Treatment effect of guided tissue regeneration on the horizontal and vertical components of furcation defects: A retrospective study

BackgroundIdentifying factors affecting the treatment outcomes of guided tissue regeneration (GTR) in furcation defects is imperative in order to obtain predictable regeneration outcomes. The aims of this study were to evaluate the clinical outcomes and survival of furcation- involved teeth treated with GTR, and potential factors affecting the results.MethodsFurcation defects treated with GTR using an allogeneic cancellous bone graft and covered by an absorbable membrane with at least 1- year follow- up were selected. All data relative to the clinical outcomes were recorded. Analyses were conducted to evaluate the immediate (1- year post- op) clinical outcomes and the long- term (the last assessment time) survival of the treated teeth. The effect of variables on the 1- year post- op clinical attachment level (CAL) changes and the tooth survival were assessed via multi- level regression analyses and Cox Proportional- Hazards Models.ResultsNinety- eight treated defects were selected. The average follow- up was 5.3 ± 4.3 years. At the 1- year post- surgical recall, 1.23 ± 1.48 mm CAL gain was observed (P < 0.05). The 5- and 10- year survival rates of the treated teeth were 86.5% and 74.3%, respectively. The vertical component of the defect and the location of the furcation were significantly related to the post- surgical 1- year CAL gain, whereas membrane exposure significantly affected tooth survival.ConclusionWithin the limitations of this study, data suggests GTR using allogeneic cancellous bone graft and absorbable collagen membrane to be a viable option for treating furcation- involved teeth if the defect morphology and the location of the defect are favorable.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/162817/2/jper10520_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/162817/1/jper10520.pd

Guided tissue regeneration combined with bone allograft in infrabony defects: Clinical outcomes and assessment of prognostic factors

BackgroundClinical data on the outcomes of guided tissue regeneration (GTR) is scarce. The aim of this retrospective cohort study was to evaluate the outcomes after GTR, their stability and the survival of the treated teeth with periodontal infrabony defects.MethodsInfrabony defects treated with GTR using a bioabsorbable membrane and a bone graft substitute with at least 1- year follow- up were included. Survival and regression analyses were conducted to evaluate the outcomes, their stability, and the retention of the teeth. The effect of recorded variables on clinical attachment gain (CAL) and tooth survival were assessed via Cox proportional- hazards models and multivariate generalized linear models.ResultsOne hundred seventy- five treated defects were selected from a total of 641 charts. The average follow- up was 5.75 ± 4.6 years. At baseline, the mean CAL was 9.56 ± 1.93 mm with a mean pocket depth (PD) of 8.41 ± 1.42 mm. At the 1- year post- surgical recall, 3.55 ± 1.85 mm of CAL gain and 3.87 ± 1.87 mm PD reduction were observed (P < 0.05). The 5- and 10- year survival rates of the treated teeth were 85.0% and 72.7%, respectively. Baseline PD, smoking, and membrane exposure were significantly related to CAL gain, whereas baseline CAL, age, frequency in maintenance visits significantly affected tooth survival.ConclusionWithin the limitations of this study, data suggests GTR is a good option for the treatment of infrabony defects because it can improve both tooth retention rate and overall clinical outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/156006/1/jper10462.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/156006/2/jper10462_am.pd

The 2nd Baltic Osseointegration Academy and Lithuanian University of Health Sciences Consensus Conference 2019. Summary and consensus statements: Group II - Extraction socket preservation methods and dental implant placement outcomes within grafted sockets

Introduction: The task of Group II was to review and update the existing data concerning extraction socket preservation with or without membranes and soft tissue influence on post-extraction alveolar ridge preservation; extraction socket preservation using different biomaterials as bone grafts, growth factors, and stem cells. Special interest was paid to the dental implant placement outcomes within grafted sockets.Material and Methods: The main areas evaluated by this group were as follows: quantitative and qualitative assessment of the effect of different alveolar preservation techniques performed immediately after tooth extraction, with or without membranes and/or soft tissue grafting, and the use of different bone substitutes, stem cells or growth factors in the postextraction socket. Evaluation of the treatment outcomes of dental implants placed in the grafted sockets in terms of primary and secondary outcomes were assessed. The systematic reviews and/or meta-analyses were registered in PROSPERO, an international prospective register of systematic reviews: http://www.crd.york.ac.uk/PROSPERO/. TThe literature in the corresponding areas of interest was screened and reported following the PRISMA guidelines (Preferred Reporting Item for Systematic Review and Meta-Analysis) Statement: http://www.prisma-statement.org/. Method of preparation of the systematic reviews, based on comprehensive search strategies, was discussed and standardized. The summary of the materials and methods employed by the authors in preparing the systematic reviews and/or meta-analyses is presented in the Preface chapter.Results: The results and conclusions of the review process are presented in the respective papers. Three systematic reviews and one systematic review and meta-analysis were performed. The group's general commentaries, consensus statements, clinical recommendations and implications for research are presented in this article.info:eu-repo/semantics/publishedVersio

Influence of restorative design on the progression of peri- implant bone loss: A retrospective study

BackgroundClinical data on the restorative designs affecting the early progression of peri- implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri- implantitis.MethodsImplants diagnosed with peri- implantitis having 1- (T1) and 2- year (T2) follow- ups were included. In addition, within 6 months pre- diagnosis (Tb), all cases required to have full documentation in which no evidence of peri- implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations.ResultsEighty- three bone- level implants from 65 patients were selected. The mean follow- up before peri- implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants- bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow- up year.ConclusionsSignificant marginal bone loss occurred in the early post- diagnosis period of peri- implantitis, which could be affected by the restoration emergence angle. Peri- implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167523/1/jper10652.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167523/2/jper10652_am.pd

Volumetric changes at implant sites: A systematic appraisal of traditional methods and optical scanning- based digital technologies

AimTo evaluate techniques for assessing soft tissue alterations at implant sites and compare the traditionally utilized methods to the newer three- dimensional technologies emerging in the literature.Materials and MethodsA comprehensive search was performed to identify interventional studies reporting on volumetric changes at implant sites following different treatments.ResultsSeventy- five articles were included the following: 30 used transgingival piercing alone, one utilized calliper, six with ultrasonography, six on cone- beam computed tomography, and 32 utilized optical scanning and digital technologies. Optical scanning- based digital technologies were the only approach that provided - volumetric changes,- reported as volumetric variation in mm3, or the mean distance between the surfaces/mean thickness of the reconstructed volume. High variability in the digital analysis and definition of the region of interest was observed. All the other methods reported volume variation as linear dimensional changes at different apico- coronal levels. No studies compared volumetric changes with different approaches.ConclusionsDespite the emergence of optical scanning- based digital technologies for evaluating volumetric changes, a high degree of variation exists in the executed workflow, which renders the comparison of study results not feasible. Establishment of universal guidelines could allow for volumetric comparisons among different studies and treatments.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/166195/1/jcpe13401-sup-0001-AppendixS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166195/2/jcpe13401.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/166195/3/jcpe13401_am.pd

Multivariate outcome evaluation of furcation-involved molars treated with non-surgical mechanical therapy alone or combined with open flap debridement: A retrospective study

BackgroundThis retrospective study assessed the effect of non-surgical and surgical mechanical therapy for furcation-involved molars.MethodsFurcation defects treated and followed for at least 1 year were selected. Data relative to the clinical outcomes were recorded. The immediate (3- to 6-month) clinical outcomes and the long-term survival of the treated molars were assessed. The potential variables influencing the treatment outcomes through multi-level regression analysis, and Cox Proportional-Hazards Models were also analyzed.ResultsOne hundred and eighty-four molars were included with an average follow-up of 7.52 years. At the 3- to 6-month re-evaluation 1.39 ± 0.99 mm pocket depth reduction, 0.88 ± 1.29 mm clinical attachment gain, and a 0.51 ± 1.13 mm increase in recession was observed. The 5- and 10-year survival rates were 88.3% and 61.3%, respectively. The horizontal and vertical extent of furcation involvement, baseline probing depth, mucoperiosteal flap elevation, and the frequency of supportive periodontal therapy influenced the clinical outcomes and tooth survival.ConclusionNon-surgical and surgical mechanical root debridement is a viable treatment for the management of furcation involved molars with shallow horizontal and vertical components.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172826/1/jper10852_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172826/2/jper10852.pd

Pro-inflammatory profiles in cardiovascular disease patients with peri-implantitis

BackgroundTo investigate the pro-inflammatory cytokine profiles in patients with or without cardiovascular disease (CVD) and with or without peri-implantitis.MethodsSerum, peri-implant crevicular fluid (PICF), and gingival crevicular fluid (GCF) were collected from patients with (n = 82) or without CVD (n = 46) at the most severe peri-implantitis site including sites with periodontitis. A panel of proinflammatory molecules including high-sensitivity C-reactive protein (hsCRP), fibrinogen, interleukin-1 beta (IL-1β), IL-6, plasma tumor necrosis factor-alpha (TNF-α), matrix metallo-proteinase-8 (MMP-8), osteoprotegerin (OPG), vascular endothelial growth factor (VEGF), IL-17, IL-8, tissue inhibitor of metalloproteinase-2 (TIMP-2), myeloperoxidase (MPO), and prostaglandin E2 (PGE2) were analyzed using human custom Quantibody arrays. Krunskal-Wallis test was used to compare groups. The diagnostic ability of each biomarker was assessed using chi-square test and ROC analysis.ResultsSerum IL-1β, TNF-α and fibrinogen were significantly higher in CVD patients than those without. Serum fibrinogen displayed a trend of higher concentration in patients with radiographic bone loss (RBL) ≥2 mm (P = 0.08). PICF TNF-α exhibited a significantly higher detection level in the CVD patients that is coincided with the local peri-implant inflammation. In addition, PICF MMP-8 was significantly higher in the RBL ≥2 mm sites than the healthy implants; whereas IL-1β, IL-8, MMP-8, and TIMP-2 proved to be the significant predictors for peri-implant disease. GCF TNF-α collected from patients with periodontitis was significantly associated with CVD cases.ConclusionThe augmented expression of local and systemic pro-inflammatory cytokines found in the current study supports the weak association between the chronic peri-implantitis with increasing severity and CVD.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172997/1/jper10905.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172997/2/jper10905_am.pd

Patient experience of autogenous soft tissue grafting has an implication for future treatment: A 10- to 15- year cross- sectional study

BackgroundPatient- reported outcomes have received a great deal of interest in periodontal plastic procedures. However, their evaluation has mainly been short- term. Thus, the aim of this study was to evaluate the impact of soft tissue grafting procedures conducted over a decade ago on the willingness of a patients to undergo the surgery again.MethodsSubjects that received an autogenous soft tissue graft over 10 years ago were screened and invited for a survey. Their response was only analyzed if they were able to correctly identify the sites of the surgical procedures. Dichotomous questions and visual analogue scales (VASs) were used to assess self- reported pain, willingness to retreat and satisfaction.ResultsFifty- two patients were included in the analyses. Higher pain was reported for mandibular sites, and treated areas including - ¥ 3 teeth (P < 0.01). Willingness to retreatment was 84.6% and it was negatively associated with self- reported pain measures, the arch location (mandible), and number of treated sites (- ¥3 teeth) (P < 0.01). Mean satisfaction rate was 86.9 ± 13.65 (VAS) and showed a positive correlation with willingness to retreat (P < 0.01). Having a complete root coverage at the recall visit was also significantly associated with higher patient satisfaction scores (P < 0.01).ConclusionsPatient experience of previous autogenous soft tissue grafting has an influence on their decision to undergo future treatment. Willingness to retreat was negatively affected by mandibular sites, larger treated areas and the perceived pain, while presenting with complete root coverage was significantly associated with patient satisfaction.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167778/1/jper10653_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167778/2/jper10653.pd

Ultrasonographic tissue perfusion analysis at implant and palatal donor sites following soft tissue augmentation: A clinical pilot study

AimTo describe the application of power Doppler Ultrasonography (US) for evaluating blood flow at implant and palatal donor sites following soft tissue augmentation with the connective tissue graft (CTG).Materials and MethodsFive patients exhibiting a peri- implant soft tissue dehiscence received treatment with a coronally advanced flap and corresponding CTG. Power Doppler US was used for assessing blood volume at baseline, 1 week, 1 month, 6 months and 12 months post- surgery for assessing blood- flow dynamics at the implant and palatal donor sites. The speed- weighted and power- weighted colour pixel density (CPPD) were computed from colour velocity (CV) and colour power (CP), respectively.ResultsA mean increase in CV of 199.25% was observed at the midfacial region of the implant sites after 1 week compared to baseline. CV and CP were increased in all sites at 1 week and 1 month. At 6 and 12 months, the mean CV appeared lower than baseline at the implant sites. CCPD was increased at the palatal donor sites and at the great palatine foramen areas at the 1- week and 1- month post- operative evaluations.ConclusionsPower Doppler US is a non- invasive and valuable tool for estimating tissue perfusion and CPPD variation during different phases of intra- oral soft tissue graft healing.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167450/1/jcpe13424.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167450/2/jcpe13424_am.pd