Clinical Advances in Periodontics最新文献

{"title":"Strategic management of altered passive eruption in anterior implant therapy: A case report.","authors":"Arsalan Danesh, Arman Danesh, Marela Garcia, Saynur Vardar, Theofilos Koutouzis","doi":"10.1002/cap.70103","DOIUrl":"https://doi.org/10.1002/cap.70103","url":null,"abstract":"<p><strong>Background: </strong>A clinical scenario in the esthetic zone is the presence of short clinical crowns, which, in the absence of occlusal wear and other injuries, is referred to as altered passive eruption (APE). The presence of APE can lead to esthetic issues, which can impact the patient's smile harmony. In esthetically demanding cases, APE must be addressed prior to or in conjunction with implant therapy, and failure to do so can result in esthetic complications and failure in prosthetic planning. This case report exhibits a digital workflow in treating such patients to achieve optimal outcomes.</p><p><strong>Methods: </strong>A 67-year-old female presented with a missing tooth #7 and APE of #6-11. Treatment included esthetic crown lengthening, guided bone regeneration (GBR) at site #7, followed by gingivectomy, implant placement, connective tissue graft (CTG), and provisionalization using lab-milled crowns to allow soft tissue maturation.</p><p><strong>Results: </strong>Osseous crown lengthening with simultaneous GBR corrected altered bony architecture and reconstructed the implant site. Horizontal bone width increased from 4.99-6.71 to 6.39-9.74 mm at 6 months, with cone-beam computed tomography confirming 1-1.5 mm of ostectomy per tooth. Gingivectomy, implant placement, and CTG yielded a mean clinical crown height increase of 1.07 ± 0.19 mm and 13.4% improvement in width-to-length ratio, with favorable peri-implant parameters at final evaluation.</p><p><strong>Conclusion: </strong>Preoperative analysis of patients' esthetics is important when implants are considered in the anterior segment. Recognition and treatment of APE can have significant effects on the 3D positioning of dental implants and the desired esthetic outcome.</p><p><strong>Key points: </strong>Altered passive eruption must be identified and corrected before implant osseointegration, as post-integration correction requires flapping and osseous recontouring around the fixture that compromises esthetic outcomes. Osseous crown lengthening should be performed concurrently with guided bone regeneration and gingivectomy deferred to implant placement, since the coronal flap advancement required for guided bone regeneration displaces the mucogingival junction and would negate any prior soft-tissue modification. Digital planning that merges the diagnostic wax-up with the preoperative scan allows a single guide to govern both ostectomy margins and prosthetically driven implant position, which is essential to producing stable peri-implant tissue and improved crown proportions.</p><p><strong>Plain language summary: </strong>Placing a dental implant in the anterior region is one of the most demanding procedures in dentistry, because the result must look natural as well as function well. This case report describes a 67-year-old woman missing an upper front tooth who also had a condition called altered passive eruption, in which the gums sit too high on the teeth, producing short","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subperiosteal circumferential connective tissue graft for vertical implant soft tissue augmentation.","authors":"Jonathan H Do, Alex S Kim","doi":"10.1002/cap.70110","DOIUrl":"https://doi.org/10.1002/cap.70110","url":null,"abstract":"<p><strong>Background: </strong>Vertical implant soft tissue augmentation is indicated to optimize esthetic outcomes in cases of peri-implant soft tissue deficiency or dehiscence, particularly when the peri-implant mucosa is exposed during a full smile. This manuscript describes the use of a subperiosteal circumferential connective tissue graft (SC CTG) for vertical implant soft tissue augmentation via the vestibular incision subperiosteal tunnel access.</p><p><strong>Methods: </strong>A 78-year-old Caucasian female presented with peri-implant soft tissue deficiency at unrestored implants #7 and #8, with peri-implant mucosal margins visible during a full smile. Vertical implant soft tissue augmentation using a SC CTG was performed initially on both implants #7 and #8, and on implant #8 alone 6 weeks later. Four weeks after the second augmentation, the implants were provisionalized, and definitive restorations were delivered 8 months thereafter.</p><p><strong>Results: </strong>The peri-implant mucosa at both implants appeared pink, firm, stippled, and well adapted to the restorations. Mucosal display at implants #7 and #8 during a full smile was comparable to and harmonious with the contralateral dentition. The patient reported satisfaction with the esthetic outcome.</p><p><strong>Conclusions: </strong>The SC CTG, featuring perforations created with a tissue punch to permit passage of the healing abutments, enabled graft stabilization solely by the abutments and facilitated circumferential enhancement of the peri-implant mucosal phenotype without the need for sutures when applied via the vestibular incision subperiosteal tunnel access. Within the limitations of this case report, this approach appears to be a simple, effective, and sutureless technique for vertical implant soft tissue augmentation.</p><p><strong>Key points: </strong>The subperiosteal circumferential connective tissue graft (SC CTG), featuring a tissue punch-created perforation for healing abutment passage, enables graft stabilization by the abutment alone and facilitates circumferential enhancement of the peri-implant mucosal phenotype. For optimal outcomes, the SC CTG should be stabilized with a narrow healing abutment or a restoration with narrow submucosal contours to maximize circumferential tissue gain and enhance peri-implant tissue stability. The thickness and dimensional stability of the SC CTG are key determinants of vertical soft tissue gain.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042161","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":"Unusual co-occurrence of cheilitis granulomatosa and plasma cell gingivitis: A case report","authors":"Lata Goyal,&nbsp;Mehak Gupta,&nbsp;Gargi Kapatia,&nbsp;Amanurrahman Zubair Ahemad,&nbsp;Shipra Gupta","doi":"10.1002/cap.70016","DOIUrl":"10.1002/cap.70016","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;Cheilitis granulomatosa (CG) and plasma cell gingivitis (PCG) are uncommon inflammatory conditions affecting the oral regions. CG manifests as chronic lip swelling with granulomatous inflammation, while PCG presents as erythematous gingiva or gingival enlargement linked to hypersensitivity reactions. Their simultaneous occurrence is exceedingly rare, posing diagnostic and therapeutic challenges.&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 32-year-old woman presented with recurrent upper lip swelling and gingival enlargement. Clinical examination revealed erythematous gingiva with a cobblestone texture and angular cheilitis. Biopsies confirmed orofacial granulomatosis with epithelioid granulomas and PCG with plasma cell infiltration. Management consists of diet modification and periodontal intervention. Postoperative outcomes demonstrated significant improvement, and allergen elimination strategies were implemented to reduce recurrence.&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 9 months of follow-up of the patient, there was significant improvement in signs and symptoms with no signs of recurrence.&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 highlights the rare co-existence of CG and PCG, emphasizing the need for a comprehensive diagnostic approach to exclude systemic causes. Successful management requires pharmacological treatment, surgical interventions, and dietary modifications. Long-term follow-up is essential to monitor recurrences and maintain clinical stability.&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;Because of the rare co-occurrence of cheilitis granulomatosis (CG) and plasma cell gingivitis (PCG), which creates unique diagnostic and therapeutic hurdles, this case offers new information. Additionally, it presents an effective treatment plan that concurrently addresses both problems.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;A comprehensive strategy is necessary for the successful management of PCG and CG. Systemic disorders must be ruled out since they might exhibit similar symptoms. Dietary changes, nonsurgical, and surgical periodontal therapy are all part of the therapy plan. In order to avoid recurrence and guarantee a long-lasting recovery, long-term monitoring and regular elimination of allergens and irritants are essential.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The possibility of the problem recurring is one of the main obstacles to this case's success. Reducing the chance of recurrence ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"505-512"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410918","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":"Customized three-dimensional–printed titanium mesh for alveolar bone augmentation: Retrospective consecutive case series","authors":"Kaio Henrique Soares,&nbsp;Catherine King,&nbsp;Daniel Palkovics,&nbsp;Raul Perez,&nbsp;Marcia Mbadu,&nbsp;Wagner R. Duarte,&nbsp;Karin C. Schey,&nbsp;Poliana M. Duarte","doi":"10.1002/cap.70015","DOIUrl":"10.1002/cap.70015","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 case series evaluated linear and volumetric bone changes in alveolar bone defects treated with guided bone regeneration (GBR) using a next-generation customized three-dimensional (3D)-printed titanium mesh.&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;Medical history, surgical details, and cone beam computed tomography (CBCT) data were collected from patients undergoing GBR with the customized 3D-printed titanium mesh. CBCT subtraction analysis was performed using 3D digital models, created via spatial registration and semi-automatic segmentation. Outcomes included complication rates, linear bone measurements, volumetric hard tissue gain, graft volume stability, and augmentation efficacy.&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;Nine cases were included: five combined large defects, two vertical large defects, and two combined medium defects. Two cases showed no complications, while seven had mesh exposure. Two cases experienced complete early mesh exposure (22.2%), resulting in total graft loss and premature removal. The mean linear vertical bone gain at the defect's middle plane was 5.7 ± 2.3 mm for large defects, 2.7 ± 0.5 mm for medium defects, and 4.8 ± 2.4 mm for both. The overall volumetric gain was 0.49 ± 0.20 cm&lt;sup&gt;3&lt;/sup&gt;, with graft volume stability at 87.9 ± 19.5% and augmentation efficacy of 0.037 ± 0.012 cm&lt;sup&gt;3&lt;/sup&gt;/mm.&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;Customized 3D-printed titanium mesh is a feasible and effective option for augmenting defective edentulous ridges, providing predictable outcomes in linear and volumetric gains. Mesh exposure is the most common complication.&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;p&gt;&lt;b&gt;Novelty and Contribution of These Cases&lt;/b&gt;: This case series provides important insights into GBR using customized 3D-printed titanium meshes. These devices aim to overcome several limitations commonly associated with traditional non-resorbable membranes and conventional titanium meshes. The inclusion of comprehensive, CBCT-based linear and volumetric measurements of hard tissue gain adds valuable quantitative data to the field, supporting the clinical utility of customized titanium meshes in alveolar ridge augmentation.&lt;/p&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Key Factors for Successful Case Management&lt;/b&gt;: Successful outcomes in these cases were associated with several critical factors:\u0000\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Thorough preoperative planning&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Precise exe","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"485-496"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276709","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":"Combination of autogenous dentin graft and allograft for horizontal ridge augmentation: A case report","authors":"Kosuke Kashiwagi,&nbsp;Yu-Cheng Chang,&nbsp;Tun-Jan Wang,&nbsp;Dumitru Gogarnoiu,&nbsp;Rodrigo Neiva","doi":"10.1002/cap.70046","DOIUrl":"10.1002/cap.70046","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;Autogenous particulate dentin has emerged as one of the promising biocompatible alternatives to traditional bone graft materials in alveolar ridge augmentation. Although its clinical success is documented, comprehensive studies combining histological and radiographic evaluations remain limited. This case report addresses this gap by detailing a novel approach using autogenous particulate dentin combined with cancellous allograft and a long-lasting absorbable barrier membrane (lasso-guided bone regeneration technique) for horizontal ridge augmentation.&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;A 49-year-old female presented with insufficient alveolar ridge width (Seibert Class I) at edentulous sites #12 and #14, necessitating bone augmentation before implant placement. The procedure involved a layered approach: Cancellous allograft (internal layer, faster remodeling) followed by autogenous particulate dentin (outer layer, slower remodeling). A bovine pericardium membrane was used to isolate the graft site and promote healing. Six months post-surgery, cone-beam computed tomography scans demonstrated significant alveolar ridge width gains of 4.64 mm at #12 and 4.21 mm at #14. Implants were successfully placed, and a bone core harvested at the 4-month mark confirmed the slow remodeling rate of the dentin particles compared to the allograft. One year post-restoration, the implants remain functional.&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 report highlights the efficacy of the layered approach using autogenous particulate dentin, particularly for space maintenance. The slower remodeling rate of dentin suggests its suitability as an outer layer, enhancing long-term stability. This innovative technique and material selection may represent a significant advancement in alveolar ridge augmentation procedures. Further studies are warranted to confirm these findings and determine optimal applications in the long term.&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;The case demonstrates that a biologically driven layered grafting approach—placing cancellous allograft internally for faster remodeling and autogenous particulate dentin externally for slower turnover and superior space maintenance—is an option to perform horizontal ridge augmentation by mimicking natural bone architecture.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Histologic findings highlight that dentin particles remodel very slowly yet rem","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"637-645"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147319009","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":"Modified Neumann incision for implant placement in overdentures: Case series of a less invasive alternative","authors":"Lucas Jardim da Silva,&nbsp;Laura Lourenço Morel,&nbsp;Luciana de Rezende Pinto,&nbsp;Otacílio Luiz Chagas-Júnior,&nbsp;Jamil Awad Shibli,&nbsp;Fernanda Faot","doi":"10.1002/cap.70044","DOIUrl":"10.1002/cap.70044","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;Conventional envelope flap techniques for implant placement in edentulous mandibles are associated with greater postoperative morbidity, especially in elderly patients or those with anatomical limitations. Minimally invasive alternatives aim to preserve soft tissues and reduce complications, enhancing clinical predictability.&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 clinical study was conducted with ten fully edentulous patients, in whom 20 regular implants were placed in the interforaminal region without surgical guides. A modified Neumann incision with a mesial relaxing cut and partial-thickness “L”-shaped flap was used. Digital planning was performed using free software. Surgical time, number of anesthetic tubes, adverse events, flap healing, peri-implant inflammation (PI), gingival bleeding index (GBI), and probing depth (PD) were evaluated at 14, 30, 60, and 90 days 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;No surgical complications, such as dehiscence, infection, paresthesia, or early implant loss, were observed. All patients achieved primary wound healing. The mean surgical time was 44 min (range: 25–61 min), with an average of four anesthetic tubes per patient. GBI and PD remained low throughout follow-up, with few sites showing PD ≥ 4 mm. Healing scores and inflammatory parameters progressively improved over time.&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 modified Neumann incision with mesial relaxing cut, guided by digital planning, proved to be a safe, predictable, and minimally invasive approach for implant placement in edentulous mandibles. This technique demonstrated favorable healing, reduced surgical time, and effective PI control, making it suitable for patients with systemic fragility or anatomical challenges.&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;The modified Neumann incision with mesial relaxing cut allows for safe and direct visualization of the mental foramen with limited flap elevation, reducing surgical trauma and preserving soft tissue integrity.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This technique demonstrated favorable healing outcomes and low postoperative morbidity, even in elderly patients and anatomically challenging mandibles, without the need for physical surgical guides.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Digital preoperati","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"593-603"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500772","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":"Root coverage of type 2/3 gingival recession using recombinant human fibroblast growth factor-2 in combination with carbonate apatite granules: A case study","authors":"Akiyoshi Funato,&nbsp;Akihiko Katayama,&nbsp;Chihiro Ishikura,&nbsp;Yusuke Katsuda,&nbsp;Akira Hasuike","doi":"10.1002/cap.70031","DOIUrl":"10.1002/cap.70031","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;One of the most challenging aspects of the treatment of Cairo Recession Type (RT) 2/3 gingival recession is the loss of adjacent interdental tissue. Successful treatment can be achieved by repositioning the interdental tissue and applying a connective tissue graft (CTG).&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 patients with RT2/3 gingival recession were treated using the vertical incision tunnel (VIT) technique. Recombinant human fibroblast growth factor-2 (rhFGF-2)-soaked carbonate apatite (CO&lt;sub&gt;3&lt;/sub&gt;Ap) was placed in the interdental space, while rhFGF-2-soaked CTG was used to cover the exposed root surfaces. Over a follow-up period of up to 2 years, complete or significant root coverage was achieved in both cases. Interdental papillae were successfully reconstructed; however, complete papillary filling was not achieved.&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 combination of rhFGF-2-soaked CO&lt;sub&gt;3&lt;/sub&gt;Ap in the interdental space and rhFGF-2-soaked CTG for root coverage represents an effective approach for treating RT3 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;\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;This case presents a novel technique combining recombinant human fibroblast growth factor-2 (rhFGF-2)-soaked carbonate apatite (CO&lt;sub&gt;3&lt;/sub&gt;Ap) granules with a connective tissue graft (CTG) for root coverage and interdental papilla reconstruction in Recession Type (RT) 2/3 recession cases.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;Successful outcomes were attributed to the use of a vertical incision tunnel (VIT) approach, which preserved the blood supply to the papilla, and the synergistic regenerative effects of rhFGF-2, CO&lt;sub&gt;3&lt;/sub&gt;Ap, and CTG.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;Despite significant improvements, complete papilla fill was not achieved in all cases, and the biological activity of rhFGF-2 occasionally led to excessive tissue proliferation requiring additional procedures. Further studies with larger sample sizes are needed to confirm long-term stability.&lt;/p&gt;\u0000 &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;Gum recession is a common dental condition where the gums pull away from the teeth, leaving the roots exposed. This can lead to tooth sensitivity, increased risk of decay, and esthetic co","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"570-580"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108394","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":"Novel use of amnion−chorion membrane in managing sinus membrane perforations during crestal sinus augmentation: The waffle cone technique","authors":"Thaer Alqadoumi,&nbsp;Noor Daras","doi":"10.1002/cap.70019","DOIUrl":"10.1002/cap.70019","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;Crestal sinus augmentation is a minimally invasive approach used to increase vertical bone height in the posterior maxilla. Compared with the traditional lateral window technique, the crestal approach reduces surgical morbidity, postoperative discomfort, and overall treatment time, while still providing the ability to regenerate sufficient bone for implant placement. Despite these advantages, a major challenge of this technique is the difficulty in detecting and managing Schneiderian membrane perforations due to limited visual access. Schneiderian membrane perforation remains the most frequent complication associated with sinus augmentation and, if left unmanaged, may compromise graft stability, increase the risk of sinus pathology, and negatively affect implant survival. Therefore, the development of reliable methods to identify and manage membrane perforations is critical for achieving predictable outcomes. This case series aims to describe a novel approach for managing sinus membrane perforations encountered during crestal sinus augmentation using amnion−chorion membrane. The technique involves the application of amnion−chorion membranes to seal perforations, allowing simultaneous bone grafting and implant placement.&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 presenting with posterior maxillary edentulism and insufficient vertical bone height were treated using the crestal sinus augmentation technique assisted by osseodensification drills. Clinical and radiographic outcomes were systematically evaluated. Preoperative assessment included measurement of the residual alveolar bone height and determination of the sinus floor angle. Each sinus was carefully examined radiographically to rule out any pre-existing pathology, such as mucosal thickening, cystic changes, or evidence of sinusitis. Intraoperative sinus membrane perforations were identified during osteotomy preparation. Management involved the placement of dehydrated amnion−chorion membrane configured in a “waffle cone” shape, which allowed simultaneous implant placement and bone grafting in all cases. The amount of vertical lift achieved was also measured postoperatively to quantify the effectiveness of the crestal sinus augmentation and to ensure adequate bone gain for implant placement. At the 2-year follow-up, both clinical and radiographic evaluations were repeated to assess implant stability, peri-implant bone levels, sinus architecture, and maintenance of the augmented height, thereby confirming the long-term success of the intervention.&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;All cases demonstrated successful sealing of the Schneiderian membrane using the amnion−chorion membrane, with succ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"530-537"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276702","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":"Impaired healing following implant placement surgery: A case report of a modern-day manifestation of scurvy","authors":"Gregor-Georg Zafiropoulos,&nbsp;Gerald Kolb,&nbsp;Dimitris N. Tatakis","doi":"10.1002/cap.70013","DOIUrl":"10.1002/cap.70013","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;Delayed wound healing following implant placement surgery is an uncommon complication, usually attributed to systemic (smoking and alcohol), local (severely inflamed tissues), or technical (poor suturing) factors. However, delayed wound healing after implant placement caused by severe hypovitaminosis C has not been previously documented.&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 report describes the case of a 40-year-old systemically healthy male who developed delayed wound healing after implant placement, despite having quit smoking 10 months prior to the uneventfully completed surgery and having received successful periodontal treatment for his previously diagnosed periodontitis. Focused history taking suggested possible nutritional deficiency, with subsequent blood testing revealing severe hypovitaminosis C (plasma vitamin C [vitC] level at 0.2 mg/dL).&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;Following oral vitC supplementation and dietary changes, a marked improvement in tissue healing was observed, and plasma vitC levels returned to within normal levels (0.8 mg/dL). Four months after surgery, vitC levels had increased to 1.2 mg/dL.&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;Vitamin C deficiency can lead to impaired wound healing following implant placement surgery. Supplementation and diet modification can rapidly correct the deficiency and reverse the associated clinical signs and symptoms. Identification and management of possible nutritional deficiencies requires detailed history taking and targeted blood testing, along with interdisciplinary care.&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;Although relatively uncommon, especially in otherwise healthy patients and in developed countries, poor or delayed wound healing after dental implant placement can occur, and the underlying etiology may not be apparent. Severe hypovitaminosis C is a previously unreported cause of such poor wound healing.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;More focused history taking and indicated blood tests can reveal serious nutritional deficiencies, such as severe lack of vitamin C (vitC), and thus identify uncommon systemic conditions that contribute to the patient's presenting problem.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"497-504"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139381","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":"Bone stability after regenerative peri-implantitis treatment: A 10-year follow-up case study","authors":"Stefano Parma-Benfenati,&nbsp;Marisa Roncati,&nbsp;Lucrezia Parma-Benfenati,&nbsp;Paolo Nava","doi":"10.1002/cap.10359","DOIUrl":"10.1002/cap.10359","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;Peri-implantitis poses a significant challenge to implant longevity, leading to progressive bone loss and potential implant failure. While reconstructive surgery has been proven effective in regenerating peri-implant tissues, the long-term stability of the regenerated tissues and the impact of supportive peri-implant care (SPIC) on bone levels remains underexplored. This case study presents a 10-year follow-up of a patient treated with reconstructive surgery for peri-implantitis and enrolled in a structured maintenance program.&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 68-year-old male with a failing implant in the mandibular right first molar was treated using a reconstructive approach involving surface decontamination, particulate bone grafts, and an acellular dermal matrix as a barrier. Three re-entry procedures were performed over a 10-year period: at 9 months for the second stage of the two-step GBR procedure and at 8 and 10 years for implant placement to replace fractured teeth. These interventions allowed for direct clinical and radiographic assessment of bone-level changes.&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 9 months, bone regeneration was observed with minor residual dehiscences. After 8 years, bone remodeling and crestal bone gain on the lingual aspect were noted in the absence of further surgical interventions. At 10 years, radiographic evaluations confirmed minimal changes in marginal bone levels.&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 presented two-stage regenerative approach successfully restored peri-implant health and function over time while minimizing the patient's financial burden. The three re-entry procedures provided direct clinical evidence of bone regeneration and demonstrated the positive impact of effective maintenance therapy on marginal bone levels and their long-term stability.&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;The described regenerative treatment for peri-implantitis may ensure long-term satisfactory outcomes.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;Supportive peri-implant care (SPIC) is effective in preventing disease recurrence and may improve crestal bone levels over time.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 3","pages":"477-484"},"PeriodicalIF":1.3,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148406945","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}