The invisible becomes visible and holds both challenge and fascination. The cellular-level biological processes that underlie osseointegration are visualized based on the cell types and messengers implicated, representing the current state of our knowledge. Complex biodynamic processes are showcased dramatically and didactically to support the transfer of knowledge in training and education. Module 1, Cell-To-Cell Communication - Osseointegration, ushers in an Initiative for Excellence entitled Education - Science Comes Alive. It will eventually present all the relevant biomedical processes in dentistry and oral and maxillofacial surgery in the form of 3D animations, to be made available to a professional public as a 3D film library. This innovative genre - with special highlights for every viewer - will open up interesting teaching and training perspectives. Outline: - Hemostasis - Inflammatory Phase - Proliferative Phase - Remodeling Phase On This Film Main Cast: Platelets, Fibroblasts, Endothelial Cells, Granulocytes, Macrophages, Pericytes, Osteoclasts, Osteoblasts, Osteocytes Also Starring: PDGF, Thromboxane, TGF - a, TGF - ß, VEGF, NO, ACE, TNF - a, IL - 1, IL - 6, FGF, MIP - 1, RANKL, Sclerostin Length: 12 minutes Project/Expert Team Authors and Scientific Management: Bernd Stadlinger, PD Dr. Dr. | Hendrik Terheyden, Prof. Dr. Dr. Advisory Board: Lyndon F. Cooper, DDS, PhD | Christoph Hämmerle, Prof. Dr. Thomas Hoffmann, Prof. Dr. | Myron Nevins, DDS Technical Advisors: Susanne Bierbaum, Dr. | Uwe Eckelt, Prof. Dr. Dr. Ute Hempel, Dr. | Lorenz Hofbauer, Prof. Dr. Dieter Scharnweber, Prof. Dr. (Transregio 67)

Objectives: The main goal of this study was to compare the soft-tissue volume gain around dental implants with subepithelial connective tissue grafts (SCTG) originating from either palate or the tuberosity. The secondary goal was to compare changes in clinical parameters: plaque index (PI), bleeding on probing (BOP), probing depth (PD) and width of keratinised tissue (KT). Methods: Patients with single tooth implants already osseointegrated and in need of soft tissue augmentation were recruited (n = 12) and randomly received an SCTG from the palate (control group) or tuberosity (test group). Recipient sites were prepared by an intracrevicular incision at the buccal side extending to one adjacent tooth on each side, before raising a partial-thickness flap. Grafts of standarised dimensions were stabilised to the buccal flap and closure was achieved without tension. In order to examine volumetric tissue changes, an intraoral optical scanner was used to take two optical impressions at baseline and again 3 months after surgery. Digital software was used to superimpose the stereolithography (STL) files and calculate volume gain. Volumetric changes were calculated at three levels below the healing abutment on the buccal side of the implants (at 1.3mm and 5.0mm). The secondary outcomes
were evaluated at baseline and at 3 months. Differences between control and teset groups were calculated for the quantitative variables using the Student’s t-test or Mann–Whitney test (depending on the normality of the distribution) and Chi-squared test for the qualitative variables. A p value of Results: No significant differences in baseline defect size were observed between groups. At 1mm volume gain was 1.28 ± 0.89mm for palate grafts (controls) and 1.28 ± 0.83mm for tuberosity grafts(p=0.39); at 3mm it wasoriginal, 84 ± 1.21mm for palate and 1.1 ± 0.4mm for tuberosity (p=0.31); and at 5mm it was 0.66 ± 0.23mm for palate and 0.95 ± 0.48mm for tuberosity (p=0.39). No statistically significant differences were observed at any level. The tuberosity grafts had a higher volume gain with a mean gain of 1.12 ± 0.57mm (versus a mean gain of 0.88 ± 0.94mm for palate), but these results were not statistically significant (p=0.42). Similarly, there was a tendency for higher KT gain for the tuberosity group, with an increase of 1.16 ± 0.98mm, versus 0.66 ± 0.82mm (p=0.36). A statistically significant reduction in PI was observed for the controls, from 18.0 ±0.89% to 16.3 ±1.03% (p=0.01), but only a slight (non-statistically) significant increase was seen in the test group. Non-statistically significant differences were also observed for PB and BOP. Conclusion: The main goal of this study was to compare the soft-tissue volume gain around dental implants using SCTGs of the same dimensions from either palate or tuberosity. Although the present data is only preliminary, procedures were effective in increasing volume gain around the implants at 3 months. Differences were statistically non-significant, but there was a tendency for increased volume gain with SCTGs from the tuberosity (1.12±0.57mm) compared to palate (0.88±0.94mm). Furthermore, there was a tendency towards for greater KT gain in the tuberosity group (1.16±0.98mm versus 0.66±0.82mm in the palate group).

Objectives: The use of a bovine-derived xenograft is a reliable alternative to autogenous bone when performing a sinus lift by means of the lateral window technique. Few studies report on the vertical resorption of the augmented bone, and these are mainly based on panoramic images. This retrospective case series aimed to assess vertical resorption of augmented bone by means of peri-apical radiographs. Methods: Between 2012 and 2013, patients underwent sinus lifting in two practices. Each augmentation procedure was performed using the lateral window technique and a bovine-derived xenograft (Bio-Ossä/®). Peri-apical radiographs were taken to assess the following parameters: initial native bone height (BH-B), bone height after sinus augmentation and implant placement (BH-IP), and bone height at tome of evaluation (BH-F). Results: Of a total of 70 eligible patients, 57 (mean age 56 years; SD11) could be evaluated. Mean follow-up time was 19 months (SD9). The parameters BH-B, BH-IP and BH-F were on average 3.87mm (SD1.74), 13.75 mm (SD2.12) and 13.11mm (SD 2.12), respectively. These differences were all highly significant (p Conclusions: Sinus lifting using the lateral window technique and bovine-derived xenografts is a predictable treatment. Irrespective of the initial native bone height, augmentation can be successfully achieved and only limited resorption is likely in the short term.