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Strauss FJ, Fukuba S, Naenni N, Jung R, Jonker B, Wolvius E, Pijpe J. Alveolar ridge changes 1-year after early implant placement, with or without alveolar ridge preservation at single-implant sites in the aesthetic region: A secondary analysis of radiographic and profilometric outcomes from a randomized controlled trial. Clin Implant Dent Relat Res 2024; 26:356-368. [PMID: 38105498 DOI: 10.1111/cid.13297] [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: 07/06/2023] [Revised: 11/08/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES To assess both the radiographic and profilometric outcomes of early implant placement with or without alveolar ridge preservation (ARP) (using two different ARP techniques) after 1 year of loading. MATERIALS AND METHODS Seventy-five patients with a failing single tooth in the anterior maxilla were randomly allocated to three groups (1:1:1): (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM), (b) ARP using DBBM-C covered with a palatal graft (PG), and (c) unassisted socket healing (control). Eight weeks after tooth extraction, early implant placement was performed in all patients. Cone-beam computed tomography (CBCT) and impressions were taken 8 weeks after tooth extraction (ARP/unassisted healing) prior to implant placement and 1-year post-loading. Radiographic and profilometric outcomes were evaluated. RESULTS Out of the 70 patients available for re-examination at 1-year post-loading, 55 datasets could be assessed (ARP-CM 19; ARP-PG 17; Control 19). The need for additional guided bone regeneration (GBR) at implant placement amounted to 31.6% (ARP-CM), 29.4% (ARP-PG), and 68.4% (unassisted healing). Adjusted models revealed that residual buccal bone height and additional GBR at implant placement significantly influenced the magnitude of the alveolar changes at 1 year (p < 0.05). In patients with ARP (group ARP-CM or ARP-PG) without additional GBR, the presence of bone convexity amounted to 36.0% (9/25) at 1-year post-loading. For patients that received ARP and additional GBR at implant placement, the frequency of bone convexity increased to 72.7% (8/11) (p = 0.042). Regarding profilometric measurements, a tendency toward agreement with radiographic outcomes was observed. CONCLUSIONS Early implant placement with ARP can attenuate alveolar ridge changes at 1-year post loading by minimizing both radiographic and profilometric alterations. However, early implant placement with simultaneous GBR consistently yields superior radiographic and profilometric outcomes, regardless of whether ARP is performed.
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Affiliation(s)
- Franz Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Shunsuke Fukuba
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Brend Jonker
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eppo Wolvius
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Justin Pijpe
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Oral and Maxillofacial Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
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Mancini L, Strauss FJ, Lim HC, Tavelli L, Jung RE, Naenni N, Thoma DS. Impact of keratinized mucosa on implant-health related parameters: A 10-year prospective re-analysis study. Clin Implant Dent Relat Res 2024. [PMID: 38419210 DOI: 10.1111/cid.13314] [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: 10/28/2023] [Revised: 01/30/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024]
Abstract
AIM To investigate whether the lack of keratinized mucosa (KM) affects peri-implant health after 10 years of loading. MATERIALS AND METHODS Data from 74 patients with 148 implants from two randomized controlled studies comparing different implant systems were included and analyzed. Clinical parameters including bleeding on probing (BOP), probing depth (PD), plaque index, marginal bone loss (MBL), and KM width (KMW) at buccal sites were collected at baseline (time of the final prosthesis insertion), 5-year and 10 years postloading. Multivariable logistic and linear regression models by means of a generalized estimated equation (GEE) were used to evaluate the influence of buccal KM on peri-implant clinical parameters; BOP, MBL, PD, and adjusted for implant type (one-piece or two-piece) and compliance. RESULTS A total of 35 (24.8%) implants were healthy, 67 (47.5%) had mucositis and 39 (27.6%) were affected by peri-implantitis. In absence of buccal KM (KM = 0 mm), 75% of the implants exhibited mucositis, while in the presence of KM (KMW >0 mm) 41.2% exhibited mucositis. Regarding peri-implantitis, the corresponding percentages were 20% (KM = 0 mm) and 26.7% (KM >0 mm). Unadjusted logistic regression showed that the presence of buccal KM tended to reduce the odds of showing BOP at buccal sites (OR: 0.28 [95% CI, 0.07 to 1.09], p = 0.06). The adjusted logistic regression model revealed that having buccal KM (OR: 0.21 [95% CI, 0.05 to 0.85], p = 0.02) and using two-piece implants (OR: 0.34 [95% CI, 0.15 to 0.75], p = 0.008) significantly reduced the odds of showing BOP. Adjusted linear regression by means of GEE showed that KM and two-piece implants were associated with reduced MBL and MBL changes (p < 0.05). CONCLUSION The lack of buccal KM appears to be linked with peri-implant parameters such as BOP and MBL, but the association is weak. The design of one-piece implants may account for their increased odds of exhibiting BOP.
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Affiliation(s)
- Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
- Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Hyun-Chang Lim
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Lorenzo Tavelli
- Center for Clinical Research and Evidence Synthesis in Oral Tissue Regeneration (CRITERION), Boston, Massachusetts, USA
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
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Ermatinger S, Lee WZ, Thoma DS, Hüsler J, Hämmerle CHF, Naenni N. Clinical Outcomes of Tooth- and Implant-Supported Restorations Performed in a University-based Undergraduate Program after 13-15 Years. INT J PROSTHODONT 2024; 0:1-23. [PMID: 37222706 DOI: 10.11607/ijp.8264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIMS To assess the clinical concept of patient treatment with fixed tooth- and implant-supported restorations in a university-based undergraduate program after 13 - 15 years. METHODS Thirty patients (mean age 56 years) who had received multiple tooth- and implant-supported restorations were recalled after 13-15 years. The clinical assessment comprised of biological and technical parameters as well as patient satisfaction. Data were analyzed descriptively and the 13-15-year survival rates for tooth- and implant-supported single crowns and fixed dental prostheses were calculated. RESULTS The survival rate of tooth-supported restorations amounted to 88.3% (single crowns) and 69.6% (fixed dental prostheses); in implants it reached 100% for all types of reconstructions. Overall, 92.4% of all reconstructions were free of technical complications. The most common technical complication was chipping of the veneering ceramic (tooth-supported restorations: 5.5%; implant-supported restorations: 13-15.9%) regardless of the material used. At teeth, increased probing depth ≥5mm was the most frequent biological complication (22.8%), followed by endodontic complications of root-canal treated teeth (14%) and loss of vitality at abutment teeth (8.2%). Peri-implantitis was diagnosed in 10.2% of implants. CONCLUSION Results of this study indicate that the clinical concept implemented in the undergraduate program and performed by undergraduate students works well. The clinical outcomes are similar to those reported in the literature. In general, the majority of biological complications occurrs in reconstructed teeth, whereas implant-supported restorations are more prone to technical complications.
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Gadzo N, Ioannidis A, Naenni N, Hüsler J, Jung RE, Thoma DS. Survival and complication rates of two dental implant systems supporting fixed restorations: 10-year data of a randomized controlled clinical study. Clin Oral Investig 2023; 27:7327-7336. [PMID: 37906305 PMCID: PMC10713755 DOI: 10.1007/s00784-023-05323-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/10/2023] [Indexed: 11/02/2023]
Abstract
OBJECTIVES To compare clinical, radiographic, biological and technical long-term outcomes of two types of dental implants over a period of 10 years. MATERIALS AND METHODS Ninety-eight implants were placed in 64 patients, randomly allocated to one of two manufacturers (AST and STM). All implants were loaded with fixed restorations. Outcome measures were assessed at implant insertion (Ti), at baseline examination (TL), at 1, 3, 5, 8 and 10 (T10) years. Data analysis included survival, bone level changes, complications and clinical measures. RESULTS Re-examination was performed in 43 patients (23 AST and 20 STM) at 10 years. The implant level analysis was based on 37 (AST) and 32 (STM) implants. Survival rates of 100% were obtained for both groups. The median changes of the marginal bone levels between baseline and T10 (the primary endpoint) amounted to a loss of 0.07 mm for group AST and a gain of 0.37 mm for group STM (intergroup p = 0.008). Technical complications occurred in 27.0% of the implants in group AST and in 15.6% in group STM. The prevalence of peri-implant mucositis was 29.7% (AST) and 50.1% (STM). The prevalence of peri-implantitis amounted to 0% (AST) and 6.3% (STM). CONCLUSIONS Irrespective of the implant system used, the survival rates after 10 years were high. Minimal bone level changes were observed, statistically significant but clinically negligible in favor of STM. Technical complications were more frequently encountered in group AST, while group STM had a higher prevalence of peri-implant mucositis.
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Affiliation(s)
- Naida Gadzo
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Alexis Ioannidis
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center for Dental Medicine, University of Zurich, 8032, Zurich, CH, Switzerland.
- Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea.
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Platt A, Liu CC, Gubler A, Naenni N, Thoma D, Schmidlin PR. In vitro evaluation of different protective techniques to reduce titanium particle contamination during implantoplasty. Clin Oral Investig 2023; 27:4205-4213. [PMID: 37140763 PMCID: PMC10415425 DOI: 10.1007/s00784-023-05037-8] [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: 02/22/2023] [Accepted: 04/21/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Our aim is to study titanium remains in a bone model during standardized implantoplasty under different isolation and protective modalities. MATERIAL AND METHODS Forty implants were placed in artificial spongy bone blocks mimicking a horizontal bone loss and implant neck protrusion of 5 mm. Samples were randomly divided into four groups (n = 10), which were treated as follows: rubber dam (A), a dental adhesive paste (B), bone wax (C), and an unprotected positive control (D). Implantoplasty was performed using carbide and diamond burs under strict water cooling and standardized suction. After removal of the respective isolation materials, the bone blocks were thoroughly rinsed with tap water for 3 min and titanium chips were collected using a filter integrated in the model. The filter paper was removed and dissolved in 37% hydrochloric acid for 2 h at 120 °C and the titanium remnants were quantified using atomic absorption spectrometry. RESULTS None of the test groups were able to completely prevent titanium particle contamination. Rubber dam (691 ± 249 µg) and bone wax (516 ± 157 µg) were found to be significantly more protective than the positive control (2313 ± 747 µg) (p < 0.001) with respect to the amount of titanium particles that remained in the bone model after implantoplasty. The adhesive paste group (1863.5 ± 538 µg) was not significantly different from the positive control (p = 0.19). CONCLUSIONS Despite some limitations of the present study, titanium particles resulting from a standardized implantoplasty can be assumed to be significantly reduced when the tissues/bone were protected with rubber dam and bone wax, or a combination, depending on individual accessibility. CLINICAL RELEVANCE Tissue protective measures to reduce or avoid particle contamination during implantoplasty is possible and should be considered and further clinically assessed to avoid iatrogenic inflammatory reactions.
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Affiliation(s)
- A Platt
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - C C Liu
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - A Gubler
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - N Naenni
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - D Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Division of Periodontology and Peri-Implant Diseases, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland.
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Sahrmann P, Naenni N, Jung RE, Hämmerle CHF, Attin T, Schmidlin PR. Ten-Year Performance of Posterior 6-mm Implants with Single-Tooth Restorations: A Randomized Controlled Trial. J Dent Res 2023:220345231170538. [PMID: 37387401 DOI: 10.1177/00220345231170538] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
The aim of the study was to compare the clinical and radiographic outcomes of short dental implants (6-mm test group, TG) to longer implants (10-mm control group, CG) with single crown restorations after 10 y of loading. Patients requiring single-tooth replacement in the posterior jaws were randomly assigned to TG or CG. Implants were loaded with screw-retained single crowns after a healing period of 10 wk. Follow-up appointments were scheduled yearly and comprised patient-adapted oral hygiene reinstructions and polishing of all teeth and implants. After 10 y, clinical and radiographical parameters were assessed again. Out of initially 94 patients (47 in TG and CG, each), 70 (36 TG and 34 CG) could be reassessed. Survival rates accounted for 85.7% (TG) and 97.1% (CG), without significant intergroup difference (P = 0.072). All but 1 lost implant had been located in the lower jaw. These implants were not lost due to peri-implantitis but due to a late loss of osseointegration without signs of inflammation and with actually stable marginal bone levels (MBLs) over the investigation period. In general, MBLs were stable with medians (interquartile ranges) of 0.13 (0.78) mm and 0.08 (1.2) mm, for TG and CG, without significant intergroup differences. Crown-to-implant ratio showed a highly significant intergroup difference of 1.06 ± 0.18 mm and 0.73 ± 0.17 mm (P < 0.001). Few technical complications (i.e., screw loosening or chipping) were registered during the investigation period. In conclusion, given stringent professional maintenance, short dental implants with single-crown restorations show a slightly worse but statistically not different survival rate after 10 y, especially in the lower jaw, but can still be considered a valuable alternative, especially when vertical bone dimensions are limited (German Clinical Trials Registry: DRKS00006290).
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Affiliation(s)
- P Sahrmann
- Clinic of Periodontology, Endodontology and Cariology, University Center of Dental Medicine, University of Basel, Basel, Switzerland
| | - N Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - R E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - C H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Zuercher AN, Mancini L, Naenni N, Thoma DS, Strauss FJ, Jung RE. The L-shape technique in guided bone regeneration with simultaneous implant placement in the esthetic zone: A step-by-step protocol and a 2-14 year retrospective study. J ESTHET RESTOR DENT 2023; 35:197-205. [PMID: 36165402 DOI: 10.1111/jerd.12965] [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: 06/24/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To describe the methodology of the "L-shape" technique in guided bone regeneration (GBR) with simultaneous implant placement and report on the clinical, esthetic, and patient satisfaction outcomes up to 14 years of follow-up. MATERIAL AND METHODS Fourteen patients treated with the "L-shape" technique were included in this retrospective study. The L-shape technique was performed by trimming and placing a soft-type bone block made of deproteinized bovine bone mineral with 10% collagen at the buccal-occlusal aspect of the dental implant. The remaining gaps were filled with deproteinized bovine bone mineral granules and the augmented area was covered with a collagen membrane. The following parameters were recorded: probing depth (PD), bleeding on probing (BOP), plaque index (PI), keratinized tissue width (KT) and marginal bone level (MBL). Esthetic outcomes were assessed according to the pink esthetic score (PES) and the white esthetic score (WES). Patient satisfaction was evaluated by means of a numerical rating scale (0-10). The stability of each augmented site was assessed by measuring the volumetric changes between baseline (crown delivery) and the respective follow-up. RESULTS A total of 13 maxillary incisors and one maxillary canine in 14 patients were included. The mean follow-up period was 7.7 ± 3.8 years. PES values amounted to 10.7 ± 3.3 and WES to 8.8 ± 1.4. Patient satisfaction reached 9.4 ± 0.8. Mean PD at implant sites were 2.7 ± 0.7 mm while BOP amounted to 15.0 ± 0.2% and Pl to 5.0 ± 0.0%. Volumetric analyses revealed minimal changes at the augmented sites irrespective of the region of interest. Radiographic MBL remained relatively stable. CONCLUSIONS Within the limitation of the present study the L-shape augmentation procedure seems to be a reliable technique when performing GBR with simultaneous implant placement in the esthetic zone. Outcomes encompassed stable clinical and esthetic results accompanied by high levels of patient satisfaction. Future randomized controlled trials are warranted to confirm possible benefits of the L-shape technique over traditional approaches. CLINICAL SIGNIFICANCE The L-shape appears to be a simple yet promising technique in GBR with simultaneous implant placement that can easily be translated into clinical practice.
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Affiliation(s)
- Anina-Nives Zuercher
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Centre for Oral Clinical Research, Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Leonardo Mancini
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel-Stefan Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz-Josef Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Ronald-Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Naenni N. [Influencing Hard and Soft Tissue Changes Following Tooth Extraction]. Praxis (Bern 1994) 2022; 111:163-167. [PMID: 35232257 DOI: 10.1024/1661-8157/a003798] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Influencing Hard and Soft Tissue Changes Following Tooth Extraction Abstract. Influencing Hard and Soft Tissue Changes Following Tooth Extraction The loss of a tooth leads to the initiation of resorption processes and thus to the remodeling of the tissues of the alveolar process. At the hard tissue level, this resorption mainly affects the bundle bone at the buccal side of the extracted tooth and occurs most rapidly in the first weeks and months after extraction. Tissue changes occur not only at the level of the hard tissue (bone), but also at the level of the soft tissue. These changes lead to a significant loss of volume, especially at the buccal area of the alveolar ridge. They are responsible for a volume loss of the alveolar ridge contour of up to 50 %.
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Affiliation(s)
- Nadja Naenni
- Zentrum für Zahnmedizin, Klinik für Rekonstruktive Zahnmedizin, Zürich
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Jonker BP, Strauss FJ, Naenni N, Jung RE, Wolvius EB, Pijpe J. Early implant placement with or without alveolar ridge preservation in single tooth gaps renders similar esthetic, clinical and patient-reported outcome measures: One-year results of a randomized clinical trial. Clin Oral Implants Res 2021; 32:1041-1051. [PMID: 34129708 PMCID: PMC8457170 DOI: 10.1111/clr.13796] [Citation(s) in RCA: 8] [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: 02/11/2021] [Revised: 05/23/2021] [Accepted: 06/07/2021] [Indexed: 12/24/2022]
Abstract
Objectives To test whether early implant placement with alveolar ridge preservation (ARP) results in different esthetic, clinical and patient‐reported outcome measures (PROMs) compared with early implant placement without ARP. Material and methods Seventy‐five patients requiring single tooth extraction in the anterior maxilla were recruited. Following tooth extraction, the patients were randomly allocated to three groups: (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM‐C) covered by a collagen matrix (CM) (n = 25), (b) ARP using DBBM‐C covered with a palatal graft (PG) (n = 25) and (c) spontaneous healing (control) (n = 25). Eight weeks after tooth extraction, a CBCT was taken and early implant placement was performed in all patients. Esthetic, clinical and PROMs were evaluated one year post‐loading. Results A total of 70 patients were available for re‐examination at one year post‐loading. The median mid‐facial mucosal margin change amounted to −0.02 mm (IQR −0.27–0.46) in the CM group, −0.13 mm (IQR −0.44–0.25) in the PG group and −0.14 mm (IQR −0.29–0.07) in the control group, with no significant differences between the groups. Mean PES scores amounted to 7.0 ± 1.4 in the CM group, 7.1 ± 1.5 in the PG group and 7.3 ± 1.7 in the control group without significant differences between the groups. Plaque, bleeding on probing and probing depth did not differ between treatment groups. PROMs in general revealed no significant differences between the groups. Conclusion Early implant placement with ARP using either a collagen matrix or a palatal graft rendered similar esthetic, clinical and PROMs to early implant placement without ARP. When a failing tooth can be replaced with an implant within 2 months after tooth extraction, the added value of ARP might be clinically negligible.
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Affiliation(s)
- Brend P Jonker
- Department of Oral & Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Eppo B Wolvius
- Department of Oral & Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Justin Pijpe
- Department of Oral & Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands.,Department of Oral & Maxillofacial Surgery, Catharina Hospital Eindhoven, Eindhoven, the Netherlands
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Naenni N, Stucki L, Hüsler J, Schneider D, Hämmerle CHF, Jung RE, Thoma DS. Implants sites with concomitant bone regeneration using a resorbable or non-resorbable membrane result in stable marginal bone levels and similar profilometric outcomes over 5 years. Clin Oral Implants Res 2021; 32:893-904. [PMID: 33977571 DOI: 10.1111/clr.13764] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/25/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess clinical and radiographic outcomes as well as the profilometric contour alterations of peri-implant hard and soft tissues around single implants treated with simultaneous guided bone regeneration (GBR) at 5 years. MATERIALS AND METHODS Twenty-seven patients presenting with a single tooth gap in the esthetic zone received a two-piece implant. GBR was randomly performed using a resorbable (RES) or a non-resorbable membrane (N-RES) combined with a bone substitute material. Follow-up examinations were performed at baseline (BL = crown insertion), 1 year (FU-1), 3 years (FU-3), and at 5 years (FU-5) including clinical and radiographic parameters as well as profilometric changes. Statistics were performed by means of parametric and nonparametric tests. RESULTS At 5 years, 20 out of 27 patients (9 RES, 11 N-RES) were re-examined. Median values for probing depth changed insignificantly between BL and FU-5 in both groups. The median marginal bone levels were located 0.23 mm (0.06; 0.46; RES) and 0.17 mm (0.13;0.28; N-RES) below the implant shoulder at FU-5 (changes over time p < .05). The calculated median profilometric change between BL and FU-5 was -0.28 mm (-0.53;-0.20; RES; p = .016) and -0.24 mm (-0.43;0.08; N-RES; p = .102; intergroup p = .380). The horizontal bone thickness decreased significantly between re-entry and FU-5 for group RES at all measured levels (p < .05) measuring 0.87 mm (0.0; 2.05) at the implant shoulder, whereas the decrease for group N-RES was insignificant (p = .031) with 0 mm (0; 0.84) at the implant shoulder at 5 years. CONCLUSIONS Implants sites with concomitant GBR using a resorbable or non-resorbable membrane revealed stable marginal bone levels and clinical outcomes. Profilometric changes were clinically negligible over 5 years. The observed change in hard tissue thickness was partially compensated by an increase in soft tissue thickness.
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Affiliation(s)
- Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Lukas Stucki
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - David Schneider
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Korea
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11
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Jonker BP, Gil A, Naenni N, Jung RE, Wolvius EB, Pijpe J. Soft tissue contour and radiographic evaluation of ridge preservation in early implant placement: A randomized controlled clinical trial. Clin Oral Implants Res 2020; 32:123-133. [PMID: 33217058 PMCID: PMC7839667 DOI: 10.1111/clr.13686] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 02/21/2020] [Revised: 08/24/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
Objectives To compare two ridge preservation techniques and spontaneous healing in terms of hard and soft tissue changes 2 months after tooth extraction. Material and methods The study was designed as a randomized controlled trial and included 75 patients. After single tooth extraction in the maxillary incisor/premolar area, patients were randomly allocated to one of the following groups: (a) ridge preservation with a xenogeneic bone substitute covered with a collagen matrix (CM‐group), (b) ridge preservation with a xenogeneic bone substitute covered with a free palatal graft (PG‐group) or (c) spontaneous healing (control). Eight weeks after tooth extraction, implants were placed and clinical, profilometric and radiographic evaluations were performed. In addition, the need for further guided bone regeneration (GBR) at implant placement was assessed. The differences between the treatment groups were compared with the One‐way ANOVA or Kruskal–Wallis test with the corresponding post hoc analysis. The proportions of the categorical parameters were compared with the Fisher´s exact test. Results Seventy‐five patients underwent early implant placement 8 weeks after tooth extraction and were evaluated. CM‐group (−0.9 SD 0.6 mm) and PG‐group (−1.0 SD 0.8 mm) showed less horizontal bone resorption compared to the control group (−3.2 SD 2.1 mm) (p < .001). Moreover, the necessity of GBR at implant placement was significantly less in CM‐group (32%) and PG‐group (24%) when compared to control group (72%) (p = .001). Patients in CM‐group experienced less pain than PG‐group, one week after tooth extraction (p = .042). No significant differences were found regarding graft evaluation, post‐operative complications, and soft tissue contour. Conclusions Ridge preservation using a xenogeneic bone substitute covered with a collagen matrix or a palatal graft, results in less bone resorption and fewer GBR procedures at early implant placement compared to spontaneous healing.
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Affiliation(s)
- Brend Pjotr Jonker
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald Ernst Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Eppo Bonne Wolvius
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Justin Pijpe
- Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Center, Rotterdam, The Netherlands.,Department of Oral & Maxillofacial Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
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12
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Naenni N, Lim HC, Strauss FJ, Jung RE, Hämmerle CHF, Thoma DS. Local tissue effects of various barrier membranes in a rat subcutaneous model. J Periodontal Implant Sci 2020; 50:327-339. [PMID: 33124210 PMCID: PMC7606894 DOI: 10.5051/jpis.2000380019] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 04/01/2020] [Accepted: 04/20/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose The purpose of this study was to examine the local tissue reactions associated with 3 different poly(lactic-co-glycolic acid) (PLGA) prototype membranes and to compare them to the reactions associated with commercially available resorbable membranes in rats. Methods Seven different membranes—3 synthetic PLGA prototypes (T1, T2, and T3) and 4 commercially available membranes (a PLGA membrane, a poly[lactic acid] membrane, a native collagen membrane, and a cross-linked collagen membrane)—were randomly inserted into 6 unconnected subcutaneous pouches in the backs of 42 rats. The animals were sacrificed at 4, 13, and 26 weeks. Descriptive histologic and histomorphometric assessments were performed to evaluate membrane degradation, visibility, tissue integration, tissue ingrowth, neovascularization, encapsulation, and inflammation. Means and standard deviations were calculated. Results The histological analysis revealed complete integration and tissue ingrowth of PLGA prototype T1 at 26 weeks. In contrast, the T2 and T3 prototypes displayed slight to moderate integration and tissue ingrowth regardless of time point. The degradation patterns of the 3 synthetic prototypes were similar at 4 and 13 weeks, but differed at 26 weeks. T1 showed marked degradation at 26 weeks, whereas T2 and T3 displayed moderate degradation. Inflammatory cells were present in all 3 prototype membranes at all time points, and these membranes did not meaningfully differ from commercially available membranes with regard to the extent of inflammatory cell infiltration. Conclusions The 3 PLGA prototypes, particularly T1, induced favorable tissue integration, exhibited a similar degradation rate to native collagen membranes, and elicited a similar inflammatory response to commercially available non–cross-linked resorbable membranes. The intensity of inflammation associated with degradable dental membranes appears to relate to their degradation kinetics, irrespective of their material composition.
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Affiliation(s)
- Nadja Naenni
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Hyun Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea
| | - Franz Josef Strauss
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Conservative Dentistry, University of Chile, School of Dentistry, Santiago, Chile.,Department of Oral Biology, Medical University of Vienna, School of Dentistry, Vienna, Austria
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | | | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.
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13
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Padhye NM, Lakha T, Naenni N, Kheur M. Effect of crown-to-implant ratio on the marginal bone level changes and implant survival - A systematic review and meta-analysis. J Oral Biol Craniofac Res 2020; 10:705-713. [PMID: 33072508 DOI: 10.1016/j.jobcr.2020.10.002] [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: 08/24/2020] [Revised: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 11/18/2022] Open
Abstract
The purpose of the systematic review and meta-analysis was to analyze the existing evidence regarding the effect of crown-to-implant ratio (CIR) on the peri-implant crestal bone level change and implant survival. Randomized controlled clinical trials, prospective as well as retrospective studies with a minimum follow-up period of 12 months and 10 patients per group were included for this systematic review. Statistical analysis was performed to determine CIR effects on the peri-implant marginal bone level changes and implant survival. A total of 28 articles (14 prospective studies and 14 retrospective studies) from a database of 201 articles, with 2097 patients and 4350 implants, were included. A mean CIR ranging from 0.6 to 2.44 was presented by the study groups. A weighted mean implant loss of 0.19% per year and peri-implant marginal bone level change of 0.63 mm ± 0.55 over 46.8 ± 5.2 months was calculated from the included studies. The peri-implant marginal bone level change (p = 0.155) and the rate of implant loss (p = 0.245) showed a statistically insignificant difference between implant restorations of a high (>1.5:1) and low (<1.5:1) CIR. Within its limitations, this review concludes that a high (>1.5:1) or a low (<1.5:1) CIR does not significantly affect the peri-implant marginal bone level change and implant survival rate. However, until further evidence becomes available, extrapolation to long term clinical success cannot be ascertained.
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Affiliation(s)
| | - Tabrez Lakha
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
| | - Nadja Naenni
- Swiss Society of Reconstructive Dentistry, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Switzerland
| | - Mohit Kheur
- Department of Fixed and Removable Prosthodontics, M.A. Rangoonwala Dental College and Research Center, Pune, India
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14
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Gil A, Jonker B, Naenni N, Strauss F, Jung R, Wolvius E, Pijpe J. Soft tissue contour and radiographic evaluation of ridge preservation in early implant placement: A randomized controlled clinical trial. Clin Oral Implants Res 2020. [DOI: 10.1111/clr.46_13643] [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)
- Alfonso Gil
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Brend Jonker
- Erasmus Medical Center, Department of Oral‐ and Maxillofacial Surgery, Rotterdam, Netherlands
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Eppo Wolvius
- Erasmus Medical Center, Department of Oral‐ and Maxillofacial Surgery, Rotterdam, Netherlands
| | - Justin Pijpe
- Erasmus Medical Center, Department of Oral‐ and Maxillofacial Surgery, Rotterdam, Netherlands
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15
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Naenni N, Michelotti G, Lee WZ, Sailer I, Hämmerle CH, Thoma DS. Resin-Bonded Fixed Dental Prostheses with Zirconia Ceramic Single Retainers Show High Survival Rates and Minimal Tissue Changes After a Mean of 10 Years of Service. INT J PROSTHODONT 2020; 33:503-512. [PMID: 32956431 DOI: 10.11607/ijp.6737] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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
PURPOSE To assess the clinical outcomes of single-retainer resin-bonded fixed dental prostheses (RBFDPs) and the profilometric changes of pontic sites after a mean of 10 years in function. MATERIALS AND METHODS Ten patients (mean age 32.4 years) who had received an RBFDP replacing a single anterior tooth were recalled after 10 years. Five patients had received a subepithelial connective tissue graft (SCTG) at the pontic site. The clinical assessment comprised the following parameters: probing depth, bleeding on probing, modified plaque control record, gingival recession, measurement of the width of keratinized mucosa, and intraoral photographs and radiographs. The modified criteria of the United States Public Health Services evaluation system were applied. Additionally, patient satisfaction was recorded. Data were analyzed descriptively, and the 10-year RBFDP survival rates were calculated using Kaplan-Meier analysis. RESULTS The RBFDP survival rate after a mean follow-up of 10.0 years (range 7.4 to 13.3 years) was 100%. Neither technical failures nor biologic complications were observed. All abutment teeth remained vital, and no secondary caries were detected. Between baseline and follow-up examinations, the profilometric changes at the pontic sites were minimal, exhibiting a loss of -0.03 ± 0.10 mm (no SCTG) and 0.00 ± 0.37 mm (SCTG). CONCLUSION The present study exhibited high survival rates and low complication rates of the restorations, as well as excellent profilometric stability of the pontic sites over 10 years. The use of an RBFDP is a viable long-term treatment option for replacing a single anterior tooth.
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16
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Naenni N, Walter P, Hämmerle CHF, Jung RE, Thoma DS. Augmentation of soft tissue volume at pontic sites: a comparison between a cross-linked and a non-cross-linked collagen matrix. Clin Oral Investig 2020; 25:1535-1545. [PMID: 32719982 PMCID: PMC7878233 DOI: 10.1007/s00784-020-03461-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 05/14/2020] [Accepted: 07/10/2020] [Indexed: 12/27/2022]
Abstract
AIM To assess histopathological and histomorphometric outcomes of soft tissue volume augmentation procedures at pontic sites using a volume-stable cross-linked collagen matrix (VCMX) and a non-cross-linked collagen matrix (XCM). MATERIALS AND METHODS In twelve adult beagle dogs, the mandibular premolars and first molar were hemisected and the mesial root extracted. Soft tissue augmentation was randomly performed using VCMX, XCM, or a sham-operated control. Sacrifice was performed after 4, 8, and 26 weeks. Non-decalcified sections were analyzed for histopathologic and histomorphometric measurements at four different levels below the crest (1.5, 2.5, 3.5, and 5.5 mm). RESULTS Group VCMX presented a greater overall amount of soft tissue at all healing time points, more pronounced fibroblast ingrowth, vascularization, and a substantial new collagen deposition. Over time, group XCM demonstrated faster signs of degradation compared with group VCMX. Four weeks after augmentation, group VCMX yielded a higher mean ridge width compared with groups XCM (2.22 mm VCMX, 0.89 mm XCM (at 2.5 mm); 2.05 mm VCMX, 0.80 mm XCM (at 3.5 mm) p < 0.05) and sham (0.59 mm sham (at 1.5 mm); 0.48 mm (at 2.5 mm); 0.44 mm (at 3.5 mm) p < 0.05). After healing periods of 8 and 26 weeks, measurements in group VCMX remained significantly higher compared with group sham both at 8 weeks (levels of 1.5 mm, 2.5 mm and 5.5 mm) and at 26 weeks (levels of 1.5 mm, 3.5 mm and 5.5 mm) (p < 0.05). CONCLUSION The use of a cross-linked collagen matrix resulted in a greater and more stable ridge width over time compared with control groups. CLINICAL RELEVANCE Soft tissue volume augmentation at pontic sites is more effective when using a cross-linked compared with a non-cross-linked collagen matrix.
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Affiliation(s)
- Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Prisca Walter
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland. .,Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry,, Yonsei University, Seoul, South Korea.
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17
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César Neto JB, Cavalcanti MC, Sapata VM, Pannuti CM, Hämmerle CHF, Naenni N, Thoma DS, Romito GA. The positive effect of tenting screws for primary horizontal guided bone regeneration: A retrospective study based on cone-beam computed tomography data. Clin Oral Implants Res 2020; 31:846-855. [PMID: 32562322 DOI: 10.1111/clr.13630] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 04/02/2020] [Accepted: 06/09/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To radiographically evaluate the effect of the adjunctive use of tenting screws (TS) for primary horizontal guided bone regeneration (GBR). MATERIALS & METHODS Twenty-eight patients in need of staged bone augmentation were consecutively treated in a private practice. A xenogenic particulate bone substitute material (DBBM) and a resorbable collagen membrane were used in all patients. Subjects were divided into two groups: control (conventional GBR; n = 22) and test (tenting screws in conjunction with GBR - TS; n = 22). CBCT images were obtained before augmentation and after 6-8 months. CBCTs were superimposed, and linear horizontal measurements were performed. Alveolar ridge width (RW) and ridge width change (RWchange) were assessed at 1, 3, 5, and 7 mm below the bone crest. RESULTS Forty-four sites in 28 patients were evaluated. No differences between the groups were detected for RW at baseline (TS: 5.87 ± 2.41; control: 5.36 ± 1.65). Regarding RWchange, TS promoted an additional effect at 1 and 3 mm below the crest compared to control (p < .05; RWchange-1 TS: 3.72 ± 2.46; control: 1.25 ± 3.05; RWchange-3 TS: 3.98 ± 2.53; control: 2.50 ± 2.02). The final RW was greater in group TS compared to the control group at the 1, 3, and 5 mm level (p < .05). CONCLUSIONS The use of tenting screws exerted a positive effect on staged GBR with a greater final RW at the 3 mm level. In addition, GBR in conjunction with TS was able to provide consistent bone augmentation at lingual/palatal sites.
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Affiliation(s)
- João B César Neto
- Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Marília C Cavalcanti
- Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Vitor M Sapata
- Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cláudio M Pannuti
- Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Christoph H F Hämmerle
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Giuseppe A Romito
- Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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18
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Sluka B, Naenni N, Jung RE, Attin T, Schmidlin PR, Sahrmann P. Changes of radiopacity around implants of different lengths: Five-year follow-up data of a randomized clinical trial. Clin Oral Implants Res 2020; 31:488-494. [PMID: 32003872 DOI: 10.1111/clr.13584] [Citation(s) in RCA: 5] [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] [Received: 08/28/2019] [Revised: 11/25/2019] [Accepted: 01/07/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To follow-up the radiographic changes in peri-implant bone of short (6 mm, test group) and long (10 mm, control group) single-unit implants five years after loading. MATERIALS AND METHODS Forty-three implants of the test and 44 implants of the control group could be reassessed from 96 originally included implants. Standardized areas of interest (AOI) were defined in the peri-implant bone at pre-defined locations at mid-length on both sides of the implants, and at the apex. An arbitrary mean grey scale value (GSV) was calculated for the AOI after brightness calibration of the radiographs. Changes for GSV were calculated and tested for possible inter- and intra-group differences using the Mann-Whitney and Wilcoxon tests. RESULTS The calculated intra-group differences between baseline and 5 years in the test group accounted for 2.4 ± 19.6 (i.e. slight brightening) and -6.2 ± 20.2 for the control group (i.e. slight shading), which resulted in a statistically significant difference in GSV change (p < .05). Crown-to-implant ratio was the only parameter showing an effect on GSV change (p = .001). CONCLUSIONS Assessing conventional radiographs, longer implants showed a slightly stronger change of radiopacity of the peri-implant bone (slight loss of density) than short ones (slightly enhanced density) after five years of loading.
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Affiliation(s)
- Benjamin Sluka
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Patrick R Schmidlin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
| | - Philipp Sahrmann
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, Zurich, Switzerland
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19
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Jepsen S, Schwarz F, Cordaro L, Derks J, Hämmerle CHF, Heitz-Mayfield LJ, Hernández-Alfaro F, Meijer HJA, Naenni N, Ortiz-Vigón A, Pjetursson B, Raghoebar GM, Renvert S, Rocchietta I, Roccuzzo M, Sanz-Sánchez I, Simion M, Tomasi C, Trombelli L, Urban I. Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration. J Clin Periodontol 2019; 46 Suppl 21:277-286. [PMID: 31038223 DOI: 10.1111/jcpe.13121] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [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: 12/18/2018] [Revised: 04/19/2018] [Accepted: 04/22/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. MATERIAL AND METHODS The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri-implantitis associated defects, and long-term results of lateral window sinus augmentation procedures. RESULTS A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri-implantitis-related bone defects has only been assessed in a few RCTs. Meta-analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. CONCLUSIONS The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post-operative complications.
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Affiliation(s)
- Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - Frank Schwarz
- Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
| | - Luca Cordaro
- Department of Periodontics and Prosthodontics, Policlinico Umberto I, Eastman Dental Hospital, Rome, Italy
| | - Jan Derks
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zürich, Zurich, Switzerland
| | - Lisa J Heitz-Mayfield
- International Research Collaborative - Oral Health and Equity, School of Anatomy, Physiology and Human Biology, University of Western Australia, Perth, Western Australia, Australia
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, International University of Catalonia, Barcelona, Spain
| | - Henny J A Meijer
- Department of Oral and Maxillofacial Surgery and Department of Implant Dentistry, University Medical Center Groningen, Groningen, The Netherlands
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zürich, Zurich, Switzerland
| | - Alberto Ortiz-Vigón
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Bjarni Pjetursson
- Department of Reconstructive Dentistry, University of Iceland, Reykjavik, Iceland
| | - Gerry M Raghoebar
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stefan Renvert
- Oral Health Sciences, Kristianstad University, Kristianstad, Sweden
| | | | - Mario Roccuzzo
- Division of Maxillofacial Surgery, University of Torino, Torino, Italy
| | - Ignacio Sanz-Sánchez
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Massimo Simion
- Department of Periodontology, University of Milan, Milan, Italy
| | - Cristiano Tomasi
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Leonardo Trombelli
- Research Centre for the Study of Periodontal and Peri-implant Diseases University of Ferrara, Ferrara, Italy
| | - Istvan Urban
- Graduate Implant Dentistry, Loma Linda University, Loma Linda, California
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Sancho-Puchades M, Alfaro F, Naenni N, Jung R, Hämmerle C, Schneider D. A Randomized Controlled Clinical Trial Comparing Conventional And Computer-Assisted Implant Planning and Placement in Partially Edentulous Patients. Part 2: Patient Related Outcome Measures. INT J PERIODONT REST 2019; 39:e99-e110. [DOI: 10.11607/prd.4145] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Naenni N, Lim HC, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: A systematic review and meta-analysis. J Clin Periodontol 2019; 46 Suppl 21:287-306. [DOI: 10.1111/jcpe.13052] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/09/2018] [Accepted: 12/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Hyun-Chang Lim
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
- Department of Periodontology; Periodontal-Implant Clinical Research Institute; School of Dentistry; Kyung Hee University; Seoul Republic of Korea
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry; Center of Dental Medicine; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; University of Zurich; Zurich Switzerland
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Naenni N, Berner T, Waller T, Huesler J, Hämmerle CHF, Thoma DS. Influence of wound closure on volume stability with the application of different GBR materials: an in vitro cone-beam computed tomographic study. J Periodontal Implant Sci 2019; 49:14-24. [PMID: 30847253 PMCID: PMC6399090 DOI: 10.5051/jpis.2019.49.1.14] [Citation(s) in RCA: 8] [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: 08/21/2018] [Accepted: 01/30/2019] [Indexed: 11/14/2022] Open
Abstract
Purpose To assess the influence of using different combinations of guided bone regeneration (GBR) materials on volume changes after wound closure at peri-implant dehiscence defects. Methods In 5 pig mandibles, standardized bone defects were created and implants were centrally placed. The defects were augmented using different combinations of GBR materials: xenogeneic granulate and collagen membrane (group 1, n=10), xenogeneic granulate and alloplastic membrane (group 2, n=10), alloplastic granulates and alloplastic membrane (group 3, n=10). The horizontal thickness was assessed using cone-beam computed tomography before and after suturing. Measurements were performed at the implant shoulder (HT0) and at 1 mm (HT1) and 2 mm (HT2) below. The data were statistically analysed using the Wilcoxon signed-rank test to evaluate within-group differences. Bonferroni correction was applied when calculating statistical significance between the groups. Results The mean horizontal thickness before suturing was 2.55±0.53 mm (group 1), 1.94±0.56 mm (group 2), and 2.49±0.73 mm (group 3). Post-suturing, the values were 1.47±0.31 mm (group 1), 1.77±0.27 mm (group 2), and 2.00±0.48 mm (group 3). All groups demonstrated a loss of horizontal dimension. Intragroup changes exhibited significant differences in group 1 (P<0.001) and group 3 (P<0.01). Intergroup comparisons revealed statistically significant differences of the relative changes between groups 1 and 2 (P=0.033) and groups 1 and 3 (P=0.015). Conclusions Volume change after wound closure was minimized by using an alloplastic membrane. The stability of the augmented horizontal thickness was most ensured by using this type of membrane irrespective of the bone substitute material used for membrane support.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tanja Berner
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Tobias Waller
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Juerg Huesler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph Hans Franz Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel Stefan Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Thoma DS, Naenni N, Figuero E, Hämmerle CHF, Schwarz F, Jung RE, Sanz-Sánchez I. Effects of soft tissue augmentation procedures on peri-implant health or disease: A systematic review and meta-analysis. Clin Oral Implants Res 2018; 29 Suppl 15:32-49. [PMID: 29498129 DOI: 10.1111/clr.13114] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To review the dental literature in terms of soft tissue augmentation procedures and their influence on peri-implant health or disease in partially and fully edentulous patients. METHODS A MEDLINE search from 1966 to 2016 was performed to identify controlled clinical studies comparing soft tissue grafting versus no soft tissue grafting (maintenance) or two types of soft tissue grafting procedures at implant sites. The soft tissue grafting procedures included either an increase of keratinized tissue or an increase of the thickness of the peri-implant mucosa. Studies reporting on the peri-implant tissue health, as assessed by bleeding or gingival indices, were included in the review. The search was complemented by an additional hand search of all selected full-text articles and reviews published between 2011 and 2016. The initial search yielded a total number of 2,823 studies. Eligible studies were selected based on the inclusion criteria (finally included: four studies on gain of keratinized tissue; six studies on gain of mucosal thickness) and quality assessments conducted. Meta-analyses were applied whenever possible. RESULTS Soft tissue grafting procedures for gain of keratinized tissue resulted in a significantly greater improvement of gingival index values compared to maintenance groups (with or without keratinized tissue) [n = 2; WMD = 0.863; 95% CI (0.658; 1.067); p < .001]. For final marginal bone levels, statistically significant differences were calculated in favor of an apically positioned flap (APF) plus autogenous grafts versus all control treatments (APF alone; APF plus a collagen matrix; maintenance without intervention [with or without residual keratinized tissue]) [n = 4; WMD = -0.175 mm; 95% CI: (-0.313; -0.037); p = .013]. Soft tissue grafting procedures for gain of mucosal thickness did not result in significant improvements in bleeding indices over time, but in significantly less marginal bone loss over time [WMD = 0.110; 95% CI: 0.067; 0.154; p < .001] and a borderline significance for marginal bone levels at the study endpoints compared to sites without grafting. CONCLUSIONS Within the limitations of this review, it was concluded that soft tissue grafting procedures result in more favorable peri-implant health: (i) for gain of keratinized mucosa using autogenous grafts with a greater improvement of bleeding indices and higher marginal bone levels; (ii) for gain of mucosal thickness using autogenous grafts with significantly less marginal bone loss.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Elena Figuero
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Frank Schwarz
- Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.,Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
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Eisner B, Naenni N, Hüsler J, Hämmerle C, Thoma D, Sailer I. Three-Year Results of a Randomized Controlled Clinical Trial Using Submucosally Veneered and Unveneered Zirconia Abutments Supporting All-Ceramic Single-Implant Crowns. INT J PERIODONT REST 2018; 38:645-652. [DOI: 10.11607/prd.3669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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25
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Naenni N, Sapata V, Bienz SP, Leventis M, Jung RE, Hämmerle CHF, Thoma DS. Effect of flapless ridge preservation with two different alloplastic materials in sockets with buccal dehiscence defects-volumetric and linear changes. Clin Oral Investig 2018; 22:2187-2197. [PMID: 29280075 DOI: 10.1007/s00784-017-2309-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/06/2017] [Accepted: 12/12/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To test whether or not one out of two alloplastic materials used for ridge preservation (RP) is superior to the other in terms of volumetric and linear ridge changes over time. MATERIALS AND METHODS In 16 adult beagle dogs, the distal roots of P3 and P4 were extracted and 50% of the buccal bone plate removed. Ridge preservation was performed randomly using two different alloplastic bone grafting substitutes (poly lactic-co-glycolic acid (PLGA) coated biphasic calcium phosphate particles consisting of 60% hydroxyapatite (HA) and 40% beta-tricalcium phosphate (ß-TCP=test 1), (a biphasic calcium phosphate consisting 60% HA and 40% ß-TCP=test 2) and a resorbable collagen membrane or a control group (sham). Sacrifice was performed at three time-points (4, 8, 16 weeks later). Impressions were taken before extraction, after RP, and at sacrifice, allowing for assessment of volumetric changes. A multi-way ANOVA was computed, and partial Type-II F tests were performed. RESULTS Both ridge preservation procedures minimized the volume loss compared to spontaneous healing. The median buccal volume changes between pre-extraction and sacrifice were - 1.76 mm (Q1 = - 2.56; Q3 = - 1.42) for test 1, - 1.62 mm (Q1 = - 2.06; Q3 = - 1.38) for test 2, and - 2.42 mm (Q1 = - 2.63; Q3 = - 2.03) for control. The mean ridge width measurements did not show statistically significant differences between test 1 (- 2.51 mm; Q1 = - 3.25; Q3 = - 1.70) and test 2 (- 2.04 mm; Q1 = - 3.82; Q3 = - 1.81) (p = 0.813), but between test and control (- 3.85 mm; Q1 = - 5.02; Q3 = - 3.27) (p = 0.003). CONCLUSIONS Both RP techniques were successful in maintaining the buccal contour from pre-extraction to sacrifice to a similar extent and more favorable compared to spontaneous healing. CLINICAL RELEVANCE Alloplastic materials can successfully be used for RP procedures.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Vitor Sapata
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Minas Leventis
- Laboratory of Experimental Surgery and Surgical Research N. S. Christeas, Medical School, University of Athens, Athens, Greece
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
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Canullo L, Genova T, Naenni N, Nakajima Y, Masuda K, Mussano F. Plasma of argon enhances the adhesion of murine osteoblasts on different graft materials. Ann Anat 2018; 218:265-270. [DOI: 10.1016/j.aanat.2018.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/09/2018] [Accepted: 03/12/2018] [Indexed: 11/26/2022]
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Basler T, Naenni N, Schneider D, Hämmerle CHF, Jung RE, Thoma DS. Randomized controlled clinical study assessing two membranes for guided bone regeneration of peri-implant bone defects: 3-year results. Clin Oral Implants Res 2018; 29:499-507. [DOI: 10.1111/clr.13147] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Tobias Basler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Naenni N, Sahrmann P, Schmidlin P, Attin T, Wiedemeier D, Sapata V, Hämmerle C, Jung R. Five-Year Survival of Short Single-Tooth Implants (6 mm): A Randomized Controlled Clinical Trial. J Dent Res 2018. [DOI: 10.1177/0022034518758036] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to evaluate whether 6-mm dental implants in the posterior segments of either jaw perform equally well in terms of clinical and radiographic outcomes when compared with 10-mm implants after 5 y of loading. Patients with single-tooth gaps in the posterior area who were scheduled for implant therapy were randomly assigned to a group receiving either a 6- or 10-mm implant. After a healing period of 10 wk, implants were loaded with a screw-retained single crown and followed up at yearly intervals. Of 96 patients, 86 could be recalled after 5 y. The implant survival rates amounted to 91% (95% confidence interval: 0.836 to 0.998) for the 6-mm group and 100% for the 10-mm group ( P = 0.036). Median crown-to-implant (C/I) ratios were 1.75 (interquartile range [IQR], 1.50 to 1.90) for the 6-mm group and 1.04 (IQR, 0.95 to 1.15) for the 10-mm group, whereas the median marginal bone levels measured −0.29 mm (IQR, −0.92 to 0.23) for the 6-mm group and −0.15 mm (IQR: −0.93 – 0.41) for the 10-mm group after 5 y. The C/I ratio turned out to be statistically significant ( P < 0.001), whereas marginal bone levels showed no significant difference between the groups. The 6-mm implants exhibited significantly lower survival rates than the 10-mm implants over 5 y, whereas there was no difference between upper and lower jaws in terms of survival ( P = 0.58). Lost implants did not show any sign of marginal bone loss or peri-implant infection previous to loss of osseointegration. High C/I ratio and implant length had no significant effect on marginal bone level changes or technical and biological complications (German Clinical Trials Registry: DRKS00006290).
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Affiliation(s)
- N. Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - P. Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P.R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T. Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - D.B. Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - V. Sapata
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - C.H.F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
| | - R.E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Zurich, Switzerland
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Naenni N, Bienz SP, Muñoz F, Hämmerle CHF, Jung RE, Thoma DS. Volumetric changes following ridge preservation or spontaneous healing and early implant placement with simultaneous guided bone regeneration. J Clin Periodontol 2018; 45:484-494. [PMID: 29266354 DOI: 10.1111/jcpe.12860] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2017] [Indexed: 11/30/2022]
Abstract
AIM To assess volumetric and linear changes following ridge preservation (RP) or spontaneous healing plus early implant placement with or without simultaneous guided bone regeneration (GBR). MATERIALS AND METHODS In eight adult beagle dogs, the mesial roots of the mandibular P3, P4 and M1 were extracted. Sites were randomized to either ridge preservation (RP) or spontaneous healing (SH). Four weeks later dental implants were placed either with (RP2) or without removing non-integrated DBBM (RP1). In RP2 and SH sites, GBR was applied using a demineralized bovine bone mineral and a resorbable membrane. Impressions were taken postextraction (SH)/postridge preservation (RP1; RP2), before and after implant placement and after healing of 4 and 12 weeks. Casts were digitized to allow for superimposition and measurement of contour alterations. RESULTS Median ridge width reduction from postextraction (SH)/postridge preservation (RP1;RP2) to implant placement ranged from -13.9% (SH) to -19.7% (RP) (p > .05), whereas from implant placement to sacrifice, it was statistically significantly lower in group RP1 (-5.5%) compared to group SH (-23.4%; p = .0013) and group RP2 (-22.1%; p = .0026). Encompassing the entire study period, median ridge width changes ranged between -17.8% (SH), -24.8% (RP2) and -32.5% (RP1) (p > .05). CONCLUSIONS Irrespective of the treatment modality and the healing period, part of the ridge contour was lost. Early implant placement after ridge preservation without additional GBR resulted in a more stable ridge contour after implant placement compared to controls.
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Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Stefan P Bienz
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Sahrmann P, Schoen P, Naenni N, Jung R, Attin T, Schmidlin PR. Peri-implant bone density around implants of different lengths: A 3-year follow-up of a randomized clinical trial. J Clin Periodontol 2017; 44:762-768. [DOI: 10.1111/jcpe.12737] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Philipp Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; Zurich Switzerland
| | - Patrizia Schoen
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; Zurich Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; Zurich Switzerland
| | - Ronald Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; Center of Dental Medicine; Zurich Switzerland
| | - Thomas Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; Zurich Switzerland
| | - Patrick R. Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology; Center of Dental Medicine; Zurich Switzerland
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Thoma DS, Naenni N, Benic GI, Muñoz F, Hämmerle CHF, Jung RE. Effect of ridge preservation for early implant placement - is there a need to remove the biomaterial? J Clin Periodontol 2017; 44:556-565. [PMID: 28207942 DOI: 10.1111/jcpe.12709] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [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: 02/12/2017] [Indexed: 11/27/2022]
Abstract
AIM To assess (i) bone regeneration around implants placed early in sites with or without ridge preservation and (ii) if the bone substitute material (DBBM-C) has to be removed at implant placement. MATERIALS AND METHODS In eight beagle dogs, three sites were randomly assigned to ridge preservation (DBBM-C plus collagen matrix (CMX)) (two sites; RP) or spontaneous healing (1 site; SH). Four weeks later, in one of the RP sites, dental implants were placed without removing the DBBM-C (RP1), whereas in RP2 and SH sites all non-integrated DBBM-C and/or granulation tissue were removed before implant placement and concomitant GBR. Histomorphometric outcomes were assessed at 4 and 12 weeks. RESULTS The median buccal fBIC (first bone-to-implant contact) was located more apical in groups RP1: 1.34 mm (0.09; 2.96) and RP2: 1.41 mm (0.54; 2.72) than in group SH: 0.79 mm (0.26; 1.50) (p = 0.452) at 4 weeks. At 12 weeks, median buccal fBIC values were for RP1: 0.88 mm (0.00; 2.33), for RP2: 0.16 mm (0.00; 1.33) and for SH: 0.00 mm (0.00; 0.98) (p = 0.362). BIC values increased over 12 weeks in all groups. CONCLUSIONS Ridge preservation followed by early implant placement led to higher BIC values at 12 than at 4 weeks. There is no need to remove the biomaterial at implant placement to ensure osseointegration. No relevant differences were observed between the three groups for any outcome measure.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Goran I Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Fernando Muñoz
- Department of Veterinary Clinical Sciences, University of Santiago de Compostela, Lugo, Spain
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Thoma DS, Naenni N, Benic GI, Hämmerle CHF, Jung RE. Cover Image. J Clin Periodontol 2017. [DOI: 10.1111/jcpe.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Thoma DS, Naenni N, Benic GI, Hämmerle CHF, Jung RE. Soft tissue volume augmentation at dental implant sites using a volume stable three-dimensional collagen matrix - histological outcomes of a preclinical study. J Clin Periodontol 2017; 44:185-194. [PMID: 27716970 DOI: 10.1111/jcpe.12635] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/29/2022]
Abstract
AIM The aim of this study was to test whether or not soft tissue augmentation with a collagen matrix (VCMX) leads to a similar increase in ridge width around dental implants compared to the use of an autogenous subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS In 12 dogs, immediate dental implants were placed with simultaneous guided bone regeneration. Three months later, soft tissue volume augmentation was performed by randomly allocating three treatment modalities to these sites [VCMX, SCTG, sham-operated group (control)]. Dogs were sacrificed at 1 (n = 4), 2 (n = 4) or 6 months (n = 4). Descriptive histology and histomorphometric measurements for soft tissue thickness were performed on non-decalcified sections. RESULTS The horizontal soft tissue thickness was maximal at the most coronal level (alveolar crest) at 1 month (VCMX: 2.1 ± 1.6 mm; SCTG: 2.5 ± 1.7 mm; p = 0.877) and decreased until 6 months. At 6 months, the greatest mucosal thickness was at a level 3.5 mm below the crest (VCMX: 0.8 ± 0.3 mm; SCTG: 0.7 ± 0.2 mm) (p = 0.754). Control sites revealed no relevant soft tissue augmentation at any level and any time-point. Tissue integration for VCMX and SCTG were favourable with minimal inflammatory reactions. CONCLUSIONS Soft tissue volume augmentation at implant sites was obtained to a similar extent using VCMX and SCTG up to 2 months. Thereafter, degradation and remodelling processes were enhanced leading to a minimal increase in soft tissue thickness at 6 months for VCMX and SCTG.
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Affiliation(s)
- Daniel S Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Goran I Benic
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christoph H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Ronald E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Naenni N, Schneider D, Jung RE, Hüsler J, Hämmerle CHF, Thoma DS. Randomized clinical study assessing two membranes for guided bone regeneration of peri-implant bone defects: clinical and histological outcomes at 6 months. Clin Oral Implants Res 2016; 28:1309-1317. [DOI: 10.1111/clr.12977] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Nadja Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - David Schneider
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Ronald E. Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Jürg Hüsler
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Christoph H. F. Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
| | - Daniel S. Thoma
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science; University of Zurich; Zurich Switzerland
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Sahrmann P, Naenni N, Jung RE, Held U, Truninger T, Hämmerle CHF, Attin T, Schmidlin PR. Success of 6-mm Implants with Single-Tooth Restorations: A 3-year Randomized Controlled Clinical Trial. J Dent Res 2016; 95:623-8. [PMID: 26917439 DOI: 10.1177/0022034516633432] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to test whether implants of 6 mm in length perform equally well as 10-mm implants in terms of survival and marginal bone-level changes when supporting single crowns. Patients with a posterior single-tooth gap were randomly allocated to either the placement of a 6-mm (test) or 10-mm implant (control). The treatment protocol allowed for internal sinus lift but not for lateral bone augmentation. After a healing period of 10 wk, implants were loaded with screw-retained single crowns. Survival rates, number of pockets ≥5 mm, and bleeding-on-probing were assessed clinically. The change of marginal bone level and crown-to-implant ratios were analyzed by 2 examiners. Longitudinal intragroup analyses for marginal bone levels were performed applying the Wilcoxon signed rank test. Intergroup differences at baseline and at 3 y were compared using the Mann-Whitney U test. The effect of implant length and crown-to-implant ratio on changes of marginal bone level also was determined. Of 94 implants placed (47 test and 47 control), 78 implants (40 test and 38 control) were available for follow-up examination at 3 y of loading. One test implant was lost during the second year. Hence, implant survival was not significantly different between the 2 groups after 3 y (98% test; 100% control). We found no significant change in the crestal bone level from baseline to 3 y for test and control implants with -0.19 ± 0.62 mm and -0.33 ± 0.71 mm, respectively. The intergroup difference was not significant. Crown-to-implant ratios were not associated with a statistically significant difference in marginal bone loss. However, the number of sites with pockets ≥5 mm was significantly higher in the test group. Based on the 3-y assessment, the use of 6-mm implants can be considered a viable option when reconstructing posterior single tooth gaps (German Clinical Trials Registry: DRKS00006290).
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Affiliation(s)
- P Sahrmann
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - N Naenni
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - R E Jung
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - U Held
- Horten Centre for Patient-Oriented Research and Knowledge Transfer, University of Zurich, Zurich, Switzerland
| | - T Truninger
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - C H F Hämmerle
- Clinic of Fixed and Removable Prosthodontics and Dental Material Science, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Naenni N, Bindl A, Sax C, Hämmerle C, Sailer I. A randomized controlled clinical trial of 3-unit posterior zirconia–ceramic fixed dental prostheses (FDP) with layered or pressed veneering ceramics: 3-year results. J Dent 2015; 43:1365-70. [DOI: 10.1016/j.jdent.2015.07.013] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 06/09/2015] [Accepted: 07/24/2015] [Indexed: 11/28/2022] Open
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Abstract
Necrotic soft-tissue remnants in root canals may provide a source of nutrition for surviving microbiota after root-canal therapy. This study assessed the necrotic tissue dissolution capacity of some popular and some potential root-canal irrigants: 1% (wt/vol) sodium hypochlorite (NaOCl), 10% chlorhexidine, 3% and 30% hydrogen peroxide, 10% peracetic acid, 5% dichloroisocyanurate (NaDCC), and 10% citric acid. Standardized necrotic tissue samples obtained from pig palates were incubated in these solutions, and their weight loss was measured over time. None of the test solutions except sodium hypochlorite had any substantial tissue dissolution capacity. It was concluded that this might be important when considering the use of irrigants other than NaOCl.
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Affiliation(s)
- Nadja Naenni
- Division of Endodontics, Department of Preventive Dentistry, Cariology, and Periodontology, University of Zürich Center for Dental Medicine, Zürich, Switzerland
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