiae of 16 rabbits. Five groups of sandblasted acid etched (SLA) discs were tested: (1) hydrophobic without nanostructures (dry/micro) (n = 13); (2) hydrophobic with nanostructures, accelerated aged (dry/nano/AA) (n = 12); (3) hydrophilic without nanostructures (wet/micro) (n = 13); (4) hydrophilic with nanostructures, accelerated aged (wet/nano/AA; SLActive®) (n = 13); (5) hydrophilic with nanostructures, real-time aged (wet/nano/RTA). The animals were sacrificed after four weeks and the biomechanical pull-out force required to remove the discs was evaluated. Adjusted mean pull-out force was greatest for group wet/nano/RTA (64.5 ± 17.7 N) and lowest for group dry/micro (33.8 ± 10.7 N). Multivariate mixed model analysis showed that the pull-out force was significantly greater for all other disc types compared to the dry/micro group. Surface chemistry and topography both had a significant effect on pull-out force (p < 0.0001 for both), but the effect of the interaction between chemistry and topography was not significant (p = 0.1056). The introduction of nanostructures on the TiZr surface significantly increases osseointegration. The introduction of hydrophilicity to the TiZr implant surface significantly increases the capacity for osseointegration, irrespective of the presence or absence of nanotopography.

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  • 49.
    Etöz, Onur
    et al.
    Malmö University, Faculty of Odontology (OD). Department of Periodontology, Gazi University, Turkey .
    Bertl, Kristina
    Malmö University, Faculty of Odontology (OD). Med Univ Vienna, Univ Clin Dent, Div Oral Surg, Vienna, Austria.
    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). Med Univ Vienna, Univ Clin Dent, Div Conservat Dent & Periodontol, Vienna, Austria; Univ Geneva, Univ Clin Dent Med CUMD, Div Regenerat Dent & Periodontol, Geneva, Switzerland.
    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.

  • 50.
    Danz, Jan C.
    et al.
    University of Bern, Bern, Switzerland.
    Kantarci, Alpdogan
    The Forsyth Institute, Cambridge, MA, United States.
    Bornstein, Michael M.
    University of Basel, Basel, Switzerland.
    Katsaros, Christos
    University of Bern, Bern, Switzerland.
    Stavropoulos, Andreas
    Malmö University, Faculty of Odontology (OD). University of Geneva, Geneva, Switzerland.
    Impact of Orthodontic Forces on Plasma Levels of Markers of Bone Turnover and Inflammation in a Rat Model of Buccal Expansion2021In: Frontiers in Physiology, E-ISSN 1664-042X, Vol. 12, article id 637606Article in journal (Refereed)
    Abstract [en]

    Plasma levels of protein analytes might be markers to predict and monitor the kinetics of bone and tissue remodeling, including maximization of orthodontic treatment stability. They could help predict/prevent and/or diagnose possible adverse effects such as bone dehiscences, gingival recession, or root resorption. The objective of this study was to measure plasma levels of markers of bone turnover and inflammation during orthodontic force application in a rat model of orthodontic expansion. Two different orthodontic forces for bilateral buccal expansion of the maxillary arches around second and third molars were applied in 10 rats equally distributed in low-force (LF) or conventional force (CF) groups. Four rats served as the control group. Blood samples were collected at days 0, 1, 2, 3, 6, 13, 21, and 58. Longitudinal concentrations of osteoprotegerin (OPG), soluble receptor activator of nuclear factor kappaB ligand (sRANKL), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor alpha (TNF), and parathyroid hormone (PTH) were determined in blood samples by a multiplex immunoassay. CF and LF resulted in a significantly maxillary skeletal expansion while the CF group demonstrated significantly higher expansion than the LF group in the long term. Bone turnover demonstrated a two-phase response. During the "early phase" (up to 6 days of force application), LF resulted in more sRANKL expression and increased sRANKL/OPG ratio than the CF and control animals. There was a parallel increase in PTH levels in the early phase in response to LF. During the "late phase" (6-58 days), the markers of bone turnover were stable in both groups. IL-4, IL-6, and IL-10 levels did not significantly change the test groups throughout the study. These results suggest that maxillary expansion in response to different orthodontic forces follows different phases of bone turnover that may be force specific.

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