| 1. |
- Jepsen, S., et al.
(författare)
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Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration
- 2019
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979 .- 1600-051X. ; 46, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- Background and Aims Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. Material and Methods The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures. Results A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. Conclusions The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post-operative complications.
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| 2. |
- Jepsen, S, et al.
(författare)
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Regenration of alveolar ridge defects : Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration
- 2019
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Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 46, s. 277-286
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS: Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects.MATERIAL AND METHODS: The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures.RESULTS: A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long-term for the partially and fully edentulous maxilla.CONCLUSIONS: The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for postoperative complications. This article is protected by copyright. All rights reserved.
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| 3. |
- Farina, R., et al.
(författare)
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Change in the Gingival Margin Profile After the Single Flap Approach in Periodontal Intraosseous Defects
- 2015
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Ingår i: Journal of Periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 86:9, s. 1038-1046
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the present study is to evaluate the association of patient-related and site-specific factors, as well as the adopted treatment modality, with the change in buccal (bREC) and interdental (iREC) gingival recession observed at 6 months after treatment of periodontal intraosseous defects with the single flap approach (SFA). Methods: Sixty-six patients contributing 74 intraosseous defects accessed with a buccal SFA and treated with different modalities were selected retrospectively. A two-level (patient and site) model was constructed, with the 6-month changes in bREC and iREC as the dependent variables. Results: 1) Significant 6-month increases in bREC (-0.6 +/- 0.7 mm) and iREC (-0.9 +/- -1.1 mm) were observed. 2) bREC change was significantly predicted by presurgery interproximal probing depth (PD) and depth of osseous dehiscence at the buccal aspect. 3) iREC change was significantly predicted by presurgery interproximal PD and the treatment modality, with defects treated with SFA in combination with a graft material and a bioactive agent being less prone to iREC increase compared to defects treated with SFA alone. Conclusions: After buccal SFA, greater post-surgery increase in bREC must be expected for deep intraosseous defects associated with a buccal dehiscence. The combination of a graft material and a bioactive agent in adjunct to the SFA may limit the postoperative increase in iREC.
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| 4. |
- Simonelli, A., et al.
(författare)
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Prognostic value of a composite outcome measure for periodontal stability following periodontal regenerative treatment: A retrospective analysis at 4 years
- 2023
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Ingår i: Journal of Periodontology. - 0022-3492. ; 94:9, s. 1090-1099
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundRecently, a composite outcome measure (COM) was proposed to describe the short-term results of periodontal regenerative treatment. The present retrospective study aimed at evaluating the prognostic value of COM on clinical attachment level (CAL) change over a 4-year period of supportive periodontal care (SPC). MethodsSeventy-four intraosseous defects in 59 patients were evaluated at 6 months and 4 years following regenerative treatment. Based on 6-month CAL change and probing depth (PD), defects were classified as: COM1 (CAL gain & GE;3 mm, PD & LE;4 mm); COM2 (CAL gain <3 mm, PD & LE;4 mm); COM3 (CAL gain & GE;3 mm, PD >4 mm); or COM4 (CAL gain <3 mm, PD >4 mm). COM groups were compared for "stability" (i.e., CAL gain, no change in CAL or CAL loss <1 mm) at 4 years. Also, groups were compared for mean change in PD and CAL, need for surgical retreatment, and tooth survival. ResultsAt 4 years, the proportion of stable defects in COM1, COM2, COM3, and COM4 group was 69.2%, 75%, 50%, and 28.6%, respectively, with a substantially higher probability for a defect to show stability for COM1, COM2, and COM3 compared with COM4 (odds ratio 4.6, 9.1, and 2.4, respectively). Although higher prevalence of surgical reinterventions and lower tooth survival were observed in COM4, no significant differences were detected among COM groups. ConclusionsCOM may be of value in predicting CAL change at sites undergoing SPC following periodontal regenerative surgery. Studies on larger cohorts, however, are needed to substantiate the present findings.
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| 6. |
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| 7. |
- Farina, R., et al.
(författare)
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Bleeding on probing around dental implants: a retrospective study of associated factors
- 2017
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979. ; 44:1, s. 115-122
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Tidskriftsartikel (refereegranskat)abstract
- AimTo (i) identify factors associated with the probability of a peri-implant site to be positive to bleeding on probing (BoP+) and (ii) compare BoP+ probability around dental implants and contra-lateral teeth. MethodsIn 112 patients, data related to 1725 peri-implant sites and 1020 contra-lateral dental sites were retrospectively obtained. To analyse the association between patient-, implant- and site-related factors and BoP+ probability, a logistic, three-level model was built with BoP as the binary outcome variable (+/-). ResultsBoP+ probability for a peri-implant site with probing depth (PD) of 4mm was 27%, and the odds ratio increased by 1.6 for each 1-mm increment in PD (p<0.001). Also, BoP+ probability was higher in females compared to males (OR=1.61; p=0.048), and lower at posterior compared to anterior dental implants (OR=0.55; p<0.01). No significant difference in BoP+ probability was observed between peri-implant and contra-lateral dental sites when controlling for the difference in PD. ConclusionsThe probability of a peri-implant site to bleed upon probing is (i) associated with PD, implant position and gender, and (ii) similar to that observed at contra-lateral dental sites when controlling for the effect of PD.
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| 8. |
- Farina, R., et al.
(författare)
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The bleeding site: a multi-level analysis of associated factors
- 2013
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Ingår i: Journal of Clinical Periodontology. - : Wiley. - 0303-6979. ; 40:8, s. 735-742
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Tidskriftsartikel (refereegranskat)abstract
- Aim To evaluate the association between the probability of a sulcus/pocket to bleed on probing (BoP) and patient related as well as site-specific characteristics. Methods Data from 88960 sites were retrospectively derived from the clinical record charts of 601 adult patients. BoP (positive/negative) had been recorded at the initial periodontal visit after probing pocket depth (PPD) assessment. To analyse the influence of patient-, tooth- and site-related factors on the probability for a site to be BoP+, a logistic, 3-level model was built with BoP as the binary outcome variable. Results (i) The mean probability to be BoP+ for a site with PPD=3mm was 18%, and the log odds increased by 0.69 for each 1mm increment in PPD; (ii) a significantly higher risk for BoP+ was observed for inter-proximal versus approximal surfaces, posterior teeth versus anterior teeth, females versus males, while a significantly lower risk was observed for smokers versus non-smokers; (iii) when controlling for the significant covariates, different BoP+ probabilities could still be observed among sites in patients with a different susceptibility to BoP. Conclusions The probability of a site to be BoP+ was associated with either site-specific (i.e. PPD, tooth aspect, tooth type) or patient-related factors (i.e. gender, smoking status).
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| 9. |
- Miron, Richard J., et al.
(författare)
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Twenty years of enamel matrix derivative : the past, the present and the future
- 2016
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Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 43:8, s. 668-683
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Forskningsöversikt (refereegranskat)abstract
- Background On June 5th, 2015 at Europerio 8, a group of leading experts were gathered to discuss what has now been 20years of documented evidence supporting the clinical use of enamel matrix derivative (EMD). Original experiments led by Lars Hammarstrom demonstrated that enamel matrix proteins could serve as key regenerative proteins capable of promoting periodontal regeneration including new cementum, with functionally oriented inserting new periodontal ligament fibres, and new alveolar bone formation. This pioneering work and vision by Lars Hammarstrom has paved the way to an enormous amount of publications related to its biological basis and clinical use. Twenty years later, it is clear that all these studies have greatly contributed to our understanding of how biologics can act as mediators for periodontal regeneration and have provided additional clinical means to support tissue regeneration of the periodontium. Aims This review article aims to: (1) provide the biological background necessary to understand the rational for the use of EMD for periodontal regeneration, (2) present animal and human histological evidence of periodontal regeneration following EMD application, (3) provide clinically relevant indications for the use of EMD and (4) discuss future avenues of research including key early findings leading to the development of Osteogain, a new carrier system for EMD specifically developed with better protein adsorption to bone grafting materials
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