Clinical Advances in Periodontics最新文献

{"title":"The application of leukocyte- and platelet-rich fibrin (L-PRF) in maxillary sinus augmentation","authors":"Charles A. Powell,&nbsp;Alicia Casarez-Quintana,&nbsp;Jacob Zellner,&nbsp;Omar Al-Bayati,&nbsp;Kerri Font","doi":"10.1002/cap.10216","DOIUrl":"10.1002/cap.10216","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since the introduction of sinus augmentation in the 1970s the procedure has been performed with or without biomaterials. Autologous blood products (ABPs) for use in sinus augmentation was first introduced in the 2000s, to aid potentially in bone and soft tissue healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three different applications of leukocyte- and platelet-rich fibrin (L-PRF) in maxillary sinus augmentation are presented in this case series. In case 1, L-PRF is used in bilateral sinus augmentation to support placement of implants to support a maxillary hybrid denture. Case 2 highlights the use of L-PRF in a complication associate with Schneiderian membrane elevation. Case 3 provides histology taken at the time of implant placement 6 months following L-PRF/xenograft sinus augmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All cases resulted in the successful placement of dental implants. In case 2, an osseodensification procedure was performed with freeze-dried bone allograft, which provided an approximate 4 mm of additional vertical height for implant placement. Histology from case 3 at 6 months post sinus augmentation demonstrated the presence of new vital bone in contact with the xenograft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To date, there is only a limited amount of evidence reporting on platelet-rich fibrin (PRF) or L-PRF use in maxillary sinus augmentation. Bone gain from either product has ranged from 3.2 to 11.8 mm, with the percentage of newly formed bone reported in case series as 33% ± 5%. Despite the lack of strong evidence, L-PRF appears to have beneficial effects on bone regeneration when used in sinus augmentation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10632636","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":"Treatment of gummy smile combining crown lengthening, lip repositioning, and the use of polyester threads","authors":"Renata O. R. Horn,&nbsp;Júlio C. Joly","doi":"10.1002/cap.10214","DOIUrl":"10.1002/cap.10214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The case report presents a new possibility of treatment for a gummy smile in a patient with multiple etiologies, such as altered passive eruption and hypermobility upper lip. At first, crown lengthening was not sufficient to achieve the desired aesthetic result, being necessary its combination with lip repositioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>Crown lengthening surgery (CLS) was performed in a 20-year-old woman, with a gingival display of 7.5 mm, having her gingival exposure reduced to 5.5 mm. Because the patient continued unsatisfied after 6 months, a new procedure was adopted. To reduce even more her gingival exposure, lip repositioning technique was performed associated with myotomy and the insertion of polyester threads as a physical barrier to prevent relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The result of the gingival display was reduced to 2.5 mm, removing the condition of a gummy smile after the combination of both techniques: crown lengthening, and lip repositioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>Why is this case new information?\u0000\u0000 <ul>\u0000 \u0000 <li>Association of the technique of lip repositioning and myotomy, the insertion of polyester threads that act as a physical barrier against recurrence.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the keys to successful management of this case?\u0000\u0000 <ul>\u0000 \u0000 <li>Correct etiological diagnosis.</li>\u0000 \u0000 <li>Prior application of botulinum toxin.</li>\u0000 \u0000 <li>Respect the period of 1 month for the insertion of the polyester thread, helping to preserve the suture (limitation of movement).</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the primary limitations to success in this case?\u0000\u0000 <ul>\u0000 \u0000 <li>Make the patient aware not to move the lips with the hands in order to observe the incision.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9194038","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 protocol for indirect fabrication of a custom provisional restoration prior to immediate implant surgery in the esthetic zone","authors":"Sarah M. Vargas,&nbsp;Walter G. Dimalanta,&nbsp;Thomas M. Johnson","doi":"10.1002/cap.10215","DOIUrl":"10.1002/cap.10215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Delivery of a high-quality provisional restoration at a maxillary anterior immediate implant site enhances patient-centered outcomes and promotes development of favorable hard and soft tissue architecture. The purpose of this report is to present a protocol relying upon compatible guided surgery and laboratory systems for fabrication of a custom provisional crown prior to immediate implant surgery in the esthetic zone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A female patient, aged 33 years, presented to the Army Postgraduate Dental School, Fort Gordon, Georgia, with an unfavorable prognosis for tooth #9. The patient elected extraction with immediate implant placement. Prior to the surgery, we utilized a cone-beam computed tomography volume, stone models, implant planning software, and an implant indexing system to fabricate a custom provisional crown. Following extraction of tooth #9 and immediate implant placement, the provisional crown exhibited excellent fit and finish, requiring virtually no chairside adjustment. We noted minimal change in baseline mucosal contours throughout the healing phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The clinical/restorative protocol described in this report assured accurate three-dimensional implant positioning and permitted indirect fabrication of a high-quality custom provisional crown in advance of surgery. The laboratory workflow—which dental technicians/auxiliaries can master—has the potential to shorten surgery, enhance treatment outcomes, and increase patient satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>Why is this case new information?\u0000\u0000 <ul>\u0000 \u0000 <li>This report provides a stepwise workflow guiding indirect fabrication of a custom provisional crown prior to immediate implant placement.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the keys to successful management of this case?\u0000\u0000 <ul>\u0000 \u0000 <li>The described technique requires compatible laboratory and guided surgery systems to assure that the restoration accounts for the three-dimensional position and timing of the implant.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the primary limitations to success in this case?\u0000\u0000 <ul>\u0000 \u0000 <li>Dental technicians/auxiliaries can master this protocol and independently produce high-quality provisional implant restorations under supervision, potentially enhancing practice efficiency. However, prac","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10499530","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":"Treatment of peri-implant soft tissue dehiscence around implants placed in calvarial bone graft maxilla and mandible 20 years ago: A case report","authors":"Martha Watanabe,&nbsp;Rémy Tanimura","doi":"10.1002/cap.10213","DOIUrl":"10.1002/cap.10213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite tissue augmentation and management prior implantation, long-term observation can reveal a change in peri-implant phenotype with some lack of keratinized mucosa (KM). The treatment approach of peri-implant dehiscence in multiple implants is not clearly defined. This report describes the different periodontal surgical approaches undertaken to promote the gingival margin stability and to prevent the peri-implant mucosal inflammation over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A 64-year-old woman with peri-implant tissue dehiscence regarding implants placed 20 years ago in a calvarial bone grafted maxilla and mandible was treated. Right maxillary and mandible peri-implants soft tissue were treated with a large apically positioned partial-thickness flap (APPTF) combined to a free gingival graft (FGG) simultaneously. For the left maxillary, where a frenum was in tension associated with infection and pockets, a large APPTF followed by a FGG 4 months later were performed. The KM width (KMW) increased in three operated sites with a gain average of 2.2 mm. The plaque control record decreased from 68% to 21%. All the probing depths were lower than 3 mm. Bleeding on probing was significantly reduced. The gingival index (GI) went from 1.5 to 0.25.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In a multiple implants soft tissue dehiscence case, an APPTF associate to a FGG, delayed or not, seems to be a safety primary approach to improve the KMW and to stabilize the peri-implants soft tissue. Further, a connective tissue graft in a bilaminar approach could be an option to enhance soft tissue thickness and esthetic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>Why is this case new information?\u0000\u0000 <ul>\u0000 \u0000 <li>To the best of the authors' knowledge, there are very limited studies regarding multi-implant soft tissue dehiscence treatment. Relevant guidelines are not clearly defined.</li>\u0000 \u0000 <li>Despite peri-implant hard and soft tissue augmentation, after a long-term observation (20 years of function), we can observe a change in peri-implant soft tissue phenotype (PISTP) with periodontal complication.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the keys to successful management of this case?\u0000\u0000 <ul>\u0000 \u0000 <li>Removal of peri-implant infection and tissue tension (frenum) by a larg","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84187543","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":"PDGF-BB-enriched collagen matrix to treat multiple gingival recessions with the tunneled coronally advanced flap","authors":"Shayan Barootchi,&nbsp;William V. Giannobile,&nbsp;Lorenzo Tavelli","doi":"10.1002/cap.10211","DOIUrl":"10.1002/cap.10211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With technological advancements in reconstructive periodontology, traditional protocols for the treatment of gingival recessions (GRs) can be challenged. This manuscript presents preliminary findings of a novel minimally-invasive approach for the regenerative treatment of multiple adjacent GR defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two healthy adults were treated as part of this study. Multiple adjacent GRs in both subjects (1 in the mandible, and 1 in the maxilla) were treated employing a tunneled coronally advanced flap (TCAF) design, with the application of a cross-linked collagen matrix (CCM) that was enriched with recombinant human platelet-derived growth factor-BB (PDGF-BB) that was also applied on the prepared root surfaces. Clinical, ultrasonographic, esthetic, and patient-reported outcomes were observed at approximately 6- and 18-month time points.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All sites healed uneventfully after the treatments. Complete root coverage was achieved and maintained throughout the follow-up observations, from 6 to 18 months. Patients reported minimal discomfort and reduction of dentinal hypersensitivity at the augmented sites. The areas augmented with CCM + PDGF-BB revealed an increased soft tissue thickness relative to baseline (pretreatment) measures, as well as reduction in the level of the facial bone dehiscences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This article describes the success of two cases of a novel minimally invasive regenerative approach for the treatment of multiple adjacent GR defects by the TCAF, using a CCM loaded with PDGF-BB. This approach offers potential as a minimally-invasive method to repair multiple adjacent GRs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://aap.onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10637069","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":"Localized CO2 laser treatment of a recalcitrant oral ulceration in pemphigus vulgaris","authors":"Nita Chainani-Wu,&nbsp;Vinitha Gopal-Murthy,&nbsp;Aadi Wu,&nbsp;M. Peter Marinkovich","doi":"10.1002/cap.10210","DOIUrl":"https://doi.org/10.1002/cap.10210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Recalcitrant oral lesions of pemphigus vulgaris (PV), an autoimmune blistering disease, can result in significant discomfort, difficulty in eating, and maintaining oral hygiene. Increasing the dosage of systemic medications to control such localized lesions results in an increased risk of adverse effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>We describe a male patient diagnosed at age 51 with PV by oral biopsy that included a direct immunofluorescence examination. After further baseline laboratory testing, he was started on prednisone and mycophenolate. These medications were slowly tapered with adjustments guided by clinical signs. Mycophenolate was replaced with intravenous immunoglobulin monthly infusions due to adverse effects about 2 years after initiation. During the 4.5-year follow-up period after diagnosis, his oral and skin lesions were well-controlled apart from minor transient flares. However, a painful ulcerated lesion on the facial gingiva between #11 and 12 was nonresponsive, even with the use of topical clobetasol in trays. A carbon dioxide (CO₂) laser was used to vaporize the recalcitrant lesion under local anesthesia. The procedure resulted in complete healing of ulceration with no recurrence until the most recent examination, 2 years postlaser surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adjunctive procedures that can facilitate a decrease in the cumulative dosage of corticosteroids and immunosuppressants have great value in the management of PV. CO₂ laser vaporization is safe, with minimal morbidity and no long-term side effects. It should be considered an adjunctive treatment option for the management of recalcitrant lesions in patients with oral PV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>Why is this case new information?\u0000\u0000 <ul>\u0000 \u0000 <li>To our knowledge, this is the second report on the use of a CO₂ laser in the treatment of recalcitrant oral lesions of PV and the first report with a documented long-term resolution of the treated lesions.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the keys to the successful management of this case?\u0000\u0000 <ul>\u0000 \u0000 <li>A localized recalcitrant lesion was treated with this approach. All other mucosal and cutaneous sites were well controlled on the patient's systemic medication regimen.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the primary limitations to success in this case?\u0000\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50117734","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":"Collagen matrix biofunctionalized with injectable platelet-rich fibrin for the treatment of single gingival recession: A case report","authors":"Mauro Pedrine Santamaria,&nbsp;Amanda Rossato,&nbsp;Laís Fernanda Ferreira Ferraz,&nbsp;Ana Carolina Bonafé,&nbsp;Manuela Maria Viana Miguel,&nbsp;Marcelo Pereira Nunes","doi":"10.1002/cap.10207","DOIUrl":"10.1002/cap.10207","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Collagen matrices have been used as connective tissue graft (CTG) substitutes. However, they do not have the same efficacy compared to CTG. Adding biological agents may increase collagen matrices' efficacy. The present case reports the use of a biofunctionalized volume-stable collagen matrix (VCMX) with injectable platelet-rich fibrin (iPRF) associated with the coronally advanced flap (CAF) to treat single gingival recession (GR) defect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>A Recession Type 1 (RT1 A-) defect at maxillary left canine in a male patient was treated using a VCMX biofunctionalized with iPRF associated with CAF. No swelling or edema was observed during the first 14 days after surgery. Complete root coverage was observed (RecRed of 4.0 mm) after 6 months. Gingival thickness (GT) increased (1.0 mm) by the end of the follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present case report shows that CAF associated with VCMX+iPRF presents good clinical outcomes for single GR defect.</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 case is the first one to our knowledge to describe the biofunctionalization of VCMX with iPRF to treat single gingival recession.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Proper material handling.</li>\u0000 \u0000 <li>Proper iPRF protocol execution.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the primary limitations to success in this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Need of venipuncture.</li>\u0000 \u0000 <li>Correct preparation of VCMX+iPRF.</li>\u0000 \u0000 <li>Patient compliance.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9647301","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":"3D-printed PMMA implant for gingival smile treatment through the VISTA technique: A report of a new approach","authors":"Luiz F. de Castro,&nbsp;Patrícia F. de Andrade,&nbsp;Gabriel G. Leite,&nbsp;Ana Júlia S. de Andrade,&nbsp;Gustavo L. Valentim,&nbsp;Ernani T. de Souza","doi":"10.1002/cap.10200","DOIUrl":"10.1002/cap.10200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A gingival display higher than 3 mm is considered a characteristic of a gingival smile (GS). Several etiological factors have been associated to GS and for this reason various treatments have been proposed according to its etiology. The aim of this study is to present a case with an alternative technique to treat GS with minimally invasive vestibular incision subperiosteal tunnel access (VISTA) and polymethyl methacrylate (PMMA) implants for lip repositioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>The patient, a 25-year-old woman diagnosed with excessive gingival exposure, had previously done botulinum toxin (BoNT) injections and did not like the result. She had a major subnasal depression and the upper lip would lodge in there during spontaneous smile. She was informed about all options of treatment and agreed to a lip repositioning installing a customized PMMA implant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to our knowledge to present a case with use of a PMMA implant associated with the VISTA approach for lip repositioning and gingival smile correction. The results are encouraging, and the patient was satisfied with results accomplished by this technique.</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 is a new and innovative surgical approach for gingival smile with PMMA implants through a minimally invasive technique (VISTA).</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Well-defined presurgical planning and the presence of the upper lip lodging in the subnasal depression during spontaneous smile.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the primary limitations to success in this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Cases with vertical maxillary excess and those in which osteotomy/osteoplasty is indicated.</li>\u0000 \u0000 <li>It is a technique-sensitive treatment dependent on the clinician's experience.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9563163","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":"Immediate implant and socket preservation using sticky bone and leukocyte-platelet-rich fibrin in the anterior maxilla: A 3-year case report","authors":"Marco Cirmeni,&nbsp;Ottavio Fedele,&nbsp;Enrica Giammarinaro,&nbsp;Simone Marconcini,&nbsp;Ugo Covani,&nbsp;Guerino Caso","doi":"10.1002/cap.10202","DOIUrl":"10.1002/cap.10202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Immediate implant in the esthetic area is a challenging procedure. Chronic infection often contributes to extensive bone loss and acute infection often precludes a safe, clean surgery. However, it is quite common to come across failing teeth in the esthetic area, where the patient often demands a faster rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>In this clinical case, a fractured upper central incisor was replaced by an immediate implant, and the perimetrical area was filled with heterologous bone blended with patient-derived leukocyte- and platelet-rich fibrin (L-PRF) in the form of sticky bone. A Maryland bridge was bonded to the adjacent teeth with the intent to guarantee minimum esthetic to the patient. After 5 months, the implant was connected to a definitive abutment and crown. The facial and interdental soft tissue was maintained with appreciable success after 2 years. The pre-treatment and 2-year- post-treatment computed tomography scans revealed marginal bone preservation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of sticky bone and L-PRF in immediate implant sites helps prevent hard and soft-tissue collapse and may favor faster and sounder healing.</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>It provides support to the efficacy of immediate implant placement with simultaneous use of L-PRF.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Having L-PRF supporting wound healing.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the primary limitations to success in this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Having sufficient bone apical to the existing socket and at adjacent teeth.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41122415","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 use of platelet-rich fibrin in vestibuloplasty: A 36-month follow-up technique report","authors":"Angel-Orión Salgado-Peralvo,&nbsp;Andrea Uribarri,&nbsp;Naresh Kewalramani,&nbsp;Juan-Francisco Peña-Cardelles,&nbsp;Antonio Liñares","doi":"10.1002/cap.10201","DOIUrl":"10.1002/cap.10201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vestibuloplasty is a mucogingival procedure that aims to increase the vestibule and the amount of keratinized tissue (KT) around teeth and dental implants. Currently, the <i>gold standard</i> in this procedure is still represented by free gingival grafts (FGGs); however, they require a second surgical site, which means more morbidity for the patient and a higher risk of surgical complications, as well as surgical time and chromatic alteration of the recipient area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Presentation</h3>\u0000 \u0000 <p>This is a description of the vestibuloplasty technique with platelet-rich fibrin (PRF) in a 35-year-old female patient with a thin gingival phenotype and no medical history of interest. The reason for consultation was tooth sensitivity during brushing and the presence of recessions in the fifth sextant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of PRF as a graft biomaterial in vestibuloplasty is a valid and effective option as an alternative to secondary epithelialization of the surgical site, as well as to FGGs, with acceptable results in terms of KT gain and root coverage, and with minimal postoperative discomfort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>Why is this case new information?\u0000\u0000 <ul>\u0000 \u0000 <li>The use of PRF is an interesting option as an alternative to second-intention healing, as FGGs in vestibuloplasty.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the keys to successful management of this case?\u0000\u0000 <ul>\u0000 \u0000 <li>The most important part of the membranes is the part that was in close relation to the erythrocyte fraction in the blood collection tube, so this part must be oriented toward the recipient bed.</li>\u0000 \u0000 <li>A minimum of four membranes should be obtained, overlapping one on top of the other.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>What are the primary limitations to success in this case?\u0000\u0000 <ul>\u0000 \u0000 <li>The stability of the PRF.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9563164","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}