Clinical Advances in Periodontics最新文献

{"title":"Root coverage in deep recessions with apex involvement: Long-term case study","authors":"João Batista César Neto, Rafael Lazarin, Vitor Mota Freitas, Henrique Rinaldi Matheus, Ricardo Takiy Sekiguchi, Giuseppe A. Romito","doi":"10.1002/cap.10345","DOIUrl":"10.1002/cap.10345","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Teeth with deep gingival recessions (GRs) associated with apex exposure present a challenging clinical scenario, often requiring a multidisciplinary approach to improve tooth prognosis. This case study presents seven RT1/RT2 deep GR (≥5 mm) associated with root apex exposure, treated with endodontic treatment, apicoectomy, and root coverage procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For this retrospective study, all surgical procedures were performed using either the laterally positioned flap technique or the modified double papilla flap combined with a connective tissue graft (CTG).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After a mean follow-up period of 3.86 years (ranging from 1 to 11 years), a mean GR reduction of 7.57 mm was observed, with four cases achieving complete root coverage. No teeth required extraction during the follow-up period and the prognosis for all teeth was improved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study highlights the effectiveness of treating teeth with severe mucogingival defects through root coverage surgery combined with CTG and apicoectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Mucogingival procedures and interdisciplinary treatment can successfully change the tooth prognosis.</li>\u0000 \u0000 <li>Currently, there is limited information on managing teeth with a deep recession and apex involvement and even less on long-term outcomes for these cases. This case study fills these gaps, demonstrating that root coverage using an autogenous connective tissue graft combined with apicoectomy can yield successful and stable outcomes.</li>\u0000 \u0000 <li>Clinicians might consider the lateral-positioned flap or the modified double papilla flap, both of which may require specialized training and experience. However, other treatment alternatives, such as extraction and subsequent hard—and soft-tissue reconstruction, would involve more surgical procedures to rebuild all the lost tissues, increasing treatment complexity, time, and morbidity. Thus, mucogingival treatment should be prioritized as the first-line approach.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>This study showed that teeth with severe gum recession, reaching the tip of the root, can be successfully treated with surgery to","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"144-152"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661112","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":"Postoperative palatal hematoma management using a near-infrared laser: A case study","authors":"Toria L. Koutras, Brian W. Stancoven, Adam R. Lincicum, Kimberly Ann Inouye, Claudia P. Millan, Thomas M. Johnson","doi":"10.1002/cap.10347","DOIUrl":"10.1002/cap.10347","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The subepithelial connective tissue graft (SCTG) is acknowledged as a reliable method for gingival/mucosal augmentation and the “gold standard” for gingival recession treatment. Excessive bleeding is a common complication of palatal soft tissue harvesting, and hematoma formation can occur deep to the primary palatal flap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A male patient aged 55 years presented with dentinal hypersensitivity associated with gingival recession at mandibular left premolar sites. After receiving an SCTG with coronally advanced flap, the patient experienced extended intermittent bleeding from the palatal donor site, likely related to undisclosed dietary supplements. At postoperative week 6, a 10×12-mm hematoma had displaced the palatal wound margins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Near complete palatal healing was observed 14 days after application of photobiomodulation (PBM) using a neodymium-doped yttrium aluminum garnet laser and discontinuation of the dietary supplements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Limited evidence indicates that near-infrared laser PBM may enhance patient-centric outcomes at palatal soft tissue donor sites. The presented case suggests that laser PBM/photocoagulation may also aid in the management of a postoperative palatal hematoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>To the authors' knowledge, no prior report has documented use of a near-infrared laser in the treatment of a palatal hematoma.</li>\u0000 \u0000 <li>Utilizing appropriate irradiation parameters is important for safe and effective PBM application.</li>\u0000 \u0000 <li>Based on prior research involving treatment of oral vascular malformations, selecting laser settings that induce thermal effects may be appropriate in this clinical context.</li>\u0000 \u0000 <li>Noncontact laser PBM appears suitable in clinical scenarios involving pooled blood. However, the presented protocol may be of little use when establishment of hemostasis is needed at an actively bleeding site. Identifying and addressing underlying causes of delayed hemostasis is essential.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>In periodontics, harvesting soft tissue from the roof of the mouth (palate) is a procedure co","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"161-169"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661111","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":"Double-vestibular incision subperiosteal tunnel access (double-VISTA) with connective tissue graft for treating multiple gingival recessions: 2-year follow-up","authors":"Guo-Hao Lin","doi":"10.1002/cap.10333","DOIUrl":"10.1002/cap.10333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival recession has a multifactorial etiology, involving various predisposing and precipitating factors. Non-carious cervical lesions (NCCLs) are often associated with gingival recession and pose challenges due to their complex pathodynamics. There is limited evidence regarding tunnel-based procedures combined with connective tissue grafts (CTGs) for treating recession-associated NCCLs. This case study illustrates a periodontal-restorative approach for addressing multiple adjacent recession-associated NCCLs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A healthy, non-smoking 55-year-old Asian male presented with generalized mucogingival conditions, including gingival recessions and lack of keratinized tissue on the facial aspect of the maxillary right first molar through the left first molar, accompanied by physiological gingival pigmentation. The recessions were classified as Cairo RT I. NCCLs were evident in all six maxillary anterior teeth. After restoring the NCCLs to the maximum root coverage (MRC) level with composite resin, the patient underwent a mucogingival procedure via a double-vestibular incision subperiosteal tunnel access (double-VISTA) approach with autogenous CTG for treating the recession defects. Due to limited CTG availability, the maxillary left side was treated first, followed by the right side 3 months later.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-surgical healing was uneventful, except for mild facial swelling for 5 days, which subsided within a week. After 12 months, all treated teeth exhibited complete coverage to the predetermined MRC level, with a thick gingival phenotype. At the 2-year follow-up, all treated teeth maintained a stable root coverage outcome with harmonious gingival margins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study demonstrates that the double-VISTA technique for treating recession-associated NCCLs is promising in achieving complete coverage at sites where the MRC level was predetermined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>This case study introduces a modified vestibular incision subperiosteal tunnel access (VISTA) technique, termed double-VISTA, which employs two distant vestibular incisions to enhance access for instrumentation and recipient site preparation in the treatment of multiple adjacent recession defects","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"74-81"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13044495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985572","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":"Tenting screw-assisted membrane alveolar ridge augmentation in the anterior mandible","authors":"Fabrizio Belleggia","doi":"10.1002/cap.10348","DOIUrl":"10.1002/cap.10348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vertical ridge augmentation with a guided bone regeneration procedure in the anterior mandible requires membrane lingual stabilization. Until now, the only predictable way was the use of titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membranes stabilized with self-drilling screws, which require large flaps for both placement and removal. This case report introduces a technique that does not require any membrane lingual fixation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A tenting screw was placed in the middle of an anterior mandibular defect. A small TR-dPTFE membrane was bent 90° to take an L shape and be positioned crestally and lingually to the defect. Then, a larger collagen membrane (CM) was sutured with absorbable stitches to its more lingual and apical part. The TR-dPTFE membrane was stabilized on top of the tenting screw with its cap screw. A mixture of autogenous and porcine bone in a 1:1 ratio filled the defect. Then, the CM was moved toward the buccal side and stabilized with pins. After 8 months, the site was re-opened, the TR-dPTFE membrane and the tenting screw were removed with a small lingual envelope flap, two implants were inserted in the augmented bone and healing abutments applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A screw-retained bridge was delivered 6 weeks after implant insertion and the 2.5-year follow-up showed perfectly maintained hard and soft tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The stabilization of both membranes to the tenting screw reduced morbidity at re-entry avoiding a large lingual flap, while CM allowed graft revascularization from the periosteum, and resulted in optimal quality of the regenerated bone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membranes require stabilization with pins or screws at the recipient site and large flaps for both placement and removal. On the lingual side of the anterior mandible the use of miniscrews is difficult and invasive, while the use of a tenting screw, placed vertically in the middle of the defect, allows for a simple and easy membrane stabilization and removal.</li>\u0000 \u0000 <li>Two membranes are utilized: a small TR-dPTFE membrane, that is stabilized to the tenting screw with its cap screw, and that does not allow to a collagen membrane (CM), that is sutured to the TR-PTFE membrane to cover the exposed part of the defect, to co","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"170-182"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470061","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":"Saving a hopeless tooth with a four-wall bone defect: A case report","authors":"Takayoshi Nagahara, Tomoyuki Iwata, Keinoshin Wada, Tomoya Ueda, Shoko Kono, Kazuhisa Ouhara, Noriyoshi Mizuno","doi":"10.1002/cap.10329","DOIUrl":"10.1002/cap.10329","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recombinant human fibroblast growth factor-2 (rhFGF-2) has been shown to effectively promote the formation of new periodontal tissues, and its efficacy has been demonstrated in clinical settings. Moreover, the clinical and radiographic outcomes in the treatment of periodontal infrabony defects can be improved by using rhFGF-2 in combination with a bone substitute. Here, we present a case of four-wall bone defect in a tooth treated by combination regenerative therapy using rhFGF-2 and beta-tricalcium phosphate (βo-TCP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 43-year-old male with a four-wall bone defect in tooth #28 was subjected to combination therapy with rhFGF-2 and β-TCP. Periodontal clinical parameters and radiographic images were evaluated at the first visit, after the initial periodontal treatment, and after 4 months and 4 years postoperation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Although gingival recession and nonvital pulp were observed postoperation, improvements in the periodontal parameters and radiographic outcomes were subsequently recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Periodontal regenerative therapy with a combination of rhFGF-2 and β-TCP showed great potential in the treatment of four-wall bone defects of teeth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) and beta-tricalcium phosphate (β-TCP) showed immense potential in the treatment of four-wall bone defect in teeth.</li>\u0000 \u0000 <li>In addition to using computed tomography for assessing bone defects and root morphologies, an evaluation of root canal morphology and pulp diagnosis is essential for understanding the internal and external aspects of the defect, which would aid in tooth preservation.</li>\u0000 \u0000 <li>Appropriate periodontal and endodontic treatments enabled tooth preservation following apical periodontitis after periodontal regenerative therapy.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>This case report focuses on a new approach for the treatment of a four-wall bone defect, a significant dental issue in which the bone around the tooth is damaged, thereby decreasing the stability of the tooth. We treated a 43-year-old male patient with a","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"48-55"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883566","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":"Apical horizontal incision with periosteum graft wall technique for periodontal regeneration: A case study","authors":"Kazuhito Shiraishi, Lan-Lin Chiou, Takeshi Haga, Yusuke Hamada, Pierpaolo Cortellini","doi":"10.1002/cap.10339","DOIUrl":"10.1002/cap.10339","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The periosteum consists of an outer fibrous layer and an inner cellular layer, where bone cells reside. Hence, it has been suggested that applying periosteum to a periodontal defect may help new bone formation. The purpose of this case study is to present the clinical and radiographic outcomes of a vestibular regenerative approach and the application of a connective tissue graft (CTG) with periosteum to improve the periodontal prognosis of a pathologically migrated hopeless tooth with an endo-periodontal lesion (EPL).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 35-year-old female presented with a hopeless tooth with EPL on #9. To preserve the papilla, a horizontal incision with two vertical releasing incisions was made on the buccal vestibule where the buccal bone was present. A CTG with periosteum was harvested from the tuberosity area. After applying enamel matrix derivative (EMD) and freeze-dried bone allograft (FDBA), the CTG was placed over the defect and stabilized with absorbable sutures. The flap was replaced and sutured, achieving primary closure and healing by primary intention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following regenerative procedure, a localized orthodontic treatment was applied. A minimal ridge resorption, shallow probing depth, and radiographic stability of periodontal bone level were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study shows the successful application of a multidisciplinary approach to save a hopeless tooth with severe bone destruction and a non-contained periodontal defect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Multi-disciplinary approach including endodontic, orthodontic, and periodontal regenerative procedure can improve the prognosis of natural teeth.</li>\u0000 \u0000 <li>It would be beneficial to maintain the blood supply to the crestal part of the flap with apical incision.</li>\u0000 \u0000 <li>Connective tissue graft with periosteum could enhance the healing potential when used in adjunct with periodontal regeneration.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>The apical horizontal incision combined with periosteum graft could successfully save a tooth with severe bone destruction and a non-contained periodontal defect. The importance of wound stability on the pa","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"99-106"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016729","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":"Regenerative surgical therapy in a frequent cannabis consumer: A case study","authors":"Carola B. Bozal, Marina Sosa, Sofía Aguirre, Cristina Rodríguez, Mariano Adrados, Mariel Gómez, Hugo J. Romanelli","doi":"10.1002/cap.10325","DOIUrl":"10.1002/cap.10325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is substantial evidence that smokers present a less favorable response following regenerative periodontal surgery. However, there are no reports to date on the response to regenerative procedures in chronic cannabis smokers. In the present case study, we discuss the periodontal outcomes of reparative and regenerative surgical treatment in a cannabis consumer patient with generalized stage III grade C periodontitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We report the case of a young adult cannabis consumer patient diagnosed with generalized stage III grade C periodontitis who had a probing depth (PD) of ≥ 4 at 18% of sites and of ≥ 7 mm at 12% of sites and radiographically confirmed generalized interproximal bone loss with horizontal and angular defects that reached the middle and apical third of the roots. An appropriate sequence of therapy based on the recommendations in the Clinical Practice Guideline (CPG) involving reparative and regenerative surgical procedures (steps 1–3) was followed. Clinical outcomes at 6 months included a decrease in PD of up to 7 mm and radiographic evidence of newly formed bone in the bony defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present case study demonstrates the use of regenerative periodontal procedures as part of a stepwise treatment approach, with different interventions at each step, to successfully manage intrabony periodontal defects in a healthy young adult male cannabis consumer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>Smoking is a well-documented dose-dependent risk factor for periodontal disease, with a demonstrated negative effect on periodontal therapy outcomes. However, the usefulness of regenerative periodontal therapy in cannabis smokers has not been established to date. This case presents new information in that it is the first report to show that appropriate periodontal treatment can stabilize the periodontal disease and that regenerative therapies were successful in healing intrabony periodontal defects in a healthy young adult cannabis user.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>The keys to successful management of this case are:\u0000\u0000 </p><ul>\u0000 \u0000 <li><span>- </span>Attention to detail in all aspects of therapy.</li>\u0000 \u0000 <li><span>- </span>Patient compliance as a co-therapist by maintaining effective plaque control.</li>\u0000","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"19-30"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified nonincised papillae surgical approach: Minimally invasive technique for periodontal regeneration","authors":"Akihiko Katayama, Eiichi Suzuki, Giulio Rasperini, Akiyoshi Funato","doi":"10.1002/cap.10343","DOIUrl":"10.1002/cap.10343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nonincised papillae surgical approach (NIPSA) preserves papillae by placing incision lines away from interdental areas, achieving good outcomes. However, these techniques may be unsuitable in cases with bone defect morphology or tissue anatomy. This case series introduces the modified nonincised papillae surgical approach (M-NIPSA), which preserves papillae while providing adequate access for periodontal defect debridement and regenerative material placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten intrabony defects were treated with M-NIPSA using recombinant human fibroblast growth factor-2 and carbonate apatite (CO3Ap) as regenerative materials. Clinical parameters were assessed at baseline and 6 and 12 months. Early wound healing index evaluated primary wound closure 7 days postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All cases achieved complete flap closure without wound dehiscence, with significant probing pocket depth and clinical attachment level (CAL) improvements compared to baseline (mean CAL gain: 3.65 ± 1.20 mm). No significant changes in gingival recession or keratinized tissue were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>M-NIPSA overcomes anatomical limitations of conventional techniques, ensuring primary healing with minimal incision and flap reflection. Combined with effective growth factors, it significantly improves periodontal parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Modified nonincised papillae surgical approach allows access to bone defects with a shorter incision range and reduced invasiveness by positioning the incision line more coronally compared to conventional nonincised papillae surgical approach.</li>\u0000 \u0000 <li>Ensuring an adequate width of keratinized gingiva (keratinized tissue width ≥3 mm) is essential. Incisions and flap elevation should minimize damage to the gingival tissue, and sutures with fine threads must be used to preserve blood flow.</li>\u0000 \u0000 <li>This incision technique is not suitable in cases with fragile gingiva due to inflammation or extensive bone defects spanning multiple teeth that could compromise blood flow.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>This case series introduces a new surgical incision design for periodontal regen","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"124-131"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222319","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":"Advanced dental surgeries using fused filament fabrication and stereolithography printing: Case reports","authors":"Jaewon Kim, Michael Danielak, Du-Hyeong Lee, Bandar Almaghrabi, Sebastiano Andreana, Jekita Kaenploy, Yousef Kareem, Fernando L. Esteban Florez, Praveen R. Arany","doi":"10.1002/cap.10344","DOIUrl":"10.1002/cap.10344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The widespread use of digital imaging can now be combined with additive three-dimensional (3D) printing, changing traditional clinical dentistry, especially in challenging cases. Visualizing the bone and soft tissue anatomy using computed tomography (CT) and intraoral scanning generated digital files that can be further processed for 3D printing. Among the popular 3D printing approaches, fused filament fabrication (FFF) and stereolithography (SLA) are broadly used due to their rapid production, precision, and ease of use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The current case series outlines three challenging clinical scenarios where a combination of CT and intraoral scans were utilized for digital planning. FFF multicolor anatomical models and SLA surgical guides were produced using 3D printing technology. The first case outlines the utility of this approach to place the optimal surgical window at the lateral sinus lift with anticipated difficult access. In the second case, distinct sites for autogenous bone harvesting were identified while preserving critical adjacent structures with surgical simulation. Finally, the third case outlines this strategy for optimal surgical access to expose an impacted second premolar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both clinicians and patients benefited from the educational use of FFF‒SLA 3D-printed models, and all cases were successfully treated without complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These cases demonstrate the significant utility of these digital technologies and rapid prototyping for improved pre-surgical planning, patient motivation, and didactic training that contribute to improved quality of clinical care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>To the authors' knowledge, this is the first case reports employing both fused filament fabrication (FFF) and stereolithography (SLA) printing techniques in dental surgery. This innovative approach addresses a range of clinically challenging scenarios presented in this report.</li>\u0000 \u0000 <li>Computed tomography (CT) and intraoral scanning are essential for three-dimensional (3D) reconstruction. Specialized software is required to design the guide with precise specifications, and FFF and SLA printers are necessary for fabricating the 3D model.</li>\u0000 \u0000 <li>Three-dimensional reconstruction can be time-intensive, particularly when manual segmen","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"132-143"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366879","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":"Vitamin C mesotherapy with microneedling for gingival depigmentation: A case study","authors":"Anika Dawar, Razia Haidrus, Sumit Kumar Das","doi":"10.1002/cap.10327","DOIUrl":"10.1002/cap.10327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Surgical methods of gingival depigmentation can be challenging, particularly if the gingival phenotype is thin due to the risk of gingival recession and bone exposure. Thus, exploring alternative, non-surgical, minimally invasive treatment modalities is warranted. In dermatology, vitamin C is extensively used for depigmentation and microneedling for collagen induction, with limited literature about its usage for improving gingival esthetics. The present preliminary case study aims to explore the synergistic use of vitamin C mesotherapy with microneedling for the esthetic management of physiologic melanin gingival hyperpigmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eleven arches from six patients having anterior physiologic melanin hyperpigmentation were recruited. Microneedling was done with a lancet, followed by intra-epidermal administration of 1.5–2 mL of vitamin C in pigmented gingiva (once weekly/four sessions). Dummett oral pigmentation index (DOPI), gingival pigmentation index (GPI), pigmented surface area (PSA), and gingival luminescence (L*) were assessed at baseline and follow-up visits of 1 week, 1 month, and 3 months. Gingival thickness (GT) was recorded at baseline and 3 months. Pain, itching, and gingival color were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant reduction (<i>p</i> < 0.05) in mean DOPI, GPI, and PSA was observed from baseline to 3 months, while L* and GT increased significantly within that timeframe. Patients reported an improvement in gingival color at 1 and 3 months. Low pain and itching scores were obtained post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Vitamin C mesotherapy with microneedling is a newer, minimally invasive approach that can effectively reduce gingival melanin pigmentation intensity and extent, and can potentially increase the gingival thickness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Vitamin C mesotherapy (intra-epidermal injection) is an effective and minimally invasive treatment modality for gingival depigmentation.</li>\u0000 \u0000 <li>The adjunctive use of microneedling with vitamin C mesotherapy can potentially increase gingival thickness non-surgically.</li>\u0000 \u0000 <li>Non-surgical methods for gingival depigmentation can be chosen as an alternative to surgical methods for esthetic management of physiologic melanin hyperpigmentation in cases with thin gingival phenotyp","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 1","pages":"31-40"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985580","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}