| 1. |
- Bengtsson, M., et al.
(författare)
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Is there a difference in judgement of facial appearance depending on ethnic background? Photographic evaluation of facial appearance in orthognathic surgery
- 2020
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Ingår i: British Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0266-4356 .- 1532-1940. ; 58:7, s. 812-818
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Tidskriftsartikel (refereegranskat)abstract
- Is there a variation in facial ideals depending on ethnic background that affects judgements of outcome in orthognathic surgery? How does the evaluation correlate with patient-reported outcome measures? Two evaluation panels, Singaporean and Swedish, judged photographs of patients undergoing orthognathic surgery taken before and after operation. Improvement in facial aesthetics was calculated between the two ratings. The result was compared between the panels and correlated with health-related quality of life (QoL) measures. Thirty male and 27 female patients aged between 18 and 28 years (mean 21) were included, and 52 subjects were eligible for comparison of health-related QoL. The photographic evaluation showed that both panels judged there to be significant improvement in facial aesthetics after treatment (p < 0.001). The Singaporean panel rated the overall facial appearance higher than the Swedish panel when evaluating photographs both before (p = 0.025) and after (p = 0.032) operation. Improvement of the overall facial appearance showed no significant difference between the panels (p > 0.30). No correlation between health-related QoL and improvement of facial appearance was found by either panel. Subjective evaluation of facial aesthetics in orthognathic surgery is unaffected by the observer's ethnic origin. Independently of their ethnicity, the evaluation juries found that facial aesthetics improved after orthognathic surgery. Improvement reported by the juries corresponded to that reported by patients. © 2020 The British Association of Oral and Maxillofacial Surgeons
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| 2. |
- Jinno, Yohei, et al.
(författare)
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Impact of a hydrophilic dental implant surface on osseointegration : biomechanical results in rabbit
- 2021
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Ingår i: Journal of Oral Implantology. - : Academy of Implant Dentistry. - 0160-6972 .- 1548-1336. ; 47:2, s. 163-168
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to evaluate the effect of surface hydrophilicity on the biomechanical aspects of osseointegration of dental implants in the tibia and femur of rabbits. Forty-eight mature female New Zealand White rabbits were included, and 96 commercially pure, Grade 4, titanium dental implants (control group), and 96 implants of same macro geometry with the hydrophilic surface (test group) were used in this study. One osteotomy was performed in each tibia and femur on both sides of the rabbit, and four implants were placed in each rabbit. Control and test groups were randomly allocated on the left and right sides. During surgery, insertion torque (ITQ) value of the complete implant placement was recorded. After healing periods of 0, 2, 4, and 8 weeks after surgery, Implant Stability Quotient (ISQ) value, and removal torque (RTQ) values were measured. No statistical difference was observed for ITQ, for ISQ and for RTQ between the control group and test group in tibia/femur for all time periods. The effect of hydrophilic properties on moderately roughened surfaces has no impact in terms of biomechanical outcomes (ISQ values and RTQ values) after a healing period of 2 to 8 weeks in rabbit tibias /femurs.
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| 3. |
- Jinno, Yohei, et al.
(författare)
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Impact of salivary contamination during implant placement with different surface characteristics in native and augmented bone : An in vivo study in sheep calvaria model
- 2023
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 34:3, s. 254-262
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to evaluate whether salivary contamination during placement of implants with different surface characteristics affects osseointegration in native and in augmented bone areas.MATERIALS AND METHODS: Forty eight implants with machined surface (MS) and 48 implants with moderately rough surface (RS) were tested in the calvaria of 12 sheep. At the first surgery, 64 bony critical defects were randomly created and were subsequently augmented with two materials (autogenous or bovine bone). After 5 weeks of graft healing, 8 implants were placed per sheep, in native bone and in the centre of the augmented defects. Forty eight implants were soaked with saliva before placement (contaminated group [CG]), while 48 implants were not (non-contaminated group [NCG]). Five weeks after implant placement, bone-to-implant contact (BIC) and bone material area fraction occupancy (BMAFO) were calculated histomorphometrically.RESULTS: Saliva contamination showed a significant negative effect (p = .000) on BIC, especially in augmented areas. RS showed significant positive effect on BIC, compared to MS (p = .000), while there were no significant differences for different bone conditions (p = .103). For BMAFO, the contamination showed a significantly negative affect (p = .000), while there were no significant differences for surface characteristics (p = .322) and for bone condition (p = .538).CONCLUSION: Saliva contamination during dental implant placement has a negative effect on osseointegration in augmented areas. Moderately rough surface has a possible advantage in the aspect of initial bone to implant contact. However, it seems to be advisable to avoid saliva contamination especially for implants placed in augmented bone areas.
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| 4. |
- Johansson, Krister, et al.
(författare)
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Estimation of Blood Loss in Oral and Maxillofacial Surgery by Measurements of Low Haemoglobin Levels in Mixtures of Blood, Saliva and Saline : a Laboratory Study
- 2021
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Ingår i: Journal of Oral & Maxillofacial Research. - : Stilus Optimus. - 2029-283X. ; 12:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Estimating blood loss is an important factor in several surgical procedures. The accuracy of blood loss measurements in situations where blood is mixed with saliva and saline is however uncertain. The purpose of this laboratory study was to ascertain if blood loss measurements in mixtures of blood, saline, and saliva are reliable and could be applicable in a clinical setting.Material and Methods: Venous blood and resting saliva were collected from six volunteers. Saliva, saline, and combinations thereof were mixed with blood to obtain different concentrations. A portable spectrophotometer was first used to measure the haemoglobin concentration in undiluted venous blood followed by measurements of the haemoglobin concentration after each dilution. To examine the strength of linear relationships, linear regression and Pearson correlations were used.Results: The measurements of haemoglobin concentrations in mixtures of blood, saline, and saliva were proven to be accurate for haemoglobin measurements > 0.3 g/dl (correlation = 0.986 to 1). For haemoglobin measurements < 0.3 g/dl, a small increase in haemoglobin values were reported, which was directly associated to the saliva concentration in the solution (correlation = 0.983 to 1). This interference of saliva was significantly eliminated by diluting the samples with saline, mimicking the clinical situation.Conclusions: The results suggest that a portable spectrophotometer can be used clinically to preoperatively measure the haemoglobin value of a venous blood sample and postoperatively measure the haemoglobin value of the collected liquids, including shed blood, thereby achieving a highly accurate method of measuring blood loss during oral and maxillofacial surgery.
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| 5. |
- Klinge, Anna, et al.
(författare)
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A rater agreement study on measurements in cross-sectional CBCT images exploring the association between alveolar bone morphology and craniofacial height
- 2021
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Ingår i: Oral Radiology/Springer. - : Springer. - 0911-6028 .- 1613-9674. ; 37, s. 573-584
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate rater agreement regarding measurements of height and width of the maxilla and mandible using cross-sectional images from CBCT examinations. Furthermore, to explore the association between vertical craniofacial height and alveolar bone morphology.METHODS: Pre-treatment CBCT scans from 450 patients referred for treatment to a private clinic for orthodontics and oral surgery in Scandinavia were available and of these, 180 were selected. Lateral head images were generated from the CBCT volumes to categorise subjects into three groups based on their craniofacial height. Cross-sectional images of the maxillary and mandibular bodies at three locations in the maxilla and mandible, respectively, were obtained and measured at one height and two width recordings by five raters. One-way analysis of variance with a Tukey post hoc test was performed. A significance level of 5% was used.RESULTS: Rater agreement was mostly excellent or good when measuring height and width of the maxilla and mandible in cross-sectional CBCT images. For height (of the alveolar bone/bodies), there were statistically significant differences between the low- and the high-angle groups for all the observers when measuring in the premolar and midline regions, both in the maxilla and in the mandible.CONCLUSION: The high agreement found ensures a reliable measurement technique and confirms the relation between craniofacial height and alveolar bone height and width.
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| 6. |
- Klinge, Anna, et al.
(författare)
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Craniofacial Height in Relation to Cross-Sectional Morphology of the Anterior Maxilla : An Anatomica Considers ion in Implant Therapy
- 2020
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Ingår i: International Journal of Oral & Maxillofacial Implants. - : QUINTESSENCE. - 0882-2786 .- 1942-4434. ; 35:2, s. 386-394
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Patients who have a vertical growth pattern are more prone to complete alveolar bone growth later and run a higher risk for inhibition of growth and infraposition after implants have been placed. Moreover, it has been suggested for the same category of patients that craniofacial height may influence the alveolar bone morphology of the anterior maxilla during growth. Hence, it is important to identify such patients early when considering implant treatment in young patients. The purpose of this study was to investigate the height and width of the alveolar bone in the anterior maxilla in subjects with different craniofacial heights to assess if there is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Materials and Methods: Measurements on cephalograms and cone beam computed tomography (CBCT) images of the maxilla from 180 fully dentate subjects were analyzed and categorized into three angle groups based on the craniofacial height: low-, normal-, and high-angle groups. Measurements of the alveolar bone were taken interradicular, at six reference points distributed between the first premolar regions in the maxilla. The height and width of the alveolar bone were measured with a standardized technique at 3, 6, 9, and 12 mm from the top of the alveolar process. Results: Significant differences were found regarding the height of the alveolar bone in all the subgroups and regarding the width in the 9- and 12-mm subgroups, and between low-/normal- and low-/high-angle groups, where the high-angle group represented the thinnest alveolar bone. A significant difference was found between male and female patients concerning all dimensions of the alveolar bone. Conclusion: There is a relation between craniofacial height and the dimensions of the alveolar bone in the anterior part of the maxilla. Craniofacial height is an important factor to analyze when implant treatment is considered in the maxillary anterior region. This identification can preferably be carried out early in young patients who are still growing when various treatment options can still be considered.
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| 7. |
- Klinge, Anna, et al.
(författare)
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The risk for infraposition of dental implants and ankylosed teeth in the anterior maxilla related to craniofacial growth, a systematic review
- 2021
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Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 79:1, s. 59-68
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Tidskriftsartikel (refereegranskat)abstract
- Background The aim of the study was to evaluate a potential association between individuals with different craniofacial types or other exposures, and the risk of infraposition due to continued growth/eruption of adjacent teeth in the anterior maxilla. Materials and methods This is a systematic review in which primary studies as well as other systematic reviews are scrutinised. A search of PubMed (Medline), Scopus, Web of science and Health technology assessment (HTA) organisations and a complementary handsearch was carried out. Selected studies were read in full-text by several reviewers. The quality of the included primary studies was assessed using a protocol for assessment of risk of bias in exposure studies. Results The literature search resulted in 3,296 publications. Title and abstract screening yielded 25, whereof one systematic review, potential publications allocated for full-text inspection. The quality assessment resulted in a total of seven studies with a low/moderate risk of bias and four studies with a high risk of bias. Conclusion In conclusion, a long-term risk for infraposition of dental implants, or ankylosed teeth, among natural teeth can be observed in some cases. The predisposing factors are still not fully understood since the current scientific evidence is very limited.
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| 8. |
- Momand, Palwasha, et al.
(författare)
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Effect of antibiotic prophylaxis in dental implant surgery: A multicenter placebo-controlled double-blinded randomized clinical trial
- 2022
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Ingår i: Clinical Implant Dentistry and Related Research. - : Wiley. - 1523-0899 .- 1708-8208. ; 24:1, s. 116-124
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Tidskriftsartikel (refereegranskat)abstract
- Background The growing resistance of bacteria to antimicrobial medicines is a global issue and a direct threat to human health. Despite this, antibiotic prophylaxis is often still routinely used in dental implant surgery to prevent bacterial infection and early implant failure, despite unclear benefits. There is a lack of sufficient evidence to formulate clear clinical guidelines and therefore there is a need for well-designed, large-scale randomized controlled trials to determine the effect of antibiotic prophylaxis. Purpose To compare the effect of a presurgical antibiotic regimen with an identical placebo regimen in healthy or relatively healthy patients receiving dental implants. Materials and Methods The 474 patients participating in the study were recruited from seven clinics in southern Sweden. We randomized the patients into a test and a placebo group; the study was conducted double-blinded. Preoperatively, the test group received 2 g of amoxicillin and the control group, identical placebo tablets. The primary outcome was implant failure; secondary outcomes were postoperative infections and adverse events. Patients were evaluated at two follow-ups: at 7-14 days and at 3-6 months. Results Postoperative evaluations of the antibiotic (n = 238) and the placebo (n = 235) groups noted implant failures (antibiotic group: six patients, 2.5% and placebo group: seven patients, 3.0%) and postoperative infections (antibiotic group: two patients, 0.8% and placebo group: five patients, 2.1%). No patient reported any adverse events. Between-group differences in implant failures and postoperative infections were nonsignificant. Conclusion Antibiotic prophylaxis in conjunction with implant placement is likely of small benefit and should thus be avoided in most cases, especially given the unabated growth in antibiotic-resistant bacteria. Clinical trial registration number: NCT03412305.
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| 9. |
- Stocchero, Michele, et al.
(författare)
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Effect of Drilling Preparation on Immediately Loaded Implants : An In Vivo Study in Sheep
- 2023
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Ingår i: International Journal of Oral & Maxillofacial Implants. - : Quintessence Publishing. - 0882-2786 .- 1942-4434. ; 38:3, s. 607-618
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To determine the biologic and biomechanical effects of two implant drilling protocols on the cortical bone around implants subjected to immediate loading. Materials and Methods: A total of 48 implants were inserted into the mandibles of six sheep following one of two drilling protocols: undersized preparation (US; n = 24) and nonundersized preparation (NUS; n = 24). Immediately after implant insertion, an abutment was placed on each implant and 36 implants were subjected to 10 sessions of dynamic vertical loads (1,500 cycles, 1 Hz) of 25 N or 50 N. Insertion torque value (ITV) was recorded at implant installation. Resonance frequency analysis (RFA) was measured at implant insertion and at each loading session. Fluorochrome was administered at day 17, and the animals were euthanized after 5 weeks. The removal torque values (RTVs) were measured, and samples underwent histomorphometric, mu CT (microcomputed tomography), and fluorescence image acquisition analyses. The bone volume density (BV/TV), bone-to-implant contact (BIC), bone area fraction occupancy (BAFO), and fluorochrome stained bone surface (MS) were calculated. A linear mixed model analysis was performed, and Pearson paired correlation was calculated. Results: Five implants from the NUS group failed, with a mean ITV of 8.8 Ncm and an RFA value of 57. The mean ITVs for US group and NUS group were 80.5 (+/- 14) Ncm and 45.9 (+/- 25) Ncm, respectively (P < .001). No differences were noted in the RFA values from the time of implant insertion until the end of the study. No differences in RTV, BV/TV, BAFO, or MS were observed between the groups. Intense new bone formation took place in the NUS group implants that were subjected to load. Conclusions: Undersized preparation of cortical bone ensured a greater BIC compared to a nonundersized preparation. Moreover, this study demonstrated that immediate loading did not interfere with the osseointegration process, but loading induced intense new bone formation in the NUS group. It is not recommended to immediately load the implants when the clinically perceived primary stability is lower than an ITV of 10 Ncm and an RFA value of 60.
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| 10. |
- Stocchero, Michele, et al.
(författare)
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In silico multi-scale analysis of remodeling peri-implant cortical bone : a comparison of two types of bone structures following an undersized and non-undersized technique
- 2020
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Ingår i: Journal of The Mechanical Behavior of Biomedical Materials. - : Elsevier. - 1751-6161 .- 1878-0180. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this multi-scale in silico study was to evaluate the influence of resorption cavities on the mechanical properties and load distribution in cortical bone after implant placement with two different drilling protocols.MATERIAL AND METHODS: Two different micro-scale bone structures were assessed: cortical bone models with cavities (test) and without cavities (control) were designed from μCT data. In a macro-scale model, representing a mandibular ridge, oblique load of 150 N was applied on the implant-abutment. Maximum principal stress/strain, and shear stress/strain were calculated in the macro- and micro-scale models.RESULTS: Test presented anisotropic material properties. In tests, significantly greater maximum values of Maximum principal stress/strain were calculated in micro-scale model. These values were located at the implant neck area in the macro-scale model and in the proximity of cavities in the micro-scale model respectively. Greater values of shear stress/strain were found in the test along the mandibular horizontal plane.CONCLUSIONS: Cortical bone with resorption cavities following undersized drilling showed an impaired load distribution compared with bone without cavities. Subsequently, stress/strain distribution suggests that this bone model is more prone to microdamage, thus delaying the healing process.
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| 11. |
- Toia, Marco, et al.
(författare)
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Fixed full-arch maxillary prostheses supported by four versus six implants with a titanium CAD/CAM milled framework: 3-year multicentre RCT
- 2021
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 32:1, s. 44-59
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This RCT compares marginal bone level (MBL) change and the clinical parameters after a 3-year function in maxillary implant-supported fixed complete dentures (FCDs) treated with four-implants (4-I) or six-implants (6-I). Material and method Three centres treated 56 patients with 280 implants allocated to the 4-I or 6-I group. Radiographic and clinical examinations were performed. The primary outcome was to investigate MBL change between the groups. Results Implant survival rates were 100% and 99% in the 4-I and 6-I groups, respectively. Considering the clustering effects, the MBL change was not significantly different between the groups over the 3-year follow-up. The MBL in the 4-I group was 0.30 +/- 0.50 mm at baseline, 0.24 +/- 0.31 mm at 1 year and 0.24 +/- 0.38 mm at 3 years. In the 6-I group, MBL was 0.14 +/- 0.32 mm at baseline, 0.16 +/- 0.35 mm at 1 year and 0.12 +/- 0.26 mm at 3 years. There was a statistically significant difference between the groups at BL and 3Y. No significant differences between the groups were reported for clinical parameters at each time point as well as in between the visits. The technical and biological complications rates were 1.6% and 6.0%, respectively. Prosthetic complications affected 25 FCDs (47.2%). Conclusion Marginal bone level change revealed a stable condition in the 3-year period in the two groups. Few technical and biological complications occurred apart from the chipping/fracture of the prosthetic teeth. Four-implant is a feasible solution if the rehabilitation is oriented towards the most cost-effective treatment and towards avoiding bone augmentation procedures. Clinicians have to consider the potential required visits for prosthetic maintenance.
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| 12. |
- Toia, Marco, et al.
(författare)
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The use of implant-level connection in screw-retained fixed partial dentures: A 3-year randomised clinical trial
- 2022
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Ingår i: Clinical Oral Implants Research. - : Wiley. - 0905-7161 .- 1600-0501. ; 33:1, s. 78-93
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This randomised controlled trial compares the 3-year outcomes, that is, marginal bone-level (MBL) changes and clinical parameters, between an abutment-level (AL) and implant-level (IL) connection for implants with an internal conical connection (ICC) supporting a screw-retained fixed partial denture. Material and methods Fifty patients with 119 implants were randomly allocated to either the AL or IL group. Radiographic and clinical examinations were performed after one, two, and 3 years. A linear mixed model was used to evaluate the differences between groups. Results The MBL change was not significantly different between the groups at any point. The MBL was 0.12 +/- 0.31 mm (AL) and 0.23 +/- 0.26 mm (IL) after 1 year; 0.15 +/- 0.34 mm (AL) and 0.17 +/- 0.22 mm (IL) after 2 years; 0.18 +/- 0.39 mm (AL) and 0.15 +/- 0.21 mm (IL) after 3 years. The bleeding on probing was 43.44 +/- 39.24% (AL) and 58.19 +/- 41.20% (IL) after 1 year; 35.78 +/- 39.22% (AL) and 50.43 +/- 41.49% (IL) after 2 years; 51.27 +/- 44.63% (AL) and 49.57 +/- 37.31% (IL) after 3 years and was significantly different (p = .025) between 1 and 2 years. The probing depth showed a significant difference at each time point while the plaque was not significant between the groups. The overall technical, biological and prosthetic complication rates were 5.04%, 3.36%, and 16.00%, respectively. Conclusions The MBL change was similar in the groups. The slight differences in the soft tissue complications between the groups are likely not of clinical relevance. An IL connection is considered to be a valid alternative to an AL set-up in ICC implants.
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