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Tang W, Zheng C, Li L. Enhancing the gingival contour of an anterior implant restoration by using a guided bone regeneration abutment. J Prosthet Dent 2024:S0022-3913(24)00060-X. [PMID: 38413266 DOI: 10.1016/j.prosdent.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 02/29/2024]
Abstract
Deficiencies in the alveolar bone and surrounding gingiva can pose challenges in implant placement within the esthetic zone. This clinical report describes the reconstruction of gingival tissue contours through guided bone regeneration (GBR) in the anterior maxilla during implant placement by using a modified titanium abutment to maintain the osteogenic space adjacent to the gingival margin and implant neck.
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Affiliation(s)
- Weimao Tang
- Postgraduate student, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Changhong Zheng
- Postgraduate student, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lei Li
- Associate Professor, State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
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2
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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [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: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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3
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Song YW, Bienz SP, Benic GI, Cha JK, Hämmerle CHF, Jung UW, Jung RE. Soft-tissue dimensional change following guided bone regeneration on peri-implant defects using soft-type block or particulate bone substitutes: 1-year outcomes of a randomized controlled clinical trial. J Clin Periodontol 2023; 50:147-157. [PMID: 36330670 DOI: 10.1111/jcpe.13738] [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: 05/26/2022] [Revised: 09/19/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
AIM To compare the peri-implant soft-tissue dimensional changes following guided bone regeneration between particulate (particle group) and collagenated soft-block-type (block group) biphasic calcium phosphate (BCP). MATERIALS AND METHODS This study investigated 35 subjects: 18 in the particle group and 17 in the block group. Cone-beam computed tomography obtained at 6 months post surgery and optical impressions taken periodically (before surgery, 6 months post surgery, and 1 year post surgery) were superimposed. The ridge contour changes over time and the peri-implant mucosal thicknesses were measured diagonally and horizontally, and analysed statistically. RESULTS The increases in diagonal (1.12 ± 0.78 mm) and horizontal (2.79 ± 1.90 mm) ridge contour of the block group were significantly higher than those in the particle group during the first 6 months (p < .05); however, the contour hardly changed thereafter (diagonal: 0.07 ± 0.75 mm; horizontal: -0.34 ± 1.26 mm), resulting in the 1-year contour changes similar between the two groups. Regardless of the type of BCP, the ridge contour increased significantly over 1 year when the dehiscence defect had a contained configuration (p < .05). CONCLUSIONS The increase in soft-tissue dimensions for 1 year was similar between the two groups. The mucosal contour increase was larger when the surgery was conducted in a more contained defect, and this was not influenced by the type of BCP.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Stefan P Bienz
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Goran I Benic
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland.,Institute for Research and Education in Dental Medicine, Lugano, Switzerland
| | - Jae-Kook Cha
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zürich, Switzerland
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4
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Zuercher AN, Mancini L, Naenni N, Thoma DS, Strauss FJ, Jung RE. The L-shape technique in guided bone regeneration with simultaneous implant placement in the esthetic zone: A step-by-step protocol and a 2-14 year retrospective study. J ESTHET RESTOR DENT 2023; 35:197-205. [PMID: 36165402 DOI: 10.1111/jerd.12965] [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: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the methodology of the "L-shape" technique in guided bone regeneration (GBR) with simultaneous implant placement and report on the clinical, esthetic, and patient satisfaction outcomes up to 14 years of follow-up. MATERIAL AND METHODS Fourteen patients treated with the "L-shape" technique were included in this retrospective study. The L-shape technique was performed by trimming and placing a soft-type bone block made of deproteinized bovine bone mineral with 10% collagen at the buccal-occlusal aspect of the dental implant. The remaining gaps were filled with deproteinized bovine bone mineral granules and the augmented area was covered with a collagen membrane. The following parameters were recorded: probing depth (PD), bleeding on probing (BOP), plaque index (PI), keratinized tissue width (KT) and marginal bone level (MBL). Esthetic outcomes were assessed according to the pink esthetic score (PES) and the white esthetic score (WES). Patient satisfaction was evaluated by means of a numerical rating scale (0-10). The stability of each augmented site was assessed by measuring the volumetric changes between baseline (crown delivery) and the respective follow-up. RESULTS A total of 13 maxillary incisors and one maxillary canine in 14 patients were included. The mean follow-up period was 7.7 ± 3.8 years. PES values amounted to 10.7 ± 3.3 and WES to 8.8 ± 1.4. Patient satisfaction reached 9.4 ± 0.8. Mean PD at implant sites were 2.7 ± 0.7 mm while BOP amounted to 15.0 ± 0.2% and Pl to 5.0 ± 0.0%. Volumetric analyses revealed minimal changes at the augmented sites irrespective of the region of interest. Radiographic MBL remained relatively stable. CONCLUSIONS Within the limitation of the present study the L-shape augmentation procedure seems to be a reliable technique when performing GBR with simultaneous implant placement in the esthetic zone. Outcomes encompassed stable clinical and esthetic results accompanied by high levels of patient satisfaction. Future randomized controlled trials are warranted to confirm possible benefits of the L-shape technique over traditional approaches. CLINICAL SIGNIFICANCE The L-shape appears to be a simple yet promising technique in GBR with simultaneous implant placement that can easily be translated into clinical practice.
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Affiliation(s)
- Anina-Nives Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel-Stefan Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Ronald-Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Frizzera F, Spin-Neto R, Padilha V, Nicchio N, Ghiraldini B, Bezerra F, Marcantonio E. Effect of osseodensification on the increase in ridge thickness and the prevention of buccal peri-implant defects: an in vitro randomized split mouth pilot study. BMC Oral Health 2022; 22:233. [PMID: 35698117 PMCID: PMC9195241 DOI: 10.1186/s12903-022-02242-x] [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: 02/01/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implant installation with conventional drilling can create buccal bone defects in areas of limited ridge thickness. Implant installation with osseodensification may aid in preventing buccal bone defects in these situations. This in vitro pilot study evaluated the impact of osseodensification on the increase in alveolar ridge thickness and the prevention of buccal peri-implant defects. METHODS Ten fresh pig mandibles with limited bone thickness were selected for use in an experimental randomized split mouth pilot study. Two site-preparation protocols were used: conventional drilling with cutting burs (CTL, n = 10) and osseodensification with Densah® burs (OD, n = 10). After implant bed preparation, 20 implants (4.5 × 10 mm) were placed in the prepared sites and the insertion torque was recorded. Clinical and photographic analysis evaluated ridge thickness and the extent (height, width, and area) of bone defects in the buccal and lingual bone walls following implant placement. Three-dimensional measurements were performed using STL files to analyze the increase in buccal ridge thickness following site preparation and implant placement. The height of the buccal bone defect was considered as the primary outcome of this study. Defect width, area, implant insertion torque, and linear buccal ridge increase after implant site preparation and installation were also assessed. Non-parametric evaluations were carried out with the Mann-Whitney test to verify intergroup differences. RESULTS There was no statistically significant difference between groups in the baseline ridge thickness. OD presented a significantly higher insertion torque, associated with reduced buccal and lingual bone defect width, in comparison to CTL. CONCLUSIONS The increase in buccal ridge thickness after site preparation and implant placement was significantly higher in OD compared to CTL. Osseodensification increased the ridge thickness through expansion and reduced buccal bone defects after implant installation.
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Affiliation(s)
| | - Rubens Spin-Neto
- Aarhus University, Department of Dentistry and Oral Health, Aarhus, Denmark
| | - Victor Padilha
- Brazilian Dental Association at Espírito Santo, Serra, Brazil
| | - Nicolas Nicchio
- São Paulo State University (UNESP), School of Dentistry, Department of Diagnostic and Surgery, Araraquara, Brazil
| | - Bruna Ghiraldini
- Dental Research Division, School of Dentistry, Paulista University, São Paulo, Brazil
| | - Fábio Bezerra
- São Paulo State University (UNESP), Department of Chemical and Biological Sciences, Institute of Biosciences, Botucatu, Brazil
| | - Elcio Marcantonio
- São Paulo State University (UNESP), School of Dentistry, Department of Diagnostic and Surgery, Araraquara, Brazil
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6
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Tavelli L, Barootchi S, Vera Rodriguez M, Mancini L, Meneghetti PC, Mendonça G, Wang HL. Early soft tissue changes following implant placement with or without soft tissue augmentation using a xenogeneic cross-link collagen scaffold: A volumetric comparative study. J ESTHET RESTOR DENT 2021; 34:181-187. [PMID: 34936177 DOI: 10.1111/jerd.12856] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/06/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Soft tissue augmentation (STA) at implant sites has the potential of improving peri-implant health, esthetics, and marginal bone level stability. The present study aimed at evaluating the volumetric changes occurring following implant placement in sites that received STA compared to non-augmented sites. METHODS A total of 26 subjects received a dental implant in a posterior edentulous site. Simultaneous STA with a xenogeneic cross-linked collagen scaffold was performed for the first 13 patients, while the remaining subjects served as the negative control. An intraoral optical scanner was used at baseline and at 12 weeks to generate digital models. RESULTS The mean volume (Vol) gain of the test group was 38.43 mm3 , while a mean Vol of -16.82 mm3 was observed for the control group (p < 0.05). The mean thickness of the reconstructed volume (ΔD) was 0.61 and -0.24 mm, for the test and control group, respectively (p < 0.05). Higher linear dimensional changes were observed for the test group (p < 0.05), while no significant differences were observed in terms of keratinized mucosa width and pocket depth changes between the two groups. CONCLUSIONS Simultaneous STA with xenogeneic collagen scaffold obtained statistically significant higher volumetric outcomes compared to the non-augmented group. CLINICAL SIGNIFICANCE STA at the time of implant placement using a xenogeneic cross-linked collagen scaffold can prevent remodeling of the ridge during the first 12 weeks, as compared to non-grafted implant sites.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Center for Clinical Research and Evidence Synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor-Boston, USA.,Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Shayan Barootchi
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Center for Clinical Research and Evidence Synthesis In oral TissuE RegeneratION (CRITERION), Ann Arbor-Boston, USA
| | - Maria Vera Rodriguez
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Leonardo Mancini
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Priscila Ceolin Meneghetti
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,Escola de Ciencias de Saúde e da Vida, Ponitificia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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7
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Zheng C, Wang S, Ye H, Liu Y, Hu W, Zhou Y. Baseline selection for evaluation of peri-implant soft tissue changes: a clinical trial. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1494. [PMID: 34805356 PMCID: PMC8573432 DOI: 10.21037/atm-21-3335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/30/2021] [Indexed: 11/15/2022]
Abstract
Background To select the optimal baseline for evaluation of peri-implant soft tissue changes among 1, 2, and 3 weeks after definitive crown insertion. Methods A total of 22 individuals who required implant restoration were recruited to this study. Each participant received a screw-retained conventional implant restoration. Peri-implant soft tissue was captured by an intraoral scanner and analyzed by 3D analysis software. Soft tissue changes [mucosal margin (MM) and soft tissue thickness (STT)] on the buccal side of implant sites were evaluated at 1, 2, and 3 weeks after definitive crown insertion. One-way analysis of variance (ANOVA) for repeated measurement and Tukey’s test were used to analyze significant differences between the 3 time points (α=0.05). Results An increased volume of peri-implant soft tissue was observed shortly after definitive crown insertion. Based on the findings of peri-implant soft tissue changes, significant differences were observed between weeks 1 and 2 (P<0.01), and weeks 1 and 3 (P<0.01), while there was no significant difference between weeks 2 and 3 (P>0.05). Conclusions Minimal peri-implant soft tissue changes occurred in this study. The time point of 2 weeks after definitive crown insertion was preliminarily selected as the baseline. The small sample size and few time points must be taken into consideration when interpreting these findings. Trial Registration This study was retrospectively registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000037954; Date of registration: 6 September 2020).
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Affiliation(s)
- Chaoling Zheng
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Shimin Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenjie Hu
- Department of Periodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China.,National Laboratory for Digital and Material Technology of Stomatology, National Clinical Research Center for Oral Diseases, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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8
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Noh K, Thoma DS, Park JC, Lee DW, Shin SY, Lim HC. A case series of profilometric changes in two implant placement protocols at periodontally compromised non-molar sites. Sci Rep 2021; 11:1714. [PMID: 33462323 PMCID: PMC7813861 DOI: 10.1038/s41598-021-81402-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 01/06/2021] [Indexed: 01/13/2023] Open
Abstract
Information regarding profilometric changes at a soft tissue level following implant placement with different protocols is insufficient. Therefore, this study aimed to comparatively investigate the profilometric tissue changes with respect to late implant placement following alveolar ridge preservation (LP/ARP) and early implantation (EP) in periodontally compromised non-molar extraction sites. Sixteen patients were randomly assigned to the following groups: implant placement 4 months post-ARP (group LP/ARP) and tooth extraction and implant placement 4–8 weeks post-extraction (group EP). Dental impressions were obtained immediately after final prosthesis insertion and at 3, 6, and 12 months. At the time of implant placement, bone augmentation was performed in the majority of the patients. Profilometric changes of the tissue contour were minimal between the final prosthesis insertion and 12 months in the mid-facial area (0.04–0.35 mm in group LP/ARP, 0.04–0.19 mm in group EP). The overall tissue volume increased in both groups (1.70 mm3 in group LP/ARP, 0.96 mm3 in group EP). In conclusion, LP/ARP and EP led to similar stability of the peri-implant tissue contour between the final prosthesis insertion and at 12 months. Moreover, the change of peri-implant tissue on the soft tissue level was minimal in both modalities.
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Affiliation(s)
- Kwantae Noh
- Department of Prosthodontics, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jung-Chul Park
- Department of Periodontology, College of Dentistry, Dankook University, Cheonan-si, Republic of Korea
| | - Dong-Woon Lee
- Department of Periodontology, Veterans Health Service Medical Center, Seoul, Republic of Korea
| | - Seung-Yun Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
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9
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Tavelli L, Barootchi S, Majzoub J, Siqueira R, Mendonça G, Wang HL. Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning-based digital technologies. J Clin Periodontol 2020; 48:315-334. [PMID: 33151586 DOI: 10.1111/jcpe.13401] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 10/06/2020] [Accepted: 10/28/2020] [Indexed: 12/13/2022]
Abstract
AIM To evaluate techniques for assessing soft tissue alterations at implant sites and compare the traditionally utilized methods to the newer three-dimensional technologies emerging in the literature. MATERIALS AND METHODS A comprehensive search was performed to identify interventional studies reporting on volumetric changes at implant sites following different treatments. RESULTS Seventy-five articles were included the following: 30 used transgingival piercing alone, one utilized calliper, six with ultrasonography, six on cone-beam computed tomography, and 32 utilized optical scanning and digital technologies. Optical scanning-based digital technologies were the only approach that provided 'volumetric changes,' reported as volumetric variation in mm3 , or the mean distance between the surfaces/mean thickness of the reconstructed volume. High variability in the digital analysis and definition of the region of interest was observed. All the other methods reported volume variation as linear dimensional changes at different apico-coronal levels. No studies compared volumetric changes with different approaches. CONCLUSIONS Despite the emergence of optical scanning-based digital technologies for evaluating volumetric changes, a high degree of variation exists in the executed workflow, which renders the comparison of study results not feasible. Establishment of universal guidelines could allow for volumetric comparisons among different studies and treatments.
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Affiliation(s)
- Lorenzo Tavelli
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Shayan Barootchi
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Jad Majzoub
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rafael Siqueira
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Gustavo Mendonça
- Department of Biologic and Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Hom-Lay Wang
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
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10
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Cairo F, Nieri M, Cavalcanti R, Landi L, Rupe A, Sforza NM, Pace R, Barbato L. Marginal soft tissue recession after lateral guided bone regeneration at implant site: A long‐term study with at least 5 years of loading. Clin Oral Implants Res 2020; 31:1116-1124. [DOI: 10.1111/clr.13658] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Francesco Cairo
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | - Michele Nieri
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | | | | | | | | | - Riccardo Pace
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
| | - Luigi Barbato
- Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine University of Florence Florence Italy
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11
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Rojo E, Stroppa G, Sanz‐Martin I, Gonzalez‐Martín O, Nart J. Soft tissue stability around dental implants after soft tissue grafting from the lateral palate or the tuberosity area – A randomized controlled clinical study. J Clin Periodontol 2020; 47:892-899. [DOI: 10.1111/jcpe.13292] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 04/06/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Ernest Rojo
- Department of Periodontology Universitat Internacional de Catalunya (UIC) Barcelona Spain
| | - Giorgio Stroppa
- Department of Periodontology Universitat Internacional de Catalunya (UIC) Barcelona Spain
| | - Ignacio Sanz‐Martin
- Department of Periodontology Universitat Internacional de Catalunya (UIC) Barcelona Spain
- Section of Post‐graduate Periodontology Faculty of Odontology University Complutense of Madrid Madrid Spain
| | - Oscar Gonzalez‐Martín
- Section of Post‐graduate Periodontology Faculty of Odontology University Complutense of Madrid Madrid Spain
- Periodontal‐Prosthesis Department School of Dental Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Jose Nart
- Department of Periodontology Universitat Internacional de Catalunya (UIC) Barcelona Spain
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12
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Recent developments in strontium-based biocomposites for bone regeneration. J Artif Organs 2020; 23:191-202. [PMID: 32100147 DOI: 10.1007/s10047-020-01159-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 01/25/2020] [Indexed: 12/13/2022]
Abstract
Recent advances in biomaterial designing techniques offer immense support to tailor biomimetic scaffolds and to engineer the microstructure of biomaterials for triggering bone regeneration in challenging bone defects. The current review presents the different categories of recently explored strontium-integrated biomaterials, including calcium silicate, calcium phosphate, bioglasses and polymer-based synthetic implants along with their in vivo bone formation efficacies and/or in vitro cell responses. The role and significance of controlled drug release scaffold/carrier design in strontium-triggered osteogenesis was also comprehensively described. Furthermore, the effects of stem cells and growth factors on bone remodeling are also elucidated.
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Hämmerle CHF, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: A narrative review. J Periodontol 2019; 89 Suppl 1:S291-S303. [PMID: 29926950 DOI: 10.1002/jper.16-0810] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 11/07/2017] [Accepted: 12/11/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The objective of the present paper was to review factors and conditions that are associated with hard and soft-tissue deficiencies at implant sites. IMPORTANCE Hard- and soft-tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft-tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft-tissue deficiencies with the aim of improving clinical outcomes of implant therapy. FINDINGS A large number of etiological factors have been identified that may lead to hard and soft-tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft-tissue defects or may appear in conjunction with other factors. CONCLUSIONS Hard- and soft-tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri-implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft-tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing.
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Affiliation(s)
- Christoph H F Hämmerle
- Chairman of the Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Switzerland
| | - Dennis Tarnow
- Director of Implant Education, Columbia University College of Dental Medicine, New York, NY, USA
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Evaluation of intraoral digital impressions for obtaining gingival contour in the esthetic zone: accuracy outcomes. Clin Oral Investig 2019; 24:1401-1410. [DOI: 10.1007/s00784-019-03105-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
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Hämmerle CHF, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: A narrative review. J Clin Periodontol 2019; 45 Suppl 20:S267-S277. [PMID: 29926502 DOI: 10.1111/jcpe.12955] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 11/07/2017] [Accepted: 12/11/2017] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The objective of the present paper was to review factors and conditions that are associated with hard and soft-tissue deficiencies at implant sites. IMPORTANCE Hard- and soft-tissue deficiencies at dental implants are common clinical findings. They can lead to complications and compromise implant survival and, hence, may require therapeutic interventions. It is, therefore, important to understand the etiology of hard and soft-tissue deficiencies. Based on this understanding, strategies should be developed to correct hard and soft-tissue deficiencies with the aim of improving clinical outcomes of implant therapy. FINDINGS A large number of etiological factors have been identified that may lead to hard and soft-tissue deficiencies. These factors include: 1) systemic diseases and conditions of the patients; 2) systemic medications; 3) processes of tissue healing; 4) tissue turnover and tissue response to clinical interventions; 5) trauma to orofacial structures; 6) local diseases affecting the teeth, the periodontium, the bone and the mucosa; 7) biomechanical factors; 8) tissue morphology and tissue phenotype; and 9) iatrogenic factors. These factors may appear as an isolated cause of hard and soft-tissue defects or may appear in conjunction with other factors. CONCLUSIONS Hard- and soft-tissue deficiencies at implant sites may result from a multitude of factors. They encompass natural resorption processes following tooth extraction, trauma, infectious diseases such as periodontitis, peri-implantitis, endodontic infections, growth and development, expansion of the sinus floor, anatomical preconditions, mechanical overload, thin soft tissues, lack of keratinized mucosa, malpositioning of implants, migration of teeth, lifelong growth, and systemic diseases. When more than one factor leading to hard and/or soft-tissue deficiencies appear together, the severity of the resulting condition may increase. Efforts should be made to better identify the relative importance of these etiological factors, and to develop strategies to counteract their negative effects on our patient's wellbeing.
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Affiliation(s)
- Christoph H F Hämmerle
- Chairman of the Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Switzerland
| | - Dennis Tarnow
- Director of Implant Education, Columbia University College of Dental Medicine, New York, NY, USA
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Fenbo M, Xingyu X, Bin T. Strontium chondroitin sulfate/silk fibroin blend membrane containing microporous structure modulates macrophage responses for guided bone regeneration. Carbohydr Polym 2019; 213:266-275. [DOI: 10.1016/j.carbpol.2019.02.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/14/2019] [Accepted: 02/17/2019] [Indexed: 12/19/2022]
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Lee J, Park D, Koo KT, Seol YJ, Lee YM. Validity of a regenerative procedure for a minor bone defect with immediate implant placement: a systematic review and meta-analysis. Acta Odontol Scand 2019; 77:99-106. [PMID: 30600736 DOI: 10.1080/00016357.2018.1508743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This systematic review evaluates implant survival and the change in the width of the horizontal ridge following immediate implant placement with or without a regenerative procedure. MATERIALS AND METHODS An electronic search of MEDLINE, EMBASE, and the LILACS database of the Cochrane Central Register of controlled trials was performed, along with a manual search, up to April 2018. Randomized controlled trials (RCTs) and quasi-randomized controlled clinical trials (CCTs) with >10 subjects were eligible for this systematic review. A meta-analysis of the risk difference in implant failure between the regenerative and non-regenerative procedure groups was performed using a fixed-effect model. In addition, a meta-analysis of the change in alveolar bone width was conducted using a fixed-effect model. RESULTS Seven studies (six RCTs and one CCT) were included. A meta-analysis of three studies found no statistically significant risk difference in implant failure between the regenerative procedure and non-regenerative procedure groups. A meta-analysis of four studies showed that horizontal shrinkage of the alveolar ridge in the site of immediate implant placement was statistically significantly lower with the regenerative procedure than without it (<1 year follow up studies: weighted mean difference (WMD) 0.75 mm, 95% confidence interval 0.41-1.09, p < .00001; ≥1 year follow up study: WMD 1.22, 95% confidence interval 0.52-1.91, p = .00006; total: WMD 0.84 mm, 95% confidence interval 0.53-1.14, p < .00001). CONCLUSION Within the study limitations, immediate implant placement with a regenerative procedure showed similar implant survival and less shrinkage of the ridge width than immediate implant placement without a regenerative procedure. Due to the high risk of bias and small sample sizes of the included studies, further clinical studies are warranted to draw definitive conclusions.
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Affiliation(s)
- Jungwon Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Dueun Park
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yang-Jo Seol
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Yong-Moo Lee
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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De Bruyckere T, Eeckhout C, Eghbali A, Younes F, Vandekerckhove P, Cleymaet R, Cosyn J. A randomized controlled study comparing guided bone regeneration with connective tissue graft to re-establish convexity at the buccal aspect of single implants: A one-year CBCT analysis. J Clin Periodontol 2018; 45:1375-1387. [DOI: 10.1111/jcpe.13006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/20/2018] [Accepted: 08/19/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Thomas De Bruyckere
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Célien Eeckhout
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Aryan Eghbali
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Faris Younes
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
| | - Paulien Vandekerckhove
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
| | - Roberto Cleymaet
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
| | - Jan Cosyn
- Vrije Universiteit Brussel (VUB); Faculty of Medicine and Pharmacy; Oral Health Research Group (ORHE); Brussels Belgium
- Department of Periodontology and Oral Implantology; Faculty of Medicine and Health Sciences; Dental School; Ghent University; Ghent Belgium
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Benic GI, Thoma DS, Jung RE, Sanz-Martin I, Unger S, Cantalapiedra A, Hämmerle CH. Guided bone regeneration with particulate vs. block xenogenic bone substitutes: a pilot cone beam computed tomographic investigation. Clin Oral Implants Res 2017; 28:e262-e270. [DOI: 10.1111/clr.13011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Goran I. Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | | | - Silvan Unger
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | | | - Christoph H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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20
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Bienz SP, Jung RE, Sapata VM, Hämmerle CHF, Hüsler J, Thoma DS. Volumetric changes and peri-implant health at implant sites with or without soft tissue grafting in the esthetic zone, a retrospective case-control study with a 5-year follow-up. Clin Oral Implants Res 2017; 28:1459-1465. [DOI: 10.1111/clr.13013] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Stefan P. Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Vitor M. Sapata
- 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
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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