| 1. |
- Aidoukovitch, Alexandra, et al.
(author)
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Strontium chloride promotes cell proliferation in a human osteoblast cell line
- 2014
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Reports (other academic/artistic)abstract
- Strontium ranelate (SrRan) is the active component of drugs currently used for reducing the risk of fractures in patients suffering from osteoporosis. Despite extensive use, the underlying mechanisms of action of Sr2+ are not fully understood. In the present study, we assess the impact of SrCl2 on human osteoblast activity and proliferation. Cultures of the human osteoblast-like cell line MG63 were treated for 72 h in presence of 0.1 mM, 1 mM, 5 mM and 10 mM SrCl2 or vehicle, used in control groups. Cells were counted manually using a Bürker chamber. Total protein content was determined by colorimetric analysis performed by a microplate reader using Bio-Rad protein assay. Alkaline phosphatase (ALP) activity was determined enzymatically and normalized to total protein content in each sample. Cell viability was assessed using the MTT assay. Treatment with 5 mM SrCl2 for 72 h enhanced total MG63 cell protein content by 37% compared to controls (p<0.01). A lower concentration (0.1 mM) of SrCl2 had no effect on total protein. Incubation with 5 mM SrCl2 for 72 h increased MG63 cell number by 38% compared to controls (p<0.001). The SrCl2-induced increase in cell number was associated with enhanced (+14% compared to controls, p<0.05) cell viability. Treatment with a higher concentration (10 mM) of SrCl2 enhanced cell number similar to 5 mM SrCl2 (+54% compared to controls, p<0.05). Treatment with 0.1 or 5 mM SrCl2 for 72 h had no effect (p>0.05) on MG63 cell ALP activity, while 1 mM SrCl2 reduced ALP activity as well as total protein content by about 25% compared to controls (p<0.05). The current results demonstrate that treatment with SrCl2 for 72 h, at concentrations higher than 1 mM promotes cell proliferation in human osteoblast-like cells, suggesting that Sr2+ may enhance bone formation through this mechanism.
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| 2. |
- Batas, Leonidas, et al.
(author)
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Histological evaluation of PRGF as adjunct to DBB in maxillary sinus floor augmentation : preliminary results of a split-mouth study
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:s9, s. 193-193
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Journal article (other academic/artistic)abstract
- Background: Autologous growth factors are currently evaluated for their potential to enhance bone formation in association with maxillary sinus floor augmentation (MSFA). Aim/Hypothesis: To evaluate histologically whether chair-side prepared autologous platelet rich growth factor (PRGF) in combination with deproteinized bovine bone (DBB) enhances bone formation when compared with DBB alone as graft material in MSFA. Material and methods: Six partially edentulous patients with ≤3 mm residual bone height bilaterally in the posterior maxilla were subjected to MSFA with DBB in combination with PRGF in one side or DBB alone in the contralateral side. PRGF was prepared by collecting 20 ml of peripheral blood from each patient into tubes containing 3.8% (wt/vol) sodium citrate as anticoagulant and centrifugation at 1400 rpm for 8 min at room temperature (PRGF System1, Vitoria, Spain). From the separated blood, the 0.5 ml plasma fraction located just above the red cell fraction, but not including the buffy coat, was then collected and deposited in an eppendorf tube, and activated with the addition of PRGF activator (50 ll calcium chloride solution 10%w/v). The resulting PRGF was then mixed with deproteinized bovine bone (DBB) in a glass dish. After 5–8 min, the material attained a viscous consistency and was ready for application. MSFA was performed with the lateral window technique. Trephine biopsies were obtained during oral implant site preparation approximately 6 months after MSFA and processed for decalcified or non-decalcified histological and histomorphometrical evaluation. Non-parametric statistics, with P set at 0.05, were performed. Results: The collected biopsies varied in length (range: 3.5– 9.9 mm); consequently, the portion of the biopsy representing augmented tissues also varied (range 2.3–14.6 mm2). New bone formation with a trabecular appearance and numerous DBB particles in contact with the new bone or with loose connective tissue were observed. No differences in the relative volumes of bone formation were found in sinuses augmented with DBB+PRGF or DBB alone 6 months after MSFA (35.6 8.26 mm and 37.8 3.15 mm, respectively). Conclusions and clinical implications: Based on these preliminary results, PRGF as an adjunct to DBB does not enhance bone formation inside the human sinus when implant installation is planned several months after MSFA.
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| 3. |
- Berglundh, Tord, 1954, et al.
(author)
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Preclinical in vivo research in implant dentistry. Consensus of the eighth European workshop on periodontology.
- 2012
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In: Journal of clinical periodontology. - 1600-051X. ; 39 Suppl 12, s. 1-5
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Research review (peer-reviewed)abstract
- Guidelines for improving the reporting in preclinical in vivo research (ARRIVE) have been recently proposed. AIM: The aim was to assess to what extent the ARRIVE guidelines were considered in preclinical in vivo studies in implant dentistry. MATERIAL AND METHODS: Four comprehensive systematic reviews evaluated to what extent the ARRIVE guidelines were considered in preclinical in vivo studies in implant dentistry. Studies on the influence of implant material, surface and design on tissue integration to implants placed in pristine bone, in locally compromised sites and/or systemically compromised animals, as well as on peri-implant mucositis and peri-implantitis were evaluated. The four reviews introduced different modifications to the ARRIVE guidelines dedicated to the specific assignment of the review. RESULTS: A large variation in the frequency of reporting with regard to the items of the modified ARRIVE guidelines was observed. The reviews revealed that relevant information, e.g. sample size calculation, blinding of the assessor etc., was often not reported. It was also identified that several items in the ARRIVE guidelines may be less--if at all--applicable to research in implant dentistry. CONCLUSION: It is suggested that researchers implement, whenever relevant, the ARRIVE guidelines during planning and reporting of preclinical in vivo studies related to dental implants.
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| 4. |
- Correa, Leticia, et al.
(author)
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Planning of dental implant size with digital panoramic radiographs, CBCT-generated panoramic images, and CBCT cross-sectional images
- 2014
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In: Clinical Oral Implants Research. - : Blackwell Munksgaard. - 0905-7161 .- 1600-0501. ; 25:6, s. 690-695
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To compare the implant size (width and length) planned with digital panoramic radiographs, cone beam computed tomography (CBCT)-generated panoramic views, or CBCT cross-sectional images, in four implant systems. MATERIAL AND METHODS: Seventy-one patients with a total of 103 implant sites in the upper premolar and/or lower molar regions were examined with digital panoramic radiography (D-PAN) and (CBCT). A metal ball 5 mm in diameter was placed in the edentulous area for the D-PAN. CBCT data sets were reformatted to a 10-mm thick CBCT panoramic view (CBCT-pan) and 1-mm cross-sections (CBCT-cross). Measurements were performed in the images using dedicated software. All images were displayed on a monitor and assessed by three observers who outlined a dental implant by placing four reference points in the site of the implant-to-be. Differences in width and length of the implant-to-be from the three modalities were analyzed. The implant size selected in the CBCT-cross images was then compared to that selected in the other two modalities (D-PAN and CBCT-pan) for each of the implant systems separately. RESULTS: The implant-to-be (average measurements among observers) was narrower when measured in CBCT-cross compared with both D-PAN and CBCT-Pan. For premolar sites, the width also differed significantly between D-PAN and CBCT-pan modalities. The implant-to-be was also significantly shorter when recorded in CBCT-cross than in D-PAN. In premolar sites, there were no significant differences in implant length among the three image modalities. It mattered very little for the change in implant step sizes whether CBCT-cross was compared to D-PAN or CBCT-pan images. CONCLUSION: Our results show that the selected implant size differs when planned on panoramic or cross-section CBCT images. In most cases, implant size measured in cross-section images was narrower and shorter than implant size measured in a panoramic image or CBCT-based panoramic view
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| 5. |
- Danz, Jan, et al.
(author)
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A rat model for orthodontic translational expansive tooth movement
- 2013
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In: Orthodontics & craniofacial research. - : John Wiley & Sons. - 1601-6335 .- 1601-6343. ; 16:4, s. 223-233
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To present the development of an experimental model in rats for translational expansive tooth movement. SETTING AND SAMPLE: Section of Periodontology at Department of Dentistry Aarhus University. Twenty male Wistar rats in two pilot experimental settings plus seven animals without any intervention serving as controls. MATERIAL AND METHODS: The second molar (group P1) or the second and third molar (group P2) in the maxillae of the animals were moved buccally using transpalatal β-titanium springs. In the group P2, two spring types (high force and low force) and two preangulations (0° passive or 30° torsion moment) were tested. The amount and type of tooth movement achieved and the resulting skeletal effect were assessed on microCT images, histological analysis was performed on few selected specimens. RESULTS: Expansive translational root movement amounting half a tooth width was achieved. Comparison of the amount of tooth movement at the right and left side of the maxilla showed that the expansion was rather symmetrical in the P2 group. Skeletal widening of the maxilla contributed in the P2 group to approximately one-third of the total root movement, whereas two-thirds were dental movement. CONCLUSION: With the model used in the P2 group, further research on translational expansive tooth movement and its effect on the periodontium can be pursued. In models for orthodontic expansion, it is strongly recommended to separately evaluate skeletal and dental effects.
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| 6. |
- Danz, Jan, et al.
(author)
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Virtual tissue alignment and cutting plane definition : a new method to obtain optimal longitudinal histological sections
- 2014
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In: Journal of Anatomy. - : John Wiley & Sons. - 0021-8782 .- 1469-7580. ; 224:2, s. 85-94
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Journal article (peer-reviewed)abstract
- Histomorphometric evaluation of the buccal aspects of periodontal tissues in rodents requires reproducible alignment of maxillae and highly precise sections containing central sections of buccal roots; this is a cumbersome and technically sensitive process due to the small specimen size. The aim of the present report is to describe and analyze a method to transfer virtual sections of micro-computer tomographic (CT)-generated image stacks to the microtome for undecalcified histological processing and to describe the anatomy of the periodontium in rat molars. A total of 84 undecalcified sections of all buccal roots of seven untreated rats was analyzed. The accuracy of section coordinate transfer from virtual micro-CT slice to the histological slice, right-left side differences and the measurement error for linear and angular measurements on micro-CT and on histological micrographs were calculated using the Bland-Altman method, interclass correlation coefficient and the method of moments estimator. Also, manual alignment of the micro-CT-scanned rat maxilla was compared with multiplanar computer-reconstructed alignment. The supra alveolar rat anatomy is rather similar to human anatomy, whereas the alveolar bone is of compact type and the keratinized gingival epithelium bends apical to join the junctional epithelium. The high methodological standardization presented herein ensures retrieval of histological slices with excellent display of anatomical microstructures, in a reproducible manner, minimizes random errors, and thereby may contribute to the reduction of number of animals needed.
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| 7. |
- Fischer, K, et al.
(author)
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Influence of local administration of pamidronate on extraction socket healing : a histomorphometric proof-of-principle preclinical in vivo evaluation
- 2014
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 25:Suppl 10, s. 148-148
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Journal article (other academic/artistic)abstract
- Background: Tooth extraction is conventionally performed without any additional tissue manipulation and left for healing by secondary intention. Maintaining hard and soft tissue volume after tooth extraction may be crucial to achieve a highly aesthetic restoration and it may also facilitate stability of the results on the long-term. Therefor, different approaches have been proposed to eliminate post-extraction ridge reduction. Today, however, no technique seems to be able to preserve the entire socket volume. Aim/Hypothesis: To evaluate histomorphometrically the influence of local administration of pamidronate, adsorbed on a deproteinized 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 deproteinized porcine bone substitute in particulate form (Osteobiol Gen-Os; DPB), rehydrated either with sterile saline (control) or 90 mg/ml pamidronic acid solution (Aredia ; test). Extraction sockets were sealed with connective tissue punches obtained from the palate and secured with sutures. After 4 months of healing, specimens containing the sockets sites and remaining roots were retrieved and histomorphometrically evaluated. Vertical and horizontal ridge changes were evaluated comparing the section containing the remaining root and the corresponding extraction sites. Results: Histological evaluation of the sections revealed significant differences in healing patterns between test and controls. While the latter group presented complete closure of the sockets with newly formed bone, pamidronate treated sites presented with open socket entrances, only sealed with soft connective tissue. Within the socket, control sites presented with various amounts of newly formed bone and no evidence of DPB; limited amounts of bone healing were observed within test sites, that were filled with DPB mainly embedded in connective tissue. Socket (bone) wall loss in a vertical dimension showed only minor differences between tests and controls sites (buccal: – 1.01 vs – 1.15 mm; lingual: – 0.92 vs – 1.15 mm;). Horizontal bone loss, measured at a level corresponding to 3 mm below the cemento-enamel-junction (CEJ), was nearly three times higher in control sites ( 2.19 1.81 mm vs. – 0.80 0.91 mm;), while no differences were observed between groups at a level corresponding to 5 mm below the CEJ. Conclusion and clinical implications: Local administration of pamidronate adsorbed on a deproteinized porcine bone substitute in particulate form appeared to delay extraction socket healing, but may also reduce post-extraction dimensional changes in the alveolar ridge, in terms of horizontal bone loss. Additionally, pamidronate appears to obstruct resorption of the porcine bone substitute.
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| 8. |
- Horváth, Attila, et al.
(author)
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Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste
- 2013
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 17:2, s. 423-430
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). MATERIALS AND METHODS: Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7 months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. RESULTS: The postoperative healing was uneventful in all cases. At 7 months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8 mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33 mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. CONCLUSION: Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. CLINICAL RELEVANCE: The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneration.
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| 9. |
- Horváth, Attila, et al.
(author)
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Histologisk evaluering af humane intraossøse parodontale defekter behandlet med en usintret nanokrystallinsk hydroxyapatit pasta
- 2013
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In: Tandlægebladet. - : Dansk Tandlægeforening. - 0039-9353. ; 117:1, s. 12-13
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Journal article (other academic/artistic)abstract
- Formål Formålet med undersøgelsen var at evaluere den kliniske og histologiske heling af humane intraossøse defekter behandlet med konventionel flapkirurgi (OFD) og anvendelse af en ny, resorberbar, fuldsyntetisk, usintret, nanokrystallinsk, hydroxyapatit (nano-HA ). Materialer og metoder Seks patienter, som hver viste en meget avanceret intraossøs defekt omkring en tand planlagt til ekstraktion på grund af svær kronisk marginal parodontitis og yderligere restaurerende overvejelser, blev inkluderet i undersøgelsen. Efter lokalbedøvelse, mucoperiosteal lapløft, granulationsvævs fjernelse og omhyggelig roddepuration og afglatning med hånd- og ultralydsinstrumenter blev der på roden placeret et mindre boremærke ved den mest apikale tilstedeværelse af tandsten eller ved bunden af defekten (hvis ikke tandsten var til stede); boremærket tjente som reference ved den histologiske evaluering. Efter defektudfyldelse med nano-HA blev lapperne syet ved hjælp af madras-suturer mhp. primær heling. Syv måneder efter regenerativ kirurgi blev tænderne ekstraheret sammen med en mindre del af de omgivende bløde og hårde væv og præpareret til histologisk undersøgelse. Resultater Postoperativ heling var komplikationsfri i alle tilfælde. Syv måneder efter operationen sås der betydelig pochedybdereduktion og klinisk fæstegevinst på 4,0 mm ± 0,8 mm og 2,5 mm ± 0,8 mm, henholdsvis. Den histologiske analyse viste, at helingen hovedsageligt kendetegnede sig ved et lang epitelialt fæste. Begrænset dannelse af ny cement med indlejrede kollagenfibre og knogleregeneration sås hos tre ud af de seks biopsier på op til henholdsvis 0,86 mm og 1,33 mm. Komplet resorption af nano-HA-partikler blev fundet i fire ud af de seks biopsier. Nogle få rester af de implanterede partikler (enten omgivet af nydannet mineraliseret væv eller indkapslet i bindevæv) blev fundet i to ud af de seks biopsier. Konklusion De foreliggende resultater viser, at nano-HA har begrænset mulighed for at fremme parodontal regeneration i humane intraossøse defekter. Klinisk relevans: De kliniske resultater opnået efter kirurgi med OFD + nano-HA afspejler måske ikke ægte parodontal regeneration. Horváth A, Stavropoulos A, Windisch P et al. Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste. Clin Oral Investig 2012.
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| 10. |
- 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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| 11. |
- Jensen, Thomas, et al.
(author)
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Sinusløftprocedure med Bio-Oss alene eller Bio-Oss blandet med autolog knogle som transplantationsmateriale : En systematisk oversigtsartikel med fokus på dyreeksperimentelle undersøgelser
- 2013
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In: Tandlægebladet. - : Dansk Tandlægeforening. - 0039-9353. ; 117:3, s. 194-194
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Journal article (other academic/artistic)abstract
- Formål Formålet med denne systematiske gennemgang af litteraturen var at teste hypotesen, at der ingen forskel er på anvendelsen af Bio-Oss alene eller Bio-Oss blandet med autolog knogle som transplantationsmateriale til sinusløftprocedure ved lateral vindueteknik baseret på dyreeksperimentelle undersøgelser. Materialer og metoder En elektronisk litteratursøgning i MEDLINE (PubMed), Embase og Cochrane kombineret med manuel søgning af relevante tidsskrifter blev udført med henblik på at inkludere dyreeksperimentelle undersøgelser offentliggjort på engelsk fra 1. januar 1990 til 1. juni 2010. Søgningen identificerede 879 undersøgelser, og 14 undersøgelser opfyldte inklusionskriterierne. Resultater Den systematiske gennemgang af de inkluderede undersøgelser viste, at stabiliteten af transplantationsmaterialets volumen forbedres signifikant ved øget mængde Bio-Oss i transplantationsmaterialet. Knogleregeneration, knogleimplantatkontakt, biomekaniske undersøgelser af implantatstabilitet og nedbrydning af Bio-Oss efter sinusløftprocedure ved de to behandlingsmodaliteter er ikke sammenlignet i dyreeksperimentelle undersøgelser. Konklusion Hypotesen om ingen forskel på anvendelsen af Bio-Oss alene eller Bio-Oss blandet med autologt knogletransplantat i forbindelse med sinusløftprocedure kunne hverken bekræftes eller forkastes baseret på de eksisterende dyreeksperimentelle undersøgelser. Jensen T, Schou S, Stavropoulos A, Terheyden H, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals: a systematic review. Int J Oral Maxillofac Surg 2012;41:114-20.
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| 12. |
- Jensen, Thomas, et al.
(author)
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Sinusløftprocedure med Bio-Oss alene eller Bio-Oss blandet med autolog knogle som transplantationsmateriale : En systematisk oversigtsartikel med fokus på humane undersøgelser
- 2013
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In: Tandlægebladet. - : Dansk Tandlægeforening. - 0039-9353. ; 117:5, s. 384-385
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Journal article (other academic/artistic)abstract
- Formål Formålet med denne systematiske gennemgang af litteraturen var at teste hypotesen, at der ingen forskel er på implantatbehandlingens resultat, når der anvendes henholdsvis Bio-Oss alene eller Bio-Oss blandet med autolog knogle som transplantationsmateriale til sinusløftprocedure ved lateral vindueteknik baseret på humane undersøgelser. Materialer og metoder En elektronisk litteratursøgning i MEDLINE (PubMed) kombineret med manuel søgning af relevante tidsskrifter blev udført med henblik på at inkludere kliniske undersøgelser offentliggjort på engelsk fra 1. januar 1990 til 1. juni 2010. Søgningen identificerede 879 undersøgelser, og 35 undersøgelser opfyldte inklusionskriterierne. Resultater Den systematiske gennemgang af de inkluderede undersøgelser viste, at det ikke var muligt at foretage en metaanalyse på grund af betydelig variation i de inkluderede studier. Endvidere kunne der ikke identificeres langtidsundersøgelser, der sammenlignede sinusløftprocedure med de to behandlingsmodaliteter. Desuden kunne der ikke identificeres undersøgelser, hvor overlevelsen af suprastrukturen efter de to behandlingsprocedurer blev sammenlignet. Den etårige implantatoverlevelse blev sammenlignet i en enkelt undersøgelse, og der kunne ikke påvises statistisk signifikant forskel. Implantatoverlevelsen var således 96 % med Bio-Oss alene og 94 % med en blanding af 80 % Bio-Oss og 20 % autolog knogle fra underkæben. Tilsætning af en begrænset mængde autolog knogle til Bio-Oss syntes ikke at øge mængden af nydannet knogle eller knogleimplantatkontakten sammenlignet med Bio-Oss alene. Konklusion Hypotesen om ingen forskel på anvendelsen af Bio-Oss alene eller Bio-Oss blandet med autologt knogletransplantat i forbindelse med sinusløftprocedure kunne derfor hverken bekræftes eller forkastes baseret på de eksisterende humane undersøgelser. Der er således behov for supplerende langtidsundersøgelser med fokus på overlevelsen af suprastrukturer og implantater ved de to behandlingsmodaliteter, før endelige konklusioner kan drages. Jensen T, Schou S, Stavropoulos A, Terheyden H, Holmstrup P. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review. Clin Oral Implants Res 2012;23:263-73.
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| 13. |
- Milosavljevic, Aleksandar, et al.
(author)
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Assessment of prognosis and treatment goals among general dental practitioners and dental hygienists
- 2014
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Reports (other academic/artistic)abstract
- Introduction: Clinicians are expected to base their treatment strategies of periodontal diseases on patient history, clinical appearance, and previous experience of periodontal disease. Treatment decisions are influenced by their prognostic assessment and treatment goals. Therefore the aim was to study patterns regarding general dental practitioners (GDPs) and dental hygienists (DHs) a) assessment of prognosis, b) setting of treatment goals, and c) estimation of amount of treatment of cases with varying severity of periodontal disease. Material and Methods: Seventy-seven GDPs and 50 DHs in a Swedish county were invited to participate in a questionnaire study. The response rate was 94 %. The questionnaire included patient history, clinical charts and radiographs, of three patient cases with a varying degree of periodontal diseases. Clinicians that judged these patients as diseased assessed the prognosis, proposed treatment goals and estimated amount of treatment, i.e. number of treatment sessions. The clinicians were compared to each other regarding their prognostic assessment and estimated amount of treatment. ANOVA and Tukey´s test compared the differences in estimated amount of treatment. Results: The majority of clinicians (58-95%) assessed that a worsening of the periodontal condition (assessment of prognosis) should occur. They had different treatment goals. Regardless of the clinicians’ former prognostic assessment there were almost no differences, overall, in estimated number of treatment sessions (p>0.05). The estimated number of treatment sessions ranged from 2 to 3 sessions in all patients. Conclusions: Most clinicians assessed the prognosis as negative. All patients were estimated to require the same amount of treatment even if their periodontal condition differed significantly in severity. This could mean that patients are over- or undertreated in relation to their periodontal condition and indicates that resources are ineffectively used.
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| 14. |
- Molnár, Bálint, et al.
(author)
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Treatment of multiple adjacent Miller Class I and II gingival recessions with collagen matrix and the modified coronally advanced tunnel technique
- 2013
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In: Quintessence International. - : Quintessence. - 0033-6572. ; 44:1, s. 17-24
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To clinically evaluate the treatment of Miller Class I and II multiple adjacent gingival recessions using the modified coronally advanced tunnel technique combined with a newly developed bioresorbable collagen matrix of porcine origin. METHOD AND MATERIALS: Eight healthy patients exhibiting at least three multiple Miller Class I and II multiple adjacent gingival recessions (a total of 42 recessions) were consecutively treated by means of the modified coronally advanced tunnel technique and collagen matrix. The following clinical parameters were assessed at baseline and 12 months postoperatively: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), recession depth (RD), recession width (RW), keratinized tissue thickness (KTT), and keratinized tissue width (KTW). The primary outcome variable was complete root coverage. RESULTS: Neither allergic reactions nor soft tissue irritations or matrix exfoliations occurred. Postoperative pain and discomfort were reported to be low, and patient acceptance was generally high. At 12 months, complete root coverage was obtained in 2 out of the 8 patients and 30 of the 42 recessions (71%). CONCLUSION: Within their limits, the present results indicate that treatment of Miller Class I and II multiple adjacent gingival recessions by means of the modified coronally advanced tunnel technique and collagen matrix may result in statistically and clinically significant complete root coverage. Further studies are warranted to evaluate the performance of collagen matrix compared with connective tissue grafts and other soft tissue grafts
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| 15. |
- Oliveira, G, et al.
(author)
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Effect of systemic administration of cyclosporine on the repair of critical size calvaria defects in rats
- 2014
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 25:s10, s. 289-289
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Journal article (other academic/artistic)abstract
- Background: To facilitate healing, bone defects are often grafted with bone substitute materials, for example of xenogenic origin or laboratory made alloplasts. An essential process for healing in bone defects is remodeling; thus, long-term use of specific drugs that interfere with bone remodeling may compromise healing of bone defects despite the use of substitute materials. Cyclosporine is an immunosuppressive drug used for the treatment of autoimmune disorders and in the prevention of organ rejection in transplant patients. Pre-clinical studies have shown that use of cyclosporine reduces bone density and also impairs healing of vascularized allografts and dental implant osseointegration. There is limited information on the effect of cyclosporine use on the healing of bone defects grafted with substitute materials. Aim/Hypothesis: To evaluate by means of micro-CT the effect of systemic administration of cyclosporine on the healing of critical- size calvaria defects in rats, grafted with deproteinized bovine bone or biphasic calcium phosphate. Material & Methods: Sixty rats were divided in two equal-sized groups. Animals in one group received systemic administration (per os) of Cyclosporine Csa (10 mg/kg/day) and those in the other group received sterile saline. After 15 days, a cylindrical critical- size defect (5 mm in Ø) was created in the calvaria of the rats. The defects were grafted with a standardized quantity of deproteinized bovine bone (BO group) or biphasic calcium phosphate (b-tricalcium phosphate 40%/hydroxyapatite 60%) (BC group) or were left empty for spontaneous healing (E group), i.e. 10 animals per treatment combination. Use of Cyclosporine or saline was continued for 15 and 60 days post-operative, where five animals per treatment combination were euthanized. Blocks of specimens containing the defect and surrounding tissues were scanned with micro-CT, operated at 50 kV and 800 mA and with image pixel set of 17.48 lm. Transaxial sections – each 35 lm thick – were generated throughout the dataset and 40 equidistant sections comprising the entire defect volume were selected for analysis. A circular region of interest (5 mm in Ø) was superimposed on the defect and the relative quantities of tissues within each defect was estimated semi-automatically by dedicated software using a gray-scale threshold between 55 and 250 to evaluate the percentage of mineralized tissues (new bone and biomaterial; MT), and a threshold of 55 and 90 to evaluate the percentage of bone. Non-paired t-tests and one-way ANOVA/Tukey tests were used to evaluate differences (P < 0.05). Results: Cyclosporine treated animals showed significantly less bone in E defects comparing to animals receiving saline at both experimental periods (15 days: 11.3 3.3 vs. 28.0 3.9; 60 days: 7.6 2.22 vs. 34.8 9.0). Cyclosporine treated animals showed also significantly less MT compering to saline controls in BC grafted defects at 15 days of healing (36.6 6.7 vs. 53. 10.1), but not after 60 after days (46.3 11.1 vs. 42.7 10.6). In BO grafted defects, systemic administration of cyclosporine resulted in reduced amounts of MT comparing to saline controls at 15 days (51.9 9.4 vs. 65.9 14.1; P > 0.05), but not after 60 days of healing (61.7 6.9 vs. 65.2 12.8). At 15 days of healing, the amount of residual bone substitute was significantly less in the cyclosporine group comparing to that observed in the saline group (BO: 32.5 11.5 vs. 50.9 13.8; BC: 17.2 4.5 vs. 32.2 12.2). Conclusion & Clinical implications: Systemic administration of cyclosporine impaired bone healing in critical-size calvaria defects in rats during the early healing period. In addition, systemic administration of cyclosporine accelerated resorption of bone substitute materials during the early healing period.
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| 16. |
- Oliveira, G, et al.
(author)
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Evaluation of ASU Administration on Bone Healing in Calvarial Defects
- 2014
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Conference paper (other academic/artistic)abstract
- Objective: Avocado/soybean unsaponifiables (ASU) is indicated as supplement for the palliative treatment of rheumatoid arthritis and osteoarthritis. In vitro studies have shown that ASU enhances Transforming Grown Factor-β1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2) expression. The objective of this study was to evaluate the influence of ASU (Piascledine 300, Expanscience Lab, France) on bone healing in critical-size calvarial defects (CCD) in the presence and absence of bone substitutes. Method: A full thickness CCD defect (Ø 5mm) was made in each of 84 male wistar rats. The defects were implanted with either deproteinized bovine bone (DBB) (Bio-Oss, Geistlich Pharma, Switzerland) or a biphasic tricalcium phosphate/hydroxyapatite (TCP/HA) (Straumann Bone Ceramic, Straumann, Switzerland) particulate material, or filled only with coagulum (COA). Starting 15 days prior to surgery, ASU (0.6 gr. per Kg body weight) or saline (CTR) was administered daily by gavage until sacrifice 15 or 60 days post-op (7 animals per group at each observation period). Tissue composition within the defect was estimated by histomorphometry. Non-paired T- test, one-way Anova, and Tukey´s tests were used to evaluate differences (P < 0.05). Result: Bone fill in the COA-ASU group was significantly higher comparing to that in the COA-CTR group, both at 15- (46.4±10.4 vs. 29.0±8.8) and 60 days (52.1±6.1 vs. 42.7±5.2). No significant differences in bone fill were observed between DBB-ASU and DBB-CTR at day 15 (29.3±4.5 vs. 31.4±7.5) and day 60 (33.1±4.6 vs. 39.9±10.5), as well as between TCP/HA-ASU and TCP/HA-CTR at day 15 (33.3±6.7 vs. 33.0±6.5) and day 60 (31.7±5.0 vs. 39.6±8.7). Bone fill in COA-ASU group was significantly more than in DDB-ASU and TCP/HA-ASU groups at day 60. Conclusion: ASU enhanced bone healing in CCD originally filled only with coagulum, while implantation of DDB and TCP/HA appeared to obstruct the positive effect of ASU.
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| 17. |
- Pessoa, Roberto, et al.
(author)
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Soft and hard tissue maintenance after the placement of immediate-loaded implants in the anterior maxilla : photographic and radiographic assessment
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:s9, s. 142-142
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Journal article (other academic/artistic)abstract
- Background: The dynamics of soft and hard tissue volume maintenance following the placement of immediate-loaded implants in aesthetic areas remains unclear in literature. Aim/Hypothesis: To present a method to evaluate by clinical (photography) and radiographic bi- and tri-dimensional means the alterations in soft and hard tissues following immediate implant placement and loading in the anterior maxilla. Material and methods: Ten patients, treated with immediateloaded implants in the maxillary central or lateral incisor, were evaluated in this study. Clinical parameters (distance from the tip of the crown to the interdental papilla – P; distance from the top of the crown to the gingiva – C; keratinized mucosa height – K) were evaluated in standardized pictures taken immediately after (baseline), and 1, 3, and 6 months after provisional implant-supported single crown placement. Bi-dimensional radiographic parameters (distance from the top of the implant to the first bone-to-implant contact – IT-FBIC; distance from the bone crest to the first bone-to-implant contact – BC-FBIC; lateral bone lost at the implant neck – LBL) were evaluated from standardized digital periapical radiographies acquired at the same time points, or from CBCT images (buccal bone wall thickness, measured at the top, the midpoint and the apex of the implant – TT, MT, and AT, respectively) acquired at baseline and 6 months after surgery. The volume of the buccal bone wall covering the central millimeter of the implant (BV) was also assessed in the CBCT images. Comparison among multiple periods of observation were performed using repeated-measures ANOVA followed by Tukey post-hoc test, while two-period based comparison were made using paired t-test. Results: The variation for all clinical (photographic), bi- and tri-dimensional parameters assessed was non-statistically significant. Mean P was 5.55 1 mm, considering all time periods, while C and K were 9.2 1.2 and 5.3 1.6 mm, respectively. Mean IT-FBIC was 1.3 0.8 mm, considering all time periods, whilst BC-FBIC and LBL were 3.9 1.1 and 0.3 0.1 mm, respectively. There was a 94% maintenance of BV. Conclusions and clinical implications: Assessed parameters showed good clinical, bi- and tri-dimensional radiographic stability of soft and hard tissues for implants immediately placed and loaded in aesthetic areas.
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| 18. |
- Pimentel Lopes de Oliveira, Guilherme Jose, et al.
(author)
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Effect of Avocado/Soybean Unsaponifiables on Osseointegration : A Proof-of-Principle Preclinical In Vivo Study
- 2014
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In: International Journal of Oral & Maxillofacial Implants. - : Quintessence. - 0882-2786 .- 1942-4434. ; 29:4, s. 949-957
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate the influence of administration of avocado/soybean unsaponifiables (ASU) on implant osseointegration in rat tibiae. Materials and Methods: Thirty rats were randomly assigned into one of three equal-sized groups: (1) ASU1: administration of ASU starting 7 days prior to implant placement; (2) ASU2: administration of ASU starting on the day of implant placement, and (3) CTL: administration of saline solution. In all animals, one titanium implant was placed in each tibia. All animals received ASU or saline solution by gavage daily until sacrifice 60 days postoperatively. Implant osseointegration and bone maturation were assessed by biomechanical and radiographic bone density analysis; descriptive histology; immunohistochemistry for bone morphogenetic protein 2 (BMP-2), transforming growth factor beta 1 (TGF-beta 1), and osteocalcin; and histomorphometric evaluation of bone-to-implant contact (BIC) and mineralized bone area fraction within the threads of the implant. Results: ASU1 and ASU2 showed three times higher expression of BMP-2 and nine times higher expression of TGF-beta compared with CTL (P < .05). Histomorphometric analysis, however, showed that both ASU1 and ASU2 groups presented significantly higher BIC values only in the cortical bone compartment when compared to CTL (P < .05). Conclusion: ASU consumption seems to exert only a subtle effect on implant osseointegration.
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| 19. |
- Schropp, Lars, et al.
(author)
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Early, delayed, or late single implant placement : 10-year results from a randomized controlled clinical trial
- 2014
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 25:12, s. 1359-1365
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Journal article (peer-reviewed)abstract
- Aim: The aim of this study was to present the 10-year clinical and radiographic data from a RCT on single-tooth implants placed early, delayed, or late after tooth extraction. Materials and Methods: Sixty-three patients were randomly allocated to three groups and received an implant on average 10 days (Ea), 3 months (De), or 17 months (La) after tooth extraction. Second-stage surgery was performed after 3 months of submerged healing; metal-ceramic crowns were cemented after one additional month. Standardized periapical radiographs were taken 1 week after implant placement (TP), 1 week (TC) and 1–1.5 year (T1) after crown delivery, and 10 years after implant placement (T10). Pocket depth (PD) and bleeding on probing were registered during controls (TC – T10). Results: Two Ea and one De implants failed to osseointegrate. Seven patients (4 Ea, 1 De, and 2 La) were not available at T10. No significant differences were found among groups regarding implant survival or radiographic peri-implant marginal bone levels (Ea: 1.15 0.77; De: 1.53 1.06; La: 1.42 1.07) at T10. Similarly, no differences were observed among groups in the number of implants with PD ≥5 mm (Ea: 29%; De: 35%; La: 44%) or the average depth of the sites with PD ≥5 mm (Ea: 5.4 0.7; De: 6.1 1.4; La: 5.4 0.5) at T10. Peri-implant mucositis was found in 70% of the cases; peri-implantitis was diagnosed only in two implants (1 De, 1 La) corresponding to 4.3%. Conclusion: Single-tooth implants placed early or delayed after tooth extraction show high survival rates and limited peri-implant marginal bone resorption or biological complications, similar to what is observed with implants placed according to the conventional (late) protocol.
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| 20. |
- Shanbhag, Siddharth, et al.
(author)
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Early Osteogenic Differentiation of Human Mesenchymal Stem Cells on SLA and modified–SLA Implant Surfaces : A Systematic Review
- 2014
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Conference paper (other academic/artistic)abstract
- Conference Paper Early Osteogenic Differentiation of Human Mesenchymal Stem Cells on SLA and modified–SLA Implant Surfaces: A Systematic Review. Siddharth Shanbhag Siddharth Shanbhag Siddharth Shanbhag Andreas Stavropoulos Andreas Stavropoulos Andreas Stavropoulos Conference: ITI World Symposium, At Geneva, Switzerland ABSTRACT Constant efforts are made to accelerate and enhance the process of osseointegration, for example via topographical or chemical modifications of titanium (Ti) implant surfaces. Among these are the hydrophobic, sand–blasted, acid–etched (SLA®) and hydrophilic, chemically modified–SLA (SLActive®) surfaces. These surfaces reportedly enhance osseointegration by influencing early cell responses in the local environment. Undifferentiated mesenchymal stem/stromal cells (MSCs) are among the first cells to colonize peri-implant regeneration sites. The recruitment, proliferation and osteogenic differentiation (OD) of these cells, especially in early stages, can influence the rate and degree of osseointegration. The aim of this study was to systematically review the available literature on the early OD of MSCs or progenitor cells on SLA and SLActive implant surfaces. Medline was searched for related literature. In vitro studies reporting the behaviour of human mesenchymal “stem”, “stromal” or “progenitor” cells cultured on commercial SLA and/or SLActive surfaces in comparison to unmodified (“smooth”) or other modified surfaces, were assessed based on inclusion/exclusion criteria. Fourteen of 145 search–identified studies were included. Human MSCs derived from bone marrow, embryonic palate or periodontal ligament, and progenitor stem cells from alveolar bone were used, mostly in early passages (0–4). Cells were grown on Ti disks with SLA or SLActive surfaces and compared to cells cultured on smooth, hydroxyapatite (HA) coated, plasma–sprayed (TPS), dual acid–etched (DAE), grit–blasted (GB), fluoride–modified (FGB) or magnesium–implanted SLA (Mg–SLA) surfaces. Early osteogenic responses included changes in cell morphology and surface adhesion (1–72 hours), cell proliferation, OD via protein or gene expression, alkaline phosphatase (ALP) activity (1–21 days) and/or in vitro mineralization (7–21 d). A general trend for slower initial (1–24 h) cell response to the SLA and SLActive surfaces was observed, i.e. cells on these surfaces were less flattened, had fewer cytoplasmic extensions (suggestive of slower spreading) and significantly lower absolute numbers (proliferation) than on smooth surfaces. However at later times (3–7 d) there were no significant differences between the different surfaces and in some studies greater proliferation was observed on both SLA surfaces with time. Cells cultured on SLA and SLActive surfaces consistently showed differentiation towards an osteoblastic lineage via early activation of key stem cell signalling pathways (TGFβ–BMP, WNT and Notch). The up–regulation of various osteoblastic and angiogenic genes, transcription factors (e.g. Runx2, Osx) and bone–specific proteins (e.g. osteocalcin, bone sialoprotein, BMPs) were significantly enhanced in these cells, while osteoclastogenic genes (e.g. RANKL) were down–regulated. Enhanced ALP activity, extracellular matrix production and mineralization on both SLA surfaces was observed as early as 1 week. An often significant trend for improved OD and mineralization was observed on the SLActive vs. SLA surface. In some studies a TPS and Mg–SLA surface enhanced OD compared to SLA, while in others OD was equally enhanced on all modified surfaces (SLActive, GB, FGB, DAE and HA). In summary, SLA and SLActive implant surfaces can enhance 1) early differentiation of MSCs and progenitor cells towards an osteoblastic lineage via differential regulation of osteoblastogenic/osteoclastogenic genes and activation of key cell signalling pathways; and 2) early deposition of mineralized collagen matrix (new bone) by the differentiated cells on Ti - suggesting a likely mechanism for improved in vivo osseointegration. A trend for better osteogenic response to the SLActive vs. SLA surface was observed. Further studies are needed to compare these osteogenic responses with other commercial implant surfaces.
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| 21. |
- Shanbhag, Siddharth, et al.
(author)
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Volume changes of maxillary sinus augmentations over time : a systematic review
- 2014
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In: International Journal of Oral & Maxillofacial Implants. - : Quintessence. - 0882-2786 .- 1942-4434. ; 29:4, s. 881-892
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Journal article (peer-reviewed)abstract
- Purpose: The objective of this study was to systematically review the available literature on three-dimensional time-dependent graft volume changes after sinus augmentation (SA) with different biomaterials in humans. Materials and Methods: MEDLINE, EMBASE, and CENTRAL were searched for related literature. Controlled and uncontrolled studies reporting volume changes of more than 10 SAs after at least 6 months, assessed by computed tomography (CT) or cone beam CT (CBCT), were eligible for inclusion. The primary outcome of interest was time-dependent percentage change in augmentation volume. Results: Seven controlled and five uncontrolled studies (n = 234 SAs) with a high risk of bias were included and reported on a range of graft materials. Autogenous bone (AB) was used in the particulate or block form. Bone substitutes (BS) were used either alone or in combination with other materials as composite grafts (CG). All studies reported reductions in augmentation volumes over time (AVR), generally after short observation periods (range, 6 months to 6 years). Substantial AVRs (approximately 45% in 77 SAs) were reported for AB after 6 months and up to 2 years. AVRs for solely BS or CG were relatively lower (approximately 18% to 22% in 142 SAs) after a similar time period. All studies reported a wide range of volume reductions. No significant differences in AVR were observed between different graft materials. Because of insufficient long-term data, a reliable association between volume reduction and time could not be established. Conclusion: Some loss of augmentation volume always occurs after SA during early healing times. In general, less AVR may be expected after SA with BS or CG compared to SA with AB. Augmentation volume loss does not seem to compromise implant placement or survival.
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| 22. |
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| 23. |
- Spin-Neto, Rubens, et al.
(author)
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Fate of autologous and fresh-frozen allogeneic block bone grafts used for ridge augmentation : A CBCT-based analysis
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:2, s. 167-173
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To evaluate dimensional changes in autologous (AT) and fresh-frozen allogeneic (AL) block bone grafts 6 months after alveolar ridge augmentation. MATERIAL AND METHODS: Twenty-six partially or totally edentulous patients treated either with fresh-frozen AL bone or AT bone onlay block grafts prior to implant placement (13 patients in each group), were included in this analysis. Patients received CBCT (i-CAT Classic) examinations prior to surgery and 14 days and 6 months after grafting. Differences in alveolar ridge area among the various observation times were evaluated by planimetric measurements on two-dimensional CBCT images of the grafted regions. Nineteen grafted blocks from each group were evaluated. RESULTS: Significant increase in alveolar ridge dimensions, allowing implant placement, was obtained with both types of grafts 6 months after grafting; no significant differences in alveolar ridge area were observed between the groups at the various observation times. However, graft resorption in the AL group was significantly larger compared to that in the AT group at 6 months. CONCLUSIONS: Larger bone graft resorption was seen in patients treated with fresh-frozen AL bone than in those treated with AT bone 6 months following alveolar ridge augmentation.
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| 24. |
- Spin-Neto, Rubens, et al.
(author)
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Graft incorporation and implant osseointegration following the use of autologous and fresh-frozen allogeneic block bone grafts for lateral ridge augmentation
- 2014
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 25:2, s. 226-233
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To compare autogenous bone (AT) and fresh-frozen allogeneic bone (AL) in terms of histomorphometrical graft incorporation and implant osseointegration after grafting for lateral ridge augmentation in humans. MATERIALS AND METHODS: Thirty-four patients were treated with either AL (20 patients) or AT (14 patients) onlay grafts. During implant installation surgery 6 months after grafting, cylindrical biopsies were harvested perpendicularly to the lateral aspect of the augmented alveolar ridge. Additionally, titanium mini-implants were installed in the grafted regions, also perpendicularly to the ridge; these were biopsied during second-stage surgery. Histological/histomorphometric analysis was performed using decalcified and non-decalcified sections. RESULTS: Histological analysis revealed areas of necrotic bone (NcB) occasionally in contact with or completely engulfed by newly formed vital bone (VB) in both AT and AL groups (55.9 ± 27.6 vs. 43.1 ± 20.3, respectively; P = 0.19). Statistically significant larger amounts of VB (27.6 ± 17.5 vs. 8.4 ± 4.9, respectively; P = 0.0002) and less soft connective tissue (ST) (16.4 ± 15.6 vs. 48.4 ± 18.1, respectively; P ≤ 0.0001) were seen for AT compared with AL. No significant differences were observed between the groups regarding both bone-to-implant contact (BIC) and the bone area between implant threads (BA) on the mini-implant biopsies. CONCLUSION: Allogeneic bone block grafts may be an option in cases where a limited amount of augmentation is needed, and the future implant can be expected confined within the inner aspect of the bone block. However, the clinical impact of the relatively poor graft incorporation on the long-term performance of oral implants placed in AL grafts remains obscure.
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| 25. |
- Spin-Neto, Rubens, et al.
(author)
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Immunological aspects of fresh-frozen allogeneic bone grafting for lateral ridge augmentation
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:9, s. 963�-968
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To present some immunological aspects of fresh-frozen allogeneic bone grafting for lateral bone augmentation, based on the quantitative evaluation of IL-10, IL-1β, IFN- γ and TNF- α in patients sera. MATERIAL AND METHODS: Thirty-three partially or totally edentulous patients received fresh-frozen allogeneic bone (AL - 20 patients) or autologous bone onlay block grafts (AT - 13 patients) prior to oral implant placement. Blood samples were collected from each patient at various time-points during a 6 month-period (baseline, 14, 30, 90 and 180 days postoperatively). Quantitative evaluation of IL-10, IL-1β, IFN- γ and TNF- α was performed by enzyme linked immunosorbent assay (ELISA). RESULTS: For all evaluated markers and at all evaluated periods, inter-group comparisons showed no statistically significant differences between the groups, while the observed values were within normal levels. For AL-treated patients, intra-group evaluation showed statistically significant increase of TNF-α from baseline to 90 (P < 0.001) and 180 (P < 0.01) days, and from 14 to 90 (P < 0.01) and 180 (P < 0.05) days. IFN- γ showed intercalated results, with a decrease from baseline to 14 days (P < 0.05), and increase from 14 to 90 days (P < 0.001) and 180 (P < 0.05) days. No differences between the periods of evaluation were found for the AT group. CONCLUSIONS: AL grafting for lateral bone augmentation, similar to AT grafting, does not seem to challenge the immune system significantly
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| 26. |
- Spin-Neto, Ruben, et al.
(author)
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Influence of fresh-frozen allogeneic bone grafts architecture on its incorporation : radiographic and histomorphometric comparison to the gold-standard
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:s9, s. 54-54
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Journal article (other academic/artistic)abstract
- Background: The influence of fresh-frozen block bone allograft architecture on its incorporation and dimensional remodeling remains unclear. Aim/Hypothesis: To compare cortical (AL-C) and corticocancellous (AL-CC) fresh-frozen block bone allografts to cortical block bone autografts (AT) in terms of histomorphometrical graft incorporation and radiographic dimensional remodeling, 6–8 months after grafting for anterior maxillary ridge augmentation. Material and methods: Twenty-four patients, requiring ridge augmentation in the anterior maxilla prior to implant placement, were treated with AT, AL-C or AL-CC (eight patients per graft type). During implant installation surgery, 6–8 months after grafting, cylindrical biopsies were harvested perpendicularly to the lateral aspect of the augmented alveolar ridge; the relative volumes of vital and necrotic bone, and soft tissue, were histomorphometrically estimated. Furthermore, all patients were examined with CBCT prior to surgery, and 14 days and 6–8 months after grafting. Amount of augmentation and dimensional block graft remodeling over time were evaluated by comparing planimetric measurements of the alveoral ridge made on serial, parasagittal, CBCT sections generated throughout the augmentation area, for each patient. Average values were calculated for each graft type; comparisons among groups and observation times were performed using repeated-measures ANOVA and Tukey post-hoc test. P was set at <0.05. Results: Histomorphometrical analysis showed that the AL-CC group had the smallest amount of necrotic bone (38.2 12.1%) compared to AT (56.7 25.9%, P < 0.05) and AL-C (83.7 10.8%, P < 0.0001). AL-CC showed the largest amount of soft tissues (52.5 11.7%) compared to AT (18.1 17.1%, P < 0.0001) and AL-C (12.3 8.5%, P < 0.0001). Larger amounts of viable bone were found in the AT-treated group (25.1 11.2%) compared to AL-CC and AL-C groups (9.3 3.8% and 3.9 4.6%, respectively; P < 0.0001). The radiographic evaluation showed that all type of grafts resulted in a significant increase in alveolar ridge dimensions, with no significant differences among the groups at the various observation times. However, graft resorption in the AL-CC group was significantly larger (P < 0.05) compared to that observed in the AT and AL-C groups. Conclusions and clinical implications: AL block bone graft architecture influences their incorporation and dimensional remodeling. Corticocancellous AL blocks seem to show larger resorption over time, while cortical blocks seem to show the least amounts of vital bone 6–8 months after grafting. Only a small portion of the AL block consists of vital bone 6–8 months after grafting.
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| 27. |
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| 28. |
- Spin-Neto, Rubens, et al.
(author)
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Técnicas Radiográficas Aplicadas à Pesquisa em Implantodontia : Racionalização
- 2013
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In: Excelência Clínica em Implantodontia. - : Quintessence. - 9788578890339 ; , s. 135-159
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Book chapter (other academic/artistic)abstract
- A reabilitarção oral por meio de implantes de titânio como alternativa às próteses convencionais, para a substituirção de dentes ausentes ou perdi dos, é uma modalidade de tratamento rotineira. O exame radiográfico é um componente indispensável em todas as fases do tratamento com implan tes, incluindo o planejamento pré-operatório, o diagnóstico, a avaliarção do tratamento e o monitoramento longitudinal dos resultados. Apesar disso, o uso descontrolado de exames radiográficos leva a uma exposirção á radiarção aumentada e desnecessária aos pacientes, sendo imprescindível a correta indicarção de cada modalidade de exame sugerido, embasados sempre nas vantagens do uso do método selecionado, e principalmente, ponderados por suas limitarções. Ao longo dos últimos anos urna grandevariedade de técnicas de ima geologia bi (2D) e tridimensionais (3D) têm sido utilizadas tanto nas áreas clínicas como nas pré-clínicas em Implantodontia, estando conectadas ás várias fases da reabilitarção com implantes. Mais recentemente, os avanços tecnológicos e os custos mais atraentes fizeram com que as técnicas de imagem 3D se tornassem mais acessíveis para os cirurgiões-dentistas de uma forma geral. Como reflexo, a utilizarção de tomografias computadori zadas de feixe cônico (TCFC) é cadavez mais comum, devendo sempre ser levado em conta que o uso desta técnica está associado a um aumento na dose de radiação fornecida ao paciente1-4 e a custos mais elevados quando comparada a radiografias panorâmicas, por exemplo, aliado ao fato de que o acesso a TCFC ainda é bastante limitado para a maioria das clínicas, con siderando o Brasil como um todo.5 Além disso, esta tecnologia é util prin cipalmente para o diagnóstico e plano de tratamento com implantes, mas não para o monitoramento do tratamento, devido aos artefatos que apare- cem adjacentes à superfície do implante, como resultado da interferência de objetos metálicos na captação dessas imagens. Por outro lado, admite -se que esta tecnologia provavelmente se tornará o padrão diagnóstico em um futuro próximo, tal como já ocorre em algumas partes do mundo. Considerando o que é exposto acima, neste capítulo discutiremos alguns aspectos relevantes da radiografia 2D, com foco em pesquisas em Implantodontia. As técnicas radiográficas em 3D serão brevemente men cionadas em relação à radiografia 2D. Mais especificamente, as questões relacionadas à confiabilidade das medidas radiográficas para estimar o nível ósseo peri-implantar (a), a geometria de projeção para qualidade apropriada das imagens de implantes e para avaliação do nível ósseo peri -implantar (b), distorçães dimensionais em radiografias periapicais e panorâmicas (c) e os prazos de exame radiográfico para avaliação longitu dinal dos níveis ósseos peri-implantares (d) serão discutidos.
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| 29. |
- Stavropoulos, Andreas, et al.
(author)
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Biological complications after early/delayed/late implant placement : 10-year results from a RCT
- 2013
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 24:s9, s. 38-38
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Journal article (other academic/artistic)abstract
- Background: Limited information is available on the influence of timing of implant placement after tooth extraction on the marginal peri-implant conditions in the long-term. Aim/Hypothesis: To report on the marginal peri-implant soft and hard tissue levels, including prevalence of peri-implant mucositis and peri-implantitis, 10 years after early (Ea), delayed (De), or late (La) implant placement. Material and methods: 64 patients, previously randomly allocated, received a single-tooth implant (Osseotite, 3i Biomet) on average 10 days (Ea: 23), 3 months (De: 22), or 12 months (La: 19) after tooth extraction. Second stage surgery was performed after 3–4 months and porcelain-fused-to-metal crowns were cemented on the implants after one additional month (TC). All patients were recalled for a clinical and radiographic examination approximately one (T1) and 10 years (T10) after implant installation. Marginal peri-implant bone levels (BL) were measured on orthogonal periapical radiographs at TC, T1, and T10. Differences among the implant placement protocols were tested by Anova and chi-square tests. Results: At T10, clinical and radiographic data were available from 49 and 48 patients, respectively; 47 patients attended all controls, while radiographic data from all visits were available for 39 patients. Proximal BL for all implants was located at 1.39 0.65 mm, 1.32 0.63 mm, and 1.38 0.98 mm apically to the implant shoulder, at TC, T1, and T10, respectively. No significant differences in proximal BL were found among the groups at TC and T10. At T1, BL was located more apically at De implants (1.71 mm) compared to Ea and La implants (1.09 and 0.99 mm, respectively) (P = 0.002). No significant differences in BL were found between TC and T10 or between T1 and T10 both regarding all implants and within each group. 55% and 47% of the implants showed at least one site with a probing depth (PD) ≥5 mm at TC and T1, respectively. At T10, 70% of the implants showed bleeding or pus on probing (BoP) and 36% of the implants showed one or more sites with PD ≥5 mm; no significant differences among the groups were seen. At T10, only two implants (De and La) (4.3%) suffered from peri-implantitis defined as PD ≥5 mm, BoP, and marginal bone loss of >1 mm from TC. Conclusions and clinical implications: Timing of implant placement after tooth extraction did not significantly influence the marginal peri-implant soft and hard tissue levels in the longterm. Peri-implant mucositis was a frequent finding, while peri-implantitis was only scarce. This study was partially supported by 3i Biomet, FL, USA.
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| 30. |
- Stavropoulos, Andreas
(author)
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When do we need autogenous bone?
- 2014
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 25:s10, s. 30-30
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Journal article (other academic/artistic)abstract
- Presence of adequate amount of bone, allowing implant installation with sufficient initial stability and with its circumference completely covered by an adequate amount of bone is considered essential for successful osseointegration. However, patients often present with less than adequate amount of bone for proper implant installation; thus, there is often a need for bone augmentation procedures. Bone augmentation procedures most often involve grafting of bone, bone substitutes, or combinations thereof. Autogenous bone is often considered the “gold standard”. However, is autogenous bone indeed the best material for all clinical indications? Can autogenous bone be replaced? Or should it be used in combination with bone substitutes in some instances? The presentation will focus on the available evidence about what is the most indicative grafting material or combination for various clinical indications.
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| 31. |
- Ucer, Cemal, et al.
(author)
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Continuing professional development in implant dentistry in Europe
- 2014
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In: European journal of dental education. - : John Wiley & Sons. - 1396-5883 .- 1600-0579. ; 18:s1, s. 33-42
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Training for dental practitioners in implant dentistry ranges from 1- or 2-day short Continuing Professional Development (CPD) courses to certificate/diploma programmes run by universities. In general, the teaching of implant dentistry in Europe lacks structure and standardisation. This paper aims to: (i) identify the current trends in CPD in implant dentistry in Europe; (ii) identify potential and limitations with regards to the design and implementation of CPD activities in implant dentistry; (iii) provide recommendations on the future structure and development of CPD activities in implant dentistry. METHODS: A search of the literature was undertaken in PubMed for manuscripts published in English after 2000 reporting on CPD in dentistry and in implant dentistry in particular. In addition, an electronic survey was conducted, investigating the attitudes towards CPD among a wide group of stakeholders in implant dentistry education. CONCLUSIONS: There is a wide diversity of educational pathways towards achieving competences in implant dentistry through CPD. At present, there is a need for improving the CPD structures in implant dentistry, strengthening the quality assurance and encouraging standardisation and transparency of the learning outcomes. Development of a structured CPD system with clearly defined educational objectives mapped against specific levels of competence is recommended.
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| 32. |
- Ucer, Cemal, et al.
(author)
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Current trends and status of continuing professional development in implant dentistry in Europe
- 2014
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In: European journal of dental education. - : John Wiley & Sons. - 1396-5883 .- 1600-0579. ; 18:s1, s. 52-59
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Previous surveys have shown that newly graduated dentists, in most European countries, do not obtain adequate theoretical knowledge and, especially, clinical skills in implant dentistry (ID) through their undergraduate education and must therefore acquire knowledge and develop competencies through further postgraduate study. Moreover, clinicians, in general, need to continue to maintain the currency of their competence by undertaking ongoing continuing professional development (CPD). This seems particularly important in ID as techniques, and materials develop rapidly due to advances in biomedical technology. Despite recent developments, CPD in ID remains poorly organised with little standardisation or harmonisation across Europe. The objective of this survey was to explore the current status and trends within CPD education in ID in Europe. MATERIALS AND METHODS: Stakeholders and opinion leaders associated with ID education were invited by email to fill an online questionnaire (closing date: 30th April 2013). Two hundred and forty-seven questionnaires were distributed, and two separate reminders were sent to participants in 38 European countries. The survey contained 14 multiple-choice questions, and the data were collected using SurveyMonkey© software, exported in SPSS (Inc, Chicago, IL, USA) format and analysed using descriptive statistics. RESULTS: Two hundred respondents working in 24 countries replied to the survey (response rate of 81% of invitees and 63% of countries surveyed). The results demonstrated a wide divergence in the content and structure of CPD in ID in Europe. CONCLUSIONS: Dentists need CPD to develop their skills and to maintain their competence in ID. There is an urgent need for structured and accredited CPD, which should be readily available to all dentists practising ID. It should have pre-determined learning objectives, delivered by accredited CPD providers and educators, and have assessable outcome measures to ensure the best possible impact on clinical practice and patient safety.
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