Hom-Lay Wang

Hom-Lay Wang
University of Michigan | U-M · Department of Periodontics and Oral Medicine

DDS. MS, Ph D
Director of Graduate Periodontics; President-Elect, Academy of Osseointegration

About

837
Publications
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Introduction
Hom-Lay Wang currently works at the Department of Periodontics and Oral Medicine, University of Michigan.
Additional affiliations
February 1989 - present
University of Michigan
Position
  • Professor (Full)

Publications

Publications (837)
Article
Background: Tooth-level prognostic systems are valuable tools for treatment planning and risk assessment of periodontally involved teeth. Recently the Miller-McEntire prognosis index was found to outperform comparable systems. However, it had some limitations. The present study aimed to develop and evaluate the prognostic performance of a modified...
Article
Full-text available
The aim of the present study was to generate an international and multidisciplinary consensus on the clinical management of implant protrusion into the maxillary sinuses and nasal fossae. A total of 31 experts participated, 23 of whom were experts in implantology (periodontologists, maxillofacial surgeons and implantologists), 6 were otolaryngologi...
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Peri-implantitis is an infectious disease that leads to progressive bone loss. Surgical therapy has been advocated as a way of halting its progression and re-establishing peri-implant health. One of the most challenging but crucial tasks in the management of peri-implantitis is biofilm removal to achieve reosseointegration and promote the reduction...
Article
Background: This study aimed to evaluate the effect of scaling and root planing (SRP) on levels of plasma C-reactive protein (CRP). Methods: A total of 30 patients with advanced periodontitis as determined by Clinical Periodontal Sum Score (CPSS) were recruited. Venous whole blood samples were drawn from to obtain serum samples were obtained fro...
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Objectives Soft tissue phenotype modification (STPM) could be performed to maintain peri-implant health. Therefore, the aim of the study was to analyze tissue alteration around implants following soft tissue phenotype modification during implant uncovering surgery.Materials and methodsPatients who had STPM (either pouch roll or modified roll techni...
Article
Background: The aim of this randomized clinical trial was to clinically and histologically compare the amount and quality of bone gained after lateral ridge augmentation (LRA) procedures performed using small (250-1000μm) versus large (1000-2000μm) particle size cortico-cancellous bone allografts at 6 months following surgical intervention. Mater...
Article
Background: The aim of this randomized clinical trial was to compare a flapless technique of alveolar ridge preservation (ARP) to a flap technique, to determine if preserving the periosteal blood supply would limit loss of crestal ridge width and height. Materials and methods: Twenty-four patients were randomly assigned to receive ARP using eith...
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The assortment of periodontal and implant‐related treatments has been continuously improved over the last 50 years. Once the decision‐making process has been established and the treatment procedure applied, the partial or complete resolution of the problem (eg, periodontal probing depth reduction, clinical attachment level gain, gingival recession...
Article
Background: The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high-density polytetrafluoroethylene (d-PTFE) membrane is well documented in the literature. Purpose: The aim of this study was to assess vital mineralized tissue formation in vertical rid...
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Objectives The aim of this study is to evaluate the effect of guide level on the accuracy of static computer-aided implant surgery (sCAIS) at post-extraction sockets and healed sites. Materials and methods A total of 30 duplicate dental models, with 300 potential implant sites, were used. All the models were equally randomized into three groups: f...
Article
Common challenges encountered for atrophic maxilla rehabilitation are the inadequate width and height of attached keratinized mucosa (AKM) and shallow vestibular depth. This study presents a buccally displaced palatal (BDP) flap technique to increase the tissue thickness and AKM width at the second-stage surgery and reestablish the correct fornix d...
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Aim: To evaluate the efficacy of recombinant human platelet-derived growth factor-BB (rhPDGF) combined with a cross-linked collagen matrix (CCM) for the treatment of multiple adjacent gingival recession type 1 defects (MAGRs) in combination with the coronally advanced flap (CAF). Materials and methods: Thirty patients were enrolled in this tripl...
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Background: The relationship between maxillary sinus pneumatization and respiratory-induced fluid mechanics remains unclear. The purpose of this study was to simulate and measure the respiratory-induced mechanical stimulation at the sinus floor under different respiratory conditions and to investigate its potential effect on the elevated sinus foll...
Article
Prosthetic design is a critical step in implant treatment planning that must synchronize with implant positioning to promote a state of peri-implant health. Improperly designed prostheses may not only hinder patient (or professional) hygiene measures but also impact the ability of clinicians to examine the peri-implant supporting tissues for diagno...
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Purpose: Since flap advancement is a prerequisite for tension-free primary closure and successful regenerative procedures, the aim of this study was to test the efficacy of six surgical approaches for flap advancement in an ex vivo porcine model. Materials and methods: A total of 60 fresh mandibles from pigs were randomized into one of six group...
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Objective To compare the in vitro decontamination efficacy of two electrolytic cleaning methods to diode laser, plasma, and air-abrasive devices. Material and methods Sixty sandblasted large-grit acid-etched (SLA) implants were incubated with 2 ml of human saliva and Tryptic Soy Broth solution under continuous shaking for 14 days. Implants were th...
Article
Background: The association between thickness of peri-implant mucosa, known as mucosal tunnel (MT) and related clinical parameters in bone-level implants has not been investigated. Methods: Posterior implants, in patients with controlled periodontitis, were evaluated at different time intervals: during uncovering surgery(T0 ), 2-month after unco...
Article
Background: The aim of this study was to compare the effects of four different commonly used wound dressings in improving patient reported outcomes (PROMS) after free epithelialized mucosal grafts (FEGs) harvesting. Material and methods: Following 72 FEGs harvesting from 72 patients, patients were assigned into 4 groups. Control: collagen plug...
Article
Objective: A buccal opening guide provides better view and better irrigation. The aim of this study was to investigate the accuracy of this open-sleeve system. Material and methods: Thirty duplicated maxillary models, each with 6 extraction sockets and 4 healed sites, were used. Based on the same digital plan, three modalities, sCAIS with open-s...
Article
Background: The amount of initial physiological bone remodeling (IPBR) after implant placement varies and the ways it may play a role in peri-implantitis development remains unknown. The aim of this retrospective study was to investigate the association between the amount of IPBR during the first year of implant placement and incidence of peri-imp...
Article
Maxillary sinus wall fenestration at the lateral wall or floor of the sinus can result from many potential factors, such as the repair of oro-antral communication, Caldwell-Luc antrostomy, tooth extraction after an endodontic or periodontal infection that eroded the sinus wall, and the combination of sinus pneumatization and alveolar ridge resorpti...
Article
In this prospective pilot study on ridge preservation (RP), a collagen sponge was placed to fill the bottom half of the socket, followed by a sequence of bone graft, collagen membrane, and a sponge placed on top. Twelve patients with 13 hopeless posterior teeth were included. Changes in bone dimension (including variations of horizontal ridge width...
Article
Autogenous soft tissue grafting is a commonly performed procedure in periodontal and implant surgery. Reharvesting a connective tissue graft (CTG) from the same palatal donor site is often required, but little is known about the volumetric changes that occur after harvesting a free gingival graft and how long the palatal mucosa takes to regain its...
Article
Horizontal ridge augmentation is a common surgical procedure performed prior to or simultaneously with implant placement, depending on the extent of the ridge deficiency. Many horizontal augmentation surgical options have been developed, spanning a wide range of materials and techniques. Given the numerous permutations available, the most suitable...
Article
Background: Implant placement in maxillary molar sites with severe height deficiency often requires multiple surgeries, which was time-consuming, invasive, and subject to serious postoperative complications. Purpose: To introduce and assess a three-in-one technique (extraction, alveolar ridge preservation [ARP], and sinus elevation) for augmenti...
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Aim: To assess the prognostic value of soft tissue phenotype modification following root coverage procedures for predicting the long-term (10-year) behaviour of the gingival margin. Materials and methods: Participants from six randomized clinical trials on root coverage procedures at the University of Michigan were re-invited for a longitudinal...
Preprint
Objectives Soft tissue phenotype modification could be performed to maintain peri-implant health. Therefore, the aim of the study was to analyze tissue alteration around implants following soft tissue phenotype modification during implant uncovering surgery. Materials and methods Patients had soft tissue phenotype modification (either pouch roll or...
Article
Full-text available
Introduction To minimize trauma and cost of treatment, oral health practitioners have successfully rehabilitated full arches by supporting the prostheses on four implants. However, there is no consensus whether less than four implants supporting full mandibular arches would provide similar clinical outcomes to other well-established all-on-four alt...
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The purpose of this clinical series was to evaluate the clinical and radiographic outcomes of 20 zirconia dental implants, with a minimum follow-up of two years. Patients with at least one zirconia dental implant were included, with a mean follow-up of 34.05 months. The patient complaints such as pain and foreign body sensation, as well as clinical...
Article
Purpose: To assess whether bone grafting is associated with early implant failure (defined as a lack of osseointegration detected prior to functional loading) and to evaluate the association between bone grafting procedures and other risk factors for early implant failure. Materials and methods: Two independent reviewers conducted an electronic...
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Background: Studies have examined the benefit of having keratinized peri-implant mucosa width with mixed results. Purpose: This study examines whether the lack of a prespecified (2 mm) amount of keratinized mucosa width (KMW) is a risk factor for peri-implant diseases. Methods: A systematic electronic and manual search of randomized or nonrand...
Article
Background: The treatment of the peri-implantitis remains complex and challenging with no consensus on which is the best treatment approach. Purpose: To examine the key local and systemic factors associated with implant loss, disease progression, or favorable outcomes after surgical peri-implantitis therapy. Materials and methods: Records of p...
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Allografts have been routinely used for immediate grafting of extraction sites as modalities of alveolar ridge preservation (ARP). Solvent-dehydrated bone allograft (SDBA), which is commonly utilized for socket grafting, exists in the form of cortical and cancellous particles. This study aims to provide a histologic comparison of cortical and cance...
Article
Background: Full thickness mucoperiosteal flap (FTF) elevation could potentially affect the periodontium of the involved teeth; it is not clear if the periodontal phenotype of teeth involved in a FTF may influence these changes. The aim of this study was to evaluate the impact of FTF on teeth periodontium, as well as assessing the impact of periodo...
Article
Background & aim: The aim of this study was to test a non-submerged reconstructive approach for peri-implantitis osseous defects, by removing the prosthetic components, augmenting of the infraosseous bony compartment, and flap re-adaptation around the replaced healing abutments, without obtaining a primary wound closure. Methods: Twenty-nine imp...
Article
Background: Along with the popularity of dental implants, implant esthetic complications are also on the rise. Recently a classification was proposed to comprehensively evaluate these conditions, with the definition of peri-implant soft tissue dehiscence/deficiencies (PSTDs). The aim of this article was therefore to test the inter-examiner agreeme...
Article
Aim: To evaluate the accuracy of dynamic navigation-guided surgery (DNGS) for implant positioning performed by a novice operator. Secondary objectives were to analyze the operator's learning curve and to identify possible complications deriving from the technique. Material & methods: Twenty-five implants were placed in eight partially edentulous...
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Background: Alveolar ridge preservation (ARP) can successfully reduce volumetric ridge changes. However, there is still no consensus on what technique is the most advantageous for each specific clinical scenario. Hence, the aim of the present paper was to provide a treatment decision tree to guide the choice of predictable ARP procedures based on...
Article
Purpose: The aim of this clinical study was to verify the predictability of the rehabilitation of extremely atrophic jaws with immediately loaded short implants and evaluate posterior mandibular regrowth. Materials and methods: A cohort of consecutive fully edentulous patients wearing complete dentures in both arches was enrolled. Periodically,...
Article
Objective Soft tissue augmentation (STA) at implant sites has the potential of improving peri-implant health, esthetics, and marginal bone level stability. The present study aimed at evaluating the volumetric changes occurring following implant placement in sites that received STA compared to non-augmented sites. Methods A total of 26 subjects rec...
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Objectives The primary aim of this systematic review was to evaluate whether intraoral scanning (IOS) is able to reduce working time and improve patient-reported outcome measures (PROMs) compared to conventional impression (CI) techniques, taking into account the size of the scanned area. The secondary aim was to verify the effectiveness of IOS pro...
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Peri-implant diseases at implant sites represent the most considerable concern for many dental clin-icians nowadays due to their detrimental effect on implant longevity. Preventive measures include patient education and motivation, supportive peri-implant therapy and routine assessment of the hard and soft tissues. Nevertheless, the reliability of...
Article
The coronally advanced flap technique is one of the most commonly used approaches for treating gingival recession. Several modifications of the technique have been proposed over the years, making it a highly predictable treatment option for gingival recession; however, as dental implants are structurally and biologically different from natural teet...
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Aim: To assess the association between peri-implantitis and cardiovascular diseases (CVD). Methods: 128 patients with dental implants were recruited to evaluate the prevalence of peri-implantitis in patients with or without CVD (Cases, n = 82, Controls, n = 46, respectively). Diagnosis of peri-implantitis followed the 2017 World Workshop guideli...
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Background: Esthetic complications of dental implants in the esthetic zone can have a major negative impact on patients' quality of life and perception of implant therapy. The aim of the present study was to evaluate the prevalence of peri-implant soft tissue dehiscence (PSTD) and the clinical and ultrasonographic risk indicators for this conditio...
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Aim: To investigate the pro-inflammatory cytokine profiles in patients with or without cardiovascular disease (CVD) and with or without peri-implantitis. Methods: Serum, peri-implant crevicular fluid (PICF), and gingival crevicular fluid (GCF) were collected from patients with (n = 82) or without CVD (n = 46) at the most severe peri-implantitis...
Article
Maxillary sinus grafting is generally a safe procedure. However, intraoperative complications, as well as early and late postoperative complications, may occur. Included in the latter group are graft infections that can be triggered by peri-implantitis. The aim of the present study was to report three cases of late maxillary sinus graft infections...
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Purpose: This study aimed to topographically examine the healing of mineralized human bone allograft in sinus augmentation. Materials and methods: Thirty-two patients with crestal bone height ≤ 2 mm who required sinus augmentation were recruited for the study. A mixture of 80/20 cortical/cancellous mineralized human bone allografts were used to...
Article
Purpose: Untreated severely damaged molar sockets often complicate implant placement. This study evaluated membrane degradation, soft tissue healing, and alveolar crest dimensional changes after alveolar ridge preservation (ARP) in severely damaged molar sockets using a polylactic acid membrane (PLA) and xenograft without primary wound closure. M...
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This technique report describes a fully digital workflow to create a prosthetic articulator-based implant rehabilitation (PAIR) virtual patient for complete-arch or complete-mouth implant rehabilitation. This workflow uses a custom gothic arch tracer during the cone beam computed tomography (CBCT) scan and a 3-dimensional virtual facebow when super...
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The aim of this retrospective study was to assess the outcomes of non-surgical and surgical mechanical root debridement for the treatment of infrabony defects and explore potential prognostic factors. Treated infrabony defects followed for at least 1 year were selected. All data pertaining to the clinical outcomes were recorded. Multi-level regress...
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Chronic stress is a relevant disease to periodontal practice, encompassing 25%-28% of the US population (American Psychological Association 2015). While it is well established that chronic psychologic stress can have significant deleterious systemic effects, only in recent decades have we begun to explore the biochemical, microbial, and physiologic...
Article
Color flow ultrasonography has played a crucial role in medicine for its ability to assess dynamic tissue perfusion and blood flow variations as an indicator of a pathologic condition. While this feature of ultrasound is routinely employed in various medical fields, its intraoral application for the assessment of tissue perfusion at diseased versus...
Article
Despite the crucial role of examiner reliability on quality research and practice, there is still limited literature analyzing factors affecting examiner variability of peri-implant clinical measurements. The present study investigated clinical peri-implant parameters to quantify their repeatability and investigate factors that may affect their acc...
Article
Background Tooth-level prognostic systems can be utilized for treatment planning and risk assessment. This retrospective longitudinal study aimed to evaluate the prognostic performance of ten different tooth-level risk assessment systems in terms of their ability to predict periodontal-related tooth loss (TLP). Methods Data was retrieved retrospec...
Article
Background: A new periodontitis classification was recently introduced involving multidimensional staging and grading. The Study's aim was to assess if individuals well-trained in periodontics consistently used the new classification for patients with severe periodontitis. The secondary goal was to identify "gray zones" related to classifications....
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Conventional crestal and intrasulcular incisions followed by full-thickness flap reflection may inevitably induce surgical trauma, resulting in facial contour reduction, mucosal recession, and interdental papilla loss. Flapless implant surgery is the most conservative approach; however, it might create undetectable bone fenestration/dehiscence and...
Article
The gingival thickness (GT) and keratinized tissue width (KTW) constitute the gingival phenotype, a concept that has received a great deal of appreciation in recent years. Gingival phenotype modification has been achieved via different surgical techniques and grafting materials. Despite the superiority of autogenous grafts, their increased patient...
Article
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Purpose: To investigate whether implant position (adjacent to teeth/implants vs most distal position in the arch) influences the clinical outcomes of short (≤ 6 mm) non-splinted implants. Materials and methods: A systematic electronic search of human randomised clinical trials and prospective cohort studies was performed using the PubMed, Embase...
Article
Purpose: To investigate the effect of platelet-rich fibrin on bone formation by investigating its use in guided bone regeneration, sinus elevation and implant therapy. Materials and methods: This systematic review and meta-analysis were conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analys...
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Purpose: To provide an up to date, contemporary and concise evidence-based review of peri-implant diseases and conditions and discuss the current therapeutic approaches to managing these diseases. Materials and methods: A literature review was conducted focusing on peri-implant health, peri-implant mucositis and peri-implantitis, as described ac...
Article
The purpose of his study was to investigate the projected ridge-implant dimensions derived from virtual superimposition of implants on intact first molars mimicking immediate implantation in the mandible (Md1) and maxilla (Mx1) using cone-beam computed tomography (CBCT). The CBCT records of 41 patients (19 males and 22 females) with Md1 or Mx1 were...
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Aim of the study: This RCT assesses patients’ 18-month clinical outcomes after the regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and an electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis wer...
Article
Aim: This retrospective study assessed the effect of non-surgical and surgical mechanical therapy for furcation-involved molars. Materials and methods: Furcation defects treated and followed for at least one year were selected. Data relative to the clinical outcomes were recorded. The immediate (3-6 month) clinical outcomes and the long-term sur...
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Full-text available
This review aims to discuss the advantages and disadvantages of zirconia implants compared with titanium implants. Moreover, it intends to review the relevant available long-term literature of these two materials regarding osteointegration, soft-tissue, microbiota, and peri-implantitis, focusing on clinical results. Briefly, titanium implants are a...
Preprint
Full-text available
Background: this RCT assesses the 18 months clinical outcomes after regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated...
Article
Introductions: Intraoral scanner has been widely used for implant impression in partially edentulous cases; however, its accuracy in the impression of full-arch implant is still questionable. Clinical report: This clinical report presents a technique to check the accuracy of intraoral scanning for complete-arch implant restorations using an impl...