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Wach T, Hadrowicz P, Trybek G, Michcik A, Kozakiewicz M. Is Corticalization in Radiographs Related to a Higher Risk of Bone Loss around Dental Implants in Smoking Patients? A 5-Year Observation of Radiograph Bone-Texture Changes. J Clin Med 2023; 12:5351. [PMID: 37629393 PMCID: PMC10456057 DOI: 10.3390/jcm12165351] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Currently, the topic of dental implants is widely researched. However, still compromising are the factors that can affect implant loss as a consequence of marginal bone loss. One of the factors is smoking, which has a devastating effect on human health and bone structure. Oral health and jaw condition are also negatively affected by smoking. The aim of this study was to evaluate the peri-implant jawbone corticalization phenomenon in tobacco smokers. METHODS A total of 2196 samples from 768 patients with an implant in the neck area were checked, and texture features were analyzed. The corticalization phenomenon was investigated. All analyses were performed in MaZda Software. The influence of corticalization was investigated as a factor on bone structure near the implant neck. The statistical analysis included a feature distribution evaluation, mean (t-test) or median (W-test) comparison, analysis of regression and one-way analysis of variance or Kruskal-Wallis test as no normal distribution or between-group variance was indicated for the significant differences in the investigated groups. Detected differences or relationships were assumed to be statistically significant when p < 0.05. RESULTS The research revealed that MBL was correlated with smoking after 5 years (0.42 mm ± 1.32 mm 0 mm ± 1.25 mm), the Corticalization Index was higher in the smoker group on the day of surgery, and it became higher after 5y of observation (185.98 ± 90.8 and 243.17 ± 155.47). The implant-loss frequency was higher in the group of smokers, too, compared to non-smokers (6.74% and 2.87%). The higher the torque value during the implant placement, the higher the Corticalization Phenomenon Index. CONCLUSIONS The research revealed a correlation between smoking and changes in bone structure in radio textures near the implants. The corticalization phenomenon is important, may be detected immediately after implant placement and may be one of the indicators of the implant success rate.
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Affiliation(s)
- Tomasz Wach
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
| | - Piotr Hadrowicz
- Department of Otolaryngology, Hospital in Sosnowiec, Zegadłowicza 3, 41-200 Sosnowiec, Poland;
| | - Grzegorz Trybek
- Department of Oral Surgery, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
- 4th Military Clinical Hospital in Wroclaw, ul. Rudolfa Weigla 5, 50-981 Wroclaw, Poland
| | - Adam Michcik
- Department of Maxillofacial Surgery, Medical University of Gdansk, 80-210 Gdańsk, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
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Kozakiewicz M, Wach T. Exploring the Importance of Corticalization Occurring in Alveolar Bone Surrounding a Dental Implant. J Clin Med 2022; 11:7189. [PMID: 36498764 PMCID: PMC9738071 DOI: 10.3390/jcm11237189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
Several measures describing the transformation of trabecular bone to cortical bone on the basis of analysis of intraoral radiographs are known (including bone index or corticalization index, CI). At the same time, it has been noted that after functional loading of dental implants such transformations occur in the bone directly adjacent to the fixture. Intuitively, it seems that this is a process conducive to the long-term maintenance of dental implants and certainly necessary when immediate loading is applied. The authors examined the relationship of implant design features to marginal bone loss (MBL) and the intensity of corticalization over a 10-year period of functional loading. This study is a general description of the phenomenon of peri-implant bone corticalization and an attempt to interpret this phenomenon to achieve success of implant treatment in the long term. Corticalization significantly increased over the first 5-year functional loading (CI from 200 ± 146 initially to 282 ± 182, p < 0.001) and maintained a high level (CI = 261 ± 168) in the 10-year study relative to the reference bone (149 ± 178). MBL significantly increased throughout the follow-up period—5 years: 0.83 ± 1.26 mm (p < 0.001), 10 years: 1.48 ± 2.01 mm (p < 0.001). MBL and radiographic bone structure (CI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. In the scope of the study, it can be concluded that the phenomenon of peri-implant jawbone corticalization seems an unfavorable condition for the future fate of bone-anchored implants, but it requires further research to fully explain the significance of this phenomenon.
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Affiliation(s)
- Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland
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Measures of Corticalization. J Clin Med 2022; 11:jcm11185463. [PMID: 36143109 PMCID: PMC9500652 DOI: 10.3390/jcm11185463] [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: 07/09/2022] [Revised: 09/14/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
After the insertion of dental implants into living bone, the condition of the peri-implant bone changes with time. Implant-loading phenomena can induce bone remodeling in the form of the corticalization of the trabecular bone. The aim of this study was to see how bone index (BI) values behave in areas of bone loss (radiographically translucent non-trabecular areas) and to propose other indices specifically dedicated to detecting corticalization in living bone. Eight measures of corticalization in clinical standardized intraoral radiographs were studied: mean optical density, entropy, differential entropy, long-run emphasis moment, BI, corticalization index ver. 1 and ver. 2 (CI v.1, CI v.2) and corticalization factor (CF). The analysis was conducted on 40 cortical bone image samples, 40 cancellous bone samples and 40 soft tissue samples. It was found that each measure distinguishes corticalization significantly (p < 0.001), but only CI v.1 and CI v.2 do so selectively. CF or the inverse of BI can serve as a measure of peri-implant bone corticalization. However, better measures are CIs as they are dedicated to detecting this phenomenon and allowing clear clinical deduction.
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What Does Bone Corticalization around Dental Implants Mean in Light of Ten Years of Follow-Up? J Clin Med 2022; 11:jcm11123545. [PMID: 35743625 PMCID: PMC9225429 DOI: 10.3390/jcm11123545] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/06/2023] Open
Abstract
The phenomenon of peri-implant bone corticalization after functional loading does not yet have a definite clinical significance and impact on prognosis. An attempt was made to assess the clinical significance of this phenomenon. This prospective study included 554 patients. Standardized intraoral radiographs documenting the jawbone environment of 1556 implants were collected. The follow-up period was 10 years of functional loading. Marginal alveolar bone loss (MBL) and radiographic bone structure (bone index, BI) were evaluated in relation to intraosseous implant design features and prosthetic work performed. After five years, bone structure abnormalities expressed by a reduction of BI to 0.47 ± 0.21 and MBL = 0.88 ± 1.27 mm were observed. Both values had an inverse relationship with each other (p < 0.0001). Reference cancellous bone showed BI = 0.85 ± 0.18. The same relationship was observed after ten years of functional loading: BI = 0.48 ± 0.21, MBL = 1.49 ± 1.94 mm, and again an inverse relationship (p < 0.0001). Increasing corticalization (lower BI) is strongly associated with increasing marginal bone loss and increasing corticalization precedes future marginal bone loss. Marginal bone loss will increase as corticalization progresses.
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Popecki P, Jurczyszyn K, Ziętek M, Kozakiewicz M. Texture Analysis in Diagnosing Skin Pigmented Lesions in Normal and Polarized Light-A Preliminary Report. J Clin Med 2022; 11:jcm11092505. [PMID: 35566634 PMCID: PMC9101611 DOI: 10.3390/jcm11092505] [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: 04/06/2022] [Revised: 04/25/2022] [Accepted: 04/27/2022] [Indexed: 12/04/2022] Open
Abstract
The differential diagnosis of benign nevi (BN), dysplastic nevi (DN), and melanomas (MM) represents a considerable clinical problem. These lesions are similar in clinical examination but have different prognoses and therapeutic management techniques. A texture analysis (TA) is a mathematical and statistical analysis of pixel patterns of a digital image. This study aims to demonstrate the relationship between the TA of digital images of pigmented lesions under polarized and non-polarized light and their histopathological diagnosis. Ninety pigmented lesions of 76 patients were included in this study. We obtained 166 regions of interest (ROI) images for MM, 166 for DN, and 166 for BN. The pictures were taken under polarized and non-polarized light. Selected image texture features (entropy and difference entropy and long-run emphasis) of ROIs were calculated. Those three equations were used to construct the texture index (TI) and bone index (BI). All of the presented features distinguish melanomas, benign and dysplastic lesions under polarized light very well. In non-polarized images, only the long-run emphasis moment and both indices effectively differentiated nevi from melanomas. TA is an objective method of assessing pigmented lesions and can be used in automatic diagnostic systems.
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Affiliation(s)
- Paweł Popecki
- Department of Oral Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Kamil Jurczyszyn
- Department of Oral Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence: ; Tel.: +48-71-784-04-23
| | - Marcin Ziętek
- Department of Oncology, Wroclaw Medical University, Plac Hirszfelda 12, 53-413 Wroclaw, Poland;
- Department of Surgical Oncology, Wroclaw Comprehensive Cancer Center, Plac Hirszfelda 12, 53-413 Wroclaw, Poland
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 S. Zeromski Street, 90-549 Lodz, Poland;
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Hadzik J, Kubasiewicz-Ross P, Simka W, Gębarowski T, Barg E, Cieśla-Niechwiadowicz A, Trzcionka Szajna A, Szajna E, Gedrange T, Kozakiewicz M, Dominiak M, Jurczyszyn K. Fractal Dimension and Texture Analysis in the Assessment of Experimental Laser-Induced Periodic Surface Structures (LIPSS) Dental Implant Surface-In Vitro Study Preliminary Report. MATERIALS (BASEL, SWITZERLAND) 2022; 15:2713. [PMID: 35454406 PMCID: PMC9027964 DOI: 10.3390/ma15082713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 12/16/2022]
Abstract
Laser-induced periodic surface structures (LIPSS) are the sub-wavelength periodic nanostructures generated by the femtosecond laser. Implant topography and its nanostructural changes can be important for biomedical applications. In order to compare the surface topography of different implants, appropriate mathematical and physical descriptive methods should be provided. The aim of the study was to evaluate the experimental LIPSS-based-Low Spatial Frequency LIPSS (LSFL) dental implant surfaces. Novel methods of surface analysis, such as Fractal Dimension Analysis and Texture Analysis, were compared to the standard surface roughness evaluation. Secondary, cell viability, and attachment tests were applied in order to evaluate the biological properties of the new titanium surface and to compare their correlation with the physical properties of the new surfaces. A Normal Human Dermal Fibroblast (NHDF) cytotoxicity test did not show an impact on the vitality of the cells. Our study has shown that the laser LIPSS implant surface modifications significantly improved the cell adhesion to the tested surfaces. We observed a strong correlation of adhesion and the growth of cells on the tested surface, with an increase in implant surface roughness with the best results for the moderately rough (2 μm) surfaces. Texture and fractal dimension analyses are promising methods to evaluate dental implants with complex geometry.
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Affiliation(s)
- Jakub Hadzik
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, ul. Krakowska 26, 50-425 Wroclaw, Poland
| | - Paweł Kubasiewicz-Ross
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, ul. Krakowska 26, 50-425 Wroclaw, Poland
| | - Wojciech Simka
- Faculty of Chemistry, Silesian University of Technology, 44-100 Gliwice, Poland
| | - Tomasz Gębarowski
- Department of Biostructure and Animal Physiology, Wroclaw University of Environmental and Life Sciences, Kożuchowska 1/3, 51-631 Wroclaw, Poland
| | - Ewa Barg
- Department of Medical Science Foundation, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
| | - Aneta Cieśla-Niechwiadowicz
- Department of Medical Science Foundation, Faculty of Pharmacy, Wroclaw Medical University, Borowska 211, 50-556 Wroclaw, Poland
| | | | | | - Tomasz Gedrange
- Department of Orthodontics, TU Dresden, 01062 Dresden, Germany
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Faculty of Military Medicine, Medical University of Lodz, 90-151 Łódź, Poland
| | - Marzena Dominiak
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, ul. Krakowska 26, 50-425 Wroclaw, Poland
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Faculty of Medicine and Dentistry, Medical University of Wroclaw, ul. Krakowska 26, 50-425 Wroclaw, Poland
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The Osteosynthesis of the Mandibular Head, Does the Way the Screws Are Positioned Matter? J Clin Med 2022; 11:jcm11072031. [PMID: 35407637 PMCID: PMC8999701 DOI: 10.3390/jcm11072031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/22/2022] [Accepted: 03/31/2022] [Indexed: 12/17/2022] Open
Abstract
Currently, an increasing number of medical centers are treating mandibular head fractures surgically. Dedicated screws for compression osteosynthesis have been developed. However, due to the very limited size of the fractured bones and the considerable technical difficulties accompanying the execution of the fixation, there is little room for correction of the positioning and reinsertion of the screws. Therefore, knowing the optimal position of the fixation material is crucial for therapeutic success. The aim of this study is the evaluation of fixation screw position on the mandibular ramus height obtained in the treatment of the condylar head fracture. A total of 57 patients were included in this study. The loss of mandibular ramus height on computed tomography twelve months after mandibular head osteosynthesis was evaluated in relation to the initial distance of the screws from the fracture line, the angle of insertion of the screw into the bone, and the size of the protrusion to the inner side of the condyle. The relationship of the proximity of the screw to the fracture line, angulation, and the size of the protrusion with the loss of ramus height was confirmed. Conclusions: the optimal location for the superior screw is approx. 4 mm below the fracture line (with any angulation), inferior screw is approx. 8 mm (with any angulation), and anterior screw position is approx. 4-5 mm distant from fracture line with the best angulation of 130 degrees to the lateral mandible ramus surface in the coronal plane.
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Kozakiewicz M, Gabryelczak I. Bone Union Quality after Fracture Fixation of Mandibular Head with Compression Magnesium Screws. MATERIALS (BASEL, SWITZERLAND) 2022; 15:2230. [PMID: 35329682 PMCID: PMC8950275 DOI: 10.3390/ma15062230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 02/13/2022] [Accepted: 03/15/2022] [Indexed: 12/22/2022]
Abstract
For some years now, fixation devices created with resorbable magnesium alloys for the mandibular head have been clinically available and are beginning to be used. It is thus valuable to evaluate the quality of unions in these cases. The aim of this study was radiological comparison of magnesium versus titanium open reduction and rigid fixations in the mandible condylar head. Thirty-one patients were treated for fractures of the mandibular head with magnesium WE43 alloy headless compression screws (diameter 2.3 mm) and, as a reference group, 29 patients were included with similar construction titanium screws (diameter 1.8 mm). The 12-month results of the treatment were evaluated by the texture analysis of CT. Near similar treatment results were found with magnesium screws in traditional titanium fixation. Magnesium screws result in a higher density of the bone structure in the mandibular head. Conclusions: The quantitative evaluation of bone union after surgical treatment of mandibular head fracture with magnesium compression headless screws indicates that stable consolidation was achieved. Undoubtedly, the resorption process of the screws was found to be incomplete after 12 months, evidenced by a marked densification of the bone structure at the fracture site.
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Affiliation(s)
- Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 Żeromskiego Str., 90-549 Lodz, Poland;
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Skośkiewicz-Malinowska K, Mysior M, Rusak A, Kuropka P, Kozakiewicz M, Jurczyszyn K. Application of Texture and Fractal Dimension Analysis to Evaluate Subgingival Cement Surfaces in Terms of Biocompatibility. MATERIALS 2021; 14:ma14195857. [PMID: 34640254 PMCID: PMC8510438 DOI: 10.3390/ma14195857] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 11/16/2022]
Abstract
Biocompatibility is defined as “the ability of a biomaterial, prosthesis, or medical device to perform with an appropriate host response in a specific application”. Biocompatibility is especially important for restorative dentists as they use materials that remain in close contact with living tissues for a long time. The research material involves six types of cement used frequently in the subgingival region: Ketac Fil Plus (3M ESPE, Germany), Riva Self Cure (SDI, Australia) (Glass Ionomer Cements), Breeze (Pentron Clinical, USA) (Resin-based Cement), Adhesor Carbofine (Pentron, Czech Republic), Harvard Polycarboxylat Cement (Harvard Dental, Great Britain) (Zinc polycarboxylate types of cement) and Agatos S (Chema-Elektromet, Poland) (Zinc Phosphate Cement). Texture and fractal dimension analysis was applied. An evaluation of cytotoxicity and cell adhesion was carried out. The fractal dimension of Breeze (Pentron Clinical, USA) differed in each of the tested types of cement. Adhesor Carbofine (Pentron, Czech Republic) cytotoxicity was rated 4 on a 0–4 scale. The Ketac Fil Plus (3M ESPE, Germany) and Riva Self Cure (SDI, Australia) cements showed the most favorable conditions for the adhesion of fibroblasts, despite statistically significant differences in the fractal dimension of their surfaces.
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Affiliation(s)
| | - Martyna Mysior
- SCTT Academic Dental Polyclinic, 50-425 Wroclaw, Poland
- Correspondence:
| | - Agnieszka Rusak
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, 50-368 Wroclaw, Poland;
| | - Piotr Kuropka
- Division of Histology and Embryology, Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, 50-375 Wroclaw, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 90-647 Lodz, Poland;
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, 50-425 Wroclaw, Poland;
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Trafalski M, Kozakiewicz M, Jurczyszyn K. Application of Fractal Dimension and Texture Analysis to Evaluate the Effectiveness of Treatment of a Venous Lake in the Oral Mucosa Using a 980 nm Diode Laser-A Preliminary Study. MATERIALS 2021; 14:ma14154140. [PMID: 34361334 PMCID: PMC8347063 DOI: 10.3390/ma14154140] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/13/2021] [Accepted: 07/22/2021] [Indexed: 12/15/2022]
Abstract
Venous lake (VL) is a common lesion resulting from the enlargement of thin-walled veins surrounded by a thick wall of fibrous tissue. Photocoagulation is becoming one of the basic methods for treating small vascular lesions. The aim of this study was an application of texture analysis (TA) and fractal dimension analysis (FDA) to evaluate VL treatment. Twenty-three VLs were included in the study. We used a 980 nm diode laser, 6 W, 100 ms pulse mode with a 50% duty cycle. The total dose of energy was in a range from 80 J to 600 J. We used the difference of intensity algorithm for FDA and microcontrast and a co-occurrence matrix for TA. A complete therapeutic effect was achieved in 83%, and in 9%, scar formation was observed after three months. No healing was observed in 4%, and there was partial healing in 4%. No differences in FD were observed between the lesions after three months and the healthy mucosa. The fractal dimension and microcontrast of a vascular lesion are mutually coupled. FDA and TA is a useful and objective method of assessing treatment effects for venous lakes. The non-contact mode of the 980 nm diode laser is an effective and safe method for treating a VL.
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Affiliation(s)
- Mateusz Trafalski
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Marcin Kozakiewicz
- Department of Maxillofacial Surgery, Medical University of Lodz, 113 S. Żeromski Street, 90-549 Lodz, Poland;
| | - Kamil Jurczyszyn
- Department of Dental Surgery, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
- Correspondence:
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