Niklaus P Lang

Niklaus P Lang
The University of Hong Kong | HKU

PhD, MS, Dr.med.dent., Dr.odont. hc

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491
Publications
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51,276
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Publications

Publications (491)
Article
Objectives: To assess long-term attachment and periodontitis-related tooth loss (PTL) in untreated periodontal disease over 40 years. Material and methods: Data originated from the natural history of periodontitis study in Sri Lankan tea labourers first examined in 1970. In 2010, 75 subjects (15.6%) of the original cohort were re-examined. Resu...
Article
The objective of the present review was to summarize the evidence available on the temporal sequence of hard and soft tissue healing around titanium dental implants in animal models and in humans. A search was undertaken to find animal and human studies reporting on the temporal dynamics of hard and soft tissue integration of titanium dental implan...
Article
Biphasic calcium phosphate (BCP) composed of 10% hydroxyapatite (HA) and 90% beta-tricalcium phosphate has been developed. Recently, a strontium hydroxyapatite-containing collagen membrane (Sr) was shown to stimulate early bone formation in rat calvarial defects at 4 weeks postoperatively, as compared with a cross-linked collagen membrane, for guid...
Article
To associate the dimension of the facial bone wall with clinical, radiological, and patient-centered outcomes at least 10 years after immediate implant placement with simultaneous guided bone regeneration in a retrospective study. Primary endpoint was the distance from the implant shoulder (IS) to the first bone-to-implant contact (IS-BIC10y ). Sec...
Article
AimTo study the sequential events in osseointegration at implants with highly hydrophilic surfaces.Material and methodsAll premolars and the first molars were bilaterally extracted in 12 Beagle dogs. After 3 months, full-thickness flaps were elevated and two different implants systems with various surfaces were randomly installed in the edentulous...
Article
To assess the influence of a collagen membrane covering a perforation of the sinus (Schneiderian) membrane on the outcome (bone fill) of a sinus floor elevation. Eighteen Pelibuey sheep were used. The animals underwent sinus floor elevation on both sides of the upper jaw. A perforation of 5 × 4 mm in dimension of the sinus mucosa was performed on b...
Article
To evaluate prospectively clinical and radiographic outcomes of 6- or 10 mm-long implants with moderately rough surface (SLA(®) ) loaded within 7 weeks from installation and supporting single crowns in the posterior regions in the course of 5 years of loading. Sixty implants with a moderately rough surface, 30 tests (6 mm long, 4.1 mm in diameter)...
Article
To study osseointegration of implants with surface modifications by the use of fluoroboric acid and/or H2 O2 installed in conventional sites or sites with circumferential marginal defects. Four implants with different surfaces were used. One basic surface (ZirTi(®) ) was sandblasted with zirconium microspheres and acid etched additionally with hydr...
Article
Objective To compare the survival rate and alveolar bone levels at implants installed in healed sites and functionally loaded within 1 h from installation or after 3 months.Material and methodsA total of 30 patients (17 male and 13 female) were recruited and 71 implants with a SLA® surface, 4.1 mm in diameter and 8–12 mm long, were installed in a f...
Article
AimsIn spite of the remarkable success of current preventive efforts, periodontitis remains one of the most prevalent diseases of mankind. The objective of this workshop was to review critical scientific evidence and develop recommendations to improve: i) plaque control at the individual and population level (oral hygiene), ii) control of risk fact...
Article
A transalveolar approach for sinus floor elevation with subsequent placement of dental implants was first suggested by Tatum in 1986. In 1994, Summers described a different transalveolar approach using a set of tapered osteotomes with increasing diameters. The transalveolar approach of sinus floor elevation, also referred to as ‘osteotome sinus flo...
Article
Objective To study the sequential healing at bicortically installed implants with surface modifications by the use of fluoroboric acid and/or H2O2.Material and methodsTwenty-eight albino New Zealand rabbits were used. Two recipient sites were prepared in the tibiae bilaterally, one in the metaphysis and the second in the diaphysis regions. Four imp...
Article
The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. Engebretson SP, Hyman LG, Michalowicz BS, Schoenfeld ER, Gelato MC, Hou W, et al (16 authors). JAMA 2013;310(23):2523-32.
Article
AimTo evaluate the influence of yellow bone marrow on osseointegration of titanium oral implants using a long bone model.Material and methodsThe two tibiae of eight sheep were used as experimental sites. Two osteotomies for implant installation were prepared in each tibia. At the control sites, no further treatments were performed while, at the tes...
Article
Objective To compare peri-implant soft- and hard-tissue integration at implants installed juxta- or sub-crestally. Furthermore, differences in the hard and soft peri-implant tissue dimensions at sites prepared with drills or sonic instruments were to be evaluated.Material and methodsThree months after tooth extraction in six dogs, recipient sites w...
Conference Paper
Objective: To compare the prevalence and levels of putative ‘periodontal pathogens’ present in the subgingival/submucosal microbiota surrounding teeth or implants in subjects with differing periodontal/peri-implant health statuses. Method: 22 subjects were included in the study. Within each subject, 4 sites were selected for sampling: (1) healthy...
Article
To evaluate the compliance of cigarette smokers with scheduled visits for supportive periodontal therapy (SPT). Qualitative and quantitative analyses of compliance with scheduled SPT visits were performed using retrospective data from patients undergoing dental hygiene treatment at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland 1985-20...
Article
To compare peri-implant tissue healing at implants installed in sites prepared with conventional drills or a sonic device. In six Beagle dogs, the mandibular premolars and first molars were extracted bilaterally. After 3 months, full-thickness muco-periosteal flaps were elevated and recipient sites were prepared in both sides of the mandible. In th...
Article
Aim: To characterize the subgingival microbiota within a cohort of adult males (n = 32) naïve to oral hygiene practices, and to compare the composition of bacterial taxa present in periodontal sites with various probing depths. Material and methods: Subgingival plaque samples were collected from single shallow pocket [pocket probing depth (PPD)≤...
Article
To study bony and soft tissue changes at implants installed in alveolar bony ridges of different widths. In 6 Labrador dogs, the mandibular premolars and first molars were extracted, and a buccal defect was created in the left side at the third and fourth premolars by removing the buccal bone and the inter-radicular and interdental septa. Three mon...
Article
To study the buccal dimensional tissue changes at oral implants following free gingival grafting, with or without including the keratin layer, performed at the time of implant installation into alveolar mucosa. The mandibular premolars and first molars were extracted bilaterally in six Beagle dogs. In the right side of the mandible (Test), flaps we...
Article
To compare the healing and bony crest resorption at implants installed conventionally or applying an edentulous ridge expansion (ERE) technique in the maxilla. In six Labrador dogs, the first and second maxillary incisors were extracted bilaterally. In the left side of the maxilla (Test), the flaps were elevated and the buccal plate of the alveoli...
Article
To evaluate the influence of the configuration of the marginal aspect of implants placed immediately into extraction sockets on peri-implant hard tissue adaptation. In 6 Labrador dogs, endodontic treatments of the mesial roots of 1 M1 were performed and the distal roots were removed. 2 P2 was extracted as well. Implants were immediately placed in t...
Article
To investigate the influence of the presence or absence of keratinized mucosa on the alveolar bony crest level as it relates to different buccal marginal bone thicknesses. In six beagle dogs, the mandibular premolars and first molars were extracted bilaterally. In the right side of the mandible (test), flaps were elevated, and the buccal as well as...
Article
The purpose of this study was to compare bone healing of experimental osteotomies applying either piezosurgery or two different oscillating saw blades in a rabbit model. The 16 rabbits were randomly assigned into four groups to comply with observation periods of one, two, three and five weeks. In all animals, four osteotomy lines were performed on...
Article
AIM: The aim of the present study was to evaluate the effectiveness of chlorhexidine (CHX) with an antidiscoloration system (ADS) on stain, plaque accumulation, and gingivitis. METHODS: A randomized, controlled clinical trial was conducted in 26 students. After a preparatory period, the students were randomly assigned to either group P (placebo), g...
Article
This review aims to highlight concepts relating to nonsurgical and surgical periodontal therapy, which have been learned and unlearned over the past few decades. A number of treatment procedures, such as gingival curettage and aggressive removal of contaminated root cementum, have been unlearned. Advances in technology have resulted in the introduc...
Article
Objectives: To evaluate the influence on osseointegration of Deproteinized bovine bone mineral (DBBM) particles used to fill defects of at least 1 mm around implants having no primary contact with bone. Material and methods: Premolars and first molars were extracted bilaterally from the mandible of six Labrador dogs. After 3 months of healing, m...
Article
Aim: To describe the sequential healing of open extraction sockets at which no attempts to obtain a primary closure of the coronal access to the alveolus have been made. Material and methods: The third mandibular premolar was extracted bilaterally in 12 monkeys, and no sutures were applied to close the wound. The healing after 4, 10, 20, 30, 90...
Conference Paper
Objective: The objective of this RCT is to evaluate the influence of three different methods for temporary tissue retraction before impression taking on the gingiva.Method: Sixty-seven individuals were included in the study and randomized into three equally large groups. In Test group 1 (T1) only aluminum chloride paste (Expasyl) was used to retrac...
Conference Paper
Full-text available
Objective: this study was designed to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets Method: Implants with 2 different configurations, cylindrical (Group A) or tapered (Group B) were installed. Prosthetic restorations were delivered 22 wee...
Article
Objective: Regulators of peri-implant bone loss in patients with diabetes appear to involve multiple risk factors that have not been clearly elucidated. This study was conducted to explore putative local etiologic factors on implant bone loss in relation to type 2 diabetes mellitus, including clinical, microbial, salivary biomarker, and psychosoci...
Article
Aim: The aim of this prospective, randomized, controlled multicenter study was to determine the 3-year efficacy and stability of the soft and hard tissues at implants with a different geometry that were placed in fresh extraction sockets. Material and methods: Implants with two different configurations, cylindrical (Group A) or conical/cylindric...
Article
Objectives To determine the effect of various systemic antibiotic prophylaxis regimes on patient-reported outcomes and postsurgical complications in patients undergoing conventional implant installation. Material and methodsThree hundred and twenty-nine healthy adults in need of conventional implant installation were randomly assigned to one of fou...
Article
Objective: To study the early sequential stages of osseointegration at implants installed in alveolar bony. Materials and methods: In 12 Labrador dogs, all mandibular premolars and first molars were extracted bilaterally. After 3 months of healing, full-thickness flaps were elevated in the edentulous region of the right side of the mandible. Imp...
Article
Aim: The first aim of the present experiment was to compare bone healing at implants installed in recipient sites prepared with conventional drills or a piezoelectric device. The second aim was to compare implant osseointegration onto surfaces with and without dendrimers coatings. Material and methods: Six Beagles dogs were used in this study. F...
Article
Aim: To evaluate the influence of the presence or absence of adjacent teeth on the level of the mesial and distal alveolar bony crest following healing at sites where implants were installed immediately into extraction sockets. Material and methods: Six Labrador dogs were used. In the right side of the mandible, full-thickness flaps were elevate...
Article
Aim: To evaluate the influence of deproteinized bovine bone mineral (DBBM), in conjunction with a collagen membrane, on bone resorption at implants installed in a lingual position immediately into extraction sockets with horizontal residual buccal defects >2.0 mm. Material & methods: The pulp tissue of the mesial roots of (1) M(1) was removed in...
Article
The aims of this study were to reexamine patients who had received fixed dental prostheses (FDPs) more than 10 years prior, list the frequencies of observed technical and biologic failures and complications, and calculate the estimated failure and complication rates at 10 and 15 years. Fifty-six of 195 patients who were treated by undergraduate stu...
Conference Paper
Background: multirooted teeth are at higher risk to be lost when compared with single-rooted teeth. Objective: to investigate the impact of risk factors on the loss of multirooted teeth in subjects treated for chronic periodontitis and enrolled in a supportive periodontal therapy (SPT) program. Method: The study sample included 172 partially ed...
Conference Paper
Objectives: To determine the effect of various systemic antibiotic regimes on patient-reported outcome measures (PROMs) and post-surgical complications in patients undergoing implant installation. Methods: 282 healthy adults (131 males, 151 females;19-80 years old), consecutively admitted to 7 study centres for conventional single implant install...
Conference Paper
Objective: To identify long-term tooth loss patterns during 40 years in untreated chronic periodontitis. Method: Original data were obtained from the natural periodontitis history study of the Sri Lankan tea workers Löe et al. (1986). In 2010 these labourers were re-examined. This resulted in a 40-years longitudinal study of natural periodontitis...
Conference Paper
Objective: To identify rates of disease progression over 40 years in untreated chronic periodontitis without the performance of oral hygiene. Method: Data were obtained from the natural periodontitis history study of the Sri Lankan tea workers (Löe et al. 1986). In 2010, these were re-examined. This resulted in a 40-years longitudinal study of na...
Article
Aim: To evaluate the influence of the width of the buccal bony wall on hard and soft tissue dimensions following implant installation. Material and methods: Mandibular premolars and first molars of six Labrador dogs were extracted bilaterally. After 3 months of healing, two recipient sites, one on each side of the mandible, were prepared in such...
Article
To assess the long-term survival of implants inserted in periodontally susceptible patients and to investigate the influence of residual pockets on the incidence of peri-implantitis and implant loss. For 70 patients, comprehensive periodontal treatment was followed by installation of 165 Straumann Dental implants. Subsequently, 58 patients entered...
Article
Aim: To evaluate the integration of implants installed at the interface of pristine and grafted tissue augmented with particulate autologous bone or deproteinized bovine bone mineral (DBBM), concomitantly with a collagen membrane. Material and methods: In 6 Labrador dogs, the distal root of (3)P(3) and (4)P(4) was endodontically treated and hemi...
Article
To evaluate the influence of a sub-epithelial connective tissue graft placed at the buccal aspect of implants installed immediately after tooth extraction on the dimensional changes of hard and soft tissues. In six Labrador dogs a bilateral partial- thickness dissection was made buccal to the second mandibular premolar. At the lingual aspect, full-...
Article
To evaluate the healing at implants with a moderately rough surface placed and stabilized in recipient sites of dimensions deeper and larger than that of the implants to avoid any contact between parent bone and the implant. In six Labrador dogs, premolars and first molars were extracted bilaterally in the mandible. After 3 months of healing, mucop...
Article
To evaluate the efficacy of a slow release doxycycline gel (SRD) adjunctively administered to non-surgical therapy in subjects with recurrent or persistent periodontitis but acceptable oral hygiene during supportive periodontal care. In this single blind, parallel group, multicentre study, 202 of 203 recruited periodontal maintenance subjects with...
Article
The objective of this analysis was to assess and compare the 5- and 10-year survival of different types of tooth-supported and implant-supported fixed dental prostheses (FDPs) and single crowns (SCs), and to describe the incidence of biological and technical complications with emphasis on quality of reporting. The analysis was based on six systemat...
Article
The articles discussed in working group 3 dealt with specific aspects of clinical research. In this context, the literature reporting on survival and complication rates of implant-supported or implant-tooth supported restorations in longitudinal studies of at least 5 years were discussed. The second aspect dealt with the evaluation of aesthetic out...
Article
Objectives The aim of this study was to assess gingival fluid (GCF) cytokine messenger RNA (mRNA) levels, subgingival bacteria, and clinical periodontal conditions during a normal pregnancy to postpartum. Materials and methods Subgingival bacterial samples were analyzed with the checkerboard DNA–DNA hybridization method. GCF samples were assessed w...
Article
To evaluate the clinical and radiographic changes at implants in posterior maxillary and mandibular areas supporting single-unit crowns (SCs) and fixed dental prostheses (FDPs) with one mesial or distal cantilever extension after an observation period of at least 3 years. Seventeen subjects with 19 implant-supported SCs and 21 subjects with 21 impl...
Article
To evaluate the influence of deproteinized bovine bone mineral in conjunction with a collagen membrane, at implants installed into sockets in a lingual position immediately after tooth extraction, and presenting initial horizontal residual buccal defects <2 mm. The pulp tissue of the mesial roots of 4P4 was removed in six Labrador dogs, and the roo...
Article
To compare the interproximal cleansing efficacy of the novel, waist-shaped Circum brush (Topcaredent, Switzerland; CB) with that of a straight soft interdental brush (IB) (TePe, Sweden; SB) on posterior surfaces. Eight patients after completion of initial periodontal therapy abolished oral hygiene for 3 days. Baseline plaque scores (PlI, Silness &...
Article
Full-text available
To evaluate the effect of mismatching abutments on implants with a wider platform on the peri-implant hard tissue remodeling and the soft tissue dimensions. Mandibular premolars and first molars of six Labrador dogs were extracted bilaterally. After 3 months of healing, one tapered implant was installed on each side of the mandibular molar region w...
Article
As more women are entering health professions, the health care system is becoming more feminized. This investigation evaluated gender differences in clinicians' treatment preferences and decision making in a complex treatment situation. A questionnaire was developed containing clinical cases and statements to assess practitioners' opinions on treat...
Article
To assess the financial benefit of cone beam computed tomography (CBCT) for the treatment options of maxillary molars including periodontal surgery and extraction followed by implant placement. Twelve patients with generalized chronic periodontitis were recruited, and CBCT was performed in maxillary molars (n = 22) with clinical furcation involveme...
Article
To evaluate the soft tissue and the dimensional changes of the alveolar bony crest at sites where deproteinized bovine bone mineral (DBBM) particles, concomitantly with the placement of a collagen membrane, were used at implants installed into sockets immediately after tooth extraction. The pulp tissue of the mesial roots of (3) P(3) was removed in...
Article
To evaluate the influence of the presence of both adjacent teeth on the level of alveolar bony crest at sites where implants were installed into the socket immediately after tooth extraction. Six Labrador dogs were used. Extractions of all teeth from the second premolar to the first molar were performed in the right side of the mandible, after full...
Article
To evaluate the integration of implants installed using a surgical guide in augmented sites with autologous bone or deproteinized bovine bone mineral (DBBM) blocks, concomitantly with a collagen membrane. Mandibular molars were extracted bilaterally in six Labrador dogs, the buccal bony wall was removed, and a box-shaped defect was created. After 3...
Article
To study the influence on the healing of soft and hard peri-implant tissues when implants of different sizes and configurations were installed into sockets immediately after tooth extraction. Transmucosal cylindrical implants, 3.3 mm in diameter in the control sites, and conical 5 mm in diameter in the test sites, were installed into the distal soc...
Article
The aim of this prospective cohort study was to evaluate an anti-infective surgical protocol for the treatment of peri-implantitis. Thirty-six implants in 24 partially dentate patients with moderate to advanced peri-implantitis were treated using an anti-infective surgical protocol incorporating open flap debridement and implant surface decontamina...
Article
To monitor clinical, microbiological and host-derived alterations occurring around teeth and titanium implants during the development of experimental gingivitis/mucositis and their respective healing sequence in humans. Fifteen subjects with healthy or treated periodontal conditions and restored with dental implants underwent an experimental 3-week...
Article
Abstract This paper reports on the discussions arising from a 2-day forum on implant dentistry education in South-East Asia. The 10 institutions present represented undergraduate and postgraduate dental curricula from seven countries, including Hong Kong, Indonesia, Malaysia, Taiwan, Thailand, the Philippines, and Singapore. While not aiming to rea...
Article
To describe the early healing processes around the implants installed after elevation of the sinus mucosa applying the lateral access technique without the use of grafting material. Immediately after the elevation of the maxillary sinus Schneiderian membrane by the lateral approach in eight monkeys, implants were installed without the use of grafti...
Article
To evaluate the influence of deproteinized bovine bone mineral (DBBM) particles concomitant with the placement of a collagen membrane on alveolar ridge preservation and on osseointegration of implants placed into alveolar sockets immediately after tooth extraction. The pulp tissue of the mesial roots of (3) P(3) was removed in six Labrador dogs and...
Article
To evaluate the effect of a space-maintaining device fixed to the lateral wall of the maxillary sinus after the elevation of the sinus mucosa on bone filling of the sinus cavity. Immediately after the elevation of the maxillary sinus Schneiderian membrane accomplished through lateral antrostomy in four monkeys, a titanium device was affixed to the...
Article
To validate the "platform switching" concept at oral implants with respect to the preservation of the alveolar crestal bone levels in an animal model. Five minipigs received three implants each with a 0.25 mm implant/abutment mismatch and were placed flush (T(0)), 1 mm below (T(1)) and 1 mm above (T(+1)) the alveolar bony crest, and as a control, o...
Article
To evaluate the rate and degree of osseointegration at chemically modified moderately rough, hydrophilic (SLActive) and moderately rough, hydrophobic (SLA) implant surfaces during early phases of healing in a human model. The devices used for this study of early healing were 4 mm long and 2.8 mm in diameter and had either an SLActive chemically mod...
Article
To evaluate morphologically and morphometrically the sequential healing and osseointegration events at moderately rough implant surfaces with and without chemical modification. Particularly the role of bone debris in initiating bone formation was emphasized. Solid, screw-type cylindrical titanium implants (SSI) (n=49), 4 mm long and 2.8 mm wide, wi...
Article
To compare the gene expression profile of osseointegration associated with a moderately rough and a chemically modified hydrophilic moderately rough surface in a human model. Eighteen solid screw-type cylindrical titanium implants, 4 mm long and 2.8 mm wide, with either a moderately rough (SLA) or a chemically modified moderately rough (SLActive) s...
Article
To determine the temporal gene expression profile associated with the early healing events during osseointegration in a human model. Nine solid screw-type cylindrical titanium implants, 4 mm long and 2.8 mm wide, with a chemically modified surface (SLActive) were surgically inserted in the retromolar area of nine human volunteers. The devices were...
Article
To compare the influence of autologous or deproteinized bovine bone mineral as grafting material on healing of buccal dehiscence defects at implants installed immediately into the maxillary second incisor extraction socket in dogs. In the maxillary second incisor sockets of 12 Labrador dogs, implants were installed immediately following tooth extra...
Article
To evaluate the influence (i) of various implant platform configurations and (ii) of implant surface characteristics on peri-implant tissue dimensions in a dog model. Mandibular premolars and first molars were extracted bilaterally in six Labrador dogs. After 3 months of healing, two implants, one with a turned and a second with a moderately rough...
Article
Aim: The validity of the risk assessment in predicting tooth loss due to periodontitis or disease progression was explored. Methods: Systemic factors, smoking status, bleeding on probing (BoP) percentage, number of residual pockets (probing pocket depth ≥6 mm), tooth loss, and alveolar bone loss in relation to age were the variables of the risk...
Article
To compare the effectiveness of two anti-infective protocols for the treatment of peri-implant mucositis. Twenty-nine patients with one implant diagnosed with peri-implant mucositis (bleeding on probing [BOP] with no loss of supporting bone) were randomly assigned to a control or test group. Following an assessment of baseline parameters (probing d...
Article
Sanz M, Lang NP, Kinane DF, Berglundh T, Chapple I, Tonetti MS. Seventh European Workshop on Periodontology of the European Academy of Periodontology at the Parador at La Granja, Segovia, Spain. J Clin Periodontol 2011; 38 (Suppl. 11): 1-2. doi: 10.1111/j.1600-051X.2010.01692.x.
Article
The purpose of this review was to compare peri-implant mucositis and gingivitis with respect to the pathogenesis aspects. An electronic search was performed up to June 2010 based on the PubMed database of the National Library of Medicine and The Cochrane Library of the Cochrane Collaboration (CENTRAL). A hand search considered the bibliography of a...
Article
Peri-implant diseases present in two forms - peri-implant mucositis and peri-implantitis. The literature was systematically searched and critically reviewed. Four manuscripts were produced in specific topics identified as key areas to understand the microbial aetiology and the pathogenesis of peri-implant diseases and how the implant surface struct...