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Objectives: To compare the clinical and radiological outcomes of novel fully tapered tissue‐level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time. Materials and Methods: For this clinical study, 318 fully tapered tissue‐level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed. Results: After a mean follow‐up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%‐CI 0.084–5.81). Neither for implant length (HR 0.53, 95%‐CI 0.055–5.08) nor for implant width (HR 0.27, CI 0.028–2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4. Conclusions: Within the limitations of this retrospective study and the short follow‐up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue‐level implant (no clinical trial registration as retrospective study design). [ABSTRACT FROM AUTHOR]

Objectives: The study aims to overview German dentists’ development of antibiotic and analgesic prescriptions from 2012 to 2021. Materials and methods: A longitudinal database analysis was performed based on the annual reports of the “Research Institute for Local Health Care Systems” (WIdO, Berlin). Results: From 2012 until 2021, dental antibiotic prescriptions fell by 17.9%. In contrast, the dental proportion of antibiotic prescriptions compared to all antibiotic prescriptions in Germany increased from 9.1 to 13.6%. Aminopenicillins enhanced their share from 35.6 to 49.4%, while clindamycin prescriptions declined from 37.8 to 23.4%. The proportion of ibuprofen prescriptions significantly increased from 60.4% in 2012 to 79.0% in 2021. Conclusions: Since 2013, the most frequently prescribed antibiotic by German dentists has been amoxicillin reaching nearly half of all dental antibiotic prescriptions in 2021. Simultaneously, the proportion of clindamycin has steadily decreased, but the level is still high compared to international data. During the past decade, ibuprofen as a first-line analgesic in German dentistry was continuously gaining in importance. Clinical relevance: Aminopenicillins have the best risk–benefit balance in dentistry, but the use of antibiotics generally must be limited only to cases of severe infections or compromised patients. Pre-existing diseases or permanent medications should always be considered when choosing an analgesic. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this meta‐analysis was to compare implant survival in irradiated and non‐irradiated bone and to investigate potential risk factors for implant therapy in oral cancer patients. Material and methods: An extensive search in the electronic databases of the National Library of Medicine was performed. Systematic review and meta‐analysis were conducted according to PRISMA statement. The meta‐analysis was performed for studies with a mean follow‐up of at least three and five years, respectively. Results: The systematic review resulted in a mean overall implant survival of 87.8% (34%–100%). The meta‐analysis revealed a significantly higher rate of implant failure in irradiated bone compared to non‐irradiated bone (p <.00001, OR 1.97, CI [1.63, 2.37]). The studies also showed that implants placed into irradiated grafted bone were more likely to fail than those in irradiated native bone (p <.0001, OR 2.26, CI [1.50, 3.40]). Conclusion: Even though overall implant survival was high, radiotherapy proves to be a significant risk factor for implant loss. Augmentation procedures may also increase the risk of an adverse outcome, especially in combination with radiotherapy. Clinical relevance: The treatment of patients receiving radiotherapy of any form requires precise individual planning and a close aftercare. Implants should be placed in local bone rather than in bone grafts, if possible. [ABSTRACT FROM AUTHOR]

Objectives: To compare clinical and radiological outcomes of narrow‐diameter implants (NDI) placed in pristine bone to standard‐diameter implants placed in combination with horizontal bone augmentation procedures (SDI+A) for horizontally deficient alveolar ridges. Material and Methods: For this retrospective study, the outcome of 597 NDI (∅ 3.3 mm, 272 patients), inserted in pristine bone, were compared with 180 SDI (∅ 4.1 mm, 83 patients), inserted in combination with horizontal augmentation procedures. Oral health‐related quality of life was assessed in patients available for recall. Results: After a mean follow‐up of 37.6 ± 40 months for the NDI and of 42.4 ± 49 months for the SDI+A, survival rates were 96.1% for NDI and 95.6% for SDI+A. Cumulative 5‐year and 10‐year implant survival rates were 94.3% and 92.2% for the NDI group and 97.0% and 88.3% for the SDI+A group, indicating no significant difference (p =.89). According to the criteria of Buser et al., an implant success rate of 84.3% was obtained for the NDI and an implant success rate of 81.3% for the SDI+A (p =.79). Regarding oral health‐related quality of life, a similar and high patient satisfaction could be observed in both groups. Conclusions: NDI without augmentation procedures showed a similar clinical outcome as SDI in combination with augmentation procedures after a follow‐up of more than 3 years. Therefore, NDI might be a reasonable alternative in cases of horizontal bone atrophy (no clinical trial registration as patient inclusion started 2003). [ABSTRACT FROM AUTHOR]

Objectives: Narrow‐diameter implants (NDI) are claimed to be a reasonable alternative to bone augmentation procedures. The aim of this comprehensive literature review was to conduct a meta‐analysis comparing the implant survival of NDI and standard diameter implants (SDI) and to provide recommendations and guidelines for application of NDI. Material and methods: An extensive systematic literature search was performed in the PubMed/MEDLINE and the Cochrane Library databases. NDI were classified into Category 1 (implant diameter <3.0 mm, "mini‐implants"), Category 2 (implant diameter 3–3.25 mm) and Category 3 (implant diameters 3.3–3.5 mm). Clinical studies at all levels of evidence with at least 10 patients included and a follow‐up time of at least 12 months were included. The primary outcome criterion was the survival rates of NDI. Results: Seventy‐six studies were identified for qualitative and 16 studies for quantitative synthesis. Quality assessment illustrated a high risk of bias for the included literature. Mean implant survival rates were 94.7 ± 5%, 97.3 ± 5% and 97.7 ± 2.3% for Categories 1, 2 and 3. Meta‐analysis indicated a statistically significant lower implant survival of Category 1 NDI compared to SDI ([OR], 4.54; [CI], 1.51–13.65). For Category 2 and Category 3, no statistical significant differences in implant survival were seen compared to SDI ([OR], 1.06; [CI], 0.31–3.61 and [OR], 1.19; [CI], 0.83–1.70). Conclusion: NDI of Category 1 performed statistically significantly worse than SDI and were mainly described for the rehabilitation of the highly atrophic maxilla or mandible. Category 2 and Category 3 NDI showed no difference in implant survival compared to SDI. Category 2 NDI were mostly used for the rehabilitation of limited interdental spaces in anterior single‐tooth restorations. NDI of Category 3 were described in all regions, including posterior single‐tooth restorations. However, resilient long‐term data and data on the possible risk of biological and technical complications with wide platform teeth on NDI are missing so far. [ABSTRACT FROM AUTHOR]

Objectives: Narrow‐diameter implants (NDI) are claimed to be a reasonable alternative to bone augmentation procedures. The aim of this comprehensive literature review was to conduct a meta‐analysis comparing the implant survival of NDI and standard diameter implants (SDI) and to provide recommendations and guidelines for application of NDI. Material and methods: An extensive systematic literature search was performed in the PubMed/MEDLINE and the Cochrane Library databases. NDI were classified into Category 1 (implant diameter <3.0 mm, "mini‐implants"), Category 2 (implant diameter 3–3.25 mm) and Category 3 (implant diameters 3.3–3.5 mm). Clinical studies at all levels of evidence with at least 10 patients included and a follow‐up time of at least 12 months were included. The primary outcome criterion was the survival rates of NDI. Results: Seventy‐six studies were identified for qualitative and 16 studies for quantitative synthesis. Quality assessment illustrated a high risk of bias for the included literature. Mean implant survival rates were 94.7 ± 5%, 97.3 ± 5% and 97.7 ± 2.3% for Categories 1, 2 and 3. Meta‐analysis indicated a statistically significant lower implant survival of Category 1 NDI compared to SDI ([OR], 4.54; [CI], 1.51–13.65). For Category 2 and Category 3, no statistical significant differences in implant survival were seen compared to SDI ([OR], 1.06; [CI], 0.31–3.61 and [OR], 1.19; [CI], 0.83–1.70). Conclusion: NDI of Category 1 performed statistically significantly worse than SDI and were mainly described for the rehabilitation of the highly atrophic maxilla or mandible. Category 2 and Category 3 NDI showed no difference in implant survival compared to SDI. Category 2 NDI were mostly used for the rehabilitation of limited interdental spaces in anterior single‐tooth restorations. NDI of Category 3 were described in all regions, including posterior single‐tooth restorations. However, resilient long‐term data and data on the possible risk of biological and technical complications with wide platform teeth on NDI are missing so far. [ABSTRACT FROM AUTHOR]

Background: Inflammation and cell-mediated immunity have a key role in different stages of carcinogenesis. The aim of this prospective study was to assess serum levels of proinflammatory cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), soluble interleukin-2 receptor (sIL-2R), tumor necrosis factor alpha (TNF-α), and MHC class I polypeptide-related sequence B (MICB) in patients with oral premalignant lesion (OPL), oral squamous cell carcinoma (OSCC), and healthy controls in a multi-biomarker approach as a potential diagnostic and prognostic tool for OSCC.Material and Methods: A total of 205 patients (81 with OSCC, 75 with OPL, and 49 healthy controls) were included in this prospective study. Cytokine concentrations were measured by commercial enzyme linked immunoassay and chemiluminescence immunoassay.Results: IL-6, IL-8, and sIL-2R were significantly elevated in OSCC patients compared to healthy controls and to OPL patients. Higher T-Grade (>T2) and positive lymph node involvement resulted in significantly higher IL-6 values (P < .001 and P = .037). IL-6 serum values ≥5 pg/mL (n = 45) and sIL-2R serum values ≥623 U/mL (n = 19) indicated a significant lower survival rate compared to OSCC patients with low IL-6 (n = 36) and sIL-2R values (n = 62, P = .023 and P = .026). ROC and classification tree analyses identified the combination of IL-6 and IL-8 as diagnostic markers with good diagnostic accuracy.Conclusion: In conclusion, IL-6, IL-8, and sIL-2R are strongly associated with OSCC oncogenesis and IL-6 and sIL-2R seem to be promising and potent biomarkers for evaluating patients' prognosis. [ABSTRACT FROM AUTHOR]

Aim: The absence of reliable single serum biomarkers for oral premalignant lesion (OPL) and oral squamous cell carcinoma (OSCC) limits early diagnosis, monitoring of advanced disease, and prediction of prognosis. Methods: In this prospective study, serum levels of matrix metalloproteinase (MMP)-2, MMP-3, MMP-13, insulin-like growth factor (IGF)-1, and IGF-binding protein (IGFBP)-3 were measured in 81 untreated OSCC patients, 49 healthy subjects, and 75 individuals with OPLs, and correlated with clinicopathological parameters. Results: Serum levels of MMP-3 were significantly higher in OSCC patients compared to healthy subjects (p=0.004). Mean IGF-1 and IGFBP-3 levels in OSCC patients were significantly lower in healthy subjects (p=0.001 and p<0.001). OSCC patients with an IGF-1 serum value <130 ng/mL (median) showed a significantly lower survival rate compared to ≥130 ng/mL (p=0.049). Combined use of IGF-1 (<130 ng/mL) and IGFBP-3 (<3.1 µg/mL) resulted in a significantly lower 12-month cumulative survival compared to the complementary set (78.5% vs 93.8%; p=0.031). There was a significantly positive correlation between IGF-1 and IGFBP-3 serum values (rs =0.625, p<0.001). Conclusion: This study shows that IGF-1 and IGFBP-3 have a vital role in the pathogenesis of OSCC and indicates for the first time that IGF-1 and IGFBP-3 in combination may be applied as potential tools for prognosis of OSCC. [ABSTRACT FROM AUTHOR]

OPMDs (oral potentially malignant disorders) are a group of disorders affecting the oral mucosa that are characterized by aberrant cell proliferation and a higher risk of malignant transformation. Vitamin D (VitD) and its receptor (VDR) have been extensively studied for their potential contributions to the prevention and therapeutic management of various diseases and neoplastic conditions, including oral cancer. Observational studies suggest correlations between VitD deficiency and higher cancer risk, worse prognosis, and increased mortality rates. Interestingly, emerging data also suggest a link between VitD insufficiency and the onset or progression of OPMDs. Understanding the role of the VitD–VDR axis not only in established oral tumors but also in OPMDs might thus enable early detection and prevention of malignant transformation. With this article, we want to provide an overview of current knowledge about OPMDs and VitD and investigate their potential association and ramifications for clinical management of OPMDs. [ABSTRACT FROM AUTHOR]

Objectives To evaluate the effect of platelet-derived growth factor (rh PDGF- BB) on the promotion of osteogenesis around variable-thread tapered implants in an animal model. Material and methods Twenty-four variable-thread tapered implants were inserted in the tibia of 12 rabbits. Twelve sites received additional rh PDGF- BB released from a presoaked xenogenic bone block that was fixed supracrestally. Primary outcomes were bone-to-implant contact ( BIC; in % ± SD) and percentage of medullary bone fill around the implants ( PMF; in % ± SD) after 3 weeks ( PDGF n = 6, no PDGF n = 6) and 6 weeks ( PDGF n = 6, no PDGF n = 6). Results Considerable crestal and medullary bone remodeling could be found around all implants. After 3 weeks, both BIC and PMF values were higher in the no PDGF group ( BIC: 63% ± 10 with PDGF vs. 85% ± 5 with no PDGF; PMF: 57% ± 10 with PDGF vs. 74% ± 4 with no PDGF). After 6 weeks, the BIC difference between the two groups was less distinct ( BIC: 78% ± 17 with PDGF vs. 72% ± 25 with no PDGF), whereas the PDGF group showed higher PMF values ( PMF: 77% ± 5 with PDGF vs. 56% ± 10 with no PDGF). Conclusions The addition of rh PDGF- BB decreases early osseous crestal and medullar healing properties around dental implants. In a later phase, an increase in the cortical area as well as an increased medullar bone formation was seen. This response is likely to provide stronger secondary stability and stability in suboptimal situations involving poor-quality bone. [ABSTRACT FROM AUTHOR]

Background and Purpose Tapered implant designs aim to improve primary stability and implant survival in soft bone. However, respective clinical long-term data are scarce. Therefore, a clinical and radiological evaluation of the long-term success of a transgingival-supracrestal inserted tapered implant system with special emphasis on the influence of augmentation procedures was conducted. Material and Methods In a retrospective study design, all in the Department of Oral and Maxillofacial Surgery of the University Medical Centre, Mainz, Germany, between May 2002 and March 2012, placed tapered implants ( Straumann TE®, Basel, Switzerland) were analyzed. In this time period, a total of one hundred ninety-seven tapered implants were inserted in 90 patients. For patients available for clinical recall, success criteria according to Albrektsson and Buser were evaluated. Results The in situ rate was 96.3% after an average time in situ of 62 ± 31 months. In one hundred twenty-seven sites, bone augmentation procedures were performed. Hereof, 96 sites were sinus augmentation procedures and 31 sites were alveolar ridge augmentations. For patients with sinus augmentation procedures, implant survival was 97.9% and for patients with alveolar ridge augmentations, implant survival was 93.5% after 5 years, indicating a higher implant survival for sinus augmentation, however not statistically different ( p = .194). Implant diameter and timing of implant placement had no significant impact on implant survival ( p > .05). Mean marginal bone loss was −0.50 ± 1.54 mm for patients receiving maxillary sinus augmentation and −1.16 ± 1.13 mm for patients with alveolar ridge augmentations, indicating a lower marginal bone loss in patients receiving maxillary sinus augmentation ( p = .046). Implant success rates ranged between 88% and 92% after a mean follow-up of 6 years. Conclusions Within the limits of the retrospective character of this study, the tapered soft tissue level implant showed especially in maxillary sinus augmentation promising long-term survival and success rates and a low peri-implant bone resorption compared with the literature. [ABSTRACT FROM AUTHOR]

Background: Growth differentiation factor 15 (GDF15) is involved in tumor pathogenesis of oral squamous cell carcinoma (OSCC). The aim of this study was an investigation of the potential influence of GDF15 on radioresistance of OSCC cells in vitro.Methods: Oral squamous cell carcinoma cell lines were irradiated with 0, 2, or 6 Gy, and GDF15 expression in the supernatant per survived cell colony was examined with ELISA. Non-irradiated and OSCC cell lines irradiated with 6 Gy were evaluated for GDF15 expression using immunofluorescent staining. For further investigation of GDF15 effects on radioresistance, a GDF15 knockdown model in a human OSCC cell line was established, and apoptotic activity after radiation was measured using the Caspase-Glo 3/7 system.Results: ELISA and immunofluorescent staining indicated an increased GDF15 expression in 5 OSCC cell lines compared with human gingival epithelial cells. Irradiation with two and six gray resulted in a significant elevation of GDF15 expression per survived cell colony in the irradiated OSCC cell lines (P < 0.001). Furthermore, a dose-dependent expression of GDF15 was seen. Immunofluorescent staining confirmed an elevated GDF15 expression in irradiated OSCC cell lines (n = 10; P ≤ 0.001). Apoptotic activity was significantly increased after irradiation in the GDF15 knockdown group compared with control cells (n = 24; P < 0.001).Conclusion: This study describes for the first time the vital role of GDF15 both in tumorigenesis and in radioresistance of OSCC cells. With its anti-apoptotic effects, GDF15 possibly promotes tumor progression and might protect carcinoma cells against irradiation effects. Consequently, GDF15 may be a promising therapeutic target in oral cancer. [ABSTRACT FROM AUTHOR]

Introduction Initial platelet activation with subsequent cytokine release at the defect site plays a crucial role in tissue integration. The aim of this study was to evaluate the influence of topographic and biomimetic collagen modifications of a xenogenic bone substitute material ( BSM) on in vitro platelet activation and cytokine release. Material and Methods Three types of xenogenic BSM were used. Two BSM with different levels of granularity (large granule BSM [ XBSM/L], small granule BSM [ XBSM/S]) and a BSM with collagen ( XBSM/C). All three samples were incubated with platelet concentrate of four healthy volunteers at room temperature for 15 min. For all groups, highly thrombogenic collagen type 1 served as a reference and an additional preparation with platelet concentrate only (without XBSM) served as control. Platelet count and cytokine release of VEGF, PDGF, TGF-β, and IGF into the supernatant were measured. Results Compared with the control group, XBSM/C showed an increase in platelets consumption (mean 41,000 ± 26,000/ml vs. 471,000 ± 38,000/ml), cytokine release of VEGF (mean 46.8 ± 7.2 pg/ml vs. 18.8 ± 2.7 pg/ml), and PDGF (mean 18,350 ± 795 pg/ml vs. 2726 ± 410 pg/ml) but not IGF (194,728 ± 51,608 pg/ml vs. 1,333,911 ± 35,314 pg/ml). There was also an increase in cytokine release of TGF-ß in XBSM/C compared with XBSM/S (77,188 ± 27,413 pg/ml vs. 38,648 ± 13,191 pg/ml), but no such difference when compared with XBSM/L (77,188 ± 27,413 pg/ml vs. 53,309 ± 29,430 pg/ml). XBSM/L showed higher platelets consumption (301,000 ± 45,000 vs. 415,000 ± 98,000) and a higher cytokine release of PDGF (3511 ± 247 pg/ml vs. 3165 ± 78 pg/ml) compared with XBSM/S. There was no distinct difference in the levels of VEGF, TGF-ß, and IGF between XBSM/L and XBSM/S. Conclusions Topographic as well as biomimetic modifications of the xenogenic BSM showed an increased platelet activation and cytokine release in vitro. This effect on the intrinsic healing cascade could result in comparable enhanced soft- and hard-tissue regeneration in vivo. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: Osteoconductive characteristics of different implant surface coatings are in the focus of current interest. The aim of the present study was to compare the vertical osteoconductivity at the implant shoulder of supracrestal inserted calcium-phosphate coated implants (SLA-CaP) with conventional sand-blasted/acid-etched (SLA) implants in a rabbit model. Materials and Methods: SLA-CaP and SLA implants were inserted bilaterally in the mandible of four rabbits in a split-mouth design. The implants were placed 2 mm supracrestal. After 3 weeks, at the left and right implant shoulder, the percentage of linear bone fill (PLF) as well as bone-implant contact (BIC-D) were determined. Results: After 3 weeks, newly formed woven bone could be found at the shoulder of the most of both surface-treated implants (75%). PLF was significantly higher in SLA-CaP implants (11.2% vs. 46.5%; n = 8, p = .008). BIC-D was significantly increased in the SLA-CaP implants (13.0% vs. 71.4%; n = 8, p < .001) as well. Conclusion: The results of this study show for the first time that calcium-phosphate coated surfaces on supracrestal inserted implants have vertical osteoconductive characteristics and increase the bone-implant contact at the implant shoulder significantly in a rabbit model. In clinical long-term settings, these implants may contribute to a better vertical bone height. [ABSTRACT FROM AUTHOR]

Objectives: This scoping review explores the risk and management of traumatic injuries to the inferior alveolar and lingual nerves during mandibular dental procedures. Emphasizing the significance of diagnostic tools, the review amalgamates existing knowledge to offer a comprehensive overview. Materials and methods: A literature search across PubMed, Embase, and Cochrane Library informed the analysis. Results: Traumatic injuries often lead to hypo-/anesthesia and neuropathic pain, impacting individuals psychologically and socially. Diagnosis involves thorough anamnesis, clinical-neurological evaluations, and radiographic imaging. Severity varies, allowing for conservative or surgical interventions. Immediate action is recommended for reversible causes, while surgical therapies like decompression, readaptation, or reconstruction yield favorable outcomes. Conservative management, utilizing topical anesthesia, capsaicin, and systemic medications (tricyclic antidepressants, antipsychotics, and serotonin-norepinephrine-reuptake-inhibitors), proves effective for neuropathic pain. Conclusions: Traumatic nerve injuries, though common in dental surgery, often go unrecorded. Despite lacking a definitive diagnostic gold standard, a meticulous examination of the injury and subsequent impairments is crucial. Clinical relevance: Tailoring treatment to each case's characteristics is essential, recognizing the absence of a universal solution. This approach aims to optimize outcomes, restore functionality, and improve the quality of life for affected individuals. [ABSTRACT FROM AUTHOR]

Background: The aim was to compare early biochemical and histological osseous healing of chronic mandibular defects regenerated with bovine bone substitute with and without collagen membrane in vivo. Methods: Eight weeks after formation of a lateral full-thickness perforating bone defect in the mandible of 40 rabbits, bovine bone substitute with ("+";n = 20) and without ("-";n = 20) collagen membrane was applied. Blood and bone was collected 24, 72 h, 7, 14 and 21 days after surgery. Total acid phosphatase, bone acid phosphatase, total alkaline phosphatase and bone alkaline phosphatase activities were compared between groups. Formation of new bone was quantified histologically for all time points. Results: Twenty-four hours after surgery, bone alkaline phosphatase was significantly elevated in "+" group when compared to "-" (p=0.012). After 72 hours, all bone turnover markers except for total acid phosphatase (p=0.078) where significantly elevated in "+" (all p < 0.05). Fourteen days after surgery, the significant highest values for all bone turnover markers were detected in "-" (all p < 0.05). A significant difference in favor of group "-" could also be detected after 3 weeks in terms of both acid phosphatases (p < 0.05). In histology, no significant differences could be detected. Conclusion: Bone regeneration with bovine bone substitute material and collagen membrane shows a significantly earlier bone remodeling activity but does not seem to influence formation of new bone in histological samples. [ABSTRACT FROM AUTHOR]

Background: Screening ultrasonography was proposed for monitoring periodontal soft tissues in the early 1960s, owing to its nonionizing, real‐time, and cost‐effective properties. Studies have provided convincing preliminary evidence for the use of ultrasound (US) in implant dentistry. Purpose: To assess the feasibility of ultrasonography (US) for measuring the buccal thickness of periodontal and peri‐implant tissues. The secondary objective was to evaluate the reliability of US measurements compared to classic techniques, such as CBCT and directly measurements. Materials and Methods: An electronic literature search was conducted by three independent reviewers through February 2023. The inclusion criteria were articles investigating at least five patients/cadavers with US measurements in periodontal or peri‐implant buccal tissues. Compliance with methodological reporting standards and risk of bias was assessed using EULAR and QUADAS‐C tools, respectively. Random‐effects meta‐analysis was conducted, using Bland–Altman analysis. Certainty of the evidence was assessed using GRADE. Results: The final selection included 12 studies examining 458 patients and 13 cadavers, with a total of 226 implants, 1958 teeth and 60 edentulous sites. The body of evidence was assessed as partially compliant with methodological reporting standards for US studies and had an unclear to high risk of bias. Meta‐analysis of five comparative studies showed no evidence of clinically significant bias between US and direct measurements (very low certainty), and between US and CBCT (very low certainty) for soft‐tissue thickness. Likewise, for bone thickness, there is no evidence of clinically significant bias between US and CBCT (low certainty). Conclusions: Compared to the CBCT and direct measurements, ultrasonography might be a reliable approach for monitoring on periodontal and peri‐implant phenotype. However, there is uncertainty about estimates of the actual effect, so further standardized and larger sample size of clinical research is needed. [ABSTRACT FROM AUTHOR]

Objectives: The aim of Working Group 3 was to address the influence of both material‐ and anti‐resorptive drug‐ related factors on clinical and biological outcomes and complications in implant dentistry. Focused questions were addressed on (a) implant materials other than titanium (alloy)s, (b) transmucosal abutment materials and (c) medications affecting bone metabolism were addressed. Materials and Methods: Three systematic reviews formed the basis for discussion in Group 3. Consensus statements and clinical recommendations were formulated by group consensus based on the findings of the systematic reviews. Patient perspectives and recommendations for future research were also conveyed. These were then presented and accepted following further discussion and modifications as required by the plenary. Results: Zirconia is a valid alternative to titanium as material for implant and transmucosal components, allowing soft and hard tissue integration with clinical outcomes—identified by implant survival, marginal bone loss and peri‐implant probing depths—up to 5‐years comparable to titatnium. However, most of the evidence for zirconia implants is based on 1‐piece implants limiting the indication range. Furthermore, based on expert opinion, zirconia transmucosal components might be preferred in the esthetic zone. In patients receiving low‐dose bisphosphonate therapy, the rate of early implant failure is not increased, while the long‐term effects remain poorly studied. Although it has not been sufficiently addressed, similar outcomes can be expected with low‐dose denosumab. A drug holiday is not recommended when considering implant placement in patients treated with low‐dose ARD. However, the specific therapeutic window, the cumulative dose and the administration time should be considered. Access to peri‐implant supportive care is mandatory to prevent peri‐implantitis‐related medication‐related osteonecrosis of the jaw (MRONJ) or implant‐related sequestra (IRS). In patients receiving low‐dose anti‐resorptive drugs (ARD) therapy, the risk of complications related to implant placement is high, and implant procedures in this specific population should be strictly treated in a comprehensive multidisciplinary center. Finally, healthy dental implants should not be removed before low or high‐dose ARD. Conclusions: Zirconia implants can be an alternative to titanium implants in selected indications. However, the current state of evidence remains limited, especially for 2‐piece implant designs. Administration of low‐dose ARD did not show any negative impact on early implant outcomes, but careful follow‐up and supportive care is recommended in order to prevent peri‐implant MRONJ and IRS. Implant placement in high‐dose patients must be strictly considered in a comprehensive multidisciplinary center. [ABSTRACT FROM AUTHOR]

The sympathetic nervous system plays a vital role in various regulatory mechanisms. These include the well-known fight-or-flight response but also, for example, the processing of external stressors. In addition to many other tissues, the sympathetic nervous system influences bone metabolism. This effect could be highly relevant concerning osseointegration, which is responsible for the long-term success of dental implants. Accordingly, this review aims to summarize the current literature on this topic and to reveal future research perspectives. One in vitro study showed differences in mRNA expression of adrenoceptors cultured on implant surfaces. In vivo, sympathectomy impaired osseointegration in mice, while electrical stimulation of the sympathetic nerves promoted it. As expected, the beta-blocker propranolol improves histological implant parameters and micro-CT measurements. Overall, the present data are considered heterogeneous. However, the available publications reveal the potential for future research and development in dental implantology, which helps to introduce new therapeutic strategies and identify risk factors for dental implant failure. [ABSTRACT FROM AUTHOR]

Periodontitis is a chronic biofilm-associated inflammatory disease of the tooth-supporting tissues that causes tooth loss. It is strongly associated with anaerobic bacterial colonization and represents a substantial global health burden. Due to a local hypoxic environment, tissue regeneration is impaired. Oxygen therapy has shown promising results as a potential treatment of periodontitis, but so far, local oxygen delivery remains a key technical challenge. An oxygen (O2)-releasing hyaluronic acid (HA)-based dispersion with a controlled oxygen delivery was developed. Cell viability of primary human fibroblasts, osteoblasts, and HUVECs was demonstrated, and biocompatibility was tested using a chorioallantoic membrane assay (CAM assay). Suppression of anaerobic growth of Porphyromonas gingivalis was shown using the broth microdilution assay. In vitro assays showed that the O2-releasing HA was not cytotoxic towards human primary fibroblasts, osteoblasts, and HUVECs. In vivo, angiogenesis was enhanced in a CAM assay, although not to a statistically significant degree. Growth of P. gingivalis was inhibited by CaO2 concentrations higher than 256 mg/L. Taken together, the results of this study demonstrate the biocompatibility and selective antimicrobial activity against P. gingivalis for the developed O2-releasing HA-based dispersion and the potential of O2-releasing biomaterials for periodontal tissue regeneration. [ABSTRACT FROM AUTHOR]

Background: Calcium phosphate (CaP) surface coatings may accelerate osseointegration and serve as a drug delivery system for mineral-binding biomolecules. In a pilot study, the impact of a commercially available, thin CaP coating on early osseous bone remodeling was compared with a modern, subtractive-treated rough surface (SLA-like) in an animal trial.Methods: In 16 rabbits, 32 endosseous implants (CaP; n = 16, SLA-like; n = 16) were bilaterally inserted in the proximal tibia after randomization. After 2 and 4 weeks, bone-implant contact (BIC;%) in the cortical (cBIC) and the trabecular bone (sBIC) as well as volume of bone within the screw thread with the highest amount of new-formed bone (area;%) were analyzed.Results: After 2 weeks, cBIC was significantly higher for CaP when compared with SLA-like (58 ± 7% versus 40.4 ± 18%; P = 0.021). sBIC for CaP was 14.7 ± 8% and for SLA-like 7.2 ± 7.8% (P = 0.081). For area, the mean volumes were 82.8 ± 10.8% for CaP and 73.6 ± 22% for SLA-like (P = 0.311). After 4 weeks, cBIC was 42.9 ± 13% for the CaP and 46.5 ± 29.1% for the SLA-like group (P = 0.775). An sBIC of 6.9 ± 9.3% was calculated for CaP and of 12.3 ± 4.8% for SLA-like (P = 0.202). The values for area were 62.3 ± 24.1% for CaP and 50.1 ± 25.9% for SLA-like (P = 0.379).Conclusions: The CaP coating has putative additional advantages in the early osseoconduction phases. It seems suitable for a feasible and clinical applicable bioactivation. [ABSTRACT FROM AUTHOR]

Objectives: Odontoma-separated into complex (CxOD) and compound (CpOD) subtypes-represents the most frequent odontogenic malformation. Retention of permanent teeth is a common symptom. Therefore, in a series of odontomas, an analysis of the management of retained teeth was conducted. Materials and methods: In a retrospective multicenter study of two University Medical Centers and one private praxis in Germany, demographic and clinical data regarding odontomas from 01/2000-03/2015 were obtained. In particular, the influence of operative therapy on the dentition and on the treatment of impacted teeth was analyzed. Results: Forty-five patients with 15 CxOD and 30 CpOD were included. Initial symptoms were delayed eruption of permanent teeth ( n = 11), pain ( n = 4), and swellings ( n = 2); 28 cases were discovered by incidence, all of them via panoramic radiographs. The mandible/maxilla ratio was about 1:0.55 (29/16). Thirty-five out of 45 odontomas were in close proximity of at least one tooth ( n = 16 at molars). A total of 14 teeth were extracted (CxOD: n = 5; CpOD: n = 9). Extractions had to be conducted more often in older patients (mean age 39.8 vs. 25.6 years). Of the non-extracted teeth, 8 teeth were displaced and retained. Of those, 4 teeth were aligned in the dental arch via orthodontic help and 2 teeth erupted spontaneously after operation during the follow-up period. In all cases, no relapse was seen. Conclusion: Odontomas can cause displacement as well as malformation and resorption of the adjacent teeth. Clinical relevance: Mostly, removal of odontomas is conducted. Extirpation of odontoma can allow for normal tooth eruption, often rendering extractions avoidable. Orthodontic alignment, though sometimes challenging, is a reasonable therapeutic option. These findings underline the value of the panoramic radiograph in preventive dentistry in younger patients. [ABSTRACT FROM AUTHOR]

Objectives: In both elective surgeries and aviation, a reduction of complications can be expected by paying attention to the so-called human factors. Checklists are a well-known way to overcome some of these problems. We aimed to evaluate the current evidence regarding the use of checklists in implant dentistry. Methods: An electronic literature search was conducted in the following databases: CINHAL, Medline, Web of Science, and Cochrane Library until March 2022. Based on the results and additional literature, a preliminary checklist for surgical implant therapy was designed. Results: Three publications dealing with dental implants and checklists were identified. One dealt with the use of a checklist in implant dentistry and was described as a quality assessment study. The remaining two studies offered suggestions for checklists based on literature research and expert opinion. Conclusions: Based on our results, the evidence for the use of checklists in dental implantology is extremely low. Considering the great potential, it can be stated that there is a need to catch up. While creating a new implant checklist, we took care of meeting the criteria for high-quality checklists. Future controlled studies will help to place it on a broad foundation. Clinical relevance: Checklists are a well-known way to prevent complications. They are especially established in aviation, but many surgical specialties and anesthesia adopt this successful concept. As implantology has become one of the fastest-growing areas of dentistry, it is imperative that checklists become an integral part of it. [ABSTRACT FROM AUTHOR]

Objectives: To assess the literature on (i) the relevance of the presence of a minimum dimension of keratinized peri‐implant mucosa (KPIM) to maintain the health and stability of peri‐implant tissues, and; (ii) the surgical interventions and grafting materials used for augmenting the dimensions of the KPIM when there is a minimal amount or absence of it. Material & Methods: Two systematic reviews complemented by expert opinion from workshop group participants served as the basis of the consensus statements, implications for clinical practice and future research, and were approved in plenary session by all workshop participants. Results: Thirty‐four consensus statements, eight implications for clinical practice, and 13 implications for future research were discussed and agreed upon. There is no consistent data on the incidence of peri‐implant mucositis relative to the presence or absence of KPIM. However, reduced KPIM width is associated with increased biofilm accumulation, soft‐tissue inflammation, greater patient discomfort, mucosal recession, marginal bone loss and an increased prevalence of peri‐implantitis. Free gingival autogenous grafts were considered the standard of care surgical intervention to effectively increase the width of KPIM. However, substitutes of xenogeneic origin may be an alternative to autogenous tissues, since similar results when compared to connective tissue grafts were reported. Conclusion: Presence of a minimum width of KPIM should be assessed routinely in patients with implant supported restorations, and when associated with pathological changes in the peri‐implant mucosa, its dimensions may be surgically increased using autogenous grafts or soft‐tissue substitutes with evidence of proven efficacy. [ABSTRACT FROM AUTHOR]

Objectives: To assess the literature on (i) the relevance of the presence of a minimum dimension of keratinized peri‐implant mucosa (KPIM) to maintain the health and stability of peri‐implant tissues, and; (ii) the surgical interventions and grafting materials used for augmenting the dimensions of the KPIM when there is a minimal amount or absence of it. Material & Methods: Two systematic reviews complemented by expert opinion from workshop group participants served as the basis of the consensus statements, implications for clinical practice and future research, and were approved in plenary session by all workshop participants. Results: Thirty‐four consensus statements, eight implications for clinical practice, and 13 implications for future research were discussed and agreed upon. There is no consistent data on the incidence of peri‐implant mucositis relative to the presence or absence of KPIM. However, reduced KPIM width is associated with increased biofilm accumulation, soft‐tissue inflammation, greater patient discomfort, mucosal recession, marginal bone loss and an increased prevalence of peri‐implantitis. Free gingival autogenous grafts were considered the standard of care surgical intervention to effectively increase the width of KPIM. However, substitutes of xenogeneic origin may be an alternative to autogenous tissues, since similar results when compared to connective tissue grafts were reported. Conclusion: Presence of a minimum width of KPIM should be assessed routinely in patients with implant supported restorations, and when associated with pathological changes in the peri‐implant mucosa, its dimensions may be surgically increased using autogenous grafts or soft‐tissue substitutes with evidence of proven efficacy. [ABSTRACT FROM AUTHOR]

Objectives The aim of this pilot study was to evaluate the vertical osteoconductive and osteointegrative dynamics around titanium-zirconium (TiZr) implants compared to titanium (Ti) implants. Materials and methods In a split-leg design, 12 TiZr-SLActive and 12 Ti-SLActive implants were inserted 3 mm above bone level in the proximal tibia of 12 rabbits. Full periosteal flaps were repositioned to cover the site. Specimens were obtained after 10, 20 and 30 days (each n = 4 per group). Histomorphometric measurements included percentage of linear bone fill (PLF; %), new marginal vertical bone height (VBH; mm) and vertical bone-to-implant contact ( vBIC; %). Statistical analysis was performed with the nonparametric F1_LD_F1 model to compare the two groups at the different time points. Results After 10 days, mean PLF was 7.7% (standard deviation (SD): 5.3) for TiZr and 17.6 (SD: 8.3) for Ti. Mean VBH was 0.35 mm (SD: 0.15) and 0.78 mm (SD: 0.4) for TiZr and Ti, respectively; mean vBIC was 24.4% (SD: 41) for TiZr and 53% (SD: 28.9) for Ti samples. The differences were significant for all parameters (PLF: P = 0.021; VBH: P = 0.009; vBIC: P = 0.011). After 20 days, mean PLF was 44.3% (SD: 26.3) for TIZr and 46.2% (SD: 21.3) for Ti implants. TiZr showed a mean VBH of 1.73 mm (SD: 1) and 1.8 mm (SD: 0.6) for Ti samples. Mean vBIC had values of 48.3% (SD: 23.7) and 68.7% (SD: 35.5) for TiZr and Ti, respectively (PLF: P = 0.78; VBH: P = 0.58; vBIC: P = 0.47). At the point of 30 days, mean PLF values were 23.7% (SD: 3.8) for TiZr and 28.9% (SD: 21.7) for Ti samples; mean for VBH in TiZr samples was 0.65 mm (SD: 0.39) and 1.7 mm (SD: 1.1) for Ti ones. Finally, mean vBIC was 28.3% (SD: 19.3) and 54.4% (SD: 26.5) for TiZr and Ti samples, respectively (PLF: P = 0.1; VBH: P = 0.088; vBIC: P = 0.089). Conclusions A significant delay in vertical osteoconductivity at the earliest time point under examination was seen for TiZr implants when compared to their Ti counterparts. For the later points, TiZr as well as Ti implants demonstrated comparable values in this animal model. The long-term osteogenic surface properties of equally pretreated TiZr dental implants are therefore similar to those of Ti implants in vivo. [ABSTRACT FROM AUTHOR]

Objectives: Porcine-derived collagen matrices (CM) can be used for oral tissue regeneration, but sufficient revascularization is crucial. The aim of this study was to analyze the influence of platelet-rich fibrin (PRF) on angiogenesis of different CM in vitro and in vivo. Materials and methods: Three different CM (mucoderm®, jason®, collprotect®) were combined with PRF in a plotting process. Growth factor release (VEGF, TGF-β) was measured in vitro via ELISA quantification after 1,4 and 7 days in comparison to PRF alone. In ovo yolk sac (YSM) and chorion allantois membrane (CAM) model, angiogenic potential were analyzed in vivo with light- and intravital fluorescence microscopy after 24 h, then verified with immunohistochemical staining for CD105 and αSMA. Results: Highest growth factor release was seen after 24 h for all three activated membranes in comparison to the native CM (VEGF 24 h: each p < 0.05; TGF-β: each p < 0.001) and the PRF (no significant difference). All activated membranes revealed a significantly increased angiogenic potential in vivo after 24 h (vessels per mm2: each p < 0.05; branching points per mm2: each p < 0.01; vessel density: each p < 0.05) and with immunohistochemical staining for CD105 (each p < 0.01) and αSMA (each p < 0.05). Conclusions: PRF improved the angiogenesis of CM in vitro and in vivo. Clinical relevance: Bio-functionalization of CM with PRF could easily implemented in the clinical pathway and may lead to advanced soft tissue healing. [ABSTRACT FROM AUTHOR]

Objectives The objective of this study was to assess and compare the growth and function of Endothelial Progenitor Cells ( EPCs) cultured on covalently bonded Vascular Endothelial Growth Factor ( VEGF) and covalently bonded Fibronectin ( FN) coating on deproteinized bovine bone ( DBB) (test samples), compared to non-modified DBB blocks (control sample). Materials and methods The test samples were prepared by plasma polymerization of allylamine onto DBB blocks. Group1 of test samples were prepared with VEGF coating ( VEGF- DBB) where as the Group2 test samples were coated with FN ( FN- DBB). Non-modified DBB blocks served as a Control. EPCs were isolated and cultivated from buffy coats of peripheral blood of healthy volunteers and cultivated in the different samples and examined at time intervals of 24 h, 3 days, and 7 days. Evaluation of growth by cell count and cell morphology was done using Confocal Laser Scanning Electron Microscopy; vitality and function of cells was assessed using MTT assay and RT- PCR and ELISA for eNOS and iNOS respectively. Results The results of the study show that both VEGF and FN could be successfully immobilized by plasma polymerization onto a complex, porous, three-dimensional structure of DBB. When comparing vital cell coverage, proliferation and function of EPCs, FN- DBB provided more positive values followed by VEGF- DBB as compared to DBB samples. eNOS level were significant higher in VEGF- DBB and FN- DBB when compared to DBB ( P = 0.019 and P = 0.002). The difference between VEGF- DBB and FN- DBB was not significant. Conclusions Biomimetic coatings of Fibronectin may clinically relate to faster angiogenesis and earlier healing potential. [ABSTRACT FROM AUTHOR]

Purpose The aim of this article was to analyze the horizontal, vertical, and histological effects of alveolar ridge preservation ( ARP) versus the ones of unassisted socket healing, in the format of an up-to-date review and meta-analysis. Materials and Methods An extensive electronic search in the electronic databases of the National Library of Medicine was conducted for articles published up to June 2014 to identify literature presenting data on the topic of ARP. Only randomized controlled trials, controlled clinical trials, and prospective trials were included for meta-analysis. Results After screening 903 abstracts from the electronic database, we included 64 studies in qualitative and 18 in quantitative synthesis. Quality assessment characterized a medium risk of bias for the included literature. The meta-analysis showed a mean difference between test and control groups of approximately 1.31 to 1.54 mm in bucco-oral bone width and 0.91 to 1.12 mm in bone height. Additionally, the intergroup difference in percentage of vital bone was assessed to be inconclusive across the included studies. Implants could be inserted into the determined position without further augmentation in 90.1% of the experimental sites, while this was the case in only 79.2% of the control sockets. Conclusions Resorption of the alveolar ridge cannot be totally stopped by ARP, while it still can be prevented compared with unassisted healing. No reliable predictions on the histological effects could be made due to limited data. Further on, no recommendation for a specific technique of ARP could be made. In conclusion, there is still need for ongoing research on the topic, even though the lower percentage of implant sites that needed additional augmentation in test sockets seemed to bring a patient benefit. [ABSTRACT FROM AUTHOR]

Objectives: Oral anticoagulation therapy (OAT) with vitamin K inhibitors protects the patients from thromboembolic events. It may however lead to excessive hemorrhage during and after an oral surgery procedure. The aim of this systematic review was to evaluate the justifications to reduce, withdraw, or alter OATs prior to minor oral surgery procedures to manage bleeding events. Materials and methods: A systematic MEDLINE search was conducted for clinical studies in English or German language from 1994 to 2014 comparing patients treated with OAT, without OAT, as well as patients with altered OAT for oral surgery purposes. Relevant outcome parameters were: postoperative local hemostasis, bleeding episodes, occurrence of thromboembolic events, and other complications due to the anticoagulation medication. A hand search for references cited in the identified publications completed the review. Results: After screening of 1755 abstracts, 16 clinical studies were identified according to the selection criteria. Due to the heterogeneity of the obtained data, aggregation and synthesis were not possible. There was no significant difference in bleeding events comparing patients under continued OAT to those with reduced, altered, and/or discontinued OAT medications. Minor bleeding events in the test and control groups were successfully stopped with local measures. However, no superiority of a single hemostatic measure could be identified. Neither the international normalized ratio (INR), within the therapeutic range (2-4), nor the extent of the minor oral surgery procedure had an influence on postoperative bleeding episodes. Discussion: There is strong evidence that OAT patients undergoing minor oral surgery should not discontinue their medication in order to prevent thromboembolic complications. Clinical relevance: Nonetheless, INR should be less than 4, local hemostatic measures are of high importance and patients need to be instructed and closely monitored as minor bleedings might occur more often in OAT patients. [ABSTRACT FROM AUTHOR]

The alveolar bone provides structural support against compressive and tensile forces generated during mastication as well as during orthodontic treatment. To avoid abnormal alveolar bone resorption and tooth loss, a balanced bone turnover by bone-degrading osteoclasts and bone-generating osteoblasts is of great relevance. Unlike its contradictory role in regulating osteoclast and osteoblast cell differentiation, the TGF-β/BMP-family member GDF15 is well known for its important functions in the regulation of cell metabolism, as well as cell fate and survival in response to cellular stress. Here, we provide first evidence for a potential role of GDF15 in translating mechanical stimuli into cellular changes in immature osteoblasts. We detected enhanced levels of GDF15 in vivo in periodontal ligament cells after the simulation of tooth movement in rat model system as well as in vitro in mechanically stressed human periodontal ligament fibroblasts. Moreover, mechanical stimulation enhanced GDF15 secretion by periodontal ligament cells and the stimulation of human primary osteoblast with GDF15 in vitro resulted in an increased transcription of osteogenic marker genes like RUNX2, osteocalcin (OCN) and alkaline phosphatase (ALP). Together, the present data emphasize for the first time a potential function of GDF15 in regulating differentiation programs of immature osteoblasts according to mechanical stimulation. [ABSTRACT FROM AUTHOR]