| 1. |
- Fischer, Kai R., et al.
(author)
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Influence of local administration of pamidronate on extraction socket healing : a histomorphometric proof-of-principle pre-clinical in vivo evaluation
- 2015
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 26:10, s. 1135-1142
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Journal article (peer-reviewed)abstract
- Objectives:To evaluate the influence of local administration of pamidronate histomorphometrically, adsorbed on a collagenated porcine bone substitute, on extraction socket healing.Material and methods:Two American Fox-hound dogs were used within this proof-of-principle study. Following endodontic treatment of the distal root of the three lower premolars, the teeth were hemisected, and the mesial roots were extracted flapless. The sockets were then loosely filled, in a split-mouth fashion, with a collagenated porcine bone substitute (Osteobiol Gen-Os; CPB), rehydrated either with 90mg/ml pamidronate (Aredia((R)); test) or with sterile saline (control). Extraction sockets were sealed with connective tissue punches obtained from the palate and secured with sutures. After 4months of healing, specimens containing the socket sites and remaining roots were retrieved and histomorphometrically examined.Results:Histological evaluation of the sections revealed substantial differences in healing patterns. Control sites presented with various amounts of newly formed bone and no evidence of CPB inside the socket; in contrast, limited amounts of bone were observed at test sites, which were filled with CPB mainly embedded in connective tissue. Only minor differences were observed between test and control sites regarding vertical bone loss (buccal bone: -1.01mm vs. -1.15mm; lingual bone: -0.92mm vs. -1.15mm). Horizontal bone loss was nearly three times higher in control sites comparing to sites treated with pamidronate (-2.191.81mm vs. -0.80 +/- 0.91mm) at a level corresponding to 3mm below the cemento-enamel junction (CEJ).Conclusion:Local administration of pamidronate adsorbed on a collagenated porcine bone substitute in particulate form appeared to delay extraction socket healing, but may also reduce post-extraction dimensional changes in terms of horizontal bone width. Additionally, pamidronate appears to obstruct resorption of the porcine bone substitute.
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| 2. |
- Hämmerle, Christoph H F, et al.
(author)
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Biology of soft tissue wound healing and regeneration : consensus report of group 1 of the 10th European workshop on periodontology
- 2014
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 41:s15, s. S1-S5
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Journal article (other academic/artistic)abstract
- BACKGROUND:The scope of this consensus was to review the biological processes of soft tissue wound healing in the oral cavity and to histologically evaluate soft tissue healing in clinical and pre-clinical models. AIMS:To review the current knowledge regarding the biological processes of soft tissue wound healing at teeth, implants and on the edentulous ridge. Furthermore, to review soft tissue wound healing at these sites, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. COLLECTION OF DATA:Searches of the literature with respect to recessions at teeth and soft tissue deficiencies at implants, augmentation of the area of keratinized tissue and soft tissue volume were conducted. The available evidence was collected, categorized and summarized. FUNDAMENTAL PRINCIPLES OF ORAL SOFT TISSUE WOUND HEALING:Oral mucosal and skin wound healing follow a similar pattern of the four phases of haemostasis, inflammation, proliferation and maturation/matrix remodelling. The soft connective tissue determines the characteristics of the overlaying oral epithelium. Within 7-14 days, epithelial healing of surgical wounds at teeth is completed. Soft tissue healing following surgery at implants requires 6-8 weeks for maturation. The resulting tissue resembles scar tissue. Well-designed pre-clinical studies providing histological data have been reported describing soft tissue wound healing, when using barrier membranes, growth and differentiation factors and soft tissue substitutes. Few controlled clinical studies with low numbers of patients are available for some of the treatments reviewed at teeth. Whereas, histological new attachment has been demonstrated in pre-clinical studies resulting from some of the treatments reviewed, human histological data commonly report a lack of new attachment but rather long junctional epithelial attachment and connective tissue adhesion. Regarding soft tissue healing at implants human data are very scarce. CONCLUSIONS:Oral soft tissue healing at teeth, implants and the edentulous ridge follows the same phases as skin wound healing. Histological studies in humans have not reported new attachment formation at teeth for the indications studied. Human histological data of soft tissue wound healing at implants are limited. CLINICAL RECOMMENDATIONS:The use of barriers membranes, growth and differentiation factors and soft tissue substitutes for the treatment of localized gingival/mucosal recessions, insufficient amount of keratinized tissue and insufficient soft tissue volume is at a developing stage.
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| 3. |
- Kröger, A, et al.
(author)
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The severity of human peri-implantitis lesions correlates with the level of submucosal microbial sysbiosis
- 2018
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In: Journal of Clinical Periodontology. - 0303-6979 .- 1600-051X. ; 45:12, s. 1498-1509
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Journal article (peer-reviewed)abstract
- AIM: To cross-sectionally analyze the submucosal microbiome of peri-implantitis (PI) lesions at different severity levels.MATERIALS AND METHODS: Microbial signatures of 45 submucosal plaque samples from untreated peri-implantitis lesions obtained from 30 non-smoking, systemically healthy subjects were assessed by 16s sequencing. Linear mixed models were used to identify taxa with differential abundance by probing depth, after correction for age, gender, and multiple samples per subject. Network analyses were performed to identify groups of taxa with mutual occurrence or exclusion. Subsequently, the effects of peri-implant probing depth on submucosal microbial dysbiosis was calculated using the microbial dysbiosis index.RESULTS: In total, we identified 337 different taxa in the submucosal microbiome of peri-implantitis. Total abundance of 12 taxa correlated significantly with increasing probing depth; a significant relationship with lower probing depth was found for 16 taxa. Network analysis identified two mutually exclusive complexes associated with shallow pockets and deeper pockets, respectively. Deeper peri-implant pockets were associated with significantly increased dysbiosis.CONCLUSION: Increases in peri-implant pocket depth are associated with substantial changes in the submucosal microbiome and increasing levels of dysbiosis. This article is protected by copyright. All rights reserved.
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| 4. |
- Kröger, A, et al.
(author)
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The severity of human peri-implantitis lesions correlates with the level of submucosal microbial sysbiosis
- 2018
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In: Journal of Clinical Periodontology. - : Blackwell Munksgaard. - 0303-6979 .- 1600-051X. ; 45:12, s. 1498-1509
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Journal article (peer-reviewed)abstract
- AIM: To cross-sectionally analyze the submucosal microbiome of peri-implantitis (PI) lesions at different severity levels. MATERIALS AND METHODS: Microbial signatures of 45 submucosal plaque samples from untreated peri-implantitis lesions obtained from 30 non-smoking, systemically healthy subjects were assessed by 16s sequencing. Linear mixed models were used to identify taxa with differential abundance by probing depth, after correction for age, gender, and multiple samples per subject. Network analyses were performed to identify groups of taxa with mutual occurrence or exclusion. Subsequently, the effects of peri-implant probing depth on submucosal microbial dysbiosis was calculated using the microbial dysbiosis index. RESULTS: In total, we identified 337 different taxa in the submucosal microbiome of peri-implantitis. Total abundance of 12 taxa correlated significantly with increasing probing depth; a significant relationship with lower probing depth was found for 16 taxa. Network analysis identified twomutually exclusive complexes associated with shallow pockets and deeper pockets, respectively. Deeper peri-implant pockets were associated with significantly increased dysbiosis. CONCLUSION: Increases in peri-implant pocket depth are associated with substantial changes in the submucosal microbiome and increasing levels of dysbiosis. This article is protected by copyright. All rights reserved.
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| 5. |
- Thoma, Daniel S., et al.
(author)
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Soft tissue management at implants: : Summary and consensus statements of group 2. The 6th EAO Consensus Conference 2021
- 2021
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 32:S21, s. 174-180
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Journal article (peer-reviewed)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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