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Manfredini M, Pellegrini M, Rigoni M, Veronesi V, Beretta M, Maiorana C, Poli PP. Oral health-related quality of life in implant-supported rehabilitations: a prospective single-center observational cohort study. BMC Oral Health 2024; 24:531. [PMID: 38704566 PMCID: PMC11069144 DOI: 10.1186/s12903-024-04265-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 04/16/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Oral Health-Related Quality of Life (OHRQoL) is a comprehensive concept covering daily comfort, self-esteem, and satisfaction with oral health, including functional, psychological, and social aspects, as well as pain experiences. Despite abundant research on OHRQoL related to oral diseases and hygiene, there is limited data on how patients perceive changes after implant-prosthetic rehabilitation. This study aimed to evaluate OHRQoL and aesthetic perception using OHIP-14 and VAS scales respectively, before (baseline-TB), during (provisional prostheses-TP), and after (definitive prostheses-TD) implant-prosthetic rehabilitation. It also explored the impact of biological sex, substitution numbers, and aesthetic interventions on OHRQoL and VAS scores, along with changes in OHIP-14 domains. METHODS A longitudinal prospective single-center observational cohort study was conducted with patients requiring implant-prosthetic rehabilitation. Quality of life relating to dental implants was assessed through the Italian version of Oral Health Impact Profile-14 (IOHIP-14), which has a summary score from 14 to 70. Patients' perceived aesthetic was analyzed through a VAS scale from 0 to 100. Generalized Linear Mixed Effect Models, Linear Mixed Effect Models, and Friedman test analyzed patient responses. RESULTS 99 patients (35 males, 64 females) aged 61-74, receiving various prosthetic interventions, were enrolled. Both provisional and definitive prosthetic interventions significantly decreased the odds of a worse quality of life compared to baseline, with odds ratios of 0.04 and 0.01 respectively. VAS scores increased significantly after both interventions, with estimated increases of 30.44 and 51.97 points respectively. Patient-level variability was notable, with an Intraclass Correlation Coefficient (ICC) of 0.43. While biological sex, substitution numbers, and aesthetic interventions didn't significantly affect VAS scores, OHRQoL domains showed significant changes post-intervention. CONCLUSIONS These findings support the effectiveness of implant-prosthetic interventions in improving the quality of life and perceived aesthetics of patients undergoing oral rehabilitation. They have important implications for clinical practice, highlighting the importance of individualized treatment approaches to optimize patient outcomes and satisfaction in oral health care.
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Affiliation(s)
- Mattia Manfredini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Matteo Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy.
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy.
| | - Marta Rigoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Valentina Veronesi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
| | - Mario Beretta
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Carlo Maiorana
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
| | - Pier Paolo Poli
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Via della Commenda 10, 20122, Milan, Italy
- Implant Center for Edentulism and Jawbone Atrophies, Maxillo-Facial Surgery and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 10, 20122, Milan, Italy
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Pellegrino G, Zaccheroni Z, Lizio G. Immediate full-arch fixed rehabilitation of a narrow mandible with newly conceived connection system implants: A case report. JOURNAL OF ADVANCED PERIODONTOLOGY & IMPLANT DENTISTRY 2024; 16:64-71. [PMID: 39027210 PMCID: PMC11252157 DOI: 10.34172/japid.2024.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 04/27/2024] [Indexed: 07/20/2024]
Abstract
Rehabilitating thin jaws without reconstructive surgery entails using narrow implants. The proposed treatment adopted an innovative implant system, allowing the mini-screws to be parallel and immediately loaded. A mandible, wearing an overdenture, was functionalized contextually to the residual dental extraction and the placement of six 2.4-mm thick one-piece implants. Low-profile intermediate abutments, the LEMs, able to rotate over the spherical heads of the fixtures, were connected after suturing, oriented, and blocked in a mutual parallel position. The copings, engaging with a tapered juncture of the LEMs, resulted in their alignment to be intraorally wedged together. The provisional superstructure enclosed the copings and was immediately connected to the implants, and the definitive prosthesis was delivered after three months. No clinical signs of peri-implantitis or radiographically evident bone loss were recorded after a two-year follow-up without any prosthetic complication. No cases have been published regarding mini-implants bearing fixed prosthesis rehabilitation.
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Affiliation(s)
- Gerardo Pellegrino
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Legg A, Hare K, Campbell C. Immediately loaded full arch implant rehabilitation and oral health-related quality of life: A retrospective cohort study from primary dental care. Clin Implant Dent Relat Res 2023; 25:1103-1111. [PMID: 37524507 DOI: 10.1111/cid.13254] [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: 03/30/2023] [Revised: 06/15/2023] [Accepted: 07/14/2023] [Indexed: 08/02/2023]
Abstract
AIMS This study evaluates patient-centered outcomes in patients undergoing full-arch rehabilitation, with immediate loading of implants. Using the Oral Health Impact Profile questionnaire pre-and post-treatment, it assesses the hypothesis that immediate full arch loading significantly improves quality of life. METHODOLOGY A dataset was defined as: 20 consecutive patients from a research database who had undergone IFAL surgery (maxilla, mandible, or both) and definitive restoration by a single clinician, and completed the OHIP-14 questionnaire prior to treatment and after restoration. RESULTS Pre (T0 ) and post (T1 ) treatment questionnaires were analyzed from 20 consecutive patients in whom a total of 160 implants were placed. The mean T0 score was 26.7, and mean T1 score 4.6. Differences were statistically significant (p = 0.00008). Greatest improvements were seen in psychological discomfort and disability, and pain. Worsening quality of life was shown by questions relating to speech in six patients and taste in three patients. CONCLUSION This study demonstrates that overall IFAL significantly improves tooth-related quality of life. It suggests reasons for patients to seek treatment while providing evidence to manage expectations, such as possible implications on speech, thus supporting informed consent of future patients in a primary care setting.
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Van Doorne L, Vandeweghe S, Matthys C, Vermeersch H, Bronkhorst E, Meijer G, De Bruyn H. Five years clinical outcome of maxillary mini dental implant overdenture treatment: A prospective multicenter clinical cohort study. Clin Implant Dent Relat Res 2023; 25:829-839. [PMID: 37309711 DOI: 10.1111/cid.13233] [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: 07/31/2022] [Revised: 04/27/2023] [Accepted: 05/22/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND The long-term clinical outcome of mini dental implants (MDIs) to support an overdenture is underreported especially in severely atrophic maxillae and when installed flaplessly. PURPOSE The current report is a 5-years follow-up of the previously published 2- and 3-years clinical outcome of MDIs supporting a maxillary overdenture in narrow alveolar ridges. MDI survival, marginal bone level, peri-implant health, technical complications, and oral health related quality of life (OHIP) and respective changes over time are reported. MATERIALS AND METHODS Subjects aged 50 years or older, in need of improvement of maxillary denture retention, were included. The MDIs were 2.4 mm diameter one-piece tapered implants, Class 4 pure Titanium, and lengths 10 or 11.5 mm. Under local anesthesia, 5-6 MDIs were placed in atrophic maxillae with a free-handed flapless approach. One week postoperative the denture was adapted with a retentive soft reliner. The final prosthetic connection was established after 6 months with a metal-reinforced horse-shoe denture. Clinical outcome after 5 years was assessed with probing pocket depts (PPD), bleeding on probing (BoP), and additional cone beam computed tomography (CBCT) MDI bone level measurements were performed. Oral Health-Related Quality of Life (OHRQoL) investigated with OHIP-14 was assessed preoperative, during provisional loading, and after final prosthetic connection up to 5 years. RESULTS Initially, 31 patients (14 females and 17 males) with mean age 62.30 underwent treatment. In the provisional loading interval, 16 patients encountered 32/185 MDIs failures, resulting in a failure of 17.3%; 170 MDIs were functionally loaded in 29 patients. Additionally, 14 implants were lost in three patients, all of whom had had already previous failures. Reimplantation of 17 MDIs were performed during the provisional loading and 2 MDI after functional loading. After 5 years, the absolute implant failure rate was 46/204 (22.5%), corresponding to a cumulative failure rate of 23.2%. Prosthetic failure was observed in four patients due to implant loss and in two patients related to excessive one-piece implant ball attachment wear, making the 5-years prosthetic success 80.0%. The mean PPD and absence/presence of BoP for 149 implants at 5 years was 4.3 and 0.2 mm, respectively. Average mesial-distal-vestibular-palatal bone loss in the interval 2-5 years was 0.08 mm. No statistically significant difference in marginal MDI bone loss between male or female (p = 0.835), smoking and nonsmoking (p = 0.666) was observed. The five-years total measured CBCT interdental bone level (mesial and distal) correlates with the 5-years PPD (Pearson 0.434; p = 0.01). After 5 years, OHRQoL with the treatment procedure was assessed in 27/31 participants. Decreasing mean total OHIP-14 scores with improved OHRQoL, was observed in 27/31 participants, with values of 21.3 at baseline to 15.6 at the time of provisional loading which significantly (p = 0.006) decrease to 7.3 at the final prosthetic connection. The next 3-5 years further decrease was observed with 6.5 and 4.96, respectively. CONCLUSIONS Maxillary MDIs for overdentures are an accessible and acceptable treatment option. Although after 5 years between one fifth and one fourth of the MDIs were lost, prosthetic success remains 80.0% and high OHRQoL could be achieved.
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Affiliation(s)
- Luc Van Doorne
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Plastic, Oral and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium
| | - Stefan Vandeweghe
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Reconstructive Dentistry, Ghent University Hospital, Ghent, Belgium
| | - Carine Matthys
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Reconstructive and Prosthetic Dentistry, Ghent University Hospital, Ghent, Belgium
| | - Hubert Vermeersch
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Plastic, Oral and Maxillo-Facial Surgery, Ghent University Hospital, Ghent, Belgium
| | - Ewald Bronkhorst
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
| | - Gert Meijer
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
| | - Hugo De Bruyn
- Department Oral Health Sciences, Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
- Department of Dentistry, Research Institute Health Sciences, Radboud UMC, Nijmegen, Netherlands
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Van Doorne L, Hommez G, Bronkhorst E, Meijer G, De Bruyn H. Effect of Sinus Perforation with Flaplessly Placed Mini Dental Implants for Oral Rehabilitation: A 5-Year Clinical and Radiological Follow-Up. J Clin Med 2022; 11:jcm11154637. [PMID: 35956252 PMCID: PMC9369462 DOI: 10.3390/jcm11154637] [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: 07/14/2022] [Revised: 08/05/2022] [Accepted: 08/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Flaplessly placed one-piece mini dental implants (MDI) are an option to support maxillary overdentures. Evenly distribution of the implants over the atrophic alveolar process implies a risk of accidental sinus perforation in the posterior area which could induce sinus-related pathology. Methods: Thirty-one patients received 5–6 maxillary MDIs. Schneiderian membrane swelling was assessed with CBCT at the deepest point of the sinus in the mid-sagittal plane prior to surgery (baseline), after 2 and 5 years. Additionally, subjective patient-reported rhinosinusitis complaints, the effect of smoking, and gender differences were investigated. Results: Mean thickness of the Schneiderian membrane was 2.87 mm at baseline, 3.15 mm at 2 years, and 4.30 mm at 5 years in 27 of 31 initially treated patients. MDI perforation was detected in 21/54 sinuses. At 2 years, perforation length does not affect membrane thickness whereas baseline swelling does. In smokers, each perforated mm induced 0.87 mm additional swelling. After 5 years, the effect of baseline swelling becomes smaller whereas perforation length became statistically significant, with 0.53 mm increase for every perforated mm. The effect of smoking lost its significance. No relations between gender, membrane thickness changes, or subjective clinical sinus complaints and MDI perforation were found. Conclusion: Accidental MDI sinus perforation induces Schneiderian membrane swelling but does not interfere with clinical sinusal outcome after 5 years.
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Affiliation(s)
- Luc Van Doorne
- Department of Plastic, Oral and Maxillo-Facial Surgery, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
- Dentistry, Prosthetic Dentistry, Endodontics, Oral and Maxillo-Facial Surgery, Private Clinic “Het Tandplein”, Bilkske 68, 8000 Brugge, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Heymanslaan 10, 9000 Ghent, Belgium
- Correspondence: or or (L.V.D.); or (H.D.B.); Tel.: +32-0474-248045 or +32-0496-804040 (L.V.D.)
| | - Geert Hommez
- Dentistry, Prosthetic Dentistry, Endodontics, Oral and Maxillo-Facial Surgery, Private Clinic “Het Tandplein”, Bilkske 68, 8000 Brugge, Belgium
- Faculty of Medicine and Health Sciences, Ghent University, Heymanslaan 10, 9000 Ghent, Belgium
| | - Ewald Bronkhorst
- Radboud Institute for Health Sciences, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Gert Meijer
- Radboud Institute for Health Sciences, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
| | - Hugo De Bruyn
- Faculty of Medicine and Health Sciences, Ghent University, Heymanslaan 10, 9000 Ghent, Belgium
- Radboud Institute for Health Sciences, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
- Correspondence: or or (L.V.D.); or (H.D.B.); Tel.: +32-0474-248045 or +32-0496-804040 (L.V.D.)
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Comparing Masticatory Performance of Maxillary Mini Dental Implant Overdentures, Complete Removable Dentures and Dentate Subjects. J Clin Med 2021; 10:jcm10215006. [PMID: 34768527 PMCID: PMC8584742 DOI: 10.3390/jcm10215006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/20/2021] [Accepted: 10/26/2021] [Indexed: 12/29/2022] Open
Abstract
Background: Mini dental implant (MDI) overdenture rehabilitation for the edentulous maxilla is a valuable, less invasive and affordable treatment alternative for complete removable dentures (CRD). However, comparative quantification of masticatory performance in different oral conditions are scarce. Purpose: This study compares objective masticatory performance of dentate groups, maxillary CRD and MDI overdentures and subjective masticatory performance in maxillary CRD and MDI overdentures. Materials and Methods: Four groups were defined, age 20+ dentate dental students (DS), age 50+ complete dentate subjects (DP), age 50+ maxillary CRD or MDI overdentures/dentate mandible. Objective masticatory performance was evaluated by measuring circular Variance of Hue (VOH) or the mixture degree of two-color chewing gum (Hue-check View Gum® Test). Additionally, subjective masticatory comparison was investigated in the CRD and MDI groups, with a visual analogue scale (VAS) for different food consistencies and the Oral Health Related Quality of Life (OHRQL) OHIP-14 questionnaire. Results: The mean VOH was 0.11 (SD 0.50, range 0.05–0.27) for the dentate dental 20+ students, 0.13 (SD 0.08, range 0.03–0.31) for the 50+ dentate group (p = 0.774), 0.41 (SD 0.41, range 0.14–0.76) for the CRD group and 0.39 (SD 0.18, range 0.07–0.76) for the MDI group (p = 0.725). Based on the VAS scores, no improvement was found between the CRD and the MDI overdenture group (p > 0.050). The mean OHIP-14 total score was 12.10 (SD 15.87, range 0–56) for CRD, while the MDI group (p = 0.039) saw a significant improvement to 2.85 (SD 2.85, range 0–15). Conclusion: Comparable results in objective masticatory performance were registered in dentate 20+ and 50+ subjects with a remarkable inferior outcome for the CRD and MDI group. Compared to CRD, MDI overdentures revealed no substantial improvement in subjective and objective masticatory performance. However, for MDI a significant increase in OHRQL was apparent.
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Van den Borre C, Rinaldi M, De Neef B, Loomans NAJ, Nout E, Van Doorne L, Naert I, Politis C, Schouten H, Klomp G, Beckers L, Freilich MM, Mommaerts MY. Radiographic Evaluation of Bone Remodeling after Additively Manufactured Subperiosteal Jaw Implantation (AMSJI) in the Maxilla: A One-Year Follow-Up Study. J Clin Med 2021; 10:jcm10163542. [PMID: 34441837 PMCID: PMC8397126 DOI: 10.3390/jcm10163542] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/07/2021] [Accepted: 08/08/2021] [Indexed: 12/12/2022] Open
Abstract
Additively manufactured subperiosteal jaw implants (AMSJI) are patient-specific, 3D-printed, titanium implants that provide an alternative solution for patients with severe maxillary bone atrophy. The aim of this study was to evaluate the bony remodeling of the maxillary crest and supporting bone using AMSJI. Fifteen patients with a Cawood–Howell Class V or greater degree of maxillary atrophy were evaluated using (cone beam) computed tomography scans at set intervals: one month (T1) and twelve months (T2) after definitive masticatory loading of bilateral AMSJI implants in the maxilla. The postoperative images were segmented and superimposed on the preoperative images. Fixed evaluation points were determined in advance, and surface comparison was carried out to calculate and visualize the effects of AMSJITM on the surrounding bone. A total mean negative bone remodeling of 0.26 mm (SD 0.65 mm) was seen over six reference points on the crest. Minor bone loss (mean 0.088 mm resorption, SD 0.29 mm) was seen at the supporting bone at the wings and basal frame. We conclude that reconstruction of the severely atrophic maxilla with the AMSJI results in minimal effect on supporting bone. Reduced stress shielding with a biomechanically tuned subperiosteal implant does not induce radiographically significant crestal bone atrophy.
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Affiliation(s)
- Casper Van den Borre
- Doctoral School of Life Sciences and Medicine, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-2-629-16-53
| | | | - Björn De Neef
- Head of Department of Oro-Maxillo-Facial Surgery, General Hospital Oudenaarde, 9700 Oudenaarde, Belgium;
| | - Natalie A. J. Loomans
- Private Clinic Face Ahead Antwerp, 2000 Antwerp, Belgium;
- Division of Oro-Maxillo-Facial Surgery, GZA Hospitals, 2000 Antwerp, Belgium
| | - Erik Nout
- Oral and Maxillofacial Surgery, ETZ Hospitals, 5022 GC Tilburg, The Netherlands; (E.N.); (G.K.)
| | - Luc Van Doorne
- Oral and Maxillofacial Surgery Cosmipolis Clinic Brugge, Ghent University Hospital, AZZENO, 8300 Knokke-Blankenberge, Belgium;
| | - Ignace Naert
- Former Head Department of Prosthetic Dentistry, KU Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium;
| | - Constantinus Politis
- OMFS-IMPATH Research Group, Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, 3000 Leuven, Belgium;
| | - Hylke Schouten
- Department of Oral and Maxillo-Facial Surgery, Rode Kruis Ziekenhuis Beverwijk, 1566 NC Beverwijk, The Netherlands;
| | - Geert Klomp
- Oral and Maxillofacial Surgery, ETZ Hospitals, 5022 GC Tilburg, The Netherlands; (E.N.); (G.K.)
| | | | - Marshall M. Freilich
- Division of Oral and Maxillofacial Surgery, Humber River Hospital, Toronto, ON M3M 0B2, Canada;
| | - Maurice Y. Mommaerts
- Private Clinic Orthoface Ghent, 9830 Ghent, Belgium;
- European Face Centre, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
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