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Rungtanakiat P, Thitaphanich N, Janda M, Strauss FJ, Arksornnukit M, Mattheos N. Association of Peri-Implant Mucosa Dimensions With Emergence Profile Angles of the Implant Prosthesis. Clin Exp Dent Res 2024; 10:e939. [PMID: 39039934 PMCID: PMC11263758 DOI: 10.1002/cre2.939] [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: 03/31/2024] [Revised: 07/02/2024] [Accepted: 07/11/2024] [Indexed: 07/24/2024] Open
Abstract
OBJECTIVES The primary aim of this cross-sectional study was to investigate the association between prosthesis design and peri-implant mucosa dimensions and morphology. The secondary aim was to investigate associations between mucosal dimensions and the presence of mucositis. MATERIALS AND METHODS Forty-seven patients with 103 posterior bone level implants underwent clinical and radiographic examination, including cone beam computer tomography and intraoral optical scanning. Three-dimensional models for each implant and peri-implant mucosa were constructed. Vertical mucosa height (TH), horizontal mucosa width at implant platform (TW), and 1.5 mm coronal of the platform (TW1.5), as well as mucosal emergence angle (MEA), deep angle (DA), and total contour angle (TA) were measured at six sites for each implant. RESULTS There was a consistent correlation between peri-implant mucosa width and height (β = 0.217, p < 0.001), with the width consistently surpassing height by a factor of 1.4-2.1. All three angles (MEA, DA, TA) were negatively associated with mucosa height (p < 0.001), while DA was negatively associated with mucosa width (TW1.5) (p < 0.001, β = -0.02, 95% CI: -0.03, -0.01). There was a significant negative association between bleeding on probing (BoP) and mucosa width at platform (OR 0.903, 95% CI: 0.818-0.997, p = 0.043) and 1.5 coronal (OR 0.877, 95% CI: 0.778-0.989, p = 0.033). Implants with less than half sites positive for BoP (0-2/6) had significantly higher mucosa height (OR 3.51, 95% CI: 1.72-7.14, p = 0.001). CONCLUSIONS Prosthesis design can influence the dimensions of the peri-implant mucosa, with wider emergence profile angles associated with reduced peri-implant mucosa height. In particular, a wider deep angle is associated with reduced mucosa width in posterior sites. Reduced peri-implant mucosa height and width are associated with more signs of inflammation. TRIAL REGISTRATION Registered in Thai Clinical Trials Registry: http://www.thaiclinicaltrials.org/show/TCTR20220204002.
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Affiliation(s)
- Piboon Rungtanakiat
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Natchaya Thitaphanich
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Martin Janda
- Department of Prosthodontics, Faculty of OdontologyMalmoe UniversityMalmöSweden
| | - Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental MedicineUniversity of ZurichZurichSwitzerland
- Faculty of DentistryUniversidad Finis TerraeSantiagoChile
| | - Mansuang Arksornnukit
- Department of Prosthodontics, Faculty of DentistryChulalongkorn UniversityBangkokThailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of DentistryChulalongkorn UniversityBangkokThailand
- Department of Dental MedicineKarolinska InstituteStockholmSweden
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Janda M, Mattheos N. Prosthetic design and choice of components for maintenance of optimal peri-implant health: a comprehensive review. Br Dent J 2024; 236:765-771. [PMID: 38789753 DOI: 10.1038/s41415-024-7357-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/07/2024] [Accepted: 01/11/2024] [Indexed: 05/26/2024]
Abstract
Current research has identified features of the prosthetic design with potential to significantly impact the long-term health of peri-implant tissues, while the choice of prosthetic components is also shown to be critical in an effort to reduce long-term complications of implant therapy. Overcontouring of the prosthesis emergence profile has been associated with marginal bone loss, recession and peri-implantitis, while the mucosal emergence angle is shown to have a strong association with peri-implant tissue inflammation. Further elements of interest include convexity/concavity of the restoration, the prosthetic connection and the different geometric configurations of junctions, as well as the peri-implant tissue dimensions. With regards to implant components, the choice between original and third-party-manufactured components might come with implications, as differences in material and microgeometry might impact precision of fit and overall performance, potentially leading to complications. Scrutiny of the specifications and manufacturing is essential when third-party-manufactured components are considered.The aim of this narrative review was to summarise the current evidence with regards to the restorative features of the implant prosthesis and also the selection of prosthetic components which can have implications for the long-term success of the implant therapy. Furthermore, the review aimed at interpretating current scientific evidence into meaningful strategies and recommendations to implement in clinical practice of implant dentistry.
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Affiliation(s)
- Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Sweden.
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Thailand; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Zhang Y, Luo J, Di P, Chen B, Li J, Yu Z, Lin Y. Screw-retained ceramic-veneered/monolithic zirconia partial implant-supported fixed dental prostheses: A 5 to 10-year retrospective study on survival and complications. J Prosthodont 2024; 33:221-230. [PMID: 37302066 DOI: 10.1111/jopr.13723] [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: 01/08/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
PURPOSE To assess the clinical performance of screw-retained, ceramic-veneered, monolithic zirconia partial implant-supported fixed dental prostheses (ISFDP) over 5-10 years and to evaluate implant- and prosthesis-related factors influencing treatment failure and complications. MATERIALS AND METHODS Partially edentulous patients treated with screw-retained all-ceramic ISFDPs with 2-4 prosthetic units with a documented follow-up of ≥5 years after implant loading were included in this retrospective study. The outcomes analyzed included implant/prosthesis failure and biological/technical complications. Possible risk factors were identified using the mixed effects Cox regression analysis. RESULTS A screened sample of 171 participants with 208 prostheses (95% of the restorations were splinted crowns without a pontic) supported by 451 dental implants were enrolled in this study. The mean follow-up duration after prosthesis delivery was 82.4 ±17.2 months. By the end of the follow-up period, 431 (95.57%) of the 451 implants remained functional at the implant level. At the prosthesis level, 185 (88.94%) of the 208 partial ISFDPs remained functional. Biological complications were observed in 67 implants (14.86%), and technical complications were observed in 62 ISFDPs (29.81%). Analysis revealed only emergence profiles (over-contoured) as a significant risk factor for implant failure (P<0.001) and biological complications (P<0.001). Full-coverage ceramic-veneered zirconia prostheses had a significantly greater chance of chipping (P<0.001) compared with buccal-ceramic-veneered or monolithic zirconia prostheses. CONCLUSIONS Screw-retained ceramic-veneered, monolithic partial ISFDPs have a favorable long-term survival rate. Over-contoured emergence profile is a significant risk factor associated with implant failure and biological complications. Buccal-ceramic-veneered and monolithic zirconia partial ISFDPs lower the initial prevalence of chipping compared with a full-coverage veneered design.
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Affiliation(s)
- Yifan Zhang
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jia Luo
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ping Di
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Bo Chen
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jianhui Li
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ziyang Yu
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Ye Lin
- Department of Oral Implantology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Disease & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
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Chou YH, Chen YJ, Pan CP, Yen WH, Liu PF, Feng IJ, Lin YC, Hu KF. Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study. Clin Implant Dent Relat Res 2023; 25:1000-1007. [PMID: 37424382 DOI: 10.1111/cid.13243] [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: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/18/2023] [Indexed: 07/11/2023]
Abstract
INTRODUCTION Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis. MATERIALS AND METHODS This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05. RESULTS The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI. CONCLUSION ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.
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Affiliation(s)
- Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Yan-Jun Chen
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Cheng-Pin Pan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wen-Hsi Yen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Feng Liu
- Department of Biomedical Science and Environmental Biology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Ying-Chu Lin
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kai-Fang Hu
- Division of Periodontics, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Takahashi A, Inoue K, Imagawa-Fujimura N, Matsumoto K, Yamada K, Sawai Y, Nakajima Y, Mano T, Kato-Kogoe N, Ueno T. Clinical Study of 14 Cases of Bone Augmentation with Selective Laser Melting Titanium Mesh Plates. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6842. [PMID: 37959439 PMCID: PMC10648651 DOI: 10.3390/ma16216842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/22/2023] [Accepted: 10/13/2023] [Indexed: 11/15/2023]
Abstract
Additive manufacturing techniques are being used in the medical field. Orthopedic hip prostheses and denture bases are designed and fabricated based on the patient's computer-aided design (CAD) data. We attempted to incorporate this technique into dental implant bone augmentation. Surgical simulation was performed using patient data. Fourteen patients underwent bone augmentation using a selective laser melting (SLM) titanium mesh plate. The results showed no evidence of infection in any of the 14 patients. In 12 patients, only one fixation screw was used, and good results were obtained. The SLM titanium mesh plate was good adaptation in all cases, with bone occupancy greater than 90%. The average bone resorption of the marginal alveolar bone from the time of dental implant placement to the time of the superstructure placement was 0.69 ± 0.25 mm. Implant superstructures were placed in all cases, and bone augmentation with SLM titanium mesh plates was considered a useful technique.
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Affiliation(s)
| | - Kazuya Inoue
- Department of Dentistry and Oral Surgery, Faculty of Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki 569-8686, Osaka, Japan (K.Y.); (Y.S.); (T.M.)
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Laleman I, Lambert F. Implant connection and abutment selection as a predisposing and/or precipitating factor for peri-implant diseases: A review. Clin Implant Dent Relat Res 2023; 25:723-733. [PMID: 36825512 DOI: 10.1111/cid.13185] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/17/2023] [Indexed: 02/25/2023]
Abstract
Peri-implant mucosal integration is becoming a critical aspect for long term implant health and can be triggered the selection of implant components. The aim of this review is therefore to investigate the evidence concerning implant connection and abutment characteristics (abutment materials, design, handling) as predisposing or precipitating factor for peri-implant mucositis and peri-implantitis. Although the evidence that these features can directly predispose/precipitate peri-implant diseases is limited, there are -few- studies showing a potential role of the implant connection, trans-mucosal configuration, and handling in the development of early bone loss and/or peri-implantitis. With bone level implants, conical internal connections (with inherent platform switching) might be preferred over internal flat-flat and external connections to decrease the risk of early bone loss and potentially the risk of peri-implant disease. Moreover, there is a trend suggesting moving the prosthetic interface coronally (to the juxta-mucosal level) as soon as possible to reduce the number of disconnections and to limit the risk of cements remnants. This can be achieved by choosing a tissue-level implant or to place a trans-mucosal abutment (one abutment-one time approach) to optimize the peri-implant soft tissue seal. In absence of evidence for the biocompatibility regarding several restorative materials, biocompatible materials such as titanium or zirconia should be preferred in the trans-mucosal portion. Finally, higher implants (≥2mm) with an emergence angle below 30° seem more favourable. It should however be noted that some of this information is solely based on indirect information (such as early bone loss) and more research is needed before making firm recommendations about abutment choice. [Correction added on 13 March 2023, after first online publication: 'longer implants (≥2mm)' was changed to 'higher implants (≥2mm)' in this version.].
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Affiliation(s)
- Isabelle Laleman
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
| | - France Lambert
- Department of Periodontology and oro-dental Surgery, Faculty of Medicine, University of Liège, Liège, Belgium
- Dental Biomaterials Research Unit (d-BRU), Faculty of Medicine, University of Liège, Liège, Belgium
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Galindo‐Moreno P, Catena A, Pérez‐Sayáns M, Fernández‐Barbero JE, O'Valle F, Padial‐Molina M. Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study. Clin Implant Dent Relat Res 2022; 24:630-642. [PMID: 35831919 PMCID: PMC9796358 DOI: 10.1111/cid.13122] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/26/2022] [Accepted: 06/29/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The aim of this study was to establish an objective criterion in terms of marginal bone level (MBL) to know the prognosis of an implant. MATERIALS AND METHODS A group of 176 patients in whom 590 implants were placed were included in this retrospective study. Patients older than 18 years, presenting either Kennedy class I or II edentulous section, or totally edentulous at least in one of the dental arches were included in this study. Those with any type of disturbance able to alter bone metabolism or with nontreated periodontal disease were excluded. Data on radiographic MBL at loading, 6 and 18 months later, age, gender, smoking habits, history of periodontitis, bone substratum, implant, and prosthetic features were recorded. Nonparametric receiver operating curves (ROC) were constructed for the MBL at 18 months in order to establish a distinction among high bone loser (HBL) and low bone loser (LBL) implants. Differences as a function of main variables were also determined, particularly abutment height and periodontal disease. RESULTS HBL implants lost at least 0.48 mm of MBL 6 months after loading; they reached at least 2 mm of MBL 18 months after loading. MBL rate followed a nonlinear trend, except in implants restored over long prosthetic abutments and in patients with history of severe periodontitis; in whom the rate of MBL over the time was nearly zero. CONCLUSION Implants that lose more than 0.5 mm of marginal bone 6 months after loading are at great risk of not being radiographically successful anymore. Therefore, 0.5 mm of MBL is proposed as a distinctive and objective criterion of success in Implant Dentistry within a 6-month follow-up period. A prosthetic abutment height ≥2 mm resulted the most protective factor in the peri-implant bone maintenance.
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Affiliation(s)
- Pablo Galindo‐Moreno
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
| | - Andrés Catena
- Department of Experimental Psychology, School of PsychologyUniversity of GranadaGranadaSpain
| | - Mario Pérez‐Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and DentistryUniversity of Santiago de CompostelaSantiago de CompostelaSpain
| | | | - Francisco O'Valle
- Department of Pathology, School of Medicine & IBIMERUniversity of GranadaGranadaSpain,Instituto de Investigación Biosanitariaibs.GRANADAGranadaSpain
| | - Miguel Padial‐Molina
- Department of Oral Surgery and Implant Dentistry, School of DentistryUniversity of GranadaGranadaSpain
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Chanthasan S, Mattheos N, Pisarnturakit PP, Pimkhaokham A, Subbalekha K. Influence of interproximal peri-implant tissue and prosthesis contours on food impaction, tissue health, and patients' quality of life. Clin Oral Implants Res 2022; 33:768-781. [PMID: 35578787 DOI: 10.1111/clr.13958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE 1) To investigate tissue features and interproximal contour of posterior implant supported single crowns (ISSC), which correlate with food impaction. 2) To evaluate the influence of food impaction on the health of the adjacent peri-implant tissue and patients' oral health related quality of life (OHRQoL). MATERIALS AND METHODS Patients with posterior ISSC under maintenance between July 2019 and July 2020 were recruited. OHRQoL of patients who self-reported food impaction between ISSC and teeth was evaluated by Oral Impacts on Daily Performance questionnaire and reported at patient level. Interproximal prosthesis contours and periodontal/peri-implant tissue conditions were assessed by clinical and radiographic examination. Differences between food impaction (FI) and non-food impaction (NFI) sites were analysed. RESULTS Totally 178 patients (286 ISSC and 410 interproximal spaces) were included. Among 119 patients who self-reported food impaction, 84 (70.6%) reported their OHRQoL to be affected with minor to severe intensity. The most common affected daily performance was the ability to clean the teeth. Plaque accumulation at ISSC, deeper probing depth, complete interdental papilla fill, loose contact, longer contact length, lower contact point level, closer distance between ISSC and tooth, lesser embrasure surface area, tissue level implant and cement-retained restoration were found significantly more in the FI group than the NFI group (P<0.05). CONCLUSION Interproximal features of the implant prosthesis were associated with food impaction between the ISSC and the adjacent tooth, which might affect periodontal and/or peri-implant tissue health conditions. Patients' OHRQoL was commonly affected by food impaction, but the intensity was low.
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Affiliation(s)
- Souknilan Chanthasan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Sweden
| | | | - Atiphan Pimkhaokham
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Keskanya Subbalekha
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Mattheos N, Janda M, Acharya A, Pekarski S, Larsson C. Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri-implant mucositis and peri-implantitis: A critical review. Clin Oral Implants Res 2021; 32 Suppl 21:181-202. [PMID: 34642979 DOI: 10.1111/clr.13823] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri-implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri-implant mucositis and peri-implantitis. METHODS Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri-implant mucositis and peri-implantitis were included. RESULTS Emerging evidence with bone-level implants suggests a link between EA combined with convex EP and peri-implantitis. Depth of the peri-implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri-implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti-infective treatment of peri-implant mucositis. Limited evidence points to no difference with regard to the risk for peri-implant mucositis between tissue- and bone-level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri-implantitis. Literature with regard to prosthesis retention type and risk for peri-implantitis is inconclusive. CONCLUSIONS Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri-implant mucositis/peri-implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose-designed studies are required to clarify current observations.
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Affiliation(s)
- Nikos Mattheos
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin Janda
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Aneesha Acharya
- Department of Periodontics, Dr. D. Y. Patil Dental College and Hospital, Pune, India
| | - Stephanie Pekarski
- Department of Periodontology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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10
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Mortazavi H, Khodadoustan A, Kheiri A, Kheiri L. Bone loss-related factors in tissue and bone level dental implants: a systematic review of clinical trials. J Korean Assoc Oral Maxillofac Surg 2021; 47:153-174. [PMID: 34187956 PMCID: PMC8249186 DOI: 10.5125/jkaoms.2021.47.3.153] [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: 10/25/2020] [Revised: 01/19/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissue-level designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.
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Affiliation(s)
- Hamed Mortazavi
- Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amin Khodadoustan
- Member of Iranian Association of Periodontology, Private Practice, Tehran, Iran
| | - Aida Kheiri
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lida Kheiri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran
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Agustín-Panadero R, Bermúdez-Mulet I, Fernández-Estevan L, Fernanda Solá-Ruíz M, Marco-Pitarch R, García-Selva M, Zubizarreta-Macho Á, León-Martínez R. Peri-Implant Behavior of Tissue Level Dental Implants with a Convergent Neck. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105232. [PMID: 34069084 PMCID: PMC8156926 DOI: 10.3390/ijerph18105232] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 02/07/2023]
Abstract
Introduction: The aim of this retrospective study was to analyze the radiographic peri-implant bone loss of bone level implants and tissue level implants with a convergent neck in screw-retained single crowns and in screw-retained fixed partial prostheses, after two years of functional loading. Materials and methods: The sample was divided into two groups according to their type: Group I: supracrestal implants with convergent transmucosal neck; Group II: crestal implants. In each group we distinguish two subgroups according to the type of prosthetic restoration: single crowns and a three-piece fixed partial prosthesis on two implants. To quantify bone loss, parallelized periapical radiographs were analyzed at the time of implant placement and after two years of functional load. Results: A total of 120 implants were placed in 53 patients. After statistical analysis it was observed that for each type of implant bone loss was 0.97 ± 0.91 mm for bone level and 0.31 ± 0.48 mm for tissue level. No significant differences were found regarding the type of prosthesis and the location (maxilla or mandible) of the implants. Conclusions: Tissue level implants with a convergent transepithelial neck exhibit less peri-implant bone loss than bone level implants regardless of the type of prosthesis.
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Affiliation(s)
- Rubén Agustín-Panadero
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
| | - Irene Bermúdez-Mulet
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
| | - Lucía Fernández-Estevan
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
| | - María Fernanda Solá-Ruíz
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
- Correspondence: ; Tel.: +34-963-864-034
| | - Rocío Marco-Pitarch
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
- Department of Dentistry, Cardenal Herrera-CEU University, 46115 Valencia, Spain
| | - Marina García-Selva
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain;
| | - Raquel León-Martínez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain; (R.A.-P.); (I.B.-M.); (L.F.-E.); (R.M.-P.); (M.G.-S.); (R.L.-M.)
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12
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Liu M, He L, Wang H. Clinical and radiographic performance of one-piece and two-piece implant:a systematic review and meta-analysis. J Prosthodont Res 2020; 65:56-66. [PMID: 32938870 DOI: 10.2186/jpr.jpor_2019_436] [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] [Indexed: 02/05/2023]
Abstract
PURPOSE The aim of this system review was to evaluate clinical and radiographic performance of one-piece implant (OPI) and two-piece implant (TPI). METHODS Electronic database searches were performed in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and OpenGrey databases up to May 2019. Two authors individually screened the related literatures according to the inclusion and exclusion criteria. Main clinical outcomes included failure and complication rates. Radiographic outcomes were peri-implant bone loss between baseline and last available follow-up. RESULTS Finally, 11 articles reporting 10 different studies were included in this review. No statistically significant difference (P = 0.22) in risk of failure was found between the two types of implants (RR: 0.49, 95% CI: 0.16-1.53). Peri-implantitis accounted for most failures and complications and there was no statistically significant difference in risk of peri-implantitis no matter after 1 year follow-up (RR: 1.15, 95% CI: 0.37-3.53, P = 0.81) or at 2-3 years (RR: 1.95, 95% CI: 0.23-16.63, P = 0.54). With regard to the marginal bone loss (MBL) around implants, subgroup meta-analysis by platform switching versus platform matching showed a significant MBL-reducing effect for TPI when compared to OPI (WMD: 0.21mm, 95% CI: 0.07-0.36mm, P = 0.004) in the platform-switching subgroup, while no significant difference in MBL was observed between the two groups in the platform-matching subgroup (P = 0.67). CONCLUSIONS The results of this review suggested that OPI and TPI showed similar short-term survival rates and incidences of complications. Nevertheless, TPI with platform switching may be a better option to reduce peri-implant bone loss.
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Affiliation(s)
- Mengqi Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of prosthodontics, West China Hospital of Stomatology, Sichuan University
| | - Lulu He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of prosthodontics, West China Hospital of Stomatology, Sichuan University
| | - Hang Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of prosthodontics, West China Hospital of Stomatology, Sichuan University
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13
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Li H, Sun T, Liu C, Cao Y, Liu X. Photobiomodulation (450 nm) alters the infection of periodontitis bacteria via the ROS/MAPK/mTOR signaling pathway. Free Radic Biol Med 2020; 152:838-853. [PMID: 32014500 DOI: 10.1016/j.freeradbiomed.2020.01.184] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/28/2020] [Accepted: 01/28/2020] [Indexed: 12/22/2022]
Abstract
We aimed to investigate the effects of photobiomodulation (PBM) on periodontitis. A periodontitis model was established via Porphyromonas gingivalis infection in beagles. Mandibular second and third premolars were removed, and implants were positioned immediately after tooth extraction. Left gingiva was irradiated with PBM (450 nm) as the LG group, and right side without irradiation was regarded as the CG (control) group. PBM treatment increased oxidative stress by increasing the levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS). The elevated levels of H2O2 (a biomarker of oxidative stress) and the free radicals (NO• and O2•-) reduced the concentration of dominant pathogens and regulated ROS/RNS/AMP-activated protein kinase (AMPK)/mTOR pathway by affecting p-AMPK, Runt-related transcription factor 2 (RUNX2), p-c-Jun N-terminal kinase (JNK)/mammalian target of rapamycin (mTOR), and acetyl-CoA carboxylase 1 (ACC1). PBM therapy increased salivary levels of interleukin-1 receptor antagonist (IL-1ra), interleukin (IL)-10, total antioxidant capacity (TAC) and catalase (CAT), and reduced the levels of tumor necrosis factor (TNF)α and interleukin (IL)-1β, malondialdehyde (MDA) and 8-hydroxydeoxyguanosine (8-OHdG) (p < 0.05). All the results contributed to preventing periodontitis infection. PBM therapy improved bone mineral density and implant osseointegration by controlling dominant pathogens invasion via the upregulation of salivary anti-inflammatory and antioxidant defense by affecting ROS/RNS/AMPK/mTOR signaling pathway.
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Affiliation(s)
- Hui Li
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Tong Sun
- Department of Breast Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Cong Liu
- Department of Stomatology, Taian City Central Hospital, Taian, 271000, Shandong, China
| | - Yan Cao
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China
| | - Xin Liu
- Department of Stomatology, China-Japan Union Hospital of Jilin University, Changchun, 130033, China.
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Taheri M, Akbari S, Shamshiri AR, Shayesteh YS. Marginal bone loss around bone-level and tissue-level implants: A systematic review and meta-analysis. Ann Anat 2020; 231:151525. [PMID: 32380195 DOI: 10.1016/j.aanat.2020.151525] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 03/19/2020] [Accepted: 04/07/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To review the scientific evidence regarding the marginal bone loss around the tissue-level and bone-level implants. METHODS MEDLINE-PubMed and EMBASE databases were searched for the relevant English articles (up to February 2019) assessing the marginal bone loss (MBL) as the primary outcome. To be selected, studies were supposed to directly mention "tissue-level" and "bone-level" implants or implants with and without a smooth neck. Relevant data were extracted and meta-analysis was performed to evaluate the effect of implant neck design. RESULTS A total of 19 studies (10 clinical, and 9 RCT studies) were included for qualitative analysis. There was a vast heterogeneity between studies in terms of implant designs and study protocol. Out of 19 articles included, 11 studies reached to a statistically significant difference in MBL between the groups; however, the differences were not found to be clinically relevant. Bone-level implants with platform-switched abutments in most of the cases showed better marginal bone stability compared to tissue-level implants or bone-level implants with matching abutments. Seven RCTs with 12 months follow-up data were selected for meta-analysis (I2=93%; heterogeneous), and the results showed less MBL around bone-level implants compared to tissue-level group (WMD=-0.21mm; 95% CI -0.42, 0.00; P=0.06). CONCLUSION The available data regarding comparison of MBL around bone-level and tissue-level implants are heterogeneous. Bone-level implants with platform switching may better preserve crestal bone.
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Affiliation(s)
- Mina Taheri
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Solmaz Akbari
- Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ahmad Reza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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15
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Uraz A, Isler SC, Cula S, Tunc S, Yalim M, Cetiner D. Platform‐switched implants vs platform‐matched implants placed in different implant‐abutment interface positions: A prospective randomized clinical and microbiological study. Clin Implant Dent Relat Res 2019; 22:59-68. [DOI: 10.1111/cid.12873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 10/28/2019] [Accepted: 11/13/2019] [Indexed: 12/27/2022]
Affiliation(s)
- Ahu Uraz
- Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey
| | - Sila C. Isler
- Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey
| | - Serpil Cula
- Department of Insurance and Risk Management, Faculty of Commercial Sciences Baskent University Ankara Turkey
| | - Samet Tunc
- Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey
| | - Mehmet Yalim
- Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey
| | - Deniz Cetiner
- Department of Periodontology, Faculty of Dentistry Gazi University Ankara Turkey
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Akram Z, Vohra F, Sheikh SA, Albaijan R, Bukhari IA, Hussain M. Clinical and radiographic peri-implant outcomes of short dental implants placed in posterior jaws of patients with treated generalized aggressive periodontitis: A 3-year follow-up study. Clin Implant Dent Relat Res 2019; 21:775-780. [PMID: 30938040 DOI: 10.1111/cid.12761] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 03/02/2019] [Accepted: 03/09/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Studies assessing clinical and radiographic peri-implant parameters around short dental implants (SDIs) in treated generalized aggressive periodontitis (GAgP) patients are scant. OBJECTIVES This 3-year follow-up study aimed to compare the clinical peri-implant and radiographic bone status around SDIs placed in partially edentulous patients treated for GAgP and periodontally healthy patients and to assess the implant success rate between both the groups. MATERIALS AND METHODS A total of seven patients clinically diagnosed with GAgP and seven periodontally healthy patients was included in the clinical study. Forty-eight (29 maxilla; 19 mandible) and 11 (8 maxilla; 3 mandible) SDIs were placed in the GAgP group and healthy group, respectively. Plaque index (PI), bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL) were recorded at six sites around all teeth and implants. Marginal bone loss (MBL) was studied incorporating in a specialized software and examined on a calibrated computer display screen with the help of an image analyzer. Patient satisfaction was recorded using a questionnaire sheet that contained questions regarding esthetics and function of the restorations. RESULTS The implant survival rate after 3 years was 81.25%. BOP and CAL around SDIs of GAgP patients were significantly higher than in periodontally healthy subjects (P = .01) throughout the follow-up. CAL around the teeth of GAgP patients was significantly greater during the follow-up than around the teeth of periodontal healthy subjects (P = .02). The PI and BOP between the teeth and implants showed no statistical significant difference. The mean PD at teeth was 0.4 mm greater than at implants. Implants showed significantly increased attachment loss than teeth (P = .01). The overall mean satisfaction of visual analogue scale was 12.8 ± 1.45. CONCLUSION This short-term follow-up study indicates SDIs remain functionally stable in the posterior jaws of treated GAgP patients.
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Affiliation(s)
- Zohaib Akram
- Department of Oral Restorative and Rehabilitative Sciences, UWA Dental School, The University of Western Australia (M512), Perth, Western Australia, Australia
| | - Fahim Vohra
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Saeed A Sheikh
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Refal Albaijan
- Department of Prosthetic Dental Science, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ishfaq A Bukhari
- Department of Pharmacology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mudassir Hussain
- Department of Surgery, College of Dentistry, Karachi Medical & Dental College, Karachi, Pakistan
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