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Sohn DS, Lui A, Choi H. Utilization of Tenting Pole Abutments for the Reconstruction of Severely Resorbed Alveolar Bone: Technical Considerations and Case Series Reports. J Clin Med 2024; 13:1156. [PMID: 38398468 PMCID: PMC10889334 DOI: 10.3390/jcm13041156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/18/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Although various surgical techniques have been utilized in the reconstruction of severely resorbed alveolar bone, its regeneration is still regarded as a major challenge. Most of the surgical techniques used in advanced ridge augmentation have the disadvantages of prolonging the patient's edentulous healing and increasing the need for surgical revisits because simultaneous implant placement is not allowed. This report presents a new and simplified method for advanced ridge augmentation, which utilizes a vertical tenting device. CASE PRESENTATION The first case presented the reconstruction of the mandibular posterior region with severely resorbed alveolar bone due to peri-implantitis using tenting pole abutment for ridge augmentation. The second and third cases presented three-dimensional ridge augmentations in severely resorbed ridges due to periodontitis. The last case presented horizontal ridge augmentation using a vertical tenting device. All cases were performed under local anesthesia. Implants were simultaneously placed in the bone defect area. A vertical tensioning device was then connected to the implant platform to minimize the collapse of the bone graft during the bone regeneration period due to the contraction of the soft tissue matrix. A sticky bone graft was transplanted onto the exposed surface of the implant and on top of the vertical tensioning device. After covering with an absorbable barrier membrane, the soft tissues were sutured without tension. CONCLUSIONS In all cases, prosthetic restorations were provided to patients after a bone grafting period of 5-6 months, leading to a rapid restoration of masticatory function. Results tracked for up to 6 years revealed observed stable reconstruction of the alveolar bone. The use of a vertical tenting device can prevent the collapse of biomaterials in the augmented ridge during the healing period, leading to predictable outcomes when achieving three-dimensional ridge augmentation.
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Affiliation(s)
- Dong-Seok Sohn
- Department of Dentistry and Oral and Maxillofacial Surgery, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea
| | - Albert Lui
- Private Practice, Calgary, AB T2P 2Y3, Canada;
| | - Hyunsuk Choi
- Department of Dentistry and Prosthodontics, Daegu Catholic University School of Medicine, Daegu 42472, Republic of Korea;
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Abdullrahman F, Assad M, Albash Z. Tent-pole technique for alveolar ridge width preservation with a compromised buccal plate: a prospective cohort study. Ann Med Surg (Lond) 2023; 85:5344-5349. [PMID: 37915712 PMCID: PMC10617838 DOI: 10.1097/ms9.0000000000001312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives The aim of this study was to assess the effectiveness of the tent-pole technique for alveolar ridge preservation of compromised alveolar socket following the surgical extraction of incurable single root premolars. Materials and methods This study was conducted on 12 patients who presented to the department of oral and maxillofacial surgery and had alveolar ridge preservation using tent-pole technique between August 2021 and February 2022. The alveolar ridge width was analyzed using cone beam computed tomography scans taken preoperative and 6 months postoperative. Statistical analysis was performed to assess the alveolar ridge width at different levels. The alveolar ridge width differences between periods were assessed with paired t-test. The comparison of alveolar ridge width loss according to jaw, sex, and different levels were done with unpaired t-test. The level of significance considered was 5% (α=0.05). Results The mean alveolar ridge width before surgery was 10.03 mm. After 6 months, the mean alveolar ridge width was 8.4 mm. The range of alveolar ridge width loss was between 0.6 and 3.22 mm with a mean of 1.63 (16.25%). There was no statistically significant difference in width loss between the maxilla and mandibular whether in males or females. Alveolar bone width loss was the greatest at W1 level (26.8%). Conclusion According to the results of this study, the authors conclude that the tent-pole technique could preserve the alveolar bone ridge width without bone graft materials.
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Affiliation(s)
| | | | - Ziad Albash
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria
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Lee C, Kim S, Kim J, Namgung D, Kim K, Ku Y. Supplemental periodontal regeneration by vertical ridge augmentation around dental implants. A preclinical in vivo experimental study. Clin Oral Implants Res 2019; 30:1118-1125. [PMID: 31436866 DOI: 10.1111/clr.13525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the supplemental periodontal regeneration on adjacent teeth by vertical ridge augmentation around dental implants. MATERIAL AND METHODS The second premolar and the fourth premolar were extracted from both sides of the mandible in four beagle dogs. After 2 months, defects of 3 mm and 5 mm deep were formed. In the test group, vertical ridge augmentation was performed around a dental implant, and in the control group, vertical ridge augmentation was performed without implant placement. The animals were euthanized 3 months after the procedure, and radiographic and histomorphometric analyses were performed. RESULTS Overall, the test group showed better results than the control group. The presence of new cementum in the histological examination of the test group confirmed that vertical ridge augmentation with proper space maintaining could contribute to periodontal regeneration of adjacent teeth. Statistically significant difference in new bone height (%) was found in group I (5-mm defect depth and implant placement, GBR) when compared with group III (5-mm defect depth, GBR) and IV (3-mm defect depth, GBR). New bone area (%) was statistically different between groups I and IV. CONCLUSIONS In conclusion, within the limitation of this study using mandibular residual ridges after extraction of a single tooth in dogs, grafted space was maintained by dental implants better in the deep defect (5-mm depth) than the shallow defect (3-mm depth). Vertical ridge augmentation around dental implants also promoted neighboring periodontal regeneration.
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Affiliation(s)
- Changseok Lee
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Sungtae Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Junhwan Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Dajeong Namgung
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Kyounghwa Kim
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
| | - Young Ku
- Department of Periodontology, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea
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Liu J, Lu Y, Liu J, Jin C, Meng Y, Pei D. Influence of epigallocatechin-3-gallate in promoting proliferation and osteogenic differentiation of human periodontal ligament cells. BMC Oral Health 2019; 19:73. [PMID: 31046751 PMCID: PMC6498622 DOI: 10.1186/s12903-019-0768-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 04/16/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Epigallocatechin-3-gallate (EGCG) was recently proposed to have the potential to regulate bone metabolism, however, its influence on osteogenesis remains controversial. The present study aimed to investigate the effects of EGCG on the proliferation and osteogenesis of human periodontal ligament cells (hPDLCs). METHODS Cells were cultured in osteogenic medium and treated with EGCG at various concentrations. Cell proliferation was analyzed using a CCK-8 assay and acridine orange (AO)/ethidium bromide (EB) staining. Flow cytometry was used to measure the intracellular reactive oxygen species (ROS) potential of hPDLCs. The expression levels of osteogenic marker genes and proteins in hPDLCs, including type I collagen (COL1), runt-related transcription factor 2 (RUNX2), osteopontin (OPN), and osterix (OSX), were determined by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot analysis. In addition, alkaline phosphatase (ALP) activity was monitored both quantitatively and qualitatively. Extracellular matrix mineralization was further analyzed by alizarin red S staining. RESULTS The results showed that EGCG concentrations from 6 to 10 μM increased the ROS level and inhibited the cell proliferation of hPDLCs. EGCG concentrations from 2 to 8 μM effectively increased extracellular matrix mineralization, in which 4 and 6 μM EGCG generated the most mineralizing nodules. The ALP activity and the mRNA and protein expression levels of the tested osteogenic markers were most strongly up-regulated by treatment with 4 and 6 μM EGCG. CONCLUSIONS The present study demonstrated that EGCG might promote the osteogenesis of hPDLCs in a dose-dependent manner, with concentrations of 4 and 6 μM EGCG showing the strongest osteogenic enhancement without cytotoxicity, indicating a promising role for EGCG in periodontal regeneration in patients with deficient alveolar bone in the future.
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Affiliation(s)
- Jie Liu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, Shaanxi, China
| | - Yi Lu
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Jin Liu
- Department of Periodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Changxiong Jin
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Yuchen Meng
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Dandan Pei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China. .,Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University, 98 Xiwu Road, Xi'an, 710004, Shaanxi, China.
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Osterne RLV, Nogueira RLM, Abreu RT, Cavalcante RB, Medeiros ÉA, Mello MDJR. A retrospective study of an alternative technique for implant repositioning in the maxillary esthetic region. Clin Implant Dent Relat Res 2018; 20:915-922. [PMID: 30230678 DOI: 10.1111/cid.12663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 06/06/2018] [Accepted: 07/12/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Implant-bone block segment repositioning may be an option of treatment for patients with vertical alveolar bone atrophy. PURPOSE To assess implant-bone block movement, gingival outcome and the subjective appreciation of patients after an alternative treatment of an implant-bone block segment repositioning in the maxillary esthetic region. MATERIALS AND METHODS Patients who underwent implant-bone block segment relocation in areas of vertical alveolar bone atrophy in the anterior esthetic region were assessed. The outcome measures were implant failure, complications after initial loading, vertical bone augmentation, papilla index, width of the keratinized mucosa, and patient satisfaction. RESULTS Twenty-five implants in nine consecutive patients were included in this study. During the follow-up period, only one implant failed. Vertical bone augmentation ranged from 3.0 to 8.4 mm (mean 4.9 mm). A significant improvement (P < .001) in the papilla index was observed, improving the esthetic outcome. Six patients (66.6%) had more than 2 mm of keratinized mucosa and all of the patients were satisfied with the treatment. CONCLUSIONS The esthetics and functional gingival outcome of oral rehabilitation in areas with vertical alveolar bone atrophy can be successfully improved with the presented technique, which had a high overall implant survival rate within a short period.
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Affiliation(s)
- Rafael Lima Verde Osterne
- Department of Pathology, University of Fortaleza/Universidade de Fortaleza, School of Medicine, Fortaleza, Ceará, Brazil
| | - Renato Luiz Maia Nogueira
- Department of Dental Clinic, Discipline of Oral and Maxillofacial Surgery and Stomatology, Federal University of Ceará, School of Dentistry, Fortaleza, Ceará, Brazil.,Department of Oral and Maxillofacial Surgery, Memorial Batista Hospital, Fortaleza, Ceará, Brazil
| | | | - Roberta Barroso Cavalcante
- Department of Oral Pathology, University of Fortaleza/Universidade de Fortaleza, School of Dentistry, Fortaleza, Ceará, Brazil
| | | | - Manoel de Jesus Rodrigues Mello
- Department of Oral and Maxillofacil Surgery, School of Dentistry, Christus University Center (Centro Universitário Christus), Fortaleza, Ceará, Brazil.,Federal University of Ceara School of Dentistry, Fortaleza, Ceará, Brazil
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Rocchietta I, Ferrantino L, Simion M. Vertical ridge augmentation in the esthetic zone. Periodontol 2000 2018; 77:241-255. [DOI: 10.1111/prd.12218] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Park SA, Lee HJ, Kim KS, Lee SJ, Lee JT, Kim SY, Chang NH, Park SY. In Vivo Evaluation of 3D-Printed Polycaprolactone Scaffold Implantation Combined with β-TCP Powder for Alveolar Bone Augmentation in a Beagle Defect Model. MATERIALS 2018; 11:ma11020238. [PMID: 29401707 PMCID: PMC5848935 DOI: 10.3390/ma11020238] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/20/2018] [Accepted: 01/31/2018] [Indexed: 01/10/2023]
Abstract
Insufficient bone volume is one of the major challenges encountered by dentists after dental implant placement. This study aimed to evaluate the efficacy of a customized three-dimensional polycaprolactone (3D PCL) scaffold implant fabricated with a 3D bio-printing system to facilitate rapid alveolar bone regeneration. Saddle-type bone defects were surgically created on the healed site after extracting premolars from the mandibles of four beagle dogs. The defects were radiologically examined using computed tomography for designing a customized 3D PCL scaffold block to fit the defect site. After fabricating 3D PCL scaffolds using rapid prototyping, the scaffolds were implanted into the alveolar bone defects along with β-tricalcium phosphate powder. In vivo analysis showed that the PCL blocks maintained the physical space and bone conductivity around the defects. In addition, no inflammatory infiltrates were observed around the scaffolds. However, new bone formation occurred adjacent to the scaffolds, rather than directly in contact with them. More new bone was observed around PCL blocks with 400/1200 lattices than around blocks with 400/400 lattices, but the difference was not significant. These results indicated the potential of 3D-printed porous PCL scaffolds to promote alveolar bone regeneration for defect healing in dentistry.
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Affiliation(s)
- Su A Park
- Department of Nature-Inspired Nanoconvergence Systems, Korea Institute of Machinery and Materials, Daejeon 34103, Korea.
| | - Hyo-Jung Lee
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea.
| | - Keun-Suh Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea.
| | - Sang Jin Lee
- Department of Nature-Inspired Nanoconvergence Systems, Korea Institute of Machinery and Materials, Daejeon 34103, Korea.
| | - Jung-Tae Lee
- Department of Periodontology, Dankook University, Yongin-si 16890, Korea.
| | - Sung-Yeol Kim
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea.
| | - Na-Hee Chang
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea.
| | - Shin-Young Park
- Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam-si 13620, Korea.
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Pourdanesh F, Esmaeelinejad M, Aghdashi F. Clinical outcomes of dental implants after use of tenting for bony augmentation: a systematic review. Br J Oral Maxillofac Surg 2017; 55:999-1007. [DOI: 10.1016/j.bjoms.2017.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 10/30/2017] [Indexed: 12/16/2022]
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Daga D, Mehrotra D, Mohammad S, Chandra S, Singh G, Mehrotra D. Tentpole technique for bone regeneration in vertically deficient alveolar ridges: A prospective study. J Oral Biol Craniofac Res 2017; 8:20-24. [PMID: 29556458 DOI: 10.1016/j.jobcr.2017.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 11/06/2017] [Accepted: 11/09/2017] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of the study was to qualitatively and quantitatively assess bone regeneration potential of tentpole technique using beta tricalcium phosphate bone graft in vertically deficient alveolar ridges. Materials and Method This prospective study comprised of 20 patients with vertically deficient alveolar ridges, wherein thirty one implants were placed. Tenting of the soft tissue matrix was done using titanium screws and beta tricalcium phosphate synthetic bone graft was filled in the vertical defect. Clinical and radiographic assessment was done at 1, 3 and 6 months. Preoperative biochemical analysis of Osteopontin and RANKL was done and then reassesed at 3 months postoperative. Bone core collected at 6 postoperative months, while removal of screw, was analysed histologically. Results A significant gain in bone height of 2.87 ± 0.79 mm was seen at 6 months postoperative. All implants osseointegrated. Loosening of screw was seen in two patients.There was no postoperative wound dehiscence. Histologic analysis revealed new bone formation .There was no significant change in the levels of RANKL and Osteopontin at 3 months postoperative. Conclusion This is a safe and effective technique for bone regeneration in vertically deficient alveolar ridges and has minimal complications. The regenerated bone has new and viable bone content and supports implant material. More studies with long term follow up are needed to assess the stability of bone after long term loading.
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Affiliation(s)
- Dipti Daga
- Department of Oral and maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Divya Mehrotra
- Department of Oral and maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Shadab Mohammad
- Department of Oral and maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Shaleen Chandra
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, India
| | - Geeta Singh
- Department of Oral and maxillofacial Surgery, King George's Medical University, Lucknow, India
| | - Divya Mehrotra
- Department of Oral and maxillofacial Surgery, King George's Medical University, Lucknow, India
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Schorn L, Sproll C, Ommerborn M, Naujoks C, Kübler NR, Depprich R. Vertical bone regeneration using rhBMP-2 and VEGF. Head Face Med 2017; 13:11. [PMID: 28592312 PMCID: PMC5463342 DOI: 10.1186/s13005-017-0146-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/29/2017] [Indexed: 11/25/2022] Open
Abstract
Background Sufficient vertical and lateral bone supply and a competent osteogenic healing process are prerequisities for the successful osseointegration of dental implants in the alveolar bone. Several techniques including autologous bone grafts and guided bone regeneration are applied to improve quality and quantity of bone at the implantation site. Depending on the amount of lacking bone one- or two-stage procedures are required. Vertical bone augmentation has proven to be a challenge particularly in terms of bone volume stability. This study focuses on the three dimensional vertical bone generation in a one stage procedure in vivo. Therefore, a collagenous disc-shaped scaffold (ICBM = Insoluble Collagenous Bone Matrix) containing rhBMP-2 (Bone Morphogenetic Protein-2) and/or VEGF (Vascular Endothelial Growth Factor) was applied around the coronal part of a dental implant during insertion. RhBMP-2 and VEGF released directly at the implantation site were assumed to induce the generation of new vertical bone around the implant. Methods One hundred eight titanium implants were inserted into the mandible and the tibia of 12 mini pigs. Four experimental groups were formed: Control group, ICBM, ICBM + BMP-2, and ICBM + BMP-2 + VEGF. After 1, 4 and 12 weeks the animals were sacrificed and bone generation was investigated histologically and histomorphometrically. Results After 12 weeks the combination of ICBM + rhBMP2 + VEGF showed significantly more bone volume density (BVD%), a higher vertical bone gain (VBG) and more vertical bone gain around the implant (PVBG) in comparison to the control group. Conclusion By using collagenous disc-shaped matrices in combination with rhBMP-2 and VEGF vertical bone can be generated in a one stage procedure without donor site morbidity. The results of the presenting study suggest that the combination of rhBMP-2 and VEGF applied locally by using a collagenous carrier improves vertical bone generation in vivo. Further research is needed to establish whether this technique is applicable in clinical routines.
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Affiliation(s)
- Lara Schorn
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Christoph Sproll
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
| | - Michelle Ommerborn
- Department of Operative and Preventive Dentistry and Endodontics, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, Duesseldorf, 40225, Germany
| | - Christian Naujoks
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Norbert R Kübler
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
| | - Rita Depprich
- Department of Oral-, Maxillo- and Plastic Facial Surgery, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany
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