73 results on '"Péter Windisch"'
Search Results
2. Virtual planning and volumetric evaluation in the regenerative-reconstructive surgical treatment of a complex periodontal defect
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Eleonóra Sólyom, Dániel Palkovics, Csaba Pintér, Francesco Guido Mangano, and Péter Windisch
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virtual surgical planning ,regenerative-reconstructive periodontal surgery ,alveolar ridge preservation ,volumetric evaluation cbct ,segmentation ,3d radiographic image reconstruction ,Dentistry ,RK1-715 - Abstract
Aim: Our aim was to present the regenerative-reconstructive surgical treatment of a complex periodontal defect. Surgical treatment planning was carried out on realistic virtual hybrid models, containing all relevant anatomical structures (teeth, alveolar bone and gingiva). Additional aim was to evaluate the outcome of the surgical treatment, by the superimposition of pre- and postoperative cone-beam computed tomography (CBCT) scans. Materials and methods: Utilizing a semi-automatic segmentation method, the 3D model of teeth and alveolar bone was generated from the CBCT scan using the open source radiographic image processing software, 3D Slicer. Spatial registration of the hard tissue model acquired from the CBCT scan and the digital model acquired with an intraoral scanner was performed based on anatomical landmarks. First step of the planned stepwise surgical treatment was the extraction and simultaneous alveolar ridge preservation of tooth 26. Surgery was carried out according to the extraction site development (XSD) technique. Second step was the regenerative treatment of the horizonto-vertical periodontal defect involving tooth 24 and 25. Superimposition of the pre- and postoperative CBCT scans allowed to validate the volumetric and linear changes. Results: In the surgical area the cumulative hard tissue gain was 0.44 cm3. Crestal bone resorption of 0.11 cm3 occurred at the palatal and buccal aspects. Linear measurements were performed to evaluate the hard tissue fill of the periodontal defect around tooth 24 and 26. On average the intrabony component showed a 53.88 ± 36.84% of hard tissue fill, with minor crestal bone resorption. On average a 1.22 ± 0.87 mm of gingival recession occurred around the teeth. Conclusion: It can be concluded that hybrid models acquired with the aforementioned technique allowed detailed planning of the surgical procedures. With the application of the postoperative volumetric and linear evaluation, the healing dynamics of the complex defect could be demonstrated thoroughly.
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- 2021
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3. Volumetric Changes of a Customized Allogeneic Bone Block Measured by Two Image Matching Tools: Introduction of a Novel Assessment Technique for Graft Resorption
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Oliver Blume, Phil Donkiewicz, Daniel Palkovics, Werner Götz, and Péter Windisch
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MeSH terms: Bone Transplantation ,Allografts ,Bone Substitutes Author keywords: Allogeneic Bone Graft ,Bone Block ,Graft Resorption ,Biomaterials ,Dentistry ,RK1-715 - Abstract
Objective: The purpose of this case report was to present a method for the assessment of volumetric changes of bone blocks during healing and demonstrate its practicability by analysing the resorption of a preshaped allogeneic bone block used for the reconstruction of a complex maxillary defect. Materials and methods: CBCT-scans of a 19-year-old male treated with an allogeneic bone block were recorded pre-OP, post-OP, and following six months of healing. Graft shrinkage was assessed via two image matching tools, namely coDiagnostiX® and Slicer. A biopsy specimen was harvested along the implant canal at the time of implantation. Results: The osseous defect was successfully restored and advanced graft remodelling was found upon re-entry as confirmed by the histomorphometric and histologic analysis. The initial volumes of the graft determined via coDiagnostiX® and Slicer were 0.373 mL and 0.370 mL., respectively, while graft resorption after six months of healing was 0.011 mL (3.00%) and 0.016 mL (4.33%). Conclusions: The avoidance of bone harvesting and reduction of invasiveness display an important issue in dentoalveolar restorations. However, before grafting materials can be considered a safe alternative, understanding their clinical performance, especially resorption stability, is pivotal. The present case report demonstrates a limited resorption of the allogeneic bone block and further emphasizes the practicability of determining bone resorption by the here introduced method. As our investigation comprises solely one subject, the results should be considered with care and substantiated by further studies.
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- 2021
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4. A customized allogenic bone block for alveolar reconstruction quantitated by a 3D matching technique: A case report
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Oliver Blume, Michael Back, Kim Martin, and Péter Windisch
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3D matching ,allograft ,alveolar ridge augmentation ,CAD/CAM ,maxillary reconstruction ,volume rendering ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract After initial resorption, the bone volume showed long‐term stability following loading of the implant. Furthermore, 3D matching was a suitable quantification method to analyze the volume development of bone augmentation.
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- 2021
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5. Biodegradable magnesium fixation screw for barrier membranes used in guided bone regeneration
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Akiva Elad, Bernhard Hesse, Patrick Rider, Fabien Bornert, Bálint Molnár, Emely L. Bortel, Till Kämmerer, Marco Bartosch, Daniel Rothamel, Dávid Botond Hangyási, Željka Perić Kačarević, Péter Windisch, Gerrit Sauer, Drazen Tadic, and Frank Witte
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musculoskeletal diseases ,Materials science ,Biocompatibility ,Magnesium ,Biomedical Engineering ,chemistry.chemical_element ,equipment and supplies ,musculoskeletal system ,Biocompatible material ,Biomaterials ,Fixation (surgical) ,Membrane ,Biodegradable magnesium ,chemistry ,Biodegradable ,Implant ,GBR ,Bone healing ,Soft tissue healing ,Magnesium alloy ,Bone regeneration ,Biotechnology ,Biomedical engineering - Abstract
An ideal fixation system for guided bone (GBR) regeneration in oral surgery must fulfil several criteria that includes the provision of adequate mechanical fixation, complete resorption when no longer needed, complete replacement by bone, as well as be biocompatible and have a good clinical manageability. For the first time, a biodegradable magnesium fixation screw made of the magnesium alloy WZM211 with a MgF2 coating has been designed and tested to fulfill these criteria. Adequate mechanical fixation was shown for the magnesium fixation screw in several benchtop tests that directly compared the magnesium fixation screw with an equivalent polymeric resorbable device. Results demonstrated slightly superior mechanical properties of the magnesium device in comparison to the polymeric device even after 4 weeks of degradation. Biocompatibility of the magnesium fixation screw was demonstrated in several in vitro and in vivo tests. Degradation of the magnesium screw was investigated in in vitro and in vivo tests, where it was found that the screw is resorbed slowly and completely after 52 weeks, providing adequate fixation in the early critical healing phase. Overall, the magnesium fixation screw demonstrates all of the key properties required for an ideal fixation screw of membranes used in guided bone regeneration (GBR) surgeries.
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- 2022
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6. Comparative analysis of lateral maxillary sinus augmentation with a xenogeneic bone substitute material in combination with piezosurgical preparation and bony wall repositioning or rotary instrumentation and membrane coverage: a prospective randomized clinical and histological study
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Bálint, Molnár, Anne-Kathrin, Jung, Zsuzsanna, Papp, Anna, Martin, Kristóf, Orbán, Annica, Pröhl, Ole, Jung, Mike, Barbeck, and Péter, Windisch
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Bone Regeneration ,Transverse Sinuses ,Bone Substitutes ,Dental Implantation, Endosseous ,Maxilla ,Humans ,Sinus Floor Augmentation ,Collagen ,Prospective Studies ,Maxillary Sinus ,General Dentistry - Abstract
Objectives The present randomized controlled clinical study aimed to investigate if, in lateral maxillary sinus augmentation, the repositioned bony wall or the application of a collagen membrane results in more preferable new hard tissue formation. Materials and methods Forty patients were divided into two study groups. Both groups received a xenogeneic bone substitute material (BSM) during lateral sinus augmentation. In the bony wall group (BW), following piezosurgery, the retrieved bony wall was repositioned. In the collagen membrane group (CM), following rotary instrument preparation, collagen membrane coverage was applied. After 6 months, biopsies were taken to histologically analyze the percentage of BSM, connective tissue (CT), and newly formed bone (NFB) following both approaches. Results Forty implants were placed and 29 harvested biopsies could be evaluated. Duration of surgery, membrane perforations, and VAS were detected. Histomorphometrical analysis revealed comparable amounts of all analyzed parameters in both groups in descending order: CT (BW: 39.2 ± 9%, CM: 37,9 ± 8.5%) > BSM (BW: 32.9 ± 6.3%, CM: 31.8 ± 8.8%) > NB (BW: 27.8 ± 11.2%, CM: 30.3 ± 4.5%). Conclusions The results of the present study show that the closure of the access window by means of the retrieved bony wall or a native collagen membrane led to comparable bone augmentation results. Clinical trial clinicaltrials.gov NCT04811768. Clinical relevance Lateral maxillary sinus augmentation with the application of a xenogeneic BSM in combination with a native collagen membrane for bony window coverage represents a reliable method for surgical reconstruction of the posterior maxilla. Piezosurgery with bony window repositioning delivers comparable outcomes without membrane coverage.
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- 2022
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7. Virtuális tervezés és volumetrikus kiértékelés egy komplex parodontális defektus regeneratív-rekonstruktív sebészi ellátásában
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Csaba Pinter, Péter Windisch, Eleonóra Sólyom, Francesco Mangano, and Daniel Palkovics
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Orthodontics ,Crestal bone ,business.industry ,Radiography ,Anatomical structures ,General Medicine ,Resorption ,stomatognathic system ,Alveolar ridge ,Medicine ,Superimposition ,medicine.symptom ,business ,Gingival recession ,Dental alveolus - Abstract
Aim: Our aim was to present the regenerative-reconstructive surgical treatment of a complex periodontal defect. Surgicaltreatment planning was carried out on realistic virtual hybrid models, containing all relevant anatomical structures (teeth,alveolar bone and gingiva). Additional aim was to evaluate the outcome of the surgical treatment, by the superimpositionof pre- and postoperative cone-beam computed tomography (CBCT) scans.Materials and methods: Utilizing a semi-automatic segmentation method, the 3D model of teeth and alveolar bonewas generated from the CBCT scan using the open source radiographic image processing software, 3D Slicer. Spatialregistration of the hard tissue model acquired from the CBCT scan and the digital model acquired with an intraoralscanner was performed based on anatomical landmarks. First step of the planned stepwise surgical treatment was theextraction and simultaneous alveolar ridge preservation of tooth 26. Surgery was carried out according to the extractionsite development (XSD) technique. Second step was the regenerative treatment of the horizonto-vertical periodontal defectinvolving tooth 24 and 25. Superimposition of the pre- and postoperative CBCT scans allowed to validate the volumetricand linear changes.Results: In the surgical area the cumulative hard tissue gain was 0.44 cm3. Crestal bone resorption of 0.11 cm3 occurredat the palatal and buccal aspects. Linear measurements were performed to evaluate the hard tissue fill of the periodontaldefect around tooth 24 and 26. On average the intrabony component showed a 53.88 ± 36.84% of hard tissuefill, with minor crestal bone resorption. On average a 1.22 ± 0.87 mm of gingival recession occurred around the teeth.Conclusion: It can be concluded that hybrid models acquired with the aforementioned technique allowed detailed planningof the surgical procedures. With the application of the postoperative volumetric and linear evaluation, the healingdynamics of the complex defect could be demonstrated thoroughly.
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- 2021
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8. The role of surgical flap design (minimally invasive flap vs. extended flap with papilla preservation) on the healing of intrabony defects treated with an enamel matrix derivative: a 12-month two-center randomized controlled clinical trial
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Vincenzo Iorio-Siciliano, Daniel Palkovics, Péter Windisch, Andrea Blasi, Anton Sculean, Luca Ramaglia, Windisch, P, Iorio-Siciliano, V, Palkovics, D, Ramaglia, L, Blasi, A, and Sculean, A.
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medicine.medical_specialty ,Test group ,Alveolar Bone Loss ,610 Medicine & health ,Surgical Flaps ,law.invention ,Dental Enamel Proteins ,Randomized controlled trial ,law ,Periodontal Attachment Loss ,Enamel matrix derivative ,medicine ,Humans ,Gingival Recession ,General Dentistry ,Gingival recession ,Wound Healing ,business.industry ,Significant difference ,Surgery ,Major duodenal papilla ,Clinical trial ,Treatment Outcome ,Guided Tissue Regeneration, Periodontal ,medicine.symptom ,business ,Follow-Up Studies - Abstract
Objectives Minimally invasive flap designs have been introduced to enhance blood clot stability and support wound healing. Limited data appear to suggest, that in intrabony defects, better clinical outcomes can be achieved by means of minimally invasive flap compared to more extended flaps. The aim of this study was to evaluate the healing of intrabony defects treated with either minimally invasive surgical flaps or with modified or simplified papilla preservation techniques in conjunction with the application of an enamel matrix derivative (EMD). Materials and methods Forty-seven subjects were randomly assigned to either test (N = 23) or control (N = 24) procedures. In the test group, the intrabony defects were accessed by means of either minimally invasive surgical technique (MIST) or modified minimally invasive surgical technique (M-MIST) according to the defect localization while the defects in the control group were treated with either the modified or simplified papilla preservation (MPP) or the simplified papilla preservation technique (SPP). EMD was used as regenerative material in all defects. The following clinical parameters were recorded at baseline and after 12 months: full-mouth plaque score (FMPS), full-mouth bleeding score (FMBS), probing depths (PD), clinical attachment level (CAL), and gingival recession (GR). Early healing index (EHI) score was assessed in both groups 1 week following the surgery. CAL gain was set as primary outcome. Results After 12 months follow-up, the CAL gain was 4.09 ± 1.68 mm in test group and 3.79 ± 1.67 mm in control group, while the PD reduction was 4.52 ± 1.34 mm and 4.04 ± 1.62 mm for test and control sites. In both groups, a minimal GR increase (0.35 ± 1.11 mm and 0.25 ± 1.03 mm) was noted. No residual PDs ≥ 6 mm were recorded in both groups. CAL gains of 4–5 mm were achieved in 30.4% and in 29.2% of test and control group, respectively. Moreover, CAL gains ≥ 6 mm were recorded in 21.7% of experimental sites and in 20.8% of control sites. No statistically significant differences in any of the evaluated parameters were found between the test and control procedures (P > 0.05). After 1 week post-surgery, a statistically significant difference (P Conclusions Within the limits of this pilot RCT, the results have failed to show any differences in the measured parameters following treatment of intrabony defects with EMD, irrespective of the employed surgical technique. Clinical relevance In intrabony defects, the application of EMD in conjunction with either MIST/M-MIST or M-PPT/SPPT resulted in substantial clinical improvements.
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- 2021
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9. Changes in soft tissue dimensions following horizontal guided bone regeneration with a split-thickness flap design – evaluation of 8 cases with a digital method
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Kristof Somodi, Andrea Dobos, Ferenc Bartha, Eleonora Solyom, Peter Windisch, Daniel Palkovics, and Balint Molnar
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Soft tissue alterations ,Horizontal ridge augmentation ,Split-thickness flap ,Intraoral scan ,CBCT analysis ,Specialties of internal medicine ,RC581-951 - Abstract
Abstract Background Peri-implant soft tissue corrections are often indicated following alveolar ridge augmentation, due to the distortion of the keratinized mucosa at the area of augmentation. The objective of the current study was to evaluate the dimensional soft tissue changes following horizontal guided bone regeneration (GBR) utilizing 3D digital data. Methods 8 mandibular surgical sites with horizontal alveolar ridge deficiencies were treated utilizing a resorbable collagen membrane and a split-thickness flap design. Baseline and 6-month follow-up cone-beam computed tomography (CBCT) scans were reconstructed as 3D virtual models and were superimposed with the corresponding intraoral scan. Linear changes of supracrestal vertical- horizontal soft tissue alterations were measured in relation to the alveolar crest at the mesial- middle- and distal aspect of the surgical area. Soft tissue dimensions were measured at baseline and at 6-month follow-up. Results Preoperative supracrestal soft tissue height measured midcrestally averaged at 2.37 mm ± 0.68 mm, 2.37 mm ± 0.71 mm and 2.64 mm ± 0.87 mm at the mesial-, middle- and distal planes. Whereas postoperative supracrestal soft tissue height was measured at 2.62 mm ± 0.72 mm, 2.67 mm ± 0.67 mm and 3.69 mm ± 1.02 mm at the mesial, middle and distal planes, respectively. Supracrestal soft tissue width changed from 2.14 mm ± 0.72 mm to 2.47 mm ± 0.46 mm at the mesial, from 1.72 mm ± 0.44 mm to 2.07 mm ± 0.67 mm and from 2.15 mm ± 0.36 mm to 2.36 mm ± 0.59 mm at the mesial, middle and distal planes, respectively. Additionally the buccal horizontal displacement of supracrestal soft tissues could be observed. Conclusions The current study did not report significant supracrestal soft tissue reduction following horizontal GBR with a split-thickness flap. Even though there was a slight increase in both vertical and horizontal dimensions, differences are clinically negligible. Trail registration The trail was approved by the U.S. National Library of Medicine ( www.clinicaltrials.gov ); trial registration number: NCT05538715; registration date: 09/09/2022.
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- 2024
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10. Biodegradable magnesium barrier membrane used for guided bone regeneration in dental surgery
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Dávid Botond Hangyási, Akiva Elad, Fabien Bornert, Gerrit Sauer, Péter Windisch, Bernhard Hesse, Patrick Rider, Bálint Molnár, Emely L. Bortel, Daniel Rothamel, Željka Perić Kačarević, Drazen Tadic, Frank Witte, Nanomédecine Régénérative (NanoRegMed), and Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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0303 health sciences ,[SDV.BIO]Life Sciences [q-bio]/Biotechnology ,Barrier membrane ,Chemistry ,Magnesium ,Biomedical Engineering ,chemistry.chemical_element ,Soft tissue ,Sciences du Vivant [q-bio]/Biotechnologies ,030206 dentistry ,Resorption ,Biomaterials ,03 medical and health sciences ,0302 clinical medicine ,Membrane ,Biodegradable ,Implant ,GBR ,Bone healing ,Soft tissue healing ,Bone regeneration ,Barrier function ,030304 developmental biology ,Biotechnology ,Biomedical engineering ,Titanium - Abstract
Barrier membranes are commonly used as part of the dental surgical technique guided bone regeneration (GBR) and are often made of resorbable collagen or non-resorbable materials such as PTFE. While collagen membranes do not provide sufficient mechanical protection of the covered bone defect, titanium reinforced membranes and non-resorbable membranes need to be removed in a second surgery. Thus, biodegradable GBR membranes made of pure magnesium might be an alternative. In this study a biodegradable pure magnesium (99.95%) membrane has been proven to have all of the necessary requirements for an optimal regenerative outcome from both a mechanical and biological perspective. After implantation, the magnesium membrane separates the regenerating bone from the overlying, faster proliferating soft tissue. During the initial healing period, the membrane maintained a barrier function and space provision, whilst retaining the positioning of the bone graft material within the defect space. As the magnesium metal corroded, it formed a salty corrosion layer and local gas cavities, both of which extended the functional lifespan of the membrane barrier capabilities. During the resorption of the magnesium metal and magnesium salts, it was observed that the membrane became surrounded and then replaced by new bone. After the membrane had completely resorbed, only healthy tissue remained. The in vivo performance study demonstrated that the magnesium membrane has a comparable healing response and tissue regeneration to that of a resorbable collagen membrane. Overall, the magnesium membrane demonstrated all of the ideal qualities for a barrier membrane used in GBR treatment.
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- 2021
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11. Digital Hybrid Model Preparation for Virtual Planning of Reconstructive Dentoalveolar Surgical Procedures
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Eleonóra Sólyom, Daniel Palkovics, Bálint Molnár, Péter Windisch, and Csaba Pinter
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Orthodontics ,General Immunology and Microbiology ,business.industry ,Computer science ,General Chemical Engineering ,General Neuroscience ,Radiography ,Soft tissue ,Image segmentation ,Cone-Beam Computed Tomography ,Ridge (differential geometry) ,General Biochemistry, Genetics and Molecular Biology ,Imaging, Three-Dimensional ,Alveolar ridge ,Superimposition ,Segmentation ,business ,Dental alveolus - Abstract
Virtual, hybrid three-dimensional (3D) model acquisition is presented in this article, utilizing the sequence of radiographic image segmentation, spatial registration, and free-form surface modeling. Firstly cone-beam computed tomography datasets were reconstructed with a semi-automatic segmentation method. Alveolar bone and teeth are separated into different segments, allowing 3D morphology, and localization of periodontal intrabony defects to be assessed. The severity, extent, and morphology of acute and chronic alveolar ridge defects are validated concerning adjacent teeth. On virtual complex tissue models, positions of dental implants can be planned in 3D. Utilizing spatial registration of IOS and CBCT data and subsequent free-form surface modeling, realistic 3D hybrid models can be acquired, visualizing alveolar bone, teeth, and soft tissues. With the superimposition of IOS and CBCT soft tissue, thickness above the edentulous ridge can be assessed about the underlying bone dimensions; therefore, flap design and surgical flap management can be determined, and occasional complications may be avoided.
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- 2021
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12. Blood flow kinetics of a xenogeneic collagen matrix following a vestibuloplasty procedure in the human gingiva—An explorative study
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Eszter Molnár, Georgina Michailovits, Orsolya Láng, Bernadett Gánti, János Vág, Péter Windisch, Bálint Molnár, Réka Fazekas, and László Kőhidai
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Adult ,Pathology ,medicine.medical_specialty ,Adolescent ,Angiogenesis ,Gingiva ,Ischemia ,Mandible ,Surgical Flaps ,Neovascularization ,Young Adult ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine ,Humans ,Prospective Studies ,Vestibuloplasty ,General Dentistry ,Wound Healing ,business.industry ,Membranes, Artificial ,030206 dentistry ,Blood flow ,Middle Aged ,medicine.disease ,Vascular endothelial growth factor ,Kinetics ,Treatment Outcome ,Otorhinolaryngology ,chemistry ,030220 oncology & carcinogenesis ,Coronal plane ,Heterografts ,Keratins ,Collagen ,medicine.symptom ,business ,Perfusion - Abstract
Objectives The aim of the present study was to investigate temporal and spatial blood flow patterns following vestibuloplasty procedures using a collagen matrix (CM) to get an insight into the timing and direction of neovascularization in the CM. Methods Five patients were treated using a modified apically repositioned flap combined with a CM. Intraoral photographs and blood flow measurements by laser speckle contrast imaging were taken for 12 months. Thirty regions of interest in the graft and the surrounding mucosa were evaluated. The clinical parameters were assessed after 6 and 12 months. VEGF expression was analyzed in the wound fluid on days 2 and 4. Results At 6 months, the mean width of keratinized gingiva increased, but the thickness was unchanged. Scar formation was observed in all cases. Perfusion in the graft began to increase at the lateral and coronal edges and then spread concentrically toward the center. The apical side showed a significant delay in perfusion, the highest VEGF expression, and wound fluid production as well as the most abundant scar formation. Conclusions Neovascularization occurs mainly from the lateral and coronal edges, which may limit the extent of the surgical area. Abundant scar formation may be explained by increased VEGF expression induced by prolonged ischemia in this area.
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- 2019
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13. Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series
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Kristof Orban, Anton Sculean, Péter Windisch, Giovanni E. Salvi, and Bálint Molnár
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Guided bone regeneration ,Reconstructive surgery ,medicine.medical_specialty ,Bone Regeneration ,Radiography ,610 Medicine & health ,Non-resorbable membrane ,Split-thickness flap ,chemistry.chemical_compound ,Alveolar ridge ,Animals ,Humans ,Medicine ,Prospective Studies ,Bone regeneration ,Polytetrafluoroethylene ,General Dentistry ,Dental alveolus ,Dental Implants ,Titanium ,Orthodontics ,Periosteum ,Bone Transplantation ,business.industry ,Xenograft ,Dental Implantation, Endosseous ,Membranes, Artificial ,Alveolar Ridge Augmentation ,Vertical augmentation ,Implant placement ,medicine.anatomical_structure ,chemistry ,Guided Tissue Regeneration, Periodontal ,Autogenous bone ,Cattle ,Original Article ,business ,Wound healing - Abstract
Objectives To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing. Materials and methods Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination. Results Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3. Conclusion Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction. Clinical relevance The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure.
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- 2021
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14. Accuracy of half-guided implant placement with machine-driven or manual insertion: a prospective, randomized clinical study
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Endre Varga, Gábor Braunitzer, Kristof Orban, Bálint Molnár, and Péter Windisch
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Machine-driven implant insertion ,Cone beam computed tomography ,Torque wrench ,Manual insertion ,Clinical study ,Insertion time ,Intraoral digital scan ,Maxilla ,Medicine ,Humans ,Prospective Studies ,General Dentistry ,Accuracy ,Orthodontics ,Dental Implants ,business.industry ,Dental Implantation, Endosseous ,Guided surgery ,Cone-Beam Computed Tomography ,Manual implant insertion ,Implant placement ,Surgery, Computer-Assisted ,Coronal plane ,Original Article ,Implant ,business - Abstract
Objectives To compare the accuracy of implant placement performed with either a surgical motor or a torque wrench as part of a half-guided surgical protocol. Materials and methods Implant insertion with half-guided surgical protocol was utilized by surgical motor (machine-driven group) or torque wrench (manual group) in the posterior maxilla. After the healing period, accuracy comparison between planned and actual implant positions was performed based on preoperative cone beam computed tomography and postoperative digital intraoral scans. Coronal, apical, and angular deviations, insertion time, and insertion torque were evaluated. Results Forty patients were treated with 1 implant each; 20 implants were inserted with a surgical motor and 20 implants with a torque wrench. Global coronal and apical deviations were 1.20 ± 0.46 mm and 1.45 ± 0.79 mm in the machine-driven group, and 1.13 ± 0.38 mm and 1.18 ± 0.28 mm in the manual group (respectively). The mean angular deviation was 4.82 ± 2.07° in the machine-driven group and 4.11 ± 1.63° in the manual group. Mean insertion torque was 21.75 ± 9.75 Ncm in the machine-driven group, compared to 18.75 ± 7.05 Ncm in the manual group. Implant placement duration was 9.25 ± 1.86 s in the machine-driven group at a speed of 50 rpm, and 36.40 ± 8.15 s in the manual group. Conclusion No significant difference was found between the two groups in terms of accuracy and mean insertion torque, while machine-driven implant placement was significantly less time-consuming. Clinical relevance Optimal implant placement accuracy utilized by half-guided surgical protocol can be achieved with both machine-driven and torque wrench insertion. Trial registration ID: NCT04854239
- Published
- 2021
15. Clinical, radiographical and histological evaluation of alveolar ridge preservation with an autogenous tooth derived particulate graft in EDS class 3-4 defects
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Gábor Gerber, Peter Tajti, Eszter Svidro, Zsombor Radoczy-Drajko, Bálint Molnár, and Péter Windisch
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Alveolar Bone Loss ,Dentistry ,Connective tissue ,Vertical Dimensions ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Alveolar ridge ,Alveolar Process ,Humans ,030212 general & internal medicine ,Tooth Socket ,General Dentistry ,Dental alveolus ,Minerals ,Bone Transplantation ,business.industry ,Soft tissue ,030206 dentistry ,Alveolar Ridge Augmentation ,lcsh:RK1-715 ,medicine.anatomical_structure ,Under local anaesthesia ,lcsh:Dentistry ,Tooth Extraction ,Oral and maxillofacial surgery ,business ,Wound healing ,Research Article - Abstract
Background The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at implant-prosthetic treatment. BonMaker® ATB is a novel autogenous bone grafting material, produced by the mechanical and chemical processing of natural teeth. This pilot case report aims at providing a clinical, radiographical, and histological evaluation of the safety and efficacy of Bonmaker ATB powder in the treatment of EDS class 3–4 postextraction sockets with alveolar ridge preservation. Methods A total of 9 teeth were extracted from 5 patients. The extracted teeth were prepared immediately with the Bonmaker® device. The extraction sockets were filled up with ATB powder. Six months after extraction, standardized intraoral x-rays and CBCT scans were performed. Re-entry was performed under local anaesthesia. Core biopsies were harvested for histological analysis and implants were placed. Results Horizontal alveolar dimension loss occurred, even though ARP was performed, but the horizontal shrinkage was moderate. Vertical dimensions did not show loss of volume, but increased defect fill. Core biopsies showed ATB particles surrounded by newly formed bone and connective tissue. According to histomorphometric analysis, the harvested samples contained 56% of newly formed bone on average, and only a mean of 7% of non-remodelled ATB material was observed. Conclusion The preliminary clinical, radiographical, and histological results of Bonmaker® autogenous tooth graft therapy indicate that ATB may be safely and successfully used as a grafting material for ARP. Optimal graft incorporation and histologically proven effective remodelling, as well as uneventful wound healing support the clinical application of ATB to minimize post-extraction hard tissue loss. Further research is needed to exploit the full potential of ATB and to evaluate the long-term peri-implant hard and soft tissue stability of ATB-treated post-extraction sites.
- Published
- 2020
16. Digital Three-Dimensional Visualization of Intrabony Periodontal Defects for Surgical Planning (Pilot Case Study)
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Daniel Palkovics, Péter Windisch, Francesco Mangano, and Katalin Nagy
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Orthodontics ,genetic structures ,Computer science ,Three dimensional visualization ,Surgical planning - Abstract
Background: In the regenerative treatment of intrabony periodontal defects, surgical strategies are determined by defect morphologies. Clinical direct measurements and intraoral radiographs are the main tools in periodontal diagnostics and surgical planning, however in certain cases they don’t provide sufficient amount of information. Therefore, the application of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of periodontally involved patients has been proposed. The aim of this study is to present a novel method for 3D visualization of intrabony periodontal defects on digital models reconstructed from CBCT datasets for diagnostics and treatment planning.Methods: 4 patients with a total of 6 intrabony periodontal defects were enrolled in the present study. 2 months following initial periodontal treatment CBCT scan is taken. Radiographic image processing (segmentation) of CBCT datasets were performed in a radiographic imaging software to acquire anatomically accurate, virtual three-dimensional polygon models of surgical areas. Intrasurgical and digital measurements were taken, and results were compared, to validate the accuracy of digital models.Results: Difference between intrasurgical- and digital measurements in depth and width of intrabony components of periodontal defects were 0,31±0,21 mm and 0,41±0,44 mm respectively.Conclusion: It can be concluded that, the described digital workflow is useful in the treatment of certain periodontal intrabony defect morphologies. However, to determine the exact use cases of such technology further studies and examination is necessary.Trial Registration: Retrospective Ethics Approval
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- 2020
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17. Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning
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Péter Windisch, Katalin Nagy, Francesco Mangano, and Daniel Palkovics
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Periodontal treatment ,Radiography ,Alveolar Bone Loss ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,Regenerative periodontal surgery ,Segmentation ,Image Processing, Computer-Assisted ,Medicine ,Humans ,3D radiographic image reconstruction ,Radiation treatment planning ,Surgical treatment ,General Dentistry ,Periodontal Diseases ,Orthodontics ,Three-dimensional treatment planning ,business.industry ,Periodontal diagnostics ,CBCT ,030206 dentistry ,Cone-Beam Computed Tomography ,Thresholding ,lcsh:RK1-715 ,Three dimensional visualization ,lcsh:Dentistry ,Oral and maxillofacial surgery ,business ,Research Article - Abstract
BackgroundIn the regenerative treatment of intrabony periodontal defects, surgical strategies are primarily determined by defect morphologies. In certain cases, however, direct clinical measurements and intraoral radiographs do not provide sufficient information on defect morphologies. Therefore, the application of cone-beam computed tomography (CBCT) has been proposed in specific cases. 3D virtual models reconstructed with automatic thresholding algorithms have already been used for diagnostic purposes. The aim of this study was to utilize 3D virtual models, generated with a semi-automatic segmentation method, for the treatment planning of minimally invasive periodontal surgeries and to evaluate the accuracy of the virtual models, by comparing digital measurements to direct intrasurgical measurements.MethodsFour patients with a total of six intrabony periodontal defects were enrolled in the present study. Two months following initial periodontal treatment, a CBCT scan was taken. The novel semi-automatic segmentation method was performed in an open-source medical image processing software (3D Slicer) to acquire virtual 3D models of alveolar and dental structures. Intrasurgical and digital measurements were taken, and results were compared to validate the accuracy of the digital models. Defect characteristics were determined prior to surgery with conventional diagnostic methods and 3D virtual models. Diagnostic assessments were compared to the actual defect morphology during surgery.ResultsDifferences between intrasurgical and digital measurements in depth and width of intrabony components of periodontal defects averaged 0.31 ± 0.21 mm and 0.41 ± 0.44 mm, respectively. In five out of six cases, defect characteristics could not be assessed precisely with direct clinical measurements and intraoral radiographs. 3D models generated with the presented semi-automatic segmentation method depicted the defect characteristics correctly in all six cases.ConclusionIt can be concluded that 3D virtual models acquired with the described semi-automatic segmentation method provide accurate information on intrabony periodontal defect morphologies, thus influencing the treatment strategy. Within the limitations of this study, models were found to be accurate; however, further investigation with a standardized validation process on a large number of participants has to be conducted.
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- 2020
18. A Proposed Method for Assessing the Appropriate Timing of Early Implant Placements: A Case Report
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Barbara Mikecs, János Vág, Eszter Molnár, Péter Windisch, Réka Fazekas, and Pál Nagy
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business.industry ,Microcirculation ,Gingiva ,MEDLINE ,Dentistry ,030206 dentistry ,030204 cardiovascular system & hematology ,Dental Implantation ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Implant ,Oral Surgery ,business - Published
- 2018
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19. Analysis of blood supply in the hard palate and maxillary tuberosity—clinical implications for flap design and soft tissue graft harvesting (a human cadaver study)
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Péter Windisch, Georg Feigl, Gábor Gerber, András Grimm, Andrea Székely, Bálint Molnár, and Arvin Shahbazi
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Palate, Hard ,medicine.medical_treatment ,Dentistry ,Greater palatine artery ,Anastomosis ,Surgical Flaps ,03 medical and health sciences ,0302 clinical medicine ,Cadaver ,Maxilla ,medicine ,Premolar ,Humans ,Bridge (dentistry) ,General Dentistry ,business.industry ,Equipment Design ,030206 dentistry ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Tissue and Organ Harvesting ,Hard palate ,business ,Maxillary tuberosity ,Artery - Abstract
The aim of the present study is to provide a detailed macroscopic mapping of the palatal and tuberal blood supply applying anatomical methods and studying specific anastomoses to bridge the gap between basic structural and empirical clinical knowledge. Ten cadavers (three dentate, seven edentulous) have been prepared for this study in the Department of Anatomy, Semmelweis University, Budapest, Hungary, and in the Department of Anatomy of the Medical University of Graz. All cadavers were fixed with Thiel’s solution. For the macroscopic analysis of the blood vessels supplying the palatal mucosa, corrosion casting in four cadavers and latex milk injection in other six cadavers were performed. We recorded major- and secondary branches of the greater palatine artery (GPA) and its relation to the palatine spine, different anastomoses with the nasopalatine artery (NPA), and lesser palatal artery (LPA) as well as with contralateral branches of the GPA. Penetrating intraosseous branches at the premolar-canine area were also detected. In edentulous patients, the GPA developed a curvy pathway in the premolar area. The blood supply around the maxillary tuberosity was also presented. The combination of different staining methods has shed light to findings with relevance to palatal blood supply, offering a powerful tool for the design and execution of surgical interventions involving the hard palate. The present study provides clinicians with a good basis to understand the anatomical background of palatal and tuberal blood supply. This might enable clinicians to design optimized incision- and flap designs. As a result, the risk of intraoperative bleeding and postoperative wound healing complications related to impaired blood supply can be minimized.
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- 2018
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20. Fogeltávolítást követően visszamaradt szöveti defektus ellátása. Három eset ismertetése
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Szandra Lemperger, Anna Martin, Péter Windisch, and Rita Marton
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03 medical and health sciences ,0302 clinical medicine ,business.industry ,Tooth removal ,Treatment outcome ,Medicine ,030212 general & internal medicine ,030206 dentistry ,General Medicine ,Nuclear medicine ,business - Abstract
Absztrakt: Kiterjedt gyulladassal korulvett fog eltavolitasat kovetően gyakran jelentős lagy- es kemenyszoveti defektus marad vissza. Ezt tovabb sulyosbitja, ha a foghuzas utan a fogmedret – alveolust – magara hagyjuk. A szovetek igy meg jobban osszeesnek, es a terulet alkalmatlanna valik implantatum behelyezesere. Az esztetikai regioban hidpotlas sem hozza meg a vart eredmenyt. A bemutatasra kerulő esetekkel azt szeretnenk demonstralni, hogy fogeltavolitast kovetően elvegzett alveolusprezervacio lehetőve teszi implantatum behelyezeset, valamint megfelelő esztetikai eredmenyt biztosit meg frontalis teruleten is. CBCT-felveteleket keszitettunk a fogeltavolitast kovető alveolusprezervacio előtt es a beavatkozast kovető hatodik–nyolcadik honapban. Vertikalis es teruletmereseket vegeztunk, illetve osszehasonlitottuk pre- es posztoperativ ertekeiket. Az implantatum mindharom esetben beultethető volt, valamint jelentős buccalis csontnovekedest (4,24 mm, 6,22 mm, 9,57 mm) es teruletnovekedest (129%, 145%, 167%) ...
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- 2017
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21. Comparison of a polyethylene glycol membrane and a collagen membrane for the treatment of bone dehiscence defects at bone level implants-A prospective, randomized, controlled, multicenter clinical trial
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Péter Windisch, Christoph H. F. Hämmerle, Ilja Mihatovic, Marc Quirynen, Mats Hallman, Anton Friedmann, Juan Blanco Carrión, Luca Cordaro, Ignacio Sanz Sanchez, Ronald E. Jung, University of Zurich, and Jung, Ronald Ernst
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Bone Regeneration ,medicine.medical_treatment ,0206 medical engineering ,Alveolar Bone Loss ,Dentistry ,610 Medicine & health ,02 engineering and technology ,Polyethylene glycol ,Dehiscence ,Polyethylene Glycols ,10068 Clinic of Reconstructive Dentistry ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Multicenter trial ,PEG ratio ,medicine ,Humans ,Prospective Studies ,Bone regeneration ,Reduction (orthopedic surgery) ,Dental Implants ,Membranes ,3504 Oral Surgery ,business.industry ,Dental Implantation, Endosseous ,Soft tissue ,Membranes, Artificial ,030206 dentistry ,020601 biomedical engineering ,chemistry ,Bone Substitutes ,Guided Tissue Regeneration, Periodontal ,Implant ,Collagen ,Oral Surgery ,business - Abstract
OBJECTIVES The aim of the present randomized, controlled clinical multicenter trial was to compare a polyethylene glycol (PEG) and a native collagen membrane (BG) for simultaneous guided bone regeneration at bony dehiscence-type defects around bone level titanium implants. MATERIAL AND METHODS The study enrolled 117 patients requiring implant treatment in the posterior maxilla or mandible with expected buccal bony dehiscence-type defects at the placed titanium implants. According to a parallel groups design, defects were filled with a synthetic bone filler and randomly assigned to either PEG or BG membrane. As primary parameter, the relative vertical bone fill was assessed at baseline and at re-entry after 6 months of healing. As secondary parameters, the marginal bone level (MBL) was assessed radiographically and soft tissue conditions were recorded up to 18 months postloading. RESULTS Both groups showed comparable vertical bone fill revealing a relative change in defect height of 59.7% (PEG) and 64.4% (BG). The absolute mean reduction in defect size was 2.5 mm in the PEG group and 3.2 mm in the BG group. Although both groups revealed a statistically significant mean defect reduction (p
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- 2019
22. Surgical management of gingival recession using autogenous soft tissue grafts
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Bálint Molnár and Péter Windisch
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Marketing ,Pharmacology ,Organizational Behavior and Human Resource Management ,medicine.medical_specialty ,genetic structures ,business.industry ,Strategy and Management ,Gold standard ,Pharmaceutical Science ,Soft tissue ,Dentistry ,Transplantation ,Plastic surgery ,Drug Discovery ,medicine ,medicine.symptom ,business ,Gingival recession - Abstract
One of the chief goals of periodontal plastic surgery is establishment of ideal pink esthetics through the reconstruction of gingival recessions. A gold standard treatment approach for coverage of gingival recession with predictable esthetic outcomes is the transplantation of autogenous soft tissue grafts. Various surgical techniques can be used in combination with autogenous soft tissue grafts for gingival recession coverage.
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- 2019
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23. Harvesting of autogenous grafts for gingival recession coverage
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Péter Windisch and Bálint Molnár
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Marketing ,Pharmacology ,Organizational Behavior and Human Resource Management ,medicine.medical_specialty ,business.industry ,Strategy and Management ,Gold standard ,Pharmaceutical Science ,Dentistry ,Soft tissue ,Soft tissue graft ,Plastic surgery ,medicine.anatomical_structure ,Treatment modality ,Drug Discovery ,Medicine ,Oral mucosa ,medicine.symptom ,business ,Gingival recession - Abstract
The ultimate aim of periodontal plastic surgery is to create optimal pink esthetics through the reconstruction of gingival recessions. Application of autogenous soft tissue grafts is considered as a gold standard treatment modality with predictable esthetic outcomes for gingival recession coverage. Harvesting a free soft tissue graft from an esthetically irrelevant region of the oral mucosa using various techniques can prevent donor site complications around the adjacent teeth.
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- 2019
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24. Demonstration of Radiographic Bone Fill in Postextraction Sockets Using a Novel Implant-Site Development Technique: A Retrospective Comparative Case Series
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Tibor Deutsch, Bálint Molnár, Anna Martin, Rita Marton, Kristof Orban, and Péter Windisch
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Orthodontics ,Cone beam computed tomography ,business.industry ,Radiography ,Cone-Beam Computed Tomography ,Implant placement ,Tooth Extraction ,Alveolar Process ,Periodontics ,Medicine ,Implant ,Oral Surgery ,Tooth Root ,Tooth Socket ,business ,Retrospective Studies - Abstract
The objective of this study was to compare the novel extraction-site development (XSD) technique with spontaneous healing. Advanced alveolar defects (extraction defect sounding, classes 3 and 4) at 33 single-rooted teeth were treated by XSD (test), and 21 extraction sites of single-rooted teeth were left for spontaneous healing (control). In pre- and postoperative cone beam computed tomography (CBCT) data sets, orovestibular and vertical socket dimensions were assessed, as were socket areas. XSD resulted in complication-free healing with significantly higher radiographic bone fill compared to spontaneous healing. Application of the XSD approach may reduce the need for augmentative procedures during implant placement.
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- 2019
25. Virtuális tervezés és volumetrikus kiértékelés egy komplex parodontális defektus regeneratív-rekonstruktív sebészi ellátásában.
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ELEONÓRA, SÓLYOM, DÁNIEL, PALKOVICS, CSABA, PINTÉR, MANGANO, FRANCESCO GUIDO, and PÉTER, WINDISCH
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ALVEOLAR process ,CONE beam computed tomography ,RADIOGRAPHIC processing ,DIGITAL dental impression systems ,IMAGE processing software ,OPERATIVE surgery ,DENTAL extraction - Abstract
Copyright of Fogorvosi Szemle is the property of Hungarian Dental Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2021
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26. Recession Coverage Using Autogenous Grafts
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Bálint Molnár and Péter Windisch
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0301 basic medicine ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Grafting (decision trees) ,Gold standard ,Soft tissue ,030206 dentistry ,Recession ,Surgical planning ,Surgery ,Postoperative management ,Transplantation ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Medicine ,business ,media_common - Abstract
Recreating natural pink esthetics around single or multiple recession defects require proper surgical planning and a careful choice of the grafting approach. The transplantation of free autogenous soft tissue grafts in combination with state-of-the-art surgical techniques for recession coverage still represents the gold standard in terms of long-term tissue stability. Donor site morbidity has to be considered prior to surgery; graft harvesting procedures should be well planned and executed to minimize postoperative patient complaints.
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- 2018
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27. Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes
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Panos Papaspyridakos, Dieter Weingart, Konstantinos Vazouras, Nikos Mardas, Christiaan M. ten Bruggenkate, Eik Schiegnitz, Ralf Smeets, Mauricio G. Araújo, Stephen Barter, Hans-Peter Weber, Alberto Monje, Gary Finelle, Michael Payer, Nadine Brodala, Simon Storgård Jensen, Bo Chen, Hadi Gholami, Gustavo Avila-Ortiz, Johannes Kleinheinz, Jeffrey Ganeles, Stefan Fickl, Péter Windisch, Martina Stefanini, Vivianne Chappuis, Hideaki Katsuyama, Bilal Al-Nawas, André Barbisan de Souza, Ronald E. Jung, Asbjørn Jokstad, Christoph H. F. Hämmerle, Ricardo Faria Almeida, Chatchai Kunavisarut, Jung, Ronald E., Al-Nawas, Bilal, Araujo, Mauricio, Avila-Ortiz, Gustavo, Barter, Stephen, Brodala, Nadine, Chappuis, Vivianne, Chen, Bo, De Souza, Andre, Almeida, Ricardo Faria, Fickl, Stefan, Finelle, Gary, Ganeles, Jeffrey, Gholami, Hadi, Hammerle, Christoph, Jensen, Simon, Jokstad, Asbjørn, Katsuyama, Hideaki, Kleinheinz, Johanne, Kunavisarut, Chatchai, Mardas, Niko, Monje, Alberto, Papaspyridakos, Pano, Payer, Michael, Schiegnitz, Eik, Smeets, Ralf, Stefanini, Martina, ten Bruggenkate, Christiaan, Vazouras, Konstantino, Weber, Hans-Peter, Weingart, Dieter, Windisch, Péter, and University of Zurich
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medicine.medical_treatment ,Osteoporosis ,biological complications ,Dentistry ,Osteoporosis/complications ,meta-analysi ,law.invention ,Proton Pump Inhibitors/adverse effects ,0302 clinical medicine ,Randomized controlled trial ,law ,Radiography, Dental ,Dental Restoration Failure ,Dental implant ,humans ,610 Medicine & health ,clinical decision-making ,dental implant ,Diphosphonates ,narrow diameter ,3504 Oral Surgery ,Jaw, Edentulous, Partially ,05 social sciences ,Dental Implantation, Endosseous ,Implant failure ,drug ,small dental implant ,VDP::Medisinske Fag: 700::Klinisk odontologiske fag: 830 ,failure ,clinical decision‐making ,Diphosphonates/adverse effects ,Meta-analysis ,randomized controlled trials ,epidemiology ,medication ,Oral Surgery ,Selective Serotonin Reuptake Inhibitors ,Consensus ,review ,survival ,03 medical and health sciences ,10068 Clinic of Reconstructive Dentistry ,SDG 3 - Good Health and Well-being ,dental implants ,0502 economics and business ,medicine ,short dental implants ,Humans ,biological complication ,Patient Reported Outcome Measures ,human ,Survival rate ,small dental implants ,Dental Implants ,business.industry ,Jaw, Edentulous, Partially/rehabilitation ,short dental implant ,Proton Pump Inhibitors ,030206 dentistry ,medicine.disease ,endosseous implant ,Survival Analysis ,VDP::Medical disciplines: 700::Clinical dentistry disciplines: 830 ,Dental Prosthesis Design ,meta‐analysis ,Relative risk ,randomized controlled trial ,050211 marketing ,Implant ,Serotonin Uptake Inhibitors/adverse effects ,business ,osteotomy ,Systematic Reviews as Topic - Abstract
The following article: Jung, R.E., Al-Nawas, B., Araujo, M., Avila-Ortiz, G., Barter, S., Brodala, N., ... Windisch, P. (2018). Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes. Clinical Oral Implants Research, 29(S16), 69-77, can be accessed at https://doi.org/10.1111/clr.13342. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. Objectives: The aim of Working Group 1 was to address the influence of different local (implant length, diameter, and design) and systemic (medications) factors on clinical, radiographic, and patient‐reported outcomes in implant dentistry. Focused questions on (a) short posterior dental implants (≤6 mm), (b) narrow diameter implants, (c) implant design (tapered compared to a non‐tapered implant design), and (d) medication‐related dental implant failures were addressed. Materials and methods: Four systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, and recommendations for future research were based on structured group discussions until consensus was reached among the entire expert Group 1. The statements were then presented and accepted following further discussion and modifications as required by the plenary. Results: Short implants (≤6 mm) revealed a survival rate ranging from 86.7% to 100%, whereas standard implant survival rate ranged from 95% to 100% with a follow‐up from 1 to 5 years. Short implants demonstrated a higher variability and a higher Risk Ratio [RR: 1.24 (95% CI: 0.63, 2.44, p = 0.54)] for failure compared to standard implants. Narrow diameter implants (NDI) have been classified into three categories: Category 1: Implants with a diameter of Tapered versus non‐tapered implants demonstrated only insignificant differences regarding clinical, radiographic, and patient‐reported outcomes. The intake of certain selective serotonin reuptake inhibitors and proton pump inhibitors is associated with a statistically significant increased implant failure rate. The intake of bisphosphonates related to the treatment of osteoporosis was not associated with an increased implant failure rate. Conclusions: It is concluded that short implants (≤6 mm) are a valid option in situations of reduced bone height to avoid possible morbidity associated with augmentation procedures; however, they reveal a higher variability and lower predictability in survival rates. Narrow diameter implants with diameters of 2.5 mm and more demonstrated no difference in implant survival rates compared to standard diameter implants. In contrast, it is concluded that narrow diameter implants with diameters of less than 2.5 mm exhibited lower survival rates compared to standard diameter implants. It is further concluded that there are no differences between tapered versus non‐tapered dental implants. Certain medications such as selective serotonin reuptake inhibitors and proton pump inhibitors showed an association with a higher implant failure rate.
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- 2018
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28. [Treating tissue defects following tooth removal. Three case reports]
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Rita, Marton, Anna, Martin, Szandra, Lemperger, and Péter, Windisch
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Dental Implants ,Male ,Wound Healing ,Treatment Outcome ,Dental Implantation, Endosseous ,Tooth Extraction ,Humans ,Female ,Alveolar Ridge Augmentation ,Collagen ,Tooth Socket - Abstract
Following tooth removal, three dimensional hard- and soft-tissue loss take place. Spontaneous healing makes the defect more severe and results in collapsing tissues. Implant placement is not feasible. In the aestethic zone even fixed partial dentures will not deliver the expected result. Our aim was to demonstrate that only ridge preservation enables implant placement and also provides excellent aestetic result even at frontal areas. CBCT was made before and 6-8 months after ridge preservation. Vertical and socket area measurements were carried out and compared in pre-, and postoperative images. Implant placement was feasible in all three cases; furthermore favourable buccal bone (4.24 mm, 6.22 mm, 9.57 mm) and area growth (129%, 145%, 167%) were measured. Ridge preservation provides appropriate therapy for complete reconstruction of tissues after tooth removal. Orv Hetil. 2017; 158(31): 1228-1234.
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- 2017
29. Three-dimensional volumetric assessment of hard tissue alterations following horizontal guided bone regeneration using a split-thickness flap design: A case series
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Daniel Palkovics, Eleonora Solyom, Kristof Somodi, Csaba Pinter, Peter Windisch, Ferenc Bartha, and Balint Molnar
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3D radiographic evaluation ,CBCT segmentation ,Subtraction analysis ,Horizontal ridge augmentation ,Split-thickness flap ,Dentistry ,RK1-715 - Abstract
Abstract Objectives To analyze morphological, volumetric, and linear hard tissue changes following horizontal ridge augmentation using a three-dimensional radiographic method. Methods As part of a larger ongoing prospective study, 10 lower lateral surgical sites were selected for evaluation. Horizontal ridge deficiencies were treated with guided bone regeneration (GBR) using a split-thickness flap design and a resorbable collagen barrier membrane. Following the segmentation of baseline and 6-month follow-up cone-beam computed tomography scans, volumetric, linear, and morphological hard tissue changes and the efficacy of the augmentation were assessed (expressed by the volume-to-surface ratio). Results Volumetric hard tissue gain averaged 605.32 ± 380.68 mm3. An average of 238.48 ± 127.82 mm3 hard tissue loss was also detected at the lingual aspect of the surgical area. Horizontal hard tissue gain averaged 3.00 ± 1.45 mm. Midcrestal vertical hard tissue loss averaged 1.18 ± 0.81 mm. The volume-to-surface ratio averaged 1.19 ± 0.52 mm3/mm2. The three-dimensional analysis showed slight lingual or crestal hard tissue resorption in all cases. In certain instances, the greatest extent of hard tissue gain was observed 2–3 mm apical to the initial level of the marginal crest. Conclusions With the applied method, previously unreported aspects of hard tissue changes following horizontal GBR could be examined. Midcrestal bone resorption was demonstrated, most likely caused by increased osteoclast activity following the elevation of the periosteum. The volume-to-surface ratio expressed the efficacy of the procedure independent of the size of the surgical area.
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- 2023
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30. Reconstruction of vertical alveolar ridge deficiencies utilizing a high-density polytetrafluoroethylene membrane /clinical impact of flap dehiscence on treatment outcomes: case series
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Daniel Palkovics, Fanni Bolya-Orosz, Csaba Pinter, Balint Molnar, and Peter Windisch
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Wound dehiscence ,Membrane exposure ,D-PTFE ,Vertical ridge augmentation ,Guided bone regeneration ,CBCT analysis ,Dentistry ,RK1-715 - Abstract
Abstract Objectives The aim of this study was to evaluate the effects of membrane exposure during vertical ridge augmentation (VRA) utilizing guided bone regeneration with a dense polytetrafluoroethylene (d-PTFE) membrane and a tent-pole space maintaining approach by registering radiographic volumetric, linear and morphological changes. Methods In 8 cases alveolar ridge defects were accessed utilizing a split-thickness flap design. Following flap elevation VRA was performed with tent-pole space maintaining approach utilizing the combination of a non-reinforced d-PTFE membrane and a composite graft (1:1 ratio of autogenous bone chips and bovine derived xenografts). Three-dimensional radiographic evaluation of hard tissue changes was carried out with the sequence of cone-beam computed tomography (CBCT) image segmentation, spatial registration and 3D subtraction analysis. Results Class I or class II membrane exposure was observed in four cases. Average hard tissue gain was found to be 0.70 cm3 ± 0.31 cm3 and 0.82 cm3 ± 0.40 cm3 with and without membrane exposure resulting in a 17% difference. Vertical hard tissue gain averaged 4.06 mm ± 0.56 mm and 3.55 mm ± 0.43 mm in case of submerged and open healing, respectively. Difference in this regard was 14% between the two groups. Horizontal ridge width at 9-month follow-up was 5.89 mm ± 0.51 mm and 5.61 mm ± 1.21 mm with and without a membrane exposure respectively, resulting in a 5% difference. Conclusions With the help of the currently reported 3D radiographic evaluation method, it can be concluded that exposure of the new-generation d-PTFE membrane had less negative impact on clinical results compared to literature data reporting on expanded polytetrafluoroethylene membranes.
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- 2022
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31. Treatment of multiple adjacent Miller class I and II gingival recessions with a Modified Coronally Advanced Tunnel (MCAT) technique and a collagen matrix or palatal connective tissue graft: a randomized, controlled clinical trial
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Sofia Aroca, Péter Windisch, István Gera, Anton Sculean, Dimitris Nikolidakis, Giovanni E. Salvi, and Bálint Molnár
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medicine.medical_specialty ,Gingival and periodontal pocket ,Visual analogue scale ,Operative Time ,Gingiva ,Connective tissue ,Dentistry ,Surgical Flaps ,Root Planing ,law.invention ,Randomized controlled trial ,law ,Absorbable Implants ,Periodontal Attachment Loss ,medicine ,Humans ,Periodontal Pocket ,Gingival Recession ,Prospective Studies ,Tooth Root ,610 Medicine & health ,Prospective cohort study ,Gingival recession ,business.industry ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Clinical attachment loss ,Connective Tissue ,Patient Satisfaction ,Keratins ,Periodontics ,Collagen ,medicine.symptom ,business ,Follow-Up Studies ,Gingival margin - Abstract
A newly developed collagen matrix (CM) of porcine origin has been shown to represent a potential alternative to palatal connective tissue grafts (CTG) for the treatment of single Miller Class I and II gingival recessions when used in conjunction with a coronally advanced flap (CAF). However, at present it remains unknown to what extent CM may represent a valuable alternative to CTG in the treatment of Miller Class I and II multiple adjacent gingival recessions (MAGR). The aim of this study was to compare the clinical outcomes following treatment of Miller Class I and II MAGR using the modified coronally advanced tunnel technique (MCAT) in conjunction with either CM or CTG.Twenty-two patients with a total of 156 Miller Class I and II gingival recessions were included in this study. Recessions were randomly treated according to a split-mouth design by means of MCAT + CM (test) or MCAT + CTG (control). The following measurements were recorded at baseline (i.e. prior to surgery) and at 12 months: Gingival Recession Depth (GRD), Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Keratinized Tissue Width (KTW), Gingival Recession Width (GRW) and Gingival Thickness (GT). GT was measured 3-mm apical to the gingival margin. Patient acceptance was recorded using a Visual Analogue Scale (VAS). The primary outcome variable was Complete Root Coverage (CRC), secondary outcomes were Mean Root Coverage (MRC), change in KTW, GT, patient acceptance and duration of surgery.Healing was uneventful in both groups. No adverse reactions at any of the sites were observed. At 12 months, both treatments resulted in statistically significant improvements of CRC, MRC, KTW and GT compared with baseline (p 0.05). CRC was found at 42% of test sites and at 85% of control sites respectively (p 0.05). MRC measured 71 ± 21% mm at test sites versus 90 ± 18% mm at control sites (p 0.05). Mean KTW measured 2.4 ± 0.7 mm at test sites versus 2.7 ± 0.8 mm at control sites (p 0.05). At test sites, GT values changed from 0.8 ± 0.2 to 1.0 ± 0.3 mm, and at control sites from 0.8 ± 0.3 to 1.3 ± 0.4 mm (p 0.05). Duration of surgery and patient morbidity was statistically significantly lower in the test compared with the control group respectively (p 0.05).The present findings indicate that the use of CM may represent an alternative to CTG by reducing surgical time and patient morbidity, but yielded lower CRC than CTG in the treatment of Miller Class I and II MAGR when used in conjunction with MCAT.
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- 2013
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32. Evaluation of Laser Speckle Contrast Imaging for the Assessment of Oral Mucosal Blood Flow following Periodontal Plastic Surgery: An Exploratory Study
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Zoltán Benyó, Péter Windisch, Zsuzsanna Tóth, Bálint Molnár, Zsolt Lohinai, János Vág, Eszter Molnár, and László Hricisák
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Adult ,Male ,Periodontium ,medicine.medical_specialty ,Time Factors ,Article Subject ,lcsh:Medicine ,Connective tissue ,Blood Pressure ,030204 cardiovascular system & hematology ,General Biochemistry, Genetics and Molecular Biology ,Microcirculation ,03 medical and health sciences ,0302 clinical medicine ,Imaging, Three-Dimensional ,medicine ,Humans ,Gingival Recession ,Oral mucosa ,Surgery, Plastic ,Gingival recession ,Wound Healing ,General Immunology and Microbiology ,business.industry ,Lasers ,lcsh:R ,Mouth Mucosa ,030206 dentistry ,General Medicine ,Blood flow ,Middle Aged ,Surgery ,Plastic surgery ,medicine.anatomical_structure ,Blood pressure ,Regional Blood Flow ,Clinical Study ,Female ,medicine.symptom ,Wound healing ,business - Abstract
The laser speckle contrast imaging (LSCI) is proved to be a reliable tool in flap monitoring in general surgery; however, it has not been evaluated in oral surgery yet. We applied the LSCI to compare the effect of a xenogeneic collagen matrix (Geistlich Mucograft®) to connective tissue grafts (CTG) on the microcirculation of the modified coronally advanced tunnel technique (MCAT) for gingival recession coverage. Gingival microcirculation and wound fluid were measured before and after surgery for six months at twenty-seven treated teeth. In males, the flap microcirculation was restored within 3 days for both grafts followed by a hyperemic response. During the first 8 days the blood flow was higher at xenogeneic graft comparing to the CTG. In females, the ischemic period lasted for 7–12 days depending on the graft and no hyperemic response was observed. Females had more intense and prolonged wound fluid production. The LSCI method is suitable to capture the microcirculatory effect of the surgical intervention in human oral mucosa. The application of xenogeneic collagen matrices as a CTG substitute does not seem to restrain the recovery of graft bed circulation. Gender may have an effect on postoperative circulation and inflammation.
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- 2016
33. A phase IIa randomized controlled clinical and histological pilot study evaluating rhGDF-5/β-TCP for periodontal regeneration
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Ulf M.E. Wikesjö, Björn Capsius, István Gera, Anton Sculean, Andreas Stavropoulos, and Péter Windisch
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Adult ,Calcium Phosphates ,Male ,medicine.medical_specialty ,Bone Regeneration ,Periodontal Ligament ,Alveolar Bone Loss ,Dentistry ,Pilot Projects ,Statistics, Nonparametric ,Growth Differentiation Factor 5 ,medicine ,Humans ,Regeneration ,Periodontal fiber ,Cementum ,Bone regeneration ,Gingival recession ,Dental alveolus ,Dental Cementum ,Drug Carriers ,business.industry ,Open flap debridement ,Middle Aged ,medicine.disease ,Chronic periodontitis ,Recombinant Proteins ,Surgery ,medicine.anatomical_structure ,Chronic Periodontitis ,Guided Tissue Regeneration, Periodontal ,Periodontics ,Female ,Dental cementum ,medicine.symptom ,business - Abstract
Aim The primary objective of this study was to clinically and histologically evaluate periodontal wound healing/regeneration following surgical implantation of recombinant human growth/differentiation factor-5 (rhGDF-5) adsorbed onto a particulate β-tricalcium phosphate (β-TCP) carrier rhGDF-5/β-TCP into periodontal defects in man. Material & Methods Twenty chronic periodontitis patients, each with at least one tooth scheduled for extraction exhibiting a probing depth ≥6 mm and an associated intra-bony defect ≥4 mm participated in the study upon written informed consent. Subjects (one defect/patient) were randomized to receive open flap debridement (OFD) + rhGDF-5/β-TCP (n = 10) or OFD alone (control; n = 10). Block biopsies of the defect sites were collected at 6 months post-surgery and prepared for the histological evaluation. Two masked examiners evaluated the deepest aspect of each defect site relative to bone (height/area), periodontal ligament (PDL) and cementum regeneration, and residual β-TCP. Results Sites receiving rhGDF-5/β-TCP showed numerically greater PD reduction (3.7 ± 1.2 versus 3.1 ± 1.8 mm; p = 0.26), less gingival recession (0.5 ± 0.8 versus 1.4 ± 1.0 mm; p
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- 2011
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34. Clinical and Histologic Evaluation of a Granular Bovine Bone Biomaterial Used as an Adjunct to GTR With a Bioresorbable Bovine Pericardium Collagen Membrane in the Treatment of Intrabony Defects
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Péter Windisch, Anton Sculean, Dinu Costa, Marius Steigmann, Andreas Stavropoulos, and Giovanni Carlo Chiantella
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Male ,Periodontal tissue ,medicine.medical_specialty ,Bovine pericardium ,Periodontal Ligament ,Alveolar Bone Loss ,Dentistry ,Collagen Type I ,medicine ,Animals ,Humans ,Regeneration ,Pericardium ,Dental Cementum ,Periodontitis ,business.industry ,Regeneration (biology) ,Collagen membrane ,Biomaterial ,Membranes, Artificial ,Middle Aged ,medicine.disease ,Surgery ,Bovine bone ,Treatment Outcome ,medicine.anatomical_structure ,Bone Substitutes ,Chronic Periodontitis ,Guided Tissue Regeneration, Periodontal ,Periodontics ,Cattle ,Female ,business - Abstract
Background: The aim of the present study was to evaluate the clinical and histological healing of deep intrabony defects treated with guided tissue regeneration (GTR) with a collagen membrane from bovine pericardium and implantation of granular bovine bone biomaterial. Methods: Thirty patients with one deep combined 1- / 2 - wall intrabony defect exhibiting a probing depth ≥ 6 mm and an associated intrabony defect ≥ 3 mm were treated with GTR with a bioresorbable collagen membrane from bovine pericardium and adjunct implantation of a granular bovine bone biomaterial. The clinical results were evaluated 1- and 3-years following surgery. In addition, five teeth fulfilling the inclusion criteria but scheduled for extraction due to advanced periodontitis and/or restorative considerations were treated similarly and then extracted along with a potion of their surrounding periodontal tissues for histological evaluation six months after surgery. Results: Healing was uneventful in all patients. Significant clinical improvements were observed at 1- and 3 years post operatively (p
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- 2011
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35. Bony wall window repositioning in sinus floor elevation - a comparative randomized, controlled trial
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Bálint Molnár, Péter Windisch, Anna Martin, Kristof Orban, and Zsuzsanna Papp
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medicine.medical_specialty ,Randomized controlled trial ,business.industry ,law ,Medicine ,Window (computing) ,Oral Surgery ,business ,Sinus floor elevation ,Surgery ,law.invention - Published
- 2018
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36. Biodegradable magnesium barrier membrane used for guided bone regeneration in dental surgery
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Patrick Rider, Željka Perić Kačarević, Akiva Elad, Drazen Tadic, Daniel Rothamel, Gerrit Sauer, Fabien Bornert, Peter Windisch, Dávid Botond Hangyási, Balint Molnar, Emely Bortel, Bernhard Hesse, and Frank Witte
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Magnesium ,Biodegradable ,Implant ,GBR ,Bone healing ,Soft tissue healing ,Materials of engineering and construction. Mechanics of materials ,TA401-492 ,Biology (General) ,QH301-705.5 - Abstract
Barrier membranes are commonly used as part of the dental surgical technique guided bone regeneration (GBR) and are often made of resorbable collagen or non-resorbable materials such as PTFE. While collagen membranes do not provide sufficient mechanical protection of the covered bone defect, titanium reinforced membranes and non-resorbable membranes need to be removed in a second surgery. Thus, biodegradable GBR membranes made of pure magnesium might be an alternative. In this study a biodegradable pure magnesium (99.95%) membrane has been proven to have all of the necessary requirements for an optimal regenerative outcome from both a mechanical and biological perspective. After implantation, the magnesium membrane separates the regenerating bone from the overlying, faster proliferating soft tissue. During the initial healing period, the membrane maintained a barrier function and space provision, whilst retaining the positioning of the bone graft material within the defect space. As the magnesium metal corroded, it formed a salty corrosion layer and local gas cavities, both of which extended the functional lifespan of the membrane barrier capabilities. During the resorption of the magnesium metal and magnesium salts, it was observed that the membrane became surrounded and then replaced by new bone. After the membrane had completely resorbed, only healthy tissue remained. The in vivo performance study demonstrated that the magnesium membrane has a comparable healing response and tissue regeneration to that of a resorbable collagen membrane. Overall, the magnesium membrane demonstrated all of the ideal qualities for a barrier membrane used in GBR treatment.
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- 2022
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37. Biodegradable magnesium fixation screw for barrier membranes used in guided bone regeneration
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Željka Perić Kačarević, Patrick Rider, Akiva Elad, Drazen Tadic, Daniel Rothamel, Gerrit Sauer, Fabien Bornert, Peter Windisch, Dávid Botond Hangyási, Balint Molnar, Till Kämmerer, Bernhard Hesse, Emely Bortel, Marco Bartosch, and Frank Witte
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Magnesium ,Biodegradable ,Implant ,GBR ,Bone healing ,Soft tissue healing ,Materials of engineering and construction. Mechanics of materials ,TA401-492 ,Biology (General) ,QH301-705.5 - Abstract
An ideal fixation system for guided bone (GBR) regeneration in oral surgery must fulfil several criteria that includes the provision of adequate mechanical fixation, complete resorption when no longer needed, complete replacement by bone, as well as be biocompatible and have a good clinical manageability. For the first time, a biodegradable magnesium fixation screw made of the magnesium alloy WZM211 with a MgF2 coating has been designed and tested to fulfill these criteria. Adequate mechanical fixation was shown for the magnesium fixation screw in several benchtop tests that directly compared the magnesium fixation screw with an equivalent polymeric resorbable device. Results demonstrated slightly superior mechanical properties of the magnesium device in comparison to the polymeric device even after 4 weeks of degradation. Biocompatibility of the magnesium fixation screw was demonstrated in several in vitro and in vivo tests. Degradation of the magnesium screw was investigated in in vitro and in vivo tests, where it was found that the screw is resorbed slowly and completely after 52 weeks, providing adequate fixation in the early critical healing phase. Overall, the magnesium fixation screw demonstrates all of the key properties required for an ideal fixation screw of membranes used in guided bone regeneration (GBR) surgeries.
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- 2022
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38. Functional characterization of collaterals in the human gingiva by laser speckle contrast imaging
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Elek Dinya, Zsuzsanna Tóth, Zsolt Lohinai, Réka Fazekas, János Vág, Eszter Molnár, and Péter Windisch
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Male ,Physiology ,Gingiva ,Ischemia ,Collateral Circulation ,Hyperemia ,030204 cardiovascular system & hematology ,Contrast imaging ,03 medical and health sciences ,Sex Factors ,Spatio-Temporal Analysis ,0302 clinical medicine ,stomatognathic system ,Physiology (medical) ,Occlusion ,Laser-Doppler Flowmetry ,medicine ,Humans ,Molecular Biology ,business.industry ,030206 dentistry ,Anatomy ,Blood flow ,Laser Doppler velocimetry ,medicine.disease ,Collateral circulation ,Major duodenal papilla ,stomatognathic diseases ,Regional Blood Flow ,Coronal plane ,Female ,Cardiology and Cardiovascular Medicine ,business ,Blood Flow Velocity - Abstract
Objective The rate of blood flow between the various areas of the gingiva in resting position and under challenge is unknown. In this study, the LSCI method was used to map spatial and temporal changes in gingival blood flow after transient compression. Methods Horizontal, vertical, and papilla base compressions were applied on the attached gingiva in 21 healthy patients (13 women, 8 men). LSCI was used to determine dynamic changes in regional blood flow during a five-second occlusion interval and subsequent reperfusion for twenty minutes. Results Resting blood flow in the attached gingiva apical to the papillae was higher as compared to that in the midbuccal area of the teeth. During short-term horizontal compression, ischemia was greater coronal than apical to the occlusion line. Postocclusive hyperemia was observed not only in the regions affected by ischemia but encompassed a wider area. Hyperemic response was more pronounced and prolonged in male than in female patients. Conclusions Blood flow in the attached gingiva shows spatial differences. Our findings corroborate the apicocoronal orientation of blood circulation. Periodontal and papillary collaterals may have little role in the blood supply of the adjacent attached gingiva under physiological conditions.
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- 2018
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39. Clinical and Histologic Evaluation of an Enamel Matrix Derivative Combined With a Biphasic Calcium Phosphate for the Treatment of Human Intrabony Periodontal Defects
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Attila Horváth, P. Rosta, Dóra Szendröi-Kiss, István Gera, Anton Sculean, Frank Schwarz, Péter Windisch, and Jürgen C. Becker
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Adult ,Calcium Phosphates ,Male ,Alveolar Bone Loss ,Epithelial Attachment ,Dentistry ,Dental Enamel Proteins ,Osteogenesis ,Periodontal Attachment Loss ,Enamel matrix derivative ,Dentin ,Humans ,Periodontal Pocket ,Medicine ,Periodontal fiber ,Prospective Studies ,Cementum ,Cementogenesis ,Tooth Root ,Dental Cementum ,business.industry ,Middle Aged ,Tooth enamel ,stomatognathic diseases ,Treatment Outcome ,medicine.anatomical_structure ,Clinical attachment loss ,Connective Tissue ,Case-Control Studies ,Bone Substitutes ,Chronic Periodontitis ,Tooth Extraction ,Guided Tissue Regeneration, Periodontal ,Periodontics ,Female ,Collagen ,Dental cementum ,business ,Follow-Up Studies - Abstract
Background: The goal of this study was to evaluate clinically and histologically the healing of advanced intrabony defects following regenerative periodontal surgery with an enamel matrix derivative (EMD) combined with a new biphasic calcium phosphate (BCP). Methods: Ten subjects, each of them displaying advanced combined 1- and 2-wall intrabony defects around teeth scheduled for extraction because of advanced chronic periodontitis and further prosthodontic considerations, were included in the study. The defects were consecutively treated with a combination of EMD + BCP. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) to serve as a reference for the histologic evaluation. At 9 months after regenerative surgery, nine of 10 teeth were extracted with some of their surrounding soft and hard tissues and processed for histologic evaluation. Results: There were no adverse effects related to EMD or the graft material used in any of the treated subjects. One tooth was not extracted because of the excellent clinical outcome. The clinical measurements at the nine biopsied teeth demonstrated a mean probing depth reduction of 3.3 ± 1.4 mm and a mean clinical attachment level gain of 3.0 ± 1.6 mm. The histologic findings indicated formation of cementum with inserting collagen fibers to a varying extent. A long junctional epithelium was observed in three of the nine biopsies. Mean new connective tissue attachment (i.e., new cementum with inserting collagen fibers) varied from 0.0 to 2.1 mm. The amount of newly formed bone was limited and varied from 0.0 to 0.7 mm. At 9 months, graft particles were still present and were mostly encapsulated in connective tissue, whereas formation of bone around the graft particles was observed only occasionally. Direct contact between the graft particles and the root surface (cementum or dentin) was not observed in any of the analyzed specimens. Conclusions: The combination of EMD with a BCP bone substitute did not interfere with the regenerative potential reported for EMD and may result in formation of new cementum with an associated periodontal ligament. However, the combination of EMD + BCP resulted in no to minimal new bone formation.
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- 2008
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40. Horizontal augmentation techniques in the mandible: a systematic review
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Ralf Smeets, Levi Matthies, Peter Windisch, Martin Gosau, Ronald Jung, Nadine Brodala, Martina Stefanini, Johannes Kleinheinz, Michael Payer, Anders Henningsen, Bilal Al-Nawas, and Christian Knipfer
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Augmentation ,Horizontal ,Lateral ,Mandible ,Lower jaw ,Medicine ,Dentistry ,RK1-715 - Abstract
Abstract Purpose Placement of dental implants has evolved to be an advantageous treatment option for rehabilitation of the fully or partially edentulous mandible. In case of extensive horizontal bone resorption, the bone volume needs to be augmented prior to or during implant placement in order to obtain dental rehabilitation and maximize implant survival and success. Methods Our aim was to systematically review the available data on lateral augmentation techniques in the horizontally compromised mandible considering all grafting protocols using xenogeneic, synthetic, or allogeneic material. A computerized and manual literature search was performed for clinical studies (published January 1995 to March 2021). Results Eight studies ultimately met the inclusion criteria comprising a total of 276 procedures of xenogeneic, allogeneic, or autogenous bone graft applications in horizontal ridge defects. Particulate materials as well as bone blocks were used as grafts with a mean follow-up of 26.0 months across all included studies. Outcome measures, approaches and materials varied from study to study. A gain of horizontal bone width of the mandible with a mean of 4.8 mm was observed in seven of eight studies. All but one study, reported low bone graft failure rates of 4.4% in average. Conclusions Only limited data are available on the impact of different horizontal augmentation strategies in the mandible. The results show outcomes for xenogeneic as well as autologous bone materials for horizontal ridge augmentation of the lower jaw. The use of allogeneic bone-block grafts in combination with resorbable barrier membranes must be re-evaluated. Randomized controlled clinical trials are largely missing.
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- 2022
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41. Healing of intra-bony defects following treatment with a composite bovine-derived xenograft (Bio-Oss Collagen) in combination with a collagen membrane (Bio-Gide PERIO)
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István Gera, Michel Brecx, Anton Sculean, Péter Windisch, Giovanni Carlo Chiantella, and Nicole B. Arweiler
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Tissue engineering and reconstructive surgery [UMCN 4.3] ,Male ,medicine.medical_specialty ,Bone Regeneration ,Test group ,Alveolar Bone Loss ,Bone Matrix ,Bone matrix ,Surgical Flaps ,medicine ,Animals ,Humans ,Bone regeneration ,Minerals ,business.industry ,Collagen membrane ,Attachment level ,Membranes, Artificial ,Surgery ,Drug Combinations ,Bone Substitutes ,Guided Tissue Regeneration, Periodontal ,Periodontics ,Cattle ,Female ,Collagen ,business ,Nuclear medicine - Abstract
Contains fulltext : 47756.pdf (Publisher’s version ) (Closed access) AIM: The purpose of the present study was to compare clinically the treatment of deep intra-bony defects with a combination of a composite bovine-derived xenograft (BDX Coll) and a bioresorbable collagen membrane [guided tissue regeneration (GTR)] to access flap surgery only. METHODS: Thirty-two patients, each of whom displayed one intra-bony defect, were treated either with BDX Coll+GTR (test) or with access flap surgery (control). The results were evaluated at 1 year following therapy. RESULTS: No differences in any of the investigated parameters were observed at baseline between the two groups. Healing was uneventful in all patients. At 1 year after therapy, the test group showed a reduction in the mean probing depth (PD) from 8.3+/-1.5 to 2.9+/-1.3 mm (p
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- 2005
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42. Healing of intrabony defects following surgical treatment with or without an Er:YAG laser. A pilot study
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Nicole B. Arweiler, George E. Romanos, Mohammad Berakdar, Frank Schwarz, Anton Sculean, and Péter Windisch
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Periodontitis ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Bleeding on probing ,Dentistry ,medicine.disease ,law.invention ,Surgery ,Randomized controlled trial ,law ,Debridement (dental) ,medicine ,Periodontics ,medicine.symptom ,business ,Prospective cohort study ,Adverse effect ,Gingival recession ,Er:YAG laser - Abstract
Aim: The aim of this controlled, parallel design clinical study was to compare the healing of intrabony periodontal defects following treatment with access flap surgery with and without debridement with an Er:YAG laser. Methods: Twenty-three patients each of whom exhibited one deep intrabony defect were randomly treated with either access flap surgery followed by root surface and defect debridement using an Er:YAG laser (KEY3®) (160 mJ, 10 Hz) (test), or with access flap surgery followed by root surface and defect debridement using hand and ultrasonic instruments (control). The following clinical parameters were recorded at baseline and at 6 months: plaque index; gingival index; bleeding on probing; probing depth (PD); gingival recession; and clinical attachment level (CAL). The primary outcome variable was CAL. No statistically significant differences between the groups were found at baseline. Results: No serious adverse events were observed after any of the treatments. The results have shown that in the test group the PD decreased from 7.8±1.3 to 4.1±1.3 mm (p
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- 2004
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43. Immunohistochemical evaluation of matrix molecules associated with wound healing following treatment with an enamel matrix protein derivative in humans
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Nicole Dünker, R. Junker, Nikolaos Donos, Anton Sculean, M Brecx, and Péter Windisch
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Periodontium ,Pathology ,medicine.medical_specialty ,Bone Regeneration ,Periodontal Ligament ,Sialoglycoproteins ,Alveolar Bone Loss ,Medizin ,Matrix (biology) ,Collagen Type I ,03 medical and health sciences ,Collagen Type III ,0302 clinical medicine ,Dental Enamel Proteins ,Alveolar Process ,medicine ,Humans ,Regeneration ,Periodontal fiber ,Cementum ,Bone regeneration ,General Dentistry ,Dental alveolus ,030304 developmental biology ,Dental Cementum ,Extracellular Matrix Proteins ,Wound Healing ,0303 health sciences ,Chemistry ,030206 dentistry ,Anatomy ,Phosphoproteins ,Immunohistochemistry ,medicine.anatomical_structure ,Connective Tissue ,Guided Tissue Regeneration, Periodontal ,Osteopontin ,Bone Remodeling ,Dental cementum ,Wound healing - Abstract
Application of enamel matrix protein derivative (EMD) onto a debrided and conditioned root surface has been shown to promote periodontal regeneration in animals and humans. However, until now there is virtually no information from humans describing the expression of different matrix molecules in the newly formed periodontal tissues following treatment with EMD. This study investigated immunohistochemically in humans the expression of matrix molecules associated with periodontal tissues reformed after treatment with EMD. Eight patients with intrabony defects were treated with EMD. Six months after surgery teeth together with some of their surrounding soft and hard tissues were removed, fixed in buffered formalin, decalcified in EDTA, and embedded in paraffin. Serial sections of 6 micro m were cut in mesiodistal direction. Sections were evaluated immunohistochemically by means of polyclonal antibodies against osteopontin, collagen I and collagen III. The original (non-treated) parts of the periodontium served as controls. In all specimens the healing resulted to a varying extent in formation of cementum, periodontal ligament and alveolar bone. In all specimens the expression of the investigated matrix molecules was stronger at the reformed than at the original sites. Osteopontin expression was most intense at the border near the newly formed cementum and bone. In the regenerated periodontal ligament, collagen I and III were localized throughout the entire periodontal ligament connective tissue. Within the newly formed PDL connective tissue the immunohistochemical staining appeared stronger for collagen III than for collagen I. The present findings suggest that (a) treatment of human intrabony defects with EMD creates an environment favourable for periodontal regeneration and, (b) in humans the healing and/or remodelling process of the reformed tissues may be followed immunohistochemically for a period of 6 months.
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- 2003
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44. Histologic Evaluation of Human Intrabony Defects Following Non-Surgical Periodontal Therapy With and Without Application of an Enamel Matrix Protein Derivative
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István Gera, Péter Windisch, Anton Sculean, and Tibor Keglevich
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Periodontal treatment ,Bone Regeneration ,Root surface ,Ultrasonic Therapy ,medicine.medical_treatment ,Alveolar Bone Loss ,Epithelial Attachment ,Junctional epithelium ,Dentistry ,Scaling and root planing ,Dental Enamel Proteins ,Periodontal Attachment Loss ,Enamel matrix derivative ,medicine ,Humans ,Treatment Failure ,Reduction (orthopedic surgery) ,Enamel paint ,business.industry ,Regeneration (biology) ,visual_art ,visual_art.visual_art_medium ,Dental Scaling ,Periodontics ,Periodontal Index ,business - Abstract
Background: Surgical periodontal treatment with enamel matrix protein derivative (EMD) has been shown to promote periodontal regeneration. However, it is not known whether nonsurgical periodontal therapy with additional subgingival application of EMD may also enhance periodontal regeneration. The purpose of this study was to clinically and histologically evaluate healing of human intrabony defects following non-surgical periodontal treatment with and without application of EMD. Methods: Sixteen patients, each of whom displayed one advanced intrabony defect around teeth or roots scheduled for extraction, were included in the study. The defects were treated as follows: 1) scaling and root planing with hand instruments and application of EMD; 2) scaling with an ultrasonic instrument and application of EMD; or 3) scaling with an ultrasonic instrument alone. Healing was uneventful in all cases. Six months after surgery, the teeth or roots were extracted together with some of their surrounding soft and hard tissues and processed for histologic evaluation. Results: Clinical examination revealed a probing depth reduction and a gain of clinical attachment after all 3 treatment modalities. The histological evaluation, however, revealed that healing in all 3 procedures was predominantly characterized by formation of a long junctional epithelium along the instrumented root surface and no predictable regeneration of attachment apparatus. Conclusion: Within its limits, the present study failed to show periodontal regeneration in advanced human intrabony defects following non-surgical treatment with subgingival application of EMD. J Periodontol 2003;74:153-160.
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- 2003
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45. Patterns of cytokeratin expression in monkey and human periodontium following regenerative and conventional periodontal surgery
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Elmar Reich, Anton Sculean, S. Pahl, Mohammad Berakdar, Nikolaos Donos, M Brecx, and Péter Windisch
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Periodontitis ,Pathology ,medicine.medical_specialty ,business.industry ,Junctional epithelium ,Periodontium ,Anatomy ,Epithelial cell rests of Malassez ,medicine.disease ,Cytokeratin ,medicine.anatomical_structure ,medicine ,Periodontics ,Periodontal fiber ,Immunohistochemistry ,Cementum ,business - Abstract
The pattern of cytokeratin expression has been extensively described in the normal and inflamed periodontium. However, there is no information regarding the pattern of cytokeratin expression in the periodontium which has been reformed following regenerative periodontal surgery. The aim of the present investigation was to evaluate the pattern or cytokeratin expression in the reformed human and monkey periodontium following regenerative and conventional periodontal surgery. In 3 monkeys. acute fenestration-type and chronic intrabony defects were treated with guided tissue regeneration (GTR), enamel matrix proteins (EMD), or coronally repositioned flap surgery (control). After a healing period of 5 months, the animals were sacrificed and perfused with 10% buffered formalin for fixation. Specimens containing the defects and surrounding tissues were dissected free, decalcified in EDTA and embedded in paraffin. Histological sections were cut with the microtome set at 3 pm. The sections were alternatively stained either with hematoxylin and eosin, or inimunohistochemically by using one of the broad range monoclonal antibodies 34 betaE 12 (for cytokeratins 1, 5, 10 and 14) or KL1 (for cytokeratins 1, 2, 5, 6, 7. 8, 10 11, 16 and 19). or one of the individual monoclonal antibodies LL025 (for cytokeratin 16), DC 10 (for cytokeratin 18), A53-B/A-2 (for cytokeratin 19). Twelve patients. each displaying one deep intrabony defect scheduled for extraction due to advanced periodontitis or prosthetic reasons, were treated as described above, Following a healing period of 6 months. the teeth were extracted together with some or their surrounding soft and hard tissues. The histological and immunohistochemical processing of the human biopsies was identical to that described in monkeys. The results revealed that both the normal non-treated (original) monkey and human junctional epithelium stained strongly with all of the monoclonal antibodies used. The reformed junctional epithelium displayed the same cytokeratin expression pattern as the non-treated junctional epithelium. No differences regarding the cytokeratin expression pattern of the junctional epithelium were found between the treatments and types of healing (i.e. regenerative. through a new periodontal ligament, or reparative through a long junctional epithelium,). In the intact periodontal ligament, the epithelial rests of Malassez displayed a comparable cytokeratin expression pattern to that of the junctional epithelium. However, no expression of cytokeratins was seen in the newly formed periodontal ligament. In such specimens. cytokeratin expression was observed only until the borderline between the regenerated cementum and the epithelial downgrowth. It was concluded that: a) the reformed junctional epithelium. following any type of surgical procedure. displays a similar pattern of cytokeratin expression to the original junctional epithelium; b) in the newly formed periodontal ligament. no expression of cytokeratins is present: and c) the epithelial rests of Malassez do not seem to reform after regenerative periodontal Surgery.
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- 2001
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46. Healing of human intrabony defects following treatment with enamel matrix proteins or guided tissue regeneration
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Elmar Reich, István Gera, Péter Windisch, Nikolaos Donos, Thorkild Karring, Anton Sculean, and M Brecx
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Adult ,Time Factors ,Biopsy ,Dentistry ,Connective tissue ,Biocompatible Materials ,Bone and Bones ,Dental Enamel Proteins ,Absorbable Implants ,Enamel matrix derivative ,medicine ,Humans ,Cementum ,Periodontitis ,Bone regeneration ,Polyglactin 910 ,Wound Healing ,Enamel paint ,business.industry ,Chemistry ,Membranes, Artificial ,Tooth enamel ,medicine.disease ,medicine.anatomical_structure ,visual_art ,Guided Tissue Regeneration, Periodontal ,visual_art.visual_art_medium ,Periodontics ,business ,Wound healing - Abstract
The aim of the present study was to evaluate histologically in humans the healing of advanced intrabony defects following treatment with enamel matrix proteins (EMD) or guided tissue regeneration (GTR). Fourteen patients, each of them displaying 1 advanced intrabony defect around teeth scheduled for extraction were included in the study. The defects were treated randomly either with an enamel matrix protein derivative (Emdogain, BIORA AB, Malmo, Sweden) or with a bioabsorbable membrane (Resolut, Regenerative Material, W.L. Gore & Assoc., Flagstaff, Arizona, USA). At baseline the mean probing pocket depth (PPD) in the EMD group was 11.3 +/- 1.8 mm and the mean clinical attachment level (CAL) 12.1 +/- 2.0 mm, whereas in the GTR group the mean PPD was 11.4 +/- 2.2 mm and the mean CAL 13.3 +/- 2.3 mm. Healing was uneventful in all cases. Neither allergic reactions against EMD or the bioabsorbable membrane, nor suppuration or abscesses were observed. The clinical results revealed at 6 months in the EMD group a mean PPD of 5.6 +/- 1.3 mm and a mean CAL of 9.1 +/- 1.5 mm. In the GTR group the mean PPD was 5.6 +/- 1.3 mm and the mean CAL 10.1 +/- 1.5 mm. The histological analysis showed in the EMD group a mean 2.6 +/- 1.0 mm of new attachment (i.e. new cementum with inserting collagen fibers) and a mean 0.9 +/- 1.0 mm of new bone. In this group, the formation of new attachment was not always followed by bone regeneration. In the GTR group, the mean new attachment was 2.4 +/- 1.0 mm and the mean new bone 2.1 +/- 1.0 mm. In every case treated with GTR, the formation of new attachment was followed by a varying amount of new bone. After both types of regenerative treatment the newly formed cementum displayed a predominantly cellular character. The findings of the present study indicate that the treatment of intrabony defects with enamel matrix proteins or with bioabsorbable membranes enhances the formation of a new connective tissue attachment in humans.
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- 1999
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47. [Prosthodontic rehabilitation of immediately placed dental implants following soft tissue augmentation. Case report]
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Péter, Windisch, Réka, Fazekas, and Arpád, Fazekas
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Dental Implants ,Male ,Titanium ,Crowns ,Dental Implantation, Endosseous ,Alveolar Bone Loss ,Dental Abutments ,Esthetics, Dental ,Allografts ,Prosthodontics ,Treatment Outcome ,Tooth Extraction ,Humans ,Acellular Dermis ,Gingival Recession ,Mandibular Diseases ,Aged - Abstract
A 68-year-old nonsmoking male patient with thin gingival biotype presented for treatment of mobile mandibular left premolars. Extraction of teeth and immediate dental implant placement has been suggested. To prevent vestibular gingival recession and insure tissue stability by increasing thickness of marginal gingiva, acellular dermal matrix allograft was applied using the coronally advanced modified tunnelling technique. Six months later premolars were extracted, immediately replaced with implants and temporary crowns. After another four months, definitive gold ceramic crowns were cemented on prefabricated titanium abutments. Due to the altered gingival biotype and application of the platform switching phenomenon no vertical bone resorption and gingival recession was recorded at 6, 12 and 24 month follow-up with a well acceptable esthetic appearance.
- Published
- 2013
48. Treatment of multiple adjacent Miller Class I and II gingival recessions with collagen matrix and the modified coronally advanced tunnel technique
- Author
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Bálint, Molnár, Sofia, Aroca, Tibor, Keglevich, István, Gera, Péter, Windisch, Andreas, Stavropoulos, and Anton, Sculean
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Adult ,Gingivoplasty ,Male ,Pain, Postoperative ,Adolescent ,Tissue Scaffolds ,Dental Plaque Index ,Gingiva ,Pilot Projects ,Surgical Flaps ,Young Adult ,Treatment Outcome ,Patient Satisfaction ,Absorbable Implants ,Humans ,Keratins ,Periodontal Pocket ,Female ,Gingival Recession ,Collagen ,Prospective Studies ,Periodontal Index ,Tooth Root ,Follow-Up Studies - Abstract
To clinically evaluate the treatment of Miller Class I and II multiple adjacent gingival recessions using the modified coronally advanced tunnel technique combined with a newly developed bioresorbable collagen matrix of porcine origin.Eight healthy patients exhibiting at least three multiple Miller Class I and II multiple adjacent gingival recessions (a total of 42 recessions) were consecutively treated by means of the modified coronally advanced tunnel technique and collagen matrix. The following clinical parameters were assessed at baseline and 12 months postoperatively: full mouth plaque score (FMPS), full mouth bleeding score (FMBS), probing depth (PD), recession depth (RD), recession width (RW), keratinized tissue thickness (KTT), and keratinized tissue width (KTW). The primary outcome variable was complete root coverage.Neither allergic reactions nor soft tissue irritations or matrix exfoliations occurred. Postoperative pain and discomfort were reported to be low, and patient acceptance was generally high. At 12 months, complete root coverage was obtained in 2 out of the 8 patients and 30 of the 42 recessions (71%).Within their limits, the present results indicate that treatment of Miller Class I and II multiple adjacent gingival recessions by means of the modified coronally advanced tunnel technique and collagen matrix may result in statistically and clinically significant complete root coverage. Further studies are warranted to evaluate the performance of collagen matrix compared with connective tissue grafts and other soft tissue grafts.
- Published
- 2013
49. Histological evaluation of human intrabony periodontal defects treated with an unsintered nanocrystalline hydroxyapatite paste
- Author
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Andreas Stavropoulos, Anton Sculean, Attila Horváth, László Lukács, István Gera, and Péter Windisch
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bone Regeneration ,Treatment outcome ,Subgingival Curettage ,Alveolar Bone Loss ,Dentistry ,610 Medicine & health ,Epithelium ,Surgical Flaps ,Young Adult ,Calcification, Physiologic ,Osteogenesis ,Absorbable Implants ,Periodontal Attachment Loss ,medicine ,Alveolar Process ,Humans ,Periodontal Pocket ,Cementogenesis ,General Dentistry ,Aged ,business.industry ,Follow up studies ,Middle Aged ,medicine.disease ,Chronic periodontitis ,Surgery ,Durapatite ,Treatment Outcome ,Connective Tissue ,Bone Substitutes ,Chronic Periodontitis ,Guided Tissue Regeneration, Periodontal ,Nanoparticles ,Female ,business ,Calcification ,Follow-Up Studies - Abstract
OBJECTIVES The aim of the study was to clinically and histologically evaluate the healing of human intrabony defects treated with open flap surgery (OFD) and application of a new, resorbable, fully synthetic, unsintered, nanocrystalline, phase-pure hydroxyapatite (nano-HA). MATERIALS AND METHODS Six patients, each of them displaying very advanced intrabony defects around teeth scheduled for extraction due to advanced chronic periodontitis and further prosthodontic considerations, were included in the study. Following local anaesthesia, mucoperiosteal flaps were reflected; the granulation tissue was removed, and the roots were meticulously debrided by hand and ultrasonic instruments. A notch was placed at the most apical extent of the calculus present on the root surface or at the most apical part of the defect (if no calculus was present) in order to serve as a reference for the histological evaluation. Following defect fill with nano-HA, the flaps were sutured by means of mattress sutures to allow primary intention healing. At 7 months after regenerative surgery, the teeth were extracted together with some of their surrounding soft and hard tissues and processed for histological analysis. RESULTS The postoperative healing was uneventful in all cases. At 7 months following surgery, mean PPD reduction and mean CAL gain measured 4.0 ± 0.8 and 2.5 ± 0.8 mm, respectively. The histological analysis revealed a healing predominantly characterized by epithelial downgrowth. Limited formation of new cementum with inserting connective tissue fibers and bone regeneration occurred in three out of the six biopsies (i.e. 0-0.86 and 0-1.33 mm, respectively). Complete resorption of the nano-HA was found in four out of the six biopsies. A few remnants of the graft particles (either surrounded by newly formed mineralized tissue or encapsulated in connective tissue) were found in two out of the six biopsies. CONCLUSION Within their limits, the present results indicate that nano-HA has limited potential to promote periodontal regeneration in human intrabony defects. CLINICAL RELEVANCE The clinical outcomes obtained following surgery with OFD + nano-HA may not reflect true periodontal regeneration.
- Published
- 2013
- Full Text
- View/download PDF
50. Possible Applications for a Biodegradable Magnesium Membrane in Alveolar Ridge Augmentation–Retrospective Case Report with Two Years of Follow-Up
- Author
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Daniel Palkovics, Patrick Rider, Svenja Rogge, Željka Perić Kačarević, and Peter Windisch
- Subjects
magnesium membrane ,resorbable barrier membrane ,staged GBR ,3D evaluation ,CBCT subtraction ,Medicine (General) ,R5-920 - Abstract
Background and Objectives: A rigid, resorbable magnesium membrane was recently developed, combining the advantages of resorbable and non-resorbable membranes. Our aim was to describe the application of this membrane for guided bone regeneration (GBR). Materials and Methods: This case report described the treatment and 3D evaluation of two cases utilizing a resorbable magnesium barrier membrane. In Case #1, GBR was performed with a bilayer tunnel flap. The magnesium barrier was placed fixed subperiosteally through remote vertical incisions. In Case #2, GBR was performed using a split-thickness flap design. Volumetric and linear hard tissue alterations were assessed by 3D cone-beam computed tomography subtraction analysis, as well as with conventional intraoral radiography. Results: Case #1 showed a volumetric hard tissue gain of 0.12 cm3, whereas Case #2 presented a 0.36 cm3 hard tissue gain. No marginal peri-implant hard tissue loss could be detected at the two-year follow-up. Conclusions: The application of conventional resorbable collagen membranes would be difficult in either of the cases presented. However, the rigid structure of the magnesium membrane allowed for the limitations of conventional resorbable membranes to be overcome.
- Published
- 2023
- Full Text
- View/download PDF
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