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Hom-Lay Wang, DDS., MSD., Ph D, Professor and Director of Graduate Periodontics at the University of Michigan.He has co-editor two textbooks, published more than 50 book chapters/invited reviews and more than 750 peer-reviewed scientific articles. Dr. Wang serves as a Co-Editor-in-Chief for Clinical Implant Dentistry and Related Research, an Associate Editor for The IJOMI and IJOI.Dr. Wang is the recipient of many awards/honors including AAP Outstanding Educator Award (2017), AAP Distinguished Scientist Award (2017),AAP Master Clinician Award (2019), AAP Distinguished Service Award (2021), and AAP Clinical Research Award (2021).
2. Auflage 2024 Buch Hardcover; 21 x 28 cm, 836 Seiten, 1800 Abbildungen Sprache: Englisch Kategorien: Implantologie, Parodontologie Artikelnr.: 7735 ISBN 978-1-78698-147-9 QP Deutschland
22. Feb. 2024 — 26. Feb. 2024Kuala Lumpur Convention Centre, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
Referenten: Nuno Sousa Dias, Gustavo Giordani, Nazariy Mykhaylyuk, Hom-Lay Wang, Giovanni Zucchelli, Otto Zuhr
The 14th International Symposium on Periodontics and Restorative Dentistry (ISPRD)
9. Juni 2022 — 12. Juni 2022Boston Marriott Copley Place, Boston, MA, Vereinigte Staaten von Amerika
Referenten: Tara Aghaloo, Edward P. Allen, Evanthia Anadioti, Wael Att, Vinay Bhide, Markus Blatz, Scotty Bolding, Lorenzo Breschi, Jeff Brucia, Daniel Buser, Luigi Canullo, Daniele Cardaropoli, Stephen J. Chu, Donald Clem, Christian Coachman, Lyndon F. Cooper, Daniel Cullum, Lee Culp, Sergio De Paoli, Marco Degidi, Nicholas Dello Russo, Serge Dibart, Joseph P. Fiorellini, Mauro Fradeani, Stuart J. Froum, David Garber, Maria L. Geisinger, William Giannobile, Luca Gobbato, Ueli Grunder, Galip Gürel, Chad Gwaltney, Christoph Hämmerle, Robert A. Horowitz, Marc Hürzeler, David Kim, Gregg Kinzer, Christopher Köttgen, Ina Köttgen, Purnima S. Kumar, Burton Langer, Lydia Legg, Pascal Magne, Kenneth A. Malament, Jay Malmquist, George Mandelaris, José Carlos Martins da Rosa, Pamela K. McClain, Michael K. McGuire, Mauro Merli, Konrad H. Meyenberg, Craig M. Misch, Julie A. Mitchell, Marc L. Nevins, Myron Nevins, Michael G. Newman, Miguel A. Ortiz, Jacinthe M. Paquette, Stefano Parma-Benfenati, Michael A. Pikos, Giulio Rasperini, Pamela S. Ray, Christopher R. Richardson, Isabella Rocchietta, Marisa Roncati, Marco Ronda, Paul S. Rosen, Maria Emanuel Ryan, Irena Sailer, Maurice Salama, David M. Sarver, Takeshi Sasaki, Todd Scheyer, Massimo Simion, Michael Sonick, Sergio Spinato, Dennis P. Tarnow, Lorenzo Tavelli, Douglas A. Terry, Tiziano Testori, Carlo Tinti, Istvan Urban, Hom-Lay Wang, Robert Winter, Giovanni Zucchelli
Quintessence Publishing Co., Inc. USA
Zeitschriftenbeiträge dieses Autors
International Journal of Periodontics & Restorative Dentistry, Pre-Print
DOI: 10.11607/prd.6568, PubMed-ID: 375521878. Aug. 2023,Seiten: 1-18, Sprache: EnglischWen, Shih-Cheng / Saleh, Muhammad / Alrmali, Abdusalam / Wu, David T / Wang, Hom-Lay
Despite the various barrier membranes proposed, one of the main challenges for guided bone regeneration (GBR) is space maintenance for large defects as well as ensure adequate blood supply. The presented feasibility case series aims to introduce an original titanium frame (TF) design, customized for each defect, as a modification of well-known principles and materials for GBR, for an enhanced and more predictable horizontal and vertical bone augmentation. Three patients with significant horizontal defects were treated with pre-trimmed TFs to create needed space, a 50%-50% mixture of autograft and bovine xenograft was placed, and then covered with collagen membrane. After 8 months of healing, the sites were reopened, the titanium screws were removed with the frame. An average of 8.0 ± 1.0mm horizontal and 3.0 ± 0.0mm vertical bone gain was achieved at the time of re-entry and implant placement surgery. Bone core biopsy was obtained during the implant placement. Histomorphometric analysis revealed that 42.8% of the sample was new vital bone, 18.8% was residual bone graft particles, and 38.4% was bone marrow like structures. After 3-4 months from implant placement, the implants were restored with provisional crowns and then finalized with zirconia screw-retained crowns. This case series suggests that GBR utilizing TFs with or without collagen membranes can be considered a suitable approach for horizontal and vertical bone augmentation. However, based on only three reported cases, the result should be carefully interpreted.
Peri-implantitis, a common complication among patients receiving implant-supported restorative
therapy, often requires surgical intervention for effective treatment. Understanding the specific
configuration of peri-implant bony defect and adjacent bone peaks is crucial for tailoring treatment
strategies and improving outcomes. A decision tree for reconstructive peri-implantitis therapy has been
developed based on the new classification of defect configurations (Class I to V), guiding clinicians in
selecting treatment options, including biomaterials, techniques, and healing approaches. Furthermore,
clinicians are encouraged to consider various factors such as local predisposing factors (such as soft
tissue characteristics, prosthetic design, and implant position in three-dimensional perspective), clinical
factors (surgeon skill and experience), and patient-related factors (such as local and systemic health,
preferences, and cost) when evaluating reconstructive therapy options.
Schlagwörter: bone regeneration, dental implants, peri-implant defect, peri-implantitis, reconstructive therapy
Successful bone augmentation relies on primary wound closure. Labial frenum is a soft tissue that connects the lip to alveolar mucosa or gingiva. However, frenum may exert biomechanical forces to the wound edge, causing wound instability. The aim of this study is to (1) review the frenum composition and classifications; (2) understand the significance of frenum in wound stability upon bone regeneration. An electronic search was conducted through the three online databases together with manual search on studies published until September 2022. A total of 300 articles were identified and 11 studies were included in this review. Two of the included six studies discovered that 35-37.5% of the labial frenum had muscle fibers. Other studies showed that labial frenum was mainly composed of connective tissue with elastic fibers. There are two widely used classifications for frenum based on morphology and position of attachment. No studies specifically evaluated the impact of frenum on bone regeneration. Frenum location intercorrelated with the amount of keratinized tissue, which could influence wound stability. A modified frenum classification for the edentulous ridge and a decision diagram to manage the frenum is proposed for research and evidenced practice.
Implants with deficient papillae and black triangle are common findings. The treatment of these esthetic complications is considered challenging, and with limited predictability. Therefore, the aim of the present report is to describe a novel technique for papilla augmentation (the "Iceberg" connective tissue graft [iCTG]) after extraction and interproximal bone reconstruction in the anterior region. A 35-year-old patient presented with a hopeless tooth with interproximal clinical attachment loss extending up the apical third of the adjacent tooth. Interproximal bone reconstruction was performed through alveolar ridge preservation by directly applying recombinant human platelet-derived growth factor-BB (rhPDGF-BB) to the exposed root surface of the adjacent tooth. A mixture of autogenous bone chips (obtained from the ramus) and bovine bone xenograft particles, previously mixed with the growth factor, was also used. The patient was able to come back for implant therapy only 2 years later. An incomplete regeneration of the interproximal bone was observed. Therefore, to compensate the interproximal deficiency, the iCTG approach, involving a double layer CTG with different origins, was utilized. Two small grafts from the tuberosity were sutured to the mesial and distal ends of a wider CTG harvested from the palate, aiming at gaining additional volume at the interproximal sites. The composite graft was then sutured on top of the implant platform, with the flap that was then released and closed by primary intention. After conditioning of the peri-implant tissues, the case was finalized with a satisfactory outcome. The described iCTG could be an effective approach for reconstructing peri-implant papilla following interproximal bone reconstruction.
Background: Multiple adjacent gingival recessions (MAGRs) are commonly treated with autogenous grafts. However, several intra- and post-surgical complications have been described following autogenous grafts, leading clinicians to explore the use of different biomaterials for the treatment of these conditions. The aim of the present study was to evaluate the root coverage outcomes of a novel porcine-derived acellular dermal matrix (PADM) in combination with the tunneled coronally advanced flap (TCAF) for the treatment of MAGRs.
Methods: Ten patients with 33 type 1 recession defects (RT1) were treated with PADM, in combination with the tunneled coronally advanced flap (TCAF). The outcomes of interest included the mean root coverage (mRC), the frequency of complete root coverage (CRC), changes in keratinized tissue width, volumetric gain at the treated sites assessed with digital intraoral scanning, as well as patient-reported outcome measures.
Results: All treated sites healed uneventfully, and no complications were noted throughout the study. At 6 months, a statistically significant reduction in recession was noted at the treated sites, exhibiting an overall mRC of 89.14 ± 19.15% and a CRC of 72.7%. The average volume gain after 6 months was 26.28 ± 11.71 in mm3 (Vol) and 0.63 ± 0.28 in mm (ΔD). The region-specific volumetric analysis revealed an overall higher linear dimensional gain at the Mid-Root aspect (ranging from 0.72 mm to 0.78 mm when assessed 1-4 mm apical to the cemento-enamel junction) compared to the other regions.
Conclusions: The present study presents the clinical and volumetric outcomes of PADM, in combination with TCAF for the treatment of MAGRs. A significant amount of volumetric gain was also observed as a result of the treatment at 6 months, along with satisfactory, esthetic and patient-reported outcomes.
Schlagwörter: Gingival recession, Acellular Dermal Matrix, Surgical flap, volumetric analysis, optical scanning
Robotic systems have revolutionized various industries, and dentistry is no exception. Recently, due to the robust advancements in artificial intelligence and technology, there has been a significant evolution of dental robotic systems, ranging from surgeon controlled, robot-assisted operations, to more autonomous processes. The present clinical case report describes a 1-year follow-up of the successful use of an autonomous dental implant robot system with an osseodensification (OD) protocol for implant osteotomy preparation, maxillary sinus elevation, and simultaneous implant placement at the maxillary second premolar site. A prefabricated provisional prosthesis was delivered immediately after implant placement, with final prosthesis delivery at 3 months. The findings from this report demonstrate the integration and clinical augmentation of more autonomous protocols in the field of implant dentistry using dental robots.
Schlagwörter: Robotics surgery, Osseodensification, Maxillary sinus, Dental implant, Case report
Purpose: The objective of this systematic review and meta-analysis was to examine the impact of
titanium base supported single implant restorations on peri-implant conditions. Materials and
Methods: Six randomized controlled trials (RCTs), comprising a total of 274 implants that met the
inclusion criteria, were chosen for data analysis. A random effects model was employed for the metaanalysis.
Results: Data from this study revealed that the Ti-base group exhibited a slightly but
statistically significant increase in peri-implant marginal bone loss (difference in means = 0.088, 95%
confidence interval = 0.003 to 0.17, p = 0.041) compared to the one-piece-abutment group. These
effects were consistent in the subgroup analysis of regular-threaded implants comparing to the microthreaded
subgroup. However, no significant differences were observed between the Ti-base group and
the abutment group concerning probing depth (PD), bleeding on probing (BOP), and the risk of
prosthetic-related complications. Conclusions: The utilization of Ti-base in single-implant supported
restoration is associated with a slight increase in peri-implant marginal bone loss, while other periimplant
health parameters show no significant correlation. Therefore, to determine the impact of Tibase
on peri-implant condition of single implant-supported restoration is insufficient based on the
findings of this meta-analysis.
Successful bone augmentation relies on primary wound closure. The labial frenum is a soft tissue that connects the lip to the alveolar mucosa or gingiva. However, the frenum may exert biomechanical forces to the wound edge, causing wound instability. The aim of this study is to review the frenum composition and classifications and to understand the significance of the frenum in wound stability upon bone regeneration. Together with a manual search, an electronic search was conducted through three online databases on studies published until September 2022. A total of 300 articles were identified, and 9 studies were included in this review. Two of the included studies discovered that 35% to 37.5% of the labial frenum had muscle fibers. Other studies showed that the labial frenum was mainly composed of connective tissue with elastic fibers. There are two widely used classifications for the frenum based on its morphology and attachment position. No studies specifically evaluated the impact of the frenum on bone regeneration, but the frenum location intercorrelated with the amount of keratinized tissue, which could influence wound stability. A modified frenum classification for the edentulous ridge and a decision diagram to manage the frenum is proposed for research and evidence-based practice.
Despite the various treatments proposed with barrier membranes, one of the main challenges for guided bone regeneration (GBR) is maintaining space for large defects and ensuring an adequate blood supply. The presented feasibility case series aims to introduce an original titanium frame (TF) design, customized for each defect, as a modification of well-known principles and materials for GBR to achieve an enhanced and more predictable horizontal and vertical bone augmentation. Three patients with significant horizontal defects were treated with pre-trimmed TFs to create needed space, and then a 50/50 mixture of autograft and bovine xenograft was placed and covered with a collagen membrane. After 8 months of healing, the sites were reopened, and the titanium screws were removed with the frame. An average of 8.0 ± 1.0 mm of horizontal and 3.0 ± 0.0 mm of vertical bone gain were achieved at the time of reentry and implant placement surgery. Bone core biopsy sample was obtained during the implant placement. Histomorphometric analysis revealed that 42.8% of the sample was new vital bone, 18.8% was residual bone graft particles, and 38.4% was bone marrow–like structures. After 3 to 4 months from implant placement, the implants were restored with provisional crowns and then finalized with zirconia screw-retained crowns. This case series suggests that GBR utilizing TFs with or without collagen membranes can be considered a suitable approach for horizontal and vertical bone augmentation. However, based on only three reported cases, the results should be carefully interpreted.
Purpose: To provide an overview of the outcomes of the use of autogenous platelet concentrates in immediate implant placement.
Materials and methods: Based on an a priori protocol, a systematic search was performed of the National Library of Medicine (MEDLINE via PubMed), Embase and Scopus databases. Randomised and non-randomised controlled clinical trials on immediate implant placement including at least one study arm with use of platelet-rich fibrin or platelet-rich plasma as a gap filler between immediately placed implants and the alveolar bone were included. A random-effects meta-analysis model was built to assess the primary outcomes of marginal bone loss and probing pocket depths between test (platelet concentrates) and control (no graft or other graft materials) groups. A risk of bias assessment was performed and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence.
Results: A total of 20 trials (595 immediate implants placed in 454 individuals) were included in the meta-analytic model. Based on the data from studies with a minimum post–prosthetic loading period of 6 months after immediate implant placement, overall, the application of platelet concentrates was associated with significantly lower marginal bone loss and probing pocket depth compared to the control groups (mean difference −0.36 mm; P < 0.01 and mean difference −0.47 mm; P < 0.01, respectively). No additional benefit of application of platelet concentrates was detected regarding primary stability of immediate implants. Subgroup analysis revealed significantly lower marginal bone loss with xenogeneic bone alone compared to platelet concentrates alone as grafting material in immediate implant placement (mean difference 0.66 mm; P < 0.01). Evidence on soft tissue outcomes and aesthetic parameters was scarce.
Conclusions: A low level of certainty based on the Grading of Recommendations Assessment, Development and Evaluation approach indicates superior outcomes in terms of marginal bone loss and probing pocket depth in immediate implant placement with the use of platelet concentrates versus no graft. Future research should be tailored towards a standardised protocol for preparation of platelet concentrates and inclusion of soft tissue and aesthetic outcomes as well.
Schlagwörter: dental implants, immediate implants, platelet concentrates, platelet-rich fibrin, platelet-rich plasma
The authors report no conflicts of interest relating to this study.