Background: Emerging clinical data points to the relevance of the presence of keratinized tissue (KT). Although apically positioned flap/vestibuloplasty along with free gingival graft (FGG) is considered as a standard intervention for augmenting KT, substitute materials appear to be a viable treatment alternative. So far, there is a lack of data investigating the dimensional changes at implant sites treated with soft-tissue substitutes or FGG. Aim: The present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period. Materials and Methods: The study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes. Results: Dimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of − 0.14 ± 0.27 mm and − 0.04 ± 0.40 mm in the CM group, and − 0.08 ± 0.29 mm and − 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: − 0.03 ± 0.22 mm, FGG: − 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001). Conclusions: CM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics. Graphical
1 January 2024 in Electronic Journal of Probability
Consider an advantageous allele that arises in a haploid population of size N evolving in continuous time according to a skewed reproduction mechanism, which generates under neutrality genealogies lying in the domain of attraction of a Beta (2−α,α)-coalescent for α∈(1,2). We prove in a setting of moderate selection that the fixation probability πN of the advantageous allele is asymptotically equal to α1∕(α−1)sN1∕(α−1), where sN is the selection strength of the advantageous allele. Our proof uses duality with a suitable Λ-ancestral selection graph.
28 June 2023 in International Journal of Implant Dentistry
Purpose: The aim of the study was to identify the best prediction model for the growth pattern of the maxillary segments of infants with unilateral cleft lip and palate post birth and prior to the primary surgical cleft closure. Materials and methods: 195 digital maxillary models of 50 infants with unilateral cleft lip and palate were collected during their preoperative alveolar molding therapy period. Intraoral scans were taken shortly after birth, at the monthly checkups and just before the surgical cleft closure at approximately 6 months of age. Surface measurements of maxillary segments were conducted using the diagnostic program OnyxCeph³™. For identifying the best fit for the growth pattern, mixed-effects regression models (fractional polynomials and B-splines) with the surface measurement as dependent variable, patient age (days) as predictor and the patient as random effect were fitted to the data. The best fit was selected according to the Akaike Information Criterium. A likelihood ratio test was performed for comparing the selected model with the intercept-only model. Results: The linear regression with mixed effects model showed the best fit for the total area, the area of the large segment and the area of the small segment. A highly significant association between the surface area and patient age was observed (p < 0.001). An increase of the area with time was estimated at 2.88 mm2 per day for the total area, 1.62 mm2 per day for the area of the large segment and 1.25 mm2 per day for the area of the small segment. The likelihood ratio tests indicated that the linear regression models were significantly better than the intercept-only models for all the measured areas (p < 0.01). Conclusion: The growth pattern for the maxillary segments of patients with unilateral cleft lip and palate in the preoperative period can be best predicted by using a linear regression model. The growth curve model developed by the present study can be used in future treatment planning of patients with unilateral cleft lip and palate.
Background and Objectives: Patients with unilateral cleft lip and palate (UCLP) require a phase of infant orthopedic treatment prior to surgical cleft closure. Treatment planning in this phase necessitates a thorough understanding of maxillary growth dynamics in this period. The aim of the present study was to evaluate the quantitative and qualitative surface growth of maxillary segments in infants with UCLP. Materials and Methods: In total, 195 intraoral scans from 50 patients were obtained postnatal (T0), at monthly intervals (T1–5), and prior to surgical cleft closure at 6 months of age (T6). Surface, linear, and angle measurements of the maxillary segments were performed. Results: Significant increases in the total surface area and the surface areas of the small and large segments were observed at monthly intervals and over the overall duration. The large segment showed greater absolute growth (11.62 mm2 per month, 46.57 mm2 total), while the small segment had a higher percentage increase (1.49% monthly, 6.57% overall). A positive small correlation was observed between surface area growth changes in the small segment and its increase in length. Conclusions: Our results revealed distinct growth patterns of the large and small segments in amount and direction, underscoring the relevance of incorporating segment arch width in surface evaluations.
Consider an advantageous allele that arises in a haploid population of size $N$ evolving in continuous time according to a skewed reproduction mechanism, which generates under neutrality genealogies lying in the domain of attraction of a Beta$(2-\alpha, \alpha)$-coalescent for $\alpha \in (1,2)$. We prove in a setting of moderate selection that the fixation probability $\pi_N$ of the advantageous allele is asymptotically equal to $\alpha^{1/(\alpha-1)} s_N^{1/(\alpha-1)}$ , where $s_N$ is the selection strength of the advantageous allele. Our proof uses duality with a suitable $\Lambda$-ancestral selection graph.