1. |
- Bertl, Kristina, et al.
(author)
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A root canal filling per se does not have a significant negative effect on the marginal periodontium
- 2015
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 42:6, s. 520-529
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Journal article (peer-reviewed)abstract
- Aim: To evaluate the periodontal status of single-rooted endodontically treated teeth (ET), correcting for patient- and tooth-related factors. Methods: Clinical parameters (BoP,PD,CAL) of 240 ET and 240 contralateral vital teeth (VT), before and after non-surgical periodontal treatment, were extracted retrospectively from the journals of 175 patients. Possible patientrelated (age, gender, smoking status) and tooth-related (interproximal restoration, root canal filling’s extent, post, tooth type) confounders were tested. Results: At baseline, frequency of BoP at an interproximal site at ET versus VT was 70.4% versus 65.0%, respectively. The frequency of teeth with interproximal PD ≥5 mm and CAL ≥5 mm was 47.9% versus 42.9% and 54.6% versus 49.6% at ET and VT, respectively. Interproximal PD and CAL at ET versus VT were 3.86 versus 3.61 mm and 4.11 versus 3.95 mm. After correcting for tooth-related factors, no significant differences were observed between ET and VT. An improper restoration had a significant (p < 0.001) negative effect on BoP [OR 3.49 (95%CI: 1.95–6.27)], PD [36.81% (95%CI: 18.52–57.92)] and CAL [27.01% (95% CI: 12.67–43.18)]. No significant differences between ET and VT were observed regarding clinical outcome of non-surgical periodontal therapy. Conclusions: Presence of a root canal filling per se does not have a significant negative influence on the marginal periodontium, when correcting for the quality of the interproximal restoration.
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2. |
- Bertl, Kristina, et al.
(author)
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A wide mesio-distal gap in sites of congenitally missing maxillary lateral incisors is related to a thin alveolar ridge
- 2017
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 28:9, s. 1038-1045
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To evaluate (i) a possible correlation between the mesio-distal gap width and the alveolar ridge (AR) dimensions in patients missing the maxillary lateral incisor (I2) either due to agenesis or loss and (ii) the possibility of straightforward implant placement based on simulation. METHODS: The bucco-palatal width, area, and height of the AR at the position of I2, and the mesio-distal gap width between the central incisor and the canine, were assessed in maxillary CT scans of three groups: Patients with (i) agenesis of I2 (TA ; n = 40); (ii) I2 regularly erupted but extracted (TL ; n = 24); (iii) I2 regularly erupted and in situ (C; n = 40). Further, the possibility of straightforward placement of an implant 3 or 3.5 mm in diameter ×10 mm in length, with 1 mm distance from the buccal and palatal plate of the alveolar ridge was simulated and compared to the actual treatment delivered. RESULTS: Bucco-palatal width and area of the AR at I2 and the adjacent teeth was significantly reduced in TA compared to TL and C. Further, in TA , but not TL , an increasing mesio-distal gap width between the central incisor and canine resulted in a significantly reduced bucco-palatal width of the edentulous AR. This impeded a simulated straightforward implant placement in >50% of the cases in TA , even with a reduced implant diameter. CONCLUSIONS: In patients congenitally missing I2, an increased mesio-distal gap width correlates significantly with reduced edentulous AR dimensions. A mesio-distal gap of >6 mm was associated with thin bucco-palatal alveolar ridges, precluding straightforward implant placement in 60-80% of the cases.
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3. |
- Bågesund, Josef, et al.
(author)
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Treatment of Intrabony Defects with Emdogain : Results After 16-20 Years
- 2016
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Conference paper (other academic/artistic)abstract
- Objectives: The aim was to evaluate retrospectively the outcome of treatment with enamel matrix derivative (EMD) as adjunct to open flap debridement in periodontal intrabony defects, on the long-term (>15 years). Methods: All journals of patients in a public dental service specialist clinic treated with EMD (Straumann Emdogain®) as adjunct to open flap debridement in periodontal intrabony defects > 15 years ago were assessed for clinical and radiographic data. On digitized/digital bite-wing radiographs from prior to treatment (baseline), 1-year, and > 15 years after treatment, measurements of radiographic defect depth (RDD) defect width (RDW), and defect angle (RDA) were performed with ImageJ® and subjected to statistical analysis with the student’s t-test. Results: Twenty-two patients (11 female; mean age of 55±12 years) were identified. Out of 28 teeth treated 16-20 years ago, only one was lost; thus data from 27 available sites (22 patients) were available. Due to inconsistencies in the clinical registrations, only radiographic data were used. At baseline, PPD, CAL, RDD and RDW averaged 8.37±2.33mm, 9.33±2.19mm, 5.26±2.34mm and 2.33±0.77mm, respectively. After an average of 17 years from reconstructive EMD treatment, RDD and RDW were reduced by 2.84±3.50mm (p=0.0003) and 0.88±1.30mm (p=0.002), respectively comparing to baseline. Compared to 1 year after EMD treatment (RDD 1.90±1.31mm RDW 1.43±0.86mm ) no significant changes in RDD (-0.52±2.98mm, p=0.38) or RDW (-0.03±1.01mm, p=0.89) were observed 16-20 years after EMD treatment. Compared to baseline RDA (26.87±12.84°), no significant changes were observed 16-20 years after EMD treatment (25.14±19.21° p=0.66). Conclusions: The radiographic improvements, (i.e. defect depth and defect width reduction) achieved 1 year after treatment with EMD as an adjunct to open flap debridement in periodontal intrabony defects can be preserved over a period of 16-20 years.
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4. |
- Abele, H., et al.
(author)
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Particle physics at the European Spallation Source
- 2023
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In: Physics reports. - : Elsevier. - 0370-1573 .- 1873-6270. ; 1023, s. 1-84
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Research review (peer-reviewed)abstract
- Presently under construction in Lund, Sweden, the European Spallation Source (ESS) will be the world’s brightest neutron source. As such, it has the potential for a particle physics program with a unique reach and which is complementary to that available at other facilities. This paper describes proposed particle physics activities for the ESS. These encompass the exploitation of both the neutrons and neutrinos produced at the ESS for high precision (sensitivity) measurements (searches).
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5. |
- Aghazadeh, Ahmad
(author)
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Peri-implantitis : risk factors and outcome of reconstructive therapy
- 2021
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Doctoral thesis (other academic/artistic)abstract
- This thesis is focused on (I) the outcome of reconstructive treatment of peri-implant defects and (II) risk factors for the development of peri-implantitis.BackgroundAn increasing number of individuals have dental implant-supported reconstructions. The long-time survival rate of dental implants is good, but complications do occur. Accumulation of bacteria on oral implants and the development of a pathogenic biofilm at the mucosal margin will result in inflammatory responses diagnosed as peri-implant mucositis(PiM). Furthermore, PiM may progress to peri-implantitis (Pi) involving the implant-supporting bone and potentially result in a severe inflammatory process resulting in alveolar bone destruction and consequently implantloss. Currently, Pi is a common clinical complication following implant therapy.The prevalence of peri-implantitis has been reported to be around 20 %. Susceptibility to infections and a history of periodontitis are considered as important risk indicators for peri-implantitis. It seems logical that a past history of periodontitis is linked to an increased risk of peri-implantitis. It is possible that other patient-associated factors such as a smoking habit, and presence of general diseases may also be linked to a higher risk for developing peri-implantitis.Treatment of peri-implantitis is difficult. Non-surgical treatment modalities may not be sufficient to resolve the inflammatory process to obtain healthy conditions.Surgical treatment of peri-implantitis has commonly been employed in clinical practice to obtain access to the implant surface thereby increasing the possibility to effectively decontaminate the implant surfaces.The effectiveness and long-term outcomes of reconstructive surgical treatments of peri-implantitis has been debated. The scientific evidence suggests that regular supportive care is an essential component in order to maintain and secure long-term results following treatment of peri-implantitis.Aims1. To assess the short-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study I).2. To analyse risk factors related to the occurrence of peri-implantitis(Study II).3. To assess the importance of defect configuration on the healing response after reconstructive surgical therapy of peri-implantitis (Study III).4. To assess the long-term efficacy of reconstructive surgical treatmentof peri-implantitis (Study IV).MethodsFour studies were designed to fulfil the aims:- A single-blinded prospective randomised controlled longitudinal human clinical trial evaluating the clinical and radiographic results of reconstructive surgical treatment of peri-implantitis defects usingeither AB or BDX.- A retrospective analysis of individuals with either peri-implantitis, or presenting with either peri-implant health, or peri-implant mucositis assessing the likelihood that peri-implantitis was associated with a history of systemic disease, a history of periodontitis, and smoking.- A prospective study evaluating if the alveolar bone defect configuration at dental implants diagnosed with peri-implantitisis related to clinical parameters at the time of surgical intervention and if the short- and long-term outcome of surgical intervention of peri-implantitis is dependent on defect configuration at the time of treatment.- A prospective 5-year follow-up of patients treated either with AB or BDX.Results- The success for both surgical reconstructive procedures was limited. Nevertheless, bovine xenograft provided evidence of more radiographic bone fill than AB. Improvements in PD, BOP, and SUP were observed for both treatment modalities-In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was expressed in the presence of a history of periodontitis and a medical history of cardiovascular disease- The buccal-lingual width of the alveolar bone crest was explanatory to defect configuration- 4-wall defects and deeper defects demonstrated more radiographic evidence of defect fill- Reconstructive surgical treatment of peri-implant defects may result in successful clinical outcomes, that can be maintained over at least five years- The use of BDX is more predictable than use of harvested bone from the patient (AB)ConclusionsThe study results suggest that a bovine xenograft provides better radiographic evidence of defect fill than the use of autogenous bone harvested from cortical autologous bone grafts.Treatment with bone grafts to obtain radiographic evidence of defect fill is more predictable at 3- and 4-wall defects than at peri-implantitis bone defects with fewer bone walls.In relation to a diagnosis of peri-implantitis, a high likelihood of comorbidity was found for a history of periodontitis and a history of cardiovascular disease.
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6. |
- Aghazadeh, Ahmad, et al.
(author)
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Reconstructive treatment of peri-implant defects - Results after three and five years
- 2022
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 33:11, s. 1114-1124
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Journal article (peer-reviewed)abstract
- Objectives The aim of this study was to assess the long-term efficacy of reconstructive treatment of peri-implantitis intraosseous defects. Material and Methods Peri-implant intraosseous defects were augmented using either an autogenous bone graft (AB) or a bovine-derived xenograft (BDX) in combination with a collagen membrane. Maintenance was provided every third month. Results In the AB group, 16 patients with 25 implants remained at year five. In the BDX group, 23 patients with 38 implants remained. Between baseline and year 5, bleeding on probing (BOP) and probing pocket depth (PPD) scores were reduced in both groups (p < .001). In the AB and BDX groups, mean PPD between baseline and year five was reduced by 1.7 and 2.8 mm, respectively. The difference between groups was significant (p < .001). In the AB group, the mean bone level change at implant level between baseline and years three and five was-0,2 and -0.7 mm, respectively. In the BDX group, the mean bone level change at implant level between baseline and years three and five was 1.6 and 1.6 mm, respectively. The difference between the groups was significant (p < .001). Successful treatment (no bone loss, no probing pocket depth (PPD) > 5 mm, no suppuration, maximum one implant surface with bleeding on probing (BOP) at year five) was obtained in 9/25 implants (36%) in the AB group and in 29/37 implants (78.3%) in the BDX group. Conclusions Reconstructive surgical treatment of peri-implant defects using BDX resulted in more predictable outcomes than using autogenous bone over 5 years.
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7. |
- 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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8. |
- Alshammari, Hatem
(author)
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Antimicrobial potential of strontium against bacteria associated with peri-implantitis
- 2023
-
Doctoral thesis (other academic/artistic)abstract
- Dental implants are nowadays a standard treatment to replace missing teeth and restore function and aesthetics. However, biological complications associated with implants, e.g., peri-implant infections, are common and jeopardize the success of treatment. The main aim of this thesis was to explore strontium (Sr) as a possible prevention strategy against peri-implant infections, since Sr has been shown to have antibacterial action and also to promote titanium (Ti) implant osseointegration. In this thesis, a systematic appraisal of the literature about the antimicrobial potential of Sr-functionalized Ti surfaces for oral applications was performed, and was followed by a series of in vitro studies assessing the antimicrobial potential of Sr against micro-organisms associated with peri-implantitis.In Study I, the systematic appraisal of the literature resulted in an initial list of 1081 potentially relevant publications, where from nine publications from in vitro studies met the inclusion criteria. Most of the included studies showed that Sr-functionalized Ti exerted a limited immediate (i.e., 24 h) antimicrobial effect, likely due to a low Sr ion release; a relevant antimicrobial effect and biofilm inhibition potential against Streptococcus aureus was observed at both early and late timepoints, with an adequate Sr ion release.Study II assessed, in vitro, five different concentrations of soluble Sr(OH)2 (100, 10, 1, 0.1, and 0.01 mM) against 6 different mono-species bacteria (Streptococcusmitis, Staphylococcus epidermidis, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Escherichia coli, and Fusobacterium nucleatum) in terms of cell growth, minimal inhibitory concentration (MIC), and biofilm viability. In the agar diffusion test, zones of inhibition were only observed for 0.01, 0.1, and 1 mM of Sr(OH)2 against P. gingivalis. Growth inhibition in planktonic cultures was achieved at 10 mM for all species tested. In the biofilm viability assay, 10 and 100 mM Sr(OH)2 showed potent bactericidal effect against S. mitis, S. epidermidis, A. actinomycetemcomitans, E. coli, and P. gingivalis. It was thus concluded that Sr(OH)2 has antimicrobial properties against bacteria associated with peri-implantitis.Study III assessed the in vitro early- and late bacteriostatic and bactericidal effect of Sr-functionalized wafers on bacteria associated with peri-implantitis (E. coli,S. aureus, Streptococcus oralis, Actinomyces naeslundii, Parvimonas micra, P.gingivalis and F. nucleatum) as mono-species after 2 and 24 hours, and as multispecies at day 1, 3, and 6. Sr-functionalized wafers, compared to Ti controls, were associated with statistically significant less viable cells in both mono- and multispecies tests. Number of colony forming units (CFUs) within the biofilm were significantly higher in Ti wafers, compared to Sr-functionalized wafers, for S. aureus at all time-points of evaluation and for E. coli at day 1. Gingipain activity was higher in Ti wafers compared to Sr-functionalized ones, and the qPCR showed that P. gingivalis comprised 15% of the total biofilm on Ti wafers at day 6, while it remained below detection levels at Sr-coated wafers.In Study IV, the impact of Ti surface roughness (turned vs moderately rough) on the antimicrobial effect of Sr on bacterial associated with peri-implantitis (S. oralis, P. micra, A. naeslundii, F. nucleatum, P. gingivalis, S. aureus, and E. coli), grown in different multispecies consortia, was assessed in vitro. Bacterial viability and biofilm formation, and well as, proteolytic activity of P. gingivalis were assessed at day 1, 3, and 6. Sr-functionalized surfaces were associated with statistically significant reduction in number of viable cells compared to nonfunctionalized surface at all times of investigation for all multispecies tested. Higher proteolytic activity of P. gingivalis was found at non-functionalized Ti disks compared to Sr-functionalized ones. Sr-functionalised surfaces were associated with notable growth inhibition of both E. coli and S. aureus, while P. gingivalis remined undetected at all time points of evaluation on all disks. The turned surface had a slightly higher release of Sr ion compared with the moderately rough surface in the first 24 hours, while both surfaces showed a sustained release for up to 15 days.Overall, the data generated with this series of projects indicate Sr surfaces exerts an antimicrobial potential on bacteria associated with peri-implantitis and it is worthwhile to further explore the potential of Sr-functionalized Ti in the prevention of peri-implant infections.
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9. |
- Alshammari, Hatem, et al.
(author)
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Antimicrobial Potential of Strontium-Functionalized Titanium Against Bacteria Associated With Peri-Implantitis
- 2024
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In: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 10:4
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Journal article (peer-reviewed)abstract
- Objectives: To explore the antimicrobial potential of strontium (Sr)-functionalized wafers against multiple bacteria associated with per-implant infections, in both mono- and multispecies biofilms. Materials and Methods: The bactericidal and bacteriostatic effect of silicon wafers functionalized with a strontium titanium oxygen coating (Sr-Ti-O) or covered only with Ti (controls) against several bacteria, either grown as a mono-species or multispecies biofilms, was assessed using a bacterial viability assay and a plate counting method. Mono-species biofilms were assessed after 2 and 24 h, while the antimicrobial effect on multispecies biofilms was assessed at Days 1, 3, and 6. The impact of Sr functionalization on the total percentage of Porphyromonas gingivalis in the multispecies biofilm, using qPCR, and gingipain activity was also assessed. Results: Sr-functionalized wafers, compared to controls, were associated with statistically significant less viable cells in both mono- and multispecies tests. The number of colony forming units (CFUs) within the biofilm was significantly less in Sr-functionalized wafers, compared to control wafers, for Staphylococcus aureus at all time points of evaluation and for Escherichia coli at Day 1. Gingipain activity was less in Sr-functionalized wafers, compared to control wafers, and the qPCR showed that P. gingivalis remained below detection levels at Sr-functionalized wafers, while it consisted of 15% of the total biofilm on control wafers at Day 6. Conclusion: Sr functionalization displayed promising antimicrobial potential, possessing bactericidal and bacteriostatic ability against bacteria associated with peri-implantitis grown either as mono-species or mixed in a multispecies consortium with several common oral microorganisms.
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10. |
- Alshammari, Hatem, et al.
(author)
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Antimicrobial Potential of Strontium Hydroxide on Bacteria Associated with Peri-Implantitis
- 2021
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In: Antibiotics. - : MDPI. - 2079-6382. ; 10:2
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Journal article (peer-reviewed)abstract
- Background: Peri-implantitis due to infection of dental implants is a common complication that may cause significant patient morbidity. In this study, we investigated the antimicrobial potential of Sr(OH)2 against different bacteria associated with peri-implantitis. Methods: The antimicrobial potential of five concentrations of Sr(OH)2 (100, 10, 1, 0.1, and 0.01 mM) was assessed with agar diffusion test, minimal inhibitory concentration (MIC), and biofilm viability assays against six bacteria commonly associated with biomaterial infections: Streptococcus mitis, Staphylococcus epidermidis, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Escherichia coli, and Fusobacterium nucleatum. Results: Zones of inhibition were only observed for, 0.01, 0.1, and 1 mM of Sr(OH)2 tested against P. gingivalis, in the agar diffusion test. Growth inhibition in planktonic cultures was achieved at 10 mM for all species tested (p < 0.001). In biofilm viability assay, 10 and 100 mM Sr(OH)2 showed potent bactericidal affect against S. mitis, S. epidermidis, A. actinomycetemcomitans, E. coli, and P. gingivalis. Conclusions: The findings of this study indicate that Sr(OH)2 has antimicrobial properties against bacteria associated with peri-implantitis.
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11. |
- Alshammari, Hatem, et al.
(author)
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Antimicrobial Properties of Strontium Functionalized Titanium Surfaces for Oral Applications, A Systematic Review
- 2021
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In: Coatings. - : MDPI. - 2079-6412. ; 11:7
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Research review (peer-reviewed)abstract
- The aim of this systematic review was to assess the current scientific evidence of the antimicrobial potential of strontium (Sr) when used to functionalize titanium (Ti) for oral applications. Out of an initial list of 1081 potentially relevant publications identified in three electronic databases (MEDLINE via PubMed, Scopus, and Cochrane) up to 1 February 2021, nine publications based on in vitro studies met the inclusion criteria. The antimicrobial potential of Sr was investigated on different types of functionalized Ti substrates, employing different application methods. Nine studies reported on the early, i.e., 6-24 h, and two studies on the late, i.e., 7-28 days, antimicrobial effect of Sr, primarily against Staphylococcus aureus (S. aureus) and/or Escherichia coli (E. coli). Sr-modified samples demonstrated relevant early antimicrobial potential against S. aureus in three studies; only one of which presented statistical significance values, while the other two presented only the percentage of antimicrobial rate and biofilm inhibition. A relevant late biofilm inhibition potential against S. aureus of 40% and 10%-after 7 and 14 days, respectively-was reported in one study. Combining Sr with other metal ions, i.e., silver (Ag), zinc (Zn), and fluorine (F), demonstrated a significant antimicrobial effect and biofilm inhibition against both S. aureus and E. coli. Sr ion release within the first 24 h was generally low, i.e., below 50 mu g/L and 0.6 ppm; however, sustained Sr ion release for up to 30 days, while maintaining up to 90% of its original content, was also demonstrated. Thus, in most studies included herein, Sr-functionalized Ti showed a limited immediate (i.e., 24 h) antimicrobial effect, likely due to a low Sr ion release; however, with an adequate Sr ion release, a relevant antimicrobial effect, as well as a biofilm inhibition potential against S. aureus-but not E. coli-was observed at both early and late timepoints. Future studies should assess the antimicrobial potential of Ti functionalized with Sr against multispecies biofilms associated with peri-implantitis.
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12. |
- Antonoglou, Georgios N., et al.
(author)
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Clinical Performance of Dental Implants Following Sinus Floor Augmentation : A Systematic Review and Meta-Analysis of Clinical Trials with at Least 3 Years of Follow-up
- 2018
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In: International Journal of Oral & Maxillofacial Implants. - : Quintessence. - 0882-2786 .- 1942-4434. ; 33:3, s. E45-E65
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Research review (peer-reviewed)abstract
- Purpose: The purpose of this systematic review was to assess the survival of implants placed in augmented sinuses on a medium-to long-term basis, and identify factors affecting implant survival such as surgical technique, bone grafts, and timing of implant placement. Materials and Methods: A literature search up to July 2016 was performed to identify prospective clinical studies on sinus floor augmentation in conjunction with implant placement with a minimum follow-up of 3 years. Meta-analytic methods were implemented to calculate implant survival rates and relative risks (RR) for failure and the effect of surgical technique, use of bone graft, graft type, use of membrane, mean residual bone height, and timing of implant insertion. Results: A total of 17 clinical trials (1 randomized and 16 prospective nonrandomized) were included, which pertained to 637 patients (at least 48% male) and 1,610 implants placed after sinus floor augmentation with the osteotome (transalveolar) or lateral window approach. The pooled implant survival rate at 3 to 6 years of follow-up was 97.7% (17 studies; 95% CI = 94.4% to 99.7%) with high heterogeneity. Smoking was associated with significantly worse implant survival (2 studies; RR = 4.8; 95% CI = 1.2 to 19.4; P < .05). However, evidence of influencing factors varied from very low to moderate after adopting the GRADE approach, due to risk of bias, imprecision, inconsistency, and small-study effects. Conclusion: Current evidence suggests that implants in augmented sinuses have high survival rates, with smoking playing a potentially important negative role in their prognosis. Both indirect and direct maxillary sinus floor augmentation seem to have a low frequency of manageable complications.
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13. |
- Aroni, Mauricio Andres Tinajero, et al.
(author)
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Loading deproteinized bovine bone with strontium enhances bone regeneration in rat calvarial critical size defects.
- 2019
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 23:4, s. 1605-1614
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate the effect of grafting with strontium (Sr)-loaded deproteinized bovine bone (DBB) on bone healing in calvarial critical size defects (CSD) in rats. MATERIAL AND METHODS: Two circular bone defects (5 mm in diameter) were created in the calvaria of 42 rats. One of the defects, randomly chosen, was grafted with (a) DBB, (b) DBB loaded with 19.6 mug/g of Sr (DBB/Sr1), or (c) DBB loaded with 98.1 mug/g of Sr (DBB/Sr2). The other defect was left empty as negative control. Groups of seven animals from each of the groups were euthanized 15 and 60 days post-op. Bone healing in the CSD was evaluated by micro-CT and histology/histomorphometry and immunohistochemistry. RESULTS: DBB/Sr2-grafted sites showed statistically significantly shorter radiographic residual defect length compared with DBB/Sr1- and DBB-grafted sites, and with empty controls at 60 days. Further, the amount of new bone formation in the DBB/Sr1- and DBB/Sr2-grafted sites was significantly higher compared with that in the DBB-grafted sites at 60 days. A larger number of DBB/Sr1- and DBB/Sr2-grafted sites presented with no- or only limited to mild inflammation, compared with the DBB-grafted sites, especially at 60 days. Higher expression of osteocalcin was observed in DBB/Sr1- and DBB/Sr2-grafted sites as compared to DBB-grafted sites. CONCLUSION: Grafting with Sr-loaded DBB enhanced bone formation in CSD in rats, when compared with grafting with non-loaded DBB. CLINICAL RELEVANCE: Grafting with Sr-loaded DBB may enhance bone formation in bone defects.
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14. |
- Aroni, Maurício, et al.
(author)
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Strontium-Coated Deproteinized Bovine Bone Grafting Enhances Bone Repair in Calvarial Critical Size Defects
- 2016
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Conference paper (other academic/artistic)abstract
- Objectives: To evaluate the effect of strontium (Sr) coated deproteinized bovine bone (DBB-Sr) grafting on bone healing of calvarial critical-size defects (CSD) in rats. Methods: Forty-two female rats were randomly divided into 3 groups of 14 animals each. Two CSD, 5mm in diameter, were created in the parietal bones and one defect was grafted either with DBB, or DBB-Sr1 (140μM per g OBD) or DBB-Sr2 (700μM per g OBD); the other defect remained empty as control. The amount of mineralized tissue into the CSD was evaluated by micro CT 7 and 14 days post-operatively (7 animals pr. group). One-way Anova complemented by Tukey test at the confidence level of 95% was used for the statistical analysis. Results: DBB-Sr2 presented a smaller length of residual CSD comparing to defects filled with DBB-Sr1 at 15 days (p <0.05) and to defects filled with DBB (p <0.05) or DBB-Sr1 (p <0.001) at 60 days. Further, DBB-Sr2 showed greater amount of mineralized tissue fill compered to defects implanted with DBB at 15 days (p<0.01) and to defects implanted with DBB (p<0.001) or DBB-Sr1 (p<0.001) at 60 days. Conclusions: Sr coating of DBB improved bone repair in critical-size calvarial defects in rats.
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15. |
- Attauabi, Mohamed, et al.
(author)
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Influence of Genetics, Immunity and the Microbiome on the Prognosis of Inflammatory Bowel Disease (IBD Prognosis Study) : the protocol for a Copenhagen IBD Inception Cohort Study
- 2022
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:6, s. e055779-e055779
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Journal article (peer-reviewed)abstract
- Introduction: Inflammatory bowel diseases (IBD), encompassing Crohn's disease and ulcerative colitis, are chronic, inflammatory diseases of the gastrointestinal tract. We have initiated a Danish population-based inception cohort study aiming to investigate the underlying mechanisms for the heterogeneous course of IBD, including need for, and response to, treatment.Methods and analysis: IBD Prognosis Study is a prospective, population-based inception cohort study of unselected, newly diagnosed adult, adolescent and paediatric patients with IBD within the uptake area of Hvidovre University Hospital and Herlev University Hospital, Denmark, which covers approximately 1 050 000 inhabitants (~20% of the Danish population). The diagnosis of IBD will be according to the Porto diagnostic criteria in paediatric and adolescent patients or the Copenhagen diagnostic criteria in adult patients. All patients will be followed prospectively with regular clinical examinations including ileocolonoscopies, MRI of the small intestine, validated patient-reported measures and objective examinations with intestinal ultrasound. In addition, intestinal biopsies from ileocolonoscopies, stool, rectal swabs, saliva samples, swabs of the oral cavity and blood samples will be collected systematically for the analysis of biomarkers, microbiome and genetic profiles. Environmental factors and quality of life will be assessed using questionnaires and, when available, automatic registration of purchase data. The occurrence and course of extraintestinal manifestations will be evaluated by rheumatologists, dermatologists and dentists, and assessed by MR cholangiopancreatography, MR of the spine and sacroiliac joints, ultrasonography of peripheral joints and entheses, clinical oral examination, as well as panoramic radiograph of the jaws. Fibroscans and dual-energy X-ray absorptiometry scans will be performed to monitor occurrence and course of chronic liver diseases, osteopenia and osteoporosis.Ethics and dissemination: This study has been approved by Ethics Committee of the Capital Region of Denmark (approval number: H-20065831). Study results will be disseminated through publication in international scientific journals and presentation at (inter)national conferences.
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16. |
- Batas, Leonidas, et al.
(author)
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Evaluation of autogenous PRGF+β-TCP with or without a collagen membrane on bone formation and implant osseointegration in large size bone defects : A preclinical in vivo study
- 2016
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 27:8, s. 981-987
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The aim of this study was to evaluate whether the adjunctive use of a collagen membrane enhances bone formation and implant osseointegration in non-contained defects grafted with chair-side prepared autologous platelet-rich growth factor (PRGF) adsorbed on a β-TCP particulate carrier. MATERIALS AND METHODS: Large box-type defects (10 × 6 mm; W × D) were prepared in the edentulated and completely healed mandibles of six Beagles dogs. An implant with moderately rough surface was placed in the center of each defect leaving the coronal 6 mm of the implant not covered with bone. The remaining defect space was then filled out with chair-side prepared autologous PRGF adsorbed on β-TCP particles and either covered with a collagen membrane (PRGF/β-TCP+CM) (6 defects) or left without a membrane (PRGF/β-TCP) (5 defects). RESULTS: Histology 4 months post-op showed new lamellar and woven bone formation encompassing almost entirely the defect and limited residual β-TCP particles. Extent of osseointegration of the previously exposed portion of the implants varied, but in general was limited. Within the defect, new mineralized bone (%) averaged 43.2 ± 9.86 vs. 39.9 ± 13.7 in the PRGF/β-TCP+CM and PRGF/β-TCP group (P = 0.22) and relative mineralized bone-to-implant contact (%) averaged 26.2 ± 16.45 vs. 35.91 ± 24.45, respectively (P = 0.5). First, bone-to-implant contact from the implant top was 4.1 ± 1.5 and 3.2 ± 2.3 (P = 0.9), in the PRGF/β-TCP+CM and PRGF/β-TCP group, respectively. CONCLUSIONS: Implantation of chair-side prepared autologous PRGF adsorbed on a β-TCP carrier in non-contained peri-implant defects resulted in large amounts of bone regeneration, but osseointegration was limited. Provisions for GBR with a collagen membrane did not significantly enhance bone regeneration or implant osseointegration.
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17. |
- 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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18. |
- Batas, Leonidas, et al.
(author)
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PRGF as adjunct to DBB in maxillary sinus floor augmentation : histological results of a pilot split-mouth study
- 2019
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In: International Journal of Implant Dentistry. - : Springer. - 2198-4034. ; 5:1
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Journal article (peer-reviewed)abstract
- Background: Various technologies of autologous blood concentrates are currently evaluated for their potential to enhance bone formation. Aim: To report on the histological outcome of maxillary sinus floor augmentation (MSFA) with deproteinized bovine bone (DBB) in combination with chair-side prepared autologous platelet-rich growth factor (PRGF), in comparison to that with DBB alone. Materials and methods: Six partially edentulous patients with 3-mm residual bone height bilaterally in the posterior maxilla were subjected to MSFA with the lateral window technique, using DBB in combination with PRGF (PRGF System1 Vitoria, Spain) on one side or DBB alone on the contralateral side. Cylindrical biopsies from the augmented sinuses were collected during implant installation, ca. 6months post-MSFA, and subjected to non-decalcified histological and histomorphometric evaluation. Results: The collected biopsies varied in length (range 3.5-9.9mm); consequently, the portion of the biopsy representing augmented tissues also varied (range 2.3-14.6mm(2)). 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 6months after MSFA (35.68.26mm and 37.8 +/- 3.15mm, respectively). Conclusion and clinical implications: In conclusion, based on these preliminary results, PRGF as adjunct to DBB for MSFA, except from improved handling during the operation, does not appear to enhance nor interfere with bone formation inside the human sinus 6months after MSFA, compared with the use of DBB alone.
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19. |
- Beck, Florian, et al.
(author)
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Devitalization of adjacent teeth following maxillary sinus floor augmentation : A retrospective radiographic study
- 2018
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In: Clinical Implant Dentistry and Related Research. - : John Wiley & Sons. - 1523-0899 .- 1708-8208. ; 20:5, s. 763-769
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Journal article (peer-reviewed)abstract
- Background: Elevation of the schneiderian membrane, during maxillary sinus floor augmentation (MSFA) may theoretically result in devitalization of adjacent teeth, which are in a close spatial relationship to the sinus floor. Purpose: To assess retrospectively the probability of devitalization of teeth adjacent to the osteotomy site after MSFA in a relatively large number of patients. Materials and Methods: All MSFA procedures, performed at a university oral surgery clinic within a time period of 10 years, were assessed on the following eligibility criteria: (1) presence of vital teeth (ie, not root canal treated and no periapical radiolucency on a panoramic radio- graph taken just after MSFA), (2) presence of a 3 to 12 months postoperative radiograph of the teeth adjacent to the osteotomy site displaying the root apices, and (3) complete medical records up to at least 12 months postoperatively. The radiographs of the different time points were compared and any changes in the radiographic status of the adjacent teeth (eg, develop- ment of a periapical lesion, root canal treatment, etc.) were recorded and the spatial relationship of the adjacent teeth to the maxillary sinus classified. Results: Out of 684 MSFAs, 257 fulfilled the inclusion criteria and involved 357 adjacent teeth, of which 221 presented close to and/or intimate relationship to the sinus. In only a single case, tooth vitality might have been lost due to the procedure. Thus, the probability for tooth devitali- zation for teeth with close to and/or intimate spatial relationship to the sinus floor ranged from 0.45% to 0.7%. Conclusions: Even for teeth with apices very close to and/or intimately related to the sinus tooth devitalization after MSFA is an extremely rare complication; that is, the probability of tooth devitalization after MSFA is ≤0.7%.
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20. |
- 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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21. |
- Bertl, Kristina, et al.
(author)
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A mini review on non-augmentative surgical therapy of peri-implantitis : What is known and what are the future challenges?
- 2021
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In: Frontiers in Dental Medicine (Section Periodontics). - : Frontiers Media S.A.. - 2673-4915. ; 2
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Journal article (peer-reviewed)abstract
- Non-augmentative surgical therapy of peri-implantitis is indicated for cases with primarily horizontal bone loss or wide defects with limited potential for bone regeneration and/or re-osseointegration. This treatment approach includes a variety of different techniques (e.g., open flap debridement, resection of peri-implant mucosa, apically positioned flaps, bone re-contouring, implantoplasty, etc.) and various relevant aspects should be considered during treatment planning. The present mini review provides an overview on what is known for the following components of non-augmentative surgical treatment of peri-implantitis and on potential future research challenges: (1) decontamination of the implant surface, (2) need of implantoplasty, (3) prescription of antibiotics, and (4) extent of resective measures.
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22. |
- Bertl, Kristina, et al.
(author)
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A survey on oral health-related standard of care for head and neck cancer patients in the EU
- 2024
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In: Oral Diseases. - : John Wiley & Sons. - 1354-523X .- 1601-0825. ; 30:4, s. 1935-1944
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Journal article (peer-reviewed)abstract
- Objective: To map oral health-related standard of care in the context of head and neck cancer (HNC) treatment across the European Union (EU).Materials and Methods: Six hundred and ninety centers across the European Union were contacted. The questionnaire contained questions focusing on the team/department structure, HNC treatment planning routines, and assessment and handling of dental treatment needs prior to cancer treatment.Results: Eighty-seven centers across the EU responded. Department structure and number of HNC patients treated per year varied widely and dental professionals are included as part of the team in about 25% of the centers. Standard of care, in terms of dental assessment and preventive dentistry routines, such as recording an orthopantomogram, offering dental treatment, and providing a radiation protection splint and splint for fluoride application, differed significantly among the European regions. Independent of the region, these aspects are positively affected if dental professionals are part of the interdisciplinary treatment team and if dental treatment is offered within the center.Conclusion: Dental professionals are still only to a very limited extent included in interdisciplinary treatment planning teams of HNC patients. However, their inclusion and/or offering dental treatment within the same hospital/center appears to improve oral health-related standard of care.Clinical Relevance: Inclusion of dental professionals in treatment planning teams of HNC patients appears to improve oral health-related standard of care within HNC treatment.
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23. |
- Bertl, Kristina, et al.
(author)
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A Wide Mesio-Distal Gap Distance in Sites of Congenitally Missing Maxillary Lateral Incisors Is Related to a Thin Bucco-Palatal Alveolar Ridge Width
- 2016
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 27:S13 : Abstracts of the EAO Congress, s. 218-219
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Journal article (other academic/artistic)abstract
- Background: In cases of a missing maxillary lateral incisor, an implant-supported crown is often the treatment of choice in order to avoid affecting intact adjacent teeth; however, proper implant placement requires a specific minimum amount of alveolar ridge bone volume. In general, alveolar ridge development is depended on tooth development and eruption; consequently, tooth loss has major impact on alveolar ridge dimensions and tooth agenesis seems to impair proper alveolar ridge development. It seems thus reasonable to consider that the impact of tooth agenesis on alveolar ridge development might depend on the gap width, i.e. the distance between the neighboring – regularly erupted – teeth. In particular, the influence from the adjacent teeth on alveolar ridge development would be diminished with an increasing mesio-distal gap distance, which in turn might result in deficient alveolar ridge dimensions, i.e. reduced height and bucco-palatal width in the center of the edentulous alveolar ridge. Aim/Hypothesis: This study aimed (a) to evaluate whether there is a correlation between the mesio-distal gap size and alveolar ridge dimension in patients missing the maxillary lateral incisor either due to agenesis or loss; (b) to determine the edentulous alveolar ridge dimension in the region of the missing maxillary lateral incisor and simulate straightforward implant placement; and (c) to assess any effect of tooth agenesis on the alveolar ridge dimension at the adjacent teeth (i.e. central incisor, canine). Material and Methods: Per protocol, 3 groups (n = 40 per group) were planned, including patients (1) with agenesis of one permanent maxillary lateral incisor (TA); (2) with the maxillary permanent lateral incisors regularly erupted but lost >3 months prior to the CT scan (TL); and (3) with the maxillary permanent lateral incisors regularly erupted and in situ (control; C). The following parameters were manually recorded by a single calibrated examiner: (1) mesio-distal gap width between the central incisor and the canine; (2) average bucco-palatal alveolar ridge width in the coronal (1st to 5th mm) and apical (6th to 10th mm) part of the alveolar ridge; (3) alveolar ridge bone area from a level 1 mm below the top of the alveolar ridge and 10 mm apically; (4) alveolar ridge height; and (5) possibility of straightforward implant placement (10 mm long x 3 or 3.5 mm in diameter). Further, clinical data regarding the actual treatment performed, i.e. bone grafting prior to- or in association with implant installation, were retrieved from the dental records of the patients of TA. Differences in alveolar ridge dimensions (i.e., bucco-palatal width, area, height) among groups [TA vs. TL vs. C) groups were assessed by One-way-ANOVA with LSD post-hoc test; correlations between the alveolar ridge dimension and the mesio-distal gap width were tested by the Spearman correlation coefficient. Results: Altogether 104 maxillary CT-scans were evaluated; the intended sample size of 40 was not achieved for TL due to frequently uncertain history of tooth loss. The area and bucco-palatal width of the alveolar ridge at the lateral incisor and at the adjacent teeth was significantly reduced in TA compared to TL and C (Table 1). Further, in TA, but not TL, an increasing mesio-distal distance between the adjacent teeth resulted in a significantly reduced bucco-palatal width of the coronal part of the edentulous alveolar ridge (r = −0.464, P = 0.003). This impeded simulated straightforward implant placement in >50% of the cases in TA, even with a reduced implant diameter of 3 mm. This simulation had good agreement with the actual treatment performed. Based on clinical data from 26 patients of the TA group, straightforward implant placement was not possible in 58% of the cases. Conclusions and Clinical Implications: The present results indicate that the wider the mesio-distal gap is in maxillary lateral incisor agenesis sites, the thinner bucco-palatally should the alveolar ridge be expected to be. In particular, a mesio-distal gap of >6 mm precluded straightforward implant placement in 60–80% of the cases. These results are relevant for treatment planning, since additional hard and/or soft tissue augmentation procedures should be frequently expected for optimal functional and aesthetic outcomes.
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24. |
- Bertl, Kristina, et al.
(author)
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Adverse reaction after hyaluronan injection for minimally invasive papilla volume augmentation : A report on two cases
- 2017
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 28:7, s. 871-876
-
Journal article (peer-reviewed)abstract
- Objectives: To report two cases of adverse reaction after mucosal hyaluronan (HY) injection around implant-supported crowns, with the aim to augment the missing interdental papilla. Material and Methods: Two patients with single, non-neighbouring, implants in the anterior maxilla, who were treated within the frames of a randomized controlled clinical trial testing the effectiveness of HY gel injection to reconstruct missing papilla volume at single implants, presented an adverse reaction. Injection of HY was performed bilaterally using a 3-step technique: (i) creation of a reservoir in the mucosa directly above the mucogingival junction, (ii) injection into the attached gingiva/mucosa below the missing papilla, and (iii) injection 2–3 mm apically to the papilla tip. The whole-injection session was repeated once after approximately 4 weeks. Results: Both patients presented with swelling and extreme tenderness with a burning sensation on the lip next to the injection area, after the second injection session. In one of the cases, a net- like skin discoloration (livedo reticularis) was also noted. The symptoms lasted for up to 7 days, and in both cases, symptoms resolved without any signs of skin or mucosal necrosis or any permanent damage. Conclusion: Most likely, water attraction over time by the highly hygroscopic HY, exerted progressively an external vascular compression and at least partial occlusion of neighbouring blood vessels. An infection or an allergic reaction seems unlikely, since all symptoms gradually disappeared within a week irrespective use of antimicrobials, while an allergic reaction most likely would not have been restricted to one side.
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25. |
- Bertl, Kristina, et al.
(author)
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Alveolar bone resorption after primary tooth loss has a negative impact on straightforward implant installation in patients with agenesis of the lower second premolar
- 2018
-
In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 29:2, s. 155-163
-
Journal article (peer-reviewed)abstract
- Objectives: To compare the alveolar bone dimensions in patients with lower second premolar (P2) agenesis prior to and after primary molar loss on CT scans, and assess the possibility for straightforward implant placement. Methods: Alveolar bone dimensions were evaluated on 150 mandibular CT scans in three groups: (i) agenesis of P2, with the primary tooth in situ, and regularly erupted first premolar (P1) and molar (M1) (AW); (ii) agenesis of P2, without the primary tooth in situ for ≥3m, but regularly erupted P1 and M1 (AWO); and (iii) P1, P2, and M1 regularly erupted (CTR). The possibility of straightforward placement of an implant 3.5 or 4.3 mm in Ø × 10 mm long was digitally simulated and compared to the actually performed treatment. Results: Buccolingual width (7.3 ± 2.0 mm) at the coronal aspect of the ridge in the AWO group was statistically significantly smaller comparing with both the AW (9.2 ± 1.4 mm) and the CTR (9.5 ± 1.1 mm) group; width reduction appeared to be mainly due to “collapse” of the buccal aspect of the ridge. Simulated straightforward placement of implants with a diameter of 3.5 or 4.3 mm was possible in 62% and 56% of the cases in the AWO vs. 86% and 84% in the AW group (p = .006 and .002, respectively). Straightforward implant placement was actually possible in all patients (22) in the AW group, while 28% (11 of 39) of the patients in the AWO group needed additional hard tissue augmentation. Conclusions: Significant dimensional differences exist in the alveolar ridge, especially in the coronal part, at lower P2 agenesis sites missing the primary tooth for ≥3m, when compared to P2 agenesis sites with the primary tooth in situ. It seems thus reasonable to advise that the primary second molar should be kept as long as possible, in order to facilitate straightforward implant installation and reduce the probability of additional bone augmentation procedures.
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26. |
- Bertl, Kristina, et al.
(author)
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Are colored periodontal probes reliable to classify the gingival phenotype in terms of gingival thickness?
- 2022
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 93:3, s. 412-422
-
Journal article (peer-reviewed)abstract
- Background: This cross-sectional study assessed the potential of colored periodontal probes (CPP) to classify gingival phenotype in terms of gingival thickness (GT).Methods: Buccal GT in 3 anterior teeth in each of 50 patients was measured by transgingival sounding and classified by 3 different methods by 8 examiners. Specifically, the diagnostic potential of visual judgement and transparency of a standard periodontal probe (SPP) to discriminate thin and thick gingiva, and of CPP to discriminate thin, medium, thick, or very thick gingiva was assessed.Results: GT ranged from 0.57-2.37mm. Using CPP resulted in a medium judgement in 87% of the cases, on average, and only between 1-10 cases/examiner were judged as thick or very thick. Considering 1mm GT as relevant cut-off value, all methods showed a high positive predictive value (≥0.82) to identify thick cases, but also a high false omission rate (≥0.73) indicating that many cases classified as thin were actually thick. Further, 88% of the cases being ≤1mm, were not classified as thin with CPP; this was inferior to SPP, for which, however, still 64% of the cases being ≤1mm thick were wrongly classified. The highest, yet moderate agreement among examiners was achieved by SPP (κ = 0.427), while visual judgement and CPP showed only fair (κ = 0.211) and slight agreement (κ = 0.112), respectively.
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27. |
- Bertl, Kristina, et al.
(author)
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Bacterial colonisation during regular daily use of a power-driven water flosser and risk for cross-contamination. Can it be prevented?
- 2022
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 26, s. 1903-1913
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Journal article (peer-reviewed)abstract
- Objective To assess whether bacterial colonisation in a power-driven water flosser can be prevented. Materials and methods Twenty-four patients undergoing supportive periodontal treatment used 2 power-driven water flossers [Sonicare AirFloss (SAF), AirFloss Ultra (SAFU)] for 12 weeks each as follows: (a) with bottled water (BW); (b) with BW and cleaning the device extra-orally twice per week with chlorhexidine gluconate or (c) essential-oil-based (EO) mouth-rinse; (d) with EO only. Water-jet samples were taken after 6 and 12 weeks with the used nozzle and after exchanging to a brand-new nozzle. After 12 weeks, all devices underwent an intensive cleaning procedure. Samples were analysed by PCR-based method for cariogenic and periodontal pathogens and culture for staphylococci, aerobe gram-negative bacteria, and Candida sp. Results Contamination of SAF/SAFU with Streptococcus mutans was found in > 95% of the samples; periodontal pathogens and aerobe gram-negative bacteria were detected in 19-56% of the samples, while Staphylococcus aureus and Candida sp. were identified only in few samples. Contamination rate was basically unaffected by time-point, device, or way of use. Further, exchanging the nozzle did not prevent transmission of a contaminated water-jet, but the intensive cleaning reduced most of the pathogens significantly, except of S. mutans. Conclusion Neither a specific way of use nor exchanging the nozzle prevented bacterial colonisation and transmission of biofilm components via the water-jet of SAF/SAFU.
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28. |
- Bertl, Kristina, et al.
(author)
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Bacterial colonization of a power-driven water flosser during regular use : A proof-of-principle study
- 2021
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In: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:5, s. 656-663
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: The present proof-of-principle study assessed whether daily use of a power-driven water flosser (Sonicare AirFloss; SAF) leads to bacterial colonization in the nozzle and/or the device, resulting in contaminated water-jet.MATERIAL AND METHODS: In five participants, saliva samples at baseline and water-jet samples of devices used daily with bottled water for 3 weeks (test) were collected. Additionally, water-jet samples from devices used daily with bottled water extra-orally for 3 weeks (positive control) and from brand new devices (negative control), as well as samples from newly opened and 1- and 3-week opened water bottles were collected. Colony forming units (CFU) were recorded after 48 h culturing and 20 oral pathogens were assessed by polymerase chain reaction-based analysis.RESULTS: Distinct inter-individual differences regarding the number of detected bacteria were observed; water-jet samples of test devices included both aerobic and anaerobic bacterial species, with some similarities to the saliva sample of the user. Water-jet samples from positive control devices showed limited number of aerobic and anaerobic bacterial species, while the samples from negative control devices did not show any bacterial species. Very few aerobic bacteria were detected only in the 3-week-old bottled water samples, while samples of newly and 1-week opened water bottles did not show any bacterial growth.CONCLUSIONS: The present proof-of-principle study showed that daily use of a power-driven water flosser for 3 weeks resulted in bacterial colonization in the nozzle and/or device with both aerobic and anaerobic, not only oral, species, that are transmitted via the water-jet.
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29. |
- Bertl, Kristina, et al.
(author)
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Can hyaluronan injections augment deficient papillae at implant-supported crowns in the anterior maxilla? A randomized controlled clinical trial with 6 months follow-up
- 2017
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 28:9, s. 1054-1061
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Journal article (peer-reviewed)abstract
- OBJECTIVES: The present randomized controlled trial aimed to assess the effect of hyaluronan (HY) injections to augment deficient interproximal papillae at implant-supported crowns in the anterior maxilla. METHODS: Twenty-two patients with a deficient papilla in the anterior maxilla next to an implant-supported crown were randomly assigned to receive twice either HY (test) or saline solution (control) injection. The following parameters were recorded prior to injection (baseline) and 3 and 6 months after injection: distance between the papilla tip and contact point (PT-CP), modified papilla index score (MPIS), and standard clinical periodontal parameters. Pain level after injection was recorded on a visual analogue scale (VAS). The deficient area was evaluated on clinical photographs, and the esthetic appearance was recorded on a VAS. Differences in mucosal volume were assessed after 3 months by intraoral scans. The bone level was assessed on periapical radiographs. RESULTS: No differences were observed between groups, neither at baseline nor at 3 and 6 months post-treatment. Mean PT-CP ranged between 1.8 mm and 2.3 mm without significant differences between groups or over time within groups; MPIS was 2 for all patients at all time points. Similarly, insignificant differences between groups or time points were observed for deficient area, gingival volume changes, bone level, and esthetic appearance. There were no differences in pain level between groups during injection, but discomfort after injection lasted longer in the test group. CONCLUSIONS: Injection of HY adjacent to maxillary anterior implant-supported crowns did not result in any clinical conspicuous volume augmentation of deficient papillae.
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30. |
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31. |
- Bertl, Kristina, et al.
(author)
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Does implantoplasty affect the failure strength of narrow and regular diameter implants? : A laboratory study
- 2021
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 25, s. 2203-2211
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Journal article (peer-reviewed)abstract
- ObjectiveTo assess whether the impact of implantoplasty (IP) on the maximum implant failure strength depends on implant type/design, diameter, or material.MethodsFourteen implants each of different type/design [bone (BL) and tissue level (TL)], diameter [narrow (3.3 mm) and regular (4.1 mm)], and material [titanium grade IV (Ti) and titanium-zirconium alloy (TiZr)] of one company were used. Half of the implants were subjected to IP in a computerized torn. All implants were subjected to dynamic loading prior to loading until failure to simulate regular mastication. Multiple linear regression analyses were performed with maximum implant failure strength as dependent variable and IP, implant type/design, diameter, and material as predictors.ResultsImplants subjected to IP and TL implants showed statistically significant reduced implant failure strength irrespective of the diameter compared with implants without IP and BL implants, respectively. Implant material had a significant impact for TL implants and for regular diameter implants, with TiZr being stronger than Ti. During dynamic loading, 1 narrow Ti TL implant without IP, 4 narrow Ti TL implants subjected to IP, and 1 narrow TiZr TL implant subjected to IP were fractured.ConclusionIP significantly reduced the maximum implant failure strength, irrespective implant type/design, diameter, or mate- rial, but the maximum implant failure strength of regular diameter implants and of narrow BL implants remained high.Clinical RelevanceIP seems to have no clinically relevant impact on the majority of cases, except from those of single narrow Ti TL implants, which may have an increased risk for mechanical complications. This should be considered for peri-implantitis treatment planning (e.g., communication of potential complications to the patient), but also in the planning of implant installation (e.g., choosing TiZr instead of Ti for narrow implants).
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32. |
- Bertl, Kristina, et al.
(author)
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Does the time-point of orthodontic space closure initiation after tooth extraction affect the incidence of gingival cleft development? A randomized controlled clinical trial.
- 2020
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 91:5, s. 572-581
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Journal article (peer-reviewed)abstract
- Background: Gingival clefts (GC) develop frequently during orthodontic space closure and may compromise the treatment outcome. This study assessed whether the time-point of orthodontic space closure initiation, after permanent tooth extraction, affects the incidence of GC. Methods: In 25 patients requiring bilateral premolar extraction due to orthodontic reasons, one premolar, chosen at random, was extracted 8 weeks before space closure initiation (“delayed movement”, DM), while the contralateral premolar was extracted one week before (“early movement”, EM) (“treatment group”). Presence/absence of GC after 3 and 6 months (“time-point”) was recorded and any association with various parameters (i.e., treatment group, time-point, gender, jaw, craniofacial growth, gingival biotype, buccal bone dehiscence after extraction, space closure) was statistically assessed. Results: Twenty-one patients contributing with 26 jaws were finally included in the analysis. Overall, GC were frequent after 3 (DM: 53.9%; EM: 69.2%) and 6 months (DM: 76.9%; EM: 88.5%). EM (p=0.014) and larger space closure within the study period (p=0.001) resulted in a significantly higher incidence of GC. Further, there was a tendency for GC development in the presence of buccal bone dehiscence (p=0.052) and thin gingival biotype (p=0.054). “Fast movers” (herein cases with a tooth movement ≥ 1mm per month) developed a GC in > 90% of the cases already after 3 months. “Slow movers” developed a GC only in 25 and 70% after 3m and FE, respectively. Conclusions: GC development is a frequent finding during orthodontic space closure and seems to occur more frequently with early tooth movement initiation and in “fast movers”.
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33. |
- Bertl, Kristina, et al.
(author)
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Health-related quality of life aspects of the ‘Periodontitis prevalence in ulcerative colitis and Crohn's disease’ (PPCC) cohort
- 2023
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 50:12, s. 1601-1620
-
Journal article (peer-reviewed)abstract
- Aim: To assess whether oral health problems affect disease-specific quality of life (QoL) of inflammatory bowel disease (IBD) patients, and vice versa, whether IBD affects oral-health-related QoL.Materials and Methods: Individuals reporting IBD and matched controls were surveyed on general anamnestic information, oral-health-related questions and the Oral Health Impact Profile (OHIP)-5. IBD patients were additionally surveyed on years since diagnosis, disease activity and severity as well as health-related QoL (Short Inflammatory Bowel Disease Questionnaire, sIBDQ). OHIP-5 and sIBDQ were defined as primary outcome parameters, and several predictors and confounders were used in adjusted univariable and multivariable regression analyses.Results: Answers from 1108 IBD patients and 3429 controls were analysed. Compared with controls, IBD patients reported significantly more frequently an oral impact on daily life and worse oral-health-related QoL, with Crohn's disease (CD) patients being more severely affected than ulcerative colitis (UC) patients. The diagnosis of UC and CD, having <20 teeth, severe periodontitis and stressful daily-life experience were associated with a higher prevalence of poor oral-health-related QoL. Among IBD patients, an impaired IBD-specific, health-related QoL was significantly associated with the diagnosis of CD and depression, IBD activity and severity, having <20 teeth, presence of oral lesions and stressful daily-life experience, while a longer time since diagnosis was significantly associated with an improved IBD-specific, health-related QoL.Conclusions: The results of the present study indicate, for the first time, that oral health problems are associated with an impairment of IBD-specific health-related QoL, and vice versa, IBD is associated with an impaired oral health-related QoL. This emphasizes the potential advantages of including dental professionals in the multi-disciplinary treatment teams of IBD patients.
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34. |
- Bertl, Kristina, et al.
(author)
-
How old is old for implant therapy in terms of early implant losses?
- 2019
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In: Journal of Clinical Periodontology. - : John Wiley & Sons. - 0303-6979 .- 1600-051X. ; 46:12, s. 1282-1293
-
Journal article (peer-reviewed)abstract
- Objectives: To assess, retrospectively, whether older age has an impact on implant osseointegration when compared with younger age. Methods: All patients ≥65 years old at implant installation, in an university setting over a time-period of 11.5 years, with complete anamnestic data and follow-up until prosthetic restoration were included and any early implant loss (EIL; i.e., lack of osseointegration prior to or at time-point of prosthetic restoration) was recorded. Further, one implant, from each of the elderly patients was attempted matched to one implant in a younger patient (35 to <55 years old at implant installation) from the same clinic based on: (1) gender, (2) implant region, (3) smoking status, and (4) bone grafting prior to/simultaneously with implant installation. The potential impact of various local and systemic factors on EIL in the entire elderly population, and in the matched elderly and younger patient group were statistically assessed. Results: Four-hundred-forty-four patients ≥65 years old (range 65.1-91.3; 56.8% female) receiving 1517 implants were identified; 10 patients had one EIL each (implant/patient level: 0.66/2.25%). Splitting this patient cohort additionally into 4 age groups [65-69.9 (n=213), 70-74.9 (n=111), 75-79.9 (n=80), ≥80 (n=40)] EIL was on the implant level 0.41, 0.83, 0.34, and 2.26%, respectively, (p=0.102) and on the patient level 1.41, 2.70, 1.25, and 7.50%, respectively, (p=0.104); multilevel analysis showed weak evidence of association of increasing age with higher EIL rate (p = 0.090). Matching was possible in 347 cases, and 5 (1.44%) and 9 (2.59%) EIL in the elderly and younger patients, respectively, were observed (p=0.280). EIL could not be associated with any systemic condition or medication intake. Conclusions: Elderly patients ≥65 years old presented a similarly low EIL rate as younger patients 35 to <55 years old, while patients ≥80 years old may have a slight tendency for a higher EIL rate. Hence, aging does not seem to compromise osseointegration, and if at all, then only slightly and at a later stage of life.
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35. |
- Bertl, Kristina, et al.
(author)
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Hyaluronan in Non-Surgical and Surgical Periodontal Therapy. A Systematic Review.
- 2015
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In: Journal of Clinical Periodontology. - : Wiley. - 1600-051X .- 0303-6979. ; 42:3, s. 236-246
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Journal article (peer-reviewed)abstract
- AIM: To evaluate the effect of hyaluronan (HY) application as monotherapy or as adjunct to non-surgical and/or surgical periodontal therapy. METHODS: Literature search was performed according to PRISMA guidelines with the following main eligibility criteria: (a) English or German language; (b) preclinical in-vivo or human controlled trials; (c) effect size of HY evaluated histologically or clinically. RESULTS: Two preclinical in-vivo studies on surgical treatment and 12 clinical trials on non-surgical and/or surgical treatment were included. Most of the studies were highly heterogeneous, regarding with HY product used and application mode, and of high risk of bias, thus not allowing meta-analysis. The majority of clinical studies described a beneficial, occasionally statistically significant, effect of HY on bleeding on probing (BoP) and pocket depth (PD) reduction (2.28-19.5% and 0.2-0.9mm, respectively), comparing to controls; no adverse effects were reported. CONCLUSIONS: HY application as adjunct to non-surgical and surgical periodontal treatment seems to have a beneficial, generally moderate, effect on surrogate outcome variables of periodontal inflammation, i.e., BoP and residual PD, and appears to be safe. The large heterogeneity of included studies, does not allow recommendations on the mode of application or effect size of HY as adjunct to non-surgical and surgical periodontal treatment.
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36. |
- Bertl, Kristina, et al.
(author)
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Hyaluronan vid parodontal behandling
- 2015
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In: Tandläkartidningen. - : Sveriges tandläkarförbund. - 0039-6982. ; 10, s. 58-65
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Research review (other academic/artistic)abstract
- Hyaluronan (HY) har på grund av sina egenskaper (bakteriostatiska, antiin ammatoriska et cetera) nyligen introducerats för användning i parodon- tal terapi. Denna litteraturgenomgång bygger del- vis på en nyligen publicerad systematisk översikt, och har kompletterats med gingivitstudier och de senast publicerade vetenskapliga arbetena med HY inom parodontitbehandling. Artikeln ger en sammanfattning av de terapeutiska möjligheterna med HY-applikation som monoterapi eller som ett tillägg till behandling av gingivit och parodontit. Vid sökning i tre litteraturdatabaser fann vi 18 kontrollerade studier. I majoriteten av dessa stu- dier beskrivs för HY-testgruppen jämfört med kontrollgruppen ● en statistiskt signi kant förbättring i gingivalin- dex för gingivitpatienter ● en statistiskt signi kant minskning i blödning vid sondering och fickdjup vid icke-kirurgisk parodontal behandling ( gur I), dock i måttligt kliniskt relevant utsträckning. Att erhålla någon ytterligare vinst i klinisk fästenivå av HY-applikation vid parodontal kirurgi verkar inte troligt. Till dags dato saknas rapporter av oönskade bi- verkningar av HY-applikation. På grund av den avsevärda heterogeniteten i studierna (avseende produkter, metoder för applicering, dos och applikationstid) går det inte att dra någon tydlig slutsats om administration och e ektstorlek av HY vid behandling av gingivit eller parodontit.
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37. |
- Bertl, Kristina, et al.
(author)
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Hyaluronanprodukte in der Therapie von Gingivitis- und Parodontitispatienten : Eine Literaturübersicht
- 2015
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In: Parodontologie. - : Quintessence. - 0937-1532. ; 26:4, s. 423-433
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Journal article (peer-reviewed)abstract
- Application of hyaluronan (HY) in periodontal treatment has recently increased due to its bacteriostatic and anti-in ammatory pro- perties. This review is based in part on a recent systematic review and also includes newly published studies such as those on gingivitis patients. It summarizes the thera- peutic possibilities of HY application as a monotherapy and as an adjunct in the treatment of gingivitis and periodontitis. Based on literature searches in 3 databases, 18 controlled trials were identi ed. When comparing the HY test group with the control group, the majority of the clinical trials reported (a) a signi cant improvement in gingival indices of gingivitis patients and (b) a signi cant but clinically moderate reduction in bleeding on probing and probing pocket depth after nonsurgical treatment of periodontitis patients. The effect of HY application on clinical attachment level gain after surgical regenerative treatment remains unclear. Because no unexpected side effects were reported after HY-application, its use can thus be considered safe. However, due to the considerable heterogeneity of the available studies, in terms of product diffe- rences and varying application modalities, no recommendation can be provided re- garding the appropriate HY administration or the effective amount for the treatment of gingivitis or periodontitis.
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38. |
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39. |
- Bertl, Kristina, et al.
(author)
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Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status
- 2022
-
In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 26, s. 2937-2948
-
Journal article (peer-reviewed)abstract
- ObjectiveTo assess in a cross-sectional study the impact of including dental professionals in the multidisciplinary treatment team of head and neck squamous cell carcinoma (HNSCC) patients on the long-term oral health status.Materials and methodsOral health status, dental care behaviours, and oral health-related quality of life were assessed based on a clinical and radiographic examination, interview, and medical records in patients treated for HNSCC ≥ 6 months ago. This patient group (‘cohort 2’) was treated in a multidisciplinary treatment team including dental professionals and compared to a group of HNSCC patients previously treated at the same university, but without dental professionals included in the multidisciplinary treatment team (‘cohort 1’).ResultsCohort 2 consisted of 34 patients, who had received a dental check-up and if necessary, treatment by dental profes- sionals prior to the initiation of cancer treatment. This cohort showed significantly improved oral hygiene habits and a better periodontal health status compared to cohort 1. However, cohort 2 still presented high demand for treatment due to active carious lesions; only a few, statistically insignificant improvements were detected compared to cohort 1.ConclusionIncluding dental professionals in the multidisciplinary treatment team of HNSCC patients has a positive impact on patient oral health status — primarily in terms of periodontal disease — 6 months and longer after finishing cancer therapy.Clinical relevanceA team-based approach including dental professionals specialised in head and neck cancer improves oral health status.
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40. |
- Bertl, Kristina, et al.
(author)
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Is a simple rational classification of maxillary sinus dimensions applicable?
- 2017
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In: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 28:S14, s. 65-65
-
Journal article (other academic/artistic)abstract
- Background Maxillary sinus floor augmentation (MSFA) with autologous bone and/or bone substitutes is a reliable procedure to develop an implant site. Loss of augmentation volume during the healing period seems to be dependent on the type of graft material and possibly on the sinus dimensions/morphology, e.g. a larger distance between the buccal and palatal sinus wall (i.e. “wide” sinus) might delay graft consolidation due to a longer distance angiogenic/osteogenic factors and cells need to cover to populate the graft. Aim/Hypothesis To assess the bucco-palatal width of the maxillary sinus in the premolar and molar region and any possible differences due to tooth region, gender, tooth-gap extent, and residual alveolar bone dimensions. Further, to attempt a rational, simple sinus classification based on its bucco-palatal width. Material and Methods CTs of the posterior maxilla were divided depending on tooth-gap extent into (a) edentulous, and (b) 1- or 2-tooth gap. Sites presenting on the CT >5 mm of the maxillary sinus, no previous augmentation procedures and/or oro-antral communication were included. A central orthoradial multiplanar reconstruction slice from each edentulous tooth site was chosen by a calibrated examiner to record the following parameters: (i) alveolar bone height (ABH), (ii) alveolar bone area (ABA), (iii) alveolar bone width (ABW) 2 mm apical to the alveolar crest (ABW2), (iv) ABW at the sinus floor (ABWS), (v) bucco-palatal sinus width (SW) and (vi) sinus area (SA) at a level 2, 4, 6, 8 and 10 mm above the sinus floor (SW2/SA2, SW4/SA4, etc.) (Figure 1). Based on mean values (i.e. <25th, 25–75th, >75th percentile and <33rd, 33–67th, >67th percentile) the sinus was classified as narrow, average, and wide, respectively, to attempt a simple sinus classification. Results Eighty-six partially dentate and 76 edentulous quadrants contributed with 383 tooth sites (58 first and 97 second premolars, 129 first and 99 second molars). Alveolar bone and sinus parameters did not differ depending on tooth-gap extent and gender, but differed significantly depending on tooth site, i.e. ABH and ABA was smallest at the first molar, and ABW, ABWS, SW, and SA were significantly larger at the molars. Further, ABW correlated significantly with SW and SA. High variability in SW among the various levels within the same tooth site, as well as high variability among tooth sites within the same person was observed, i.e. in >50% of the cases, sinus classification (i.e., narrow, average, or wide) varied depending on SW height level (Table 1) and among tooth sites within each patient. Conclusions and Clinical Implications Maxillary sinus bucco-palatal width varies significantly among the various height levels within the same tooth site and among tooth sites within the same person. A rational, simple classification of each sinus as narrow, average, or wide was not applicable.
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41. |
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42. |
- Bertl, Kristina, et al.
(author)
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Kieferorthopädie bei Parodontitispatienten : Worauf sollte man Acht geben? [Orthodontic Therapy in Periodontitis Patients: What Should be Taken Care of?]
- 2017
-
In: Informationen aus Orthodontie und Kieferorthopädie. - : Georg Thieme Verlag KG. - 0020-0336 .- 1439-4200. ; 49:01, s. 11-17
-
Research review (peer-reviewed)abstract
- Objective To provide an overview on "orthodontic therapy in periodontitis patients" by addressing the following three questions: (1) At which time point can orthodontic treatment start in periodontitis patients? (2) What should be considered during orthodontic treatment? (3) Can teeth with a reduced periodontium be maintained after orthodontic treatment? Results In general, the scientific evidence on this topic is mainly based on preclinical, retrospective studies, and case series; controlled clinical trials are scarce. Nevertheless, it is clear, that orthodontic tooth movement should be performed only in periodontally healthy (i.e., non-inflamed) tissues, otherwise further attachment loss might occur. Therefore, cause-related periodontal therapy should always precede orthodontic treatment and supportive periodontal treatment should be continuously provided during orthodontic therapy. Yet, up-to-now, there is no clear treatment recommendation regarding the time-point and type of any surgical intervention before orthodontic treatment. In relation to treatment of patients with vertical defects it is, however, not clear whether an open flap debridement is sufficient or application of any additional regenerative material will improve the prognosis. The results of orthodontic treatment can be successfully preserved on the long-term – also on a reduced periodontium – if sufficient stabilization and periodontal maintenance is provided. Conclusion Orthodontic therapy has no negative influence on teeth with a reduced but healthy periodontium and the results can be maintained for a large period of time. Hence, cause-related periodontal therapy should always precede orthodontic treatment to establish inflammation-free conditions, but up-to-now there is no clear recommendation regarding the time-point and type of periodontal surgical interventions.
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43. |
- Bertl, Kristina, et al.
(author)
-
Micro-CT evaluation of the cortical bone micro-architecture in the anterior and posterior maxilla and the maxillary sinus floor
- 2019
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 23, s. 1453-1459
-
Journal article (peer-reviewed)abstract
- Objectives: To perform a within-subject comparison of the cortical bone micro-architecture of the maxillary sinus floor (MSF) to that of the buccal aspect of the anterior and posterior maxilla. Methods: Micro-CT scans of the buccal aspect of the anterior and posterior maxilla and of the MSF in 14 human anatomical specimens were recorded. Within-subject comparisons were performed for cortical thickness (Ct.Th) and porosity (Ct.Po), average pore volume (AvgPo.V), and pore density (Po.Dn). Results: The MSF presented the lowest and the anterior maxilla the highest Ct.Th, while Ct.Po was significantly higher at the MSF compared to the posterior maxilla (p = 0.021). No relevant differences were recorded for AvgPo.V and Po.Dn among regions (p > 0.067). Further, an increased Ct.Th at the MSF was significantly associated with a lower Po.Dn, while a higher Ct.Th and an increased AvgPo.V in the anterior maxilla were associated with a higher Ct.Th and an increased AvgPo.V, respectively, in the posterior maxilla and MSF. Finally, within each region, the AvgPo.V was associated positively with Ct.Po and negatively with Po.Dn. Conclusions: The cortical bone of the MSF is slightly less thick and slightly more porous compared to the cortical bone at the buccal aspect of the anterior and posterior maxilla. Clinical relevance: During lateral and vertical bone augmentation procedures, the cortical recipient bone is perforated several times to open the bone marrow compartment to facilitate provision of osteoinductive cells and molecules in the augmented space. Whether it is meaningful to approach the MSF in a similar way during MSF augmentation procedures or whether the slightly more porous structure of the MSF observed herein reduces the cortical barrier function already sufficiently has to be assessed in future clinical trials.
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44. |
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45. |
- Bertl, Kristina, et al.
(author)
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Oral health status and dental care behaviours of head and neck cancer patients : a cross-sectional study in an Austrian tertiary hospital
- 2016
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In: Clinical Oral Investigations. - : Springer. - 1432-6981 .- 1436-3771. ; 20:6, s. 1317-1327
-
Journal article (peer-reviewed)abstract
- OBJECTIVES: This study aimed to assess the oral health status and dental care behaviours of patients treated for head and neck squamous cell carcinoma (HNSCC) in an Austrian tertiary hospital. MATERIALS AND METHODS: Dental care behaviours, oral hygiene level, caries, and periodontal parameters were assessed in 48 patients treated for HNSCC >6 months ago. RESULTS: Only 52 % requested a dental check-up after HNSCC diagnosis and prior to treatment, and of those, 80 % received some type of dental treatment. At time-point of clinical examination, 69 % of the patients had consulted a dentist within the last year, but 88 % still needed dental treatment; 75 % had at least one tooth with caries and 78 % had moderate to severe periodontitis. CONCLUSION: Although it was recommended, only half of the patients did consult a dentist prior to HNSCC treatment and oral health appeared, in general, low prioritized. CLINICAL RELEVANCE: About 90 % of the current group of head and neck squamous cell carcinoma cancer patients presented large treatment needs, both in regard with caries and periodontal disease, about 20 months after cancer treatment.
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46. |
- Bertl, Kristina, et al.
(author)
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Osteoimmunological Aspects of Periodontal Diseases
- 2016
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In: Principles of Osteoimmunology. - Cham : Springer. - 9783319342368 - 9783319342382 ; , s. 289-321
-
Book chapter (other academic/artistic)abstract
- Osteoimmunology describes the cross-talk of cells of the musculoskeletal and the immune system during the pathogenesis of various diseases; among the most prevalent ones is periodontitis, a chronic infectious inflammatory disease of the tooth-supporting structures, i.e., the periodontium consisting of the gingiva, alveolar bone, periodontal ligament, and root cementum. Periodontal disease is initiated by oral pathogens that accumulate at the gingival margin of the teeth and thereby trigger a response of the innate and adaptive immunity. In contrast to other osteoimmunological disorders (e.g., osteoporosis, rheumatoid arthritis), the immune system plays a two-sided role in the pathogenesis of periodontitis: it controls the infection and protects the organism from bacterial invasion but also propagates the destruction of the soft and hard tissues surrounding the tooth. Periodontitis, if left untreated, finally results in tooth loss.
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47. |
- Bertl, Kristina, et al.
(author)
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Patients’ opinion on the use of 2 generations of power-driven water flossers and their impact on gingival inflammation
- 2021
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In: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:6, s. 1089-1095
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Journal article (peer-reviewed)abstract
- Objectives: To assess patients' opinion on the use of 2 generations of power-driven water flossers and their impact on gingival inflammation.Material & Methods: In the present prospective cohort study 24 periodontitis patients under regular supportive periodontal therapy used daily 2 generations of a power- driven water flosser (Sonicare AirFloss [SAF] and Sonicare AirFloss Ultra [SAFU]) for 12 weeks each. Patients were instructed to position the nozzle interproximally from the buccal aspect at each interproximal space. Patients' opinion was assessed by a questionnaire and interproximal bleeding on probing (BoP) was recorded.Results: Overall satisfaction with SAF/SAFU was rated high, by about 80% of the patients. About 66% of the patients preferred SAF/SAFU compared to their previous interdental cleaning device and indicated that they would continue using SAF/SAFU after the study; none of the patients reported any discomfort or pain. Compared to only tooth brushing, daily use of SAF/SAFU caused a significant reduction of inter- proximal BoP values, which were well maintained over 6 months; that is, BoP at interproximal buccal and oral sites (pooled), as well as at interproximal buccal and oral sites separately, was proportionately reduced by 29.1%, 41.2%, and 24.8%, respec- tively (pooled: p = 0.027; buccal sites: p = 0.030; oral sites: p = 0.030).Conclusion: Patients were very fond of the power-driven water flossers tested herein, and daily use of the devices for 6 months (i.e., each device was used for 3 months) resulted in a significant reduction of gingival inflammation interproximally.
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48. |
- Bertl, Kristina, et al.
(author)
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Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls : The Periodontitis Prevalence in ulcerative Colitis and Crohn disease (PPCC) case-control study
- 2024
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In: Journal of Periodontology. - : John Wiley & Sons. - 0022-3492 .- 1943-3670. ; 95:2, s. 159-174
-
Journal article (peer-reviewed)abstract
- Background: To describe the frequency and impact of oral lesions and professional dental care costs in patients with inflammatory bowel disease (IBD) (i.e., Crohn disease [CD] or ulcerative colitis [UC]) compared to matched controls).Methods: IBD patients and matched controls were surveyed on general anamnestic information, eating and drinking habits, and oral health- and dental care-related questions; IBD patients were additionally surveyed on oral lesions. Problems related to oral lesions and the amount of money spent for professional dental care in the past 12 months were defined as primary outcome parameters.Results: Answers from 1108 IBD patients and 3429 controls were analyzed. About 30% of the patients indicated having had problems with oral lesions, with CD patients having 46% higher odds and having them more often in a generalized form compared to UC patients. Further, self-reported severe periodontitis increased the odds of having oral lesions by almost 2.3-times. However, only about 12.5% of IBD patients were informed by their physician about oral lesions and about 10% indicated receiving treatment for them. Compared to controls, IBD patients required more often dental treatment and spent more money; specifically, UC and CD patients had 27 and 89% higher odds, respectively, for having spent ≥3000 DKK (ca. 440 USD) at the dentist compared to controls.Conclusions: IBD patients have more often oral health problems and higher expenses for professional dental care compared to matched controls. This included problems with IBD-related oral lesions, but these are rarely addressed by the medical or dental team.Keywords: Crohn disease; case-control studies; colitis; dental care; inflammatory bowel diseases; surveys and questionnaires; ulcerative.
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49. |
- Bertl, Kristina, et al.
(author)
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Periodontitis prevalence in patients with ulcerative colitis and Crohn's disease - PPCC : a case–control study
- 2022
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In: Journal of Clinical Periodontology. - : Wiley-Blackwell. - 0303-6979 .- 1600-051X. ; 49:12, s. 1262-1274
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Journal article (peer-reviewed)abstract
- Aim: The aim of this questionnaire-based, case-control study was to assess whether self-reported oral health and periodontitis in ulcerative colitis (UC) and Crohn's disease (CD) patients differ from that in matched controls without inflammatory bowel disease (IBD).Methods: A survey including questions on general anamnestic information, IBD diagnosis, and oral health was distributed online. Self-perceived overall health of teeth and gums, severe periodontitis, and tooth loss were defined as outcome parameters.Results: Analyses were based on answers from 1108 IBD patients and 3429 controls. IBD patients reported significantly worse oral health and more periodontal problems compared to controls. Regression analyses corrected for relevant confounders showed for UC and CD patients significantly increased odds for fair or poor self-perceived overall health of teeth and gums (OR 2.147 and 2.736, respectively) and for severe periodontitis (OR 1.739 and 2.574, respectively) compared to controls; CD patients presented additionally 91% higher odds for having <20 remaining teeth.Conclusions: UC and CD patients have significantly increased odds for worse self-perceived oral health and severe periodontitis compared to controls, with CD patients being more severely affected and losing more teeth. It is strongly recommended that IBD patients are kept under close surveillance to prevent periodontitis development and/or mitigate its progression.
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50. |
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