Clinical Advances in Periodontics最新文献

{"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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Key points: </strong>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.</p><p><strong>Plain language summary: </strong>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}

{"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":"https://doi.org/10.1002/cap.10347","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusions: </strong>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><p><strong>Key points: </strong>To the authors' knowledge, no prior report has documented use of a near-infrared laser in the treatment of a palatal hematoma. Utilizing appropriate irradiation parameters is important for safe and effective PBM application. Based on prior research involving treatment of oral vascular malformations, selecting laser settings that induce thermal effects may be appropriate in this clinical context. 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.</p><p><strong>Plain language summary: </strong>In periodontics, harvesting soft tissue from the roof of the mouth (palate) is a procedure commonly performed to treat gingival recession (exposure of the root of a tooth) or improve the health of the soft tissue around teeth and dental implants. Bleeding from the palate after the procedure is one of the most common adverse events. Occasionally, blood can pool beneath the palatal soft tissue, resulting in a hematoma. This report illustrates a case in which a neodymium-doped yttrium aluminum garnet (Nd:YAG) laser was used to manage a palatal hematoma in a male patient aged 55 years. The lesion exhibited near complete resolution 14 days after laser use. Based on limited evidence, this laser may help stop the bleeding at the site of an injured vessel, favorably alter the local inflammatory response, and improve wound healing. Controlled clinical research to validate the protocol applied in t","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-17","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":"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":"https://doi.org/10.1002/cap.10345","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>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><p><strong>Conclusion: </strong>This case study highlights the effectiveness of treating teeth with severe mucogingival defects through root coverage surgery combined with CTG and apicoectomy.</p><p><strong>Key points: </strong>Mucogingival procedures and interdisciplinary treatment can successfully change the tooth prognosis. 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. 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.</p><p><strong>Plain language summary: </strong>This study showed that teeth with severe gum recession, reaching the tip of the root, can be successfully treated with surgery to cover the exposed root, combined with tissue grafting and a procedure to remove the root tip. These treatments provided long-lasting results.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-17","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":"Perigraftitis treatment and histology: A case report.","authors":"Jonathan H Do, Charles M Cobb, John T Shen","doi":"10.1002/cap.10370","DOIUrl":"https://doi.org/10.1002/cap.10370","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Currently, the two diagnoses of inflammatory peri-implant diseases are peri-implant mucositis and peri-implantitis. The etiology of peri-implant mucositis and peri-implantitis is bacterial colonization of the implant. Thus, removal of the implant should eliminate the infection and allow the inflammation to resolve. However, at least three publications have reported unresolved infection and persistent inflammation following removal of implants diagnosed with peri-implantitis. Perigraftitis is an emerging concept introduced to explain specific biologic complications observed at sites where implants have been placed into grafted bone. Perigraftitis is defined as inflammation induced by bacterial contamination of nonresorbing grafted bone and/or residual graft particulates. Since perigraftitis is an emerging concept reported only in a few publications, the purpose of this paper is to present a case of perigraftitis with treatment and supporting histology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 41-year-old healthy, nonsmoking, Asian female presented with pain and exudate at site #19, which had a history of multiple bone grafts, implant placements and implant removals. The site exhibited mixed density with an overall radiolucency containing a radiopaque mass in the middle and multiple small radiopacities consistent with graft particulates. The site was diagnosed with perigraftitis and surgically accessed. A hard tissue specimen and the surrounding inflammatory tissue were removed and submitted for histology. The site was thoroughly debrided and allowed to heal naturally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;One year postdebridement, an implant was successfully placed and subsequently restored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Perigraftitis may be resolved simply by removing all grafted bone and surrounding inflammatory tissue and allowing the site to heal naturally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Implant failure and persistent infection at a site that had been previously augmented with bone graft material(s) may suggest the presence of perigraftitis. Perigraftitis may be resolved by thoroughly removing all grafted bone, graft materials, and surrounding inflammatory tissue. Once the perigraftitis lesion has been thoroughly debrided, resolution is most predictably obtained by allowing the site to heal naturally, without the addition of biomaterials or biologics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;A patient had persistent pain and infection at a site in the lower left jaw that has had two bone grafts and two failed implants. The site was diagnosed with perigraftitis-inflammation due to infection of the grafted bone. The site was opened. All the grafted bone, bone graft, and inflammatory tissue were removed. The site was cleaned down to bone and allowed to heal naturally. After 3 weeks, the infection had resolved, and the patient was no longer in pain. After 1 year, a third implant was placed. At the time of implant","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585727","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":"Voclosporin-induced gingival enlargement: A case report.","authors":"Francesca Racca, Jessica M Greco, Dimitris N Tatakis","doi":"10.1002/cap.10369","DOIUrl":"https://doi.org/10.1002/cap.10369","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug-influenced gingival enlargement (DIGE) is a recognized adverse effect of certain medications, particularly immunosuppressants like cyclosporin and tacrolimus. However, there have been no documented cases of DIGE associated with voclosporin, a newer calcineurin inhibitor used primarily to treat lupus nephritis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This report describes the case of a 27-year-old female with systemic lupus erythematosus and lupus nephritis who developed significant gingival enlargement within 2 months of initiating voclosporin therapy. The patient presented with generalized gingival swelling, spontaneous bleeding, and difficulty eating, leading to her referral to a periodontics clinic. Nonsurgical periodontal therapy was initially attempted, followed by a biopsy to confirm the diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Despite nonsurgical interventions, the gingival enlargement persisted. Surgical therapy was offered but declined by the patient. Following interdisciplinary consultation, the voclosporin dosage was gradually reduced, and the drug was eventually discontinued. Marked clinical improvement was observed within 1 month after drug discontinuation, with reduced enlargement and diminished pain.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This case is the first to document gingival enlargement associated with voclosporin therapy. The findings emphasize the need for awareness of this potential adverse effect and highlight the importance of interdisciplinary care in managing such cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Voclosporin may cause gingival enlargement, similar to other calcineurin inhibitors, such as cyclosporin. With voclosporin emerging as a promising alternative for nephrologists in managing lupus nephritis, its prescription rates are likely to rise, which accentuates the importance of dental professionals being informed and vigilant about associated adverse effects on gingival tissues. Discontinuation of voclosporin should be considered, in consultation with the patient's medical team, if its oral adverse effects outweigh its therapeutic benefits, underscoring the significance of interdisciplinary cooperation and care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;The gingiva (gums) is often a site in the mouth where changes or reactions can occur in response to certain systemic medications. Some drugs, particularly those used to treat autoimmune conditions or following organ transplants, can cause the gums to grow excessively, a condition known as drug-induced gingival enlargement (also known as gingival overgrowth). In this report, we document the case of a 27-year-old woman with lupus nephritis who developed gingival enlargement after starting a medication called voclosporin. This drug is a newer treatment option for lupus nephritis, but until now had not been linked to gingival enlargement. The patient experienced significant gum swelling, bleeding, and pain, making it difficult for her","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499439","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":"Papilla preservation technique for the reconstruction of the interdental papilla: A case report.","authors":"Luiz F de Castro, Ernani T de Souza, Maíza C A Ferreira, Camila S Senisse, Gabriella C Canhoni, Ana Júlia S de Andrade, Daniel J Braga Dutra","doi":"10.1002/cap.10349","DOIUrl":"https://doi.org/10.1002/cap.10349","url":null,"abstract":"<p><strong>Background: </strong>Interdental papilla reconstruction is frequently discussed in the literature, with techniques like tunnelization commonly used. However, tunnelization presents significant challenges in flap positioning, stabilization, and ensuring adequate blood supply to maintain the graft. The approach described in this article provides enhanced visualization, allowing better graft positioning, proper vascularization, and increased procedural stability.</p><p><strong>Methods: </strong>This case report details the interdental papilla reconstruction in a healthy 53-year-old female patient using a combination of techniques from the literature, adapted for optimized outcomes. The patient presented with a loss of gingival tissue between the lower left central incisor (24) and the lower right central incisor (25), resulting in a large black triangle. The reconstructive procedure involved papilla preservation via flap elevation, allowing wide visualization and precise graft placement. Composite resin was used to close the diastema after surgery.</p><p><strong>Results: </strong>The final outcome showed significant papillary gain, filling approximately 50% of the black triangle. The remaining space was covered with composite resin. After 2 years of follow-up, the procedure remained stable, with no signs of gingival recession.</p><p><strong>Conclusions: </strong>The combination of techniques used in this case is effective for papilla reconstruction in large interdental spaces, achieving a satisfactory outcome and resolving the patient's main concern. The method should be further replicated to refine its precision and viability, as various cases require tailored approaches, integrating both periodontics and restorative dentistry.</p><p><strong>Key findings: </strong>This case report demonstrates a combination of surgical and restorative techniques that effectively reconstructed the interdental papilla. A 50% papillary fill was achieved with stable results over two years. The proposed approach proves to be viable for the treatment of large black triangles using combined techniques.</p><p><strong>Key points: </strong>Enhanced visualization for precise graft placement, integrating surgical and restorative approaches, long-term stability.</p><p><strong>Plain language summary: </strong>This article discusses a case where the small tissue between the lower front teeth was lost and explores the benefits of a new type of surgical method for fixing it. A case report was done to look at different treatment options and compare the new method to existing methods in research. This surgical method has advantages, like better placement of the tissue graft. The case had good results, but more studies are needed to confirm how effective and reliable the technique is. The authors believe this could be a new and effective way to fix gaps between teeth.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499438","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 severe gingival recession using a double papilla connective tissue graft: A 2-year follow-up case study.","authors":"Yu-Chang Wu, Oscar Duran-Garnica, Hsun-Liang Chan, Dimitris N Tatakis","doi":"10.1002/cap.10368","DOIUrl":"https://doi.org/10.1002/cap.10368","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This case study presents the treatment of a 7 mm deep and 5 mm wide RT1 gingival recession on the mandibular left canine in a 30-year-old systemically and periodontally healthy female, with the defect being associated with a self-injurious habit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following counseling, self-injurious habit cessation, and oral hygiene reinforcement, a double papilla flap (DPF) plus subepithelial connective tissue graft (SCTG) procedure (DPF+SCTG) was performed. After de-epithelialization of the gingival margin, horizontal and vertical incisions were made, and a partial-thickness DPF was elevated. The SCTG was placed at the cementoenamel junction level and covered by the DPF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nearly complete root coverage was achieved, with recession depth reduced to 1 mm and keratinized tissue width increased from 1 mm to 6 mm. Ultrasound imaging confirmed successful graft integration and thick gingiva. At 2-year follow-up, creeping attachment was observed after the patient discontinued the self-injurious habit, despite a prior recurrence that had caused additional trauma. The successful surgical outcome resulted in patient satisfaction, plaque control improvement, and prevention of further recession, benefiting the ongoing orthodontic treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DPF+SCTG is an effective approach for treating an isolated deep and wide RT1 recession, providing long-term benefits, particularly when combined with behavior modification in patients with self-injurious habits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Technique choice and patient behavior management: The combination of double papilla flap and subepithelial connective tissue graft effectively achieved significant root coverage and increased keratinized tissue width in a patient with self-injurious habit. However, patient behavior management was crucial in preventing recurrence. Long-term stability and creeping attachment: Despite a relapse due to the patient's habit, the thickened gingiva facilitated natural healing through creeping attachment, reinforcing the importance of both surgical intervention and behavioral modifications in maintaining long-term stability. Ultrasound for non-invasive monitoring: Ultrasound imaging confirmed successful graft integration and determined tissue thickness, highlighting its potential as a non-invasive periodontal healing monitoring tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Gum recession is a common condition where the gum tissue pulls away from the teeth, exposing the roots and making them more prone to damage. This report describes the treatment of a 30-year-old woman who had severe gum recession on her lower left canine tooth, caused by her long-term habit of scratching the gums with her fingernail. To restore the lost tissue and protect the tooth, a double papilla flap (a surgical technique that moves nearby tissue) along with a connective tissue graft (transplanted ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303711","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":"Risk for peri-implant diseases and defects: Report of workgroup 1 of the joint AO/AAP consensus conference on prevention and management of peri-implant diseases","authors":"Purnima S. Kumar,&nbsp;Joseph Kan,&nbsp;Maria Elisa Galarraga-Vinueza,&nbsp;Guo-Hao Lin,&nbsp;Alberto Monje,&nbsp;Lorenzo Tavelli,&nbsp;Sandra Stuhr,&nbsp;Yung-Ting Hsu,&nbsp;Junying Li,&nbsp;Alexandra Tsigarida,&nbsp;Debora Dias,&nbsp;SukirthMurthy Ganesan,&nbsp;Shi Yin,&nbsp;Don Curtis","doi":"10.1002/cap.10367","DOIUrl":"10.1002/cap.10367","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A consensus meeting on peri-implant diseases and treatment was initiated by the American Academy of Periodontology (AAP) and the Academy of Osseointegration (AO) with the goal of developing subject- and site-level risk profiles for peri-implant diseases and defects, and risk-informed treatment recommendations. This report summarizes the conclusions of Working Group 1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Working Group 1 evaluated the risk for peri-implant diseases and defects based on four commissioned systematic reviews, followed by an in-person workshop to discuss the reviews and the inferences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several factors emerged as risk markers for peri-implant mucositis, peri-implantitis, as well as for soft and hard tissue discrepancies and defects in the absence of disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patient- and site-level factors can increase the odds of developing peri-implant disease or defects in soft tissue and marginal bone surrounding clinically healthy implants. Risk-informed treatment recommendations were made by the panel of experts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>This consensus estimates risk based on both patient and site-level factors.</li>\u0000 \u0000 <li>Consideration must be given to modifiable and non-modifiable risk factors, and treatment modified accordingly.</li>\u0000 \u0000 <li>There is a lack of primary research on several topics that were considered by the consensus panel, and several gaps in knowledge still continue to exist.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"93-102"},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10367","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259441","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":"Retro molar papilla pedunculated flap: A retrospective case series.","authors":"Marco Castiglioni","doi":"10.1002/cap.10366","DOIUrl":"https://doi.org/10.1002/cap.10366","url":null,"abstract":"<p><strong>Background: </strong>The primary purpose of this paper is to introduce a new flap design to improve keratinized tissue (KT) around implants in the posterior mandible, avoiding the need for harvesting tissue from the palate, which is associated with significant discomfort for patients.</p><p><strong>Methods: </strong>Eleven patients requiring implants in the molar regions with a KT width (KTW) < 2 mm at the buccal aspect were treated using this surgical technique. Outcomes, including the increase in KT width and postoperative discomfort, were measured at intervals of 1, 4, and 10 months.</p><p><strong>Results: </strong>An average increase of 4.2 mm in KT width was achieved. Postoperative pain was minimal, with most patients reporting low scores on the Visual Numerical Scale. No significant reduction in KT width was observed during follow-up.</p><p><strong>Conclusion: </strong>Within the limitations of the present case series, the data suggest that this flap is a promising and less invasive technique for treating KT deficiency around implants, eliminating the need for palate harvesting. Further long-term studies are needed to confirm the stability of the results.</p><p><strong>Plain language summary: </strong>This case series presents a new surgical method designed to improve the protective gum tissue (called keratinized gingiva) around dental implants in the back part of the lower jaw. This type of gum tissue is important because it helps keep implants stable and healthy over time. Traditionally, the best way to add this tissue is by taking a piece from the roof of the mouth, but that can be painful and lead to complications. In recent years, researchers have explored less invasive options, but most haven't matched the effectiveness of using the patient's own tissue. In this study, the new approach allowed the treatment of 11 patients who had too little gum tissue around their implants. The technique used the patient's own gum tissue but avoided taking it from the palate, making the procedure more comfortable. The results showed that this method was effective in increasing the amount of healthy gum tissue, offering a promising alternative that prioritizes both results and patient comfort.</p><p><strong>Key points: </strong>Effective strategies for increasing keratinized tissue in Mandibular posterior areas. Minimal postoperative discomfort; minimally invasive surgery Stability of peri-implant tissues.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136626","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":"Clear orthodontic aligners in patients with a history of severe periodontitis: Two case reports with 12 months of follow-up","authors":"Ana Carla Raphaelli Nahás,&nbsp;Mayara Paim Patel,&nbsp;Liliana Avila Maltagliati,&nbsp;Murilo Matias,&nbsp;Sandra Marques De Jesus,&nbsp;Renata Tavares,&nbsp;Renata Amad,&nbsp;Danilo Vinicius Aparecido De Paula Domingues,&nbsp;Katiane Silva Sousa,&nbsp;Edoardo Staderini,&nbsp;Israel Chilvarquer,&nbsp;Michel Eli Lipiec-Ximenez,&nbsp;Magda Feres,&nbsp;Belen Retamal-Valdes","doi":"10.1002/cap.10301","DOIUrl":"10.1002/cap.10301","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The orthodontic treatment of patients with a history of severe periodontitis helps to improve periodontal health, functional occlusion, and esthetics. The use of aligners in patients with a history of severe periodontitis, with a single protocol of periodontal treatment, and the report of periodontal parameters throughout the orthodontic treatment has not yet been evidenced. Therefore, this manuscript aimed to describe the treatment with a clear orthodontic aligner system in two patients with reduced periodontium associated with a history of severe periodontitis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods and Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two male participants (43-year-old and 62-year-old, respectively) were diagnosed with generalized, stage III, grade B periodontitis and treated with the same periodontal treatment protocol. After a 12-month follow-up of periodontal maintenance, the subjects were referred for tooth migration and Class II malocclusion orthodontic treatment. The subjects received orthodontic treatment with clear aligners. After starting orthodontic therapy, the patient received periodontal maintenance and clinical monitoring at 3, 6, 9, and 12 months. The periodontal parameters remained stable throughout the aligner treatment. At 12 months of orthodontic treatment, an improvement in angulations, inclinations, and dental positioning was observed, obtaining a stable occlusion, and reaching the proposed objectives for the treatment stage.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A significant improvement in the occlusal relationship could be achieved with the clear orthodontic aligner system in adult patients with reduced periodontium by a history of severe periodontitis. Orthodontic therapy with clear aligners was shown to be safe in maintaining good periodontal health with the protocol of periodontal treatment used in the clinical cases presented.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain Language Summary&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;This case presentation is a contemporary and innovative approach to orthodontic and periodontic treatment of patients with a history of severe periodontitis that in the recent past would not be referred to an interdisciplinary treatment because of the lengthy orthodontic treatment time and the difficulty of hygiene that fixed appliance brings, putting at risk the permanence of these teeth in the oral cavity even with adequate periodontal treatment.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The keys to the success of this partnership intervention are a precise diagnosis and careful treatment planning of orthodontic tre","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"160-168"},"PeriodicalIF":0.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136625","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}