1
|
Schiegnitz E, Sagheb K, Raahimi L, König J, Azaripour A, Al-Nawas B. Immediate versus delayed implant placement of novel fully tapered tissue-level implants - A retrospective multicenter clinical study. Clin Oral Implants Res 2024. [PMID: 38572982 DOI: 10.1111/clr.14263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 02/13/2024] [Accepted: 03/24/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To compare the clinical and radiological outcomes of novel fully tapered tissue-level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time. MATERIALS AND METHODS For this clinical study, 318 fully tapered tissue-level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed. RESULTS After a mean follow-up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%-CI 0.084-5.81). Neither for implant length (HR 0.53, 95%-CI 0.055-5.08) nor for implant width (HR 0.27, CI 0.028-2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4. CONCLUSIONS Within the limitations of this retrospective study and the short follow-up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue-level implant (no clinical trial registration as retrospective study design).
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Leila Raahimi
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Adriano Azaripour
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Private Praxis, Bad Soden am Taunus, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
2
|
Kämmerer PW, Heimes D, Hartmann A, Kesting M, Khoury F, Schiegnitz E, Thiem DGE, Wiltfang J, Al-Nawas B, Kämmerer W. Clinical insights into traumatic injury of the inferior alveolar and lingual nerves: a comprehensive approach from diagnosis to therapeutic interventions. Clin Oral Investig 2024; 28:216. [PMID: 38488908 PMCID: PMC10942925 DOI: 10.1007/s00784-024-05615-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVES This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview. MATERIALS AND METHODS A literature search across PubMed, Embase, and Cochrane Library informed the analysis. RESULTS Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain. CONCLUSIONS Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial. CLINICAL RELEVANCE Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals.
Collapse
Affiliation(s)
- Peer W Kämmerer
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany.
| | - Diana Heimes
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany
| | - Amely Hartmann
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany
| | - Marco Kesting
- Department of Oral and Cranio-Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Glückstraße 11, 91054, Erlangen, Germany
| | - Fouad Khoury
- International Dental Implant Center, Private Clinic Schloss Schellenstein, Am Schellenstein 1, 59939, Olsberg, Germany
| | - Eik Schiegnitz
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany
| | - Daniel G E Thiem
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, Christian Albrechts University, UKSH Campus Kiel, 24105, Kiel, Germany
| | - Bilal Al-Nawas
- Clinic of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 1, D-55131, Mainz, Germany
| | - Wolfgang Kämmerer
- Pharmacy Department, University of Augsburg, Medical Faculty, D-86156, Augsburg, Germany
| |
Collapse
|
3
|
Sagheb K, Wentaschek S, Bjelopavlovic M, Berres M, Díaz L, Fan S, Schiegnitz E, Al-Nawas B, Sagheb K. Evaluation of masticatory efficiency and OHRQoL in implant-retained overdenture with different numbers of implant in the edentulous mandible: a one-year follow-up prospective study. Int J Implant Dent 2024; 10:12. [PMID: 38480586 PMCID: PMC10937875 DOI: 10.1186/s40729-024-00519-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/04/2024] [Indexed: 03/17/2024] Open
Abstract
PURPOSE The aim of this article is to evaluate to the masticatory function performance and Oral Health-related Quality of Life (OHRQoL) in implant-retained overdenture compared with different implant number placements in the edentulous mandible. METHODS From 2013 to 2015, each patients received 3 implants (iSy-Implant, Camlog, Wimsheim, Germany) in intraforaminal mandible (34, 41/31, 44). After operation, inserted implants were gradually loaded and incorporated into an overdenture with a self-aligning attachment system (Locator abutments) in 3 + 3 + 3 months. Five checked points were performed chewing cycle test with multicolored chewing gum and OHIP-G14 questionnaire and a sum score questionnaire as following: pre-operation, one implant load (41/31), two implants loaded (33,43), three implants loaded and 1-year follow up. RESULT A total of 10 patients with 30 implants were placed, the survival rate of the implants was 100% within 1-year follow-up. Regarding the masticatory function analysis, for the higher number of chewing cycles, the higher mixing rate was observed. After 1 year, the inter-mixing rate without significant changes was found compared to the time after three implants were loaded with attachment system. The mean value of OHIP-G14 was 30.4 preoperatively, 21.1 after loading the first locator, 10.7 after loading two locator abutments, and 3.2 after loading all three locator abutments. After 1 year, OHIP-G14 was 2.6 without significantly changed. The mean of the sum score was 15.5 preoperatively, 27.8 after activation of the first locator, 39.4 after activation of two locators, 46.2 after activation of all three locators, and 47.3 after 1 year. An increase of 0.7 sum score units per time point was observed. No significance was detectable, analogous to OHIP-G14, compared to the time of activation of all three locator setups (p-value = 0.22). CONCLUSIONS A significant improvement in masticatory function performance and OHRQoL was evaluated with the increasing number of implants with locator attachment in edentulous mandible. With the investigation of the OHIP-G14 and sum score, the results of patient report outcome might be associated with the increase in the number of implants.
Collapse
Affiliation(s)
- Kawe Sagheb
- Department of Prosthetic, University Medical Center Mainz, Mainz, Germany
| | - Stefan Wentaschek
- Department of Prosthetic, University Medical Center Mainz, Mainz, Germany
| | | | - Manfred Berres
- Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Leonardo Díaz
- Postgraduate School, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany.
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany.
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery-Plastic Operations, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
4
|
Albrecht H, Schiegnitz E, Halling F. Facts and trends in dental antibiotic and analgesic prescriptions in Germany, 2012-2021. Clin Oral Investig 2024; 28:100. [PMID: 38231453 PMCID: PMC10794513 DOI: 10.1007/s00784-024-05497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVES The study aims to overview German dentists' development of antibiotic and analgesic prescriptions from 2012 to 2021. MATERIALS AND METHODS A longitudinal database analysis was performed based on the annual reports of the "Research Institute for Local Health Care Systems" (WIdO, Berlin). RESULTS From 2012 until 2021, dental antibiotic prescriptions fell by 17.9%. In contrast, the dental proportion of antibiotic prescriptions compared to all antibiotic prescriptions in Germany increased from 9.1 to 13.6%. Aminopenicillins enhanced their share from 35.6 to 49.4%, while clindamycin prescriptions declined from 37.8 to 23.4%. The proportion of ibuprofen prescriptions significantly increased from 60.4% in 2012 to 79.0% in 2021. CONCLUSIONS Since 2013, the most frequently prescribed antibiotic by German dentists has been amoxicillin reaching nearly half of all dental antibiotic prescriptions in 2021. Simultaneously, the proportion of clindamycin has steadily decreased, but the level is still high compared to international data. During the past decade, ibuprofen as a first-line analgesic in German dentistry was continuously gaining in importance. CLINICAL RELEVANCE Aminopenicillins have the best risk-benefit balance in dentistry, but the use of antibiotics generally must be limited only to cases of severe infections or compromised patients. Pre-existing diseases or permanent medications should always be considered when choosing an analgesic.
Collapse
Affiliation(s)
- Helena Albrecht
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany.
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Frank Halling
- Gesundheitszentrum Fulda | Praxis für MKG-Chirurgie/Plast. OP, Fulda, Germany
- Department of Oral and Maxillofacial Surgery, University Hospital Marburg UKGM GmbH, Marburg, Germany
| |
Collapse
|
5
|
Khamis A, Salzer L, Schiegnitz E, Stauber RH, Gül D. The Magic Triangle in Oral Potentially Malignant Disorders: Vitamin D, Vitamin D Receptor, and Malignancy. Int J Mol Sci 2023; 24:15058. [PMID: 37894739 PMCID: PMC10606220 DOI: 10.3390/ijms242015058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023] Open
Abstract
OPMDs (oral potentially malignant disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of various diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also suggest a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD-VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD and investigate their potential association and ramifications for clinical management of OPMDs.
Collapse
Affiliation(s)
- Aya Khamis
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
- Oral Pathology Department, Faculty of Dentistry, Alexandria University, Alexandria 5372066, Egypt
| | - Lara Salzer
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg—University Mainz, 55131 Mainz, Germany;
| | - Roland H. Stauber
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| | - Désirée Gül
- Department of Otorhinolaryngology Head and Neck Surgery, Molecular and Cellular Oncology, University Medical Center, 55131 Mainz, Germany; (L.S.); (R.H.S.)
| |
Collapse
|
6
|
Fan S, Sáenz-Ravello G, Al-Nawas B, Schiegnitz E, Diaz L, Sagheb K. The feasibility of ultrasonography for the measurement of periodontal and peri-implant phenotype: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2023; 25:892-909. [PMID: 37337110 DOI: 10.1111/cid.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Screening ultrasonography was proposed for monitoring periodontal soft tissues in the early 1960s, owing to its nonionizing, real-time, and cost-effective properties. Studies have provided convincing preliminary evidence for the use of ultrasound (US) in implant dentistry. PURPOSE To assess the feasibility of ultrasonography (US) for measuring the buccal thickness of periodontal and peri-implant tissues. The secondary objective was to evaluate the reliability of US measurements compared to classic techniques, such as CBCT and directly measurements. MATERIALS AND METHODS An electronic literature search was conducted by three independent reviewers through February 2023. The inclusion criteria were articles investigating at least five patients/cadavers with US measurements in periodontal or peri-implant buccal tissues. Compliance with methodological reporting standards and risk of bias was assessed using EULAR and QUADAS-C tools, respectively. Random-effects meta-analysis was conducted, using Bland-Altman analysis. Certainty of the evidence was assessed using GRADE. RESULTS The final selection included 12 studies examining 458 patients and 13 cadavers, with a total of 226 implants, 1958 teeth and 60 edentulous sites. The body of evidence was assessed as partially compliant with methodological reporting standards for US studies and had an unclear to high risk of bias. Meta-analysis of five comparative studies showed no evidence of clinically significant bias between US and direct measurements (very low certainty), and between US and CBCT (very low certainty) for soft-tissue thickness. Likewise, for bone thickness, there is no evidence of clinically significant bias between US and CBCT (low certainty). CONCLUSIONS Compared to the CBCT and direct measurements, ultrasonography might be a reliable approach for monitoring on periodontal and peri-implant phenotype. However, there is uncertainty about estimates of the actual effect, so further standardized and larger sample size of clinical research is needed.
Collapse
Affiliation(s)
- Shengchi Fan
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
- School of Medicine; National Clinical Research Center for Oral Disease, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Second Dental Clinic, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Gustavo Sáenz-Ravello
- Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
| | - Leonardo Diaz
- Postgraduate School, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery - Plastic Operations, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
7
|
Al-Nawas B, Lambert F, Andersen SWM, Bornstein MM, Gahlert M, Jokstad A, Jung J, Kwon YD, Laleman I, Oteri G, Roehling S, Schiegnitz E, Takeda Y, Terheyden H. Group 3 ITI Consensus Report: Materials and antiresorptive drug-associated outcomes in implant dentistry. Clin Oral Implants Res 2023; 34 Suppl 26:169-176. [PMID: 37750518 DOI: 10.1111/clr.14135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 07/06/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of Working Group 3 was to address the influence of both material- and anti-resorptive drug- related factors on clinical and biological outcomes and complications in implant dentistry. Focused questions were addressed on (a) implant materials other than titanium (alloy)s, (b) transmucosal abutment materials and (c) medications affecting bone metabolism were addressed. MATERIALS AND METHODS Three systematic reviews formed the basis for discussion in Group 3. Consensus statements and clinical recommendations were formulated by group consensus based on the findings of the systematic reviews. Patient perspectives and recommendations for future research were also conveyed. These were then presented and accepted following further discussion and modifications as required by the plenary. RESULTS Zirconia is a valid alternative to titanium as material for implant and transmucosal components, allowing soft and hard tissue integration with clinical outcomes-identified by implant survival, marginal bone loss and peri-implant probing depths-up to 5-years comparable to titatnium. However, most of the evidence for zirconia implants is based on 1-piece implants limiting the indication range. Furthermore, based on expert opinion, zirconia transmucosal components might be preferred in the esthetic zone. In patients receiving low-dose bisphosphonate therapy, the rate of early implant failure is not increased, while the long-term effects remain poorly studied. Although it has not been sufficiently addressed, similar outcomes can be expected with low-dose denosumab. A drug holiday is not recommended when considering implant placement in patients treated with low-dose ARD. However, the specific therapeutic window, the cumulative dose and the administration time should be considered. Access to peri-implant supportive care is mandatory to prevent peri-implantitis-related medication-related osteonecrosis of the jaw (MRONJ) or implant-related sequestra (IRS). In patients receiving low-dose anti-resorptive drugs (ARD) therapy, the risk of complications related to implant placement is high, and implant procedures in this specific population should be strictly treated in a comprehensive multidisciplinary center. Finally, healthy dental implants should not be removed before low or high-dose ARD. CONCLUSIONS Zirconia implants can be an alternative to titanium implants in selected indications. However, the current state of evidence remains limited, especially for 2-piece implant designs. Administration of low-dose ARD did not show any negative impact on early implant outcomes, but careful follow-up and supportive care is recommended in order to prevent peri-implant MRONJ and IRS. Implant placement in high-dose patients must be strictly considered in a comprehensive multidisciplinary center.
Collapse
Affiliation(s)
- Bilal Al-Nawas
- Department for Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the J. Gutenberg University Mainz, Mainz, Germany
| | - France Lambert
- Department of Periodontology, Oro-dental and Implant Surgery, CHU of Liège, Liège University, Liège, Belgium
- Dental Biomaterials Research Unit, Liège University, Liège, Belgium
| | | | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland
| | - Michael Gahlert
- Private Dental Clinic PD Dr. Gahlert & PD Dr. Roehling, Munich, Germany
- Clinic for Oral and Cranio-Maxillofacial Surgery, Hightech Research Center, University Hospital Basel, University of Basel, Basel, Switzerland
- Sigmund Freud Private University, Vienna, Austria
| | - Asbjorn Jokstad
- Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Junho Jung
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Yong-Dae Kwon
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Isabelle Laleman
- Department of Periodontology, Oro-dental and Implant Surgery, CHU of Liège, Liège University, Liège, Belgium
- Dental Biomaterials Research Unit, Liège University, Liège, Belgium
| | - Giacomo Oteri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Stefan Roehling
- Private Dental Clinic PD Dr. Gahlert & PD Dr. Roehling, Munich, Germany
- Clinic for Oral and Cranio-Maxillofacial Surgery, Hightech Research Center, University Hospital Basel, University of Basel, Basel, Switzerland
- Clinic for Oral and Cranio-Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Eik Schiegnitz
- Head Division of Implantology, Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Yukihiro Takeda
- Private Dental Clinic, Takeda Dental Clinic, Tokyo, Japan
- Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Hendrik Terheyden
- Department of Oral & Maxillofacial Surgery, Helios Kliniken Kassel, Germany
| |
Collapse
|
8
|
Sáenz-Ravello G, Ossandón-Zúñiga B, Muñoz-Meza V, Mora-Ferraro D, Baeza M, Fan S, Sagheb K, Schiegnitz E, Díaz L. Short implants compared to regular dental implants after bone augmentation in the atrophic posterior mandible: umbrella review and meta-analysis of success outcomes. Int J Implant Dent 2023; 9:18. [PMID: 37400739 DOI: 10.1186/s40729-023-00476-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 04/28/2023] [Indexed: 07/05/2023] Open
Abstract
PURPOSE To assess the body of evidence of short versus regular implants after bone augmentation (BA) in the atrophic posterior mandible in the context of implant treatment success outcomes. METHODS Seven databases, two registries, and reference lists were searched for systematic reviews and meta-analysis (SR/MA), randomized controlled trials (RCTs) and longitudinal studies published in English, Spanish or German since 2012. Confidence in the SR/MA methodology was evaluated using AMSTAR-2 and the risk of bias of primary studies using Cochrane's RoB 2.0 and ROBINS-I. A random-effects meta-analysis and a meta-regression were performed for continuous and dichotomous outcomes. GRADE approach was used to assess the certainty of the evidence. RESULTS Eighteen SRs/MAs, most of them "critically low" and "low" confidence with substantial overlap, included 14 relevant RCTs with a high risk of bias. A cohort study with moderate risk of bias was added. Quantitative synthesis of 595 implants and 281 hemiarches/patients indicates that the use of short implants (< 10 mm) compared to regular implants and BA may reduce implant failure at 1-year follow-up, and marginal bone loss (MBL) at 3-, 5-, and 8-year follow-up; is likely to reduce the risk of biological complications at 1-, 3-, 5-, and 8-year follow-up; and may be the patient's preferred alternative. There is a correlation between bone height, MBL and biological complications. CONCLUSIONS The available evidence partially suggests that the use of short implants could decrease implant failure, MBL, and biological complications, and increase patient satisfaction. However, given the need for further RCTs and real-world evidence to fully evaluate short- and long-term outcomes, it would be prudent for clinicians to carefully consider the individual needs and circumstances of the patients before deciding whether to use short implants. Trial registration PROSPERO CRD42022333526.
Collapse
Affiliation(s)
- Gustavo Sáenz-Ravello
- Faculty of Dentistry, Center for Epidemiology and Surveillance of Oral Diseases, University of Chile, Santiago, Chile
| | | | | | | | - Mauricio Baeza
- Faculty of Dentistry, Center for Epidemiology and Surveillance of Oral Diseases, University of Chile, Santiago, Chile
| | - Shengchi Fan
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany
| | - Leonardo Díaz
- Faculty of Dentistry, Postgraduate School, University of Chile, Santiago, Chile.
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Augustusplatz 2, 55131, Mainz, Germany.
| |
Collapse
|
9
|
Azaripour A, Sagheb K, Stock L, Schiegnitz E, Esposito M, Al Nawas B. The Use of a Soft Tissue Substitute at Immediate Postextractive Implants to Reduce Tissue Shrinkage: One-Year Results from a Randomized Controlled Trial. INT J PERIODONT REST 2023; 43:463-469. [PMID: 37552189 DOI: 10.11607/prd.5620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
The aim of this randomized controlled trial (RCT) was to evaluate whether placement of a soft tissue graft substitute (STGS) could decrease peri-implant tissue shrinkage at immediate postextractive implants. Twenty patients with one missing tooth between two adjacent healthy teeth in esthetic areas and at least 4 mm of bone apical to the tooth apex were randomly allocated (after tooth extraction) to receive (n = 10; test group) or not receive (n = 10; control group) a subepithelial buccal STGS. Implants were inserted with a torque of at least 30 Ncm, and sites were grafted with a cancellous particulate allograft. All patients were restored with nonoccluding immediate provisional screw-retained crowns, replaced after 6 months by definitive metal-ceramic crowns. One year after loading, no dropouts, crown or implant failure, or complications occurred. No statistically significant difference or trends in volume shrinkage, esthetics, peri-implant marginal bone loss, and keratinized mucosa heights between the two groups were observed. Acknowledging that the sample size was small, no clinical benefit could be observed for the use of a STGS in immediate postextractive implants.
Collapse
|
10
|
Kupka JR, Sagheb K, Al-Nawas B, Schiegnitz E. The Sympathetic Nervous System in Dental Implantology. J Clin Med 2023; 12:jcm12082907. [PMID: 37109243 PMCID: PMC10143978 DOI: 10.3390/jcm12082907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/07/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure.
Collapse
Affiliation(s)
- Johannes Raphael Kupka
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, 55131 Mainz, Germany
| |
Collapse
|
11
|
Müller-Heupt LK, Wiesmann-Imilowski N, Schröder S, Groß J, Ziskoven PC, Bani P, Kämmerer PW, Schiegnitz E, Eckelt A, Eckelt J, Ritz U, Opatz T, Al-Nawas B, Synatschke CV, Deschner J. Oxygen-Releasing Hyaluronic Acid-Based Dispersion with Controlled Oxygen Delivery for Enhanced Periodontal Tissue Engineering. Int J Mol Sci 2023; 24:ijms24065936. [PMID: 36983008 PMCID: PMC10059003 DOI: 10.3390/ijms24065936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
Periodontitis is a chronic biofilm-associated inflammatory disease of the tooth-supporting tissues that causes tooth loss. It is strongly associated with anaerobic bacterial colonization and represents a substantial global health burden. Due to a local hypoxic environment, tissue regeneration is impaired. Oxygen therapy has shown promising results as a potential treatment of periodontitis, but so far, local oxygen delivery remains a key technical challenge. An oxygen (O2)-releasing hyaluronic acid (HA)-based dispersion with a controlled oxygen delivery was developed. Cell viability of primary human fibroblasts, osteoblasts, and HUVECs was demonstrated, and biocompatibility was tested using a chorioallantoic membrane assay (CAM assay). Suppression of anaerobic growth of Porphyromonas gingivalis was shown using the broth microdilution assay. In vitro assays showed that the O2-releasing HA was not cytotoxic towards human primary fibroblasts, osteoblasts, and HUVECs. In vivo, angiogenesis was enhanced in a CAM assay, although not to a statistically significant degree. Growth of P. gingivalis was inhibited by CaO2 concentrations higher than 256 mg/L. Taken together, the results of this study demonstrate the biocompatibility and selective antimicrobial activity against P. gingivalis for the developed O2-releasing HA-based dispersion and the potential of O2-releasing biomaterials for periodontal tissue regeneration.
Collapse
Affiliation(s)
- Lena Katharina Müller-Heupt
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Nadine Wiesmann-Imilowski
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Department of Otorhinolaryngology, University Medical Center Mainz, Langenbeck Str. 1, 55131 Mainz, Germany
| | - Sofia Schröder
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Jonathan Groß
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Pablo Cores Ziskoven
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Philipp Bani
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Peer Wolfgang Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Anja Eckelt
- WEE-Solve GmbH, Auf der Burg 6, 55130 Mainz, Germany
| | - John Eckelt
- WEE-Solve GmbH, Auf der Burg 6, 55130 Mainz, Germany
| | - Ulrike Ritz
- Department of Orthopaedics and Traumatology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany
| | - Till Opatz
- Department of Chemistry, Johannes Gutenberg-University, Duesbergweg 10-14, 55128 Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | | | - James Deschner
- Department of Periodontology and Operative Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
12
|
Noelken R, Westphal L, Schiegnitz E, Al-Nawas B. Hard and soft tissue regeneration of severe peri-implantitis defects with the laser-assisted peri-implant defect regeneration technique: 3-year results. Int J Implant Dent 2023; 9:3. [PMID: 36739596 PMCID: PMC9899875 DOI: 10.1186/s40729-023-00467-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/22/2023] [Indexed: 02/06/2023] Open
Abstract
PURPOSE This retrospective cohort study evaluates the regeneration of severe peri-implantitis deficiencies treated with the laser-assisted peri-implant defect regeneration (LAPIDER) approach within a 3-year follow-up. METHODS Twenty-four implants with severe peri-implantitis in 18 patients were treated according to the LAPIDER technique. In contrast to classic techniques for reconstructive peri-implantitis surgery with a marginal incision, a buccal split-flap preparation avoiding papillae separation was used. After a coronal flap elevation and a laser-assisted peri-implant defect cleaning, connective tissue and autogenous bone grafting was performed. Primary outcomes were the changes of the marginal bone levels (MBL) and the buccal bone thickness. Secondary outcomes included implant survival, peri-implant probing depths (PPD), bleeding on probing (BOP), recession, width of keratinized mucosa (KMW), thickness of keratinized mucosa (KMT), soft tissue esthetics (PES), and implant success. RESULTS MBL improved interproximal by 3.10 ± 2.02 mm (p < 0.001), buccal by 3.49 ± 2.89 mm (p < 0.001), and lingual by 1.46 ± 1.98 mm (p = 0.003); buccal bone thickness by 0.55 ± 0.60 mm (p = 0.005), and 1.01 ± 1.25 mm (p = 0.001) at 1 and 3 mm below reference level. Two implants were removed; 22 implants were still in function at a mean follow-up of 36 months. PPD changed from 5.05 ± 1.39 to 3.08 ± 0.71 mm (p < 0.001); recession was reduced from 2.07 ± 1.70 to 0.91 ± 1.13 mm (p = 0.001); KMW increased from 2.91 ± 1.81 to 4.18 ± 1.67 mm (p = 0.006); KMT improved from 1.73 ± 0.50 to 2.44 ± 0.43 mm (p < 0.001); PES changed from 7.7 ± 2.8 to 10.7 ± 1.9 (p < 0.001). 45.8% to 54.2% of the implants met the criteria of implant success. CONCLUSIONS The favorable results document the proof of principle for the regeneration of severe peri-implant hard and soft tissue deficiencies by the LAPIDER treatment approach.
Collapse
Affiliation(s)
- Robert Noelken
- Private Practice for Oral Surgery, Paradiesplatz 7-13, 88131, Lindau, Lake Constance, Germany. .,Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | | | - Eik Schiegnitz
- grid.410607.4Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- grid.410607.4Department of Oral and Maxillofacial Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
13
|
Sagheb K, Blatt S, Rahimi-Nedjat RK, Lingawi A, Schiegnitz E, Kumar VV, Walter C, Sagheb K. Oral Squamous Cell Carcinomas Developing from Oral Lichen Planus: A 5-21 year Retrospective Study. J Maxillofac Oral Surg 2022; 21:1088-1095. [PMID: 36891504 PMCID: PMC9989091 DOI: 10.1007/s12663-022-01729-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background and Aims There is insufficient data regarding clinical characteristics, relapse rates, as well as lymph node metastasis of squamous cell carcinomas of the oral cavity (OSCC) developing from oral lichen planus (OLP-OSCC). The aim of this retrospective study was to evaluate clinical characteristics, as well as relapse, recurrence and survival rates of OLP-OSCC. Methods In a retrospective monocenter analysis, all consecutive patients with an OSCC treated in the time period 1st January 2000-December 31 2016 were reviewed. All patients with OSCC developing from OLP/OLL (oral lichenoid lesions) were identified and analyzed for epidemiological data, risk profile, location of primary tumor, pTNM classification, lymph node metastasis, primary therapy, recurrence, and outcome. Results A total of 103 patients (45%♂/ 55%♀) with an average age of 62 ± 14 year were included in this study. At the time of initial diagnosis, 17% (n = 18) of patients had cervical metastases (CM) whereas only 11% (11 patients) displayed advanced tumor sizes (T > 2). T-status (p = 0.003) and histopathological grading (p = 0.001) had an impact on the incidence of CM. 39.6% of the patients developed a relapse after an average of 24 months with a mean of two recurrences per patient. Advanced tumor size had a significant impact on the 5 year overall survival and was associated with disease-free survival of the patients (p < 0.001, respectively p = 0.004). Conclusion Although initial lymph node metastases were not more frequent, more aggressive recurrence patterns compared to OSCC were seen for OLP-OSCC. Therefore, based on the study results, a modified recall for these patients is suggested.
Collapse
Affiliation(s)
- Kawe Sagheb
- Department of Prosthetic Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Roman-Kia Rahimi-Nedjat
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Abdullatif Lingawi
- Clinic for Psychiatry, Psychotherapy and Psychosomatic, St. Valentinus Hospital, Suttonstraße 24, 65399 Kiedrich, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Vinay V Kumar
- Department of Oral and Maxillofacial Surgery - Integrated Head and Neck Surgery, Sri Shankara Cancer Hospital and Research Center, Basavangudi, Bangalore, 560004 India.,Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden
| | - Christian Walter
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany.,Private Practice for Oral- and Maxillofacial Surgery - Facial Plastic Surgery, Mediplus Clinic, Haifa-Allee 20, 55128 Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
14
|
Müller-Heupt LK, Schiegnitz E, Kaya S, Jacobi-Gresser E, Kämmerer PW, Al-Nawas B. The German S3 guideline on titanium hypersensitivity in implant dentistry: consensus statements and recommendations. Int J Implant Dent 2022; 8:51. [PMID: 36329297 PMCID: PMC9633908 DOI: 10.1186/s40729-022-00451-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND There is currently a lack of guidelines for clinicians regarding titanium hypersensitivity in implant dentistry. Diagnostic tests such as the epicutaneous test or the lymphocyte transformation test showed inconsistent results regarding reliability and validity and thus, evidence-based consensus recommendations regarding diagnostic and therapeutic options may be helpful in clinical decision-making. Therefore, the German S3 guideline on titanium hypersensitivity in implant dentistry was developed. FINDINGS In the objectives, procedure, voting method and venue were defined and the consensus participants were invited. A systematic literature research was performed, and the overall quality of the evidence was rated according to the GRADE working group. Eight recommendations were formulated within the framework of a structured consensus conference under independent moderation and could be voted on with strong consensus (> 95% agreement). The formulated statements and recommendations were developed in small groups according to the guidelines of the Association of the Scientific Medical Societies in Germany (AWMF) and were discussed and agreed upon in the plenum. CONCLUSIONS For reasonable decision-making, a patient's clinical symptoms should be regarded as leading parameters, which are usually expressed by a local inflammatory reaction with subsequent disturbed osseous integration. Allergy tests, such as the epicutaneous test or the lymphocyte transformation test are not helpful in titanium intolerance assessments, since these tests indicate T cell-mediated allergies, which are not observed in titanium intolerance reactions. Other metals and impurities that might be present in superstructures or alloys also need to be considered as the cause of an intolerance reaction and a trigger for contact sensitization. In the case of a suspected titanium particle-related, local immunologically induced inflammatory reaction with subsequent impaired osseous integration, dental ceramic implants can be considered as a therapeutic option.
Collapse
Affiliation(s)
- Lena Katharina Müller-Heupt
- Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Eik Schiegnitz
- grid.410607.4Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Sebahat Kaya
- grid.410607.4Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | | | - Peer Wolfgang Kämmerer
- grid.410607.4Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Bilal Al-Nawas
- grid.410607.4Department of Oral- and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
15
|
Schiegnitz E, Reinicke K, Sagheb K, König J, Al-Nawas B, Grötz KA. Dental implants in patients with head and neck cancer - a systematic review and meta-analysis of the influence of radiotherapy on implant survival. Clin Oral Implants Res 2022; 33:967-999. [PMID: 35841367 DOI: 10.1111/clr.13976] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 05/23/2022] [Accepted: 06/12/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this meta-analysis was to compare implant survival in irradiated and non-irradiated bone and to investigate potential risk factors for implant therapy in oral cancer patients. MATERIAL AND METHODS An extensive search in the electronic databases of the National Library of Medicine was performed. Systematic review and meta-analysis were conducted according to PRISMA statement. The meta-analysis was performed for studies with a mean follow-up of at least three and five years, respectively. RESULTS The systematic review resulted in a mean overall implant survival of 87.8% (34-100%). The meta-analysis revealed a significantly higher rate of implant failure in irradiated bone compared to non-irradiated bone (p<0.00001, OR 1.97, CI [1.63, 2.37]). The studies also showed that implants placed into irradiated grafted bone were more likely to fail than those in irradiated native bone (p<0.0001, OR 2.26, CI [1.50, 3.40]). CONCLUSION Even though overall implant survival was high, radiotherapy proves to be a significant risk factor for implant loss. Augmentation procedures may also increase the risk of an adverse outcome, especially in combination with radiotherapy.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz
| | - Katrin Reinicke
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz
| | - Knut A Grötz
- Department of Oral and Maxillofacial Surgery, Dr. Horst Schmidt Clinic Wiesbaden, Germany
| |
Collapse
|
16
|
Schiegnitz E, Hill N, Sagheb K, König J, Sagheb K, Al-Nawas B. Short versus Standard Length Implants with Sinus Floor Elevation for the Atrophic Posterior Maxilla. Acta Stomatol Croat 2022; 56:143-153. [PMID: 35821724 PMCID: PMC9262115 DOI: 10.15644/asc56/2/5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/20/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives the aim of this clinical study was to compare clinical and radiological outcomes of short dental implants inserted in pristine bone to standard length implants inserted in combination with sinus floor elevation. Materials and methods For this clinical study, the clinical and radiological outcome of 126 short dental implants (84 patients), inserted in pristine bone were compared with 312 standard length implants (156 patients), placed in combination with maxillary sinus floor elevation procedures. Results The short implant group (test group [TG]; mean follow-up (± standard deviation (SD) 56.6 ± 42.9 months) and the augmented group (control group [CG]; mean follow-up 41.6 ± 37.6 months) showed cumulative survival rates of 91.8% and 92.4%. Cumulative 5-year implant survival rates were 91.8% for the TG and 90.7% for the CG (p=0.421). Mean marginal bone loss was significantly higher in the CG than in the TG, with a mean MBL of 0.70 ± 0.72 mm in the TG and 0.96 ± 0.91 mm in the CG (p<0.001). A comparable and promising oral health-related quality of life (OHRQoL) was observed in the control and test groups. Conclusions After over 3 years, short implants placed in the resorbed posterior maxilla obtained similar results to standard implants combined with maxillary sinus floor augmentation procedures.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz2
| | - Nina Hill
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz2
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz2
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Germany
| | - Kawe Sagheb
- Department of Prosthodontics, University Medical Centre of the Johannes Gutenberg-University, Germany, http://orcid.org/0000-0002-8665-5803
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Johannes Gutenberg-University, Mainz2
| |
Collapse
|
17
|
Sanz M, Schwarz F, Herrera D, McClain P, Figuero E, Molina A, Monje A, Montero E, Pascual A, Ramanauskaite A, Renouard F, Sader R, Schiegnitz E, Urban I, Heitz-Mayfield L. Importance of keratinized mucosa around dental implants: Consensus report of group 1 of the DGI/SEPA/Osteology Workshop. Clin Oral Implants Res 2022; 33 Suppl 23:47-55. [PMID: 35763021 DOI: 10.1111/clr.13956] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/01/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the literature on (i) the relevance of the presence of a minimum dimension of keratinized peri-implant mucosa (KPIM) to maintain the health and stability of peri-implant tissues, and; (ii) the surgical interventions and grafting materials used for augmenting the dimensions of the KPIM when there is a minimal amount or absence of it. MATERIAL & METHODS Two systematic reviews complemented by expert opinion from workshop group participants served as the basis of the consensus statements, implications for clinical practice and future research, and were approved in plenary session by all workshop participants. RESULTS Thirty-four consensus statements, eight implications for clinical practice, and 13 implications for future research were discussed and agreed upon. There is no consistent data on the incidence of peri-implant mucositis relative to the presence or absence of KPIM. However, reduced KPIM width is associated with increased biofilm accumulation, soft-tissue inflammation, greater patient discomfort, mucosal recession, marginal bone loss and an increased prevalence of peri-implantitis. Free gingival autogenous grafts were considered the standard of care surgical intervention to effectively increase the width of KPIM. However, substitutes of xenogeneic origin may be an alternative to autogenous tissues, since similar results when compared to connective tissue grafts were reported. CONCLUSION Presence of a minimum width of KPIM should be assessed routinely in patients with implant supported restorations, and when associated with pathological changes in the peri-implant mucosa, its dimensions may be surgically increased using autogenous grafts or soft-tissue substitutes with evidence of proven efficacy.
Collapse
Affiliation(s)
- Mariano Sanz
- ETEP (Etiology and Research of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Frank Schwarz
- Department of Oral Cranio-Maxillofacial and Facial Plastic Surgery, Madical Center of the Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - David Herrera
- ETEP (Etiology and Research of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Pamela McClain
- Private Practice, Aurora, Colorado, USA.,School of Dentistry, University of Colorado Health Sciences Center, Denver, USA
| | - Elena Figuero
- ETEP (Etiology and Research of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Ana Molina
- ETEP (Etiology and Research of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Alberto Monje
- Department of Periodontology, School of Dentistry, International University of Catalonia (UIC), Barcelona, Spain.,Department of Periodontology and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Eduardo Montero
- ETEP (Etiology and Research of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain
| | - Andrés Pascual
- Department of Periodontology, School of Dentistry, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Ausra Ramanauskaite
- Department of Oral Cranio-Maxillofacial and Facial Plastic Surgery, Madical Center of the Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | | | - Robert Sader
- Department of Oral Cranio-Maxillofacial and Facial Plastic Surgery, Madical Center of the Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes-Gutenberg University, Mainz, Germany
| | - Itsvan Urban
- Department of Periodontics & Oral Medicine, Ann Arbor, Michigan, USA.,Urban Regeneration Institute, Budapest, Hungary
| | - Lisa Heitz-Mayfield
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, The University of Western Australia, Crawley, Western Australia, Australia
| |
Collapse
|
18
|
Werny JG, Sagheb K, Diaz L, Kämmerer PW, Al-Nawas B, Schiegnitz E. Does vitamin D have an effect on osseointegration of dental implants? A systematic review. Int J Implant Dent 2022; 8:16. [PMID: 35403929 PMCID: PMC9001786 DOI: 10.1186/s40729-022-00414-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/23/2022] [Indexed: 12/14/2022] Open
Abstract
Abstract
Purpose
The aim of this study was to systematically review the available evidence to evaluate the efficacy of vitamin D supplementation or vitamin D depletion on the osseointegration of implants in animals and humans.
Methods
The focus questions addressed were “Do vitamin D deficient subjects treated with (dental) implants have an inferior osseointegration than subjects with adequate serum vitamin D level?” and “Do vitamin D supplemented subjects treated with (dental) implants have a superior osseointegration than subjects with adequate serum vitamin D level?” Humans and animals were considered as subjects in this study. Databases were searched from 1969 up to and including March 2021 using different combination of the following terms: “implant”, “bone to implant contact”, “vitamin D” and “osseointegration”. Letters to the editor, historic reviews, commentaries and articles published in languages other than English and German were excluded. The pattern of the present systematic review was customize to primarily summarize the pertinent data.
Results
Thirteen experimental studies with animals as subject, two clinical studies and three case reports, with humans as subjects, were included. The amount of inserted titanium implants ranged between 24 and 1740. Results from three animal studies showed that vitamin D deficiency has a negative effect on new bone formation and/or bone to implant contact (BIC). Eight animal studies showed that vitamin D supplementation has a enhancing effect on BIC and/or new bone formation around implants. Furthermore, enhancing the impact of vitamin D supplementation on the osseointegration of implants in subjects with diabetes mellitus, osteoporosis and chronic kidney disease (CKD) were assessed. Studies and case reports involving human subjects showed that patients with a low serum vitamin D level have a higher tendency to exhibit an early dental implant failure. When supplemented with vitamin D the osseointegration was successful in the case reports and a beneficial impact on the changes in the bone level during the osseointegration were determined.
Conclusions
Vitamin D deficiency seems to have a negative effect on the osseointegration of implants in animals. The supplementation of vitamin D appears to improve the osseointegration in animals with systemic diseases, such as vitamin D deficiency, diabetes mellitus, osteoporosis, and CKD. Slight evidence supports the hypothesis that humans similarly benefit from vitamin D supplementation in terms of osseointegration. Further investigation is required to maintain these assumptions.
Collapse
|
19
|
Heimes D, Schiegnitz E, Kuchen R, Kämmerer PW, Al-Nawas B. Buccal Bone Thickness in Anterior and Posterior Teeth-A Systematic Review. Healthcare (Basel) 2021; 9:1663. [PMID: 34946389 PMCID: PMC8700878 DOI: 10.3390/healthcare9121663] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Immediate dental implant placement has been a subject of great interest over the last decade. Here, information regarding the anatomy and bone thickness of the jaw prior to dental implant placement is crucial to increase the surgery's success and the patient's safety. The clinical premises for this approach have been controversially discussed. One of those heavily discussed premises is a buccal bone thickness of at least 1 mm thickness. This meta-analysis aims to systematically review buccal bone thickness (BBT) in healthy patients. Thus, the feasibility of immediate dental implant placement in daily practice can be assessed. (2) Methods: A search in the electronic databases was performed to identify articles reporting on BBT that was measured by computed tomography in adults. (3) Results: We were able to find 45 studies, including 4324 patients with 25,452 analyzed teeth. The analysis showed a BBT at the alveolar crest of 0.76 ± 0.49 mm in the maxillary frontal and of 1.42 ± 0.74 mm in the maxillary posterior region. In the mandible, the average measured values were similar to those in the maxilla (front: 0.95 ± 0.58 mm; posterior: 1.20 ± 0.96 mm). In the maxillary frontal region 74.4% and in the mandibular frontal region 61.2% of the crestal buccal bones showed widths <1 mm. (4) Conclusions: In more than 60% of the cases, the BBT at the alveolar crest is <1 mm in maxillary and mandibular frontal regions. This anatomic data supports careful pre-surgical assessment, planning of a buccal graft, and critical selection of indication for immediate implant placement, especially in the maxillary and mandibular frontal and premolar region.
Collapse
Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Robert Kuchen
- Institute for Medical Statistics, Epidemiology and Informatics, University Medical Center of the Johannes-Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany; (E.S.); (P.W.K.); (B.A.-N.)
| |
Collapse
|
20
|
Noelken R, Schiegnitz E, Al-Nawas B, Wagner W. Marginal Bone and Keratinized Mucosa Alterations Around Sloped Implants Placed in Healed Sloped Crests: A Long-Term Cohort Study. INT J PERIODONT REST 2021; 41:733-741. [PMID: 34547078 DOI: 10.11607/prd.5198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To improve the adaptation to bone level discrepancies of sloped alveolar crests, an implant with a sloped implant-abutment interface has been developed. In a previously reported international multicenter study, 65 sloped implants replaced single teeth with a buccolingual bone level discrepancy at least 3 months after tooth loss. The present study reports the long-term outcomes of one study center and also evaluates marginal bone and keratinized mucosa alterations around sloped implants in healed, sloped crests in a long-term follow-up. Implant survival, marginal bone levels, and buccal bone dimensions in relation to the implant shoulder level (assessed by periapical radiographs and CBCT), width of keratinized mucosa, and probing depths were observed. Two patients did not present for follow-up examinations. No implants were lost. The remaining 13 implants were followed for a mean period of 123 months. Mean marginal bone levels were maintained slightly coronal to implant shoulder level at the interproximal (0.13 mm) and the buccal aspects (0.57 mm). The width of keratinized mucosa improved significantly from delivery (1.85 mm) to the 1-year follow-up (3.39 mm) and was thereafter unchanged. Placing implants with a sloped shoulder in a healed crest with lingual-buccal bone level discrepancy resulted in circumferential marginal bone maintenance and improved width of the keratinized mucosa.
Collapse
|
21
|
Schiegnitz E, Kämmerer PW, Hellwich P, König J, Sagheb K, Al-Nawas B. Treatment concepts of horizontally deficient ridges-A retrospective study comparing narrow-diameter implants in pristine bone with standard-diameter implants in augmented bone. Clin Oral Implants Res 2021; 32:1159-1167. [PMID: 34224171 DOI: 10.1111/clr.13807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/12/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To compare clinical and radiological outcomes of narrow-diameter implants (NDI) placed in pristine bone to standard-diameter implants placed in combination with horizontal bone augmentation procedures (SDI+A) for horizontally deficient alveolar ridges. MATERIAL AND METHODS For this retrospective study, the outcome of 597 NDI (∅ 3.3 mm, 272 patients), inserted in pristine bone, were compared with 180 SDI (∅ 4.1 mm, 83 patients), inserted in combination with horizontal augmentation procedures. Oral health-related quality of life was assessed in patients available for recall. RESULTS After a mean follow-up of 37.6 ± 40 months for the NDI and of 42.4 ± 49 months for the SDI+A, survival rates were 96.1% for NDI and 95.6% for SDI+A. Cumulative 5-year and 10-year implant survival rates were 94.3% and 92.2% for the NDI group and 97.0% and 88.3% for the SDI+A group, indicating no significant difference (p = .89). According to the criteria of Buser et al., an implant success rate of 84.3% was obtained for the NDI and an implant success rate of 81.3% for the SDI+A (p = .79). Regarding oral health-related quality of life, a similar and high patient satisfaction could be observed in both groups. CONCLUSIONS NDI without augmentation procedures showed a similar clinical outcome as SDI in combination with augmentation procedures after a follow-up of more than 3 years. Therefore, NDI might be a reasonable alternative in cases of horizontal bone atrophy (no clinical trial registration as patient inclusion started 2003).
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Philipp Hellwich
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Jochem König
- Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
22
|
Kämmerer T, Lesmeister T, Palarie V, Schiegnitz E, Schröter A, Al-Nawas B, Kämmerer PW. Calcium Phosphate-Coated Titanium Implants in the Mandible: Limitations of the in vivo Minipig Model. Eur Surg Res 2021; 61:177-187. [PMID: 33601367 DOI: 10.1159/000513846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to compare implant osseointegration with calcium phosphate (CaP) surfaces and rough subtractive-treated sandblasted/acid etched surfaces (SA) in an in vivo minipig mandible model. MATERIALS AND METHODS A total of 36 cylindrical press-fit implants with two different surfaces (CaP, n = 18; SA, n = 18) were inserted bilaterally into the mandible of 9 adult female minipigs. After 2, 4, and 8 weeks, we analyzed the cortical bone-to-implant contact (cBIC; %) and area coverage of bone-to-implant contact within representative bone chambers (aBIC; %). RESULTS After 2 weeks, CaP implants showed no significant increase in cBIC and aBIC compared to SA (cBIC: mean 38 ± 5 vs. 16 ± 11%; aBIC: mean 21 ± 1 vs. 6 ± 9%). Two CaP implants failed to achieve osseointegration. After 4 weeks, no statistical difference between CaP and SA was seen for cBIC (mean 54 ± 15 vs. 43 ± 16%) and aBIC (mean 43 ± 28 vs. 32 ± 6). However, we excluded two implants in each group due to failure of osseointegration. After 8 weeks, we observed no significant intergroup differences (cBIC: 18 ± 9 vs. 18 ± 20%; aBIC: 13 ± 8 vs. 16 ± 9%). Again, three CaP implants and two SA implants had to be excluded due to failure of osseointegration. CONCLUSION Due to multiple implant losses, we cannot recommend the oral mandibular minipig in vivo model for future endosseous implant research. Considering the higher rate of osseointegration failure, CaP coatings may provide an alternative to common subtractive implant surface modifications in the early phase post-insertion.
Collapse
Affiliation(s)
- Till Kämmerer
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany, .,Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany,
| | - Tony Lesmeister
- Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany
| | - Victor Palarie
- Clinic for Oral and Maxillofacial Surgery, University Nicolae Testemitanu, Chisinau, Moldova
| | - Eik Schiegnitz
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | | | - Bilal Al-Nawas
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
23
|
Kyyak S, Blatt S, Schiegnitz E, Heimes D, Staedt H, Thiem DGE, Sagheb K, Al-Nawas B, Kämmerer PW. Activation of Human Osteoblasts via Different Bovine Bone Substitute Materials With and Without Injectable Platelet Rich Fibrin in vitro. Front Bioeng Biotechnol 2021; 9:599224. [PMID: 33681155 PMCID: PMC7925396 DOI: 10.3389/fbioe.2021.599224] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/21/2021] [Indexed: 01/06/2023] Open
Abstract
Introduction The aim of the in vitro study was to compare the effect of four bovine bone substitute materials (XBSM) with and without injectable platelet-reach fibrin for viability and metabolic activity of human osteoblasts (HOB) as well as expression of alkaline phosphatase (ALP), bone morphogenetic protein 2 (BMP-2), and osteonectin (OCN). Materials and Methods Cerabone® (CB), Bio-Oss® (BO), Creos Xenogain® (CX) and MinerOss® X (MO) ± i-PRF were incubated with HOB. At day 3, 7, and 10, cell viability and metabolic activity as well as expression of ALP, OCN, and BMP-2, was examined. Results For non-i-PRF groups, the highest values concerning viability were seen for CB at all time points. Pre-treatment with i-PRF increased viability in all groups with the highest values for CB-i-PRF after 3 and 7 and for CX-i-PRF after 10 days. For metabolic activity, the highest rate among non-i-PRF groups was seen for MO at day 3 and for CB at day 7 and 10. Here, i-PRF groups showed higher values than non-i-PRF groups (highest values: CB + i-PRF) at all time points. There was no difference in ALP-expression between groups. For OCN expression in non-i-PRF groups, CB showed the highest values after day 3, CX after day 7 and 10. Among i-PRF-groups, the highest values were seen for CX + i-PRF. At day 3, the highest BMP-2 expression was observed for CX. Here, for i-PRF groups, the highest increase was seen for CX + i-PRF at day 3. At day 7 and 10, there was no significant difference among groups. Conclusion XBSM sintered under high temperature showed increased HOB viability and metabolic activity through the whole period when compared to XBSM manufactured at lower temperatures. Overall, the combination of XBSM with i-PRF improved all cellular parameters, ALP and BMP-2 expression at earlier stages as well as OCN expression at later stages.
Collapse
Affiliation(s)
- Solomiya Kyyak
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Diana Heimes
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Henning Staedt
- Private Practice, University Medical Center Rostock, Rostock, Germany.,Department of Prosthodontics and Materials Science, University Medical Center Rostock, Rostock, Germany
| | - Daniel G E Thiem
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
24
|
Pabst AM, Blatt S, Epperlein P, Schmidtmann I, Krüger M, Schiegnitz E, Goetze E, Ziebart T, Al-Nawas B. The risk of tooth root injuries using cortical screws for intermaxillary fixation and osteosynthesis plates - A retrospective analysis. J Craniomaxillofac Surg 2019; 47:1767-1778. [PMID: 31711997 DOI: 10.1016/j.jcms.2019.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/28/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022] Open
Abstract
Intermaxillary fixation (IMF) and osteosynthesis plates (OP) are widely used for the non-surgical and surgical treatment of mandible and condyle fractures. The aim of this retrospective study was to analyze the frequency of tooth root injuries by IMF and OP screws. Electronic patient reports (2004-2013) were screened for patients treated with either IMF screws and/or OP in the Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Germany. The frequency and the position of endangered and injured teeth were analyzed by orthopantomogram (OPTG) and cone beam computer tomography (CBCT). Next, possible predictive factors for tooth root injuries, namely interdental- and crestal distance, screw length and distance between tooth root and screw were evaluated. Further, the accuracy of OPTG vs. CBCT concerning the diagnosis of tooth root injuries was analyzed. Three-hundred sixty-six patients were included and 3388 teeth were defined as endangered by IMF- and OP screws. Overall, 16 injured teeth (0.5%) in 13 patients (3.55%) were detected. Nine injuries (56.3%) were caused by IMF- and seven injuries (43.8%) by OP screws. Three teeth were non-vital, one tooth had to be extracted. No correlation between the predictive factors crestal distance, screw length and tooth root injuries was found. If tooth injury occurred, a significant correlation between the interdental distance and the distance between tooth root and screw was found (κ = 0.48; p < 0,0001). Comparison between OPTG vs. CBCT demonstrated that many of the injuries that were seen in the OPTG (n = 230) could not be verified in the CBCT scans (n = 16) (κ = 0.12). To conclude, screws for IMF and OP can be considered as a safe procedure concerning the risk of tooth root injuries.
Collapse
Affiliation(s)
- Andreas Max Pabst
- Department of Oral- and Maxillofacial Surgery, Federal Armed Forces Hospital, (Head: Prof. Dr. Dr. R. Werkmeister), Rübenacherstrasse 170, 56072 Koblenz, Germany; Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany.
| | - Sebastian Blatt
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Pia Epperlein
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Irene Schmidtmann
- Institute for Medical Biometry, Epidemiology and Informatics (IMBEI), University Medical Center, (Head: Prof. Dr. S. Singer), Obere Zahlbacherstr. 69, 55131 Mainz, Germany
| | - Maximilian Krüger
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Elisabeth Goetze
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| | - Thomas Ziebart
- Department of Oral- and Maxillofacial Surgery, University Hospital Giessen and Marburg, Campus Marburg, (Head: Univ.-Prof. Dr. Dr. Andreas Neff), Baldingerstrasse, 35043 Marburg, Germany
| | - Bilal Al-Nawas
- Department of Oral- and Maxillofacial Surgery, University Medical Center, (Head: Univ.-Prof. Dr. Dr. B. Al-Nawas), Augustusplatz 2, 55131 Mainz, Germany
| |
Collapse
|
25
|
Noelken R, Schiegnitz E, Berglundh T, Wagner W. Functional hard and soft tissue regeneration around Profile implants placed in sloped alveolar ridges ‐ 10‐year results. Clin Oral Implants Res 2019. [DOI: 10.1111/clr.30_13508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Eik Schiegnitz
- Department for Oral and Maxillofacial Surgery, University Medicine of Mainz, Germany
| | - Tord Berglundh
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Sweden
| | - Wilfried Wagner
- Department for Oral and Maxillofacial Surgery, University Medicine of Mainz, Germany
| |
Collapse
|
26
|
Schiegnitz E, Al‐Nawas B. Narrow‐diameter implants: A systematic review and meta‐analysis. Clin Oral Implants Res 2018; 29 Suppl 16:21-40. [DOI: 10.1111/clr.13272] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| | - Bilal Al‐Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery University Medical Centre of the Johannes Gutenberg‐University Mainz Mainz Germany
| |
Collapse
|
27
|
Jung RE, Al-Nawas B, Araujo M, Avila-Ortiz G, Barter S, Brodala N, Chappuis V, Chen B, De Souza A, Almeida RF, Fickl S, Finelle G, Ganeles J, Gholami H, Hammerle C, Jensen S, Jokstad A, Katsuyama H, Kleinheinz J, Kunavisarut C, Mardas N, Monje A, Papaspyridakos P, Payer M, Schiegnitz E, Smeets R, Stefanini M, Ten Bruggenkate C, Vazouras K, Weber HP, Weingart D, Windisch P. Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes. Clin Oral Implants Res 2018; 29 Suppl 16:69-77. [PMID: 30328189 DOI: 10.1111/clr.13342] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/22/2018] [Accepted: 05/26/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of Working Group 1 was to address the influence of different local (implant length, diameter, and design) and systemic (medications) factors on clinical, radiographic, and patient-reported outcomes in implant dentistry. Focused questions on (a) short posterior dental implants (≤6 mm), (b) narrow diameter implants, (c) implant design (tapered compared to a non-tapered implant design), and (d) medication-related dental implant failures were addressed. MATERIALS AND METHODS Four systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, and recommendations for future research were based on structured group discussions until consensus was reached among the entire expert Group 1. The statements were then presented and accepted following further discussion and modifications as required by the plenary. RESULTS Short implants (≤6 mm) revealed a survival rate ranging from 86.7% to 100%, whereas standard implant survival rate ranged from 95% to 100% with a follow-up from 1 to 5 years. Short implants demonstrated a higher variability and a higher Risk Ratio [RR: 1.24 (95% CI: 0.63, 2.44, p = 0.54)] for failure compared to standard implants. Narrow diameter implants (NDI) have been classified into three categories: Category 1: Implants with a diameter of <2.5 mm ("Mini-implants"); Category 2: Implants with a diameter of 2.5 mm to <3.3 mm; Category 3: Implants with a diameter of 3.3 mm to 3.5 mm. Mean survival rates were 94.7 ± 5%, 97.3 ± 5% and 97.7 ± 2.3% for category 1, 2 and 3. Tapered versus non-tapered implants demonstrated only insignificant differences regarding clinical, radiographic, and patient-reported outcomes. The intake of certain selective serotonin reuptake inhibitors and proton pump inhibitors is associated with a statistically significant increased implant failure rate. The intake of bisphosphonates related to the treatment of osteoporosis was not associated with an increased implant failure rate. CONCLUSIONS It is concluded that short implants (≤6 mm) are a valid option in situations of reduced bone height to avoid possible morbidity associated with augmentation procedures; however, they reveal a higher variability and lower predictability in survival rates. Narrow diameter implants with diameters of 2.5 mm and more demonstrated no difference in implant survival rates compared to standard diameter implants. In contrast, it is concluded that narrow diameter implants with diameters of less than 2.5 mm exhibited lower survival rates compared to standard diameter implants. It is further concluded that there are no differences between tapered versus non-tapered dental implants. Certain medications such as selective serotonin reuptake inhibitors and proton pump inhibitors showed an association with a higher implant failure rate.
Collapse
Affiliation(s)
- Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mauricio Araujo
- Department of Dentistry, Universidade Estadual de Maringa, Maringa, Brazil
| | - Gustavo Avila-Ortiz
- Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa
| | - Stephen Barter
- Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Vivianne Chappuis
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Bo Chen
- Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China
| | - Andre De Souza
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | | | - Stefan Fickl
- Department of Periodontology, University of Würzburg, Germany and Private Office, Nuremberg/Fuerth, Germany
| | | | - Jeffrey Ganeles
- South Florida Center for Periodontics and Implant Dentistry, Boca Raton, Florida
- Nova Southeastern University, Fort Lauderdale, Florida
| | - Hadi Gholami
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Christoph Hammerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Simon Jensen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Asbjørn Jokstad
- Clinical Dentistry, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
- Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Hideaki Katsuyama
- Private Practice, MM Dental Clinic, Tokyo, Japan
- Tokyo Medical and Dental University, Tokyo, Japan
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, University Hospital Münster, Münster, Germany
| | - Chatchai Kunavisarut
- Advanced General Dentistry Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Nikos Mardas
- Adult Oral Health-Periodontology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Alberto Monje
- Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
- Department of Periodontology, International University of Catalonia, Barcelona, Spain
| | - Panos Papaspyridakos
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Michael Payer
- Department of Oral Surgery and Radiology, Dental School, Medical University of Graz, Graz, Austria
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - Konstantinos Vazouras
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Hans-Peter Weber
- Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts
| | - Dieter Weingart
- Klinik für Mund-, Kiefer- und Gesichtschirurgie, Plastisch-ästhetische Operationen, Zentrum für Implantologie, Klinikum Stuttgart, Katharinen Hospital, Stuttgart, Germany
| | - Péter Windisch
- Department of Periodontology, Semmelweis Egyetem, Budapest, Hungary
| |
Collapse
|
28
|
Beger B, Goetz H, Morlock M, Schiegnitz E, Al-Nawas B. In vitro surface characteristics and impurity analysis of five different commercially available dental zirconia implants. Int J Implant Dent 2018; 4:13. [PMID: 29696470 PMCID: PMC5918143 DOI: 10.1186/s40729-018-0124-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 02/08/2018] [Indexed: 11/20/2022] Open
Abstract
Background The aim of this study was to assess surface characteristics, element composition, and surface roughness of five different commercially available dental zirconia implants. Five zirconia implants (Bredent whiteSKY™ (I1), Straumann® PURE Ceramic (I2), ceramic.implant vitaclinical (I3), Zeramex® (I4), Ceralog Monobloc M10 (I5)) were evaluated. Methods The evaluation was performed by means of scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and confocal laser scanning microscopy (CLSM). Results The semi-quantitative element composition showed no significant impurity of any implant tested. Both the machined and the rough areas of the investigated implants were predominated by zirconium, oxygen, and carbon. Roughness values (Sa) showed highest values for I2 and I5. Conclusions The investigated zirconia implants showed surface characteristics and roughness values close to those of conventionally produced titanium implants, making them a promising alternative. However, zirconia implants have yet to prove themselves in clinical practice and clinical controlled trials.
Collapse
Affiliation(s)
- B Beger
- Department of Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - H Goetz
- Biomaterials in Medicine (BioAPP), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - M Morlock
- Department of Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - E Schiegnitz
- Department of Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - B Al-Nawas
- Department of Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany
| |
Collapse
|
29
|
Blatt S, Schön H, Sagheb K, Kämmerer PW, Al-Nawas B, Schiegnitz E. Hemoglobin, C-reactive protein and ferritin in patients with oral carcinoma and their clinical significance – A prospective clinical study. J Craniomaxillofac Surg 2018; 46:207-212. [DOI: 10.1016/j.jcms.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/28/2017] [Accepted: 12/05/2017] [Indexed: 11/24/2022] Open
|
30
|
Schiegnitz E, Kämmerer PW, Schön H, Blatt S, Berres M, Sagheb K, Al-Nawas B. Proinflammatory cytokines as serum biomarker in oral carcinoma-A prospective multi-biomarker approach. J Oral Pathol Med 2018; 47:268-274. [PMID: 29272054 DOI: 10.1111/jop.12670] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Inflammation and cell-mediated immunity have a key role in different stages of carcinogenesis. The aim of this prospective study was to assess serum levels of proinflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), soluble interleukin-2 receptor (sIL-2R), tumor necrosis factor alpha (TNF-α), and MHC class I polypeptide-related sequence B (MICB) in patients with oral premalignant lesion (OPL), oral squamous cell carcinoma (OSCC), and healthy controls in a multi-biomarker approach as a potential diagnostic and prognostic tool for OSCC. MATERIAL AND METHODS A total of 205 patients (81 with OSCC, 75 with OPL, and 49 healthy controls) were included in this prospective study. Cytokine concentrations were measured by commercial enzyme linked immunoassay and chemiluminescence immunoassay. RESULTS IL-6, IL-8, and sIL-2R were significantly elevated in OSCC patients compared to healthy controls and to OPL patients. Higher T-Grade (>T2) and positive lymph node involvement resulted in significantly higher IL-6 values (P < .001 and P = .037). IL-6 serum values ≥5 pg/mL (n = 45) and sIL-2R serum values ≥623 U/mL (n = 19) indicated a significant lower survival rate compared to OSCC patients with low IL-6 (n = 36) and sIL-2R values (n = 62, P = .023 and P = .026). ROC and classification tree analyses identified the combination of IL-6 and IL-8 as diagnostic markers with good diagnostic accuracy. CONCLUSION In conclusion, IL-6, IL-8, and sIL-2R are strongly associated with OSCC oncogenesis and IL-6 and sIL-2R seem to be promising and potent biomarkers for evaluating patients' prognosis.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Holger Schön
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Sebastian Blatt
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred Berres
- Department of Mathematics and Technology, RheinAhrCampus Remagen, University of Applied Sciences Koblenz, Remagen, Germany.,Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg-University, Mainz, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
31
|
Schiegnitz E, Kämmerer PW, Schön H, Gülle C, Berres M, Sagheb K, Al-Nawas B. The matrix metalloproteinase and insulin-like growth factor system in oral cancer - a prospective clinical study. Onco Targets Ther 2017; 10:5099-5105. [PMID: 29123408 PMCID: PMC5661464 DOI: 10.2147/ott.s149231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim The absence of reliable single serum biomarkers for oral premalignant lesion (OPL) and oral squamous cell carcinoma (OSCC) limits early diagnosis, monitoring of advanced disease, and prediction of prognosis. Methods In this prospective study, serum levels of matrix metalloproteinase (MMP)-2, MMP-3, MMP-13, insulin-like growth factor (IGF)-1, and IGF-binding protein (IGFBP)-3 were measured in 81 untreated OSCC patients, 49 healthy subjects, and 75 individuals with OPLs, and correlated with clinicopathological parameters. Results Serum levels of MMP-3 were significantly higher in OSCC patients compared to healthy subjects (p=0.004). Mean IGF-1 and IGFBP-3 levels in OSCC patients were significantly lower in healthy subjects (p=0.001 and p<0.001). OSCC patients with an IGF-1 serum value <130 ng/mL (median) showed a significantly lower survival rate compared to ≥130 ng/mL (p=0.049). Combined use of IGF-1 (<130 ng/mL) and IGFBP-3 (<3.1 μg/mL) resulted in a significantly lower 12-month cumulative survival compared to the complementary set (78.5% vs 93.8%; p=0.031). There was a significantly positive correlation between IGF-1 and IGFBP-3 serum values (rs =0.625, p<0.001). Conclusion This study shows that IGF-1 and IGFBP-3 have a vital role in the pathogenesis of OSCC and indicates for the first time that IGF-1 and IGFBP-3 in combination may be applied as potential tools for prognosis of OSCC.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre Rostock, Rostock
| | - Holger Schön
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz
| | - Christoph Gülle
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Remagen.,Institute of Medical Biometry, Epidemiology and Informatics, Johannes Gutenberg University of Mainz, Mainz
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center, Johannes Gutenberg University of Mainz, Mainz
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Martin-Luther University Halle, Halle, Germany
| |
Collapse
|
32
|
Sagheb K, Schiegnitz E, Moergel M, Walter C, Al-Nawas B, Wagner W. Clinical outcome of alveolar ridge augmentation with individualized CAD-CAM-produced titanium mesh. Int J Implant Dent 2017; 3:36. [PMID: 28748521 PMCID: PMC5529307 DOI: 10.1186/s40729-017-0097-z] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 07/13/2017] [Indexed: 03/04/2023] Open
Abstract
Background The augmentation of the jaw has been and continues to be a sophisticated therapy in implantology. Modern CAD-CAM technologies lead to revival of old and established augmentation techniques such as the use of titanium mesh (TM) for bone augmentation. The aim of this retrospective study was to evaluate the clinical outcome of an individualized CAD-CAM-produced TM based on the CT/DVT-DICOM data of the patients for the first time. Methods In 17 patients, 21 different regions were augmented with an individualized CAD-CAM-produced TM (Yxoss CBR®, Filderstadt, Germany). For the augmentation, a mixture of autologous bone and deproteinized bovine bone mineral (DBBM) or autologous bone alone was used. Reentry with explantation of the TM and simultaneous implantation of 44 implants were performed after 6 months. Preoperative and 6-month postoperative cone beam computed tomographies (CBCT) were performed to measure the gained bone height. Results The success rate for the bone grafting procedure was 100%. Thirty-three percent of cases presented an exposure of the TM during the healing period. However, premature removal of these exposed meshes was not necessary. Exposure rate in augmentations performed with mid-crestal incisions was higher than in augmentations performed with a modified poncho incision (45.5 vs. 20%, p = 0.221). In addition, exposure rates in the maxilla were significantly higher than in the mandible (66.7 vs. 8.3%, p = 0.009). Gender, smoking, periodontal disease, gingiva type, used augmentation material, and used membrane had no significant influence on the exposure rate (p > 0.05). The mean vertical augmentation was 6.5 ± 1.7 mm, and the mean horizontal augmentation was 5.5 ± 1.9 mm. Implant survival rate after a mean follow-up of 12 ± 6 months after reentry was 100%. Conclusion Within the limits of the retrospective character of this study, this study shows for the first time that individualized CAD-CAM TM provide a sufficient and safe augmentation technique, especially for vertical and combined defects. However, the soft tissue handling for sufficient mesh covering remains one of the most critical steps using this technique.
Collapse
Affiliation(s)
- K Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - E Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - M Moergel
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - C Walter
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany.,Mediplus, Oral and Maxillofacial Surgery, Private Praxis, Mainz, Germany
| | - B Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - W Wagner
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
33
|
Schiegnitz E, Kämmerer P, Al-Nawas B. Quality Assessment of Systematic Reviews
and Meta-analyses on Biomarkers in Oral Squamous Cell Carcinoma. Oral Health Prev Dent 2017; 15:13-21. [PMID: 28232970 DOI: 10.3290/j.ohpd.a37709] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To examine the methodological quality of systematic reviews (SR) and meta-analyses on biomarkers in oral squamous cell carcinoma (OSCC) using validated checklists. MATERIALS AND METHODS A systematic literature search was performed to identify SR and meta-analyses focusing on biomarkers in OSCC published between January 1990 and March 2014. Details of the relevant aspects of methodology as reported in these SR were extracted from the full text publications. The methodological quality of these SR and meta-analyses was evaluated using the AMSTAR and Glenny checklists. RESULTS After screening 1098 abstracts from the electronic database, seven studies were included in quality assessment. The mean AMSTAR score of all SR was 4.6 ± 1.9 of a possible 11 (range: 2-7) and the mean score of all SR using the checklist devised by Glenny et al was 7.1 ± 1.6 of a possible 14 (range: 5-9). Spearman correlation analysis revealed that AMSTAR and Glenny scores were highly correlated (rs = 0.757; p = 0.049). The methodological quality in journals with an impact factor above 2.5 (AMSTAR: p = 0.031; Glenny: p = 0.046) was significantly higher. In addition, in SR published after 2007, higher AMSTAR and Glenny scores were noted; however, this was not statistically significant (AMSTAR: p = 0.076; Glenny: p = 0.232). CONCLUSIONS Systematic reviews and meta-analyses on biomarkers in OSCC presented marked methodological and structural variability, which elevates the risk of bias and hence invalid conclusions. Checklists such as AMSTAR or Glenny may improve quality and uniformity of SR, and would thus also increase the clinical validity and applicability of SR.
Collapse
|
34
|
Schiegnitz E, Kämmerer PW, Sagheb K, Wendt AJ, Pabst A, Al-Nawas B, Klein MO. Impact of maxillary sinus augmentation on oral health-related quality of life. Int J Implant Dent 2017; 3:10. [PMID: 28353194 PMCID: PMC5371166 DOI: 10.1186/s40729-017-0072-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 03/12/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient. METHODS Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Gutenberg University, Mainz, Germany, between July 2002 and December 2007 were included in this retrospective study. Total implant survival was assessed. Completion of a modified 26-item version of the Oral Health Impact Profile (OHIP-G) for assessing the oral health-related quality of life before and after the treatment was asked for. Subcategories were (1) functional limitations, (2) physical and psychological disabilities, and (3) complaints due to the surgical procedure. In 53 patients available for clinical follow-up examination, assessment of soft tissue parameters was performed. RESULTS After an average time in situ of 41.2 ± 27 months (3.4 years), the in situ rate was 95.4%. One-year survival rate and five-year survival rate according to Kaplan Meier were 95.4 and 94.4%. Concerning functional limitations, significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p < 0.001) were seen. In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p < 0.001). Concerning complaints due to the surgical procedure, mean total scores were 5.1 ± 5.4 pre-operative, 6.9 ± 6.1 (0-31) post-operative, and 2.4 ± 3.7 recently. This meant a significant difference between "pre-operative" vs. "post-operative" (p = 0.003), "pre-operative" vs. "recently" (p < 0.001), and "post-operative" vs. "recently" (p < 0.001). Concerning the influence of implant indication, edentulous patients showed the most distinct improvement after the procedure. Clinical assessment showed stable soft tissue parameters. CONCLUSIONS Evaluation of OHRQoL after sinus augmentation showed a significant improvement indicating a remarkable benefit for the patients through this procedure.
Collapse
Affiliation(s)
- E Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany.
| | - P W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University of Rostock, Rostock, Germany
| | - K Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
| | - A J Wendt
- Department of Prosthodontics, University of Hamburg-Eppendorf, Hamburg, Germany
| | - A Pabst
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
| | - B Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
| | - M O Klein
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany.,Oral and Maxillofacial Surgery, Private Praxis, Düsseldorf, Germany
| |
Collapse
|
35
|
Kämmerer TA, Palarie V, Schiegnitz E, Topalo V, Schröter A, Al-Nawas B, Kämmerer PW. A biphasic calcium phosphate coating for potential drug delivery affects early osseointegration of titanium implants. J Oral Pathol Med 2016; 46:61-66. [PMID: 27272434 DOI: 10.1111/jop.12464] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Calcium phosphate (CaP) surface coatings may accelerate osseointegration and serve as a drug delivery system for mineral-binding biomolecules. In a pilot study, the impact of a commercially available, thin CaP coating on early osseous bone remodeling was compared with a modern, subtractive-treated rough surface (SLA-like) in an animal trial. METHODS In 16 rabbits, 32 endosseous implants (CaP; n = 16, SLA-like; n = 16) were bilaterally inserted in the proximal tibia after randomization. After 2 and 4 weeks, bone-implant contact (BIC;%) in the cortical (cBIC) and the trabecular bone (sBIC) as well as volume of bone within the screw thread with the highest amount of new-formed bone (area;%) were analyzed. RESULTS After 2 weeks, cBIC was significantly higher for CaP when compared with SLA-like (58 ± 7% versus 40.4 ± 18%; P = 0.021). sBIC for CaP was 14.7 ± 8% and for SLA-like 7.2 ± 7.8% (P = 0.081). For area, the mean volumes were 82.8 ± 10.8% for CaP and 73.6 ± 22% for SLA-like (P = 0.311). After 4 weeks, cBIC was 42.9 ± 13% for the CaP and 46.5 ± 29.1% for the SLA-like group (P = 0.775). An sBIC of 6.9 ± 9.3% was calculated for CaP and of 12.3 ± 4.8% for SLA-like (P = 0.202). The values for area were 62.3 ± 24.1% for CaP and 50.1 ± 25.9% for SLA-like (P = 0.379). CONCLUSIONS The CaP coating has putative additional advantages in the early osseoconduction phases. It seems suitable for a feasible and clinical applicable bioactivation.
Collapse
Affiliation(s)
- Till A Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Victor Palarie
- Laboratory of Tissue Engineering, State University of Medicine and Pharmacy "N. Testemitanu", Chisinau, Moldova
| | - Eik Schiegnitz
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Valentin Topalo
- Clinic for Oral & Maxillofacial Surgery, State University of Medicine and Pharmacy "N. Testemitanu", Chisinau, Moldova
| | | | - Bilal Al-Nawas
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| |
Collapse
|
36
|
Schiegnitz E, Noelken R, Moergel M, Berres M, Wagner W. Survival and tissue maintenance of an implant with a sloped configurated shoulder in the posterior mandible-a prospective multicenter study. Clin Oral Implants Res 2016; 28:721-726. [DOI: 10.1111/clr.12869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2016] [Indexed: 11/28/2022]
Affiliation(s)
- E. Schiegnitz
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - R. Noelken
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
- Private Practice; Lindau/Lake Constance; Lindau Germany
| | - M. Moergel
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| | - M. Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz; RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry; Epidemiology and Informatics; Johannes Gutenberg-University; Remagen Germany
| | - W. Wagner
- Department of Oral and Maxillofacial Surgery; Plastic Surgery; University Medical Center of the Johannes Gutenberg-University Mainz; Mainz Germany
| |
Collapse
|
37
|
Kämmerer PW, Schneider D, Palarie V, Schiegnitz E, Daubländer M. Comparison of anesthetic efficacy of 2 and 4 % articaine in inferior alveolar nerve block for tooth extraction-a double-blinded randomized clinical trial. Clin Oral Investig 2016; 21:397-403. [PMID: 27020911 DOI: 10.1007/s00784-016-1804-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 03/16/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this clinical prospective, randomized, double-blind trial was to compare the anesthetic efficacy of 2 % articaine and 4 % articaine in inferior alveolar nerve block anesthesia for extraction of mandibular teeth. MATERIALS AND METHODS In 95 patients, 105 lower molar and premolar teeth were extracted after intraoral inferior alveolar nerve block. In 53 cases, 2 % articaine (group I) and, in 52 cases, 4 % articaine (group II) was administered. The primary objective was to analyze the differences of anesthetic effects between the two groups (complete/sufficient vs. insufficient/none). Furthermore, differences in pulpal anesthesia (onset and depth, examined with pulp vitality tester (min)), as well as in length of soft tissue anesthesia (min), were evaluated. Additionally, the need of a second injection, pain while injecting (numeric rating scale (NRS)), pain during treatment (NRS), pain after treatment (NRS), and other possible complications (excessive pain, bleeding events, prolonged deafness) were analyzed. RESULTS Anesthesia was sufficient for dental extractions in both groups without significant differences (p = 0.201). The onset of anesthesia did not differ significantly (p = 0.297). A significantly shorter duration of soft tissue anesthesia was seen in group I (2.9 vs. 4 h; p < 0.001). There was no significant difference in the need for a second injection (p = 0.359), in injection pain (p = 0.386), as well as in pain during (p = 0.287) or after treatment (p = 0.121). In both groups, no complications were seen. CONCLUSIONS The local anesthetic effect of the 4 % articaine solution is not significantly better when compared to 2 % articaine. CLINICAL RELEVANCE For mandibular tooth extraction, articaine 2 % may be used as alternative as well.
Collapse
Affiliation(s)
- P W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Schillingallee 35, 18057, Rostock, Germany.
| | | | - V Palarie
- Laboratory of Tissue Engineering, State University of Medicine and Pharmacy "N. Testemitanu", Chisinau, Moldova
| | - E Schiegnitz
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - M Daubländer
- Department of Oral Surgery, University Medical Centre Mainz, Mainz, Germany
| |
Collapse
|
38
|
Kumar VV, Heller M, Götz H, Schiegnitz E, Al-Nawas B, Kämmerer PW. Comparison of growth & function of endothelial progenitor cells cultured on deproteinized bovine bone modified with covalently bound fibronectin and bound vascular endothelial growth factor. Clin Oral Implants Res 2016; 28:543-550. [PMID: 26992449 DOI: 10.1111/clr.12832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2016] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The objective of this study was to assess and compare the growth and function of Endothelial Progenitor Cells (EPCs) cultured on covalently bonded Vascular Endothelial Growth Factor (VEGF) and covalently bonded Fibronectin (FN) coating on deproteinized bovine bone (DBB) (test samples), compared to non-modified DBB blocks (control sample). MATERIALS AND METHODS The test samples were prepared by plasma polymerization of allylamine onto DBB blocks. Group1 of test samples were prepared with VEGF coating (VEGF-DBB) where as the Group2 test samples were coated with FN (FN-DBB). Non-modified DBB blocks served as a Control. EPCs were isolated and cultivated from buffy coats of peripheral blood of healthy volunteers and cultivated in the different samples and examined at time intervals of 24 h, 3 days, and 7 days. Evaluation of growth by cell count and cell morphology was done using Confocal Laser Scanning Electron Microscopy; vitality and function of cells was assessed using MTT assay and RT-PCR and ELISA for eNOS and iNOS respectively. RESULTS The results of the study show that both VEGF and FN could be successfully immobilized by plasma polymerization onto a complex, porous, three-dimensional structure of DBB. When comparing vital cell coverage, proliferation and function of EPCs, FN-DBB provided more positive values followed by VEGF-DBB as compared to DBB samples. eNOS level were significant higher in VEGF-DBB and FN-DBB when compared to DBB (P = 0.019 and P = 0.002). The difference between VEGF-DBB and FN-DBB was not significant. CONCLUSIONS Biomimetic coatings of Fibronectin may clinically relate to faster angiogenesis and earlier healing potential.
Collapse
Affiliation(s)
- Vinay V Kumar
- Department of Oral and Maxillofacial Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany.,Department of Oral and Maxillofacial Surgery, University Medical Center of Rostock University, Rostock, Germany.,Head and Neck Institute, Mazumdar Shaw Medical Center and Center for Translational Research, Narayana Health, Bangalore, India
| | - Martin Heller
- Max Plank Institute for Polymer Research, Mainz, Germany
| | - Hermann Götz
- Department of Applied Structure and Microanalysis, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center of Rostock University, Rostock, Germany
| |
Collapse
|
39
|
Schiegnitz E, Palarie V, Nacu V, Al-Nawas B, Kämmerer PW. Vertical osteoconductive characteristics of titanium implants with calcium-phosphate-coated surfaces - a pilot study in rabbits. Clin Implant Dent Relat Res 2016; 16:194-201. [PMID: 23675992 DOI: 10.1111/j.1708-8208.2012.00469.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Osteoconductive characteristics of different implant surface coatings are in the focus of current interest. The aim of the present study was to compare the vertical osteoconductivity at the implant shoulder of supracrestal inserted calcium-phosphate coated implants (SLA-CaP) with conventional sand-blasted/acid-etched (SLA) implants in a rabbit model. MATERIALS AND METHODS SLA-CaP and SLA implants were inserted bilaterally in the mandible of four rabbits in a split-mouth design. The implants were placed 2 mm supracrestal. After 3 weeks, at the left and right implant shoulder, the percentage of linear bone fill (PLF) as well as bone-implant contact (BIC-D) were determined. RESULTS After 3 weeks, newly formed woven bone could be found at the shoulder of the most of both surface-treated implants (75%). PLF was significantly higher in SLA-CaP implants (11.2% vs. 46.5%; n = 8, p = .008). BIC-D was significantly increased in the SLA-CaP implants (13.0% vs. 71.4%; n = 8, p < .001) as well. CONCLUSION The results of this study show for the first time that calcium-phosphate coated surfaces on supracrestal inserted implants have vertical osteoconductive characteristics and increase the bone-implant contact at the implant shoulder significantly in a rabbit model. In clinical long-term settings, these implants may contribute to a better vertical bone height.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; State Medical and Pharmaceutical University "Nicolae Testemitanu", Chisinau, Moldova, Clinic for Oral & Maxillofacial Surgery, Chisinau, Moldova; State Medical and Pharmaceutical University "Nicolae Testemitanu," Chisinau, Moldova, Clinic for Oral & Maxillofacial Surgery, Chisinau, Moldova; Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | | | | | | |
Collapse
|
40
|
Kämmerer PW, Schiegnitz E, Palarie V, Dau M, Frerich B, Al-Nawas B. Influence of platelet-derived growth factor on osseous remodeling properties of a variable-thread tapered dental implant in vivo. Clin Oral Implants Res 2016; 28:201-206. [PMID: 26771071 DOI: 10.1111/clr.12782] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To evaluate the effect of platelet-derived growth factor (rhPDGF-BB) on the promotion of osteogenesis around variable-thread tapered implants in an animal model. MATERIAL AND METHODS Twenty-four variable-thread tapered implants were inserted in the tibia of 12 rabbits. Twelve sites received additional rhPDGF-BB released from a presoaked xenogenic bone block that was fixed supracrestally. Primary outcomes were bone-to-implant contact (BIC; in % ± SD) and percentage of medullary bone fill around the implants (PMF; in % ± SD) after 3 weeks (PDGF n = 6, no PDGF n = 6) and 6 weeks (PDGF n = 6, no PDGF n = 6). RESULTS Considerable crestal and medullary bone remodeling could be found around all implants. After 3 weeks, both BIC and PMF values were higher in the no PDGF group (BIC: 63% ± 10 with PDGF vs. 85% ± 5 with no PDGF; PMF: 57% ± 10 with PDGF vs. 74% ± 4 with no PDGF). After 6 weeks, the BIC difference between the two groups was less distinct (BIC: 78% ± 17 with PDGF vs. 72% ± 25 with no PDGF), whereas the PDGF group showed higher PMF values (PMF: 77% ± 5 with PDGF vs. 56% ± 10 with no PDGF). CONCLUSIONS The addition of rhPDGF-BB decreases early osseous crestal and medullar healing properties around dental implants. In a later phase, an increase in the cortical area as well as an increased medullar bone formation was seen. This response is likely to provide stronger secondary stability and stability in suboptimal situations involving poor-quality bone.
Collapse
Affiliation(s)
- Peer W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| | - Eik Schiegnitz
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| | - Victor Palarie
- Department of Oral and Maxillofacial Surgery and Oral Implantology, "A. Gutan" of the State University of Medicine and Pharmacy "N. Testemitanu,", Chisinau, Moldova
| | - Michael Dau
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| | - Bernhard Frerich
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany
| | - Bilal Al-Nawas
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Mainz, Mainz, Germany
| |
Collapse
|
41
|
Schiegnitz E, Al-Nawas B, Kämmerer PW, Grötz KA. Erratum to: oral rehabilitation with dental implants in irradiated patients: a meta-analysis on implant survival. Clin Oral Investig 2015; 19:1693. [PMID: 26082311 DOI: 10.1007/s00784-015-1508-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- E Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany,
| | | | | | | |
Collapse
|
42
|
Willenbacher M, Al-Nawas B, Berres M, Kämmerer PW, Schiegnitz E. The Effects of Alveolar Ridge Preservation: A Meta-Analysis. Clin Implant Dent Relat Res 2015; 18:1248-1268. [DOI: 10.1111/cid.12364] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Maximillian Willenbacher
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| | - Manfred Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz, RheinAhrCampus Remagen; Remagen Germany
- Institute of Medical Biometry, Epidemiology, and Informatics; Johannes Gutenberg-University; Mainz Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University of Rostock; Rostock Germany
| | - Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre of the Johannes Gutenberg-University; Mainz Germany
| |
Collapse
|
43
|
Schiegnitz E, Al-Nawas B, Kämmerer PW, Grötz KA. Dental implants in irradiated patients: which factors influence implant survival? Clin Oral Investig 2015; 19:1691-2. [DOI: 10.1007/s00784-015-1480-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 04/14/2015] [Indexed: 10/23/2022]
|
44
|
Schiegnitz E, Kämmerer PW, Rode K, Schorn T, Brieger J, Al-Nawas B. Growth differentiation factor 15 as a radiation-induced marker in oral carcinoma increasing radiation resistance. J Oral Pathol Med 2015; 45:63-9. [PMID: 25880686 DOI: 10.1111/jop.12323] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Growth differentiation factor 15 (GDF15) is involved in tumor pathogenesis of oral squamous cell carcinoma (OSCC). The aim of this study was an investigation of the potential influence of GDF15 on radioresistance of OSCC cells in vitro. METHODS Oral squamous cell carcinoma cell lines were irradiated with 0, 2, or 6 Gy, and GDF15 expression in the supernatant per survived cell colony was examined with ELISA. Non-irradiated and OSCC cell lines irradiated with 6 Gy were evaluated for GDF15 expression using immunofluorescent staining. For further investigation of GDF15 effects on radioresistance, a GDF15 knockdown model in a human OSCC cell line was established, and apoptotic activity after radiation was measured using the Caspase-Glo 3/7 system. RESULTS ELISA and immunofluorescent staining indicated an increased GDF15 expression in 5 OSCC cell lines compared with human gingival epithelial cells. Irradiation with two and six gray resulted in a significant elevation of GDF15 expression per survived cell colony in the irradiated OSCC cell lines (P < 0.001). Furthermore, a dose-dependent expression of GDF15 was seen. Immunofluorescent staining confirmed an elevated GDF15 expression in irradiated OSCC cell lines (n = 10; P ≤ 0.001). Apoptotic activity was significantly increased after irradiation in the GDF15 knockdown group compared with control cells (n = 24; P < 0.001). CONCLUSION This study describes for the first time the vital role of GDF15 both in tumorigenesis and in radioresistance of OSCC cells. With its anti-apoptotic effects, GDF15 possibly promotes tumor progression and might protect carcinoma cells against irradiation effects. Consequently, GDF15 may be a promising therapeutic target in oral cancer.
Collapse
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.,Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre, Rostock, Germany
| | - Katharina Rode
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Schorn
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Jürgen Brieger
- Department of Otorhinolaryngology, Molecular Tumor Biology Laboratory, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| |
Collapse
|
45
|
Schiegnitz E, Al-Nawas B, Tegner A, Sagheb K, Berres M, Kämmerer PW, Wagner W. Clinical and Radiological Long-Term Outcome of a Tapered Implant System with Special Emphasis on the Influence of Augmentation Procedures. Clin Implant Dent Relat Res 2015; 18:810-20. [DOI: 10.1111/cid.12338] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Eik Schiegnitz
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre; Johannes Gutenberg-University; Mainz Germany
| | - Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre; Johannes Gutenberg-University; Mainz Germany
| | - Alexander Tegner
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre; Johannes Gutenberg-University; Mainz Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre; Johannes Gutenberg-University; Mainz Germany
| | - Manfred Berres
- Department of Mathematics and Technology; University of Applied Sciences Koblenz; Remagen Germany
- Institute of Medical Biometry, Epidemiology and Informatics; Johannes Gutenberg-University; Mainz Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University of Rostock; Rostock Germany
| | - Wilfried Wagner
- Department of Oral and Maxillofacial Surgery, Plastic Surgery; University Medical Centre; Johannes Gutenberg-University; Mainz Germany
| |
Collapse
|
46
|
Kämmerer PW, Schiegnitz E, von Haussen T, Shabazfar N, Kämmerer P, Willershausen B, Al-Nawas B, Daubländer M. Clinical efficacy of a computerised device (STA™) and a pressure syringe (VarioJect INTRA™) for intraligamentary anaesthesia. Eur J Dent Educ 2015; 19:16-22. [PMID: 24646115 DOI: 10.1111/eje.12096] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION To evaluate the impact of experience whilst using different devices for intraligamentary anaesthesia, dental students tested clinical anaesthetic efficacy of a mechanical (PDL-S) and a computer-controlled (CCLAD) application system in restorative patients. MATERIAL AND METHODS In a prospective study, 41 Patients in need of restorative treatment in lower posterior mandible were randomised into three groups (PDL-S: teeth n = 22; CCLAD: teeth n = 20; inferior alveolar nerve block (IANB): teeth n = 20). Dental last year students conducted anaesthesia and dental treatment. Primary objectives were differences in pain during treatment [numeric rating scale (NRS)] as well as in anaesthetic efficacy (complete/sufficient vs. insufficient/no effect) between PDL-S and CCLAD. Pain of injection, need for second injections, amount of anaesthetic solution and duration of local numbness were assessed. IANB as gold standard was compared to each system descriptively. RESULTS PDL-S had a significant lower pain during treatment (P = 0.017) but a similar anaesthetic efficacy (P = 0.175) compared to the CCLAD system. Concerning pain of injection (P = 0.42), quantity of second injections (P = 0.232), amount of used solution (P = 0.073) as well as duration of local numbness (P = 0.253), no differences were seen. When comparing both periodontal ligament injection (PDL)-systems with IANB, pain rating was higher when using CCLAD. Injection pain, amount of used solution as well as soft tissue anaesthesia was less for PDL-S and CCLAD. DISCUSSION Both PDL techniques showed a good success for dental routine treatments. Although, compared to the mechanic device, the CCLAD system might need more clinical daily experience. CONCLUSION We recommend including specific trainings in intraligamentary anaesthesia in the dental curriculum.
Collapse
Affiliation(s)
- P W Kämmerer
- Department of Oral, Maxillofacial and Plastic Surgery, University Medical Centre Rostock, Rostock, Germany
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Klein M, Schiegnitz E, Al-Nawas B. Systematic Review on Success of Narrow-Diameter Dental Implants. Int J Oral Maxillofac Implants 2014; 29 Suppl:43-54. [DOI: 10.11607/jomi.2014suppl.g1.3] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
48
|
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone - a systematic review and meta-analysis. Eur J Oral Implantol 2014; 7 Suppl 2:S219-S234. [PMID: 24977257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS Bone substitute materials (BSM) are described as a reasonable alternative to autologous bone (AB) to simplify the grafting procedure. In a systematic review and meta-analysis, the influence of BSM compared to AB on treatment success in augmentation procedures of the edentulous jaw was analysed. MATERIAL AND METHODS Literature analysis resulted in only two studies addressing reconstruction of the totally edentulous jaw using BSM. Therefore the literature analysis was extended to partially and totally edentulous jaws. The following augmentation procedures were analysed: maxillary sinus floor augmentation (MSFA) and vertical and/or lateral alveolar ridge augmentation; guided bone regeneration (minor and contained defects) were excluded. Meta-analysis was implemented using the literature from the years 2000 to early 2014 and only studies with a mean follow-up of at least 10 months were included. RESULTS After screening 843 abstracts from the electronic database, 52 studies in qualitative and 14 in quantitative synthesis were included. In studies examining MSFA, the mean implant survival rate was 98.6% ± 2.6 for BSM, 88.6 ± 4.1% for BSM mixed with AB and 97.4 ± 2.2% for AB alone. For MSFA, meta-analysis showed a trend towards a higher implant survival when using BSM compared to AB, however the difference was not statistically significant ([OR], 0.59; [CI], 0.33-1.03). No statistically significant difference in implant survival for MSFA between BSM mixed with AB and AB was seen ([OR], 0.84; [CI], 0.5-1.42). Concerning ridge augmentation, the mean implant survival rate was 97.4 ± 2.5% for BSM, 100 ± 0% for BSM mixed with AB and 98.6 ± 2.9% for AB alone. Metaanalysis revealed no statistically significant difference in implant survival for ridge augmentation using BSM or AB ([OR], 1.85; [CI], 0.38 to 8.94). For BSM mixed with AB versus AB alone, a meta-analysis was not possible due to missing data. CONCLUSIONS Within the limitation of the meta-analytical approach taken, implant survival seems to be independent of the biomaterial used in MSFA and alveolar ridge augmentation. Therefore, based on the current literature, there is no evidence that AB is superior to BSM. The conclusions are limited by the fact that influence of defect size, augmented volume and regenerative capacity of the defects is not well described in the respective literature.
Collapse
|
49
|
Schiegnitz E, Al-Nawas B, Kämmerer PW, Grötz KA. Oral rehabilitation with dental implants in irradiated patients: a meta-analysis on implant survival. Clin Oral Investig 2013; 18:687-98. [DOI: 10.1007/s00784-013-1134-9] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 10/31/2013] [Indexed: 01/03/2023]
|
50
|
Kämmerer PW, Palarie V, Schiegnitz E, Hagmann S, Alshihri A, Al-Nawas B. Vertical osteoconductivity and early bone formation of titanium-zirconium and titanium implants in a subperiosteal rabbit animal model. Clin Oral Implants Res 2013; 25:774-80. [DOI: 10.1111/clr.12175] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2013] [Indexed: 12/28/2022]
Affiliation(s)
- Peer W. Kämmerer
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
- Harvard Medical School; Boston MA USA
| | - Victor Palarie
- Department of Oral and Maxillofacial Surgery; University of Chisinau; Chisinau Moldova
| | - Eik Schiegnitz
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
| | - Sebastien Hagmann
- Department of Orthopedics; University of Heidelberg; Heidelberg Germany
| | - Abdulmonem Alshihri
- Department of Restorative and Biomaterial Sciences; Harvard School of Dental Medicine; Boston MA USA
| | - Bilal Al-Nawas
- Department of Oral; Maxillofacial and Plastic Surgery; University Medical Centre Mainz; Mainz Germany
| |
Collapse
|