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

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

Soft tissue contour and radiographic evaluation of ridge preservation in early implant placement: A randomized controlled clinical trial

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

The Relation Between Histological, Tumor-Biological and Clinical Parameters in Deep and Superficial Leiomyosarcoma and Leiomyoma

Purpose: Leiomyosarcomas (LMS) of deep and superficial tissues were examined to identify prognostic markers explaining their different biological behaviour and to define differences between cutaneous and subcutaneous LMS. LMS and leiomyomas (LM) of the skin were compared to and consistent differences that could aid in the (sometimes difficult) diagnosis

The Future of Biologic Agents in the Treatment of Sjögren’s Syndrome

The gain in knowledge regarding the cellular mechanisms of T and B lymphocyte activity in the pathogenesis of Sjögren’s syndrome (SS) and the current availability of various biological agents (anti-TNF-α, IFN- α, anti-CD20, and anti-CD22) have resulted in new strategies for therapeutic intervention. In SS, various phase I and II studies have been performed to evaluate these new strategies. Currently, B cell-directed therapies seem to be more promising than T cell-related therapies. However, large, randomized, placebo-controlled clinical trials are needed to confirm the promising results of these early studies. When performing these trials, special attention has to be paid to prevent the occasional occurrence of the severe side effects

Digitaal plannen, een grote stap vooruit binnen de implantologie:Expert uitgelicht

Dr. Justin Pijpe werkt als mka-chirurg in het Catharina Ziekenhuis Eindhoven. Ook is hij verbonden aan het Erasmus Medisch Centrum als onderzoeker met als aandachtsgebied de implantologie en preprothetische chirurgie. Hij is sinds 1 juni 2018 redacteur van het NTVT en had het thema ‘Antibiotica’ onder zijn hoede, dat in oktober 2019 is gepubliceerd. Hij is auteur van het artikel ‘Mondgezondheidgerelateerde kwaliteit van leven voor en na bariatrische chirurgie' dat recent in de mei-editie is verschenen

Digitaal plannen, een grote stap vooruit binnen de implantologie:Expert uitgelicht

Dr. Justin Pijpe werkt als mka-chirurg in het Catharina Ziekenhuis Eindhoven. Ook is hij verbonden aan het Erasmus Medisch Centrum als onderzoeker met als aandachtsgebied de implantologie en preprothetische chirurgie. Hij is sinds 1 juni 2018 redacteur van het NTVT en had het thema ‘Antibiotica’ onder zijn hoede, dat in oktober 2019 is gepubliceerd. Hij is auteur van het artikel ‘Mondgezondheidgerelateerde kwaliteit van leven voor en na bariatrische chirurgie' dat recent in de mei-editie is verschenen

Diagnosis, progression and intervention in Sjogren's syndrome

Sjögren’s syndrome (SS) is a chronic inflammatory and lymphoproliferative progressive autoimmune disease. It is characterized by B cell activation and infiltration of T and B cells in the exocrine glands. Common symptoms are related to diminished lacrimal and salivary gland function. Besides keratoconjunctivitis sicca and xerostomia, patients can present with severe systemic complications, such as vasculitis and nephritis. Furthermore, 5 percent of patients with SS develop malignant B cell lymphoma during follow-up. Diagnosis of SS remains difficult, especially with regard to the oral component. Still is much unknown with regard to loss of salivary gland function and the evolution of malignant lymphoma, and there is no evidence-based intervention therapy. The main objective of the first part of this thesis was to optimize diagnostic procedures in SS with regard to histopathology, collecting of saliva, and imaging. Next, progression of salivary gland dysfunction and lymphoma development were studied. In the last part of this thesis, the effect of B cell depletion in SS with or without MALT lymphoma was evaluated.