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Monje A, Roccuzzo A, Buser D, Wang HL. Influence of buccal bone wall thickness on the peri-implant hard and soft tissue dimensional changes: A systematic review. Clin Oral Implants Res 2023; 34 Suppl 26:8-27. [PMID: 37750522 DOI: 10.1111/clr.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 09/27/2023]
Abstract
BACKGROUND The significance on the association between the peri-implant bucco-lingual dimension (BLD) at the stage of implant placement and the occurrence of biological and esthetic complications is yet unknown. MATERIAL AND METHODS Systematic screening of electronic sources was carried out to identify clinical and preclinical studies reporting on the baseline BLD and/or buccal bone thickness (BBT) values. A secondary objective was to assess the effect of simultaneous grafting at sites with deficient or no buccal bone wall (BBW) at baseline. The primary outcome variables were BBT, BLD, and buccal vertical bone loss (VBL) at re-evaluation. Moreover, radiographic, clinical, and patient-reported outcome measures (PROMs) were evaluated. RESULTS Overall, 12 clinical and four preclinical studies met the inclusion criteria. Inconsistencies were found in defining the critical BBT across the clinical and preclinical data evaluated. The clinical evidence demonstrated that during healing, dimensional changes occur in the alveolar bone and in the BBW that may compromise the integrity of the peri-implant bone, leading to VBL and mucosal recession (MR), particularly in scenarios exhibiting a thin BBW. The preclinical evidence validated the fact that implants placed in the presence of a thin BBW, are more prone to exhibit major dimensional changes and VBL. Moreover, the clinical data supported that, in scenarios where dehiscence-type defects occur and are left for spontaneous healing, greater VBL and MR together with the occurrence of biologic complications are expected. Furthermore, the augmentation of dehiscence-type defects is associated with hard and soft tissue stability. PROMs were not reported. CONCLUSIONS Dimensional changes occur as result of implant placement in healed ridges that may lead to instability of the peri-implant hard and soft tissues. Sites presenting a thin BBW are more prone to exhibit major changes that may compromise the integrity of the buccal bone and may lead to biologic and esthetic complications.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Oral Maxillofacial Surgery, Copenaghen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Monje A, Roccuzzo A, Buser D, Wang HL. Significance of buccal bone wall thickness on the fate of peri-implant hard and soft tissues: A systematic review. Clin Oral Implants Res 2023; 34:157-176. [PMID: 36626118 DOI: 10.1111/clr.14029] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The significance of the association between the peri-implant buccolingual dimension (BLD) at the stage of implant placement and the occurrence of biological and esthetic complications is yet unknown. MATERIAL AND METHODS Systematic screening of electronic sources was carried out to identify clinical and preclinical studies reporting on the baseline BLD and/or buccal bone thickness (BBT) values. A secondary objective was to assess the effect of simultaneous grafting at sites with deficient or no buccal bone wall (BBW) at baseline. The primary outcome variables were BBT, BLD, and vertical bone loss (VBL) at re-evaluation. Moreover, radiographic, clinical- and patient-reported outcome measures (PROMs) were evaluated. RESULTS Overall, 12 clinical and four preclinical studies met the inclusion criteria. The clinical evidence demonstrated that during healing, dimensional changes occur in the alveolar bone and in the BBW that may compromise the integrity of bone around a dental implant. The preclinical evidence validated the fact that implants placed in the presence of thin BBW are more prone to exhibit major dimensional changes. Moreover, the clinical and preclinical data supported that in scenarios where dehiscence-type defects are left for spontaneous healing, greater VBL and mucosal recession (MR) together with the occurrence of biologic complications are expected. Furthermore, the augmentation of dehiscence-type defects is associated with hard and soft tissue stability. CONCLUSIONS Dimensional changes occur as a result of implant placement in healed ridges that may lead to VBL and MR. Thin BBW (≲2 mm) are prone to exhibit major postchanges that may compromise the integrity of the buccal bone, biologic and esthetic complications.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.,Department of Periodontology, University of Bern, Bern, Switzerland
| | - Andrea Roccuzzo
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Donati M, Noelken R, Fiorellini J, Gellrich NC, Parker W, Berglundh T. Implants placed in an alveolar ridge with a sloped configuration. A 3-year prospective multicenter study. Clin Oral Implants Res 2023; 34:13-19. [PMID: 36245313 PMCID: PMC10092546 DOI: 10.1111/clr.14012] [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: 05/25/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 01/11/2023]
Abstract
AIM The aim of the present study was to evaluate soft and hard tissue alterations around implants with a modified marginal portion placed in a healed, sloped ridge over 3 years of follow-up. MATERIAL AND METHODS 65 patients with a single recipient implant site in an alveolar ridge with a lingual-buccal sloped configuration were recruited. Implants with a modified geometry in the marginal portion were installed in such a way that the sloped part of the device was located at the buccal and most apical position of the osteotomy preparation. Crowns were placed 21 weeks after implant placement. Radiologic examinations were performed at implant installation and at 1 and 3 years of follow-up. Bleeding on probing (BoP), probing pocket depth (PPD), and clinical attachment level (CAL; from the crown margin) were recorded at the insertion of the prosthesis and after 1 and 3 years. RESULTS 57 patients with 57 implant-supported restorations attended the 3 years follow-up examination. The radiographic analysis revealed a mean marginal bone loss of 0.57 mm during the 3 years period. While the average bone loss between 1 and 3 years amounted to 0.30 mm, approximately 50% of the implants showed no bone loss during this period. The results from the clinical examinations showed a CAL gain of 0.11 ± 0.85 mm between baseline and 3 years of follow-up. About 65% of the implants showed no loss of attachment between 1 and 3 years. BoP and PPD ≥5 mm were identified at <10% of implants at the 3 years examination. CONCLUSION Hard and soft tissues formed around dental implants that were designed to match the morphology of an alveolar ridge with a lingual-buccal sloped configuration remained stable over 3 years.
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Affiliation(s)
- Mauro Donati
- Private Practice, Perugia, Italy.,Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Robert Noelken
- Private Practice, Lindau/Lake Constance & Department of Oral & Maxillofacial Surgery, University of Mainz, Mainz, Germany
| | | | | | - William Parker
- Nova Southeastern University, Fort Lauderdale, Florida, USA
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Galve-Huertas A, Zilleruelo-Pozo MJ, García-González S, Ortíz-Puigpelat O, Hernández-Alfaro F, Aboul-Hosn Centenero S. Clinical Evidence on a Novel Macrohybrid Design Dental Implant with 12° Angled Platform: A Systematic Review. MATERIALS 2022; 15:ma15145011. [PMID: 35888482 PMCID: PMC9322499 DOI: 10.3390/ma15145011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022]
Abstract
Background: Immediate implant placement with immediate esthetics has become a more common procedure over time, though ensuring good emergence of the axis of the implant has been a challenge. A novel macroimplant design with an angled platform (Co-Axis®) has been developed to ensure exit of the head of the implant in the correct prosthetic position. A systematic literature review was carried to determine the survival rate and marginal bone loss associated with these implants. Material and Methods: An electronic and manual literature search was made in accordance with the PRISMA statement. The search strategy was limited to human studies, retrospective and prospective clinical trials, cross-sectional studies, and cohort studies reporting outcomes of a novel macrohybrid implant with a 12° angled implant connection. Results: Three articles met the inclusion criteria and were reviewed in the analysis. The estimated success rate was 95.9%. The global marginal bone loss was estimated to be −0.17 ± 0.58 mm in an environment characterized by great heterogeneity (I2 = 99%). The estimated mean implant stability was 69.6 ± 0.92 (ISQ). As only two studies provided the required information, it was not possible to determine publication bias. Lastly, mean recession was estimated to be practically zero (0.06 ± 0.23 mm), with great heterogeneity. Conclusions: Within the limitations of this systematic review, it can be affirmed that immediate implant treatment with Co-Axis® implants shows a survival rate of 95.9% at one year of follow-up, with low marginal bone loss values, near-zero soft tissue recession, and favorable papilla index values. Nevertheless, the great heterogeneity of the data requires the findings to be interpreted with caution.
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Affiliation(s)
- Andrea Galve-Huertas
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
- Correspondence:
| | - Maria José Zilleruelo-Pozo
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
| | - Susana García-González
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
| | - Octavi Ortíz-Puigpelat
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
| | - Samir Aboul-Hosn Centenero
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya, 08017 Barcelona, Spain; (M.J.Z.-P.); (S.G.-G.); (O.O.-P.); (F.H.-A.); (S.A.-H.C.)
- Staff Member of the Oral and Maxillofacial Surgery Department, Hospital Clinic de Barcelona, 08036 Barcelona, Spain
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Tu CC, Wang SH, Hu CY, Chen MH, Hsieh O, Chang PC. Comparison of regular- and slope-configured dental implants placed in the edentulous ridge with height discrepancy: A pilot randomized controlled trial. J Formos Med Assoc 2020; 120:1386-1393. [PMID: 33162294 DOI: 10.1016/j.jfma.2020.10.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/PURPOSE Edentulous ridges with height discrepancies (RHDs) could jeopardize the outcome of implant placement. This study aimed at evaluating the outcomes of placing regular- and slope-configured implants in RHDs. METHODS Patients with >1 mm RHDs requesting implant rehabilitation were recruited and randomly assigned to regular- (control) or slope-configured (test) implant treatment using a submerged installation protocol. Thread exposure (TE) and implant stability quotient (ISQ) were evaluated during implant installation (S1) and uncovered surgery (S2), and marginal bone level (MBL) was evaluated after implant installation (T1) and uncovery (T3), and one year after implant placement (T4). Periodontal status and gingival crevicular fluid (GCF) biomarkers of adjacent teeth were evaluated before implant installation (T0), before uncovery (T2), and at T4. Peri-implant clinical status and peri-implant crevicular fluid (PICF) biomarkers of examined implants were evaluated at T4. RESULTS Nineteen patients with 17 control and 13 test implants were included. All of the implants survived with acceptable peri-implant health, and PICF biomarkers were at equivalent levels as GCF biomarkers of the adjacent teeth at T4. Compared with the control group, the test group showed reduced TE and equivalent ISQ at S1 and S2, and the loss of MBL was reduced at T4. Regarding the adjacent teeth, all periodontal parameters and GCF biomarkers were slightly decreased from T0 to T2, and the reductions in probing pocket depth and clinical attachment level were slightly greater at T4. CONCLUSION Slope-configured implants maintained the implant-supporting structures and minimally altered periodontal status of the adjacent teeth in RHDs.
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Affiliation(s)
- Che-Chang Tu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Szu-Han Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chia-Yuan Hu
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Olivia Hsieh
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | - Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Survival and Success Rates of Different Shoulder Designs: A Systematic Review of the Literature. Int J Dent 2018; 2018:6812875. [PMID: 29853895 PMCID: PMC5944269 DOI: 10.1155/2018/6812875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 03/01/2018] [Indexed: 01/12/2023] Open
Abstract
Objectives To identify whether there is a relationship between different implant shoulder positions/orientations/designs and prosthetic and/or implant failures, biological or mechanical complications, radiographic marginal bone loss (MBL), peri-implant buccal recession (RC), aesthetic scores (Papilla Index, PES, and WES), and patient satisfaction after a minimum of 1 year function in the aesthetic zone, compared to the two-piece, conventional implant neck architecture. Materials and Methods The systematic review was written according to the PRISMA guidelines. The search strategy encompassed the English literature from 1967 to September 2016 and was performed online (in the PubMed database of the U.S. National Library of Medicine, Embase, and the Cochrane Library) to identify relevant studies that met the inclusion criteria. The assessment of quality and risk of bias of the selected manuscripts was performed according to the guidelines provided by CONSORT and STROBE statements. Results A total of 16 articles (7 randomized controlled trials, 4 observational comparative studies, and 5 systematic reviews) were selected to fulfill the inclusion criteria. A trend of higher implant failure and prosthetic complications were experienced in the one-piece group compared to the two-piece group, although no statistically significant differences were found. Higher marginal bone loss was found in the test group (one-piece, scalloped implants) compared to the control group (two-piece, flat implants). No comparative studies reporting data on sloped implants were found that fulfilled the inclusion and exclusion criteria of this systematic review. No differences were experienced between groups regarding aesthetic outcomes and patient satisfaction. Conclusions There was sufficient evidence that different implant shoulder positions/orientations/designs (scalloped, sloped, and one piece) offer no benefit when compared to two-piece, conventional flat implants. Current evidence is limited due to the quality of available studies.
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Rojas-Vizcaya F, Zadeh HH. Minimizing the discrepancy between implant platform and alveolar bone for tilted implants with a sloped implant platform: A clinical report. J Prosthet Dent 2017; 119:319-324. [PMID: 28652075 DOI: 10.1016/j.prosdent.2017.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 04/04/2017] [Accepted: 04/04/2017] [Indexed: 10/19/2022]
Abstract
In a patient with edentulism, distally tilted implants with a novel sloped implant platform were used to minimize the discrepancy between the implant platform and alveolar bone crest and to restore complete-arch monolithic zirconia implant-supported fixed prostheses.
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Affiliation(s)
- Fernando Rojas-Vizcaya
- Adjunct Assistant Professor, Department of Prosthodontics, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC. and Director, Mediterranean Prosthodontic Institute, Castellon, Spain.
| | - Homayoun H Zadeh
- Associate Professor and Director, Post-Doctoral Periodontology Program, Laboratory for Immunoregulation and Tissue Engineering, Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif
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Schiegnitz E, Noelken R, Moergel M, Berres M, Wagner W. Survival and tissue maintenance of an implant with a sloped configurated shoulder in the posterior mandible-a prospective multicenter study. Clin Oral Implants Res 2016; 28:721-726. [DOI: 10.1111/clr.12869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E. Schiegnitz
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - R. Noelken
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
- Private Practice; Lindau/Lake Constance; Lindau Germany
| | - M. Moergel
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - M. Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz; RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry; Epidemiology and Informatics; Johannes Gutenberg-University; Remagen Germany
| | - W. Wagner
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
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Noelken R, Oberhansl F, Kunkel M, Wagner W. Immediately provisionalized OsseoSpeed™Profile implants inserted into extraction sockets: 3-year results. Clin Oral Implants Res 2015; 27:744-9. [DOI: 10.1111/clr.12651] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Robert Noelken
- Private Practice for Oral Surgery; Lindau/Lake Constance Germany
- Department of Oral and Maxillofacial Surgery; University Medical Center; Johannes Gutenberg University of Mainz; Mainz Germany
| | | | - Martin Kunkel
- Department of Oral and Maxillofacial Surgery; University Hospital of Bochum; Bochum Germany
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery; Johannes Gutenberg University of Mainz; Mainz Germany
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Eerdekens L, Schols M, Coelst L, Quirynen M, Naert I. A 5-Year Prospective Study on Cone-Anchored Implants in the Edentulous Maxilla. Clin Implant Dent Relat Res 2015; 17 Suppl 2:e621-32. [DOI: 10.1111/cid.12295] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Liesbeth Eerdekens
- Unit of Prosthetic Dentistry/BIOMAT Research Group; Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - Marlies Schols
- Unit of Prosthetic Dentistry/BIOMAT Research Group; Department of Oral Health Sciences; KU Leuven; Leuven Belgium
| | - Ludo Coelst
- Unit of Operative Dentistry; Department of Oral Health Sciences; Faculty of Medicine; KU Leuven; Leuven Belgium
| | - Marc Quirynen
- Unit of Periodontology; Department of Oral Health Sciences; Faculty of Medicine; KU Leuven; Leuven Belgium
| | - Ignace Naert
- Unit of Prosthetic Dentistry/BIOMAT Research Group; Department of Oral Health Sciences; KU Leuven; Leuven Belgium
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Koutouzis T, Gadalla H, Lundgren T. Bacterial Colonization of the Implant-Abutment Interface (IAI) of Dental Implants with a Sloped Marginal Design: Anin-vitroStudy. Clin Implant Dent Relat Res 2015; 18:161-7. [DOI: 10.1111/cid.12287] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Theofilos Koutouzis
- Department of Periodontology; College of Dental Medicine; Nova Southeastern University; Ft Lauderdale FL USA
| | - Hana Gadalla
- Department of Periodontology; School of Dentistry; University of Detroit Mercy; Detroit MI USA
| | - Tord Lundgren
- Department of Dentistry; King Faisal Specialist Hospital and Research Center; Jeddah Saudi Arabia
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