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Ashique S, Hussain A, Khan T, Pal S, Rihan M, Farid A, Webster TJ, Hassan MZ, Asiri YI. Insights into Intra Periodontal Pocket Pathogenesis, Treatment, In Vitro-In Vivo Models, Products and Patents, Challenges and Opportunity. AAPS PharmSciTech 2024; 25:121. [PMID: 38816555 DOI: 10.1208/s12249-024-02842-6] [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: 01/27/2024] [Accepted: 05/15/2024] [Indexed: 06/01/2024] Open
Abstract
Periodontal disease is a multifactorial pathogenic condition involving microbial infection, inflammation, and various systemic complications. Here, a systematic and comprehensive review discussing key-points such as the pros and cons of conventional methods, new advancements, challenges, patents and products, and future prospects is presented. A systematic review process was adopted here by using the following keywords: periodontal diseases, pathogenesis, models, patents, challenges, recent developments, and 3-D printing scaffolds. Search engines used were "google scholar", "web of science", "scopus", and "pubmed", along with textbooks published over the last few decades. A thorough study of the published data rendered an accurate and deep understanding of periodontal diseases, the gap of research so far, and future opportunities. Formulation scientists and doctors need to be interconnected for a better understanding of the disease to prescribe a quality product. Moreover, prime challenges (such as a lack of a vital testing model, scarcity of clinical and preclinical data, products allowing for high drug access to deeper tissue regions for prolonged residence, lack of an international monitoring body, lack of 4D or time controlled scaffolds, and lack of successful AI based tools) exist that must be addressed for designing new quality products. Generally, several products have been commercialized to treat periodontal diseases with certain limitations. Various strategic approaches have been attempted to target certain delivery regions, maximize residence time, improve efficacy, and reduce toxicity. Conclusively, the current review summarizes valuable information for researchers and healthcare professional to treat a wide range of periodontal diseases.
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Affiliation(s)
- Sumel Ashique
- Department of Pharmaceutics, School of Pharmacy, Bharat Institute of Technology (BIT), Meerut, 250103, UP, India
| | - Afzal Hussain
- Department of Pharmaceutics, College of Pharmacy, King Saud University, 11451, Riyadh, Saudi Arabia.
| | - Tasneem Khan
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, 110062, India
| | - Sejuti Pal
- School of Pharmacy, College of Health and Medicine, University of Tasmania, Churchill Ave, Sandybay, Hobart, TAS- 7005, Australia
| | - Mohd Rihan
- Department of Pharmacology, National Institute of Pharmaceutical Education and Research (NIPER), S.A.S. Nagar, Punjab, 160062, India
| | - Arshad Farid
- Gomal Center of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, 29050, Pakistan
| | - Thomas J Webster
- Division of Pre-college and Undergraduate Studies, Brown University, Providence, Rhode Island, 02912, USA.
| | - Mohd Zaheen Hassan
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Asir, Saudi Arabia
| | - Yahya I Asiri
- Department of Pharmacology, College of Pharmacy, King Khalid University, Asiri, Saudi Arabia
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Ahmad S, Alam S, Andrabi SMUN, Kumar A. Combined surgical and conservative endodontic management of Oehler's type 3b dens invaginatus aided by guided tissue regeneration. BMJ Case Rep 2023; 16:e255546. [PMID: 37758663 PMCID: PMC10537856 DOI: 10.1136/bcr-2023-255546] [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] [Indexed: 09/29/2023] Open
Abstract
The present case describes the successful healing of a periapical lesion associated with the left maxillary lateral incisor (# 22, Federation Dentaire Internationale) having a type 3b dens invaginatus tooth morphology. The treatment was complicated by the presence of blunderbuss root apex and large periapical lesion (>10 mm) with through and through bone defect (Bucco palatal cortical bone perforation, Von Arx Type 1b). An adolescent boy reported palatal swelling and pus discharge in relation to tooth #22. A thorough clinical and radiographic examination revealed tooth #22 as having a type 3b dens invaginatus with an open apex and a diagnosis of pulp necrosis and acute apical abscess. The case was managed by non-surgical root canal treatment followed by endodontic surgery using principles of guided tissue regeneration. A 5-year recall revealed an asymptomatic functional tooth with complete healing.
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Affiliation(s)
- Sarah Ahmad
- Conservative Dentistry and Endodontics, Dr Z.A Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Sharique Alam
- Conservative Dentistry and Endodontics, Dr Z.A Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Syed Mukhtar-Un-Nisar Andrabi
- Conservative Dentistry and Endodontics, Dr Z.A Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
| | - Ashok Kumar
- Conservative Dentistry and Endodontics, Dr Z.A Dental College, Faculty of Medicine, Aligarh Muslim University, Aligarh, India
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Shaheen MY. Nanocrystalline hydroxyapatite in periodontal bone regeneration: A systematic review. Saudi Dent J 2022; 34:647-660. [PMID: 36570589 PMCID: PMC9767838 DOI: 10.1016/j.sdentj.2022.09.005] [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: 06/23/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/06/2022] Open
Abstract
Background Periodontal diseases when persistent, results in periodontal pockets, attachment loss and progressive destruction of the alveolar bone. Grafting periodontal bone defects with bone substitute biomaterials has proven clinical success for accomplishing reconstruction of lost attachment apparatus, especially in deep intra-bony defects. Nanoparticles (NPs) have been considered indispensable in the future of health sciences and NP based alloplastic graft materials such as nanocrystalline hydroxyapatite (NCHA) hold great promise for regeneration of periodontal defects. Therefore the aim of this review is to evaluate the role of NCHA as an effective substitute for periodontal bone regeneration. Material & methods Popular scientific databases such as PubMed (Medline), Cochrane database of clinical trials, Scopus (Elsevier), Web of science (Clarivate Analytics) and Google Scholar, were searched. The literature search was restricted to published reports in English, between January 2000 and December 2021. Database search returned 1227 results which were screened based on title, author names and publication dates. Results Data from the 14 included studies were reviewed and tabulated. In the present review, all the studies reported using commercially available NCHA for periodontal bone regeneration. Conclusion NCHA is a suitable bone substitute material for periodontal bone regeneration, with outcomes comparable to that of conventionally used graft materials such as bovine xenograft and other synthetic alloplastic materials. While grafting with NCHA in intrabony periodontal defects, after any form of periodontal flap surgery or debridement, significantly improves bone regeneration by 6 months, addition of adjuncts like EMD and PRF further enhance the outcomes.
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Shaikh MS, Zafar MS, Alnazzawi A, Javed F. Nanocrystalline hydroxyapatite in regeneration of periodontal intrabony defects: A systematic review and meta-analysis. Ann Anat 2021; 240:151877. [PMID: 34864225 DOI: 10.1016/j.aanat.2021.151877] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/09/2021] [Accepted: 11/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Alveolar bone loss and mobility of teeth is commonly observed in periodontitis patients. Regeneration of periodontal intrabony defects is indicated to restore the lost bone and periodontal tissues. The aim of the present study was to evaluate the clinical outcomes of periodontal intrabony lesions by using nanocrystalline hydroxyapatite (NHA) graft and comparing it with open flap debridement (OFD) alone. MATERIALS AND METHODS The eligibility criteria encompassed randomized (RCTs) and controlled clinical trials (CCTs). Weighted mean differences were calculated for clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction and gingival recession (REC) change, demonstrated as forest plots. The revised Cochrane Risk of Bias tool for randomized trials (RoB2) and Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) tool were used for quality assessment of RCTs and non-randomized trials respectively. RESULTS From 22 full-text articles identified, three RCTs, one CCT and one retrospective follow-up of RCT were included. All the five papers comprised the quantitative evaluation. The use of NHA graft provided additional CAL gain of 0.96 mm (p = 0.0009) and PPD reduction of 0.97 mm (p < 0.00001) when compared to OFD alone. However, in terms of REC changes, no considerable benefits of NHA graft were demonstrated than OFD alone (p = 0.48). CONCLUSIONS The bioactive NHA graft showed promising results clinically in regenerative periodontology and can be considered for the management of periodontal intrabony defects. The use of NHA graft considerably provided better clinical outcomes in intrabony defects compared to using the OFD alone. Future research investigating NHA graft against other regenerative materials including specific BGs, at longer follow-up periods and bigger sample sizes and in furcation defects warranted.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi, 75510, Pakistan
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia; Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan.
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 41311, Saudi Arabia
| | - Fawad Javed
- Department of Orthodontics, Eastman Institute for Oral Health, University of Rochester, New York 14620, United States
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Shaikh MS, Zafar MS, Alnazzawi A. Comparing Nanohydroxyapatite Graft and Other Bone Grafts in the Repair of Periodontal Infrabony Lesions: A Systematic Review and Meta-Analysis. Int J Mol Sci 2021; 22:12021. [PMID: 34769451 PMCID: PMC8584357 DOI: 10.3390/ijms222112021] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the results of periodontal infrabony lesions treated using nanohydroxyapatite (NcHA) graft with other bone grafts (BGs). METHODS Four electronic databases were searched including PubMed (NLM), Embase (Ovid), Medline, and Dentistry and Oral Sciences (EBSCO). The inclusion criteria included randomised controlled clinical trials (RCTs) and controlled clinical trials (CCTs). The clinical results of NcHA were compared with other BGs. For clinical attachment level (CAL) gain, probing pocket depth (PPD) decrease, and gingival recession (REC) change, weighted averages and forest plots were computed. RESULTS Seven RCTs fulfilled the selection criteria that were included. When NcHA was compared to other BGs, no clinically significant differences were found in terms of each outcome assessed, except the REC change for synthetic BGs as compared to NcHA. CONCLUSIONS The use of an NcHA graft showed equivalent results compared to other types of BGs. To further validate these findings, future studies are required to compare the NcHA and various BGs over longer time periods and in furcation deficiencies.
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Affiliation(s)
- Muhammad Saad Shaikh
- Department of Oral Biology, Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi 75510, Pakistan;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan
| | - Ahmad Alnazzawi
- Department of Substitutive Dental Sciences, College of Dentistry, Taibah University, Al Madinah 41311, Al Munawwarah, Saudi Arabia;
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Koduru S, Aghanashini S, Nadiger S, Apoorva SM, Bhat D, Puvvalla B. A Clinical and Radiographic Evaluation of the Efficacy of Nanohydroxyapatite (Sybograf™) versus Bioactive Calcium Phosphosilicate Putty (Novabone ®) in the Treatment of Human Periodontal Infrabony Defects: A Randomized Clinical Trial. Contemp Clin Dent 2020; 10:16-23. [PMID: 32015636 PMCID: PMC6974983 DOI: 10.4103/ccd.ccd_52_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study is to compare and to evaluate clinically and radiographically the bone regeneration and the amount of bone fill (BL) between nanocrystalline hydroxyapatite (Nc-HA) (Sybograf™) and bioactive synthetic NovaBone Putty in the treatment of intrabony component of periodontal osseous defects. Materials and Methods: Twenty sites in 20 patients, within the age range of 25–55 years, showing intrabony defects were selected and divided into Group I (Nc-HA) and Group II (Bioactive synthetic NovaBone Putty). All the selected sites were assessed with the clinical and radiographic parameters such as plaque index, gingival index, sulcus bleeding index, probing pocket depth, clinical attachment level, gingival recession, and radiographic BL. All the clinical and radiographic parameter values obtained at different intervals (baseline, 3, and 6 and 9 months) were subjected to statistical analysis. Results: A statistically significant reduction in pocket depth of 4.400 ± 0.843 mm (Group I), 3.800 ± 0.789 mm (Group II) and gain in clinical attachment level of 6.2 mm (Group I), 5.9 mm (Group II) were recorded at the end of the study. A slight increase in gingival recession was observed. The mean percentage changes in the amount of radiographic BL of Group II and Group I were significant, However, when compared between the groups, there is no significant difference in BL observed. Conclusion: Both the graft materials appear to have nearly comparable effects, with nanocrystalline hydroxyapatite (Sybograf™), displaying slightly superior effect over bioactive glass especially in relation to clinical parameters. However, long-term, controlled clinical trials are required to confirm these findings.
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Affiliation(s)
- Sravani Koduru
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - Suchetha Aghanashini
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - Sapna Nadiger
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - S M Apoorva
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - Divya Bhat
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
| | - Bhavana Puvvalla
- Department of Periodontology, D.A.P.M.R.V. Dental College, Bengaluru, Karnataka, India
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Hemaid S, Saafan A, Hosny M, Wimmer G. Enhancement of Healing of Periodontal Intrabony Defects Using 810 nm Diode Laser and Different Advanced Treatment Modalities: A Blind Experimental Study. Open Access Maced J Med Sci 2019; 7:1847-1853. [PMID: 31316672 PMCID: PMC6614254 DOI: 10.3889/oamjms.2019.484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 05/23/2019] [Accepted: 05/24/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Low-level laser therapy (LLLT) in the early stage of bone healing was demonstrated as a positive local biostimulative effect. It was also shown that platelet-rich fibrin (PRF) and nanohydroxyapatite alloplast (NanoHA) are effective in treating periodontal intrabony defects. AIM The study aimed to evaluate the combined effects of LLLT (810 nm), PRF and NanoHA on induced intrabony periodontal defects healing. MATERIAL AND METHODS The study was conducted on 16 defects in 8 adult male rabbits (n = 16) divided into 4 groups; Control non-treated group (C), laser irradiated control group (CL), PRF+NanoHA graft (NanoHA-Graft+PRF) treated group and laser irradiated and treated group (NanoHA-Graft+PRF+L). CT radiography was made at baseline, 15 and 30 days later. The defects were induced in the form of one osseous wall defects of 10 mm height, 4 mm depth between the 1st and the 2nd molars using a tapered fissure drill coupled to a high-speed motor. Statistical analysis was done using ANOVA. RESULTS (NanoHA-Graft+PRF+L) group significantly produced bone density higher than C, CL and NanoHA-G+PRF alone. CONCLUSION The combination of LLLT+PRF+NanoHA as a treatment modality induced the best results in bone formation in the bone defect more than LLLT alone or PRF+NanoHA alone.
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Affiliation(s)
- Shrief Hemaid
- Dental Laser Applications, Department of Medical Applications of Laser, National Institute for Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Ali Saafan
- Dental Laser Applications, Department of Medical Applications of Laser, National Institute for Laser Enhanced Sciences, Cairo University, Cairo, Egypt
| | - Manal Hosny
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Gernot Wimmer
- Department of Oral Medicine and Periodontology, Meduni Graz, Graz, Austria
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A Biomimetic Alternative to Synthetic Hydroxyapatite: "Boron-Containing Bone-Like Hydroxyapatite" Precipitated From Simulated Body Fluid. Ann Plast Surg 2018; 79:304-311. [PMID: 28430676 DOI: 10.1097/sap.0000000000001072] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Biological hydroxyapatite (HA), has several mechanical and physical advantages over the commercially available synthetic apatite (CAP-HA). The aim of this in vivo study was to investigate the effect of osteoinductive "bone-like hydroxyapatite" obtained from simulated body fluid (SBF) combined with osteoinductive "boron" (B) on bone healing. MATERIALS Bone like nanohydroxyapatite (SBF-HA) was precipitated from 10× simulated body fluid (10×SBF). Thirty Sprague-Dawley rats were randomly divided into 5 experimental groups (n = 6 each). The groups were involving blank defect, chitosan, SBF-HA, SBF-HA/B, and CAP-HA. Two biparietal round critical sized bone defect was created using a dental burr. The rats were sacrificed respectively at the end of second and fourth months after surgery and their calvarium were harvested for further macroscopic, microtomographic, and histologic evaluation. RESULTS The SBF-HA/B group demonstrated the highest mineralized matrix formation rates (30.69 ± 3.73 for the second month, 62.68 ± 7.03 for the fourth month) and was significantly higher than SBF-HA and the CAP-HA groups. The SBF-HA/B group demonstrated the highest mineralized matrix formation rates (30.69 ± 3.73 for the second month, 62.68 ± 7.03 for the fourth month) and was significantly higher than SBF-HA and the CAP-HA groups. In means of bone defect repair histologically, the highest result was observed in the SBF-HA/B group (P < 0.001). CONCLUSIONS The "bone-like hydroxapatite" obtained from simulated body fluid is worth attention when both its beneficial effects on bone healing and its biological behavior is taken in consideration for further bone tissue engineering studies. It appears to be a potential alternative to the commercially available hydroxyapatite samples.
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Echazú MIA, Tuttolomondo MV, Foglia ML, Mebert AM, Alvarez GS, Desimone MF. Advances in collagen, chitosan and silica biomaterials for oral tissue regeneration: from basics to clinical trials. J Mater Chem B 2016; 4:6913-6929. [DOI: 10.1039/c6tb02108e] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Different materials have distinct surface and bulk characteristics; each of them potentially useful for the treatment of a particular wound or disease.
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Affiliation(s)
- Maria Inés Alvarez Echazú
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Maria Victoria Tuttolomondo
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Maria Lucia Foglia
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Andrea Mathilde Mebert
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Gisela Solange Alvarez
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
| | - Martin Federico Desimone
- Universidad de Buenos Aires
- Instituto de Química y Metabolismo del Fármaco (IQUIMEFA)
- Facultad de Farmacia y Bioquímica
- Ciudad Autónoma de Buenos Aires
- Argentina
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Stoecklin-Wasmer C, Rutjes A, da Costa B, Salvi G, Jüni P, Sculean A. Absorbable Collagen Membranes for Periodontal Regeneration. J Dent Res 2013; 92:773-81. [DOI: 10.1177/0022034513496428] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Guided tissue regeneration (GTR) with bioabsorbable collagen membranes (CM) is commonly used for the treatment of periodontal defects. The objective of this systematic review of randomized clinical trials was to assess the clinical efficacy of GTR procedures with CM, with or without bone substitutes, in periodontal infrabony defects compared with that of open flap debridement (OFD) alone. Primary outcomes were tooth loss and gain in clinical attachment level (CAL). Screening of records, data extraction, and risk-of-bias assessments were performed by two reviewers. Weighted mean differences were estimated by random effects meta-analysis. We included 21 reports on 17 trials. Risk of bias was generally high. No data were available for the primary outcome tooth loss. The summary treatment effect for change in CAL for GTR with CM compared with OFD was 1.58 mm (95% CI, 1.27 to 1.88). Despite large between-trial heterogeneity (I2 = 75%, p < .001), all trials favored GTR over OFD. No differences in treatment effects were detected between trials of GTR with CM alone and trials of GTR with CM in combination with bone substitutes ( p for interaction, .31). GTR with CM, with or without substitutes, may result in improved clinical outcomes compared with those achieved with OFD alone. Our findings support GTR with CM for the treatment of infrabony periodontal defects.
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Affiliation(s)
- C. Stoecklin-Wasmer
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - A.W.S. Rutjes
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- Centre for Aging Sciences (Ce.S.I.), G. d’Annunzio University Foundation, Palazzina SEBI 3° livello, Campus Universitario Chieti Scalo, 66100 Chieti Scalo, Italia
| | - B.R. da Costa
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- CTU Bern, Department of Clinical Research, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - G.E. Salvi
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
| | - P. Jüni
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
- CTU Bern, Department of Clinical Research, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - A. Sculean
- Department of Periodontology, University of Bern, Freiburgstrasse 7, 3010 Bern, Switzerland
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