Clinical Advances in Periodontics最新文献

{"title":"Periodontitis treatment and microbiome in a patient with FAM20A mutation: Case study of 1.5 years.","authors":"John Rong Hao Tay, Preethi Balan, Chaminda Jayampath Seneviratne","doi":"10.1002/cap.10365","DOIUrl":"https://doi.org/10.1002/cap.10365","url":null,"abstract":"<p><strong>Background: </strong>Enamel-renal-gingival syndrome (ERGS) is an autosomal recessive disorder caused by mutations in the FAMily with sequence similarity 20A (FAM20A) gene, and is characterized by amelogenesis imperfecta, delayed or failed tooth eruption, and periodontitis. This study aims to profile the salivary microbiome and monitor the clinical progression in a young adult patient with FAM20A mutations.</p><p><strong>Methods: </strong>Treatment involved non-surgical therapy including scaling and root planing (SRP) and systemic amoxicillin and metronidazole, and reviewed for 1.5 years.</p><p><strong>Results: </strong>Probing depth reduction with no sites of 5 mm or deeper was achieved at 1.5 years post-treatment. Saliva microbiome profiles of the patient revealed a decrease in periodontitis-associated pathogenic bacteria including Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Treponema parvum, and a repopulation of health-associated species at 6 months. Predictive analysis revealed a decrease in the cell motility pathway relative to the 2-month time point and baseline.</p><p><strong>Conclusions: </strong>FAM20A mutations may alter the periodontal microenvironment, potentially contributing to microbial dysbiosis. However, therapy consisting of SRP and systemic antibiotics may result in clinical improvements, demonstrating that the microbiome plays a role in health and disease even in syndromic cases.</p><p><strong>Key points: </strong>Patients presenting with amelogenesis imperfecta may present with periodontitis as a manifestation of systemic disease. Such cases are treatable without the need for extensive serial extractions of teeth.</p><p><strong>Plain language summary: </strong>People with enamel-renal-gingival syndrome, a rare genetic condition, experience problems such as poorly formed enamel, delayed tooth eruption, and severe gum disease. In this study, a 22-year-old adult with enamel-renal-gingival syndrome was followed up to understand how her saliva microbiome changed after treatment. The patient received professional deep cleaning and systemic antibiotics and was followed up for 1.5 years. Treatment successfully led to probing depth reduction. Analysis of the saliva microbiome showed a reduction in bacteria associated with periodontitis and an increase in bacteria associated with health. These findings suggest that enamel-renal-gingival syndrome may create an oral environment that encourages bacterial imbalance in the mouth, contributing to gum disease. However, the results also show that standard gum disease treatment can still be effective. Changes in the microbiome were observed alongside clinical improvement, pointing to the microbiome's potential relevance in both disease and recovery.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735604","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":"Necrotizing ulcerative stomatitis following bone marrow transplantation in a patient with chronic granulomatous disease: Case report.","authors":"Lama Alabdulaaly, Christy Lucas, Susan Prockop, Birgitta Schmidt, Nathaniel Treister, Herve Sroussi","doi":"10.1002/cap.10363","DOIUrl":"https://doi.org/10.1002/cap.10363","url":null,"abstract":"<p><strong>Background: </strong>Chronic granulomatous disease (CGD) is an inborn error of immunity characterized by life-threatening infections and inflammation. Allogeneic hematopoietic stem cell transplantation (alloHSCT) is potentially curative. Necrotizing periodontal diseases (NPDs) are rare and can be seen in immunocompromised/immunosuppressed individuals but have not been reported in patients with CGD. We report NPD in the form of necrotizing stomatitis (NS) in a patient transplanted for CGD.</p><p><strong>Methods: </strong>A 12-year-old male presented with severe gingival pain. The patient's medical history was significant for X-linked CGD diagnosed at 4 years of age and a heterozygous RIPK1 mutation. The patient underwent alloHSCT from a mismatched unrelated donor. Intraoral examination on day +61 post-alloHSCT revealed multifocal gingival ulceration, which did not respond to a short course of prednisone and topical dexamethasone oral solution. The ulcers progressed to involve the lip mucosa and soft palate/tonsil (day +88).</p><p><strong>Results: </strong>Biopsy from the soft palate/tonsillar area showed deep acute inflammation and abscesses consistent with the diagnosis of NS. The patient underwent deep gingival scaling on day +103 and received amoxicillin and metronidazole. The patient had complete resolution of the oral ulcers by day +125 but developed chronic graft-versus-host disease involving the oral mucosa on day +314 post-alloHSCT.</p><p><strong>Conclusion: </strong>We report the first case of NS as a complication of alloHSCT in a patient transplanted for CGD which was successfully managed with antibiotic therapy, periodontal debridement, and discontinuation of potentially triggering agents. Our report demonstrates that NS/NPD may occur in post-alloHSCT setting.</p><p><strong>Key points: </strong>Chronic granulomatous disease is an inherited multisystem autoinflammatory condition. Patients with chronic granulomatous disease may have oral manifestations including oral ulcerations and gingivitis/periodontitis. Necrotizing ulcerative stomatitis may arise in the post-hematopoietic stem cell transplantation setting.</p><p><strong>Plain language summary: </strong>Chronic granulomatous disease (CGD) is a condition that impairs the immune system and can be managed with bone marrow transplantation. Necrotizing periodontal disease (NPD) are a group of rare conditions that affect the mouth and cause tissue death (necrosis) and present clinically as oral ulcers (mouth sores). In this article, we report NPD in a child who received bone marrow transplantation for his CGD. This report broadens the differential diagnosis of oral ulcers in the post-transplant setting.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735602","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":"Management of peri-implantitis with a reconstructive approach: Guided bone regeneration using the open membrane technique: A case study.","authors":"Hsin-Chiang Lee","doi":"10.1002/cap.70001","DOIUrl":"https://doi.org/10.1002/cap.70001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The restoration of the healthy peri-implant tissue and re-osseointegration represent the goals of reconstructive procedures for treating peri-implantitis. Peri-implant regeneration is a field that requires further optimization to increase predictability. The submerged approach has been shown to yield superior defect fill compared to the non-submerged approach. Nevertheless, primary closure in the submerged approach can result in diminished keratinized tissue. This case study presents an alternative approach to managing advanced peri-implantitis, with the use of open membrane technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 71-year-old female presented with #30 peri-implantitis, exhibiting 10 mm probing depth, suppuration upon probing, and severe bone loss. The implant prosthesis was removed prior to the surgery to gain access to instrumentation. Subsequent to the debridement of the defect and implant detoxification, a mix of xenograft and enamel matrix derivatives was used to fill the defect. High-density polytetrafluoroethylene membrane was placed over the defect. The flaps were replaced without attempting primary closure, and the membrane was intentionally left exposed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Disease resolution with significant radiographic bone fill was achieved and remained stable with 20 months follow-up. In addition, keratinized tissue was adequately preserved after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Reconstructive surgery using the open membrane approach can be an alternative for managing advanced peri-implantitis defects, with the advantages of preserving keratinized tissue and reducing intrasurgical trauma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The open membrane technique may serve as a viable alternative to primary closure in guided bone regeneration for peri-implant reconstructive procedures. Advantages include reduced surgical trauma, shorter procedure time, and preservation of keratinized tissue. Careful case selection is essential for achieving predictable outcomes. Factors to consider include defect configuration, the number of remaining bony walls, and the size of the wound opening. In more challenging cases, combination therapy and the adjunctive use of biologics may be considered to enhance regenerative potential and improve clinical results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case study presents the regenerative treatment of chronic inflammation and bone loss around a dental implant using the open membrane technique. To manage the condition, the crown portion of the dental implant was removed, and the implant surface was thoroughly cleaned and disinfected. The space around the implant was then filled with bone graft and biological agents and covered with a membrane. Unlike typical regenerative procedures, the membrane was intentionally left partially exposed rather than being fully covered by the gum during healing. After the procedure, the infection was resolved, and ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735601","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":"Preservation therapy for vertically fractured teeth with periodontal tissue regeneration using FGF-2.","authors":"Masaichiro Iwasaki, Masahide Takedachi, Keigo Sawada, Koji Miki, Shinya Murakami","doi":"10.1002/cap.10357","DOIUrl":"https://doi.org/10.1002/cap.10357","url":null,"abstract":"<p><strong>Background: </strong>Vertically fractured teeth often have a poor prognosis, and extraction is considered the most predictable treatment. Conventional management has consisted of preservation therapy involving extraction, bonding, root restoration, and replantation of fractured teeth. However, these methods fail to adequately address the periodontal tissue damage associated with root fractures. This report describes successful periodontal tissue regeneration using basic fibroblast growth factor (FGF-2) combined with a carbonate apatite-based bone graft material (CaAp) as a scaffold during the replantation of vertically fractured teeth.</p><p><strong>Methods: </strong>Our series included four patients: a 57-year-old woman, a 59-year-old woman, a 45-year-old man, and a 41-year-old woman, all diagnosed with vertically fractured teeth. The fractured teeth were extracted, bonded using 4-methacryloxyethyl trimellitate anhydride in methyl methacrylate initiated by tri-n-butyl borane (4-META/MMA-TBB) resin, and replanted. CaAp was applied to the extraction sockets; FGF-2 was administered to the periodontal ligament-deficient root areas prior to replantation.</p><p><strong>Results: </strong>In all cases, periodontal pocket depths were reduced to 3 mm or less, and no signs of inflammation were evident. Cone-beam computed tomography revealed substantial regeneration of periodontal tissues.</p><p><strong>Conclusions: </strong>The combination of FGF-2 and CaAp during the replantation of vertically fractured teeth promotes periodontal tissue regeneration and demonstrates potential for long-term tooth preservation.</p><p><strong>Key points: </strong>What new information do these cases provide? This is the first report to our knowledge demonstrating that replantation of a root-fractured tooth, historically considered suitable only for extraction, can achieve substantial periodontal tissue regeneration. This regeneration was accomplished by bonding and restoring the tooth using 4-methacryloxyethyl trimellitate anhydride in methyl methacrylate initiated by tri-n-butyl borane (4-META/MMA-TBB) resin in combination with fibroblast growth factor (FGF-2) and carbonate apatite-based bone graft material (CaAp). What are the keys to successful management of these cases? Atraumatic tooth extraction Thorough curettage of the extraction socket Comprehensive debridement of the fractured root surface Precise bonding and restoration of the fractured tooth Effective application of FGF-2 and CaAp, with accurate positioning and stabilization of the replanted tooth What are the primary limitations to success in these cases? The mechanical factors that can cause root fracture need to be eliminated for this treatment to succeed. The long-term prognosis depends on consistent follow-up and monitoring. The procedure is highly technique-sensitive; outcomes are closely associated with operator skill and experience.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735605","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":"Root coverage using a microsurfaced acellular dermal matrix: A retrospective case series.","authors":"Yu-Chang Wu, Guo-Liang Cheng, Shaun Rotenberg","doi":"10.1002/cap.10361","DOIUrl":"https://doi.org/10.1002/cap.10361","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acellular dermal matrices (ADMs) have been used for root coverage for over 25 years, yet few advancements have improved clinical outcomes or reduced complications. This case series evaluated the use of a novel microsurfaced ADM (mADM), which features a microtextured surface designed intended to promote healing and improve graft integration, for treating gingival recession defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Eleven RT1 gingival recession defects from five patients were treated using mADM between January and May 2023 by a single surgeon (S.R.). A modified vestibular incision subperiosteal tunnel access technique was used for multiple recession defects, while a subperiosteal pouch technique was performed for single-tooth recession defects. Clinical outcomes were assessed at baseline and 12 months. Pair t-tests were utilized to compare changes overtime.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean recession depth reduced from 3.64 ± 0.50 mm to 0.73 ± 0.79 mm after 12 months. Keratinized tissue width increased from 2.32 ± 0.81 mm to 3.36 ± 0.92 mm. Gingival phenotype remained thick for all the cases. Significant root coverage was achieved (p &lt; 0.05) with no graft exposure; complete root coverage was observed in 45.5% (5/11). Patients reported minimal discomfort and satisfactory healing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Within the limits of this retrospective case series, mADM may be considered a viable option for the treatment of RT1 gingival recession defects. Future randomized clinical trials should be performed to compare this matrix with other options to deal with recession defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;In this case study, the novel microsurfaced acellular dermal matrices (mADM) demonstrated significant root coverage improvements in RT1 gingival recession defects, with a mean recession reduction from 3.64 to 0.73 mm at 12 months, achieving 80% root coverage and complete coverage in 45.5% of treated sites. The mADM may serve as a promising alternative to autogenous grafts, but larger-scale randomized clinical trials are necessary to confirm long-term efficacy and patient-reported outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;For decades, gum recession-when the gum tissue pulls back from the teeth and exposes the roots-has been treated with acellular dermal matrices (ADMs) made from donated cadaver tissue, avoiding the need to harvest tissue from the patient. Although traditional ADM is widely used, concerns exist regarding its healing and long-term stability. In this case series, a new type of ADM called microsurfaced ADM (mADM) was used. Like ADM, mADM is derived from cadaver tissue but has a specially textured surface intended to support graft integration with the gums. Five non-smoking patients were treated with mADM and followed for 12 months. The treatment resulted in excellent root coverage without complications such as graft exposure or infection. Patients reported very little disc","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735606","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":"A rare mental foramen variation and the role of cone-beam computed tomography in preventing nerve injury: A case report.","authors":"Magdalena Orlowska, Hend Abulatifa, Muhammad H A Saleh, Hom-Lay Wang","doi":"10.1002/cap.70002","DOIUrl":"https://doi.org/10.1002/cap.70002","url":null,"abstract":"<p><strong>Background: </strong>The interforaminal space is frequently used for dental implant placement due to its strategic location between the bilateral mental foramina. However, neurosensory disturbances following surgical intervention near the mental foramen (MF) can occur in up to 43% of cases. Understanding anatomical variations of the MF is crucial to preventing surgical complications. Traditional two-dimensional radiographs have limitations in accurately visualizing anatomical structures, whereas cone-beam computed tomography (CBCT) provides high-resolution three-dimensional imaging that enhances diagnostic accuracy and clinical decision making. This case report highlights such a scenario.</p><p><strong>Methods: </strong>A 54-year-old male referred for implant placement underwent preoperative evaluation with CBCT, which revealed a rare anatomical variation: the MF was positioned distal to the right mandibular second incisor (distal to #25) roughly 3 mm from the crest of the ridge, rather than its typical between the apices first and second premolars. The mental nerve exhibited an aberrant course, traversing in a superficial, buccal direction along the alveolar crest of site #25. This variability placed the neurovascular bundle at an extremely high risk for intraoperative injury. Consequently, the implant treatment plan was modified to reposition the implants away from the nerve pathway, and a customized CBCT-based surgical guide was utilized to facilitate accurate implant placement while preserving neurovascular integrity.</p><p><strong>Results: </strong>The patient exhibited no neurosensory disturbances postoperatively, and a 2-week follow-up showed normal healing. The adjusted implant placement strategy successfully avoided nerve injury.</p><p><strong>Conclusion: </strong>Conventional radiographs are limited in detecting neurovascular structures and anatomical variations. CBCT serves as an essential diagnostic tool for identifying rare variations of the MF, ensuring precise implant placement, and preventing surgical complications.</p><p><strong>Plain language summary: </strong>Before placing dental implants, its important to know exactly where key structures are located to avoid causing injury. This case reports on a 54-year-old man who needed dental implants in his lower front jaw. The mental nerve was not identified with conventional radiography, but this was not a crucial issue since the implants planned were lower front teeth. Cone-beam computed tomography (CBCT) revealed that the mental foramen was in an unusual spot-closer to the front teeth, where the implant was planned. If this had gone unnoticed, the surgery could have certainly damaged the nerve, potentially causing permanent numbness. Thanks to the detailed imaging from the CBCT scan, the treatment plan was changed to avoid the nerve. The surgery went smoothly, the patient had no nerve problems afterward, and healing was normal.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735576","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":"Labial overlay cervical composite for containment of partially exposed connective tissue graft.","authors":"Jonathan H Do","doi":"10.1002/cap.70004","DOIUrl":"https://doi.org/10.1002/cap.70004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Placement of a connective tissue graft (CTG) in the facial abutment‒socket gap without any flap/pouch preparation has been demonstrated to effectively increase mucosal thickness and maintain midfacial marginal stability. At sites where the mucosal margin must be coronally advanced to improve esthetics, a flapless/pouchless approach requires the graft to be left partially exposed, which increases the risk of graft necrosis. The purpose of this report is to introduce the labial overlay cervical composite (LOCC) to provide graft containment and stabilization in these challenging situations to improve graft survival.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 67-year-old healthy, nonsmoking, Caucasian female presented with tooth #10 having external resorption that had progressed to the pulp, and the gingival margin 3‒4 mm apical to the gingival margin of the contralateral incisor. The tooth was extracted, and an immediate implant was placed flapless. The provisional restoration was fabricated ∼2 mm short of the mucosal margin. The implant‒socket gap was grafted with bone, and the abutment‒socket gap was grafted with a CTG, which was ∼2 mm exposed. The LOCC was fabricated by bonding flowable composite to the midfaciocervical surface of the provisional crown and extending it apically to cover the graft.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The exposed CTG covered by the LOCC survived. Twenty-one months post-treatment, the midfacial mucosal margin remained consistent with the contralateral gingival margin, and the convex facial tissue contour was preserved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The LOCC may effectively enhance graft survival and overall esthetic outcome when the CTG must be left exposed by providing containment and stabilization of the graft.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Labial overlay cervical composite (LOCC) is a simple addition to the provisional crown during treatment and can be easily removed during post-op. LOCC may effectively enhance graft survival and overall esthetic outcome when the connective tissue graft must be left partially exposed by providing containment and stabilization of the graft.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;A patient needed to have an upper left front tooth replaced with a dental implant. The gumline of the tooth to be replaced was 3‒4 mm higher than the gumline of the same tooth on the right side. The patient wanted the gumline from both sides to match. The tooth was extracted, and an implant was placed on the same day. The gap between the implant and tooth socket was grafted with bone from the bottom of the socket to the top of the implant, and a gum graft above the implant. The gum graft was partially sticking out so that the gumlines would match. A temporary crown was made and attached to the implant. To prevent the gum graft from dislodging, a labial overlay cervical composite (LOCC) was added to the temporary crown to cover and contain the gum graft. The treatment wa","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735577","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 \"ring around the collar\" and other gingival leukoplakias with high-power diode laser: A single-center case series.","authors":"Daniel L F Ferraz, Caique M Pedroso, Alan R Dos Santos-Silva, Pablo A Vargas, Marcio Ajudarte Lopes","doi":"10.1002/cap.70005","DOIUrl":"https://doi.org/10.1002/cap.70005","url":null,"abstract":"<p><strong>Background: </strong>Oral leukoplakia is the most common oral potentially malignant disorder. Currently, there is still no consensus on the best approach for its treatment. Marginal gingival cases (\"ring around the collar\") can pose an additional challenge for treatment, being associated with high recurrence rates. This case series report 10 patients with \"ring around the collar\" lesions treated with diode laser excision in a single center.</p><p><strong>Methods: </strong>Ten patients diagnosed with marginal gingival leukoplakia were treated with high-power diode laser excision. The demographic data were extracted from the medical charts and the patients were followed up every 3 months after treatment.</p><p><strong>Results: </strong>Of the 10 patients, three were men and seven were women, with a mean age of 64.4 years. Five had a history of tobacco smoking and one reported alcohol consumption. Eight had multifocal lesions, with all of them being homogeneous. Eight cases were diagnosed as proliferative verrucous leukoplakia and two had previously undergone treatment for gingival squamous cell carcinoma. Postoperative complications were limited to mild pain within the first week. During an average follow-up of 27.4 months, seven patients experienced recurrence, occurring after a mean of 8.6 months, with smaller, homogeneous, and clinically less aggressive lesions. No malignant transformation was observed.</p><p><strong>Conclusions: </strong>Marginal gingival leukoplakias, often associated with proliferative verrucous leukoplakia, are challenging to manage due to their high recurrence rates and malignant transformation risk. This case series suggests that high-power diode laser excision may offer better lesion control while minimizing gingival recession. However, further research is necessary to improve knowledge of this entity.</p><p><strong>Key points: </strong>Marginal gingival leukoplakias, especially the \"ring around the collar\" type, are relatively uncommon, but can show an aggressive nature, being associated with high recurrence rates. Removing these lesions with a high-power diode laser, even with the chance of recurrence, may be a better option than more aggressive modalities. This method helps control recurring lesions and might reduce the chances of gingival recession.</p><p><strong>Plain language summary: </strong>This case series suggests that removing these lesions with a high-power diode laser, even with the chance of recurrence, may be a better option than more aggressive modalities. This method helps control recurring lesions and might reduce the chances of gingival recession.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735608","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":"Oral injury from Calotropis procera: A case report on inadvertent gingival damage.","authors":"Maria Sharon Velraj, Balaji Ganesh Subramanian, Kaarthikeyan Gurumoorthy","doi":"10.1002/cap.70003","DOIUrl":"https://doi.org/10.1002/cap.70003","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chemical burns of the oral cavity and esophagus are frequently reported in southeast Europe, often resulting from the improper use of pharmaceutical or non-pharmaceutical substances. Calotropis procera (Apple of Sodom, Giant milkweed), a plant known for its toxic latex, has been associated with various dermatological and mucosal injuries. The objective of this case report is to describe a rare instance of gingival chemical burn caused by direct application of C. procera latex and to raise awareness about the potential risks of plant-based self-treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 49-year-old female presented with a painful lesion in the mandibular vestibule following direct application of C. procera latex. Clinical examination revealed a white, scrapable patch with irregular borders localized to the lower right alveolar mucosa and gingival region, extending from tooth #29 to tooth #31. The diagnosis was made based on history, clinical presentation, and exclusion of other potential etiologies. The patient was prescribed Curnext oral gel 2%, primarily composed of curcumin, the active polyphenol derived from Curcuma longa (turmeric), to be applied thrice daily for 1 week to 10 days. Supportive oral prophylaxis was provided, and the patient was educated on appropriate oral hygiene measures RESULTS: The patient demonstrated 94% adherence based on self-reported feedback and a log diary, with no adverse effects noted from Curnext oral gel 2%. By day 7, symptoms had resolved significantly, and a 3-month follow-up confirmed complete recovery without recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This case illustrates the risk of chemical burns associated with exposure to C. procera latex and the essential role of patient education in mitigating the dangers of unverified traditional remedies. Timely diagnosis, appropriate management, and comprehensive preventive counselling are critical in promoting healing and preventing long-term complications, thereby enhancing patient outcomes and contributing to public health efforts aimed at reducing preventable oral injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Why is this case new information? Despite the fact that Calotropis is one of the most widely utilized plants in India, there have never been any case reports of chemical burns to our knowledge. What are the keys to successful management of this case? The chemical burn was promptly diagnosed, herbal gel was applied, and full recovery was seen. What are the primary limitations to success in this case? Only 3 months of follow-up was conducted; any additional follow-up should be reviewed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case report describes a woman who accidentally injured the soft tissues inside her mouth after applying the sap of a plant called Calotropis procera-commonly known as Apple of Sodom or Giant Milkweed-to her gums in an attempt to relieve pain. While this plant is widely used in traditional","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735603","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":"Three-year follow-up of periodontal regenerative therapy for multiple severe intrabony defects: A case report.","authors":"Lan-Lin Chiou, Yusuke Hamada","doi":"10.1002/cap.70008","DOIUrl":"https://doi.org/10.1002/cap.70008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The effectiveness of periodontal regenerative therapy has been well-documented in the literature, with various factors influencing treatment outcomes. This case report illustrates the successful management of a systemically healthy patient diagnosed with Generalized Stage III Grade C periodontitis through the application of periodontal regenerative therapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following nonsurgical periodontal therapy, including oral hygiene instructions and scaling and root planing, the patient underwent full-mouth regenerative treatment secondary to persistent deep probing depths (PDs), radiographic evidence of intrabony defects (primarily 1- to 2-wall defects), and degree II furcation defects associated with the maxillary first molars. Treatment consisted of a combination of bone grafts, biologics, and absorbable barrier membranes utilized to maximize the regeneration of alveolar bone, periodontal ligament, and cementum.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the 6-month follow-up, significant improvements relative to reductions in PDs, gains in clinical attachment levels, minimal bleeding on probing, and radiographic bone fill were observed. Additionally, the prognosis of affected teeth improved, and the risk of disease progression was reduced. These outcomes have been well maintained for 3 years with appropriate supportive periodontal treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Within the parameters of this single case report, we can propose that there is the possibility that periodontal defects with a potentially poor regenerative likelihood can be successfully managed with regenerative therapy utilizing open flap debridement, bone grafts, biologic mediators, and barrier membranes. It is noteworthy that careful consideration and management of factors influencing the outcomes of periodontal regenerative therapy are crucial for treatment success.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Severe periodontal defects with limited regenerative potential can be successfully treated with periodontal regenerative therapy using the combination approach. Periodontal regenerative therapy can improve tooth prognosis and reduce a patient's overall periodontal risk. Careful management of etiology and risk factors, along with patient compliance with periodontal maintenance, are critical to achieving favorable treatment outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case report presents medium-term outcomes of periodontal regenerative therapy aimed at restoring tooth-supporting structures lost to periodontal disease. A combination approach using bone grafts, biologic mediators, and barrier membranes can effectively treat multiple periodontal defects with limited regenerative potential, thereby restoring periodontal health. The therapy improved tooth prognosis and reduced the patient's risk of future periodontal disease progression. Treatment success depends on various factors, including proper management of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735607","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}