Clinical Advances in Periodontics最新文献

{"title":"Volumetric analysis of root coverage with porcine acellular dermal matrix: Case study","authors":"Edgar Daniel Vargas-Quiroga,&nbsp;Giovanna Fernanda Favero da Silva,&nbsp;Bruna Santos Honorio Tonin,&nbsp;Arthur Belém Novaes-Jr,&nbsp;Marilia Bianchini Lemos Reis","doi":"10.1002/cap.70029","DOIUrl":"10.1002/cap.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival recession is prevalent and often treated with coronally advanced flap plus connective tissue graft (CAF+CTG). Porcine acellular dermal matrix (PADM) offers a donor-site-free alternative. Contemporary digital imaging allows minimally invasive, three-dimensional (3D) soft-tissue assessment. This case report quantified 3D soft-tissue changes after PADM-based root coverage using an integrated digital workflow.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 38-year-old woman presenting with recession-type 2 (RT2) defects on teeth #7, #6, and #5 underwent root coverage with an extended CAF in combination with a PADM. Three-dimensional datasets were obtained at baseline, 6 months, and 12 months using intraoral scanning and cone-beam computed tomography (CBCT). These were processed with image-analysis software to assess volumetric and contour changes over time. Clinical parameters and patient-reported satisfaction (visual analog scale, VAS) were also recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Buccal soft-tissue volume increased from 329.70 mm³ (baseline) to 454.81 mm³ (6 months), then to 345.25 mm³ (12 months), yielding a net gain of +4.72% versus baseline and a −24.09% reduction from the 6-month peak. Color-coded maps indicated predominant augmentation in the cervical third with contour stability at 12 months. VAS scores improved over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PADM-assisted root coverage increased gingival thickness and resulted in a stable buccal contour. 3D CT volumetric assessment seems to be a promising method for quantifying long-term changes in regenerated tissues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"562-569"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222330","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":"Digital workflow for dual full-arch rehabilitation using guided surgery: Two-year follow-up case report","authors":"E. Todd Scheyer,&nbsp;Ron Hickerson,&nbsp;Luken de Arbeloa,&nbsp;Patricia Gomes","doi":"10.1002/cap.70027","DOIUrl":"10.1002/cap.70027","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;A digital guided surgery system (DSD Clic-Guide, Digital Smile Design) is a digital rehabilitation planning system recommended in the rehabilitation of fully edentulous jaws, which orients implant placement procedures, immediate provisional loading, and final prosthesis based on an ideal facially generated three-dimensional design. This system increases the level of predictability of procedures in complex clinical cases and consists of a sequence of surgical guides used during procedures that may include teeth extractions, osteotomies, implant placements, and immediate prosthesis installation. This case report aims to present the complete digital workflow of a dual full-arch oral rehabilitation using a guided system, from initial planning through final restoration, with a 2-year post-restoration follow-up.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The patient treated required total oral rehabilitation in both arches. Once the rehabilitation parameters were defined and the treatment plan was approved, the following guides were printed and used in sequence: a base guide that was used as a reference for the osteotomy procedure; a guide for installing the implants; and a guide with the 3D printed temporary prosthesis for immediate loading, bone reduction, and osteotomy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;At the 2-year follow-up appointment post-restoration, the prosthesis and implants remained stable. The implants appeared healthy, with no signs of bone loss. The patient was extremely satisfied with the treatment, esthetics, and function.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;It can be concluded that the digital guided surgery system enabled the osteotomy, implants placement, and installation of an immediate loading prosthesis in totally edentulous patients, allowing for the delivery of temporary and ultimately final restorations with a high level of predictability.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Careful digital planning in stages makes full-arch rehabilitation more predictable and reliable.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Even patients with severe periodontal disease can be treated successfully using integrated digital workflows.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Collaboration among different specialists, supported by digital technology, improves treatment efficiency and long-term results.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;sect","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"548-561"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222284","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 bone loss in patients at risk of medication-related osteonecrosis of the jaw with microsurgery and guided bone regeneration: A case study","authors":"Pedro Franco Ferreira,&nbsp;José Maurício Paradella de Camargo,&nbsp;Lara Maria Alencar Ramos Innocentini,&nbsp;Ana Carolina Fragoso Motta","doi":"10.1002/cap.70026","DOIUrl":"10.1002/cap.70026","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;Medication-related osteonecrosis of the jaw (MRONJ) is a challenging complication associated with antiresorptive medications. Its exact pathophysiology remains unclear, but dental extractions and infections are known triggers, complicating prevention, and treatment. While conservative approaches aim to minimize bone exposure, they may be inadequate in severe cases. When surgery is required, results can be unpredictable, potentially complicating rehabilitation and patient satisfaction. This case study explores the potential role of microsurgical techniques and regenerative procedures in treating MRONJ-risk patients.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study presents three cases of female patients over 60 years old, with a history of bisphosphonate use and ongoing denosumab therapy for osteoporosis. Each patient exhibited extensive maxillary bone defects caused by endodontic and/or periodontal disease. Initial conservative treatment was insufficient, due to persistent infection or complications, ultimately requiring surgical intervention. All patients underwent surgery utilizing guided tissue regeneration techniques and biomaterials, following MRONJ-preventive protocols.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Short- and long-term postoperative follow-ups, including clinical, radiographic, and tomographic evaluations, demonstrated successful outcome. Patients exhibited improved recovery, bone regeneration, tissue volume preservation, and complete resolution of the infection.&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;The integration of magnification, microsurgery, and regenerative techniques may provide a viable strategy for managing severe bone loss in MRONJ-risk patients.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;Microsurgical techniques and regenerative procedures can be successfully applied in the treatment of severe bone loss in patients at risk of MRONJ.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;When surgery is required in these patients, the approach should focus on minimizing invasiveness while integrating techniques that may enhance oral health and overall quality of life.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;Keys to successful management","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"538-547"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222293","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":"Periodontal plastic surgery for cases with fixed “hygienic” lingual retainer: Case study","authors":"Sérgio Kahn,&nbsp;Mayra Seixas,&nbsp;Marcella B. Kahn,&nbsp;Juliana Campos Hasse Fernandes,&nbsp;Gustavo Vicentis Oliveira Fernandes","doi":"10.1002/cap.70050","DOIUrl":"10.1002/cap.70050","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 fixed “hygienic” lingual retainer (FHLiR)’s design is consistently observed as a contributing factor to plaque accumulation, possible minor undesired tooth movement, resulting in buccal bone loss, and gingival recession (GR). This case study aimed to describe the clinical outcomes of a combined periodontal treatment and periodontal plastic surgical approach for the treatment of GR in patients using FHLiR.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This case study involves three systemically healthy, non-smoking patients with localized GRs (RT1 and/or RT2) in the mandibular central incisors associated with FHLiR. The proposed treatment included replacement of the FHLiR with a straight retainer, periodontal therapy, and surgical root coverage procedures. Subepithelial connective tissue grafts (sCTG), tunnel techniques, microsurgical approaches, and adjunctive biomaterials were employed according to case-specific needs. All surgeries were performed by a single experienced periodontist, with follow-up up to 12 months.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Clinical outcomes consistently improved gingival thickness, root coverage, and periodontal tissue stability. Patients expressed satisfaction or high satisfaction, even in cases requiring two procedures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This case study illustrates the clinical outcomes of a combined basic periodontal and periodontal plastic surgical approach for the treatment of RT1/RT2 GRs in mandibular incisors associated with FHLiR, suggesting its potential to achieve functional and esthetic rehabilitation in this clinical context.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Association of fixed “hygienic” lingual retainers (FHLiR) with gingival recession (GR): FHLiR, particularly those with curved or looped designs, may be a contributing factor for plaque accumulation, minor tooth movements, and buccal bone loss, leading to localized GR (RT1/RT2) in mandibular incisors.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Comprehensive treatment approach: Management included replacing the FHLiR with a straight retainer, performing basic periodontal therapy, and applying periodontal plastic surgery(s) – mainly subepithelial connective tissue grafts with coronally advanced flap (using tunnel and microsurgical techniques) – with or without biomaterials, tailored to each patient's needs.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Consistent clinical improvement: Across th","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"655-664"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222314","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":"EPPT–CTG regeneration using rhFGF-2/CO3Ap for cemental tear defects: A case report","authors":"Takayoshi Nagahara,&nbsp;Tomoyuki Iwata,&nbsp;Keinoshin Wada,&nbsp;Kosuke Yamamoto,&nbsp;Masaru Shimizu,&nbsp;Yukiko Nagatani,&nbsp;Noriyoshi Mizuno","doi":"10.1002/cap.70048","DOIUrl":"10.1002/cap.70048","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;Cemental tear, representing separation of cementum from the root surface, is a rare but challenging condition often mimicking vertical root fracture or endodontic–periodontal lesions. Despite advances in regenerative therapy, a predictable treatment protocol for cemental tears with non-contained bone defects remains lacking. Minimally invasive regenerative surgical techniques, such as the entire papilla preservation technique (EPPT) and connective tissue graft (CTG) wall technique, may optimize wound stability and enhance clinical outcomes when combined with biologic agents.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A 73-year-old male patient presenting with gingival swelling and suppuration in #8 was diagnosed with a two-wall bone defect associated with a cemental tear (Class 3/Stage B) using cone-beam computed tomography (CBCT). Regenerative therapy was performed using recombinant human fibroblast growth factor-2 (rhFGF-2), carbonate apatite (CO&lt;sub&gt;3&lt;/sub&gt;Ap), and a CTG applied via the EPPT. Clinical parameters and radiographic findings were evaluated at baseline and 1, 3, 6, and 12 months postoperatively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Healing progressed without postoperative complications such as gingival recession or graft exposure. The probing pocket depth was reduced from 10 to ≤3 mm, and clinical attachment gain of 7 mm was achieved at 12 months. CBCT demonstrated complete radiographic bone fill and reformation of the proximal and labial bone walls.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Combination regenerative therapy using rhFGF-2, CO&lt;sub&gt;3&lt;/sub&gt;Ap, and CTG with the EPPT achieved stable soft and hard tissue regeneration in an elderly patient with a cemental tear–associated two-wall bone defect. This multidisciplinary, minimally invasive approach shows promise for managing complex non-contained intrabony defects while maintaining gingival esthetics.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;A multidisciplinary regenerative approach combining rhFGF-2, CO&lt;sub&gt;3&lt;/sub&gt;Ap, and CTG with EPPT resulted in favorable clinical and radiographic outcomes for a cemental tear–associated two-wall bone defect.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The CTG wall technique functioned as a protective barrier, minimized gingival recession, and promoted soft tissue stability.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Cone-beam computed tomography aided in the accurate diagnosis of cemental tear morphology and post","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"618-628"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222356","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 coronally advanced flap for multiple anterior gingival recessions: Case report","authors":"Kevimy Agossa,&nbsp;Dino Calzavara,&nbsp;Javier Calatrava,&nbsp;Hom-Lay Wang","doi":"10.1002/cap.70049","DOIUrl":"10.1002/cap.70049","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 frontal envelope coronally advanced flap (CAF), designed for multiple adjacent gingival recessions (MAGR) of the anterior maxilla, involves tunneling of the midline papilla. However, when treating frontal and lateral MAGR in a single session, the tunneled midline papilla can act as a fixed point, which may limit coronal advancement or lead to mucosal folds in the gingival margin.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This case report introduces a modification of the CAF technique in which a V-shaped split-thickness surgical papilla is elevated at the midline to enhance flap mobility. Two patients with combined maxillary frontal and bilateral types 1 and 2 (RT1, RT2) MAGR ranging from 2–6 mm were treated using this approach.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Postoperative healing was uneventful for both cases. In Case 1, complete and stable root coverage with excellent tissue integration and color match was observed at 18 months. In Case 2 (RT2 MAGR), near-complete root coverage was achieved at 6 months.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Within the limitations of this case report, the modified CAF appears to be an effective approach for managing MAGR extending beyond the incisors and involving both maxillary quadrants. Clinicians may consider this modification when enhanced coronal flap mobility is required to treat extensive frontal and lateral MAGR in a single session.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;In the traditional frontal envelope coronally advanced flap, the tunneled midline papilla may act as a fixed point, which may restrict coronal advancement or lead to mucosal fold formation in the gingival margin.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This case presents a modified design that enhances coronal flap mobility and achieves optimal root coverage in cases of extensive frontal and lateral maxillary anterior gingival recessions (MAGR).&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The success of this approach relies on midline papilla anatomy and precise incision placement, both of which support adequate flap stability, enhancing the predictability of root coverage outcomes.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain language summary&lt;/h3&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"629-636"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70049","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267082","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":"A successful periodontal-orthodontic treatment of an advanced case of dental trauma in a 9-year-old patient: A case report with 16-year follow-up","authors":"João Carnio,&nbsp;Maísa Casarin,&nbsp;João Kreling Carnio,&nbsp;Flavia Q. Pirih","doi":"10.1002/cap.70047","DOIUrl":"10.1002/cap.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Traumatic dental injury (TDI) most often requires complex and interdisciplinary management. Several factors are associated with the success of TDI treatment, including proper treatment planning and periodontal maintenance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The present 16-year follow-up report describes the interdisciplinary management of an extrusive luxation of teeth #8 and #9 in a 9-year-old-patient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After the extrusion, endodontic treatment was performed on teeth #8 and #9 and then periodontal treatment with supra and subgingival debridement associated with locally antibiotic application was done. Once periodontal treatment was stable, orthodontic treatment started. During orthodontic treatment, the patient was advised to have periodontal maintenance every 3–4 months. At the 16-year follow-up appointment, both teeth were in function and in acceptable esthetic condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This report demonstrates that proper diagnosis combined with interdisciplinary therapeutic approaches and periodontal maintenance could lead to long-term successful and stable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>The effective management and proper treatment of dental trauma depend on an accurate diagnosis.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Interdisciplinary management is essential for successful treatment of dental trauma.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Patient adherence to periodontal maintenance directly influences outcomes.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>When dental injuries are diagnosed correctly and treated with the help of different dental specialists—along with regular periodontal care—the long-term results can be stable and successful.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"646-654"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318948","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":"Novel overlapping rotated double flap: A modified pedicle technique for root coverage in isolated RT1 gingival recession—Case study of two patients","authors":"Ritika Arora,&nbsp;Sakshi Verma,&nbsp;Ridhima Singhal,&nbsp;Nitika Monga,&nbsp;Rajinder K. Sharma,&nbsp;Shikha Tewari","doi":"10.1002/cap.70018","DOIUrl":"10.1002/cap.70018","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;This case report presents a modified pedicle flap technique—the novel overlapping rotated double (NORD) flap—as an alternative to conventional approaches such as coronally advanced flap with subepithelial connective tissue graft (SCTG). While SCTG offers predictable outcomes, it involves a second surgical site, increasing patient morbidity. In contrast, the NORD flap uses adjacent pedicle flaps in an overlapping design, with one flap mimicking a connective tissue graft, thereby enhancing tissue thickness and vascularity without donor site complications.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two systemically healthy patients—a 35-year-old female with a thick gingival phenotype and a 40-year-old male with a thin phenotype—presenting with isolated recession type 1 (RT1) gingival recessions were treated using the NORD flap. All procedures were performed under local anesthesia with standard postoperative protocols. Follow-ups were conducted at 14 days, 1 month, 6 months, and 12 months. Clinical outcomes were assessed using the root coverage esthetic score and patient-reported outcome measures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Over 90% root coverage was achieved in both cases, regardless of phenotype. The technique eliminated graft harvesting, minimized complications, and was associated with minimal postoperative pain, requiring only two analgesic doses in 48 h.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The NORD flap offers a conservative and effective alternative for managing isolated gingival recessions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Value of innovation&lt;/b&gt;: This novel pedicle-based technique serves as a viable alternative to graft harvesting in cases where minimizing patient morbidity is a priority, thereby avoiding a secondary surgical site or when subepithelial connective tissue graft is contraindicated or undesirable:\u0000\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Achieves high root coverage (&gt;90%) across different gingival phenotypes, demonstrating versatility.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Enhances soft tissue thickness and vascularity through an overlapping pedicle design that mimics a connective tissue graft.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Minimizes postoperative discomfort, with low analgesic requirement.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Plain language summary&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This case report int","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"522-529"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287908","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":"Microscope-assisted implant surface decontamination combined with surgical treatment for peri-implantitis: A retrospective case series study","authors":"Yang Zhao,&nbsp;Wenjie Cui,&nbsp;Kexin Lin,&nbsp;Jiahong Shi,&nbsp;Yu Chen,&nbsp;Lang Lei,&nbsp;Houxuan Li","doi":"10.1002/cap.70036","DOIUrl":"10.1002/cap.70036","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;This retrospective analysis aims to assess the efficacy of microscope-aided implant decontamination combined with surgical intervention for peri-implantitis and identify factors influencing its success.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Patients diagnosed with peri-implantitis in at least one implant and treated with microscope-assisted implant surface decontamination combined with surgery were evaluated. Clinical and radiographic parameters were assessed at baseline, 1-year, and 3-year intervals. Disease resolution, defined as ≤1 bleeding site, probing depth (PD) ≤5 mm, and no bone loss &gt;0.5 mm, was the primary outcome. Multilevel regression analysis identified predictors affecting disease resolution.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty-three patients with 50 implants were included. The 1-year success rate was 92% (N = 46), declining to 80% (N = 40) at 3 years and 76% (N = 38) at final evaluation (37–98 months). At the final visit, 89.4% of implants had PD ≤5 mm, with no suppuration (SUP) in 95.7% of cases. Deepest PD at baseline negatively impacted outcomes.&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;Microscope-assisted implant decontamination combined with surgical treatment is effective for peri-implantitis management long-term, serving as a potential reference for implant decontamination procedures. Further randomized controlled trials should investigate this approach's effectiveness compared to non-microscope-assisted decontamination.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;This is the first clinical study to our knowledge to demonstrate the long-term efficacy (up to 8 years) of a microscope-assisted, multi-step decontamination protocol combined with surgery for treating peri-implantitis.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The presented protocol achieved high disease resolution rates of 76%–92%, with significant improvements in probing depth, bleeding, and bone level.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Microscopic visualization ensures thorough implant surface cleaning, addressing a critical limitation of conventional blind debridement techniques.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This study establishes a potential new standard of care for achieving predictable and sustainable outcomes in the management of advanced peri-implantitis.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Pl","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"581-592"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151407","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, an independent biologic complication associated with implants placed in grafted bone","authors":"Jonathan H. Do,&nbsp;Charles M. Cobb,&nbsp;John T. Shen","doi":"10.1002/cap.70043","DOIUrl":"10.1002/cap.70043","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;Perigraftitis is a recently introduced concept describing biologic complications specifically associated with implants placed in grafted bone. It is characterized by inflammation resulting from bacterial colonization of grafted bone and/or residual graft particulates. Reported cases have been managed by removal of the implant, grafted bone, and surrounding inflammatory tissue, and therefore have not definitively established perigraftitis as an independent disease entity. This report describes a histologically confirmed case of perigraftitis treated successfully without implant removal, supporting its recognition as a distinct pathologic condition.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A 63-year-old healthy, nonsmoking Asian male presented with discomfort, and a foul taste around implant #31, placed in a site previously grafted with deproteinized bovine bone mineral. Examination revealed infection and bone loss that centered on the grafted bone, and the site was diagnosed with perigraftitis. The implant crown was removed, and surgical access was obtained using a laser. Three hard tissue specimens were removed and submitted for histology, revealing numerous graft particulates surrounded by mature necrotic host bone with bacterial aggregates within intertrabecular spaces of all three specimens. The site was thoroughly debrided and allowed to heal without the use of any biomaterials.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Three weeks post-treatment, symptoms had resolved. At 13.5 months post-treatment, crestal bone regeneration up to the implant collar was observed. Vertical implant soft tissue augmentation with a subperiosteal circumferential connective tissue graft was then performed, and the implant crown was reseated following soft tissue healing.&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;The histologic findings and clinical outcome of this case support the recognition of perigraftitis as an independent disease entity. Further controlled studies are warranted to elucidate the etiopathogenesis, risk factors, and prevalence of perigraftitis, and to optimize its prevention and treatment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Perigraftitis may be considered an independent disease entity, distinct from peri-implant mucositis and peri-implantitis.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Perigraftit","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"604-617"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146151449","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}