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1.
  • Christiaens, Veronique, et al. (författare)
  • Intraoral radiography lacks accuracy for the assessment of peri-implant bone level : a controlled clinical study
  • 2017
  • Ingår i: European Journal of Oral Implantology. - : Quintessence. - 1756-2406 .- 1756-2414. ; 10:4, s. 435-441
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: The aim of this study was to compare clinical and radiographic bone level assessments to intra-surgical bone level registration around implants with peri-implantitis and to identify the clinical variables rendering peri-implant bone level assessment accuracy. Materials and methods: The study sample included 50 implants with peri-implantitis in 23 patients. Registration methods included probing of the vertical distance between the implant/abutment interface and the bottom of the pocket (= VPD), intraoral radiography, bone sounding without flap elevation and intra-surgically assessed interproximal bone level. The latter was considered the true bone level (gold standard). Twenty clinicians evaluated all radiographs. Results: VPD and intraoral radiography resulted in a significant underestimation of the true bone level by 1.0 mm (95% CI: 0.495-1.585; P < 0.001) and 2.3 mm (95% CI: 1.650-2.980; P < 0.013) respectively. Bone sounding without flap elevation did not differ significantly from the true bone level (mean difference 0.2 mm; 95% CI: -0.775 - 0.335; P = 0.429). Duplicate magnification registration of 50 implants resulted in excellent intra- and inter-rater reliability (ICC intra <= 0.99; ICC inter = 0.964; P < 0.001). Radiographic underestimation was significantly affected by defect depth (P < 0.001). Variation among clinicians was substantial (mean underestimation range 1.1 mm to 3.8 mm); however, clinical experience had no impact on radiographic underestimation (P = 0.796). Conclusions: Bone sounding without flap elevation was the best predictor of peri-implant bone level, whereas intraoral radiography was the most inferior. Consequently, peri-implantitis may be under-diagnosed if examination is only based on radiographs.
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2.
  • Cosyn, Jan, et al. (författare)
  • A 5-year prospective study on single immediate implants in the aesthetic zone
  • 2016
  • Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 43:8, s. 702-709
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim There is a paucity of long-term data on soft tissue aesthetics of single immediate implants. The objective of this study was to evaluate the 5-year clinical and aesthetic outcome of this treatment concept. Materials and methods Twenty-two periodontally healthy patients (12 men, 10 women; mean age 50) with low risk for aesthetic complications (thick gingival biotype, intact buccal bone wall, both neighbouring teeth present) were consecutively treated with a single immediate implant in the aesthetic zone (15-25). Flapless surgery was performed and the gap between the implant and buccal bone wall was systematically filled with bovine bone particles. Implants were immediately non-functionally loaded with a screw-retained provisional crown. Cases demonstrating major alveolar process changes and/or advanced mid-facial recession (>1mm) at 3months were additionally treated with a connective tissue graft (CTG). Permanent crowns were installed at 6months. The clinical and aesthetic results at 5years were compared to those obtained at 1 year Results Seventeen patients attended the 5-year re-assessment, of whom five had been treated with a CTG for early aesthetic complications. There was one early implant failure and one complication after 1 year (porcelain chipping). Mean marginal bone loss was 0.12mm at 1 year and 0.19mm at 5years (p=0.595) with the moment of implant installation as baseline. Papilla height increased between 1 and 5years (p0.007), whereas mid-facial contour (p=0.005) and alveolar process deficiency (p=0.008) deteriorated. Mean mid-facial recession was on average 0.28mm (SD 0.48) at 1 year and 0.53mm (SD 0.53) at 5years (p=0.072) with the preoperative status as baseline. Three implants demonstrated advanced mid-facial recession (>1mm) at 5years. All three were in a central incisor position and none had been treated with a CTG. Thus, 8/17 implants showed aesthetic complications (five early and three late aesthetic complications). Implants in a lateral incisor position showed stable soft tissue levels. The pink aesthetic score was on average 12.15 at 1 year and 11.18 at 5years (p=0.030 Conclusion Single immediate implants showed high implant survival and limited marginal bone loss in the long term. However, mid-facial recession, mid-facial contour and alveolar process deficiency deteriorated after 1year. With an aesthetic complication rate of 8/17 in well-selected patients who had been treated by experienced clinicians, type I placement may not be recommended for daily practice
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3.
  • Cosyn, Jan, et al. (författare)
  • A double-blind randomized placebo-controlled study on the clinical and microbial effects of an essential oil mouth rinse used by patients in supportive periodontal care
  • 2013
  • Ingår i: International Journal of Dental Hygiene. - : John Wiley & Sons. - 1601-5029 .- 1601-5037. ; 11:1, s. 53-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim This 3-month double-blind randomized placebo-controlled study evaluated the clinical and microbial effects of an essential oil mouth rinse used as an adjunct to mechanical plaque control by patients in supportive periodontal care. Material and methods Fifty patients were randomly allocated to an essential oil group (Listerine® Coolmint; Johnson & Johnson, New Brunswick, NJ, USA) or placebo group to rinse twice per day as an adjunct to mechanical plaque control. At baseline and after 3 months, plaque index (PI), gingivitis index (GI), probing pocket depth, bleeding on probing (BoP) and clinical attachment level were registered. Subgingival plaque samples were collected for the detection and quantification of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Micromonas micros, Prevotella intermedia, Fusobacterium genus and Streptococcus mutans by means of real-time PCR (qPCR). Patient's compliance, satisfaction and side effects were registered. Results Twenty-three patients in the essential oil group (mean age: 57) and 21 in the placebo group (mean age: 55) with acceptable oral hygiene at intake (mean PI <1.5 on a scale of 5) adhered to the study protocol. Gingivitis index, PI and BoP significantly reduced over time (P ≤ 0.029); however, between group analyses revealed no significant differences. There was no significant change over time neither in detection frequency nor load for any of the microbiota. Daily rinsing with an essential oil rinse was found safe and perceived beneficial by the patients. Conclusion Patients in supportive periodontal care who are fairly compliant with oral hygiene may not benefit from additional mouth rinsing using an essential oil solution.
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4.
  • Cosyn, Jan, et al. (författare)
  • An analysis of the decision-making process for single implant treatment in general practice
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:2, s. 166-172
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To study the frequency of and factors associated with the decision to perform single implant treatment after tooth extraction by general practitioners in a private, fee-for-service setting. Material and methods One hundred practitioners with a general dental practice in Ghent were randomly selected. Clinicians were asked to fill in a study form for every single extraction they performed during an 8-week period. The form related to the treatment decision and a number of patient- and clinician-related factors. Results Ninety-four general dentists (52 men, 42 women; mean age 49; range 24–68) agreed to participate and extracted 1180 single teeth. After exclusion of third molars and cases where the reason for tooth loss would generally prohibit replacement, 900 cases were identified. In 24% of these patients, there was no treatment decision and in 18% replacement was deemed unnecessary. When replacement was necessary (n = 526), removable partial denture (RPD), fixed partial denture (FPD), single implant treatment and resin-bonded bridge were chosen in 54%, 24%, 21% and 1% of the patients, respectively. Multinomial logistic regression was used to evaluate the decision-making process for single implant treatment against RPD and FPD. In relation to RPD, single implant treatment was more likely in highly educated patients with few missing teeth and no bone loss at adjacent teeth. In relation to FPD, single implant treatment was more likely in patients with intact adjacent teeth and when the tooth was extracted by a female dentist. Experience in implant prosthetics was positively associated with single implant treatment in all analyses. Conclusions Single implant treatment is not the most common procedure in daily practice to restore a single tooth gap. Patient's education, oral factors and clinician-related factors may affect the decision-making process, whereas medical factors may not.
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5.
  • Cosyn, Jan, et al. (författare)
  • An Exploratory Case-Control Study on the Impact of IL-1 Gene Polymorphisms on Early Implant Failure
  • 2016
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:2, s. 234-240
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The association between IL-1 gene polymorphisms and peri-implantitis has been well documented. However, data on the association with early implant failure are scarce. Purpose The objective of this case-control study was to explore the impact of IL-1A (-889), IL-1B (-511), and IL-1B (+3,954) gene polymorphisms on early implant failure in Caucasians Materials and Methods Between September 2004 and August 2007, 461 patients were treated with dental implants at the University Hospital in Ghent, Belgium. Fourteen subjects of this patient group who had experienced one or more early implant failures (within 6 months from implant installation) were recruited as cases. Fourteen controls, matched in terms of age, gender, and smoking habits, with only surviving implants, were selected from the same patient group. Allele and genotype analysis was performed on the basis of a blood sample by Sanger sequencing of polymerase chain reaction products containing the IL-1A (-889), IL-1B (-511), and IL-1B (+3,954) gene polymorphisms Results A significant impact of the IL-1A (-889) T allele (p=.039) and the IL-1B (+3,954) T allele (p=.003) on early implant failure was demonstrated (odds ratios=3.9 and 15.0, respectively). In addition, the genotypic distribution differed significantly between cases and controls for IL-1B (+3,954) (p=.015 ConclusionsThe IL-1B (+3,954) gene polymorphism seems to affect osseointegration. Additional case-control studies in larger patient groups are needed to confirm this observation.
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6.
  • Cosyn, Jan, et al. (författare)
  • Disparity in embrasure fill and papilla height between tooth- and implant-borne fixed restorations in the anterior maxilla : a cross-sectional study
  • 2013
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 40:7, s. 728-733
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The objective of the present study was to compare inter-proximal fill and papilla height between different embrasures. Material & Methods One hundred and fifty non-smoking consecutive patients (mean age 54, range 32–73; 63 males and 87 females) without periodontal disease were selected in a multidisciplinary practice during regular supportive care. All had been treated for multiple tooth loss in the anterior maxilla at least 1 year earlier by means of a fixed restoration on teeth (n = 50) or implants (n = 100) using straightforward procedures (without hard and/or soft tissue augmentation). Embrasure fill was assessed by means of Jemt's papilla index and papilla height was registered following local anaesthesia by means of bone sounding by one clinician. Results Tooth-pontic and tooth-implant embrasures demonstrated comparable inter-proximal fill and papilla height (≥58% Jemt's score 3; mean papilla height ≥4.1 mm). Between missing teeth, embrasure fill and papilla height were lower regardless of the embrasure type. The implant-implant and implant-pontic embrasure demonstrated comparable outcome (≤42% Jemt's score 3; mean papilla height ≤ 3.3 mm; p ≥ 0.416), which was significantly poorer when compared to the pontic-pontic embrasure (82% Jemt's score 3; mean papilla height 3.7 mm; p ≤ 0.019). Overall, papilla index and papilla height demonstrated a weak correlation (Spearman's correlation coefficient: 0.198; p = 0.002). Conclusions The re-establishment of a papilla is difficult when there is no tooth involved. In that scenario a short papilla should be expected and implant-borne restorations demonstrate the poorest outcome. Moreover, an implant with a pontic may not perform better than adjacent implants.
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7.
  • Cosyn, Jan, et al. (författare)
  • Minimally Invasive Single Implant Treatment (MISIT) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile : one-year results
  • 2015
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 42:4, s. 398-405
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo evaluate the 1-year outcome of Minimally Invasive Single Implant Treatment (M.I.S.I.T.) based on ridge preservation and contour augmentation in patients with a high aesthetic risk profile. Materials and MethodsPeriodontally healthy non-smoking patients with a failing tooth in the anterior maxilla (15-25) were selected. All were in need of a single implant and demonstrated high risk for aesthetic complications given mid-facial recession at the failing tooth and/or a buccal bone dehiscence and/or a thin-scalloped gingival biotype. Patients without mid-facial recession (NRG) received flapless tooth extraction and ridge preservation using a collagen-enriched bovine-derived xenograft, flapless installation of a bone condensing implant with variable-thread design (4-6months later), a provisional screw-retained crown and connective tissue graft (CTG) inserted in the buccal mucosa (3months later) and a permanent crown (3months later). Patients with mid-facial recession (RG) were treated similarly, yet they received a CTG at the time of ridge preservation. All patients were treated by an experienced periodontist using a microsurgical approach. Primary outcome variables included papillary and mid-facial recession. Clinical parameters, pink (PES) and white aesthetic score (WES) were considered secondary outcome variables. ResultsFifty patients (25 females, 25 males; mean age 39, range 19-81; 42 in NRG and 8 in RG) met the selection criteria and consented to the treatment. Forty-seven could be examined at 12months and all implants survived. Mean bone loss amounted to 0.48mm (range 0.00-1.80) at 12months. Papillary recession was minimal in both groups at 12months (mean0.3mm), as was mid-facial recession in the NRG (mean 0.1mm). Twelve patients in the NRG even demonstrated coronal migration of the mucosal margin following CTG and needed adaptation of the provisional crown to induce soft tissue retraction. Due to CTG at the time of ridge preservation in the RG, mid-facial soft tissue gain amounted to 0.9mm at 12months, hereby eliminating 2/3rd of the initial recession. PES and WES were favourable pointing to 10.9/14 and 8.2/10 respectively. ConclusionThis short-term prospective study offers a proof of principle of M.I.S.I.T. in patients with a high aesthetic risk profile.
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8.
  • Cosyn, Jan, et al. (författare)
  • Predictors of Alveolar Process Remodeling Following Ridge Preservation in High-Risk Patients
  • 2016
  • Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley-Blackwell. - 1523-0899 .- 1708-8208. ; 18:2, s. 226-233
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose(1) To clinically evaluate horizontal remodeling of the alveolar process (hard and soft tissues) following ridge preservation in high-risk patients and (2) to identify predictors of such remodeling. Materials and MethodsPeriodontally healthy nonsmoking patients with a failing tooth in the anterior maxilla (15-25) were selected for a prospective case series. All were in need of a single implant and demonstrated high risk for aesthetic complications given an incomplete buccal bone wall and/or thin-scalloped gingival biotype. Following flapless tooth extraction, ridge preservation was performed using one or more collagen-enriched, bovine-derived block grafts (Geistlich Bio-Oss (R) Collagen (R) 100mg, Geistlich Pharma AG, Wolhusen, Switzerland) without the additional use of membranes or soft tissue grafts. The change in buccopalatal dimension of the alveolar process between baseline (prior to tooth extraction) and 4 months was assessed on the basis of superimposed occlusal slides. Regression analysis was performed to identify predictors of alveolar process remodeling ResultsForty-two patients (21 females, 21 males; mean age 38) met the selection criteria and consented to the treatment. Mean alveolar process remodeling was 14% (SD 7, range 4-30) with minimal remodeling (10%) in 16 patients (38%) and advanced remodeling (>20%) in 10 patients (24%). A single implant could be installed in all subjects without additional guided bone regeneration. Connective tissue grafting was performed later on in the treatment for aesthetic purposes, hereby compensating for tissue loss at the buccal aspect. Predictors of alveolar process remodeling were tooth location (central incisors and cuspids>laterals incisors and premolars), tooth abscess (p=.025), and buccal bone loss (p=.035 ConclusionAlveolar process remodeling seems inevitable yet acceptable following ridge preservation in high-risk patients. Proper case selection may reduce the incidence of advanced remodeling
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9.
  • Cosyn, Jan, et al. (författare)
  • Predictors of inter-proximal and midfacial recession following single implant treatment in the anterior maxilla : a multivariate analysis
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 39:9, s. 895-903
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose A number of factors have been associated with soft tissue recession following single implant treatment. However, given the cross-sectional design of most of these studies and crude associations based on univariate analyses, such factors may only be considered risk indicators. The objective of the present retrospective cohort study using multivariate analyses was to identify predictors of recession. Material and Methods Patients who had been treated by two periodontists and two prosthodontists in 2006 and 2007 for a single implant in the anterior maxilla were re-examined in 2009 and their records were scrutinized. Subjects treated via flap surgery with and without ridge re-contouring were considered. Outcome variables were inter-proximal and midfacial recession. Explanatory variables included demographic data, the surgical approach and a number of local factors that were evaluated on radiographs taken pre-operatively or at permanent crown installation (baseline). Results Data pertaining to 97/115 (60 females, 37 males; mean age 51, SD 13, range 23–80) patients were available for evaluation. Significant bone loss was observed between baseline and re-examination at the implant surface (0.2–0.3 mm, p < 0.001) and tooth surface (0.3–0.5 mm, p < 0.001). Surgery with ridge re-contouring demonstrated 0.2 mm additional bone loss at the distal tooth surface when compared to surgery without ridge re-contouring (p = 0.034). This could be explained by a disparity in possible papilla-opening procedures (three versus one or two). As a result, regression analyses identified surgery with ridge re-contouring as a predictor of inter-proximal recession (OR ≥ 3.4). Pre-operative bone level at the tooth surface was another predictor of inter-proximal recession (OR ≥ 2.1). Recession of the distal papilla was also affected by a missing contact point (OR = 221.9), the implant-to-tooth distance (OR = 0.3) and the distance of the bone peak to the contact point (OR = 2.9). Midfacial recession was only associated with a buccal shoulder position (OR = 17.2). Conclusions To optimize soft tissue levels around single implants, clinicians should limit papilla-opening procedures and pay utmost attention to a correct implant and contact point positioning.
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10.
  • Cosyn, Jan, et al. (författare)
  • Regenerative periodontal therapy of infrabony defects using minimally invasive surgery and a collagen-enriched bovine-derived xenograft : a 1-year prospective study on clinical and aesthetic outcome
  • 2012
  • Ingår i: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 39:10, s. 979-986
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To evaluate the clinical and aesthetic outcome of regenerative periodontal therapy (RPT) using minimally invasive surgery and a collagen-enriched bovine-derived xenograft (1); to identify risk factors for failure (clinical attachment level (CAL) gain ≤ 1 mm) and advanced gingival recession (REC) increase (>1 mm) (2). MATERIAL AND METHODS: Ninety-five non-smoking patients, with ≤ 25% full-mouth plaque and bleeding presenting ≥ 6 months after initial periodontal therapy with ≥ 1 isolated inter-dental infrabony defect were recruited. Patients were consecutively treated by the same clinician using minimally invasive surgery and a collagen-enriched bovine-derived xenograft. Clinical, radiographic and aesthetic data were collected before surgery and up to 1 year. Multivariate analyses were used to identify risk factors for failure and advanced REC increase. RESULTS: Eighty-four patients (39 men, 45 women; mean age 53) complied and demonstrated mean probing depth (PD) of 7.8 mm, CAL of 10.0 mm and defect depth of 5.2 mm before surgery. At 1 year, postsurgery mean PD reduction was 3.5 mm (range 0.0-8.0), CAL gain was 3.1 mm (range 0.0-7.0) and radiographic defect fill was 53% (range 0-100). Forty-nine percentage showed ≥ 4 mm CAL gain, whereas 15% were considered failures. Mean inter-dental and midfacial REC increase was 0.3 mm (range-2.0-2.0) and 0.5 mm (range-1.5-2.0) respectively. Midfacial REC increase and contour deterioration contributed most to a small, yet significant reduction in the Pink Esthetic Score from 10.06 to 9.42 (p = 0.002). Risk factors for failure included defects with a non-supportive anatomy (OR: ≥ 10.4), plaque (OR: 14.7) and complication(s) (OR: 12.0). Risk factors for advanced midfacial REC increase included defects with a non-supportive anatomy (OR: 58.8) and a thin-scalloped gingival biotype (OR: 76.9). CONCLUSIONS: RPT using minimally invasive surgery and a collagen-enriched bovine-derived xenograft demonstrated favourable clinical outcome after 1 year, even though soft tissue aesthetics could not be fully preserved. Defects with a non-supporting anatomy may be at risk for failure and advanced midfacial recession.
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11.
  • Cosyn, Jan, et al. (författare)
  • The peri-implant sulcus compared with internal implant and suprastructure components : a microbiological analysis.
  • 2011
  • Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 13:4, s. 286-295
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: A recent in vivo study has shown considerable contamination of internal implant and suprastructure components with great biodiversity, indicating bacterial leakage along the implant-abutment interface, abutment-prosthesis interface, and restorative margins. The goal of the present study was to compare microbiologically the peri-implant sulcus to these internal components on implants with no clinical signs of peri-implantitis and in function for many years. Checkerboard DNA-DNA hybridization was used to identify and quantify 40 species.MATERIAL AND METHODS: Fifty-eight turned titanium Brånemark implants in eight systemically healthy patients (seven women, one man) under regular supportive care were examined. All implants had been placed in the maxilla and loaded with a screw-retained full-arch bridge for an average of 9.6 years. Gingival fluid samples were collected from the deepest sulcus per implant for microbiological analysis. As all fixed restorations were removed, the cotton pellet enclosed in the intra-coronal compartment and the abutment screw were retrieved and microbiologically evaluated.RESULTS: The pellet enclosed in the suprastructure was very similar to the peri-implant sulcus in terms of bacterial detection frequencies and levels for practically all the species included in the panel. Yet, there was virtually no microbial link between these compartments. When comparing the abutment screw to the peri-implant sulcus, the majority of the species were less frequently found, and in lower numbers at the former. However, a relevant link in counts for a lot of bacteria was described between these compartments. Even though all implants in the present study showed no clinical signs of peri-implantitis, the high prevalence of numerous species associated with pathology was striking.CONCLUSIONS: Intra-coronal compartments of screw-retained fixed restorations were heavily contaminated. The restorative margin may have been the principal pathway for bacterial leakage. Contamination of abutment screws most likely occurred from the peri-implant sulcus via the implant-abutment interface and abutment-prosthesis interface.
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12.
  • De Bruyn, Hugo, et al. (författare)
  • Implant surface roughness and patient factors on long-term peri-implant bone loss
  • 2017
  • Ingår i: Periodontology 2000. - : John Wiley & Sons. - 0906-6713 .- 1600-0757. ; 73:1, s. 218-227
  • Forskningsöversikt (refereegranskat)abstract
    • Dental implant placement is a common treatment procedure in current dental practice. High implant survival rates as well as limited peri-implant bone loss has been achieved over the past decades due to continuous modifications of implant design and surface topography. Since the turn of the millennium, implant surface modifications have focused on stronger and faster bone healing. This has not only yielded higher implant survival rates but also allowed modifications in surgical as well as prosthetic treatment protocols such as immediate implant placement and immediate loading. Stable crestal bone levels have been considered a key factor in implant success because it is paramount for long-term survival, aesthetics as well as peri-implant health. Especially during the past decade, clinicians and researchers have paid much attention to peri-implant health and more specifically to the incidence of bone loss. This could furthermore increase the risk for peri-implantitis, the latter often diagnosed as ongoing bone loss and pocket formation beyond the normal biological range in the presence of purulence or bleeding on probing. Information on the effect of surface topography on bone loss or peri-implantitis, a disease process that is to be evaluated in the long-term, is also scarce. Therefore, the current narrative review discusses whether long-term peri-implant bone loss beyond physiological bone adaptation is affected by the surface roughness of dental implants. Based on comparative studies, evaluating implants with comparable design but different surface roughness, it can be concluded that average peri-implant bone loss around the moderately rough and minimally rough surfaces is less than around rough surfaces. However, due to the multifactorial cause for bone loss the clinical impact of surface roughness alone on bone loss and peri-implantitis risk seems rather limited and of minimal clinical importance. Furthermore, there is growing evidence that certain patient factors, such as a history of periodontal disease and smoking, lead to more peri-implant bone loss.
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13.
  • De Bruyn, Hugo, et al. (författare)
  • Long-term clinical, microbiological, and radiographic outcomes of Brånemark™ implants installed in augmented maxillary bone for fixed full-arch rehabilitation.
  • 2013
  • Ingår i: Clinical Implant Dentistry and Related Research. - 1523-0899 .- 1708-8208. ; 15:1, s. 73-82
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The purpose of this study was to document the long-term outcome of Brånemark implants installed in augmented maxillary bone and to identify parameters that are associated with peri-implant bone level.MATERIAL AND METHODS: Patients of a periodontal practice who had been referred to a maxillofacial surgeon for iliac crest bone grafting in the atrophic maxilla were retrospectively recruited. Five months following grafting, they received 7-8 turned Brånemark implants. Following submerged healing of another 5 months, implants were uncovered and restorative procedures for fixed rehabilitation were initiated 2-3 months thereafter. The primary outcome variable was bone level defined as the distance from the implant-abutment interface to the first visible bone-to-implant contact. Secondary outcome variables included plaque index, bleeding index, probing depth, and levels of 40 species in subgingival plaque samples as identified by means of checkerboard DNA-DNA hybridization.RESULTS: Nine out of 16 patients (eight females, one male; mean age 59) with 71 implants agreed to come in for evaluation after on average 9 years (SD 4; range 3-13) of function. One implant was deemed mobile at the time of inspection. Clinical conditions were acceptable with 11% of the implants showing pockets ≥ 5 mm. Periodontopathogens were encountered frequently and in high numbers. Clinical parameters and bacterial levels were highly patient dependent. The mean bone level was 2.30 mm (SD 1.53; range 0.00-6.95), with 23% of the implants demonstrating advanced resorption (bone level > 3 mm). Regression analysis showed a significant association of the patient (p < .001) and plaque index (p = .007) with bone level.CONCLUSIONS: The long-term outcome of Brånemark implants installed in iliac crest-augmented maxillary bone is acceptable; however, advanced peri-implant bone loss is rather common and indicative of graft resorption. This phenomenon is patient dependent and seems also associated with oral hygiene.
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14.
  • De Bruyn, Hugo, et al. (författare)
  • Radiographic evaluation of modern oral implants with emphasis on crestal bone level and relevance to peri-implant health.
  • 2013
  • Ingår i: Periodontology 2000. - : Wiley. - 1600-0757 .- 0906-6713. ; 62:1, s. 256-70
  • Tidskriftsartikel (refereegranskat)abstract
    • Implant stability and maintenance of stable crestal bone level are prerequisites for the successful long-term function of oral implants, and continuous crestal bone loss constitutes a threat to the longevity of implant-supported prosthetic constructions. The prevalence/incidence and reasons for crestal bone loss are under debate. Some authors regard infection (i.e. peri-implantitis) as the cause for virtually all bone loss, while others see crestal bone loss as an unavoidable phenomenon following surgery and implant loading. Irrespective of the cause of continuous crestal bone loss, correct usage and scientifically sound interpretation of radiographs are of utmost importance for evaluation of oral implants. The periapical radiographic technique is currently the preferred method for evaluating implant health based on bone loss, and digital radiographs allow easy standardization of the image contrast. It is suggested that baseline radiographs should be taken at the time the transmucosal part pierces the mucosal tissues and annually thereafter. The number of unreadable radiographs should be presented in scientific publications to give insights into the quality of the radiographic examination. It is suggested that not only mean values, but also the range of bone levels, should be presented to describe the proportion of implants that show continuous crestal bone loss. In the absence of other clinical symptoms, bleeding on probing around implants seems to be a weak indicator of ongoing or future loss of crestal bone. According to recent longitudinal studies on modern implant surfaces peri-implantitis defined as 'infection with suppuration associated with clinically significant progressing crestal bone loss' occurs with a prevalence of less than 5 % in implants with 10 years in function.
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15.
  • De Bruyn, Hugo, et al. (författare)
  • The current use of patient-centered/reported outcomes in implant dentistry : a systematic review
  • 2015
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:S11, s. 45-56
  • Forskningsöversikt (refereegranskat)abstract
    • Aim: To provide an update on the use of Patient-Reported Outcome Measures (PROMs) in the field of implant dentistry (1); to compare PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition (2). Materials and methods: The dental literature was searched on PubMed until December 31, 2014, using a general search algorithm. An overall quantitative analysis was performed, and a qualitative appraisal was made on the output of the last 6 years. Per type of edentulism and prosthetic treatment, the general search algorithm was refined in order to select controlled studies comparing PROMs for prostheses supported by one or more implants to alternative treatment options or a healthy dentition. Results: With nearly half of the output (300 of 635) published in the last 6 years, there is a growing interest in PROMs by the scientific community. When scrutinizing the 300 most recent publications, only 84 controlled studies could be identified among which 38 RCTs and 31 cohort studies. An "ad hoc" approach is commonly employed using non-standardized questions and different scoring methods, which may compromise validity and reliability. Overall, 39 eligible papers related to fully edentulous patients treated with an implant overdenture (IOD) and 9 to fully edentulous patients treated with a fixed implant prosthesis (FIP). There is plenty of evidence from well-controlled studies showing that fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a conventional denture (CD). This may not hold true for fully edentulous patients in the maxilla. In general, fully edentulous patients seem to opt for a fixed or removable rehabilitation on implants for specific reasons. Data pertaining to partially edentulous patients were limited (FIP: n = 6; single implants: n = 16). In these patients, the timing of implant placement does not seem to affect patient satisfaction. Patients seem to prefer straightforward implant surgery over complex surgery that includes bone grafting. Conclusion: There is an urgent need for standardized reporting of PROMs in the field of implant dentistry. Fully edentulous patients in the mandible experience higher satisfaction with an IOD when compared to a CD. All other types of prostheses have been underexposed to research.
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16.
  • Dierens, Melissa, et al. (författare)
  • Alterations in soft tissue levels and aesthetics over a 16–22 year period following single implant treatment in periodontally-healthy patients : a retrospective case series
  • 2013
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 40:3, s. 311-318
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose Long term studies on single implants are scarce and merely focus on clinical response parameters, complications and bone remodelling. The objective of this retrospective case series was to assess alterations in soft tissue levels and aesthetics over a 16–22 year period in periodontally-healthy patients. Material and methods Patients who had received a single turned implant in the anterior maxilla/mandible at the Dental Specialist Clinic in Malmö between 1987 and 1993 were invited for a re-examination on the basis of a number of inclusion criteria. Both neighbouring teeth had to be present at re-examination and baseline clinical photographs (within the first year of function) had to be available for soft tissue evaluation. These photographs were superimposed onto final clinical photographs to assess longitudinal soft tissue alterations. Results Twenty-one patients (nine females; mean age 23, range 16–41) treated with 24 single implants met the criteria for soft tissue evaluation. Peri-implant soft tissue levels (papillae, midfacial level) remained stable over a 16–22 year observation period (p ≥ 0.372). However, neighbouring teeth demonstrated midfacial recession and eruption pointing to a major distortion with the implant crown (> 1 mm) in 5/24 (21%) and 10/24 (42%) of the cases, respectively. Baseline aesthetics was considered poor (mean Pink Esthetic Score 7.42, mean White Esthetic Score 5.43), yet a significant time effect could not be demonstrated (p ≥ 0.552). Implant and tooth bone loss was low (mean 0.6 mm and 0.4 mm, respectively) over a 16–22 year period. Conclusions This limited case series demonstrated stable peri-implant soft tissue levels and aesthetics in the long term following single implant treatment in periodontally-healthy patients. However, midfacial recession and eruption may be expected at neighbouring teeth.
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17.
  • Dierens, Melissa, et al. (författare)
  • Long-Term Follow-Up of Turned Single Implants Placed in Periodontally Healthy Patients After 16 to 22 Years : Microbiologic Outcome
  • 2013
  • Ingår i: Journal of Periodontology. - : Amer Acad Periodontology. - 0022-3492 .- 1943-3670. ; 84:7, s. 880-894
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Survival rates in implant dentistry today are high, although late failures do occur for many reasons, including peri-implant infections. The primary objective of this study is to investigate microbiota around single turned implants after 16 to 22 years. Secondary objectives are to compare teeth and implants and to correlate microbiologic, radiographic, and clinical parameters. Methods: A total of 46 patients with single implants were invited for a clinical examination. Clinical datawere collected from implants and contralateral natural teeth. Radiographic bone level was measured around implants. Microbiologic samples were taken from implants, contralateral teeth, and the deepest pocket per quadrant. Samples were analyzed with DNA-DNA hybridization including 40 species. Statistical analysis was performed using Wilcoxon signed-rank tests, McNemar tests, and Spearman correlation coefficients with a 0.05 significance level. Results: Mean follow-up was 18.5 years (range 16 to 22 years). Tannerella forsythia (1.5 x 10(5)) and Veillonella parvula (1.02 x 10(5)) showed the highest concentrations around implants and teeth, respectively. Porphyromonas gingivalis, Prevotella intermedia, and T. forsythia were significantly more present around implants than teeth. Mean counts were significantly higher around implants than teeth for Parvimonas micra, P. gingivalis, P. intermedia, T. forsythia, and Treponema denticola. Total DNA count was correlated to interproximal bleeding index (r = 0.409) and interproximal probing depth (r = 0.307). No correlations were present with plaque index or radiographic bone level. Conclusions: In the present study, bacterial counts around single implants in periodontally healthy patients are rather low. Although pathogenic bacteria are present, some in higher numbers around implants than teeth (five of 40), the majority of implants present with healthy peri-implant tissues without progressive bone loss.
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18.
  • Dierens, Melissa, et al. (författare)
  • Prosthetic Survival and Complication Rate of Single Implant Treatment in the Periodontally Healthy Patient after 16 to 22 Years of Follow-Up
  • 2016
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:1, s. 117-128
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Single implants were introduced in the 1980s, but long-term follow-up is scarce. Purpose The study aims to retrospectively investigate the prosthetic survival and complication rates of single implants in periodontally healthy patients after 16-22 years, and to evaluate the influence of different prosthetic procedures Materials and Methods Patients with a single implant were recalled for clinical examination. Prosthetic procedures included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Prosthetic survival, success, and occurrence of biological, technical, and aesthetic complications were obtained. Procedures were compared by log-rank tests Results Fifty patients attended the examination. All implants were functional; however, 15% of abutments and 27% of crowns had been renewed. Replacements (1/4) were related to technical issues whereas the main cause was aesthetics. The abutment cumulative survival rate (CSR) differed significantly between ST-PFM (74%), ST-ACR (0%), and CO reconstructions (97%). The crown CSR was significantly lower for ST-ACR crowns (0%) compared with ST-PFM (68%) and CO (81%). Thirty-nine percent of implants remained complication free throughout the mean 18.5 years. Complications (1/3) required component replacement, and 53% occurred within 5 years after surgery Conclusion Prosthetic survival rates of single implants are encouraging after 16 to 22 years. However, 66% of the patients encountered at least one complication during follow-up.
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19.
  • Doornewaard, Ron, et al. (författare)
  • Long-Term Effect of Surface Roughness and Patients' Factors on Crestal Bone Loss at Dental Implants : A Systematic Review and Meta-Analysis
  • 2017
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 19:2, s. 372-399
  • Forskningsöversikt (refereegranskat)abstract
    • Publications from 2011 to 2015 were selected to evaluate effect of implant surface roughness on long-term bone loss as surrogate for peri-implantitis risk. 87 out of 2,566 papers reported the mean bone loss after at least 5 years of function. Estimation of the proportion of implants with bone loss above 1, 2, and 3 mm as well as analysis the effect of implant surface roughness, smoking, and history of periodontitis was performed. By means of the provided statistical information of bone loss (mean and standard deviation) the prevalence of implants with bone loss ranging from 1 to 3 mm was estimated. The bone loss was used as a surrogate parameter for peri-implantitis given the fact that peri-implantitis prevalence was not reported in most studies or when reported, the diagnostic criteria were unclear or of dubious quality. The outcome of this review suggests that peri-implant bone loss around minimally rough implant systems was statistically significant less in comparison to the moderately rough and rough implant systems. No statistically significant difference was observed between moderately rough and rough implant systems. The studies that compared implants with comparable design and different surface roughness, showed less average peri-implant bone loss around the less rough surfaces in the meta-analysis. However, due to the heterogeneity of the papers and the multifactorial cause for bone loss, the impact of surface roughness alone seems rather limited and of minimal clinical importance. Irrespective of surface topography or implant brand, the average weighted implant survival rate was 97.3% after 5 years or more of loading. If considering 3 mm bone loss after at least 5 years to represent the presence of peri-implantitis, less than 5% of the implants were affected. The meta-analysis indicated that periodontal history and smoking habits yielded more bone loss.
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20.
  • Duss, Christof, et al. (författare)
  • A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
  • 2010
  • Ingår i: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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21.
  • Duss, Christof, et al. (författare)
  • A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery
  • 2010
  • Ingår i: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 37:11, s. 988-997
  • Tidskriftsartikel (refereegranskat)abstract
    • Background Chlorhexidine (CHX) rinsing after periodontal surgery is common. We assessed the clinical and microbiological effects of two CHX concentrations following periodontal surgery. Materials and methods In a randomized, controlled clinical trial, 45 subjects were assigned to 4 weeks rinsing with a 0.05 CHX/herbal extract combination (test) or a 0.1% CHX solution. Clinical and staining effects were studied. Subgingival bacteria were assessed using the DNA-DNA checkerboard. Statistics included parametric and non-parametric tests (p < 0001 to declare significance at 80% power). Results At weeks 4 and 12, more staining was found in the control group (p < 0.05 and p < 0.001, respectively). A higher risk for staining was found in the control group (crude OR: 2.3:1, 95% CI: 1.3 to 4.4, p < 0.01). The absolute staining reduction in the test group was 21.1% (9 5% CI: 9.4-32.8%). Probing pocket depth (PPD) decreases were significant (p < 0.001) in both groups and similar (p=0.92). No rinse group differences in changes of bacterial counts for any species were found between baseline and week 12. Conclusions The test CHX rinse resulted in less tooth staining. At the study endpoint, similar and high counts of periodontal pathogens were found.
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22.
  • Klinge, Björn, et al. (författare)
  • Dental implant register: Summary and consensus statements of group 2. The 5th EAO Consensus Conference 2018
  • 2018
  • Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:Supplement: 18, s. 157-159
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This publication reports the EAO Workshop group-2 and consensus plenary discussions and statements on a narrative review providing the background and possible facilities and importance of a dental implant register, to allow for a systematic follow-up of the clinical outcome of dental implant treatment in various clinical settings. It should be observed that the format of the review and the subsequent consensus report consciously departs from conventional consensus publications and reports. Material and methods: The publication was a narrative review on the presence and significance of quality registers regarding select medical conditions and procedures. The group discussed and evaluated the publication and made corrections and recommendations to the authors and agreed on the statements and recommendations described in this consensus report. Results: Possible registrations to be included in an implant register were discussed and agreed as a preliminary basis for further development, meaning that additional parameters be included or some be deleted. Conclusions: It was agreed to bring the idea of an implant quality register, including the presented results of discussions and proposals by the group- and plenary sessions, to the EAO Board for further discussion and decision.
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23.
  • Klinge, Björn, et al. (författare)
  • The patient undergoing implant therapy : summary and consensus statements: the 4th EAO Consensus Conference 2015
  • 2015
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26 Suppl 11, s. 64-7
  • Tidskriftsartikel (refereegranskat)abstract
    • INTRODUCTION: The assignment for this working group was to update the existing knowledge regarding factors considered being of special relevance for the patient undergoing implant therapy. This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis. Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review.MATERIALS AND METHODS: The literature in the respective areas of interest (antibiotic prophylaxis, peri-implantitis, patient-reported outcome measurements and health-economic aspects) was searched using different strategies for the different papers. Search strategies ranged from a complex systematic review to systematic- and narrative reviews, depending on subject and available literature. All collected material was critically reviewed. Four manuscripts were subsequently presented for group analysis and discussion and plenum discussions and concensus approval. The selected areas were considered to be of key importance and relevance for the patient undergoing implant therapy.RESULTS: The results and conclusions of the review process are presented in the respective papers. The group's conclusions, identified knowledge gaps, directions for future research and concensus statements are presented in this article. The following reviews were available for group discussions and the foundation for subsequent plenary sessions: Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. (2015) Perioperative antibiotics in conjunction with dental implant placement. A complex systematic review. Renvert S & Quirynen M. (2015) Risk indicators for peri-implantitis. A narrative review. De Bruyn H, Raes S, Matthys C, Cosyn J. (2015) The current use of patient centered/reported outcomes in implant dentistry. A systematic review. Beikler T & Flemmig T.F. (2015) Economic evaluation of implant-supported prostheses. A narrative review.
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24.
  • Klinge, Björn, et al. (författare)
  • The patient undergoing implant therapy : Summary and consensus statements: The 4th EAO Consensus Conference 2015
  • 2015
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:S11, s. 64-67
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The assignment for this working group was to update the existing knowledge regarding factors considered being of special relevance for the patient undergoing implant therapy. This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis. Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review. Materials and methods: The literature in the respective areas of interest (antibiotic prophylaxis, peri-implantitis, patient-reported outcome measurements and health-economic aspects) was searched using different strategies for the different papers. Search strategies ranged from a complex systematic review to systematic-and narrative reviews, depending on subject and available literature. All collected material was critically reviewed. Four manuscripts were subsequently presented for group analysis and discussion and plenum discussions and concensus approval. The selected areas were considered to be of key importance and relevance for the patient undergoing implant therapy. Results: The results and conclusions of the review process are presented in the respective papers. The group's conclusions, identified knowledge gaps, directions for future research and concensus statements are presented in this article. The following reviews were available for group discussions and the foundation for subsequent plenary sessions: Lund B, Hultin M, Tranaeus S, Naimi-Akbar A, Klinge B. (2015) Perioperative antibiotics in conjunction with dental implant placement. A complex systematic review. Renvert S & Quirynen M. (2015) Risk indicators for peri-implantitis. A narrative review. De Bruyn H, Raes S, Matthys C, Cosyn J. (2015) The current use of patient centered/reported outcomes in implant dentistry. A systematic review. Beikler T & Flemmig T. F. (2015) Economic evaluation of implant-supported prostheses. A narrative review.
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25.
  • Koole, Sebastiaan, et al. (författare)
  • Competence profiles in undergraduate dental education : a comparison between theory and reality
  • 2017
  • Ingår i: BMC Oral Health. - : BioMed Central. - 1472-6831. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Competence profiles are purposed to provide a blueprint in support to develop and/or benchmark the learning outcomes of undergraduate dental curricula. This study aims to investigate whether a competence profile as proposed by academic-and clinical experts is able to represent the real clinical reality. Methods: A questionnaire was developed including questions about gender and age, perception about required competences, and educational organisation and was distributed among Flemish dentists via email and on paper during a symposium. The data was analysed using descriptive statistics, Chi-square and non-parametric Mann-Whitney U-tests. Results: A total of 312 questionnaires were completed (= 6.5% of dentist population, with similar gender and age characteristics). All competences in the European competence profile were rated between 7.2 and 9.4 on a 10-point scale. In dentists under 50 years, females rated the importance of identifying/managing anxiety and abnormal patient behaviour; and promoting/improving oral health as significantly higher than males. In dentists of 50 years and above, females rated 8 competences significantly higher than males, including obtaining/recording a complete history; identifying/managing anxiety and abnormal patient behaviour; obtaining/interpreting radiography; identifying temporomandibular and associated disorders; identifying orthodontic needs; awareness of own limitations/when to refer; managing dental urgencies; and basic-life-support/defibrillation. Clinical practice management was most frequently reported as additional competence to address in dental education. Furthermore, the respondents suggested an undergraduate dental curriculum based on 34% theoretical education, 26% preclinical skills training, and 40% clinical education and 86% agreed with a duration of 5 years. Finally, the respondents also illustrated the dynamic nature of dentistry including a reduction of amalgam fillings, a shift from individual practice to group practices, an increased administrative load, and more assertive patients. Conclusion: Findings in the present study suggest the validation of the proposed competences for graduating European dentists within the clinical reality of dental professionals in daily practice. Nevertheless, the results have also demonstrated heterogeneity regarding gender and age within the dentist population and emphasised a continuously evolving dental profession and required competences. Hence, to maintain high quality of dental care, a strategy should be developed in which dental curricula are continuously benchmarked against an evolving clinical reality.
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26.
  • Koole, Sebastiaan, et al. (författare)
  • Exploring the relation between online case-based discussions and learning outcomes in dental education
  • 2014
  • Ingår i: Journal of Dental Education. - : John Wiley & Sons. - 0022-0337 .- 1930-7837. ; 78:11, s. 1552-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Online case-based discussions, parallel to theoretical dental education, have been highly valued by students and supervisors. This study investigated the relation between variables of online group discussions and learning outcomes. At Ghent University in Belgium, undergraduate dental students (years two and three) are required to participate in online case-based discussion groups (five students/group) in conjunction with two theoretical courses on basic periodontics and related therapy. Each week, a patient case is discussed under supervision of a periodontist, who authored the case and performed the treatment. Each case includes treatment history and demand, intra- and extraoral images, and full diagnostic information with periodontal and radiographic status. For this retrospective study, data were obtained for all 252 students in forty-three discussion groups between 2009 and 2012. Spearman's rank correlations were calculated to investigate the relation among group dynamics (number of group posts and views), individual student contributions (number of individual posts, newly introduced elements, questions, and reactions to other posts), supervisors' interventions (number of posts and posed questions), and learning outcomes (examination result). The results showed that learning outcomes were significantly related to the number of student posts (Spearman's rho (ρ)=0.19), newly introduced elements (ρ=0.21), reactions to other posts (ρ=0.14), number of supervisors' interventions (ρ=0.12), and supervisors' questions (ρ=0.20). These results suggest that individual student contributions during online case-based discussions and the provided supervision were related to learning outcomes.
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27.
  • Koole, Sebastiaan, et al. (författare)
  • Facilitating Dental Student Reflections : Using Mentor Groups to Discuss Clinical Experiences and Personal Development
  • 2016
  • Ingår i: Journal of Dental Education. - : American Dental Education Association. - 0022-0337 .- 1930-7837. ; 80:10, s. 1212-1218
  • Tidskriftsartikel (refereegranskat)abstract
    • Despite the consensus on the importance of reflection for dental professionals, a lack of understanding remains about how students and clinicians should develop their ability to reflect. The aim of this study was to investigate dental students' and mentors' perceptions of mentor groups as an instructional method to facilitate students' reflection in terms of the strategy's learning potential, role of the mentor, group dynamics, and feasibility. At Ghent University in Belgium, third-and fourth-year dental students were encouraged to reflect on their clinical experiences and personal development in three reflective mentor sessions. No preparation or reports afterwards were required; students needed only to participate in the sessions. Sessions were guided by trained mentors to establish a safe environment, frame clinical discussions, and stimulate reflection. Students' and mentors' perceptions of the experience were assessed with a 17-statement questionnaire with response options on a five-point Likert scale (1=totally disagree to 5=totally agree). A total of 50 students and eight mentors completed the questionnaire (response rates 81% and 89%, respectively). Both students and mentors had neutral to positive perceptions concerning the learning potential, role of the mentor, group dynamics, and feasibility. The mean ideal total time for sessions in a year was 99 minutes (third-year students), 111 minutes (fourth-year students), and 147 minutes (mentors). Reported reflective topics related to patient management, frustrations, and practice of dentistry. Overall mean appreciation for the experience ranged from 14.50 to 15.14 on the 20-point scale. These findings about students' and mentors' positive perceptions of the experience suggest that mentor groups may be a potentially valuable strategy to promote dental students' reflection.
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28.
  • Miremadi, S. Reza, et al. (författare)
  • A randomized controlled trial comparing surgical and non-surgical periodontal therapy : a 3-year clinical and cost-effectiveness analysis
  • 2015
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 42:8, s. 748-755
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo compare immediate surgery to scaling and root planing (SRP) in the treatment of advanced periodontitis focusing on the prevalence of residual pockets after treatment and cost-effectiveness (1); to elucidate the adjunctive effects of azithromycin in a second-treatment phase (2) up to 36months. Materials and MethodsThirty-nine patients (18 males, 21 females; mean age: 54.6) received oral hygiene instructions and were randomly allocated to surgery (n=19) or SRP (n=20). Patients with residual pockets (6mm) at 6months received re-debridement of these sites and systemic azithromycin. Clinical measurements were performed at 12, 24 and 36months whereby residual pockets underwent re-debridement. Patients were evaluated in terms of clinical response parameters and cost-effectiveness. Chair-time was used to assess the financial impact of treatment. ResultsOnly six patients in the surgery group required additional treatment at 6months, whereas 14 patients in the SRP underwent this therapy. Both treatment arms were equally effective in terms of clinical outcome demonstrating <2% residual pockets at 36months. Surgery imposed an extra 746 Euro on the patient up to 6months compared to SRP. At 36months, 69 Euro of this amount could be offset due to the lower need for re-treatment during maintenance phase. ConclusionsSurgery was ultimately associated with a significantly lower need for re-treatment during supportive care, however, at significantly higher costs over the 3years.
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29.
  • Miremadi, Seyed Reza, et al. (författare)
  • A randomized controlled trial on immediate surgery versus root planing in patients with advanced periodontal disease : a cost-effectiveness analysis
  • 2014
  • Ingår i: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 41:2, s. 164-171
  • Tidskriftsartikel (refereegranskat)abstract
    • AimTo compare immediate surgery to scaling and root planing (SRP) in the treatment of advanced periodontal disease focusing on the prevalence of residual sites and cost-effectiveness (1); to evaluate the adjunctive effects of azithromycin in a second treatment phase (2). Materials and MethodsThirty-nine patients (18 males, 21 females; mean age: 54.6) received oral hygiene instructions and were randomly allocated to surgery (n=19) or SRP (n=20). Patients with residual pockets (6mm) at 6months received re-debridement of these sites and systemic azithromycin. Treatment groups were followed up to 12months and evaluated in terms of clinical response parameters and cost-effectiveness. Chair-time was used to assess the financial impact of treatment. ResultsBoth treatment arms were equally effective in terms of clinical outcome demonstrating less than 1% residual pockets at 12months. Surgery imposed an extra 746 Euro on the patient up to 6months when compared to SRP. At 12months, 46 Euro of this amount could be offset as a result of a reduced need for supportive care. Only 6 patients in the surgery group needed systemic antibiotics, whereas 14 patients in the SRP needed such additional treatment. ConclusionsAlthough 700 Euro could be saved on average by performing SRP instead of surgery, the latter significantly reduced the need for supportive care and systemic antibiotics.
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30.
  • Raes, Filiep, et al. (författare)
  • Clinical, aesthetic, and patient-related outcome of immediately loaded single implants in the anterior maxilla : a prospective study in extraction sockets, healed ridges, and grafted sites
  • 2013
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 15:6, s. 819-835
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The objective of this prospective clinical study was to document the overall treatment outcome of immediately loaded single Astra Tech Osseospeed™ (Astra Tech AB, Mölndal, Sweden) implants placed in extraction sockets, healed ridges, and grafted sites. MATERIALS AND METHODS: Forty-eight patients in need of a single implant in the anterior maxilla (15-25) were recruited. Patients were allocated to a conventional implant treatment (CIT) or immediate implant treatment (IIT) group on the basis of specific criteria. If the buccal bone plate was damaged or missing upon tooth removal, patients were allocated to a grafted implant treatment (GIT) group. Irrespective of the treatment concept, implants were immediately provisionalized. Hard and soft tissue alterations, aesthetic parameters (pink and white esthetic scores, [PES and WES]) and patient's opinion (Oral Health Impact Profile [OHIP-14] questionnaires) were registered at different time points. RESULTS: After 1 year of function, the overall implant survival rate was 98% with one failure following IIT. The mean bone level to the implant-abutment interface was 0.65 (SD 0.79), 0.85 (SD 0.64), and 0.56 mm (SD 0.44) for CIT, IIT, and GIT. Complete papilla loss was rare following either strategy. Mean midfacial recession amounted to 1.00 (SD 1.15), 0.12 (SD 0.78), and 0.49 mm (SD 0.82) for CIT, IIT, and GIT, respectively. The aesthetic outcome showed a mean PES of 10.30 (SD 1.89) and mean WES of 7.11 (SD 2.14), all patients considered. Patient's satisfaction showed a significant improvement after 1 year of function on all seven domains (p < .001). CONCLUSIONS: This prospective study showed that single implants clinically and aesthetically perform well under immediate non-occlusal loading conditions in the premaxilla. In this context, it is of pivotal importance to stress that patients were carefully selected for IIT and GIT.
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31.
  • Raes, Filiep, et al. (författare)
  • Reliability of circumferential bone level assessment around single implants in healed ridges and extraction sockets using cone beam CT
  • 2013
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 15:5, s. 661-672
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: Cone beam computerized tomography (CBCT) provides three-dimensional information and could absolutely be useful for evaluating circumferential implant bone levels. However, the accuracy and precision of the technique has not been described. The aim of the study was to assess the accuracy and precision of CBCT (i-CAT(R), Imaging Sciences International(R), Hatfield, PA, USA) using periapical radiographs (PA) as a reference and to evaluate the circumferential bone level on CBCT around immediately loaded single implants placed in healed ridges (CIT, conventional implant treatment) and extraction sockets (IIT, immediate implant placement). MATERIALS AND METHODS: PA and CBCT radiographs were obtained from 26 single Astra Tech Osseospeed implants (Astra Tech AB, Molndal, Sweden) 1 year after loading in respectively healed ridges (CIT) or extraction socket (IIT). For accuracy analysis, the three mesial and three distal interproximal levels obtained by CBCT were pooled to enable a comparison with PA. Precision was analyzed by intra- and interexaminer reliability calculation from mesial and distal sites on CBCT. The circumferential bone level considered all eight positions assessed on CBCT. RESULTS: Accuracy of CBCT was low (R = 0.325/p = .019) given the fact that bone level of the total group was 0.70 mm (standard deviation [SD] 0.78, range 0.00-3.20) on PA and 0.23 mm (SD 0.27, 0.00-1.20) on CBCT (p < .001) with only 42% of the measurements showing deviation within 0.2 mm. However, intra- and interexaminer reliability were favorable (R >/= 0.611/p < .001, >/= 83%). The mean circumferential bone level on CBCT was 0.21 mm (SD 0.30) and 0.26 mm (SD 0.18) for IIT and CIT, respectively. The impact of the treatment strategy was not significant. CONCLUSION: PA should be the standard technique to assess interproximal bone level but correlates poorly with the CBCT measurements. However, the precision of CBCT was high. CBCT requires further improvements of hardware and/or software. Within the limitations of the study, there is an indication that the buccal bone 1 year after implant treatment is evenly preserved when implants are immediately loaded in extraction sockets or in healed bone.
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32.
  • Raes, Stefanie, et al. (författare)
  • A long-term prospective cohort study on immediately restored single tooth implants inserted in extraction sockets and healed ridges : CBCT analyses, soft tissue alterations, aesthetic ratings, and patient-reported outcomes
  • 2018
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:4, s. 522-530
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Although many studies have been published on single implants, long-term data remain scarce. Purpose: To evaluate immediately restored single implants after at least 8 years of follow-up in terms of buccal bone, soft tissue alterations, aesthetic ratings, and patient-reported outcomes. Materials and Methods: This prospective cohort study included patients who were consecutively treated with an immediately restored single implant installed in an extraction socket (IIT) or a healed ridge (CIT) in the anterior maxilla. Biomaterials were never used. CBCTs were taken at study termination, soft tissue alterations, and Pink Esthetic Score were evaluated between 1 year and study termination using standardized clinical images. Patient satisfaction was also registered. Results: About 11/16 initially treated patients in the IIT cohort (10 men, 6 women; mean age 45) and 18/23 initially treated patients in the CIT cohort (12 men, 11 women; mean age 40) could be evaluated after more than 8 years. A buccal bone wall less than 2 mm was found at all implant sites. A thin buccal bone wall less than 1 mm was found at 42% of the implant sites. In the CIT cohort, 8 patients had a missing buccal bone in the crestal area, although bone was present at the time of surgery. Alveolar process deficiency significantly deteriorated (P .046), whereas vertical soft tissue levels and PES remained stable over time in both cohorts. Patients expressed high overall satisfaction. Conclusions: Substantial dimensional changes may be expected at the buccal aspect of single implants inserted in the premaxilla. As a result, contour augmentation procedures at the time of implant placement should be considered to counteract these bone alterations, even when implants are fully embedded in bone upon insertion.
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33.
  • Raes, Stefanie, et al. (författare)
  • A prospective cohort study on the impact of smoking on soft tissue alterations around single implants
  • 2015
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:9, s. 1086-1090
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectivesTo compare smokers to non-smokers in terms of soft tissue alterations following single implant treatment in healed bone. Material and methodsNon-smoking and smoking patients with sufficient bone volume in need of a single implant in the anterior maxilla (15-25) were consecutively recruited in three centres. Conventional single implant surgery was performed and an immediate provisional crown was installed. Eight to 12weeks later, the latter was replaced by a permanent one (baseline). Papilla regrowth and midfacial recession was registered after 2years of function. ResultsThe sample consisted of 39 non-smokers (21 females; mean age 42) and 46 smokers (22 females; mean age 45). Smokers had three early failures, whereas all implants integrated successfully in non-smokers. Statistically significant papilla regrowth was observed in non-smokers (distal 0.63mm, mesial 0.76mm), whereas smokers showed stable papillae (between cohorts: P0.025). Midfacial soft tissue level demonstrated statistically significant regrowth in non-smokers (0.53mm), whereas it remained stable in smokers (between cohorts: P=0.004). ConclusionSmokers failed to demonstrate papilla regeneration and showed more midfacial recession following single implant treatment when compared to non-smokers.
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34.
  • Raes, Stefanie, et al. (författare)
  • Oral health-related quality of life changes after placement of immediately loaded single implants in healed alveolar ridges or extraction sockets : a 5-year prospective follow-up study
  • 2016
  • Ingår i: Clinical Oral Implants Research. - : Blackwell Munksgaard. - 0905-7161 .- 1600-0501. ; 28:6, s. 662-667
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVES: The impact of single implants on oral health-related quality of life (OHRQoL) is scarcely investigated, especially when combined with immediate placement and loading in extraction sockets. The aim was to describe prospectively the changes of OHRQoL with single implants placed in the esthetic zone in healed ridges or in extraction sockets after 5 years. MATERIAL AND METHODS: Ninety-six patients, enrolled at three clinical centers, received 102 single implants placed in a healed ridge (n = 54 implants/50 patients) or in extraction sockets (n = 48 implants/46 patients). Implants were immediately provisionalized, and permanent crowns were cemented after 12 weeks. Oral health impact profile questionnaires (OHIP-14) were completed before surgery, after 1 (provisional crown), 6 (permanent crown), 12 and 60 months, respectively. The overall OHIP-14 score pertains to seven domains with two items each and was assessed on a Likert scale of 0-4 (0 = never and 4 = very often). The evolution of the total OHIP-14 score and changes within all OHIP domains over time and between groups were assessed with a linear mixed-effect model analysis. RESULTS: After 5 years, overall implant survival was 98%. The total OHIP-14 score for both groups combined decreased from 0.50 at baseline to 0.17 at 6 months (P < 0.001), indicative of improvement. For both groups, this remained stable up to 5 years (P = 0.41). However, after 5 years, the total OHIP-14 score revealed a statistically significantly higher improvement in the healed group compared with the extraction group (P = 0.027). CONCLUSION: Missing a single tooth in the maxillary esthetic zone leads to limited OHRQoL problems as reflected by a low overall OHIP score. However, OHRQoL improves less in the extraction group, reflecting that replacing a missing tooth is perceived as more beneficial than replacing a present tooth.
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35.
  • Sanz, M., et al. (författare)
  • Biological aspects: Summary and consensus statements of group 2. The 5th EAO Consensus Conference 2018
  • 2018
  • Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 29:Supplement: 18, s. 152-156
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This publication reports the EAO Workshop group-2 discussions and consensus statements which provided the scientific evidence on the influence of biological parameters on implant-related clinical outcomes. Material and methods: The first publication was a systematic review on the biological effects of abutment material on the stability of peri-implant marginal bone levels and the second, a critical narrative review on how peri-implant diagnostic parameters correspond with long-term implant survival and success. The group evaluated the content of both publications, made corrections and recommendations to the authors and agreed on the consensus statements, clinical recommendations and recommendations for future research, which are described in this consensus report. Results: Tested abutment materials can be considered appropriate for clinical use according to the observation period studied (mean 3.5 years). Mean peri-implant bone loss and mean probing pocket depths are not adequate outcomes to study the prevalence of peri-implantitis, while the reporting of frequency distributions is considered more appropriate. Conclusions: Titanium is currently considered the standard of care as abutment material, although other materials may be more suitable for aesthetic locations. Peri-implantitis should be diagnosed through composite evaluations of peri-implant tissue inflammation and assessment of marginal bone loss with different thresholds.
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36.
  • Thoma, Daniel S., et al. (författare)
  • Soft tissue management at implants: : Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021
  • 2021
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 32:S21, s. 174-180
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The task of working Group 2 at the 6th Consensus Meeting of the European Association for Osseointegration was to comprehensively assess the effects of soft tissue augmentation procedures at dental implant sites on clinical, radiographic and patient-reported outcome measures (PROMs) including an overview on available outcome measures and methods of assessment.Materials and methods: Three systematic reviews and one critical review were performed in advance on (i) the effects of soft tissue augmentation procedures on clinical, radiographic and aesthetic outcomes, (ii) reliability and validity of outcome measures and methods of assessment and (iii) PROMs applied in clinical studies for soft tissue augmentation procedures at dental implant sites. Major findings, consensus statements, clinical recommendations and implications for future research were discussed in the group and approved during the plenary sessions.Results: The four reviews predominantly revealed: Soft tissue augmentation procedures in conjunction with immediate and delayed implant placement result in superior aesthetic outcomes compared to no soft tissue augmentation in the zone of aesthetic priority. Soft tissue augmentation procedures have a limited effect on marginal bone level changes compared to implant sites without soft tissue augmentation. Clinically relevant parameters (gingival index, mucosal recession) and plaque control improve at implant sites when the width of keratinised mucosa is increased. A variety of aesthetic indices have been described with good reliability. Pink Esthetic Score and Complex Esthetic Index are the most validated aesthetic indices for single implants, though. Superimposed digital surface scans are most accurate to assess profilometric tissue changes. PROMs following soft tissue augmentation procedures have been assessed using various forms of questionnaires. Soft tissue augmentation had a limited effect on PROMs.Conclusions: Soft tissue augmentation procedures are widely applied in conjunction with implant therapy. Depending on the indication of these interventions, clinical, radiographic and aesthetic outcomes may improve, whereas the effect on PROMs is limited.
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37.
  • Vervaeke, Stijn, et al. (författare)
  • A 9-Year Prospective Case Series Using Multivariate Analyses to Identify Predictors of Early and Late Peri-Implant Bone Loss
  • 2016
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 18:1, s. 30-39
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose The study aims to identify predictors of early and late peri-implant bone loss following complete implant-supported rehabilitation using multivariate analyses. Materials and Methods Fifty patients (28 women, 22 men; mean age 58, range 35-76) in need of a complete implant-supported rehabilitation on five to eight implants were consecutively treated. Patients were reinvited for a clinical and radiographic examination after an average 9 years of function. Implant survival and peri-implant bone loss were considered the dependent variables. Multivariate analyses were adopted to identify predictors of early and late peri-implant bone loss Results In total, 39 patients were examinated. Two implants failed after 4 years of function, resulting in an overall survival rate of 99.2%. After a mean follow-up of 9 years, mean bone loss of 1.68mm (SD 2.08, range -1.05 to 10.95) was found. The abutment height was a significant predictor of early peri-implant bone loss (1 year) (p=.024), whereas smoking (p=.046) and history of periodontitis (p=.046) affected late peri-implant bone loss Conclusion Within the limits of this study, it can be concluded that initial bone remodeling was affected by soft tissue thickness as reflected by the height of the abutment, whereas smoking and history of periodontitis affected long-term peri-implant bone stability
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38.
  • Vervaeke, Stijn, et al. (författare)
  • A Multifactorial Analysis to Identify Predictors of Implant Failure and Peri-Implant Bone Loss
  • 2013
  • Ingår i: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 17:S1, s. e298-e307
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To identify risk factors for failure and bone loss of implants in a large study sample on the basis of multivariate analyses. MATERIALS AND METHODS: Patient files of all patients referred for implant treatment from November 2004 to December 2007 were scrutinized, and information on implant- and patient-related factors was collected. The study sample in this retrospective cohort study consisted of both partially dentate and fully edentulous patients referred for various indications. The only inclusion criterion was a follow-up of at least 2 years. Implant survival and bone loss were assessed by an external investigator (SV) comparing digital periapical radiographs taken during recall visits with the postoperative ones. Univariate and multivariate tests were adopted to identify possible risk indicators for implant failure and peri-implant bone loss. RESULTS: Twenty-one of 1,320 (1.6%) implants were lost in 19 of 376 (5.1%) patients (210 female, 166 male; mean age 56, range 17-82) after a mean follow-up of 32 months (range 24-62). Based on multivariate analysis, only smoking (p = .001) and recall compliance (p = .010) had a significant influence on implant failure, with smokers more prone to failure. The overall mean bone loss was 0.36 mm (SD 0.68, range 0.00-7.10). Smoking (p = .001) and jaw of treatment (p = .001) affected peri-implant bone loss. More peri-implant bone loss was observed in smokers and in the maxilla. A clear discrepancy was found between univariate and multivariate analysis with regard to identification of risk factors. CONCLUSION: Multivariate analysis demonstrated that implant-related factors did not affect the clinical outcome, but smoking was identified as a predictor for implant failure. Predictors for peri-implant bone loss were smoking and jaw of treatment.
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39.
  • Vervaeke, Stijn, et al. (författare)
  • The effect of smoking on survival and bone loss of implants with a fluoride-modified surface : a 2-year retrospective analysis of 1106 implants placed in daily practice
  • 2012
  • Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 23:6, s. 758-766
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To compare the survival and peri-implant bone loss of implants with a fluoride-modified surface in smokers and nonsmokers. Materials and methods: Patient files of all patients referred for implant treatment from November 2004 to 2007 were scrutinized. All implants were placed by the same experienced surgeon (B. C.). The only inclusion criterion was a follow-up time of at least 2 years. Implant survival and bone loss were assessed by an external calibrated examiner (S. V.) comparing digital peri-apical radiographs taken during recall visits with the post-operative ones. Implant success was determined according to the international success criteria (Albrektsson et al. 1986). Survival of implants installed in smokers and nonsmokers was compared using the log-rank test. Both nonparametric tests and fixed model analysis were adopted to evaluate bone loss in smokers and nonsmokers. Results: One-thousand one-hundred and six implants in 300 patients (186 females; 114 males) with a mean follow-up of 31 months (SD 7.15; range 24–58) were included. Nineteen implants in 17 patients failed, resulting in an overall survival rate of 98.3% at the implant level and 94.6% at the patient level. After a follow-up period of 2 years, the cumulative survival rates was 96.7% and 99.1% with the patient and implant as the statistical unit, respectively. Implant survival was significantly higher for nonsmokers compared with smokers (implant level P=0.025; patient level P=0.017). The overall mean bone loss was 0.34 mm (n=1076; SD 0.65; range 0–7.1). Smokers lost significantly more bone compared with nonsmokers in the maxilla (0.74 mm; SD 1.07 vs. 0.33 mm; SD 0.65; P<0.001), but not in the mandible (0.25 mm; SD 0.65 vs. 0.22 mm; SD 0.5; P=0.298). Conclusion: The present study is the first to compare peri-implant bone loss in smokers and nonsmokers from the time of implant insertion (baseline) to at least 2 years of follow-up. Implants with a fluoride-modified surface demonstrated a high survival rate and limited bone loss. However, smokers are at a higher risk of experiencing implant failure and more prone to show peri-implant bone loss in the maxilla. Whether this bone loss is predicting future biological complications remains to be evaluated.
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40.
  • Younes, Faris, et al. (författare)
  • Relationship between buccal bone and gingival thickness revisited using non-invasive registration methods
  • 2016
  • Ingår i: Clinical Oral Implants Research. - : Blackwell Munksgaard. - 0905-7161 .- 1600-0501. ; 27:5, s. 523-528
  • Tidskriftsartikel (refereegranskat)abstract
    • ObjectiveTo determine the relationship between buccal bone and soft tissue thickness at teeth in the premaxilla by means of non-invasive registration methods. Materials and MethodsBuccal bone thickness at central incisors, lateral incisors and canines was measured at five reference points (1-5mm from the top of the alveolar crest) on CB-CT scans of 21 patients. The corresponding buccal gingival thickness was measured by the use of an ultrasonic device. Spearman's correlation coefficient was calculated to assess the correlation between buccal bone and soft tissue thickness at each tooth type ResultsMean buccal bone thickness (SD) at central incisors, lateral incisors and canines was 1.07mm (0.34mm), 1.16mm (0.54mm) and 0.98mm (0.37mm), respectively. For central incisors, 68% of all sites had a thickness <1mm and 32% had a thickness between 1.0 and 2.0mm. At lateral incisors, 44% demonstrated buccal bone thickness between 0 and 1.0mm, 48% between 1.0 and 2.0mm and 8% 2mm. For canines, 57% of the sites were <1mm thick; 41% were between 1.0 and 2.0mm thick, and 2% demonstrated 2mm thickness. Mean gingival thickness (SD) at central incisors, lateral incisors and canines was 1.37mm (0.32mm), 1.33mm (0.32mm) and 1.08mm (0.25mm), respectively. The correlation between buccal bone and soft tissue thickness was moderately positive (=0.406; P<0.001 ConclusionsA thin buccal bone wall (<1mm) may be expected in over half of the central incisors and canines. The correlation between buccal bone and soft tissue thickness was moderately positive
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