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  • 1.
    Starch-Jensen, Thomas
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.;Aalborg Univ, Fac Med, Dept Clin Med, Aalborg, Denmark..
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Bruun, Niels Henrik
    Aalborg Univ Hosp, Unit Clin Biostat, Aalborg, Denmark..
    Becktor, Jonas Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Maxillary sinus floor augmentation with autogenous bone graft compared with composite grafts: A one-year single-blinded randomized controlled trial2024Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: The objective was to assess the one year implant treatment outcome and patient-related outcome measures (PROMs) following maxillary sinus floor augmentation (MSFA) with autogenous bone graft (ABG) from the zygomatic buttress (control) compared with 1:1 mixture of ABG and anorganic porcine bone mineral (APBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Materials and Methods: Sixty healthy patients (34 females, 26 males) were randomly allocated to either control or test groups. Outcome measures included survival of suprastructures and implants, implant stability quotient, health status of peri-implant tissue, peri-implant marginal bone loss, frequency of complications, and PROMs using Oral Health Impact Profile-14 combined with questionnaire assessing patient perception of peri-implant soft tissue, prosthetic solution, implant function, and implant treatment outcome using visual analogue scale. Mean differences were expressed with standard deviation and 95% confidence interval. Level of significance was .05. Results: All suprastructures and implants were well-functioning after one year of functional implant loading. There was no significant difference between control and test groups in any of the applied outcome measures. The implant stability significantly increased from implant placement to abutment connection within all groups (p < .001). High patient satisfaction and significant improvement in oral health-related quality of life was also reported within all groups. Conclusion: This study demonstrates that MSFA with composite grafts containing minimal amounts of ABG reveals comparable implant treatment outcomes as compared with ABG alone, after one year of functional implant loading. Extensive ABG harvesting in conjunction with MSFA therefore seems not to be needed.

  • 2.
    Stocchero, Michele
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Kyushu Univ, Fac Dent Sci, Div Oral Rehabil, Sect Implant & Rehabilitat Dent, Fukuoka, Japan..
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Galli, Silvia
    Malmö universitet, Odontologiska fakulteten (OD).
    Papia, Evaggelia
    Malmö universitet, Odontologiska fakulteten (OD).
    Herath, Manjula
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Effect of Drilling Preparation on Immediately Loaded Implants: An In Vivo Study in Sheep2023Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 38, nr 3, s. 607-618Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To determine the biologic and biomechanical effects of two implant drilling protocols on the cortical bone around implants subjected to immediate loading. Materials and Methods: A total of 48 implants were inserted into the mandibles of six sheep following one of two drilling protocols: undersized preparation (US; n = 24) and nonundersized preparation (NUS; n = 24). Immediately after implant insertion, an abutment was placed on each implant and 36 implants were subjected to 10 sessions of dynamic vertical loads (1,500 cycles, 1 Hz) of 25 N or 50 N. Insertion torque value (ITV) was recorded at implant installation. Resonance frequency analysis (RFA) was measured at implant insertion and at each loading session. Fluorochrome was administered at day 17, and the animals were euthanized after 5 weeks. The removal torque values (RTVs) were measured, and samples underwent histomorphometric, mu CT (microcomputed tomography), and fluorescence image acquisition analyses. The bone volume density (BV/TV), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and fluorochrome stained bone surface (MS) were calculated. A linear mixed model analysis was performed, and Pearson paired correlation was calculated. Results: Five implants from the NUS group failed, with a mean ITV of 8.8 Ncm and an RFA value of 57. The mean ITVs for US group and NUS group were 80.5 (+/- 14) Ncm and 45.9 (+/- 25) Ncm, respectively (P < .001). No differences were noted in the RFA values from the time of implant insertion until the end of the study. No differences in RTV, BV/TV, BAFO, or MS were observed between the groups. Intense new bone formation took place in the NUS group implants that were subjected to load. Conclusions: Undersized preparation of cortical bone ensured a greater BIC compared to a nonundersized preparation. Moreover, this study demonstrated that immediate loading did not interfere with the osseointegration process, but loading induced intense new bone formation in the NUS group. It is not recommended to immediately load the implants when the clinically perceived primary stability is lower than an ITV of 10 Ncm and an RFA value of 60.

  • 3.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dentistry, Kyushu University, Fukuoka, Japan.
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Papia, Evaggelia
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Impact of salivary contamination during implant placement with different surface characteristics in native and augmented bone: An in vivo study in sheep calvaria model2023Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 34, nr 3, s. 254-262Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: The aim of this study was to evaluate whether salivary contamination during placement of implants with different surface characteristics affects osseointegration in native and in augmented bone areas.

    MATERIALS AND METHODS: Forty eight implants with machined surface (MS) and 48 implants with moderately rough surface (RS) were tested in the calvaria of 12 sheep. At the first surgery, 64 bony critical defects were randomly created and were subsequently augmented with two materials (autogenous or bovine bone). After 5 weeks of graft healing, 8 implants were placed per sheep, in native bone and in the centre of the augmented defects. Forty eight implants were soaked with saliva before placement (contaminated group [CG]), while 48 implants were not (non-contaminated group [NCG]). Five weeks after implant placement, bone-to-implant contact (BIC) and bone material area fraction occupancy (BMAFO) were calculated histomorphometrically.

    RESULTS: Saliva contamination showed a significant negative effect (p = .000) on BIC, especially in augmented areas. RS showed significant positive effect on BIC, compared to MS (p = .000), while there were no significant differences for different bone conditions (p = .103). For BMAFO, the contamination showed a significantly negative affect (p = .000), while there were no significant differences for surface characteristics (p = .322) and for bone condition (p = .538).

    CONCLUSION: Saliva contamination during dental implant placement has a negative effect on osseointegration in augmented areas. Moderately rough surface has a possible advantage in the aspect of initial bone to implant contact. However, it seems to be advisable to avoid saliva contamination especially for implants placed in augmented bone areas.

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  • 4.
    Momand, Palwasha
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Naimi-Akbar, Aron
    Malmö universitet, Odontologiska fakulteten (OD).
    Tobin, Gunnar
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Pharmacol, Gothenburg, Sweden..
    Götrick, Bengt
    Malmö universitet, Odontologiska fakulteten (OD).
    Effect of antibiotic prophylaxis in dental implant surgery: A multicenter placebo-controlled double-blinded randomized clinical trial2022Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, nr 1, s. 116-124Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The growing resistance of bacteria to antimicrobial medicines is a global issue and a direct threat to human health. Despite this, antibiotic prophylaxis is often still routinely used in dental implant surgery to prevent bacterial infection and early implant failure, despite unclear benefits. There is a lack of sufficient evidence to formulate clear clinical guidelines and therefore there is a need for well-designed, large-scale randomized controlled trials to determine the effect of antibiotic prophylaxis. Purpose To compare the effect of a presurgical antibiotic regimen with an identical placebo regimen in healthy or relatively healthy patients receiving dental implants. Materials and Methods The 474 patients participating in the study were recruited from seven clinics in southern Sweden. We randomized the patients into a test and a placebo group; the study was conducted double-blinded. Preoperatively, the test group received 2 g of amoxicillin and the control group, identical placebo tablets. The primary outcome was implant failure; secondary outcomes were postoperative infections and adverse events. Patients were evaluated at two follow-ups: at 7-14 days and at 3-6 months. Results Postoperative evaluations of the antibiotic (n = 238) and the placebo (n = 235) groups noted implant failures (antibiotic group: six patients, 2.5% and placebo group: seven patients, 3.0%) and postoperative infections (antibiotic group: two patients, 0.8% and placebo group: five patients, 2.1%). No patient reported any adverse events. Between-group differences in implant failures and postoperative infections were nonsignificant. Conclusion Antibiotic prophylaxis in conjunction with implant placement is likely of small benefit and should thus be avoided in most cases, especially given the unabated growth in antibiotic-resistant bacteria. Clinical trial registration number: NCT03412305.

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  • 5.
    Toia, Marco
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Galli, Silvia
    Malmö universitet, Odontologiska fakulteten (OD).
    Papia, Evaggelia
    Malmö universitet, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    University of Gothenburg.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    The use of implant-level connection in screw-retained fixed partial dentures: A 3-year randomised clinical trial.2022Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, nr 1, s. 78-93Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: This randomised controlled trial compares the 3-year outcomes, that is, marginal bone-level (MBL) changes and clinical parameters, between an abutment-level (AL) and implant-level (IL) connection for implants with an internal conical connection (ICC) supporting a screw-retained fixed partial denture.

    MATERIAL AND METHODS: Fifty patients with 119 implants were randomly allocated to either the AL or IL group. Radiographic and clinical examinations were performed after one, two, and 3 years. A linear mixed model was used to evaluate the differences between groups.

    RESULTS: The MBL change was not significantly different between the groups at any point. The MBL was 0.12 ± 0.31 mm (AL) and 0.23 ± 0.26 mm (IL) after 1 year; 0.15 ± 0.34 mm (AL) and 0.17 ± 0.22 mm (IL) after 2 years; 0.18 ± 0.39 mm (AL) and 0.15 ± 0.21 mm (IL) after 3 years. The bleeding on probing was 43.44 ± 39.24% (AL) and 58.19 ± 41.20% (IL) after 1 year; 35.78 ± 39.22% (AL) and 50.43 ± 41.49% (IL) after 2 years; 51.27 ± 44.63% (AL) and 49.57 ± 37.31% (IL) after 3 years and was significantly different (p = .025) between 1 and 2 years. The probing depth showed a significant difference at each time point while the plaque was not significant between the groups. The overall technical, biological and prosthetic complication rates were 5.04%, 3.36%, and 16.00%, respectively.

    CONCLUSIONS: The MBL change was similar in the groups. The slight differences in the soft tissue complications between the groups are likely not of clinical relevance. An IL connection is considered to be a valid alternative to an AL set-up in ICC implants.

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  • 6.
    Klinge, Anna
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Al-Okshi, Ayman
    Malmö universitet, Odontologiska fakulteten (OD). Department of Oral Medicine and Radiology, Sebha University, Sebha, Libyan Arab Jamahiriya.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Lindh, Christina
    Malmö universitet, Odontologiska fakulteten (OD).
    A rater agreement study on measurements in cross-sectional CBCT images exploring the association between alveolar bone morphology and craniofacial height2021Ingår i: Oral Radiology/Springer, ISSN 0911-6028, E-ISSN 1613-9674, Vol. 37, s. 573-584Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: To investigate rater agreement regarding measurements of height and width of the maxilla and mandible using cross-sectional images from CBCT examinations. Furthermore, to explore the association between vertical craniofacial height and alveolar bone morphology.

    METHODS: Pre-treatment CBCT scans from 450 patients referred for treatment to a private clinic for orthodontics and oral surgery in Scandinavia were available and of these, 180 were selected. Lateral head images were generated from the CBCT volumes to categorise subjects into three groups based on their craniofacial height. Cross-sectional images of the maxillary and mandibular bodies at three locations in the maxilla and mandible, respectively, were obtained and measured at one height and two width recordings by five raters. One-way analysis of variance with a Tukey post hoc test was performed. A significance level of 5% was used.

    RESULTS: Rater agreement was mostly excellent or good when measuring height and width of the maxilla and mandible in cross-sectional CBCT images. For height (of the alveolar bone/bodies), there were statistically significant differences between the low- and the high-angle groups for all the observers when measuring in the premolar and midline regions, both in the maxilla and in the mandible.

    CONCLUSION: The high agreement found ensures a reliable measurement technique and confirms the relation between craniofacial height and alveolar bone height and width.

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  • 7.
    Papia, Evaggelia
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Brodde, Sara Anna Caroline
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Deformation of polyetheretherketone, PEEK, with different thicknesses.2021Ingår i: Journal of The Mechanical Behavior of Biomedical Materials, ISSN 1751-6161, E-ISSN 1878-0180, Vol. 125, artikel-id 104928Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In order to determine a suitable thickness of polyetheretherketone (PEEK) for manufacturing of surgical membranes, the purpose was to evaluate how different thicknesses of PEEK influence the mechanical properties under flexure and tension. In total 20 specimens in PEEK with two different thicknesses, 0.5 mm and 1.0 mm were fabricated and tested in a three-point flexural strength test and tensile strength test (n = 5 specimens). Statistical analysis was done with non-parametric Mann-Whitney test with level of significance α = 0.05, for both material tests, respectively. The 1.0 mm-thick samples resulted in higher values in elastic limit and conventional deflection (Sc-value) in the flexural strength test compared to 0.5 mm-thick samples. In the tensile strength test, the results did not show any significant difference in elastic limit depending on the thickness evaluated. However, PEEK with thickness of 1.0 mm received significantly higher maximum value at fracture. Within the limitations of this study, PEEK with a thickness of 0.5 mm–1.0 mm shows mechanical properties that are appropriate thickness and can meet the complex demands for dimensioning of surgical membranes.

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  • 8.
    Johansson, Krister
    et al.
    Malmö universitet, Odontologiska fakulteten (OD). Department of Oral & Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden.
    Lindström, Martin
    Malmö universitet, Odontologiska fakulteten (OD).
    Alhabshi, Manaf
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Svensson, Peter J.
    Department of Translational Medicine, Clinical Coagulation Research Unit, Skåne University Hospital, Malmö, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Estimation of Blood Loss in Oral and Maxillofacial Surgery by Measurements of Low Haemoglobin Levels in Mixtures of Blood, Saliva and Saline: a Laboratory Study2021Ingår i: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 12, nr 2Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

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

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

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

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  • 9.
    Toia, Marco
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Corrà, Enrico
    Institute Franci, Padova, Italy.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Department of Prosthodontics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Cecchinato, Denis
    Institute Franci, Padova, Italy.
    Fixed full-arch maxillary prostheses supported by four versus six implants with a titanium CAD/CAM milled framework: 3-year multicentre RCT2021Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, nr 1, s. 44-59Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: This RCT compares marginal bone level (MBL) change and the clinical parameters after a 3-year function in maxillary implant-supported fixed complete dentures (FCDs) treated with four-implants(4-I) or 6-implants(6-I).

    MATERIAL AND METHOD: Three centres treated 56 patients with 280 implants allocated to the 4-I or 6-I group. Radiographic and clinical examinations were performed. The primary outcome was to investigate MBL change between the groups.

    RESULTS: Implant survival rates were 100% and 99% in the 4-I and 6-I groups, respectively. Considering the clustering effects, the MBL change was not significantly different between the groups over the 3-year follow-up. The MBL in the 4-I group was 0.30±0.50mm at baseline, 0.24±0.31mm at 1-year and 0.24±0.38mm at 3-year. In the 6-I group, MBL was 0.14±0.32mm at baseline, 0.16±0.35mm at 1-year and 0.12±0.26 mm at 3-year. There was a statistically significant difference between the groups at BL and 3Y. No significant differences between the groups were reported for clinical parameters at each time point as well as in between the visits. The technical and biological complications rates were 1.6% and 6.0%, respectively. Prosthetic complications affected 25 FCDs (47.2%).

    CONCLUSION: MBL change revealed a stable condition in the 3-year period in the two groups. Few technical and biological complications occurred apart from the chipping/fracture of the prosthetic teeth. Four-implant is a feasible solution if the rehabilitation is oriented towards the most cost-effective treatment and towards avoiding bone augmentation procedures. Clinicians have to consider the potential required visits for prosthetic maintenance.

  • 10.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Galli, Silvia
    Malmö universitet, Odontologiska fakulteten (OD). Malmö universitet, Biofilms Research Center for Biointerfaces.
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Impact of a hydrophilic dental implant surface on osseointegration: biomechanical results in rabbit2021Ingår i: Journal of Oral Implantology, ISSN 0160-6972, E-ISSN 1548-1336, Vol. 47, nr 2, s. 163-168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study aimed to evaluate the effect of surface hydrophilicity on the biomechanical aspects of osseointegration of dental implants in the tibia and femur of rabbits. Forty-eight mature female New Zealand White rabbits were included, and 96 commercially pure, Grade 4, titanium dental implants (control group), and 96 implants of same macro geometry with the hydrophilic surface (test group) were used in this study. One osteotomy was performed in each tibia and femur on both sides of the rabbit, and four implants were placed in each rabbit. Control and test groups were randomly allocated on the left and right sides. During surgery, insertion torque (ITQ) value of the complete implant placement was recorded. After healing periods of 0, 2, 4, and 8 weeks after surgery, Implant Stability Quotient (ISQ) value, and removal torque (RTQ) values were measured. No statistical difference was observed for ITQ, for ISQ and for RTQ between the control group and test group in tibia/femur for all time periods. The effect of hydrophilic properties on moderately roughened surfaces has no impact in terms of biomechanical outcomes (ISQ values and RTQ values) after a healing period of 2 to 8 weeks in rabbit tibias /femurs.

  • 11.
    Starch-Jensen, Thomas
    et al.
    Aalborg University Hospital, Denmark; Aalborg University, Denmark.
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Bruun, Niels Henrik
    Aalborg University Hospital, Denmark.
    Becktor, Jonas Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Patient's perception of recovery after maxillary sinus floor augmentation with autogenous bone graft compared with composite grafts: a single-blinded randomized controlled trial.2021Ingår i: International Journal of Implant Dentistry, E-ISSN 2198-4034, Vol. 7, nr 1, artikel-id 99Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Autogenous bone graft is considered as the preferred grafting material for maxillary sinus floor augmentation (MSFA). However, harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. From a clinical and patient perspective, it would therefore be an advantage, if postoperative discomfort could be minimized by diminishing the need for autogenous bone graft harvesting. The objective of the present study was to test the hypothesis of no difference in patient's perception of recovery after MSFA with autogenous bone graft from the zygomatic buttress (control) compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral (DPBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Sixty healthy patients were randomly allocated to either control or test groups. Oral Health-related Quality of Life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment. Recovery was estimated by self-administrated questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment and discomfort after 1 week and 1 month. Descriptive statistics was expressed as mean with standard deviation (SD). Correlation between OHRQoL at enrollment and recovery were assessed by linear regression. p-value below 0.05 was considered significant.

    RESULTS: Treatment satisfaction and willingness to undergo similar surgery were high in all groups. Average numbers of days with pain and sick leave were 3.5 (SD 3.9) and 0.5 (SD 1.2), respectively, with no significant difference between groups. Moreover, no significant difference in eating and speaking ability, physical appearance, work performance and sleep impairment were seen between groups. Mean OHIP-14 score at enrollment was 9.30 (SD 9.25) (control), 9.95 (SD 7.96) (Test I) and 8.15 (SD 9.37) (Test II), with no significant differences between groups. Impaired OHRQoL, gender or age seems not to predispose for delayed recovery or increased postoperative discomfort.

    CONCLUSIONS: MSFA with diminutive autogenous bone graft harvesting is associated with high patient satisfaction, limited postoperative discomfort and willingness to undergo similar surgery. Presurgical OHRQoL, gender or age seems not to be associated with impaired patient's perception of recovery.

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  • 12.
    Klinge, Anna
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Tranaeus, Sofia
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Winitsky, Nicole
    Folktandvården Eastmaninstitutet. Public Dental Health, Stockholm, Sweden.
    Naimi-Akbar, Aron
    Malmö universitet, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska institutet, Stockholm, Sweden; Folktandvården Eastmaninstitutet. Public Dental Health, Stockholm, Sweden.
    The risk for infraposition of dental implants and ankylosed teeth in the anterior maxilla related to craniofacial growth, a systematic review2021Ingår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 79, nr 1, s. 59-68Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background The aim of the study was to evaluate a potential association between individuals with different craniofacial types or other exposures, and the risk of infraposition due to continued growth/eruption of adjacent teeth in the anterior maxilla. Materials and methods This is a systematic review in which primary studies as well as other systematic reviews are scrutinised. A search of PubMed (Medline), Scopus, Web of science and Health technology assessment (HTA) organisations and a complementary handsearch was carried out. Selected studies were read in full-text by several reviewers. The quality of the included primary studies was assessed using a protocol for assessment of risk of bias in exposure studies. Results The literature search resulted in 3,296 publications. Title and abstract screening yielded 25, whereof one systematic review, potential publications allocated for full-text inspection. The quality assessment resulted in a total of seven studies with a low/moderate risk of bias and four studies with a high risk of bias. Conclusion In conclusion, a long-term risk for infraposition of dental implants, or ankylosed teeth, among natural teeth can be observed in some cases. The predisposing factors are still not fully understood since the current scientific evidence is very limited.

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  • 13.
    Klinge, Anna
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Eldh, Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Ulvan, Rasmus
    Malmö universitet, Odontologiska fakulteten (OD).
    Andersson, Lars
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Craniofacial Height in Relation to Cross-Sectional Morphology of the Anterior Maxilla: An Anatomica Considers ion in Implant Therapy2020Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 35, nr 2, s. 386-394Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Patients who have a vertical growth pattern are more prone to complete alveolar bone growth later and run a higher risk for inhibition of growth and infraposition after implants have been placed. Moreover, it has been suggested for the same category of patients that craniofacial height may influence the alveolar bone morphology of the anterior maxilla during growth. Hence, it is important to identify such patients early when considering implant treatment in young patients. The purpose of this study was to investigate the height and width of the alveolar bone in the anterior maxilla in subjects with different craniofacial heights to assess if there is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Materials and Methods: Measurements on cephalograms and cone beam computed tomography (CBCT) images of the maxilla from 180 fully dentate subjects were analyzed and categorized into three angle groups based on the craniofacial height: low-, normal-, and high-angle groups. Measurements of the alveolar bone were taken interradicular, at six reference points distributed between the first premolar regions in the maxilla. The height and width of the alveolar bone were measured with a standardized technique at 3, 6, 9, and 12 mm from the top of the alveolar process. Results: Significant differences were found regarding the height of the alveolar bone in all the subgroups and regarding the width in the 9- and 12-mm subgroups, and between low-/normal- and low-/high-angle groups, where the high-angle group represented the thinnest alveolar bone. A significant difference was found between male and female patients concerning all dimensions of the alveolar bone. Conclusion: There is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Craniofacial height is an important factor to analyze when implant treatment is considered in the maxillary anterior region. This identification can preferably be carried out early in young patients who are still growing when various treatment options can still be considered.

  • 14.
    Stocchero, Michele
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Malmö universitet, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Department of Regenerative Oral Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
    Lee, Chunwoo
    Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
    Yamaguchi, Satoshi
    Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
    Imazato, Satoshi
    Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    In silico multi-scale analysis of remodeling peri-implant cortical bone: a comparison of two types of bone structures following an undersized and non-undersized technique2020Ingår i: Journal of The Mechanical Behavior of Biomedical Materials, ISSN 1751-6161, E-ISSN 1878-0180, Vol. 103, artikel-id 103598Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: The aim of this multi-scale in silico study was to evaluate the influence of resorption cavities on the mechanical properties and load distribution in cortical bone after implant placement with two different drilling protocols.

    MATERIAL AND METHODS: Two different micro-scale bone structures were assessed: cortical bone models with cavities (test) and without cavities (control) were designed from μCT data. In a macro-scale model, representing a mandibular ridge, oblique load of 150 N was applied on the implant-abutment. Maximum principal stress/strain, and shear stress/strain were calculated in the macro- and micro-scale models.

    RESULTS: Test presented anisotropic material properties. In tests, significantly greater maximum values of Maximum principal stress/strain were calculated in micro-scale model. These values were located at the implant neck area in the macro-scale model and in the proximity of cavities in the micro-scale model respectively. Greater values of shear stress/strain were found in the test along the mandibular horizontal plane.

    CONCLUSIONS: Cortical bone with resorption cavities following undersized drilling showed an impaired load distribution compared with bone without cavities. Subsequently, stress/strain distribution suggests that this bone model is more prone to microdamage, thus delaying the healing process.

  • 15.
    Bengtsson, M
    et al.
    Department of Oral & Maxillofacial Surgery, the University Hospital of Skåne, 22185 Lund.
    Loh, J S P
    Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, National University of Singapore.
    Wall, G
    Department of Oral & Maxillofacial Surgery, the University Hospital of Skåne, 22185 Lund.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Rasmusson, L
    Department of Oral & Maxillofacial Surgery, the Sahlgrenska Academy, Gothenburg University, Box 450, 405 30 Göteborg.
    Is there a difference in judgement of facial appearance depending on ethnic background? Photographic evaluation of facial appearance in orthognathic surgery.2020Ingår i: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 58, nr 7, s. 812-818, artikel-id S0266-4356(20)30173-XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    Is there a variation in facial ideals depending on ethnic background that affects judgements of outcome in orthognathic surgery? How does the evaluation correlate with patient-reported outcome measures? Two evaluation panels, Singaporean and Swedish, judged photographs of patients undergoing orthognathic surgery taken before and after operation. Improvement in facial aesthetics was calculated between the two ratings. The result was compared between the panels and correlated with health-related quality of life (QoL) measures. Thirty male and 27 female patients aged between 18 and 28 years (mean 21) were included, and 52 subjects were eligible for comparison of health-related QoL. The photographic evaluation showed that both panels judged there to be significant improvement in facial aesthetics after treatment (p<0.001). The Singaporean panel rated the overall facial appearance higher than the Swedish panel when evaluating photographs both before (p=0.025) and after (p=0.032) operation. Improvement of the overall facial appearance showed no significant difference between the panels (p>0.30). No correlation between health-related QoL and improvement of facial appearance was found by either panel. Subjective evaluation of facial aesthetics in orthognathic surgery is unaffected by the observer's ethnic origin. Independently of their ethnicity, the evaluation juries found that facial aesthetics improved after orthognathic surgery. Improvement reported by the juries corresponded to that reported by patients.

  • 16.
    Bengtsson, M.
    et al.
    Department of Oral & Maxillofacial Surgery, Skåne University Hospital, Sweden.
    Wall, G.
    Department of Oral & Maxillofacial Surgery, Skåne University Hospital, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Rasmusson, L.
    Department of Oral & Maxillofacial Surgery, The Sahlgrenska Academy, Gothenburg University, Sweden.
    A comparison of cost-effectiveness of computer-assisted 2-and 3-dimensional planning techniques in orthognathic surgery2019Ingår i: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 57, nr 4, s. 352-358Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this randomised controlled trial was to compare the costs and benefits of computer-based 2-dimensional and 3-dimensional predictions in orthognathic surgery. Subjects aged 18-30 years with severe class III malocclusion had their treatment planned with both 2- and 3-dimensional techniques. They were randomised in a 1: 1 ratio for one or other planning technique. Costs (financial, time, and dose of radiation) were compared with benefits (accuracy and health-related quality of life (HRQoL)). In total, 57 subjects (27 women and 30 men, mean (range) age 21 (18-28) years) completed the study. Comparisons showed no significant difference in total time spent, but a large advantage for the 2-dimensional technique in financial costs (p < 0.001); it also required a significantly lower dose of radiation (p < 0.001). The cost-effectiveness analysis showed a reduction in time of 0.53 minutes/HRQoL-point gained, and an increased economic cost of US$15/HRQoL point gained for the 3-dimensional technique. It also showed that the two techniques consumed an equal amount of time, but that the 2-dimensional technique had lower financial costs, and the 3-dimensional technique a larger dose of radiation. (C) 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  • 17.
    Toia, Marco
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Malmö universitet, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Department of Prosthodontics, Sahlgrenska Academy, University of Gothenburg, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
    Halldin, Anders
    I3tex, Gothenburg, Sweden.
    Effect of Misfit at Implant-Level Framework and Supporting Bone on Internal Connection Implants: Mechanical and Finite Element Analysis2019Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 34, nr 2, s. 320-328Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To evaluate the effect of misfit at implant-level fixed partial dentures (ILFPDs) and marginal bone support on the generation of implant cracks. Materials and Methods: This in vitro study included a mechanical fatigue test and finite element analysis. A mechanical cycling loading test was performed using 16 experimental models, each consisting of two parallel implants subdivided into four groups based on the misfit and the supporting bone condition. The framework, firmly seated at implants, was dynamically loaded vertically with a force of 1,600/160 N and 15 Hz for 1 × 106 cycles. Optical microscope, scanning electron microscope (SEM), and computed tomography three-dimensional (CT-3D) analyses were performed to detect impairments. Finite element models, representing the setups in the mechanical fatigue test, were used to represent the fatigue life. Results: None of the mechanical components presented distortion or fracture at the macroscopic level during the test. In a microscopy evaluation, the fatigue test revealed scratches visible in the inner part of the conical portion of the implants regardless of the groups. SEM and CT-3D analysis revealed one implant from the misfit/no bone loss group with a microfracture in the inner part of the conical interface. The simulated effective stress levels in the coronal body were higher in the misfit groups compared with the no misfit groups. The misfit groups presented effective stress levels, above 375 MPa, that penetrated the entire wall thickness. The no bone loss group presented an effective stress level above 375 MPa along its axial direction. In the no misfit group, the area presenting effective stress levels above 375 MPa in the conical connection was larger for the bone loss group compared with the no bone loss group. Conclusion: This study confirmed that implant fracture is an unlikely adverse event. A clear pattern of effective distribution greater than fatigue limit stresses could be noticed when the misfit was present. The dynamic load simulation demonstrated that the crack is more likely to occur when implants are fully supported by marginal bone compared with a bone loss scenario. Within the limitations of this study, it is speculated that marginal bone loss might follow the appearance of an undetected crack. Further research is needed to develop safe clinical protocols with regard to ILFPD.

  • 18.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Johansson, Krister
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Galli, Silvia
    Malmö universitet, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Impact of salivary contamination during placement of implants with simultaneous bony augmentation in iliac bone in sheep2019Ingår i: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 57, nr 10, s. 1131-1136Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Our aim was to investigate the possible impact of contamination with saliva on osseointegration during placement of implants with simultaneous bone augmentation. Six hemispheric shape bone defects (8mm in diameter×4mm deep) were prepared in each iliac bone of six sheep. A dental implant (2.9mm in diameter×10mm long) was placed in the centre of each defect, and then pairs of defects were filled with one of the following bone augmentation materials: autogenous bone, autogenous bone plus bovine bone, or resorbable biphasic ceramic bone substitute. One site in each augmentation group was impregnated with saliva (contaminated group), while the other was not (non-contaminated group). Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) within implant threads were measured after a healing period of five weeks, both in respect of the implant inserted in the augmented bone and in that inserted in the residual bone. Overall results showed that there was a significant difference between the contaminated and non-contaminated group for BIC in the augmented implant (p=0.028), while there were no significant differences in the implant in residual bone (p=0.722). For BAFO, there were no significant differences between the contaminated and non-contaminated groups among the different augmentation materials. The results showed that contamination with saliva during placement of an implant with simultaneous bone augmentation had a serious deleterious effect on osseointegration of the aspect of the implant within the augmented defect. Contamination with saliva during placement of an implant with simultaneous bone augmentation should therefore be avoided.

  • 19.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
    Hjalmarsson, J
    Malmö universitet, Odontologiska fakulteten (OD).
    Johansson, Krister
    Malmö universitet, Odontologiska fakulteten (OD).
    Stavropoulos, Andreas
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Impact of surface contamination of implants with saliva during placement in augmented bone defects in sheep calvaria.2019Ingår i: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 57, nr 1, s. 41-46Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Our aim was to try and find out whether contamination with saliva during insertion of dental implants affects osseointegration in bone that has been augmented with different grafts. Six bony defects were created in each of the calvaria of six sheep, and then augmented with three different materials (autogenous bone, bovine bone, and resorbable biphasic ceramic bone substitute) After five weeks of healing, three implants contaminated with saliva (contaminated group) and three not contaminated (uncontaminated group) were placed in the centre of the augmented areas. For histomorphometric analysis, bone implant contact, bone area fraction occupancy, bone and material area, and bony area were measured after a healing period of five weeks. There was a significant difference between the contaminated and uncontaminated groups (p=0.036) for bone implant contact only in the augmented areas, but there were no significant differences in bone area fraction occupancy, bone and material area, and bony area. We conclude that contamination with saliva during placement of dental implants can significantly compromise bone implant contact in augmented areas, but had no significant effect on the formation of bone in areas more distant from the surface of the implant. We suggest that salivary contamination should be avoided during placement of dental implants in augmented areas.

  • 20.
    Toia, Marco
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Stocchero, Michele
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Chrcanovic, Bruno
    Malmö universitet, Odontologiska fakulteten (OD).
    Wennerberg, Ann
    Department of Prosthodontics, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
    Implant vs abutment level connection in implant supported screw‐retained fixed partial dentures with cobalt‐chrome framework: 1‐year interim results of a randomized clinical study2019Ingår i: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 21, nr 2, s. 238-246Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Screw‐retained fixed partial dentures (FPD) have shown a lower incidence of biologic complications and an easier retrievability compared with cemented FPD. Purpose: To compare the marginal bone loss at conical connection implant restored with a screw retained cobalt‐chrome FPD in an implant‐level (IL) or an abutment‐level (AL) setup. Materials and Methods: Patients with at least two adjacent missing teeth were randomly allocated to be restored with IL or AL FPD. Periapical radiographs and clinical examination were taken at implant placement, prosthetic connection, 6 and 12 months to evaluate marginal bone loss (MBL), and soft tissue conditions. Complications were used to calculate prognostic indexes. Results: Fifty patients were treated with 50 FPD supported by 119 implants. The difference of MBL between the IL and AL groups was statistically significant (P = 0.003). At 1 year, MBL was 0.086 ± 0.313 mm and 0.005 ± 0.222 mm in the IL and AL groups, respectively. The presence of BoP increased with time in IL, whereas it decreased in AL group (P < 0.001). A minor complication was encounted in one FPD. Conclusions: A low grade of MBL was present after 1 year. IL showed greater amount of MBL and soft tissue inflammation indexes than AL. In FPD, AL may be a safer procedure than IL setup in order to preserve a healthy periimplant tissue.

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  • 21.
    Stocchero, Michele
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Malmö universitet, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Papia, Evaggelia
    Malmö universitet, Odontologiska fakulteten (OD).
    Yamaguchi, Satoshi
    Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, 565-0871, Japan.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Intraosseous Temperature Change during Installation of Dental Implants with Two Different Surfaces and Different Drilling Protocols: An In Vivo Study in Sheep2019Ingår i: Journal of Clinical Medicine, E-ISSN 2077-0383, Vol. 8, nr 8, artikel-id 1198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: The intraosseous temperature during implant installation has never been evaluated in an in vivo controlled setup. The aims were to investigate the influence of a drilling protocol and implant surface on the intraosseous temperature during implant installation, to evaluate the influence of temperature increase on osseointegration and to calculate the heat distribution in cortical bone. METHODS: Forty Branemark implants were installed into the metatarsal bone of Finnish Dorset crossbred sheep according to two different drilling protocols (undersized/non-undersized) and two surfaces (moderately rough/turned). The intraosseous temperature was recorded, and Finite Element Model (FEM) was generated to understand the thermal behavior. Non-decalcified histology was carried out after five weeks of healing. The following osseointegration parameters were calculated: Bone-to-implant contact (BIC), Bone Area Fraction Occupancy (BAFO), and Bone Area Fraction Occupancy up to 1.5 mm (BA1.5). A multiple regression model was used to identify the influencing variables on the histomorphometric parameters. RESULTS: The temperature was affected by the drilling protocol, while no influence was demonstrated by the implant surface. BIC was positively influenced by the undersized drilling protocol and rough surface, BAFO was negatively influenced by the temperature rise, and BA1.5 was negatively influenced by the undersized drilling protocol. FEM showed that the temperature at the implant interface might exceed the limit for bone necrosis. CONCLUSION: The intraosseous temperature is greatly increased by an undersized drilling protocol but not from the implant surface. The temperature increase negatively affects the bone healing in the proximity of the implant. The undersized drilling protocol for Branemark implant systems increases the amount of bone at the interface, but it negatively impacts the bone far from the implant.

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  • 22.
    Starch-Jensen, Thomas
    et al.
    Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark.
    Becktor, Jonas Peter
    Malmö universitet, Odontologiska fakulteten (OD).
    Maxillary Alveolar Ridge Expansion with Split-Crest Technique Compared with Lateral Ridge Augmentation with Autogenous Bone Block Graft: a Systematic Review2019Ingår i: Journal of Oral & Maxillofacial Research, E-ISSN 2029-283X, Vol. 10, nr 4, artikel-id e2Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

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

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

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

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

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  • 23.
    Bengtsson, M.
    et al.
    Department of Oral & Maxillofacial Surgery, The University Hospital of Skåne, 22185 Lund, Sweden.
    Al-Ateyah, Amjad
    Malmö universitet, Odontologiska fakulteten (OD).
    Wall, G.
    Department of Oral & Maxillofacial Surgery, The University Hospital of Skåne, 22185 Lund, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Rasmusson, L.
    Department of Oral & Maxillofacial Surgery, The Sahlgrenska Academy, Gothenburg University, Box 450, 405 30 Göteborg, Sweden.
    Outcome of photographic evaluation of facial appearance in orthognathic surgery: how does it correlate with planning of treatment and patient-reported outcome?2019Ingår i: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 57, nr 4, s. 345-351Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The outcome of treatment in orthognathic surgery is dependent on preoperative surgical planning. The main purpose of the present study was to evaluate from photographs the improvement in facial appearance after orthognathic surgery. In addition, the outcomes of two different planning techniques, 2-dimensional and 3-dimensional, were compared and the correlation between the outcome and health-related quality of life (HRQoL) assessed. The study was a randomised controlled trial with the intervention being either 2-dimensional or 3-dimensional treatment planning. An evaluation panel compared photographs taken before and after operation on patients with severe class III malocclusion. The change in facial appearance was rated, the two planning techniques compared, and the result correlated with previously published findings on cephalometric accuracy and HRQoL in the same group. Completed 12-month follow-up resulted in the inclusion of 57 subjects aged between 18 and 28 years at the time of operation (mean 21 years). We found significant differences between the two evaluations (p = 4.4E-9) but no significant difference in facial improvement between the planning techniques (p = 0.54). However, there was a correlation between cephalometric measurement of accuracy in the anterior maxilla and evaluation of improvement of facial appearance (p = 0.024, r = 0.30), but we found no correlation + between HRQoL and the evaluation of facial appearance (p = 0.31, r = -0.14). We conclude that there was an improvement in facial aesthetics after orthognathic surgery that was independent of the planning technique used. (C) 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  • 24.
    Lindström, Martin J R
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Ahmad, Marianne
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Malmö universitet, Odontologiska fakulteten (OD).
    Ameri, Arman
    Malmö universitet, Odontologiska fakulteten (OD).
    Vult von Steyern, Per
    Malmö universitet, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Volumetric measurement of dentoalveolar defects by means of intraoral 3D scanner and gravimetric model2019Ingår i: Odontology: official journal of The Society of the Nippon Dental University, ISSN 1618-1247, E-ISSN 1618-1255, Vol. 103, nr 3, s. 353-359Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to evaluate the accuracy in volumetric measurements obtained on an experimental model using an intraoral scanner and a gravimetric method. Three identical partial dentate maxillary acrylic models with three fabricated alveolar defects, in anterior and posterior regions, were scanned using an intraoral scanner (20 scans/defects). The defects differed in terms of size and distance of neighbouring teeth. As references, replicas of each defect were created using a dimensional stable silicone impression material. After measuring the mass of each replica, the volume was calculated by dividing the mass of each replica by the density of the impression material. The defects had a volume, according to the gravimetric method, ranging from 40.5 to 143.7 mm. The scans were imported to metrology software for analyses. Accuracy was determined in terms of trueness and precision. The mean trueness for all defect types was 0.168 mm (SD 0.691, range 2.82). There was no statistical significant difference between the mean trueness for all defects measured (p = 0.910). The mean precision for all defect types was 0.147 mm (SD 0.524, range 2.86). There were no statistical significant differences between the dental models in regard to mean precision (p = 0.401), however, there were statistical significant differences between defects in position 1 and 2 (p = 0.002) and 1 and 3 (p = 0.001). Based on the findings of this study, the intraoral scanner utilized in the current study presented an acceptable level of accuracy when measuring volume of defects.

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  • 25.
    Stocchero, Michele
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö universitet, Odontologiska fakulteten (OD).
    Jinno, Yohei
    Malmö universitet, Odontologiska fakulteten (OD).
    Cecchinato, Francesca
    Institute Franci, Padova, Italy.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Naito, Yoshihito
    Department of Biomaterials and Bioengineering, Graduate School of Oral Science, Tokushima University, Tokushima, Japan.
    Halldin, Anders
    R&D Dental Implants, DentsplySirona, Mölndal, Sweden.
    Jimbo, Ryo
    Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
    Influence of different drilling preparation on cortical bone: A biomechanical, histological, and micro-CT study on sheep2018Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, nr 7, s. 707-715Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    ObjectiveThe aim of this study was to investigate the extent of cortical bone remodeling between two different drilling protocols by means of histomorphometric, mu-CT, and biomechanical analyses. Material and methodsA total of 48 implants were inserted into the mandible of six sheep following two drilling protocols: Group A (Test, n=24), undersized preparation; Group B (Control, n=24), non-undersized preparation. The animals were euthanatized to obtain 5 and 10weeks of implantation time. Removal torque (RTQ) was measured on 12 implants of each group and the peri-implant bone was mu-CT scanned. Bone volume density (BV/TV) was calculated in pre-determined cylindrical volumes, up to 1.5mm from implant surface. Non-decalcified histology was prepared on the remaining 12 implants from each group, where total bone-to-implant contact (totBIC) and newly-formed BIC (newBIC) was measured. Bone Area Fraction Occupancy (BAFO) was determined in pre-determined areas up to 1.5mm from implant surface. Paired sample t test or Wilcoxon signed-rank test was used to investigate differences between the groups. ResultsGroup A presented significantly increased RTQ value at 5weeks, while no difference was observed at 10weeks. Group B presented increased BV/TV value at 5weeks. Both groups showed comparable values for totBIC at both time-points. However, Group A presented significantly lower newBIC at 5weeks. Higher BAFO was observed in Group B at 5weeks. ConclusionsImplants inserted into undersized sites has an increased biomechanical performance, but provoked major remodeling of the cortical bone during the early healing period compared to non-undersized preparations. After 10weeks, no difference was observed.

  • 26.
    Starch-Jensen, Thomas
    et al.
    Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, Aalborg, Denmark.
    Mordenfeld, Arne
    Department of Oral and Maxillofacial Surgery, Public Health Service, Gävle, Sweden; Centre for Research and Development, Uppsala University/Gävleborg County Council, Gävleborg, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Jensen, Simon Storgård
    Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
    Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials: A Systematic Review and Meta-analysis2018Ingår i: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 27, nr 3, s. 363-374Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Objective: To test the hypotheses of no differences in implant treatment outcome after maxillary sinus floor augmentation (MSFA) with synthetic bone substitutes (SBS) compared with other grafting materials applying the lateral window technique. Materials and Methods: A MEDLINE/PubMed, Embase and Cochrane Library search in combination with hand-search of selected journals was conducted. Results: Five randomized controlled trials with low risk of bias fulfilled the inclusion criteria. SBS disclosed high survival rate of suprastructures and implants with no significant differences compared to autogenous bone graft or xenograft. Meta-analysis revealed a patient-based implant survival rate of 0.98 (confidence interval: 0.89-1.08), indicating no differences between SBS and xenograft. SBS demonstrated significant less newly formed bone compared with autogenous bone graft, whereas no significant difference was revealed as compared to xenograft. High implant stability values, limited periimplant marginal bone loss, and few complications were reported with SBS. Conclusions: There seem to be no differences in implant treatment outcome after MSFA with SBS compared to other grafting materials.

  • 27.
    Bengtsson, Martin
    et al.
    Department of Oral and Maxillofacial Surgery, University Hospital of Skåne, Lund, Sweden.
    Wall, Gert
    Department of Oral and Maxillofacial Surgery, University Hospital of Skåne, Lund, Sweden.
    Larsson, Pernilla
    Malmö universitet, Odontologiska fakulteten (OD). Center of Oral Rehabilitation, Östergötland County Council, Linköping, Sweden.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Rasmusson, Lars
    Department of Oral and Maxillofacial Surgery, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
    Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2-or 3-dimensional planning: A randomized double-blind active-controlled clinical trial2018Ingår i: American Journal of Orthodontics and Dentofacial Orthopedics, ISSN 0889-5406, E-ISSN 1097-6752, Vol. 153, nr 6, s. 786-796Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Introduction: Thorough treatment planning is essential for a good clinical outcome in orthognathic treatment. The planning is often digital. Both 2-dimensional (2D) and 3-dimensional (3D) software options are available. The aim of this randomized 2-arm parallel double-blinded active-controlled clinical trial was to comprae the outcomes of computer-based 2D and 3D planning techniques according to patient-reported health related quality of life. The hypothesis was that a 3D technique would give a better treatment outcome compared with a 2D technique. Methods: Orthognathic treatment for 62 subjects, aged 18 to 28 years, with severe Class III malocclusion was planned with both 2D and 3D techniques. After treatment planning but before surgery, the patients were randomly allocated via blind collection of 1 enveloped card for each subject in a 1:1 ratio to the test (3D) or the control (2D) group. Thus, the intervention was according to which planning technique was used. The primary outcome was patient-reported outcome measures. The secondary outcome was relationship between patient-reported outcome measures and cephalometric accuracy. Questionnaires on the patient's health-related quality of life (HRQoL) were distributed preoperatively and 12 months after surgical treatment. The questionnaires were coded, meaning blinding throughout the analysis. Differences between groups were tested with the Fisher permutation test. The HRQoL was also compared with measurements of cephalometric accuracy for the 2 groups. Results: Three subjects were lost to clinical follow-up leaving 57 included. Of these, 55 subjects completed the questionnaires, 28 in the 2D and 27 in the 3D groups. No statistically significant difference regarding HRQoL was found between the studied planning techniques: the Oral Health Impact Profile total showed -3.69 (95% confidence interval, -19.68 to 12.30). Consistent results on HRQoL and cephalometric accuracy showed a difference between pretreatment and postreatment that increased in both groups but to a higher level in the 3D group. A difference between pretreatment and posttreatment HRQoL was shown for both groups, indicating increased quality of life after treatment. This supports recent findings comparing 3D and 2D planning techniques. No serious harm was observed during the study. Conclusions: Improvements of HRQoL were shown after treatment independent of which planning technique, 2D or 3D, was used. No statistically significant difference was found between the planning techniques. Registration: This trial was not registered. Protocol: The protocol was not published before trial commencement.

  • 28.
    Jinno, Yohei
    et al.
    Malmö universitet, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Japan.
    Lindström, Martin
    Malmö universitet, Odontologiska fakulteten (OD).
    Sawase, Takashi
    Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Japan.
    Lilin, Thomas
    Centre de Recherche BioMédicale (CRBM), École Nationale Vétérinaire d'Alfort, France.
    Becktor, Jonas P
    Malmö universitet, Odontologiska fakulteten (OD).
    Vertical Bone Augmentation Using Ring Technique with Three Different Materials in the Sheep Mandible Bone2018Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 33, nr 5, s. 1057-1063Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The purpose of this study was to examine the volumetric alterations and osseointegration properties in the augmented area of the ring technique using different types of bone graft material in sheep mandible bone. Materials and Methods: Three different materials (columnar forms, 7-mm diameter, 3-mm height) were stabilized using dental implants with a turned surface in the mandible bone of Finnish Dorset cross-bred sheep: group A, autogenous bone; group B, bovine bone; group C, biphasic bone substitute. Animals were euthanized after 5 weeks (N = 6). Three-dimensional image data by digital oral scanner were taken at the surgery and sacrifice, and the volume alteration of the material was calculated. The bone samples were fixed in formalin and dehydrated in ethanol. Resin-embedded samples were subjected to non-decalcified ground sectioning, and histologic and histomorphometric analysis (bone and material area alteration, bone-to-implant contact [BIC]) were done. Results: In three-dimensional (3D) image analysis, group A showed a statistically higher percentage of remaining materials compared with groups B and C. The histologic observation showed no new bone formations around the implants in all groups, especially at the maxillary site of the implant in the augmented area. In histomorphometric analysis, group A showed a statistically higher percentage of bone area (BA) compared with groups B and C; however, in all groups, bone-to-implant contact (BIC) showed low values, and there were no statistical differences between groups. Conclusion: The results of this study suggested that the autogenous bone maintained bone volume around the dental implant using the ring technique, and the impact of surface properties was of some importance; osseointegration with the turned surface in the augmented area showed low BIC values in all groups.

  • 29.
    Hallmer, Fredrik
    et al.
    Malmö högskola, Odontologiska fakulteten (OD). Department of Oral and Maxillofacial Surgery, Skåne University Hospital, Lund, Sweden.
    Bjørnland, Tore
    Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, University of Oslo, Oslo, Norway.
    Andersson, Gunilla
    Malmö högskola, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Kristoffersen, Anne K.
    Senior Engineer, Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
    Enersen, Morten
    Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
    Bacterial diversity in medication-related osteonecrosis of the jaw2017Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 123, nr 4, s. 436-444Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective. The aim was to study the association between microflora and medication-related osteonecrosis of the jaw (MRONJ) by using culture-independent molecular techniques to detect bacteria in necrotic bone lesions. Study Design. Included were 18 consecutive patients with MRONJ, 10 with osteoporosis and 8 cancer patients. Bone biopsies were retrieved from the center of the necrotic bone and from visually healthy bone, and 16 S rRNA gene fragments from bacterial DNA were amplified with polymerase chain reaction. Results. The study revealed a diversity of bacteria represented by 16 S rRNA sequences in all the necrotic bone samples and in 60% of the visually healthy bone. Eight dominating taxa groups were identified at the genus level: Porphyromonas, Lactobacillus, Tannerella, Prevotella, Actinomyces, Treponema, Streptococcus, and Fusobacterium. Conclusions. The necrotic bone lesions contained mainly anaerobic bacteria, representative of periodontal microflora, suggesting that a periodontal infection in combination with antiresorptive treatment could initiate osteonecrosis.

  • 30.
    Klinge, Anna
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Becktor, Karin
    Clinic for Orthodontics and Oral Surgery, Strandvejen 116A, 2900, Hellerup, Copenhagen, Denmark.
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Craniofacial height in relation to cross-sectional maxillary and mandibular morphology2017Ingår i: Progress in Orthodontics, ISSN 1723-7785, Vol. 18, nr 32, artikel-id 32Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background In order to gain a better understanding of how growth of the alveolar bone is linked to the vertical development of the face, the purpose of this study was to investigate if there is an association between the cross-sectional morphology of the maxillary and mandibular bodies with the craniofacial height, using images from cone beam computed tomography (CBCT). Methods From 450 pre-treatment CBCT scans, 180 were selected to be included in the study. Lateral head images were generated from the CBCT scans and were used to categorise subjects into three groups based on their vertical craniofacial height. Cross-sectional images from CBCT volumes were reformatted of the maxillary and mandibular bodies at five locations in the maxilla and five in the mandible. Each image was measured at one height and two width measurements. Statistical analysis performed was the one-way analysis of variance with a Tukey post hoc test. A significance level of 5% was used in all comparisons. Results Patients with large vertical craniofacial height had a significantly higher cross-sectional area both in the maxilla and in the mandible. In the same group, the cross-sectional area was significantly thinner in the mandible compared with the other two groups, especially in the anterior region. Conclusions This study further highlights the close relationship between craniofacial height and alveolar bone dimensions and contributes with important knowledge for planning and follow-up of comprehensive dental- and orthodontic treatments.

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  • 31.
    Johansson, Krister
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Östlund, Pernilla
    Malmö högskola, Odontologiska fakulteten (OD).
    Tranæus, Sofia
    Malmö högskola, Odontologiska fakulteten (OD). Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Effects of Bacterial Contamination on Dental Implants During Surgery: A Systematic Review2017Ingår i: Implant Dentistry, ISSN 1056-6163, E-ISSN 1538-2982, Vol. 26, nr 5, s. 778-789Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Contamination during surgery negatively influences the prognosis of orthopaedic implants; however, it has not been proven whether contamination influences the success of dental implant treatment. The aim of the systematic review was to investigate if there exists evidence in the literature whether contamination of dental implants during surgery affects osseointegration and clinical success. MATERIALS AND METHODS: Four data bases were used for the literature search. Primary studies and reviews regarding both clinical and preclinical research were eligible. Rating of the summarized quality of the evidence was performed. RESULTS: Five preclinical studies were included. Because of the estimated high risk of bias in all included studies and extensive differences in study design between the included studies, meta-analysis was not performed and no reliable aggregated data could be extracted. CONCLUSIONS: It is suggested that the scientific evidence with regard to the current topic is insufficient. Further controlled studies are warranted.

  • 32.
    Stocchero, Michele
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Toia, Marco
    Malmö högskola, Odontologiska fakulteten (OD).
    Cecchinato, Denis
    Institute Franci, Private Practice, Padova, Italy.
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Coelho, Paulo G
    Department of Biomaterials and Biomimetics, New York University, New York, NY, United States.
    Jimbo, Ryo
    Malmö högskola, Odontologiska fakulteten (OD).
    Biomechanical, Biologic, and Clinical Outcomes of Undersized Implant Surgical Preparation: A Systematic Review2016Ingår i: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 31, nr 6, s. 1247-1263Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    PURPOSE: To compile the current evidence on biomechanical, biologic, and clinical outcomes of undersized surgical preparation protocols in dental implant surgery. MATERIALS AND METHODS: An electronic search using three different databases (PubMed, Web of Science, and Cochrane Library) and a manual hand search were performed including in vitro, animal, and clinical studies published prior to October 2015. Studies in which an undersized drilling protocol was compared with a nonundersized drilling protocol were included. RESULTS: From an initial selection of 1,655 titles, 29 studies met the inclusion criteria, including 14 biomechanical, 7 biologic, 6 biologic and biomechanical, and 2 clinical. Due to methodologic variation, meta-analysis was not performed. Several studies showed that implants inserted with an undersized drilling approach reached a significantly higher insertion torque value than conventional drilling in low-density substrates, while this effect is less evident if a thick cortical layer is present. Similar results in terms of boneto-implant contact (BIC) were achieved in the longer term between implants inserted with undersized and nonundersized protocols. Results in the short term were inconclusive. Clinical studies did not show negative outcomes for undersized drilling, although clinical evidence was sparse. No data are available on marginal bone loss. CONCLUSION: From the biomechanical standpoint, an undersized drilling protocol is effective in increasing insertion torque in low-density bone. Biologic response in long-term healing after undersized implant placement is comparable to that in the nonundersized surgical drilling protocol. Clinical studies indicate that performing an undersized drilling protocol on low-density bone is a safe procedure; however, more extensive studies are needed to confirm these data.

  • 33.
    Bengtsson, Martin
    et al.
    Senior Consultant, Department of Oral and Maxillofacial Surgery, The University Hospital of Skåne, Lund, Sweden.
    Korduner, Mikael
    Head and Senior Consultant, Department of Oral and Maxillofacial Surgery, The University Hospital of Skåne, Lund, Sweden.
    Campbell, Vanessa
    Malmö högskola, Odontologiska fakulteten (OD).
    Fransson, Philip
    Malmö högskola, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Mandibular Access Osteotomy for Tumor Ablation: Could a More Tissue-Preserving Technique Affect Healing Outcome?2016Ingår i: Journal of oral and maxillofacial surgery (Print), ISSN 0278-2391, E-ISSN 1531-5053, Vol. 74, nr 10, s. 2085-2092Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: Paramedial mandibulotomy facilitates access for the resection of tumors in the oral and oropharyngeal space; however, severe complications related to surgical techniques and radiotherapy have been reported for this procedure. This study evaluated whether preservation of the periosteum during a mandibulotomy would decrease postoperative complications owing to the increased healing capacity provided by preserving more tissue. Materials and Methods: Patients who underwent mandibulotomy for surgical tumor ablation from 2007 through 2012 were included in a retrospective controlled cohort study. The trial was comprised of 2 groups: 1 group underwent subperiosteal and 1 group underwent supraperiosteal surgical dissection in the area of the mandibulotomy. The primary predictor variable was surgical technique and the primary outcome variable was surgical complications. The groups were matched according to tumor type, age, and gender. Clinical and radiographic follow-up was performed 12 months after surgery. Complications regarding bone exposure, plate exposure, osteoradionecrosis, nonunion, infection of the soft tissue flap, abscesses, fistulas, and gingival necrosis were recorded. Recordings of other factors, such as age, smoking habits, and timing of radiotherapy and chemotherapy, were performed and the 2 groups were compared for postoperative complications. Data analysis used the c2 test (Fisher exact test) to compare the sub- and supraperiosteal groups for postoperative complications. Results: Thirty-two patients were included (16 per group; 14 women and 18 men; mean age, 56 yr). Thir- teen patients in the subperiosteal group and 7 in the supraperiosteal group showed complications during the first 12 months. Seven patients had complications that persisted to the 12-month follow-up (6 in the subperiosteal group and 1 in the supraperiosteal group); however, the difference was not statistically relevant. Conclusion: This study found more persistent complications in the subperiosteal group compared with the supraperiosteal group at 12-month follow-up, which could imply that a more tissue-preserving surgical technique promotes mandibular healing in patients undergoing mandibular access osteotomy in combination with radiotherapy.

  • 34.
    Hallmer, Fredrik
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Bjørnland, Tore
    Nicklasson, Anders
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Andersson, Gunilla
    Malmö högskola, Odontologiska fakulteten (OD).
    Osteonecrosis of the jaw in patients treated with oral and intravenous bisphosphonates: experience in Sweden2014Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology, ISSN 2212-4403, E-ISSN 2212-4411, Vol. 118, nr 2, s. 202-208Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the prevalence, inciting factors, and treatment outcomes of bisphosphonate-related osteonecrosis of the jaw (BRONJ) during the 2003-2010 period in southern Sweden (population, approximately 1.2 million people). STUDY DESIGN: Patient records were searched for inflammatory conditions including unspecified inflammation, osteomyelitis, osteonecrosis due to drugs, and other osteonecrosis. Data on underlying disease, type of bisphosphonate (BP), inciting factor, location, stage, treatment, and treatment outcomes were collected. RESULTS: Of the 341 patients identified, 55 had been diagnosed with BRONJ. Those with a malignant disease were treated with intravenous BPs, and those with osteoporosis were treated with oral BPs. All but 5 were treated with antibiotics and 47 with local resection. Healing was recorded in 79% of patients with osteoporosis and in 26% of patients with malignant disease. CONCLUSIONS: Healing in patients with osteoporosis occurred more frequently than in patients with a malignant disease treated with intravenous BPs (P = .00009).

  • 35. Svensson, Roger
    et al.
    Hallmer, Fredrik
    Malmö högskola, Odontologiska fakulteten (OD).
    Englesson, Charlotta Sahlstrom
    Svensson, Peter J
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Treatment with local hemostatic agents and primary closure after tooth extraction in warfarin treated patients2013Ingår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, nr 2, s. 71-77Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract The aim of this retrospective study was to assess the frequency of postoperative bleeding in patients on warfarin after tooth removal followed by a complete soft tissue closure of the surgical site. A total of 124 consecutive patients, 69 males and 55 females with a mean age of 71 years (range 28-95 years) were included in this study. Inclusion criteria were patients on warfarin with an INR <or=3.5 who were referred for tooth removal (single or multiple) during 2004-2009. After tooth extraction all sockets were packed with an absorbable haemostatic gelatin sponge or a collagen fleece and subsequently the sockets was primary closed with sutures. 5/124 (4%) patients returned with postoperative bleedings. All patients with a postoperative bleeding had received a surgical extraction in the posterior part of the maxilla. Consequently no patient had a postoperative bleeding in the mandible. None of the 124 patients returned to the clinic with a dry socket or postoperative pain. 3/124 (2%) patients returned with postoperative infection that required antibiotic treatment. All patients who bled were managed conservatively and none was admitted to hospital. CONCLUSION: According to the protocol of this study (local hemostatic, primary closure, sutures and tranexamic acid) the risk of postoperative bleeding after tooth removal in patients on continued warfarin medication is low.

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  • 36. Galindo-Moreno, Pablo
    et al.
    Nilsson, Peter
    King, Paul
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Speroni, Stefano
    Schramm, Alexander
    Maiorana, Carlo
    Clinical and radiographic evaluation of early loaded narrow diameter implants - 1-year follow-up2012Ingår i: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 23, nr 5, s. 609-616Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 37. Johansson, Lars-Åke
    et al.
    Isaksson, Sten
    Lindh, Christina
    Malmö högskola, Odontologiska fakulteten (OD).
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Sennerby, Lars
    Maxillary sinus floor augmentation and simultaneous implant placement using locally harvested autogenous bone chips and bone debris: a prospective clinical study2010Ingår i: Journal of oral and maxillofacial surgery (Print), ISSN 0278-2391, E-ISSN 1531-5053, Vol. 68, nr 4, s. 837-844Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract PURPOSE: The aim of this study was to prospectively evaluate the status of implants, marginal bone loss, and outcome of maxillary sinus floor augmentation in patients undergoing maxillary sinus lift and simultaneous implant placement with the use of bone grafts harvested adjacent to the actual surgical site. MATERIALS AND METHODS: Patients in need of maxillary sinus floor augmentation to enable implant placement were enrolled in 2 different groups. In group A, a "bone trap" was used to harvest bone debris during implant preparation with additional bone collected by further drilling adjacent to the implant sites. In group B, a "bone scraper" was used to harvest cortical bone chips from the zygomatic buttress and from the lateral sinus wall before opening of a bony window. All patients were provided a fixed partial denture after a healing period of 3 to 6 months. A total of 61 patients with 81 Straumann implants (Institut Straumann AG, Basel, Switzerland) were assessed, with 17 patients (20 implants) in group A and 44 patients (61 implants) in group B. RESULTS: One implant was lost (in group B) before loading. The survival rate after a follow-up of 12 to 60 months was 98.8%. There was no significant difference in marginal bone loss on the mesial and distal sides of the implant when baseline to 1-year registration was compared with baseline to final registration. During the same time, graft height decreased significantly on the distal apical side of the implants. CONCLUSIONS: Bone grafts can be locally harvested at the site of the maxillary sinus augmentation procedure to enable placement, successful healing, and loading of 1 to 3 implants.

  • 38. Isaksson, Rita
    et al.
    Becktor, Jonas P
    Malmö högskola, Odontologiska fakulteten (OD).
    Brown, Andrew
    Laurizohn, Christer
    Isaksson, Sten
    Oral health and oral implant status in edentulous patients with implant-supported dental prostheses who are receiving long-term nursing care2009Ingår i: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 26, nr 4, s. 245-249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: The aim of this study was to investigate oral health and oral implant status in a group of edentulous patients receiving long-term residential or nursing care (LTC), all of whom had implant-supported fixed or removable dental prostheses. MATERIAL AND METHODS: A dental examination was performed on a total of 3310 patients receiving LTC and from this population 35 edentulous patients in whom dental implants had been placed formed the cohort for this study. All examinations were performed by a specialist in hospital dentistry and took place in the patients' own home environment. Oral health was assessed by means of a protocol which evaluated oral hygiene status, possible oral mucosal inflammation and oral mucosal friction levels. Any problems with the implant-supported prosthesis, implant mobility or other complications were also assessed. In addition, patients were asked about any oral symptoms and their usual oral hygiene procedures. RESULTS: About half of the subjects (17/35) were registered as having no/mild inflammation with 18 of 35 having moderate/severe inflammation. Twelve of the 35 patients had good/acceptable oral hygiene and 23 of 35 had poor/bad oral hygiene. Twenty-one of the 35 patients depended on help from the nursing personnel for their daily oral hygiene procedures. Obvious problems with food impaction were noted in 11 patients. A total of 229 implants had been placed in 43 jaws supporting 40 full arch-fixed prostheses and three implant-borne overdentures. There was no evidence of mobility or fractures of either the implants or the prostheses. Fifteen implants showed some exposed screw threads. Pus was exuding from one implant site and general peri-implant gingival hyperplasia was noted in two patients. Twenty-four patients were completely satisfied with the function and appearance of their implant-supported prostheses. Two patients were totally dissatisfied. CONCLUSION: This study indicates that oral implant therapy can be considered as a treatment of choice in elderly patients, even if oral hygiene is sub-optimal.

  • 39.
    Becktor, Jonas P
    et al.
    Malmö högskola, Odontologiska fakulteten (OD).
    Hallström, Hadar
    Malmö högskola, Odontologiska fakulteten (OD).
    Isaksson, Sten
    Sennerby, Lars
    The Use of Particulate Bone Grafts From the Mandible for Maxillary Sinus Floor Augmentation Before Placement of Surface-Modified Implants: Results From Bone Grafting to Delivery of the Final Fixed Prosthesis2008Ingår i: Journal of oral and maxillofacial surgery (Print), ISSN 0278-2391, E-ISSN 1531-5053, Vol. 66, nr 4, s. 780-786Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose This prospective study followed 61 patients who were partially dentulous and considered to have insufficient bone volume for routine implant treatment and consequently underwent sinus inlay bone grafting. Patients and Methods The patients were treated with maxillary sinus floor augmentation with particulated autogenous bone from the mandibular ramus/corpus. After a healing period, dental implants (n = 180) were installed. Results Radiographic examination revealed average residual vertical bone heights of 6.5 mm in the first premolar region, 3.8 mm in the second premolar region, 3.5 mm in the first molar region, and 2.6 mm in the second molar region. The average implant lengths were 12 mm in the first premolar region and 11 mm in the second premolar, first, and second molar regions. All patients received a fixed partial prosthesis. All bone grafts were stable, and the implant survival rate was 98.9%. There were few cases of minor complications postoperatively and no record of any injured teeth, heavy bruising, bleeding, or swelling in either the donor site or the recipient site. The present clinical study demonstrated a low failure rate of surface-modified dental implants when placed into the maxillary sinus an average of 7 months after augmentation with particulate mandibular bone grafts and followed up to delivery of the final fixed prosthesis. Conclusion The findings indicate that treatment with endosseous implants may be as predictable in patients with inadequate bone who underwent sinus floor augmentation as in patients with adequate bone volume.

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