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  • 1.
    Aludden, Hanna
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark..
    Dahlin, Anna
    Univ Gothenburg, BIOMATCELL VINN Excellence Ctr, Inst Surg Sci, Dept Biomat,Sahlgrenska Acad, Gothenburg, Sweden..
    Starch-Jensen, Thomas
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark..
    Dahlin, Christer
    Univ Gothenburg, BIOMATCELL VINN Excellence Ctr, Inst Surg Sci, Dept Biomat,Sahlgrenska Acad, Gothenburg, Sweden.;NU Hosp Org, Dept Oral & Maxillofacial Surg, Trollhattan, Sweden..
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Publ Hlth Serv, Dept Oral & Maxillofacial Surg, Gavle, Sweden.
    Histomorphometric analyses of area fraction of different ratios of Bio-Oss((R)) and bone prior to grafting procedures - An in vitro study to demonstrate a baseline2018In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 29, no 2, p. 185-191Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to estimate the area fraction of different ratios of Bio-Oss((R)) and bone, prior to grafting in an in vitro model to demonstrate a histomorphometric baseline.

    Methods: Bio-Oss((R)) particles were mixed with autogenous bone from pig jaw in three different ratios (50:50, 80:20 and 100:0) and packed in rice paper in a standardized procedure. Histomorphometric analyses were performed in 25 specimens and 74 regions of interest. The area percentage of Bio-Oss((R)), bone, and non-mineralized tissue (NMT) were calculated. Results were reported as mean values and 95% confidence interval (CI).

    Results: The mean area fraction of Bio-Oss((R)) was 20.6% (CI: 18.2-23) in the 50:50 mixture, 33.6% (CI: 29.7-37.6) in the 80:20 mixture, and 43.4% (CI: 40.5-46.3) in the 100:0 mixture. The mean area fraction of NMT was 60.5% (CI: 57.9-63.1) in the 50:50 mixture, 59.6% (CI: 56.4-62.7) in the 80:20 mixture, and 56.6% (CI: 53.7-59.5) in the 100:0 mixture. The mean area fraction of bone was 18.9% (CI: 16.9-20.9) in the 50:50 mixture and 6.8% (CI: 5-8.6) in the 80:20 mixture.

    Conclusion: There is a great difference in the clinically estimated percentage and the histomorphometrically evaluated percentage of Bio-Oss((R)) at baseline, prior to grafting. The area fraction of different tissues presented in this study may be beneficial as guidance for histomorphometrical baseline calculations when different mixtures of Bio-Oss((R)) and autogenous bone are used as grafting materials.

  • 2.
    Aludden, Hanna
    et al.
    Aalborg Univ, Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark.;Aalborg Univ, Fac Med, Dept Clin Med, Aalborg, Denmark.;NU Hosp, Dept Oral & Maxillofacial Surg, Org Trollhättan, Trollhättan, Sweden..
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Cederlund, Andreas
    Eastman Inst, Dept Oral Radiol, Stockholm, Sweden..
    Dahlin, Christer
    NU Hosp, Dept Oral & Maxillofacial Surg, Org Trollhättan, Trollhättan, Sweden.;Univ Gothenburg, Sahlgrenska Acad, BIOMATCELL VINN Excellence Ctr, Inst Surg Sci,Dept Biomat, Gothenburg, Sweden..
    Spin-Neto, Rubens
    Aarhus Univ, Dept Dent & Oral Hlth, Sect Oral Radiol, Aarhus, Denmark..
    Veiss-Pedersen, Pernille
    Aalborg Univ Hosp, Dept Radiol, Aalborg, Denmark..
    Sritharan, Babyasha
    Aalborg Univ Hosp, Unit Clin Biostat, Aalborg, Denmark..
    Starch-Jensen, Thomas
    Aalborg Univ, Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, Aalborg, Denmark.;Aalborg Univ, Fac Med, Dept Clin Med, Aalborg, Denmark..
    Radiographic changes in height and volume after lateral GBR procedures with different ratios of deproteinized bovine bone mineral and autogenous bone at different time points: An experimental study2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no 2, p. 167-179Article in journal (Refereed)
    Abstract [en]

    Objective Estimate changes in augmentation height and volume after lateral guided bone regeneration (GBR) augmentation with different ratios of deproteinized bovine bone mineral (DBBM) and particulate autogenous bone (PAB) and autogenous bone block (ABB), at different time points.

    Material and methods Twenty-four minipigs were randomly allocated into three healing periods. Lateral augmentation in 96 sites with standardized quantity of graft material was performed with different ratios of DBBM and PAB (50:50, 75:25, and 100:0) and ABB in combination with DBBM, covered by a collagen membrane. Changes in augmentation height and volume were assessed on CT volumes acquired 10, 20, and 30 weeks after surgery.

    Results Reduction in bone augmentation height was as follows: 50:50-1.7 mm (-33.1%), 75:25-1.8 mm (-37.8%), 100:0-1.7 mm (-35.8%), and ABB - 0.2 mm (-3.7%), after 30 weeks. The augmentation height was significantly better preserved with ABB compared to 50:50, 75:25, and 100:0, while no significant difference was present among particulate grafts. No significant difference in volumetric reduction was found among 50:50, 75:25, 100:0 and ABB after 30 weeks, while 100:0 presented significant less reduction compared to 50:50, 75:25 and ABB after 10 and 20 weeks.

    Conclusions Augmentation height following GBR was better preserved with ABB covered with DBBM. Addition of PAB to DBBM did not affect the changes in height of the graft. The volumetric stability seems to be comparable for ABB covered by DBBM and all particulate grafts after 30 weeks. However, DBBM alone revealed significant less volume reduction in the early healing phase.

  • 3.
    Aludden, Hanna
    et al.
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery.
    Dahlin, Christer
    Univ Gothenburg, Sahlgrenska Acad, Inst Surg Sci, Dept Biomat,BIOMATCELL VINN Excellence Ctr, Gothenburg, Sweden; NU Hosp, Org Trollhättan, Dept Oral & Maxillofacial Surg, Trollhättan, Sweden.
    Hallman, Mats
    Gävle Cty Hosp, Dept Oral & Maxillofacial Surg, Gävle, Sweden.
    Starch-Jensen, Thomas
    Aalborg Univ Hosp, Dept Oral & Maxillofacial Surg, 18-22 Hobrovej, DK-9000 Aalborg, Denmark.
    Histological and histomorphometrical outcome after lateral guided bone regeneration augmentation of the mandible with different ratios of deproteinized bovine bone mineral and autogenous bone: A preclinical in vivo study2020In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 31, no 10, p. 1025-1036Article in journal (Refereed)
    Abstract [en]

    Objective

    To test the hypotheses of no differences in (I) percentage of bone (POB), non‐mineralized tissue (NMT), and deproteinized bovine bone mineral (DBBM), and (II) ingrowth of mineralized bone after lateral guided bone regeneration (GBR) augmentation of the mandible with different ratios of DBBM and particulate autogenous bone (PAB) at different time points.

    Material and methods

    Twenty‐four minipigs were randomly allocated into three groups. Lateral augmentation in 96 sites (4 in each animal) was performed unilaterally with a standardized quantity of grafting material in each animal with different ratios of DBBM and PAB (50:50, 75:25, 100:0) and autogenous bone block in combination with DBBM and covered with a collagen membrane. The percentage of different tissues in the graft and ingrowth of mineralized bone was assessed by histomorphometrical and histological analyses after 10, 20, and 30 weeks, respectively.

    Results

    The POB was 54% (50:50), 50% (75:25), and 48% (100:0) after 10 weeks, 60% (50:50), 61% (75:25), and 60% (100:0) after 20 weeks, and 63% (50:50), 62% (75:25), and 62% (100:0) after 30 weeks. There was no significant difference between the groups at any time points. There was a significant increase in POB and a significant decrease in NMT for 75:25 and 100:0 from 10 to 30 weeks. All ratios demonstrated a non‐complete ingrowth of mineralized bone into the graft after 10 weeks and complete mineralization after 30 weeks.

    Conclusion

    Within the limitations of the present study, it seems like addition of autogenous bone to DBBM for LRA did not affect the bone formation nor graft incorporation after 10–30 weeks of healing. However, a prolonged healing time seems to result in an increased POB for all ratios.

  • 4. Aludden, Hanna
    et al.
    Starch-Jensen, Thomas
    Dahlin, Christer
    Sdik, Joana
    Cederlund, Andreas
    Mordenfeld, Arne
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Odontology & Maxillofacial Surgery.
    Histological and radiological outcome after horizontal guided bone regeneration with bovine bone mineral alone or in combination with bone in edentulous atrophic maxilla: A randomized controlled trial2024In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 35, no 4, p. 396-406Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To assess the radiological and histological outcome after horizontal guided bone regeneration (GBR) with deproteinized bovine bone mineral (DBBM) alone or in combination with particulate autogenous bone (PAB).

    MATERIALS AND METHODS: Eighteen edentulous patients with an alveolar ridge of ≤4 mm were included in this split-mouth randomized controlled trial. Horizontal GBR with a graft composition of 100% DBBM (100:0) on one side and 90% DBBM and 10% PAB (90:10) on the other side were conducted in all patients. Cone beam computed tomography (CBCT) was obtained preoperatively, immediately postoperative, and after 10 months of healing. Width and volumetric changes in the alveolar process were measured on CBCT. Implants were placed after 10 months of graft healing where biopsies were obtained for histomorphometrical evaluation.

    RESULTS: The gained widths were 4.9 (±2.4) mm (100:0) and 4.5 (±2.0) mm (90:10) at 3 mm from the top of the crest, and 5.6 (±1.3) mm (100:0) and 4.6 (±2.1) mm (90:10) at 6 mm from the top of the crest. The mean volumetric reductions were 32.8% (±23.8) (100:0) and 38.2% (±23.2) (90:10). Histomorphometry revealed that mean percentages of bone were 50.8% (±10.7) (100:0) and 46.4% (±11.3) (90:10), DBBM were 31.6% (±12.6) (100:0) and 35.4% (±14.8) (90:10), and non-mineralized tissue were 17.6% (±11.7; 100:0) and 18.2% (±18.2) (90:10). No significant differences were evident between in any evaluated parameters.

    CONCLUSIONS: There were no additional effects of adding PAB to DBBM regarding bone formation, width changes, or volumetric changes after 10 months of graft healing.

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  • 5. Dasmah, A.
    et al.
    Sennerby, L.
    Rasmusson, L.
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Intramembraneous bone tissue responses to calcium sulfate: an experimental study in the rabbit maxilla2011In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 22, no 12, p. 1404-1408Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to histologically examine the responses of intramembraneous bone to calcium sulfate (CaS) and evaluate the resorption and replacement process.

    Material and methods: Fourteen rabbits were used in this study. Defect healing without any filling material was compared with CaS. Five millimetres wide and 4 mm deep defects were drilled with a trephine bur on both sides of the edentulous space between the incisors and the molars. Test vs. control sites were randomly selected and thereby compared in each animal. The animals were killed after 2, 4 and 8 weeks for histological examination.

    Results: After 2 weeks, the specimens showed a great extent of degradation of CaS. No signs of the material could be seen after 4 and 8 weeks. There were no statistically significant differences in bone regeneration between the test and control sites within the 8 weeks group in this study. However, there was tendency of more blood vessels in the test sites after 4 weeks of healing.

    Conclusion: The present study showed that CaS does not interfere with intramembraneous bone healing. In this animal model, the CaS exhibited resorption/degradation early in the healing process while seemingly stimulating angiogenesis. However, there was no significant increase in bone regeneration in the sites treated with CaS during an 8 week period of healing and observation time, as compared with a control defect.

  • 6.
    Hirsch, Jan M
    et al.
    Department of Oral & Maxilla-Facial Surgery, University of Göteborg, Sweden.
    Ericsson, I
    Maxillary sinus augmentation using mandibular bone grafts and simultaneous installation of implants: A surgical technique1991In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 2, no 2, p. 91-96Article in journal (Refereed)
    Abstract [en]

    This paper presents a specific technique for maxillary sinus augmentation and simultaneous placement of implants in partially edentulous patients. In such patients, there is from time to time insufficient interarch distance for any type of onlay grafting. Health, non-smoking patients without previous or present sinus pathology, where the radiological and clinical examination revealed insufficient height and/or width of the remaining alveolar process in the posterior maxillary region, were selected. They were operated on using a mandibular bone graft obtained from the symphyseal region between the mental foramina and placed in the maxillary sinus. The recipient site was prepared by cutting in a rectangular shape the lateral sinus wall into the sinus lining. The bone wall was then separated towards the lateral nasal wall by rotating the inferior portion of the cut sinus wall medially. In the space thus created, the bone graft was placed. Fixtures were installed at the same session. The method described has proved to be uncomplicated to perform under local anesthesia and no major disadvantages for the patient or pre- or postoperative complications have so far been observed.

  • 7. Lindgren, Christer
    et al.
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Sennerby, Lars
    Sammons, Rachel
    Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate2010In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 9, p. 924-930Article in journal (Refereed)
    Abstract [en]

    Objectives: To compare resorption of a synthetic biphasic calcium phosphate (BCP) bone-graft substitute with deproteinized bovine bone (DBB) used for human maxillary sinus augmentation. Materials and methods: Eleven patients underwent bilateral maxillary sinus floor augmentation with DBB in one side and a BCP (40%beta-tricalcium phosphate (beta-TCP) and 60% hydroxyapatite) in the contralateral side. Simultaneously, with the augmentation on each side a microimplant was placed vertically from the top of the alveolar crest penetrating the residual bone and the grafting material. Eight months after initial surgery the microimplants were retrieved with a surrounding bone core. The composition of residual graft material and surrounding bone was analysed by scanning electron microscopy and energy dispersive X-ray spectroscopy. Results: Residual graft material of both types was present as 10-500 mum particles in direct contact with, or completely surrounded by, newly formed bone; smaller particles were also present in non-mineralized tissue. In the case of BCP the bone-graft substitute interface showed evidence of superficial disintegration of particles into individual grains. Median Ca/P ratios (at.%), determined from >200 discreet sites within residual graft particles and adjacent bone, were: DBB: 1.61 (confidence interval [CI] 1.59-1.64); BCP: 1.5 (CI 1.45-1.52); DBB-augmented bone: 1.62 (CI 1.59-1.66); BCP-augmented bone: 1.52 (CI 1.47-1.55); P=0.028 for DBB vs. BCP and DBB- vs. BCP-augmented bone. The reduction in Ca/P ratio for BCP over the healing period is consistent with the dissolution of beta-TCP and reprecipitation on the surface of calcium-deficient hydroxyapatite. Conclusion: The beta-TCP component of BCP may be gradually substituted by calcium-deficient hydroxyapatite over the healing period. This process and superficial degranulation of BCP particles may influence the progress of resorption and healing. To cite this article: Lindgren C, Hallman M, Sennerby L, Sammons R. Back-scattered electron imaging and elemental analysis of retrieved bone tissue following sinus augmentation with deproteinized bovine bone or biphasic calcium phosphate.

  • 8.
    Mordenfeld, Arne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
    Johansson, Carina B
    Albrektsson, Tomas
    Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone2010In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 21, no 9, p. 961-970Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of the present study was to histologically and histomorphometrically evaluate the long-term tissue response to deproteinized bovine bone (DPBB) particles used in association with autogenous bone and to compare particle size after 6 months and 11 years, in the same patients, in order to determine possible resorption. Material and methods: Twenty consecutive patients (14 women and six men) with a mean age of 62 years (range 48-69 years) with severe atrophy of the posterior maxilla were included in this study. Thirty maxillary sinuses with <5 mm subantral alveolar bone were augmented with a mixture of 80% DPBB and 20% autogenous bone. Eleven years (mean 11.5 years) after augmentation, biopsies were taken from the grafted areas of the 11 patients who volunteered to participate in this new surgical intervention. The following histomorphometrical measurements were performed in these specimens: total bone area in percentage, total area of the DPBB, total area of marrow space, the degree of DPBB-bone contact (percentage of the total surface length for each particle), the length of all DPBB particles and the area of all DPBB particles. The length and the area of the particles were compared with samples harvested from the same patients at 6 months (nine samples) and pristine particles from the manufacturer. Results: The biopsies consisted of 44.7+/-16.9% lamellar bone, 38+/-16.9% marrow space and 17.3+/-13.2% DPBB. The degree of DPBB to bone contact was 61.5+/-34%. There were no statistically significant differences between the length and area of the particles after 11 years compared with those measured after 6 months in the same patients or to pristine particles from the manufacturer. Conclusion: DPBB particles were found to be well integrated in lamellar bone, after sinus floor augmentation in humans, showing no significant changes in particle size after 11 years.

  • 9.
    Mordenfeld, Arne
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Johansson, Carina B
    Albrektsson, Tomas
    Hallman, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation2014In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 25, no 3, p. 310-320Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The aim of the study was to radiologically and histologically evaluate the graft healing and volumetric changes after lateral augmentation with two different compositions of deproteinized bovine bone (DPBB) and autogenous bone (AB).

    MATERIAL AND METHODS:

    Thirteen patients with a mean age of 59.6 ± 12.1 years (six men and seven women) were included in this randomized and controlled trial, designed as a split-mouth study. Ten edentulous and four partially edentulous jaws with an alveolar ridge width of ≤4 mm were laterally augmented with a graft composition of 60 : 40 (DPBB/AB) on one side and 90 : 10 (DPBB/AB) on the contralateral side. Cone beam computed tomography (CB/CT) was obtained immediately postoperatively and after a healing period of 7.5 months. Width changes were measured on CB/CT scans. After a mean healing period of 8.1 months (range, 7.9-8.3), biopsies were retrieved perpendicular to the crest from each graft by means of a trephine bur. Histomorphometry was performed, and the following variables were recorded: Ingrowth of new bone (percentage of total graft width), percentage of DPBB, bone and soft tissue, and percentage of DPBB particles in contact with bone.

    RESULTS:

    The mean gained width of the alveolar crest after 7.5 months was significantly more for the 60 : 40 mixture compared with the 90 : 10 mixture, 3.5 (±1.3) mm and 2.9 (±1.3) mm, respectively. There was a significant difference in graft width reduction between 60 : 40 and 90 : 10 after 7.5 months, 37 (±19.9)% and 46.9 (±23.5)%, respectively. New bone ingrowth had occurred in 82.1 (±23.3)% and 82.3 (±26.6)% of the graft, respectively. There were no statistical differences between fractions of different tissues between the 90 : 10 and 60 : 40 compositions. However, there were significantly more soft tissue and less new bone formation closer to the periosteum compared with the graft portion closer to the residual bone in both 60 : 40 and 90 : 10 compositions.

    CONCLUSIONS:

    There was significantly less graft width reduction with a mixture of 60 : 40 (DPBB/AB) compared with a mixture of 90 : 10 composition, but the results from the histomorphometry showed no statistical differences comparing the groups.

  • 10.
    Stefanski, Sebastian
    et al.
    Ostersund Hosp, Dept Oral & Maxillofacial Surg, Ostersund, Sweden.
    Svensson, Börje
    Orebro Univ Hosp, Dept Oral & Maxillofacial Surg, Orebro, Sweden.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Plastic Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Implant survival following sinus membrane elevation without grafting and immediate implant installation with a one-stage technique: an up-to-40-month evaluation2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 11, p. 1354-1359Article in journal (Refereed)
    Abstract [en]

    PURPOSE:

    Various augmentation procedures involving the maxillary sinus, using bone substitutes or bone, have been used to enhance bone support for dental implants. The aim of this study was to retrospectively evaluate the status of implants in patients who had undergone a maxillary sinus lift and immediate implant placement without the addition of graft material.

    MATERIALS AND METHODS:

    Nineteen patients who had required bone augmentation of their maxillary sinus floor were evaluated in this study. After a bone window in the lateral wall of the sinus has been prepared and the Schneiderian membrane had been carefully elevated, dental implants were inserted in the residual bone, creating a membrane elevation. Resorbable collagenous membrane was used to seal the lateral access window of the maxillary sinus after implant placement. Clinical and radiological follow-up was carried out up to 40 months after implant installation.

    RESULTS:

    A total of 28 implants in lengths of 10 and 12 mm were placed in a one-stage healing protocol, with an average residual bone height of 5.25 mm (SD = 1.48). All implants remained stable, with a survival rate of 100%. An increase in mean bone height of 4.75 mm (SD = 1.13) was gained. The marginal bone levels relative to the coronal aspect of the implant shoulder exhibited a mean change of 1.01 mm (SD = 0.49) from the baseline. Of the 19 patients, none showed a plaque index or gingival index greater than 2, and 14 patients showed no presence of plaque.

    CONCLUSION:

    The findings of the study regarding the immediate placement of implants without the use of bone grafts or other bone substitute materials demonstrate a successful approach for new bone formation around implants in the posterior part of the maxilla, when the preoperative height of the subantral bone is moderate and enough to achieve primary stability.

  • 11. Temmerman, Andy
    et al.
    Rasmusson, Lars
    Kübler, Alexander
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Quirynen, Marc
    An open, prospective, non-randomized, controlled, multicentre study to evaluate the clinical outcome of implant treatment in women over 60 years of age with osteoporosis/osteopenia: 1-year results2017In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 28, no 1, p. 95-102Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Osteoporosis has been called a potential risk factor for bone healing around implants.

    AIM:

    The aim of this multicentre study was to verify the clinical performance of fluoridated implants in the maxilla of subjects with diagnosed systemic primary osteoporosis/osteopenia.

    MATERIAL AND METHODS:

    Postmenopausal women in need of 2-8 splinted implants in maxilla underwent bone mineral density measurements in the hip and spine, using dual-energy X-ray absorptiometry scans. Based on their T-scores, they were divided into two study groups: Group O (osteoporosis/osteopenia group) subjects had a T-score ≤-2, Group C (control group) had a T-score of ≥-1, and subjects with a T-score <-1 but >-2 were excluded. Implants were placed with a two-stage procedure and loaded 4-8 weeks after abutment surgery. At 6 months and 1 year after functional loading, clinical parameters (including peri-apical radiographs) were assessed.

    RESULTS:

    One hundred and forty-eight implants were placed in 48 subjects (mean age: 67 years (range [59-83]). Sixty-three implants were placed in 20 osteoporosis subjects (Group O, mean age: 69 years; range [59-83]), and 85 were placed in control subjects (Group C, mean age: 65 years; range [60-74]). The cumulative survival rate, on an implant level, was 99.3% (Group O: 98.4%; Group C: 100.0%). The cumulative survival rate, on a subject level, was 97.9% (Group O: 94.7%; Group C: 100.0%). Marginal bone level (MBL) alterations from functional loading to the 1-year follow-up visit were measured on an implant level and a subject level. The overall MBL alteration on an implant level was -0.01 ± 0.51 mm (Group O: -0.11 ± 0.49 mm; Group C: 0.05 ± 0.52 mm). The overall MBL alteration on a subject level was -0.04 ± 0.27 mm (Group O: -0.17 ± 0.30 mm; Group C: 0.04 ± 0.23 mm).

    CONCLUSION:

    Within the limitations of this prospective, non-randomized, controlled, multicentre study, it can be concluded that oral implant therapy in patients suffering from osteoporosis/osteopenia is a reliable treatment option with comparable integration rates as in healthy patients. Long-term follow of the study groups is necessary to compare marginal bone alterations and treatment outcomes.

  • 12. Winitsky, Nicole
    et al.
    Naimi-Akbar, Aron
    Nedelcu, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Odontology & Maxillofacial Surgery.
    Jemt, Torsten
    Smedberg, Jan-Ivan
    3-D tooth movement adjacent to single anterior implants and esthetic outcome: A 14- to 20-year follow-up study2021In: Clinical Oral Implants Research, ISSN 0905-7161, E-ISSN 1600-0501, Vol. 32, no 11, p. 1328-1340Article in journal (Refereed)
    Abstract [en]

    Objectives: To report three-dimensional (3-D) movement of teeth adjacent to single-implant crowns (SICs) in the anterior maxilla and to relate the findings to patient characteristics and esthetic outcome.

    Materials and Methods: 3-D movements of teeth adjacent to anterior maxillary SICs were measured in 30 patients with original SICs in function after 14-20 years. The movements were related to facial type, lower anterior facial height (LAFH), age at crown delivery, sex, the position of the implant, implant occlusion, cause of tooth loss, follow-up period, orthodontic treatment prior to implant placement, and marginal bone-level changes. The esthetic outcome and quality were assessed using Visual Analog scale (VAS) and California Dental Association (CDA) index.

    Results: 3-D movement of adjacent teeth between 0 and 2.5 mm was observed at follow-up with incisal and palatal movement being most pronounced. Incisal tooth movement of >1 mm was observed in 30% of the patients and was significantly associated with LAFH ≥70 mm. VAS rating associated poorly between patients and clinicians with scores of >80% in 63% and 20%, respectively. The CDA rating was assessed as satisfactory in 87% of the patients.

    Conclusions: Significantly more extensive infraposition was observed in patients with SICs without occlusion, other causes of tooth loss than trauma, implant in lateral incisor and canine position, and a LAFH of ≥70 mm. Although infraposition occurs, patients are highly satisfied with the esthetics of their implants and the esthetic results are valued as higher by patients than dentists.

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