Clinical Advances in Periodontics最新文献

{"title":"Enhancing root coverage and esthetic outcomes in isolated gingival recession using orthodontic intervention and lateral closed tunnel technique: An interdisciplinary prospective case series","authors":"Neelima Katti, Rimsha KP, Ashish Kumar Barik, Surya Kanta Das, Srivani Peri, Devapratim Mohanty","doi":"10.1002/cap.10285","DOIUrl":"10.1002/cap.10285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival recession (GR) in malposed tooth in association with bone dehiscence and/or fenestration poses a challenge for successful root coverage treatment. Lateral closed tunnel (LCT) technique is particularly useful in isolated GR in mandibular anterior region, where the shallow vestibular depth prevents tension-free coronal mobilization of tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty patients with GR associated with tooth malposition were treated using a combined orthodontic—periodontic approach with a torquing auxiliary spring followed by LCT technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The two techniques resulted in a combined recession depth reduction from 3.75 ± 1.14 mm to 0.40 ± 0.50 mm at the end of 6-month study period. The orthodontic intervention led to an increase in labial marginal bone levels, as assessed through cone beam computed tomography (CBCT), while the LCT achieved closure of residual recession defect. Also, an increase of keratinized tissue width from 0.81 ± 0.88 mm at baseline to 3.30 ± 0.67 mm at 6 months was achieved. Mean root coverage percentage (MRC%) of 91.40% + 10.25% was seen, with 11 out of 20 sites (55%) showing complete root coverage (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Single tooth orthodontic repositioning followed by LCT technique proved effective in successfully managing isolated recession defects in the mandibular anterior gingival region, which often presents challenging mucogingival conditions. The precise single tooth repositioning resulted in labial marginal bone augmentation, while the LCT surgical approach allowed residual defect closure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why are these cases new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Correction of single tooth malposition is achieved before recession coverage treatment to achieve a favorable environment for graft uptake. The reduction in denuded root surface along with the bone remodeling results in increasing the ratio of vascular to avascular region, thus improving the overall prognosis of the treatment.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of these cases?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>The lateral closed tunnel technique involves creating a mucoperiosteal tunnel to close the recession site. Precision is crucial to avoid damage to surrounding tissues. The rec","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"14-24"},"PeriodicalIF":0.9,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified coronally advanced flap technique in the treatment of fibrous epulis: A case report with 1-year follow-up","authors":"Kaixin Zheng, Yuan Zhang","doi":"10.1002/cap.10286","DOIUrl":"10.1002/cap.10286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Currently, the treatment of epulis is primarily surgical excision, which would greatly affect the aesthetics of patients if happened in the anterior region. It's challenging for clinicians to balance the aesthetic after surgery and less surgical trauma. To overcome this disadvantage, the authors propose the modified coronally advanced flap technique which applies the principles of minimally invasive surgery to provide satisfactory therapeutic results in fibrous epulis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We report a case of an 18-year-old female with the chief complaint of a gingival swelling in the right upper anterior region. After the initial periodontal therapy, the modified surgical approach was applied to this patient. Unlike conventional coronally advanced flap technique, an additional incision was made, and the free portion was rotated into the adjacent space to completely cover the trauma, which avoided the use of the second operative zone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The gingiva recovered with normal color, contour, and consistency after surgery, the papilla filled up the proximal space well and was in good harmony with the adjacent papillae. The surgical results remained stable during the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of modified coronally advanced flap technique allows the clinician to successfully resume the natural appearance of gingiva in the treatment of fibrous epulis, as well as simplify the surgical approach, shorten the operative time, and demonstrate no tendency of recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why is this case new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>This novel technique not only removes the epulis, but also takes into account the postoperative aesthetics of the surgery at the same time.</li>\u0000 \u0000 <li>This minimally invasive surgical technique reduces operative time and increases patient comfort.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <p>Keys to successful management of this case are as follows: (i) Adequate preoperative assessment of the location of the additional incision; (ii) tension-free coronal flap advancement.</p>\u0000 \u0000 <div><b>What are the primary limitations to success in this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Clinical studies with long-term outcomes of this approach are needed.</l","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"25-30"},"PeriodicalIF":0.9,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nasal spine suture: A novel approach for membrane stabilization","authors":"William E. Bane, Gary M. Blyleven, Adam R. Lincicum, Brian W. Stancoven, Kimberly A. Inouye, Thomas M. Johnson","doi":"10.1002/cap.10279","DOIUrl":"10.1002/cap.10279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current evidence acknowledges guided bone regeneration (GBR) as a predictable therapeutic modality in the augmentation of a deficient alveolar ridge. Such deficiencies often reveal inadequate bone volume to support implant placement in a position amenable to prosthetic reconstruction. Additionally, an evolving body of literature demonstrates that membrane fixation may lead to improved clinical bone gain through positively influencing blood clot formation, stability, and the eventual osteogenic potential of the defect. Alternative benefits to membrane fixation, such as reduced graft displacement and reduction in wound micromotion, have also been cited as mechanisms for an increased regenerative response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The aim of this report was to present a case, including diagnosis, treatment, and follow-up for the reconstruction of a horizontal ridge deficiency. The patient's deficiency in ridge volume was found to be a developmental sequelae of lateral incisor agenesis, resulting in an underdeveloped midfacial region of the alveolar process subjacent to sites #7 and #10. The fixation protocol outlined in this report demonstrated adequate horizontal ridge augmentation to facilitate future prosthetic reconstruction with the use of implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Numerous protocols have been established in an attempt to achieve effective barrier membrane stabilization for bone augmentation procedures. However, some techniques are poorly suited for the anatomically challenging region of the anterior maxilla. A case report describing the utilization of the anterior nasal spine for anchorage of a membrane-stabilizing suture may present a novel, safe, and effective technique for stabilizing the intended region of augmentation, as well as preventing graft migration beyond the membrane–maxilla interface.</p>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>Regarding guided bone regeneration (GBR) procedures, micromotion of the membrane or of the underlying particulate graft may negatively influence the volume of the augmented site.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>The ability to adequately stabilize the graft–membrane interface is recognized as a necessary prerequisite to predictably achieve optimal surgical outcomes.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>To the authors’ knowledge, there is no","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"300-309"},"PeriodicalIF":0.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-surgical and guided-bone-regeneration surgical management of Type-3b dens invaginatus with an apico-marginal defect: A case report","authors":"Aaliya Rahman, Sharique Alam, Afaf Zia, R. K. Tiwari, S. Mukhtar Un Nisar Andrabi, Maahin Mahmood","doi":"10.1002/cap.10283","DOIUrl":"10.1002/cap.10283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dens invaginatus (DI), an unusual developmental anomaly is a challenge for the operating dentist with regard to its diagnosis and treatment. This case report presents the successful management of a Type-3b DI in a permanent maxillary lateral incisor associated with a large radicular cyst and communicating apico-marginal defect (Von Arx type IIb).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A 19-year-old female patient reported pain and palatal swelling. During the clinical examination, tooth #12 exhibited tenderness to percussion, and presented a deep periodontal pocket depth (PPD) of 12 mm, along with grade I mobility. Radiographic examination revealed a large peri-radicular radiolucency with atypical tooth morphology. Cone beam computed tomography clarified the complicated root canal anatomy to be Type-3b DI associated with an apico-marginal defect. The case was managed successfully by non-surgical endodontic therapy followed by surgical intervention utilizing a guided bone regenerative (GBR) approach. Eighteen-month follow-up showed an asymptomatic and functional tooth with a significant reduction in pocket depth. The periapical radiographs showed continued healing of the osseous defect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The successful healing outcome of a challenging case, characterized by a complex DI morphology, a large peri-radicular lesion, a through-and-through defect, and a combined endodontic-periodontal apico-marginal defect was achieved through accurate diagnosis, treatment planning, and execution using contemporary endodontic and periodontal treatment techniques. The application of GBR techniques during the surgical phase of treatment may have contributed to the improved regenerative healing outcome in this case, which was initially considered prognostically questionable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why is this case new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Type-3b DI exhibits a complex root canal structure, each case displaying unique characteristics, necessitating a case-specific treatment plan. In this case report the Type-3b DI morphology was associated with a large peri-radicular, through and through defect and combined endodontic periodontal apico-marginal defect. The treatment approach involved incorporating guided bone regenerative (GBR) principles during the surgical phase. This case report contributes to the existing evidence on the diagnosis and successful management of Type-3b DI with a concurrent apico-marginal defect.</li>\u0000 </ul>\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"276-283"},"PeriodicalIF":0.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided coronally advanced flap to treat gingival recession: Digital workflow and case report","authors":"Mauro Pedrine Santamaria, Amanda Rossato, Manuela Maria Viana Miguel, Ingrid Fernandes Mathias-Santamaria, Marcelo Pereira Nunes, Lucas Araújo Queiroz","doi":"10.1002/cap.10282","DOIUrl":"10.1002/cap.10282","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The inherently technique-sensitive nature of periodontal plastic procedures demands a significant level of skill and expertise. The incorporation of three-dimensional (3D) printing technologies emerges as a potential strategy to optimize and simplify surgical procedures. This case report describes the digital workflow and presents the clinical outcomes achieved using a guided coronally advanced flap for the treatment of a single gingival recession (GR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A female patient with a gingival recession type 1 (RT1 B-) defect on the mandibular second left premolar underwent successful treatment using a guided coronally advanced flap (g-CAF) and de-epithelized connective tissue graft (CTG). The digital planning included intraoral scanning of the mandible and hard palate using an intraoral scanner, with resulting polygon format (PLY) files exported for virtual model creation. The CAF guide was meticulously designed to orient horizontal and vertical incisions at the papillae base adjacent to the GR defect. For the donor site, a guide was specifically created, positioning the graft area 2 mm apically to the premolars' gingival margins. The delineation of this area involved two horizontal and vertical incisions, meticulously based on the dimensions of the GR. The digitally designed guides were then 3D-printed using a surgical guide-specific resin, contributing to the precise execution of the innovative surgical approach. Complete root coverage was achieved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case report demonstrates that g-CAF can be a promising approach for the treatment of single GR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Highlights</h3>\u0000 \u0000 <div><b>Why is this case new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>To the best of the authors' knowledge, this is the first manuscript to report a guided procedure for the treatment of gingival recession.</li>\u0000 \u0000 <li>This report provides the digital workflow for the fabrication of a guide to perform the coronally advanced flap for single recession defects.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successfully manage this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>It is necessary to adequately scan the recession defect area and palate.</li>\u0000 \u0000 <li>Properly not only design the guide using specific software but also print it.</li>\u0000 \u0000 <li>The guide","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"7-13"},"PeriodicalIF":0.9,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histologic wound healing in studies using different ridge preservation protocols: A review","authors":"Brian L. Mealey, Francis Keeling, A. Archontia Palaiologou","doi":"10.1002/cap.10281","DOIUrl":"10.1002/cap.10281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alveolar ridge preservation (ARP) procedures are designed to lessen dimensional changes in the alveolar ridge after tooth extraction. Wound healing after ridge preservation involves the formation of new vital bone in the former socket, and this vital bone is important in the osseointegration of dental implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A series of ARP studies have been performed to help clinicians better understand the wound-healing events that occur following tooth extraction and ridge preservation. Different protocols have been examined using various materials and periods of healing time prior to implant placement. The primary aim of these studies was to ascertain the relative percentage of vital bone formation, residual graft material, and connective tissue (CT)/other at the healing site using histomorphometric examination of bone core biopsies obtained during osteotomy preparation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For allografts, the use of demineralized bone alone or in combination with mineralized is associated with more vital bone formation than the use of mineralized allograft alone. For mineralized allografts, the use of cortical versus cancellous bone has only minimal impact on new bone formation. Xenografts from bovine and porcine sources appear to have similar vital bone formation. Longer healing times prior to implant placement are associated with increased vital bone formation and decreased residual graft material. The most stable component in most studies is the percentage of CT/other.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The percentage of vital bone and residual graft at ARP sites is dependent on the materials used and the length of healing time prior to obtaining core biopsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Points</h3>\u0000 \u0000 <div><b>What factors may affect the amount of new bone at the ARP site?</b>\u0000 \u0000 <ol>\u0000 \u0000 <li>At a time point about 4 months after ARP, the type of graft material used for ARP plays a large role in new bone formation.</li>\u0000 \u0000 <li>Studies focus on means and standard deviations, but patients often do not “follow the mean.” Even if a single ARP protocol is used for all patients, there is great interindividual variability in new bone formation, and there is often variability between sites within a single patient.</li>\u0000 </ol>\u0000 </div>\u0000 \u0000 <div><b>How long after ARP with an allograft should I wait ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 1","pages":"52-62"},"PeriodicalIF":0.9,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epithelial cyst following subepithelial connective tissue graft: A case report","authors":"Julien de Paula, Luise A. B. da Silva, Mariane A. S. Wayar, Eduardo B. Campagnoli, Fábio A. dos Santos","doi":"10.1002/cap.10284","DOIUrl":"10.1002/cap.10284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various surgical approaches have been employed to manage gingival recession, including subepithelial connective tissue grafting, which has yielded favorable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We present the case of a 17-year-old patient who developed gingival recession on tooth #6 following an esthetic crown lengthening procedure. The recession was treated with a subepithelial connective tissue graft; however, this case details the occurrence of two epithelial cysts adjacent to the region subjected to the surgical procedure, 6 months after surgery. The treatment involved periodontal surgical intervention, during which the lesions were completely excised and the associated osseous defect was filled using an inorganic bovine bone matrix along with a collagen membrane. The healing progressed without any complications. Histopathological analysis revealed the presence of cystic lesions, which were characterized by a cystic cavity lined with stratified orthokeratinized epithelium with cuboidal cells in some areas surrounded by fibrous connective tissue. The patient's progress was monitored through tomography performed 6 months, 1 year, and 5 years post-procedure, all of which demonstrated the absence of any signs of lesion recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study emphasizes the effectiveness and predictability of subepithelial connective tissue grafting in the treatment of gingival recession. However, dental professionals should be cautious about the potential risk of gingival recession following esthetic crown lengthening procedures and recognize the potential complications associated with subepithelial connective tissue grafting, such as the observed development of epithelial cysts in this specific case.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <p><b>Why is this case new information?</b></p>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>We present a case of an epithelial cyst following a subepithelial connective tissue graft, which resulted in buccal cortical bone resorption. The treatment involved excisional biopsy and the use of an inorganic bovine bone matrix with a collagen membrane.</li>\u0000 </ul>\u0000 <b>What are the keys to the successful management of this case?</b></div>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Successful treatment included periodontal surgery, bone defect filling using an inorganic bovine bone matrix and a collagen membrane, and regular monitoring with CT scans at 6 months, 1 y","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"290-299"},"PeriodicalIF":0.9,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital assessment of supracrestal tissue attachment and its correlation with dentogingival components","authors":"Hesham H. Abdulkarim, Nathan M. Antoine, Mary Ying-Fang Wang, Elio Reyes Rosales, D. Douglas Miley","doi":"10.1002/cap.10280","DOIUrl":"10.1002/cap.10280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study is to measure, in vivo, the supracrestal tissue attachment dimensions (STADs) by means of a noninvasive digital method and to investigate the association between STADs and gingival thickness (GT), tooth position, tooth length, tooth width, keratinized tissue width (KTW), buccal bone thickness (BBT), and bone crest (BC) level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nineteen periodontally healthy subjects who previously received full mouth periodontal charting, cone beam computed tomography, and intraoral scan for the purpose of implant planning were included in the study. A digital imaging software was used for the superimposition of Digital Imaging and Communications in Medicine and stereolithography files, along with hard and soft tissue measurements. Pearson's correlation and ANOVA statistical analyses were used to investigate potential trends between STADs and other dentogingival components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 203 teeth were assessed, with an average STADs of 2.05 mm (±0.99 mm). STADs were larger in mandibular than maxillary teeth (<i>p</i>-value <0.001) and decreased from anterior to posterior teeth. STADs exhibited an inverse relationship with BBTs and GTs (<i>p</i>-value <0.001) and the KTW (<i>p</i>-value = 0.05). Positive correlations were found between GT and BBT (<i>p</i>-value <0.001), whereas both were negatively correlated with the distance between the cementoenamel junction and BC (<i>p</i>-values 0.019 and 0.006, respectively) and positively correlated with KTW (<i>p</i>-value <0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlighted the dynamic nature of STA relative to tooth position. Additionally, it explored the intricate relationships of STADs with various dentogingival components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>To the best of the authors’ knowledge, this study represents the first application of CBCTs, intraoral scans, and clinical probe depths for noninvasive supracrestal tissue attachment measurements.</li>\u0000 \u0000 <li>This study advocates for a personalized assessment of supracrestal attachments, incorporating tooth position and other dentogingival components.</li>\u0000 \u0000 <li>The study emphasizes the importance for practition","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"310-318"},"PeriodicalIF":0.9,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical approach for the management of gingival cleft: A case series and decision-making process","authors":"Saravanan Sampoornam Pape Reddy, Balaji Manohar","doi":"10.1002/cap.10277","DOIUrl":"10.1002/cap.10277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival clefts, once known as “Stillman's Cleft”, now considered an obsolete phenomenon, cannot be neglected in clinical practice, especially when it is persistent and epithelialized. The attached gingiva and alveolar mucosa are composed of epithelial layers with subjacent connective tissue. Gingival clefts, notwithstanding their intrinsic differences, may exhibit keratinized or non-keratinized tissue. Coupled with additional risk factors, it can result in progressive attachment loss and gingival recession.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two cases with three distinct types of gingival clefts were described. Case 1 was identified as having a 2 mm white cleft coupled with lack of attached gingiva, while Case 2 was described as having a 3 mm white and red cleft which were treated with gingival cleft approximation subsequent to connective tissue grafting, non-surgical periodontal therapy and cleft approximation, respectively. The diagnostic confirmation was verified using an operating microscope set at a magnification of 5×, while the subsequent surgical stages were carried out with a magnification of 8×. These treatments yielded complete elimination and closure of the gingival clefts in addition to increased width of attached gingiva and soft tissue phenotype in Case 1 where bilaminar approach was utilized. The three clefts were effectively addressed using an operating microscope for both non-surgical and surgical interventions in the cleft management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All the three clefts exhibited complete elimination and closure of the gingival cleft. At 3 years follow up, there was reduction of the probing depth (1 mm) and attachment gain (1 mm) in all the three clefts. There was increase in width of attached gingiva to 3 mm and increase in soft tissue thickness in Case 1, where connective tissue graft was utilized. As microsurgical treatment approach was employed, the patients did not manifest with any intra-operative or postoperative complications. The first case showed the presence of soft tissue bulk at the treated site warranting debulking at 12 months postoperatively. The stability of the width of attached gingiva was maintained over the course of the 3-year follow-up period. The use of a microsurgical method in these settings enhances the predictability of outcomes than a macrosurgical approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The utilization of microsurgical techniques for the closure of gingival clefts allows for the accurate and meticulous insertion and placement of grafts, resulting in improved outcomes and enhanced a","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"259-268"},"PeriodicalIF":0.9,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncovering of transplanted connective tissue graft: Clinical and histological evaluation","authors":"Adriano Fratini, Leonardo Mancini, Margherita G Liguori, Stefano Gotti, Enrico Marchetti","doi":"10.1002/cap.10278","DOIUrl":"10.1002/cap.10278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontal plastic surgery aims to restore recessions and dehiscence around teeth and implants. Several techniques, such as subepithelial connective tissue graft (CTG), were proposed with the main outcome of improving volume and root coverage. Nevertheless, this surgery might not improve the keratinized tissue width. Thus, the primary aim of this case report was to describe the possible increase in keratinized tissue after a subepithelial CTG and simultaneously use the previously harvested graft as a source for covering an adjacent tooth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 38-year-old patient presented brushing discomfort 2 years after undergoing periodontal plastic surgery with a CTG from the palate to cover a recession. Despite the increased thickness of the soft tissue, brushing discomfort was not reduced because the tissue quality remained unchanged. Therefore, a surgical procedure in the area of teeth 3.2–3.4 was performed to remove the more superficial masticatory mucosa and to induce keratinization of the previously grafted connective tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 6 months, the epithelium appears to be clinically and histologically keratinized, with characteristics comparable to those of the original tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The connective tissue grafted maintains the potential to induce keratinization over time, if it is exposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p><b>Why is this case new information?</b></p>\u0000 \u0000 <p>To the best of our knowledge, this is the first case report in the literature with a histological evaluation in a human of the tissue grafted exposed after 2 years.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p><b>What are the keys to successful management of this case?</b></p>\u0000 \u0000 <p>The graft covered by the alveolar mucosa did not induce keratinization of the epithelium of the overlying mucosa.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>\u0000 <ul>\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"269-275"},"PeriodicalIF":0.9,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}