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Schmitt CM, Moest T, Lutz R, Wehrhan F, Neukam FW, Schlegel KA. Long-term outcomes after vestibuloplasty with a porcine collagen matrix (Mucograft ® ) versus the free gingival graft: a comparative prospective clinical trial. Clin Oral Implants Res 2015; 27:e125-e133. [PMID: 25720794 DOI: 10.1111/clr.12575] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Porcine collagen matrices are proclaimed being a sufficient alternative to autologous free gingival grafts (FGG) in terms of augmenting the keratinized mucosa. The collagen matrix Mucograft® (CM) already showed a comparable clinical performance in the early healing phase, similar histological appearance, and even a more natural appearance of augmented regions. Predictability for long-term stability does not yet exist due to missing studies reporting of a follow-up >6 months. MATERIAL AND METHODS The study included 48 patients with atrophic edentulous or partially edentulous lower jaw situations that had undergone an implant treatment. In the context of implant exposure, a vestibuloplasty was either performed with two FGGs from the palate (n = 21 patients) or with the CM (n = 27 patients). Surgery time was recorded from the first incision to the last suture. Follow-up examinations were performed at the following time points: 10, 30, 90, and 180 days and 1, 2, 3, 4, and 5 years after surgery. The width of keratinized mucosa was measured at the buccal aspect of each implant, and augmented sites were evaluated in terms of their clinical appearances (texture and color). RESULTS The groups showed similar healing with increased peri-implant keratinized mucosa after surgery (FGG: 13.06 mm ± 2.26 mm and CM: 12.96 mm ± 2.86 mm). The maximum follow-up was 5 years (5 patients per group). After 180 days, the width of keratinized mucosa had decreased to 67.08 ± 13.85% in the FGG group and 58.88 ± 14.62% in the CM group with no statistically significant difference. The total loss of the width of keratinized mucosa after 5 years was significant between the FGG (40.65%) and the CM group (52.89%). The CM group had significantly shorter operation times than the FGG group. Augmented soft tissues had a comparable clinical appearance to adjacent native gingiva in the CM group. FGGs could still be defined after 5 years. CONCLUSIONS The FGG and the CM are both suitable for the regeneration of the peri-implant keratinized mucosa with a sufficient long-term stability. With the CM, tissue harvesting procedures are invalid, surgery time can be reduced, and regenerated tissues have a more esthetic appearance.
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Affiliation(s)
- Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Tobias Moest
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Falk Wehrhan
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Friedrich W Neukam
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Karl Andreas Schlegel
- Department of Oral and Maxillofacial Surgery, University of Erlangen-Nuremberg, Erlangen, Germany
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Baulin IM, Badalyan VA, Ryakhovsky AN. [Experimental study of the collagen matrix for increase the gums using a 3D-modeling]. STOMATOLOGII︠A︡ 2015; 94:8-10. [PMID: 26953420 DOI: 10.17116/stomat20159458-10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
In an experimental study on mini-pigs demonstrated that the use of collagen matrix Mucograft open method leads to the formation of mature connective tissue around the implants, more pronounced after 70 days, and the width of attached mucosa already 45th day (from 4.4 ± 0.3 to 7.7 ± 0.5 mm) is comparable to that of free gingival graft. Three-dimensional computer modeling of jaws experimental animals showed the soft tissue augmentation by 0.8 ± 0.1 cm3 after use of collagen matrix Mucograft and 1.1 ± 0.12 cm3 after free gingival graft.
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Affiliation(s)
- I M Baulin
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - V A Badalyan
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - A N Ryakhovsky
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
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Roman A, Cioban C, Stratul SI, Schwarz F, Muste A, Petrutiu SA, Zaganescu R, Mihatovic I. Ridge preservation using a new 3D collagen matrix: a preclinical study. Clin Oral Investig 2014; 19:1527-36. [DOI: 10.1007/s00784-014-1368-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 11/13/2014] [Indexed: 12/24/2022]
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Dias SBF, Fonseca MVA, dos Santos NCC, Mathias IF, Martinho FC, Junior MS, Jardini MAN, Santamaria MP. Effect of GaAIAs low-level laser therapy on the healing of human palate mucosa after connective tissue graft harvesting: randomized clinical trial. Lasers Med Sci 2014; 30:1695-702. [DOI: 10.1007/s10103-014-1685-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Accepted: 10/23/2014] [Indexed: 12/26/2022]
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Thoma DS, Nänni N, Benic GI, Weber FE, Hämmerle CHF, Jung RE. Effect of platelet-derived growth factor-BB on tissue integration of cross-linked and non-cross-linked collagen matrices in a rat ectopic model. Clin Oral Implants Res 2014; 26:263-70. [PMID: 25267409 DOI: 10.1111/clr.12496] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2014] [Indexed: 11/28/2022]
Abstract
AIM To test whether or not the network structure and the addition of recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to a chemically cross-linked collagen matrix (CCM)- and a non-cross-linked collagen matrix (NCCM)-influenced tissue integration, angiogenesis, and matrix degradation. MATERIALS AND METHODS Four treatment modalities were randomly assigned to four unconnected pouches in the back of 50 rats: (i) CCM-S (soaked in saline), (ii) CCM-P (plus rhPDGF-BB), (iii) NCCM-S (soaked in saline), and (iv) NCCM-P (plus rhPDGF-BB). The animals were sacrificed at 2, 4, 8, 16, and 24 weeks. Descriptive histology and histomorphometric assessments were performed thereby evaluating matrix thickness, the number of vessels (angiogenesis), and connective tissue formation. Means and standard deviations were calculated. Robust linear mixed modeling was used to test the effect of group (NCCM vs CCM), rhPDGF-BB, and time point of sacrifice (2, 4, and 8 weeks). RESULTS The thickness of NCCM groups revealed stability (range 440-570 μm) over 8 weeks, while the matrices were no longer present at 16 and 24 weeks. CCM matrices demonstrated a maximal thickness at 2 weeks (2689 ± 187 μm for CCM-S and 2693 ± 389 μm for CCM-P), a decrease of roughly 40% at 8 weeks, but were still present at 16 and 24 weeks. Vascularization of NCCM gradually increased over time with a peak (mean 17.0; SD 1.7) for NCCM-S and NCCM-P (22.0 ± 34.8) at 8 weeks. Angiogenesis in CCM was significantly more pronounced at early time points with a peak at 2 weeks (29.3 ± 16.8 for CCM-S and 30.3 ± 18.4 for CCM-P). No statistically significant effect of rhPDGF-BB was observed for any of the evaluated parameters (all P > 0.05). CONCLUSIONS The compact layer (in NCCM) delayed angiogenesis and connective tissue formation, while the spongeous cross-linked matrix of CCM facilitated early vascularization and demonstrated network presence over a longer time span.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zürich, Switzerland
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Thoma DS, Mühlemann S, Jung RE. Critical soft-tissue dimensions with dental implants and treatment concepts. Periodontol 2000 2014; 66:106-18. [DOI: 10.1111/prd.12045] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2013] [Indexed: 11/30/2022]
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Vignoletti F, Nuñez J, de Sanctis F, Lopez M, Caffesse R, Sanz M. Healing of a xenogeneic collagen matrix for keratinized tissue augmentation. Clin Oral Implants Res 2014; 26:545-52. [DOI: 10.1111/clr.12441] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Fabio Vignoletti
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Javier Nuñez
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Francesco de Sanctis
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Monica Lopez
- School of Veterinary; University of Santiago de Compostela; Santiago de Compostela Spain
| | - Raul Caffesse
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
| | - Mariano Sanz
- Department of Periodontology; Faculty of Dentistry; Complutense University of Madrid; Madrid Spain
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Zuhr O, Bäumer D, Hürzeler M. The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: critical elements in design and execution. J Clin Periodontol 2014; 41 Suppl 15:S123-42. [DOI: 10.1111/jcpe.12185] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 10/07/2013] [Accepted: 10/16/2013] [Indexed: 01/27/2023]
Affiliation(s)
- Otto Zuhr
- Private Practice Hürzeler/Zuhr; Munich Germany
- Department of Periodontology; Centre for Dental, Oral, and Maxillofacial Medicine (Carolinum); Johann Wolfgang Goethe-University Frankfurt/Main; Frankfurt Germany
| | | | - Markus Hürzeler
- Private Practice Hürzeler/Zuhr; Munich Germany
- Department of Operative Dentistry and Periodontology; University Dental School; University of Freiburg; Freiburg Germany
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Thoma DS, Buranawat B, Hämmerle CH, Held U, Jung RE. Efficacy of soft tissue augmentation around dental implants and in partially edentulous areas: a systematic review. J Clin Periodontol 2014; 41 Suppl 15:S77-91. [DOI: 10.1111/jcpe.12220] [Citation(s) in RCA: 158] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Borvornwut Buranawat
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ulrike Held
- Horten Centre for Patient Oriented Research and Knowledge Transfer; University Hospital Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Kaufman JJ, Ottman R, Tao G, Shabahang S, Banaei EH, Liang X, Johnson SG, Fink Y, Chakrabarti R, Abouraddy AF. In-fiber production of polymeric particles for biosensing and encapsulation. Proc Natl Acad Sci U S A 2013; 110:15549-54. [PMID: 24019468 PMCID: PMC3785740 DOI: 10.1073/pnas.1310214110] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Polymeric micro- and nanoparticles are becoming a mainstay in biomedicine, medical diagnostics, and therapeutics, where they are used in implementing sensing mechanisms, as imaging contrast agents, and in drug delivery. Current approaches to the fabrication of such particles are typically finely tuned to specific monomer or polymer species, size ranges, and structures. We present a general scalable methodology for fabricating uniformly sized spherical polymeric particles from a wide range of polymers produced with complex internal architectures and continuously tunable diameters extending from the millimeter scale down to 50 nm. Controllable access to such a wide range of sizes enables broad applications in cancer treatment, immunology, and vaccines. Our approach harnesses thermally induced, predictable fluid instabilities in composite core/cladding polymer fibers drawn from a macroscopic scaled-up model called a "preform." Through a stack-and-draw process, we produce fibers containing a multiplicity of identical cylindrical cores made of the polymers of choice embedded in a polymer cladding. The instability leads to the breakup of the initially intact cores, independent of the polymer chemistry, into necklaces of spherical particles held in isolation within the cladding matrix along the entire fiber length. We demonstrate here surface functionalization of the extracted particles for biodetection through specific protein-protein interactions, volumetric encapsulation of a biomaterial in spherical polymeric shells, and the combination of both surface and volumetric functionalities in the same particle. These particles used in distinct modalities may be produced from the desired biocompatible polymer by changing only the geometry of the macroscopic preform from which the fiber is drawn.
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Affiliation(s)
- Joshua J. Kaufman
- Center for Research and Education in Optics and Lasers (CREOL), The College of Optics and Photonics
| | - Richard Ottman
- Burnett School of Biomedical Sciences, College of Medicine, and
| | - Guangming Tao
- Center for Research and Education in Optics and Lasers (CREOL), The College of Optics and Photonics
| | - Soroush Shabahang
- Center for Research and Education in Optics and Lasers (CREOL), The College of Optics and Photonics
| | - Esmaeil-Hooman Banaei
- Department of Electrical Engineering and Computer Science, University of Central Florida, Orlando, FL 32816; and
| | | | | | - Yoel Fink
- Materials Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139
| | | | - Ayman F. Abouraddy
- Center for Research and Education in Optics and Lasers (CREOL), The College of Optics and Photonics
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Abou Neel EA, Bozec L, Knowles JC, Syed O, Mudera V, Day R, Hyun JK. Collagen--emerging collagen based therapies hit the patient. Adv Drug Deliv Rev 2013; 65:429-56. [PMID: 22960357 DOI: 10.1016/j.addr.2012.08.010] [Citation(s) in RCA: 190] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 08/10/2012] [Accepted: 08/28/2012] [Indexed: 12/11/2022]
Abstract
The choice of biomaterials available for regenerative medicine continues to grow rapidly, with new materials often claiming advantages over the short-comings of those already in existence. Going back to nature, collagen is one of the most abundant proteins in mammals and its role is essential to our way of life. It can therefore be obtained from many sources including porcine, bovine, equine or human and offer a great promise as a biomimetic scaffold for regenerative medicine. Using naturally derived collagen, extracellular matrices (ECMs), as surgical materials have become established practice for a number of years. For clinical use the goal has been to preserve as much of the composition and structure of the ECM as possible without adverse effects to the recipient. This review will therefore cover in-depth both naturally and synthetically produced collagen matrices. Furthermore the production of more sophisticated three dimensional collagen scaffolds that provide cues at nano-, micro- and meso-scale for molecules, cells, proteins and bulk fluids by inducing fibrils alignments, embossing and layered configuration through the application of plastic compression technology will be discussed in details. This review will also shed light on both naturally and synthetically derived collagen products that have been available in the market for several purposes including neural repair, as cosmetic for the treatment of dermatologic defects, haemostatic agents, mucosal wound dressing and guided bone regeneration membrane. There are other several potential applications of collagen still under investigations and they are also covered in this review.
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Ettlin DA, Hitz T, Ramel C, Meier ML, Roos M, Gallo LM, Svensson P, Hämmerle CH. Quantitative sensory testing of intraoral open wounds. Int J Oral Maxillofac Surg 2012; 42:401-5. [PMID: 23238026 DOI: 10.1016/j.ijom.2012.11.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 10/08/2012] [Accepted: 11/12/2012] [Indexed: 11/26/2022]
Abstract
Wound healing is an important aspect of oral and maxillofacial surgery. Positive sensory signs (allodynia, hyperalgesia) and negative sensory signs (hypoesthesia, hypoalgesia) may be encountered. Quantitative sensory testing (QST) has moved from bench to bedside for the detection, therapy selection and monitoring the recovery of individuals with sensory disturbances. Tracking somatosensory changes during normal and abnormal wound healing has not previously been reported. This report presents data obtained by a novel, automated, non-contact psychophysical method for assessment of wound sensitivity after standardized oral mucosal biopsy. By directing graded air puffs towards palatal biopsy wounds, thresholds for sensory detection, pain detection and pain tolerance were repeatedly assessed across 19 days, demonstrating high reliability. Participants recorded daily spontaneous and chewing-evoked maximum pains. Pain detection and tolerance thresholds increased linearly across time. Comparison between air puff evoked pain detection threshold and chewing-evoked pain demonstrated a strong correlation. Thus, for the first time, this study tracked the time course of somatosensory sensitivity of wounds induced by oral biopsies. The psychophysical data on wound healing obtained by this automated, contact-free stimulation method can be utilized as a surrogate marker for clinical pain improvements and standardized assessment of intraoral pain sensitivity, for example in oral mucositis.
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Affiliation(s)
- D A Ettlin
- University of Zurich, Center of Dental Medicine, Clinic of Masticatory Dysorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Zurich, Switzerland.
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Schwarz F, Mihatovic I, Shirakata Y, Becker J, Bosshardt D, Sculean A. Treatment of soft tissue recessions at titanium implants using a resorbable collagen matrix: a pilot study. Clin Oral Implants Res 2012; 25:110-5. [DOI: 10.1111/clr.12042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Frank Schwarz
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf Germany
| | - Ilja Mihatovic
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf Germany
| | - Yoshinori Shirakata
- Department of Periodontology; University of Berne; Berne Switzerland
- Department of Periodontology; Kagoshima University Graduate School of Medical and Dental Sciences; Kagoshima Japan
| | - Jürgen Becker
- Department of Oral Surgery; Heinrich Heine University; Düsseldorf Germany
| | - Dieter Bosshardt
- Department of Periodontology; University of Berne; Berne Switzerland
- Department of Oral Surgery and Stomatology; University of Berne; Berne Switzerland
| | - Anton Sculean
- Department of Periodontology; University of Berne; Berne Switzerland
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Jepsen K, Jepsen S, Zucchelli G, Stefanini M, de Sanctis M, Baldini N, Greven B, Heinz B, Wennström J, Cassel B, Vignoletti F, Sanz M. Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial. J Clin Periodontol 2012; 40:82-9. [PMID: 23050490 DOI: 10.1111/jcpe.12019] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2012] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized recession defects. MATERIAL & METHODS In a multicentre single-blinded, randomized, controlled, split-mouth trial, 90 recessions (Miller I, II) in 45 patients received either CAF + CM or CAF alone. RESULTS At 6 months, root coverage (primary outcome) was 75.29% for test and 72.66% for control defects (p = 0.169), with 36% of test and 31% of control defects exhibiting complete coverage. The increase in mean width of keratinized tissue (KT) was higher in test (from 1.97 to 2.90 mm) than in control defects (from 2.00 to 2.57 mm) (p = 0.036). Likewise, test sites had more gain in gingival thickness (GT) (0.59 mm) than control sites (0.34 mm) (p = 0.003). Larger (≥3 mm) recessions (n = 35 patients) treated with CM showed higher root coverage (72.03% versus 66.16%, p = 0.043), as well as more gain in KT and GT. CONCLUSIONS CAF + CM was not superior with regard to root coverage, but enhanced gingival thickness and width of keratinized tissue when compared with CAF alone. For the coverage of larger defects, CAF + CM was more effective.
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Affiliation(s)
- Karin Jepsen
- Department of Periodontology, University of Bonn, Bonn, Germany.
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