Clinical Advances in Periodontics最新文献

{"title":"Guided roll flap in combination with static computer-assisted implant surgery: A technique report.","authors":"Ignacio Pedrinaci, Javiera Casas, Samuel Akhondi, Javier Calatrava, David Palombo, Alejandro Lanis, German O Gallucci","doi":"10.1002/cap.70069","DOIUrl":"https://doi.org/10.1002/cap.70069","url":null,"abstract":"<p><strong>Background: </strong>Peri-implant soft tissues are usually reduced when using a tissue punch in flapless static computer-assisted implant surgery (s-CAIS). The purpose of this article is to introduce a technique combining a minimally invasive guided roll flap (GRF) with s-CAIS to enhance buccal mucosal thickness and maintain peri-implant soft tissues.</p><p><strong>Methods: </strong>A surgical template is used to define a crest-centered de-epithelialization window and to guide a palatal semilunar full-thickness pedicle that is rolled into a mid-buccal tunnel and stabilized. Osteotomy and implant placement are performed through the same template; the transmucosal profile is supported by an immediate provisional restoration, a sealing socket abutment, or an stock healing abutment. Clinical and volumetric outcomes were assessed over a 12-month follow-up.</p><p><strong>Results: </strong>At 12 months, all implants demonstrated increased buccal mucosal thickness and adequate keratinized mucosa width. Volumetric analysis confirmed soft tissue volume augmentation compared to baseline. No vertical loss of adjacent papillae was observed. Clinical parameters, including PPD and BOP, remained stable, indicating maintained peri-implant health.</p><p><strong>Conclusions: </strong>This technique demonstrates the feasibility of combining s-CAIS with specific surgical approaches to potentially maintain or slightly improve peri-implant soft tissues. It offers clinicians an alternative method to the soft tissue punch, so the peri-implant soft tissues may be maintained or even augmented in a minimally invasive way.</p><p><strong>Key points: </strong>Static-computer assisted implant surgery integration: bridges the gap between flapless implant surgery and soft tissue management/augmentation. Enhanced peri-implant soft tissues: combines s-CAIS and modification of tissue phenotype. Minimally invasive: reduced patient morbidity due to no need for additional grafting donor sites.</p><p><strong>Plain language summary: </strong>Dental implants placed with flapless guided surgery can sometimes reduce the thickness of the surrounding peri-implant mucosa by the use of tissue punches. Soft tissues are essential for long-term implant health and appearance. This article presents a surgical approach that combines guided implant placement with a soft tissue management technique that repositions the site peri-implant mucosa to make it thicker instead of removing it. Using a surgical guide, the clinician knows exactly where to reshape the soft tissue and also use the same guide for implant placement. This minimally invasive approach helps to preserve or even improve the gum tissues around implants while maintaining the benefits of computer-guided surgery, potentially improving patient comfort and clinical outcomes.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044813","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":"Fibroblast growth factor-2 with beta-tricalcium phosphate for the deep and wide intrabony defect reaching the apex and Class II furcation involvement of a mandibular molar.","authors":"Shinichi Takayama, Tomoaki Iwayama, Masahide Takedachi","doi":"10.1002/cap.70074","DOIUrl":"https://doi.org/10.1002/cap.70074","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The basic fibroblast growth factor (FGF-2) drug formulation, human recombinant FGF-2 and hydroxypropylcellulose, developed in Japan, has been confirmed to induce effective periodontal regeneration. However, in cases with minimal residual bone walls or vertical bone defects fused with furcation involvement, FGF-2 alone does not achieve ideal periodontal regeneration. Therefore, it is necessary to attempt to use FGF-2 in combination with bone grafting materials. Beta-tricalcium phosphate (β-TCP) has been developed as a bone graft material and has a long history of use. Its advantage lies in its ability to be absorbed early during wound healing and replaced by bone. In this study, we examined the effectiveness of the smallest particle-sized β-TCP in combination with FGF-2 for the severe deep and wide combined one- to three-walled bone defect and Class II furcation involvement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;FGF-2 with β-TCP was applied to an intrabony defect and Class II furcation involvement of a 40-year-old female patient with aggressive periodontitis (stage III and grade C). As far as possible, the incision line was not placed over the bone defect. The interdental papillae were dissected using a simplified papilla preservation technique. Full-thickness buccal and lingual mucoperiosteal flaps were reflected. After thorough debridement, FGF-2 with small-particle β-TCP was applied to the bone defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Radiographic examination at 1 month demonstrated early radiographic bone fill. Over time, layered bone‑like radiopacity was observed extending from the remaining bone wall. In addition, by 6 months, a distinctive protruding bone‑like radiopacity arising from the alveolar crest of the adjacent tooth was observed extending toward the defect. At 41 months, substantial radiographic bone fill was evident. While Class II furcation involvement showed overall improvement, some sites exhibited only limited reparative changes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The combination of FGF-2 and small‑particle β‑TCP may promote periodontal regeneration in severe intrabony and furcation defects, although definitive confirmation of complete regeneration requires further investigation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The optimal β‑TCP particle size for use with FGF‑2 remains unclear. In this study, the smallest available β‑TCP granules were incorporated into the hydroxypropylcellulose‑based FGF‑2 formulation, functioning as a dispersed, space‑maintaining scaffold. Periodontal tissue regeneration using the smallest and rapidly absorbable β‑TCP granules in combination with FGF‑2 demonstrated favorable healing in complex, deep vertical bone defects and Class II furcation lesions. Although larger β‑TCP granules are generally considered advantageous because their greater porosity allows easier migration of undifferentiated mesenchymal cells from existing bone walls or periodontal ligament remnants, the small‑","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935698","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":"Bottom-up suturing approach with biologic and grafting support for RT2 gingival recessions with papilla deficiency: Two case reports.","authors":"Akihiro Yuguchi, Eiichi Suzuki, Akihiko Katayama, Otto Zuhr, Akiyoshi Funato","doi":"10.1002/cap.70076","DOIUrl":"https://doi.org/10.1002/cap.70076","url":null,"abstract":"<p><strong>Background: </strong>The management of multiple recession type 2 (RT2) gingival recessions remains a major clinical challenge because of interproximal attachment loss and limited predictability. This study aimed to present a graft-driven bottom‒up suturing concept for simultaneous root coverage and interdental papilla reconstruction.</p><p><strong>Methods: </strong>Two systemically healthy patients with RT2 multiple gingival recessions in the mandibular anterior region were treated using a bilaminar approach with basal positioning of a connective tissue graft. Interproximal bone grafting and biologic adjuncts were used to provide structural support and enhance the healing environment. A modified vertical double-crossed suturing technique was applied to achieve graft-driven coronal advancement and tension control. Clinical outcomes were evaluated at 6‒12 months.</p><p><strong>Results: </strong>At 12 months, root coverage reached 94.4% in one case and 100% in the other. Both cases demonstrated stable interdental papilla height and a keratinized tissue width gain of 2.00‒2.33 mm. Comparable favorable outcomes were observed with both recombinant human fibroblast growth factor-2 and enamel matrix derivative.</p><p><strong>Conclusions: </strong>The graft-driven bottom‒up suturing approach may represent a promising technique for the management of complex RT2 gingival recession defects. Surgical design and tension control appear to be key factors for achieving predictable root coverage and papilla reconstruction in challenging clinical scenarios.</p><p><strong>Key points: </strong>A graft-driven bottom‒up suturing approach can achieve favorable root coverage in recession type 2 multiple gingival recessions. This technique enables simultaneous reconstruction of interdental papillae in challenging anterior cases. Careful surgical design and tension control are critical factors for improving clinical outcomes in complex recession defects.</p><p><strong>Plain language summary: </strong>Gum recession, a condition in which the gums recede from the teeth, can be difficult to treat when the supporting tissue between teeth is also lost. In these cases, it is often hard to fully cover exposed roots or restore the natural shape of the gums. In these reports, we describe a new surgical approach used in two patients with multiple gum recessions in the lower front teeth. The technique uses a small piece of the patient's own tissue placed under the gum to support healing, along with a specific suturing method that gently moves the gum upward. After 12 months, both patients showed substantial root coverage and improvement in the shape of the gum between teeth, with stable results over time. These findings suggest that careful surgical design and control of tissue tension may help improve outcomes in challenging cases of gum recession.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935744","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":"Use of microsurfaced acellular dermal matrix for the generation of site-appropriate keratinized tissue in soft tissue augmentation healing: Proof of concept.","authors":"Michael K McGuire, E Todd Scheyer, Kathryn E Davis, John C Gunsolley, Rick H Heard","doi":"10.1002/cap.70073","DOIUrl":"10.1002/cap.70073","url":null,"abstract":"<p><p>May 9, 2026: This article published in Early View in error. The corrected article will republish shortly.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846599","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":"Fixed contralateral anchored suturing for coronal flap advancement.","authors":"Pooria Fallah Abed, Stephanie Bowers, Wade Knight, Rodrigo Neiva","doi":"10.1002/cap.70064","DOIUrl":"https://doi.org/10.1002/cap.70064","url":null,"abstract":"<p><strong>Background: </strong>Fixed contralateral anchored suturing (FICAS) for coronal flap advancement is a novel suturing technique that utilizes ceramic attachments bonded to the buccal or lingual of the teeth as an anchorage point for suspensory sutures. This technique is designed to increase flap stability and improve graft adaptation in periodontal plastic surgery.</p><p><strong>Methods: </strong>Two patients with localized gingival recession defects were treated with connective tissue grafting. One case used a tunneling technique, and the other used a coronally advanced flap. A ceramic button is bonded to the tooth surface contralateral to the flap. This is the lingual surface in both cases presented. Subepithelial connective tissue grafts and flaps were coronally advanced using periosteal stretching and then secured with nylon sutures. The sutures are looped over the ceramic button in a specific suspensory configuration.</p><p><strong>Results: </strong>Follow-up at 2 weeks and 6 months revealed uneventful healing. No loss of sutures, ceramic buttons, or any postoperative infection occurred. The bonded buttons successfully protected the sutures and wound from disruption by tongue movements and food. There were visible increases in gingiva thickness, keratinized and attached tissue. Significant root coverage was achieved.</p><p><strong>Conclusions: </strong>The FICAS technique may be a viable alternative for tension-free coronal flap advancement and stable soft tissue adaptation, specifically in complex soft tissue cases such as a dehiscence or Recession type (RT)2 and RT3 defects. Additional research, ideally randomized controlled trials, is necessary to substantiate these observations and determine the long-term success of this technique compared to others previously described.</p><p><strong>Key points: </strong>Fixed contralateral anchored suturing used ceramic buttons as a remote anchorage point for suspensory sutures. Maximizing flap stability and minimizing tension on delicate tissues are critical factors for favorable healing in periodontal plastic surgery. Buttons bonded to the contralateral surface of the flap may improve esthetics compared to other suspensory suturing techniques.</p><p><strong>Plain language summary: </strong>Fixed contralateral anchored suturing technique is a new suturing technique that involves bonding a button to the tooth surface, which will hold suspensory sutures. Sutures play a critical role in holding the tissues in a stable and favorable position during initial healing. The authors aim to introduce this technique to improve upon the esthetics of previously reported suspensory suturing techniques, and potentially improve outcomes and root coverage in both simple and complex recession cases.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846320","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":"Multidisciplinary oral rehabilitation after head and neck radiotherapy.","authors":"Fernanda C B S Bettero, Ana V G L C Oliveira, Ana L C Mendonça, Camila C A Lopes, Veridiana R Novais","doi":"10.1002/cap.70066","DOIUrl":"https://doi.org/10.1002/cap.70066","url":null,"abstract":"<p><strong>Background: </strong>Radiotherapy for head and neck cancer is associated with adverse oral effects, including salivary gland hypofunction, radiation-related caries, and periodontal tissue alterations, which negatively impact oral health and quality of life.</p><p><strong>Methods: </strong>A 56-year-old male previously treated with surgery, radiotherapy, and chemotherapy for oropharyngeal cancer presented with dentin hypersensitivity, gingival recession, and reduced keratinized tissue. A multidisciplinary rehabilitation was performed, including non-surgical periodontal therapy, free gingival grafting, restorative treatment of cervical lesions, prosthetic rehabilitation, and individualized preventive maintenance.</p><p><strong>Results: </strong>Uneventful healing was observed at all surgical sites. The free gingival grafts resulted in increased keratinized tissue and vestibular depth, with stable periodontal conditions and resolution of dentin hypersensitivity. Clinical stability was maintained throughout a 24-month follow-up period, with no adverse radiation-related effects.</p><p><strong>Conclusions: </strong>Multidisciplinary oral rehabilitation, including mucogingival surgery and preventive care, can be safely and effectively performed in irradiated patients, improving periodontal stability, oral comfort, and quality of life.</p><p><strong>Key points: </strong>Head and neck radiotherapy can cause long-lasting oral complications that require careful and individualized dental management. Periodontal surgery, restorative treatment, and prosthetic rehabilitation can be safely performed in irradiated patients when properly planned and followed. Long-term preventive maintenance is essential to maintain oral health and minimize complications in head and neck cancer survivors.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846473","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":"Five-year tomographic and clinical evaluation of the socket shield technique: Case report.","authors":"Renan Dalla, Khalila C Cotrim, Rafael A Siqueira, Eduardo C Kalil","doi":"10.1002/cap.70065","DOIUrl":"https://doi.org/10.1002/cap.70065","url":null,"abstract":"<p><strong>Background: </strong>The socket shield technique, one modality of partial extraction therapy, aims to preserve periodontal tissues and maintain the buccal alveolar bone volume following immediate implant placement or in prosthetic pontic sites, by the strategic maintenance of a tooth root fragment. This case report presents a 5 year-follow up of this technique, in a full maxillary implant-supported rehabilitation, evaluating the alveolar dimensional changes over time.</p><p><strong>Methods: </strong>A 54-year-old patient underwent a full maxillary implant-supported rehabilitation. Partial tooth extraction was performed on the five anterior sites, numbers 6, 8, 9, 10, and 11. In each site where the socket shield technique was performed, changes in alveolar dimensions at the cervical, middle, and apical levels were measured using computed tomography at baseline, 1, 3, and 5-year follow-up intervals. In addition, the Pink Esthetic Score evaluation was performed.</p><p><strong>Results: </strong>The mean values (mm) in the five evaluated sites, at each time period, were respectively: cervical = 7.92 ± 0.46; 8.38 ± 0.61; 8.28 ± 0.51; and 8.32 ± 0.47. Medium third = 7.84 ± 0.99; 8.18 ± 1.05; 7.22 ± 0.69; 7.24 ± 0.72. Apical = 6.84 ± 0.91; 6.88 ± 0.74; 6.40 ± 0.70; 6.40 ± 0.69.</p><p><strong>Conclusion: </strong>Despite its inherent limitations, this case report suggests that the socket shield technique can represent a promising alternative for the stability of peri-implant tissues, in pontic and implant sites.</p><p><strong>Key points: </strong>In this case report, the socket shield technique was able to preserve alveolar dimension in both implant and pontic sites at 5-year follow-up. Careful planning and execution are crucial to prevent interference between retained root fragments and prosthetic components. Patient satisfaction and favorable Pink Esthetic Scores demonstrated good esthetic outcomes with this technique.</p><p><strong>Plain language summary: </strong>Preserving bone and soft tissue volume and position after tooth extraction is a major challenge in implant dentistry, particularly in anterior sites. This case report illustrates the five-year follow-up of a patient who received a full-arch, implant-supported rehabilitation in the upper jaw using the socket shield technique. This approach preserves a portion of the tooth root to help maintain the natural contour of bone and soft tissues. Clinical and tomographic evaluations, along with esthetic scoring systems, were used to assess tissue stability and appearance over time. In this case report, after five years, the technique showed stable preservation of bone and gingival tissues, with favorable esthetic outcomes and high patient satisfaction. Although based on a single case, these findings suggest that the socket shield technique may be a useful option for achieving long-term tissue stability and esthetic success in challenging implant-supported rehabilitations.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846277","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":"Connective tissue graft wall technique with concentrated growth factors and allograft: A case series.","authors":"Hou-En Lin, Yu-Ting Tsai, Li-Wen Lin","doi":"10.1002/cap.70067","DOIUrl":"https://doi.org/10.1002/cap.70067","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Severe periodontitis often results in extensive attachment loss and non-contained bony defects, compromising regenerative predictability. This case series evaluates the clinical and radiographic outcomes of treating extensive infrabony defects with buccal dehiscence using a synergistic approach: the connective tissue graft (CTG) wall technique combined with freeze-dried bone allograft (FDBA) and concentrated growth factors (CGF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two patients underwent regenerative surgery following initial periodontal therapy. Intraoperatively, two-wall, non-contained defects with complete buccal bone dehiscence were identified. The defects were grafted with \"CGF sticky bone\" (FDBA mixed with CGF). A CTG was secured to the interdental papillae and periosteum to establish a biological barrier, followed by a coronally advanced flap for closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the 8-month follow-up, both cases demonstrated significant pocket probing depth reduction (&lt;4 mm) and clinical attachment level gains (4-5 mm). While minor residual gingival recession and partial papilla collapse occurred, a notable increase in gingival thickness was observed. Periapical radiographs confirmed substantial infrabony bone fill and increased radiopacity within the previous defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The combination of the CTG wall technique, FDBA, and CGF provides a viable strategy for managing complex, non-contained periodontal defects. This integrated approach effectively stabilizes graft materials and improves soft tissue quality, though complete prevention of recession in advanced defects remains a clinical challenge.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Regenerating non-contained infrabony defects remains clinically challenging due to compromised space maintenance and wound stability. This case series demonstrates that the CTG wall technique, integrated with FDBA and CGF, effectively manages these complex defects by providing a stable biological barrier. This approach yields favorable short-term CAL gains, substantial radiographic bone fill, and beneficial soft tissue phenotype modification, even in cases with extensive buccal bone loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Periodontitis is a severe gum infection that destroys the supporting tissues and bone around teeth, often leading to tooth loss. Traditional treatments sometimes struggle to fully regrow these lost structures. This study introduces a specialized surgical approach called the \"CTG Wall Technique.\" By combining a patient's own gum tissue with advanced blood-derived growth factors and bone graft materials, we created a biological \"wall\" to stabilize the wound and enhance healing. We applied this method to patients with deep bone defects and followed their progress. The results showed significant improvement in gum attachment and bone height. This technique offers a promising, biological way to save teeth that might oth","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846196","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":"Subperiosteal peri-implant augmented layer to correct bone dehiscence at immediate implant placement.","authors":"Tommaso Grenzi, Chiara Franzini, Mattia Severi, Leonardo Trombelli","doi":"10.1002/cap.70070","DOIUrl":"https://doi.org/10.1002/cap.70070","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The purpose of the present case report is to describe the potential of the subperiosteal peri-implant augmented layer (SPAL) technique in peri-implant bone dehiscence (PIBD) correction at immediate implant placement (IIP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This case report describes the application of the SPAL technique in two patients undergoing IIP at compromised sockets resulting in a PIBD. A split-thickness flap was raised to preserve the periosteal layer, which was coronally advanced to compensate the missing portion of buccal bone plate. A deproteinized bovine bone mineral graft, with or without autogenous bone, was placed beneath the periosteal envelope to reconstruct the buccal defect. Mucosal layer was used to achieve primary closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Both patients exhibited uneventful healing. At re-entry, complete PIBD correction was observed, with newly formed peri-implant bone extending to the level of the implant collar. Clinical and radiographic evaluation assessed healthy peri-implant tissues at prosthetic rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;SPAL technique may be considered a simplified option in the treatment of PIBD at IIP.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Peri-implant bone dehiscence (PIBD) requires treatment to prevent long-term biological complications, such as peri-implant disease and progressive bone loss and soft tissue dehiscence. Periosteal layer (PL) plays a key role by serving as a biologically active barrier that compensates for the absence of the buccal socket wall and converts the defect into a self-contained one, thereby supporting graft stabilization and bone regeneration. Severity of the PIBD, on one hand, and the extent of coronal advancement of the PL at surgical manipulation, on the other, may represent relevant limitations for the generalizability of the application of PL-based procedures for bone augmentation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Immediate implant placement after tooth extraction can be complicated when part of the buccal bone is missing. This condition may compromise implant stability, peri-implant tissue health, and esthetic outcomes if not properly managed. This case report presents a surgical approach that uses the patient's own periosteum, a thin tissue layer covering the bone, to help reconstruct buccal bone defects at the time of immediate implant placement. The periosteum was carefully separated and repositioned to act as a natural biological membrane, creating a protected space that contained the bone graft and supported new bone formation. Two patients with buccal bone defects were treated using this technique in combination with bone graft materials. Healing occurred without complications. Clinical and radiographic evaluations showed complete correction of the bone defects, stable peri-implant tissues, and favorable esthetic outcomes. These findings suggest that the surgical use of the periosteum may represen","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789325","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":"Reconstruction of a severely atrophied maxilla using titanium-reinforced membranes: A case report.","authors":"Thaer Alqadoumi, Noor Daras","doi":"10.1002/cap.70071","DOIUrl":"https://doi.org/10.1002/cap.70071","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Severe maxillary alveolar ridge atrophy secondary to advanced periodontal disease presents a challenge for implant rehabilitation, particularly in patients with systemic comorbidities. Guided bone regeneration combined with sinus augmentation may provide an alternative to remote anchorage implants when conditions permit. This case has educational value for clinicians by illustrating a staged reconstructive approach for severe maxillary atrophy, including complication management and subsequent implant rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 55-year-old male with uncontrolled diabetes mellitus presented with maxillary edentulism with severe horizontal and vertical bone loss of the maxillary arch due to a history of periodontal disease and requested implant-retained overdenture rehabilitation. After consultation regarding remote anchorage implants, the patient elected a staged regenerative approach. Glycemic control was optimized prior to surgery, with hemoglobin A1c reduced from 8.9% to 7.6%. Bilateral lateral window sinus augmentation was performed, followed by a 5-month healing period. Subsequently, full-arch guided bone regeneration using particulate grafting and a titanium-reinforced polytetrafluoroethylene membrane was completed. Membrane exposure occurred on the left side at 4 months and was managed by membrane removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Cone beam computed tomography obtained 9 months after guided bone regeneration demonstrated adequate vertical and horizontal ridge dimensions to permit implant placement. Four implants were placed to support a maxillary implant-retained overdenture. At 1-year follow-up, peri-implant soft tissues and supporting bone levels remained stable.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case demonstrates that a staged regenerative approach combining sinus augmentation and guided bone regeneration can facilitate implant-supported overdenture rehabilitation of a severely atrophied maxillary arch in a patient with controlled systemic risk factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Staged regenerative therapy combining sinus floor augmentation and guided bone regeneration can facilitate implant placement in the severely atrophied maxilla when systemic conditions are appropriately managed. Titanium-reinforced non-resorbable PTFE membranes provide effective space maintenance for full-arch ridge reconstruction; however, membrane exposure remains a recognized complication that can be managed without compromising subsequent implant placement. Optimization of glycemic control and careful surgical planning may allow successful implant-retained overdenture rehabilitation in patients with a history of advanced periodontal disease and controlled diabetes mellitus.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Severe bone loss in the upper jaw can make placement of dental implants difficult, especially in patients with medical conditions such as diabetes. Some patients are of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823912","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}