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  • 201.
    Toljanic, Joseph A.
    et al.
    Midwestern University, College of Dental Medicine Illinois, Downers Grove, IL, USA.
    Ekstrand, Karl
    University of Oslo, Oslo, Norway.
    Baer, Russell A.
    University Associates in Dentistry, Chicago, IL USA.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Immediate Loading of Tilted and Axial Posterior Implants in the Edentulous Maxillary Arch: A Retrospective Comparison of 5-Year Outcomes2018In: International Journal of Oral & Maxillofacial Implants, ISSN 0882-2786, E-ISSN 1942-4434, Vol. 33, no 2, p. 433-438Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to retrospectively compare long-term outcomes for immediately loaded tilted and axial implants placed in the posterior region of the edentulous maxillary arch.

    Materials and Methods: Data obtained from a 5-year prospective study designed to assess clinical outcomes following immediate loading of implants with screw-retained fixed restorations in the edentulous maxillary arch were retrospectively reviewed. Where insufficient alveolar bone was available for axial placement of the posterior-most implant on each side of the arch, tilted placement was employed. Implant survival and marginal bone level changes for these tilted and axial posterior implants were compared.

    Results: Fifty-one subjects received 64 tilted and 38 axial posterior implants. Forty subjects with 53 tilted and 34 axial posterior implants returned for follow-up after 5 years. Five tilted and seven axial implants failed, representing an 89% and 86% survival proportion, respectively. The mean marginal bone loss was 0.79 (SD: 1.42) mm for tilted implants and 0.14 (SD: 0.34) mm for axial implants. The differences in survival proportions and marginal bone loss between axial and tilted implants were not statistically significant.

    Conclusion: Predictable long-term implant rehabilitation may be achieved in the edentulous maxillary arch using posterior tilted implants in combination with immediate loading.

  • 202. Toljanic, Joseph A.
    et al.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Baer, Russell
    Ekstrand, Karl
    Immediate fixed restoration of implants in the atrophic edentulous maxilla2008In: Dentistry today, ISSN 8750-2186, Vol. 27, no 6, p. 56, 58, 60 passim; quiz 63-Article in journal (Refereed)
  • 203.
    Trbakovic, Amela
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Clinical and experimental studies of bone substitutes and dental implants in compromised bone sites2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: With an ageing population, an increase of more challenging implant treatments is expected. In this thesis, we evaluate the outcome of two faster implant protocols, in patients with compromised alveolar bone. We examine the bone integrating abilities of two new synthetic bone substitute materials and in another paper, we discuss the effects of nonsteroidal anti-inflammatory drugs (NSAID) on bone healing.

    Aim: In paper I we investigate implant survival and effect of reduced implant-tooth distance. In paper II we evaluate the long-term implant survival and function of immediately loaded implants. In paper III & IV, we analyse if added NSAID reduce postoperative pain and if it has a reduced effect on new bone formation in a rabbit sinus lift model. We also investigate if a ceramic compound (CPC, granules) and hydrogel (HABP.CaP) result in a similar or larger bone amount, in comparison with bovine bone mineral. In Paper V we assess new bone formation adjacent to a hollow CPC implant.

    Material & Methods: Paper I present a clinical and radiological follow-up, performed on subjects that previously received 3.0-3.3 mm diameter implants in the aesthetic area. In paper II, clinical and radiographic examinations were performed on subjects that had received six implants each with immediate loading in the maxilla 8-11-year ago. For paper III-IV, pain was assessed by clinical examination and scoring of facial expressions from photos. Histomorphometry and histology evaluations were performed. In paper V, a critical radius defect was created and either replaced by particulate autologous bone (AB) or a CPC implant. Qualitative and quantitative radiographic and histology evaluations were performed. 

    Results: In paper I, an implant survival of 97.2% up to 124 months was shown with a tooth-implant distance in many cases of  <1.5 mm. Discoloration and recession of the buccal gingiva was the most frequent patient concern. In paper II a cumulative implant survival rate was 81.9 % at the final follow-up. In paper III and IV it was shown that NSAID had no effect on pain relief or bone formation. No difference was shown between CPC and control, but both showed larger bone amount and BIC than HABP.CaP. In paper V new bone was seen in sites throughout the entire CPC implant.

    Conclusion: Satisfactory long-term dental implant results can be obtained without bone augmentation in most patients with atrophic alveolar bone, but there is still a minority in this group that may benefit of bone enhancement prior to implant treatment. To avoid the negative effects of autologous bone grafting, synthetic materials as the presented CPC, have shown promising results as a solution or alternative to existing bone substitutes in animal models.

    List of papers
    1. A clinical and radiological long-term follow-up study of narrow diameter implants in the aesthetic area
    Open this publication in new window or tab >>A clinical and radiological long-term follow-up study of narrow diameter implants in the aesthetic area
    2018 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 20, no 4, p. 598-605Article in journal (Refereed) Published
    Abstract [en]

    Purpose

    To study long-term function of narrow diameter implants (NDI:s) and if reduced implant-tooth distance negatively impacts adjacent teeth.

    Materials and Methods

    A clinical and radiological follow-up of NDI:s replacing maxillary laterals and mandibular incisors was performed. Subjects that received 3.0-3.3 mm-diameter single implants from 3 units in Uppsala and Vasteras, Sweden, between 2002 and 2011 were offered to participate in this retrospective study.

    Results

    Twenty-seven patients (30 implants) underwent clinical and CBCT examination, mean follow-up time was 63.3 months. On average, the implant-tooth distance was 1.6 mm at the cervical region and 17 implants were placed 1 mm or less to the adjacent root. Additionally, 2 patients (3 implants) underwent clinical examination (I). Twenty-seven patients (36 implants) declined the examination but agreed to an interview (II). At the time of the follow-up, all implants had good function, and implant survival of group I and II together was 97.2%. In both groups, the 2 main patient concerns were discoloration and regression of the buccal gingiva.

    Conclusion

    Survival of implants is in accordance to standard diameter studies and although most implants were placed very close to the adjacent teeth, no pathologies could be linked to this except aesthetic concerns.

    Place, publisher, year, edition, pages
    WILEY, 2018
    Keywords
    cbct imaging, implant survival, long-term survival, narrow implants
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-363062 (URN)10.1111/cid.12627 (DOI)000440988300022 ()29920935 (PubMedID)
    Available from: 2018-10-18 Created: 2018-10-18 Last updated: 2018-10-28Bibliographically approved
    2. Eight to eleven-year follow-up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study
    Open this publication in new window or tab >>Eight to eleven-year follow-up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study
    2020 (English)In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 22, no 1, p. 69-76Article in journal (Refereed) Published
    Abstract [en]

    Background

    There is a lack of long‐term evaluations of immediately loaded implants in patients with compromised maxillary bone.

    Purpose

    To evaluate long‐term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume.

    Material and methods

    Follow‐up was performed on subjects who received six implants loaded within 24 hours with screw‐retained fixed prostheses. Twenty‐five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8‐11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing.

    Results

    The mean follow‐up was 9 years and 2 months (101‐131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0‐11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5‐13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing.

    Conclusion

    This nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.

    Place, publisher, year, edition, pages
    WILEY, 2020
    Keywords
    clinical study, dental implants, edentulous atrophic maxilla, immediate loading, implant stability, long-term follow-up, non-augmented maxilla
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-423504 (URN)10.1111/cid.12874 (DOI)000503424300001 ()31860148 (PubMedID)
    Available from: 2020-10-28 Created: 2020-10-28 Last updated: 2022-10-17Bibliographically approved
    3. Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting
    Open this publication in new window or tab >>Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting
    Show others...
    2016 (English)In: Research in Veterinary Science, ISSN 0034-5288, E-ISSN 1532-2661, Vol. 107, p. 123-131Article in journal (Refereed) Published
    Abstract [en]

    In connection with bilateral maxillary sinus augmentation, the acute effects of the nonsteroidal anti-inflammatory drug carprofen on facial expressions and long-term effects on bone formation were evaluated in 18 male New Zealand White rabbits. A 10 x 10 mm bone window was drilled in the maxilla, the sinus membrane elevated and a titanium mini-implant inserted. One of two test materials was randomly inserted unilaterally and bovine bone chips (control) on the contralateral side in the created space. Rabbits were randomly allocated to receive buprenorphine plus carprofen (n = 9) or buprenorphine plus saline (n = 9) postoperatively. Buprenorphine was administered subcutaneously every 6 h for 3 days in a tapered dose (0.05-0.01 mg/kg) and carprofen (5 mg/kg) or saline administered subcutaneously 1 h before, and daily for 4 days postoperatively. To assess pain, clinical examination, body weight recording and scoring of facial expressions from photos taken before, and 6-13 h after surgery were performed. Twelve weeks after surgery the rabbits were euthanized and sections of maxillary bones and sinuses were analysed with histomorphometry and by qualitative histology. Carprofen had no effect on mean facial expression scores, which increased from 0.0 to 3.6 (carprofen) and 43 (saline), of a maximum of 8.0. Neither did carprofen have an effect on bone formation or implant incorporation, whereas the test materials had. In conclusion, treatment with 5 mg/kg carprofen once daily for 5 days did not reduce facial expression scores after maxillary sinus augmentation in buprenorphine treated rabbits and did not affect long term bone formation.

    Keywords
    Bone formation, Pain, NSAID, Implant, Sinus-lift, Experimental animal
    National Category
    Veterinary Science
    Identifiers
    urn:nbn:se:uu:diva-304437 (URN)10.1016/j.rvsc.2016.05.010 (DOI)000381541600019 ()27473985 (PubMedID)
    Funder
    Swedish Research Council, VR2013_6373 MR
    Available from: 2016-10-05 Created: 2016-10-05 Last updated: 2018-10-28Bibliographically approved
    4. A new synthetic granular calcium phosphate compound induces new bone in a sinus lift rabbit model
    Open this publication in new window or tab >>A new synthetic granular calcium phosphate compound induces new bone in a sinus lift rabbit model
    Show others...
    2018 (English)In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 70, p. 31-39Article in journal (Refereed) Published
    Abstract [en]

    OBJECTIVES: The aim of this study was to investigate if a synthetic granular calcium phosphate compound (CPC) and a composite bisphosphonate-linked hyaluronic acid-calcium phosphate hydrogel (HABP·CaP) induced similar or more amount of bone as bovine mineral in a modified sinus lift rabbit model.

    MATERIAL AND METHODS: Eighteen adult male New Zeeland White rabbits, received randomly one of the two test materials on a random side of the face, and bovine mineral as control on the contralateral side. In a sinus lift, the sinus mucosa was elevated and a titanium mini-implant was placed in the alveolar bone. Augmentation material (CPC, HABP·CaP or bovine bone) was applied in the space around the implant. The rabbits were euthanized three months after surgery and qualitative and histomorphometric evaluation were conducted. Histomorphometric evaluation included three different regions of interest (ROIs) and the bone to implant contact on each installed implant.

    RESULTS: Qualitative assessment (p = <.05), histomorphometric evaluations (p = < .01), and implant incorporation (p = <.05) showed that CPC and bovine mineral induced similar amount of bone and more than the HABP·CaP hydrogel.

    CONCLUSION: CPC induced similar amount of bone as bovine mineral and both materials induced more bone than HABP·CaP hydrogel.

    CLINICAL SIGNIFICANCE: The CPC is suggested as a synthetic alternative for augmentations in the maxillofacial area.

    Keywords
    Animal experiments, Bone implant interactions, Bone regeneration, Bone substitutes, Ceramic granules
    National Category
    Dentistry
    Identifiers
    urn:nbn:se:uu:diva-341457 (URN)10.1016/j.jdent.2017.12.009 (DOI)000425888900004 ()29258851 (PubMedID)
    Available from: 2018-02-09 Created: 2018-02-09 Last updated: 2018-10-28Bibliographically approved
    5. Guided bone tissue regeneration using a hollow calcium phosphate based implant in a critical size rabbit radius defect
    Open this publication in new window or tab >>Guided bone tissue regeneration using a hollow calcium phosphate based implant in a critical size rabbit radius defect
    Show others...
    2021 (English)In: Biomedical Materials, ISSN 1748-6041, E-ISSN 1748-605X, Vol. 16, no 3, article id 035018Article in journal (Refereed) Published
    Abstract [en]

    Long bone fractures are common and sometimes difficult to treat. Autologous bone (AB), bovine bone and calcium phosphates are used to stimulate bone growth with varying results. In the present study, a calcium phosphate cement (CPC) that previously showed promising grafting capabilities was evaluated for the first time in a long bone defect. A radius defect of 20 mm was created in 20 rabbits. The defect was filled by either a hollow CPC implant that had been manufactured as a replica of a rabbit radius through indirect 3D printing, or by particulate AB as control. Defect filling and bone formation was evaluated after 12 weeks by combining micro computed tomography (μCT) and scoring of 3D images, together with histomorphometry and histology. The μCT and histomorphometric evaluations showed a similar amount of filling of the defect (combining graft and bone) between the CPC and AB group, but the scoring of 3D images showed that the filling in the CPC group was significantly larger. Histologically the AB graft could not be distinguished from the new bone. The AB treated defects were found to be composed of more bone than the CPC group, including reorganised cancellous and cortical bone. Both the CPC and AB material was associated with new bone formation, also in the middle of the defect, which could result in closing of the otherwise critically sized gap. This study shows the potential for an indirectly 3D printed implant in guided bone regeneration in critically sized long bone defects.

    Place, publisher, year, edition, pages
    Institute of Physics Publishing (IOPP), 2021
    Keywords
    3D printing, bone augmentation, bone substitute, long bone, in vivo
    National Category
    Surgery Medical Biotechnology
    Identifiers
    urn:nbn:se:uu:diva-364438 (URN)10.1088/1748-605X/abde6f (DOI)000625123100001 ()33477115 (PubMedID)
    Funder
    Swedish Research Council, 2013-5419
    Note

    De två första författarna delar förstaförfattarskapet

    Title in thesis list of papers: Guided bone tissue regeneration using a hollow calcium phosphate based implant in a critically sized rabbit radius defect

    Available from: 2018-10-28 Created: 2018-10-28 Last updated: 2024-01-15Bibliographically approved
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  • 204.
    Trbakovic, Amela
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Bongenhielm, Ulf
    Uppsala & Västerås Käkkirurgiska Ctr, Vaksalagatan 8, S-75320 Uppsala, Sweden.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    A clinical and radiological long-term follow-up study of narrow diameter implants in the aesthetic area2018In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 20, no 4, p. 598-605Article in journal (Refereed)
    Abstract [en]

    Purpose

    To study long-term function of narrow diameter implants (NDI:s) and if reduced implant-tooth distance negatively impacts adjacent teeth.

    Materials and Methods

    A clinical and radiological follow-up of NDI:s replacing maxillary laterals and mandibular incisors was performed. Subjects that received 3.0-3.3 mm-diameter single implants from 3 units in Uppsala and Vasteras, Sweden, between 2002 and 2011 were offered to participate in this retrospective study.

    Results

    Twenty-seven patients (30 implants) underwent clinical and CBCT examination, mean follow-up time was 63.3 months. On average, the implant-tooth distance was 1.6 mm at the cervical region and 17 implants were placed 1 mm or less to the adjacent root. Additionally, 2 patients (3 implants) underwent clinical examination (I). Twenty-seven patients (36 implants) declined the examination but agreed to an interview (II). At the time of the follow-up, all implants had good function, and implant survival of group I and II together was 97.2%. In both groups, the 2 main patient concerns were discoloration and regression of the buccal gingiva.

    Conclusion

    Survival of implants is in accordance to standard diameter studies and although most implants were placed very close to the adjacent teeth, no pathologies could be linked to this except aesthetic concerns.

  • 205.
    Trbakovic, Amela
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Hedenqvist, Patricia
    Mellgren, Torbjörn
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - Ångström, Polymer Chemistry.
    Ley, Cecilia
    Hilborn, Jöns
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - Ångström, Polymer Chemistry.
    Ossipov, Dmitri A.
    Uppsala University, Disciplinary Domain of Science and Technology, Chemistry, Department of Chemistry - Ångström, Polymer Chemistry.
    Ekman, Stina
    Johansson, Carina B
    Jensen-Waern, Marianne
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    A new synthetic granular calcium phosphate compound induces new bone in a sinus lift rabbit model2018In: Journal of Dentistry, ISSN 0300-5712, E-ISSN 1879-176X, Vol. 70, p. 31-39Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to investigate if a synthetic granular calcium phosphate compound (CPC) and a composite bisphosphonate-linked hyaluronic acid-calcium phosphate hydrogel (HABP·CaP) induced similar or more amount of bone as bovine mineral in a modified sinus lift rabbit model.

    MATERIAL AND METHODS: Eighteen adult male New Zeeland White rabbits, received randomly one of the two test materials on a random side of the face, and bovine mineral as control on the contralateral side. In a sinus lift, the sinus mucosa was elevated and a titanium mini-implant was placed in the alveolar bone. Augmentation material (CPC, HABP·CaP or bovine bone) was applied in the space around the implant. The rabbits were euthanized three months after surgery and qualitative and histomorphometric evaluation were conducted. Histomorphometric evaluation included three different regions of interest (ROIs) and the bone to implant contact on each installed implant.

    RESULTS: Qualitative assessment (p = <.05), histomorphometric evaluations (p = < .01), and implant incorporation (p = <.05) showed that CPC and bovine mineral induced similar amount of bone and more than the HABP·CaP hydrogel.

    CONCLUSION: CPC induced similar amount of bone as bovine mineral and both materials induced more bone than HABP·CaP hydrogel.

    CLINICAL SIGNIFICANCE: The CPC is suggested as a synthetic alternative for augmentations in the maxillofacial area.

  • 206.
    Trbakovic, Amela
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Toljanic, Joseph A.
    Midwestern Univ, Coll Dent Med Illinois, Downers Grove, IL 60515 USA..
    Kumar, Vinay V.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Eight to eleven-year follow-up of immediately loaded implants placed in edentulous maxillae with compromised bone volume and poor bone quality: A prospective cohort study2020In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 22, no 1, p. 69-76Article in journal (Refereed)
    Abstract [en]

    Background

    There is a lack of long‐term evaluations of immediately loaded implants in patients with compromised maxillary bone.

    Purpose

    To evaluate long‐term survival and success of immediately loaded implants in subjects with poor maxillary bone quality and volume.

    Material and methods

    Follow‐up was performed on subjects who received six implants loaded within 24 hours with screw‐retained fixed prostheses. Twenty‐five subjects with limited bone (Lekholm and Zarb, quantity 3 and 4, and quality C and D) were included in the study. Nineteen participated in the radiographic examination and of these 17 participated in the clinical examination at the last visit. Evaluations of marginal bone loss were performed at 1, 3, 5, and 8‐11 years. The last clinical examination included removal of the prosthesis followed by registration of: plaque, pus, pocket depth, bleeding upon probing, mobility, and percussion testing.

    Results

    The mean follow‐up was 9 years and 2 months (101‐131 months) after surgery and showed a cumulative implant survival rate of 81.9% and success rate of 74.7%. Mean marginal bone loss was 1.29 mm (SD 2.47 mm range 0‐11 mm) with a mean pocket depth of 3.1 mm (SD 2.4 mm, range 1.5‐13.5 mm). 42.5% of the implants showed plaque retention and 72.2% showed bleeding on probing.

    Conclusion

    This nonaugmenting immediate loaded implant protocol for maxillary edentulous patients is a satisfactory solution for selected patients.

  • 207.
    Vejbrink Kildal, Villiam
    et al.
    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.
    Jensson, David
    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.
    Weninger, Wolfgang J.
    Center of Anatomy and Cell Biology, Medical University of Vienna, Austria.
    Meng, Stefan
    Center of Anatomy and Cell Biology, Medical University of Vienna, Austria.
    Tzou, Chieh-Han John
    Plastic and Reconstructive Surgery, Department of Surgery, Hospital of Divine Savior (Krankenhaus Goettlicher Heiland), Vienna, Austria; Faculty of Medicine, Sigmund Freud University, Vienna, Austria.
    Rodriguez-Lorenzo, Andrés
    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.
    Anatomical features in lower lip depressor muscles for optimization of myectomies in marginal mandibular nerve palsy2021In: The Journal of Craniofacial Surgery, ISSN 1049-2275, E-ISSN 1536-3732, Vol. 32, no 6, p. 2230-2232Article in journal (Refereed)
    Abstract [en]

    Introduction: Myectomies of the lower-lip depressor muscles, with the aim to improve facial balance in unilateral facial paralysis, have unexplained high recurrence rates. A potential explanation is that these recurrences are due to inadequate resection through the muscle width, leaving lateral muscle fibers intact.

    Aim: Revisit the anatomy of the lower-lip depressor muscles and suggest an optimization of the surgical technique. Perform a literature review to identify recurrence rates and surgical technique of the procedure.

    Materials and Methods: Ten fresh hemifaces were dissected. The following measurements of depressor labii inferioris and depressor anguli oris were made: the widths of the muscles, the distance from the mandibular midline to the lateral borders of the muscles, and the intraoral distance from the lateral canine to the lateral border of depressor anguli oris. A literature review was performed.

    Results: The width of depressor labii inferioris was 20 ± 4 mm and depressor anguli oris 14 ± 3 mm. The distance from the midline to the lateral border of depressor labii inferioris was 32 ± 4 mm and 54 ± 4 mm for depressor anguli oris. The literature review revealed a mean recurrence rate of 21%.

    Discussion: A potential optimization of the surgical technique in lower-lip depressor myectomies is to extend the muscle resection laterally. To ensure inclusion of the whole width of the depressor muscles and decrease the recurrence rates of the procedure, the measurements presented in this study should be kept in mind during surgery.

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  • 208. Wallström, Mats
    et al.
    Bolinder, Gunilla
    Hassèus, Bengt
    Hirsch, Jan M.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    A cessation program for snuff-dippers with long-term, extensive exposure to Swedish moist snuff: A 1-year follow-up study2010In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 68, no 6, p. 377-384Article in journal (Refereed)
    Abstract [en]

    Objective: Smokeless tobacco (Swedish moist 'snus') users are often strongly addicted to nicotine. Compared to the large number of smoking-cessation studies, there have been few evaluated clinical cessation programs in conjunction with nicotine replacement therapy (NRT). The aim of this study was to evaluate a cessation program for snus users with a weekly use of >2 cans/week for >10 years. Material and methods: A prospective, open, non-randomized intervention trial was undertaken including baseline oral examination and soft tissue biopsy, minor physical examination, brief cessation advice, NRT recommendations and five prospective follow-up visits within 12 months. Individual cessation counseling was given, together with oral examination in the dental office. Fifty snus users with a minimum consumption of 100 g/week who were actively seeking cessation treatment were recruited through advertising. Self-reported abstaining, including random-sample biochemical verification, and NRT use were evaluated at 6 weeks and 3, 6 and 12 months. Results: At the 3-, 6- and 12-month visits, 58%, 46% and 30% of subjects, respectively were tobacco-abstinent. All nicotine abstinence was randomly controlled during the study except at 12 months, where all subjects claiming abstinence were confirmed biochemically and clinically. Conclusion: Smokeless tobacco cessation achieved together with suitable NRT seems a promising way to improve a persistent tobacco-free condition.

  • 209. Wedenberg, C
    et al.
    Jönsson, A
    Hirsch, Jan M
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Assessment of p53 and Ki-67 expression in snuff-induced lesions1996In: British Journal of Oral & Maxillofacial Surgery, ISSN 0266-4356, E-ISSN 1532-1940, Vol. 34, no 5, p. 409-413Article in journal (Refereed)
    Abstract [en]

    An immunohistochemical study of snuff-induced lesions with a monoclonal antibody (DO-7) specific to p53 mutant and wildtype antioncogene product demonstrated nuclear overexpression of the mutant protein in 45.9 nuclear profiles/mm2 epithelium (SEM 10.8; n = 15) compared with only 0.18 positively stained nuclear profiles/mm2 in the control group (SEM 0.18; n = 4). Furthermore, the biopsy material was also stained with the antibody Ki-67, which has been shown to be excellent for the estimation of the growth fraction in both normal and malignant human tissues. Ki-67 stained positive in 566.1 nuclear profiles/mm2 epithelium (SEM 85.0; n = 15) in the snuff group compared with 20.2 nuclear profiles/mm2 (SEM 4.9; n = 4) in the control group. To the best of our knowledge, this is the first study showing overexpression of p53 protein and Ki-67 in snuff-induced lesions. The results may indicate that the p53 gene is involved in the initial events leading to subsequent malignant transformation of oral mucosa exposed to snuff. Furthermore, mutations of the p53 gene have been associated with increased cellular proliferation with greater risk of perpetuation of mutations and malignant transformation.

  • 210. Westin, M.
    et al.
    Blomstrand, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Jontell, M.
    Mutations of keratin genes in patients with white sponge nevus2010In: Oral Diseases, ISSN 1354-523X, E-ISSN 1601-0825, Vol. 16, no 6, p. 529-529Article in journal (Other academic)
  • 211. Westin, Maria
    et al.
    Rekabdar, Elham
    Blomstrand, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Klintberg, Per
    Jontell, Mats
    Robledo-Sierra, Jairo
    Mutations in the genes for keratin-4 and keratin-13 in Swedish patients with white sponge nevus.2018In: Journal of Oral Pathology & Medicine, ISSN 0904-2512, E-ISSN 1600-0714, Vol. 47, no 2, p. 152-157Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: White sponge nevus is a rare autosomal dominant disorder that affects the non-keratinised stratified squamous epithelium. Mutations in the genes that encode mucosa-specific keratin-4 and keratin-13 are strongly linked to the manifestation of white sponge nevus. This study involved mutational analysis of the genes encoding keratin-4 and keratin-13 in two Swedish families with white sponge nevus.

    METHODS: The diagnosis of white sponge nevus was based on disease history, clinical characteristics of the lesions and, in the majority of the cases, histopathological examination. Samples were collected from the affected buccal mucosa using buccal swabs. DNA was subsequently extracted and amplified using touchdown-PCR. The keratin-4 and keratin-13 genes were sequenced, and a genetic analysis was performed.

    RESULTS: A novel heterozygous missense mutation was identified in exon 1A of the keratin-4 gene in Family 2. In addition, previously reported heterozygous missense mutations were identified in the keratin-4 (E449K, A72V, Q156R, R208H) and keratin-13 (L115P) genes in both families.

    CONCLUSION: We describe a novel heterozygous missense mutation in the keratin-4 gene of a Swedish family with white sponge nevus. Our results support the notion that mutations in keratin-4 and keratin-13 are the underlying cause of white sponge nevus.

  • 212.
    Wieslander, Håkan
    et al.
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Forslid, Gustav
    Bengtsson, Ewert
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Wählby, Carolina
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Hirsch, Jan-Michaél
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Runow Stark, Christina
    Sadanandan, Sajith Kecheril
    Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Division of Visual Information and Interaction. Uppsala University, Disciplinary Domain of Science and Technology, Mathematics and Computer Science, Department of Information Technology, Computerized Image Analysis and Human-Computer Interaction.
    Deep convolutional neural networks for detecting cellular changes due to malignancy2017In: Proc. 16th International Conference on Computer Vision Workshops, IEEE Computer Society, 2017, p. 82-89Conference paper (Refereed)
  • 213. Zätterström, Ulf
    et al.
    Thor, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Oral and Maxillofacial Surgery.
    Nordgren, Hans
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Genetics and Pathology.
    Cervical metastasis from Spitz nevus of the buccal mucosa2008In: Melanoma research, ISSN 0960-8931, E-ISSN 1473-5636, Vol. 18, no 1, p. 36-39Article in journal (Refereed)
    Abstract [en]

    A 23-year-old woman was presented with a prolonged history of a small lump in the buccal mucosa. A local excision was performed. The morphology diagnosed a Spitz nevus and she underwent supplementary excision of scar tissue. Two years later a submandibular lump appeared on the ipsilateral side of the neck. Cytology from fine needle aspiration indicated spread of a melanocytic tumor and she underwent a modified supraomohyiod neck dissection. One of the lymph nodes showed an inclusion of cells in the deep layers with epitheloid and spindle cells in a pattern similar to that of the primary oral lesion. The finding suggests a mechanical spread of melanocytes from the Spitz nevus to the regional lymph node. After more than 3 years of follow-up there is no further manifestation of disease. It is believed that this may be an example of how a Spitz tumor, although inherently benign, can spread along lymphatics in a pseudometastatic fashion. To our knowledge this is the first report of an oral Spitz melanoma with metastatic behavior.

2345 201 - 213 of 213
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