Clinical Advances in Periodontics最新文献

{"title":"Surgically facilitated orthodontics with clear aligners for severe malocclusion and gingival recessions.","authors":"Elli Anna Kotsailidi, Lucy Johnson, Christopher Burns, Paul Emile Rossouw, Dimitrios Michelogiannakis","doi":"10.1002/cap.10324","DOIUrl":"https://doi.org/10.1002/cap.10324","url":null,"abstract":"<p><strong>Background: </strong>Gingival recession defects (GRDs) pose functional and esthetic concerns and may be associated with unfavorable tooth positions. Surgically facilitated orthodontic treatment (SFOT) with clear aligners can be a valuable option for adults with severe malocclusion and GRDs.</p><p><strong>Methods: </strong>A 28-year-old male presented with severe dental crowding, Class III dental malocclusion, localized tooth crossbites, and tapered maxillary arch. He exhibited multiple gingival recessions type I up to 6 mm in depth, at least 2 mm of keratinized tissue throughout, and a thick scalloped gingival phenotype. Clear aligner SFOT was performed including buccal corticotomies and bone augmentation with demineralized allograft between the first molars on both arches, dental expansion, interproximal enamel reduction, and use of intermaxillary elastics. Progress of the aligners occurred every 3 days for the first 6 months; and every 5 days thereafter, for a total duration of 10.5 months.</p><p><strong>Results: </strong>Clear aligner SFOT led to tooth alignment, Class I occlusion, and improvement in smile esthetics. Complete root coverage was achieved on 50% of the teeth and the mean root coverage was 81.6%, ranging from 1 to 6 mm, while residual GRDs ranged from 1 to 2 mm.</p><p><strong>Conclusion: </strong>Clear aligner SFOT can be a valuable interdisciplinary approach for the management of adults with multiple GRDs and severe malocclusion.</p><p><strong>Plain language summary: </strong>Recession of the gingiva creates functional and esthetic concerns and is often related to unfavorable tooth position and tooth crowding. A surgical procedure called \"surgically facilitated orthodontic treatment\" (SFOT) with clear aligners instead of metal braces is a valuable treatment option for adults with receding gingiva and unfavorable tooth position. This report presents a 28-year-old male with severe tooth crowding and narrow tooth arches. He had several areas with thick, receding gingiva on the upper and lower jaws. The surgery involved the creation of bony cuts in between the roots, followed by bone grafting over the roots and cuts, on both jaws. The orthodontic treatment was executed with clear aligners and elastics. The patient was switching aligners every 3 days for the first 6 months and every 5 days thereafter. The total treatment duration was 10.5 months. Eventually, clear aligner SFOT led to the alignment of all teeth and improved the appearance of the smile. Receding gingiva was completely reversed on 50% of the teeth and improved by a mean of 81.6% (1-6 mm gain in gingiva). This report exhibits that this technique can be a valuable treatment approach for patients with multiple areas of receding gingiva, unfavorable tooth position, and crowding.</p><p><strong>Key points: </strong>This case is the first to illustrate the successful management of multiple and severe gingival recession defects along with severe malocclusion with clea","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saving a hopeless tooth with a four-wall bone defect: A case report.","authors":"Takayoshi Nagahara, Tomoyuki Iwata, Keinoshin Wada, Tomoya Ueda, Shoko Kono, Kazuhisa Ouhara, Noriyoshi Mizuno","doi":"10.1002/cap.10329","DOIUrl":"https://doi.org/10.1002/cap.10329","url":null,"abstract":"<p><strong>Background: </strong>Recombinant human fibroblast growth factor-2 (rhFGF-2) has been shown to effectively promote the formation of new periodontal tissues, and its efficacy has been demonstrated in clinical settings. Moreover, the clinical and radiographic outcomes in the treatment of periodontal infrabony defects can be improved by using rhFGF-2 in combination with a bone substitute. Here, we present a case of four-wall bone defect in a tooth treated by combination regenerative therapy using rhFGF-2 and beta-tricalcium phosphate (β-TCP).</p><p><strong>Methods: </strong>A 43-year-old male with a four-wall bone defect in tooth #28 was subjected to combination therapy with rhFGF-2 and β-TCP. Periodontal clinical parameters and radiographic images were evaluated at the first visit, after the initial periodontal treatment, and after 4 months and 4 years postoperation.</p><p><strong>Results: </strong>Although gingival recession and nonvital pulp were observed postoperation, improvements in the periodontal parameters and radiographic outcomes were subsequently recorded.</p><p><strong>Conclusion: </strong>Periodontal regenerative therapy with a combination of rhFGF-2 and β-TCP showed great potential in the treatment of four-wall bone defects of teeth.</p><p><strong>Key points: </strong>Periodontal regenerative therapy using recombinant human fibroblast growth factor-2 (rhFGF-2) and beta-tricalcium phosphate (β-TCP) showed immense potential in the treatment of four-wall bone defect in teeth. In addition to using computed tomography for assessing bone defects and root morphologies, an evaluation of root canal morphology and pulp diagnosis is essential for understanding the internal and external aspects of the defect, which would aid in tooth preservation. Appropriate periodontal and endodontic treatments enabled tooth preservation following apical periodontitis after periodontal regenerative therapy.</p><p><strong>Plain language summary: </strong>This case report focuses on a new approach for the treatment of a four-wall bone defect, a significant dental issue in which the bone around the tooth is damaged, thereby decreasing the stability of the tooth. We treated a 43-year-old male patient with a combination of two key components: the growth factor rhFGF-2, which helps promote the growth of new tissues, and the synthetic bone graft substitute β-TCP, which acts as a substitute for the missing bone. Over the course of 4 years, we monitored the patient's progress using dental exams and X-ray photos. Despite some minor side effects, such as gum recession and the loss of tooth vitality, the overall condition of the tooth and surrounding bone showed significant improvement. This combination therapy shows promise in repairing similar bone defects, which would help save teeth that might otherwise be lost.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Odontogenic keratocyst management using guided tissue regeneration: Literature review - Two case reports.","authors":"Bassam M Kinaia, Mirranda Kinaia, Joshua Graham, Naiomy Perez Villaneuva, David Van Winkle, Anmar Dawood, Anthony L Neely","doi":"10.1002/cap.10316","DOIUrl":"https://doi.org/10.1002/cap.10316","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Odontogenic cysts of the jaws are pathologies that require timely recognition and management. The initial diagnosis is based on clinical and radiographic appearance and dental history. A variety of surgical treatments are used for odontogenic keratocyst (OKC) depending on the clinical and radiographic presentation. The aim of this report and literature review is to highlight methods to treat OKC combined with guided tissue regeneration (GTR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two cases with similar clinical presentations are included. Case 1 was a 60-year-old healthy Caucasian female who presented with jaw expansion around teeth #'s 21 and 22. Initial exam revealed clinical gingival health on an intact periodontium. The patient presented with enlarged gingival tissue between teeth #'s 21 and 22 measuring 9 × 12 mm and vital teeth without root displacement radiographically. Case 2 had a similar clinical and radiographic presentation located between teeth #'s 5-6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Case 1 treatment included excisional biopsy with complete enucleation of the cystic lesion. Thereafter, GTR was performed using allograft internally then covered with a xenograft externally, resorbable collagen membrane (RCM), and primary closure. Case 2 was managed with excisional biopsy with lesion enucleation, GTR with allogenic bone graft, enamel matrix derivative and RCM, and primary closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;OKC enucleation combined with GTR using mineralized allograft, enamel matrix derivative, and collagen membrane or a layering technique of allograft internally and xenograft externally covered by a collagen membrane showed proper regeneration with stable periodontium at 6-36 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Guided tissue regeneration is an acceptable treatment for management of OKC. Complete enucleation of an OKC lesion is important to reduce recurrence. The use of allograft with xenograft or allograft with enamel matrix derivative and RCM can provide proper bone fill after OKC removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Odontogenic cysts are growths that can form in the jaw or soft tissues around the teeth. If not treated, they can grow larger, damage the bone, and even push teeth out of place. To prevent this, it's important to diagnose and remove them early. The most common way to treat these cysts is through a surgical method called enucleation, where the cyst is carefully removed. In these two cases, enucleation was used along with guided tissue regeneration, a technique to help the bone and tissue heal better after surgery. In the first case, a bone graft (made from human and animal bone) and a special material called a resorbable collagen membrane were used to protect and support the healing area. In the second case, a mineralized bone graft along with a substance that helps repair tissues called an enamel matrix derivative, and the same collagen membrane were used. Both p","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856922","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":"Bone dimensions relationship with gingival phenotype in smokers and nonsmokers using cone-beam computed tomography.","authors":"Shiva Barmar, Azadeh Torkzadeh, Roshanak Ghaffari, Shirin Zahra Farhad, Seyed Sasan Aryanezhad","doi":"10.1002/cap.10326","DOIUrl":"https://doi.org/10.1002/cap.10326","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the relationship of maxillary alveolar bone thickness (BT) and height (BH) with gingival phenotype (GP) in smokers and nonsmokers using cone-beam computed tomography (CBCT).</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 60 participants. The participants underwent periodontal examination, and their GP was determined by placing a periodontal probe in the gingival sulcus at the midline and observing the transparency. The participants were then assigned to four groups (n = 15) based on their smoking status and GP: thin phenotype/smoker, thick phenotype/smoker, thin phenotype/nonsmoker, and thick phenotype/nonsmoker. BT and BH of the participants were measured in the sagittal plane on CBCT scans at the bone crest and at 2, 4, and 6 mm apical to the crest at the site of maxillary central and lateral incisors. Data were analyzed by two-way ANOVA and LSD test (alpha = 0.05).</p><p><strong>Results: </strong>The distance between the cementoenamel junction (CEJ) of maxillary central and lateral incisors and alveolar bone crest in smokers was significantly greater than that in nonsmokers (p < 0.001). Smoking had no significant effect on alveolar BT at the crestal level or 2, 4, and 6 mm apical to the crest. BT at the crest and 2, 4, and 6 mm apical to the crest was significantly greater in thick, versus thin, GP (p < 0.001).</p><p><strong>Conclusion: </strong>Smoking significantly increased the distance between the CEJ and alveolar crest at the site of central and lateral incisors but had no significant effect on BT.</p><p><strong>Plain language summary: </strong>This study found that smoking significantly increased the distance between the cementoenamel junction and the alveolar bone crest in maxillary incisors but did not affect alveolar bone thickness, which was greater in individuals with a thick gingival phenotype compared to those with a thin gingival phenotype.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848499","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":"In vitro ultrastructure and biodegradation of activated plasma albumin gel derived from human samples: A prospective observational study.","authors":"Behzad Houshmand, Mohammadreza Talebi Ardakani, Farshad Armandei, Anahita Moscowchi, Ahmad Nazari, Jafar Ai, Mehdi Ekhlasmand Kermani, Hamoun Sabri","doi":"10.1002/cap.10330","DOIUrl":"https://doi.org/10.1002/cap.10330","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In soft tissue regeneration, the clinical efficacy of fibrin membranes has been a pressing concern. The key to this efficacy lies in the stability of membrane and its controlled absorption. Human serum albumin, with its influence on the formation and stability of fibrin networks, could hold the key to developing a more stable alternative. This study investigates the ultrastructure and biodegradability of plasma albumin-activated gel, a potential game-changer in the field.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Blood samples were collected from the participants and centrifuged to obtain the concentrated growth factor. The poor platelet plasma syringe was placed inside the activated plasma albumin gel device. The ultrastructure of the membrane was examined using a scanning electron microscope (SEM). The weight difference was measured over 21 days to investigate the biodegradability of the samples.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-two samples were prepared from six individuals (three males and three females). Based on SEM images, activated albumin gel after 21 days in Hank's solution exhibited a significant decrease in density and evident signs of surface degradation. The weight was significantly reduced after 21 days (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In the present study, the investigation of the ultrastructure and biodegradability of activated albumin gel showed that, based on the observed weight difference, the amount of biodegradation is high, and it may be necessary to use a thicker membrane compared to the conventional thickness of the connective tissue graft.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Enhanced stability and biocompatibility: The study highlights plasma albumin-activated gel's potential as a soft tissue scaffold, demonstrating significant biodegradation and structural changes that support cell infiltration and nutrient exchange, essential for tissue regeneration. Controlled degradation profile: Plasma albumin gel offers a prolonged biodegradation period compared to conventional fibrin membranes, making it suitable for applications requiring stable, long-lasting scaffolds in soft tissue regeneration. Future clinical applications: Findings suggest that thicker plasma albumin membranes may be needed for optimal effectiveness, paving the way for further exploration in clinical trials and animal models to validate this approach in soft tissue grafting.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This study investigates plasma albumin-activated gel as a promising material for supporting soft tissue repair, particularly in periodontal regeneration. Traditional materials, such as fibrin membranes, are often used to aid healing, but their rapid breakdown can limit effectiveness in the body. Plasma albumin, a protein naturally found in human blood, might offer a more stable alternative by forming a longer-lasting structure. In this study, researchers processed blood samples from participants to cre","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848504","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 post-implant fibrous dysplasia in the maxilla: A case study.","authors":"Yousef Taha Y Amrou, Anass M Koleilat, Abdusalam E Alrmali, Felipe Nor, Hom-Lay Wang","doi":"10.1002/cap.10328","DOIUrl":"https://doi.org/10.1002/cap.10328","url":null,"abstract":"<p><strong>Background: </strong>Fibrous dysplasia is generally rare, and even rarer in older adults. Special care is needed when altering the alveolar bone in these cases, especially if an implant is involved. This case study highlights such a scenario.</p><p><strong>Methods: </strong>This case study details the experience of a 63-year-old African American female who presented with a bump on her jaw, ultimately leading to a diagnosis of fibrous dysplasia. The patient underwent surgery for osseous recontouring to address the bone overgrowth associated with the condition.</p><p><strong>Results: </strong>The study documents the successful surgical recontouring of a fibrous dysplasia lesion in the upper right maxilla that developed 5 years after dental implant placement. Additionally, it highlights the preservation of peri-implant hard and soft tissues over a 6-month follow-up period post-surgery, ensuring proper tissue healing and bone shaping for optimal patient outcomes.</p><p><strong>Conclusion: </strong>The successful surgical recontouring of fibrous dysplasia in the upper right maxilla, along with the preservation of peri-implant hard and soft tissues, underscores the potential for effective oral rehabilitation in similar cases involving dental implants.</p><p><strong>Plain language summary: </strong>In this study, we managed a rare bone disorder called fibrous dysplasia in a 63-year-old woman, 5 years after she had dental implants in her upper jaw. This condition leads to bone overgrowth and deformities, making oral rehabilitation challenging. The patient presented with a bump in her upper jaw, which was diagnosed through various tests. We performed surgery to reshape the overgrown bone while preserving her dental implants and surrounding tissues. The surgery was successful, and 6 months later, the implants remained stable with no signs of recurring issues.</p><p><strong>Key points: </strong>Why is this case new information? This case is rare because it presents a successful management strategy for fibrous dysplasia in the maxilla with dental implants, a combination that is both uncommon and challenging. What are the keys to the successful management of this case? Successful management relies on accurate diagnosis, careful surgical recontouring to preserve peri-implant bone while providing a maintainable environment for the patient, and thorough postoperative care to ensure healing and stability. What are the primary limitations to success in this case? Primary limitations include the risk of implant compromise, potential recurrence of fibrous dysplasia, and challenges related to bone quality and healing, particularly in an older patient.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142781959","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":"The laterally closed coronally advanced flap: A case study.","authors":"Jochen Tunkel, Jessica M Latimer, Luca de Stavola, Peer W Kämmerer","doi":"10.1002/cap.10319","DOIUrl":"https://doi.org/10.1002/cap.10319","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Several methods have been described for treating deep Cairo Class RT1 recessions. Most involve relieving incisions, which cause scar tissue formation or use a tunneled approach. This report introduces a modified technique for treating a single deep recession beyond the mucogingival margin. The approach uses a laterally closed coronally advanced flap (LCAF) without relieving incisions, combined with a subepithelial connective tissue graft and enamel matrix derivative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 28-year-old woman was referred to our periodontal practice for the treatment of a progressive deep Cairo Class I recession with hypersensitivity and limited access to hygiene measures. The root coverage procedure was performed using a modified LCAF, combined with a connective tissue graft from the palate and enamel matrix derivative. The case was followed for 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The healing process was uneventful. Six months after surgery, the root surfaces remained completely covered. Hypersensitivity resolved entirely, and there was only a slight formation of visible scar tissue.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This modified technique of an LCAF is a feasible and effective method for treating single deep RT1 recessions. By avoiding visible relieving incisions, scar tissue formation is minimized. The preparation of an LCAF allows for adequate coronal advancement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;As far as our knowledge, this is the first description of a laterally closed coronally advanced flap (LCAF) combining the advantage of a minimalized scarring root coverage with a simplified coronally advancement for recessions exceeding the mucogingival junction. This modified technique combines the advantages of a lateral closing with a CAF for covering deep class RT1 recessions. Meticulous handling of the delicate pedicles combined with a coronal advancement of at least 2 mm beyond the cemento-enamel junction is the key factor for the successful adaption of this technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Deep gum recessions originating from traumatic hygiene measures can cause hypersensitivity and limit patients´ access to oral hygiene. Especially in deep recessions, the common surgical techniques have shortcomings due to a post-surgical lack of keratinized gingiva or visible scar tissue formation. This case study shows the treatment of a 28-year-old woman´s deep recession on a mandibular front tooth introducing a modified surgical technique for covering deep gum recessions exceeding the area of the keratinized gingiva (so-called deep Cairo RT1 recessions). This new technique uses a \"laterally closed coronally advanced flap\" (LCAF), which combines a curtain-similar lateral closing of the flap pedicles with a coronal advancement to cover the recession without making cuts that can lead to scars. It is combined with a tissue graft from the patient's palate and a special protein to rege","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648770","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":"Periodontal phenotype modification in surgically facilitated orthodontics: A case report.","authors":"Francesco Tironi, Stavros Sofos, Jason Wong, Megan Leyva, Gisella Contasti, Myron Nevins, Saynur Vardar-Sengul","doi":"10.1002/cap.10321","DOIUrl":"https://doi.org/10.1002/cap.10321","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic treatment in adults with thin periodontal phenotype presents challenges such as lengthy treatment time and increased risk for gingival recessions. In this case, surgically facilitated orthodontic treatment (SFOT) was proposed to accelerate orthodontic tooth movement while modifying the periodontal phenotype.</p><p><strong>Methods: </strong>An orthodontic patient was referred for periodontal evaluation of lower anterior teeth, which presented a thin gingival phenotype and bone dehiscence. SFOT was performed on the mandible using particulate allograft combined with platelet rich fibrin (PRF) and collagen membrane to augment soft and hard tissue, thereby preventing future recessions, while accelerating the treatment times.</p><p><strong>Results: </strong>Six-month and 3-year follow-ups confirmed radiographic bone fill, absence of gingival recession and thick band of keratinized gingiva. SFOT also resulted in a shorter treatment time where desired tooth movements were achieved within 6 months with periodontal stability.</p><p><strong>Conclusions: </strong>SFOT provided clinical benefits by accelerating orthodontic movement, improving periodontal phenotype, preventing the displacement of teeth beyond the alveolar housing and minimizing the risk for development of dehiscences and gingival recessions.</p><p><strong>Key points: </strong>Orthodontic movements can create recessions and dehiscence in thin periodontal phenotypes. SFOT can help prevent bone dehiscence and creates a thicker gingival phenotype while accelerating treatment time.</p><p><strong>Plain language summary: </strong>Adults who face lengthy orthodontic treatments and have thin gums have risks of gum problems. Surgically facilitated orthodontic treatment (SFOT) can help by speeding up tooth movements and improving gum health and thickness. A patient with thin gums and lack of bone in the lower front teeth was evaluated. The SFOT procedure involved using a bone graft, healing factors, and a collagen membrane to strengthen the gums and bones. This approach aimed to prevent future gum problems and speed up orthodontic treatment. Follow-ups at 6 months and 3 years after treatment showed good healing of the gums and bones, with no signs of gum recession and healthier, thicker gums. The desired tooth movements were achieved within 6 months, resulting in a shorter treatment time. The patient's gums remained stable throughout this period. SFOT offered significant clinical benefits, including faster tooth movement and improved gum health. It also helped prevent teeth from moving out of place and minimized the risk of gum recession and bone issues. This approach can be a valuable option for adults with thin gums undergoing orthodontic treatment.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced platelet-rich fibrin versus connective tissue graft in maxillary gingival recession management.","authors":"Anupama Tadepalli, Lakshmi Ramachandran, Harinath Parthasarathy, Priyanka Cholan, Swapna Chekurti, Tinu George Peter","doi":"10.1002/cap.10317","DOIUrl":"https://doi.org/10.1002/cap.10317","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Platelet concentrates have gained significant attention in periodontology due to their regenerative properties. This randomized clinical trial was aimed to compare the clinical efficacy of advanced platelet-rich fibrin (A-PRF) and connective tissue graft (CTG) in the management of recession defects. The objectives were to compare changes in recession height and root coverage percentage between the groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Systemically healthy individuals presenting Cairo's RT1/RT2 gingival recession defects in the maxilla (n = 40) were treated with either A-PRF or CTG in combination with coronally advanced flap (CAF). Clinical parameters were measured at baseline, 3 months, and 6 months. Mean and complete root coverage percentages were calculated at 3 and 6 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In both the test (CAF + A-PRF) and control (CAF + CTG) groups, a statistically significant reduction in mean recession height was seen from baseline values of 2.90 ± 0.55 mm and 3.15 ± 0.87 mm to 0.80 ± 0.95 mm and 0.15 ± 0.48 mm at 6 months, respectively (p &lt; 0.001). In the test group, 10 sites had complete root coverage at 6 months with mean root coverage of 73.76 ± 29.58%. In the control group, 18 of 20 sites had complete root coverage with mean root coverage of 93.35 ± 23.1%. The control sites had a significantly greater reduction in recession height and higher mean and complete root coverage percentages at 6 months (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The study findings suggest that, the CTG had resulted in superior outcomes than A-PRF along with CAF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Question: To compare the efficacy of advanced platelet-rich fibrin (A-PRF) with connective tissue graft (CTG) in the management of gingival recession defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Finding: &lt;/strong&gt;Both interventions showed satisfactory healing. At 6 months, the CTG group demonstrated superior results than the A-PRF group. Meaning: CTG has a greater therapeutic potential than A-PRF in the management of gingival recessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Platelet-derived membranes are widely used in various dental therapies due to their healing properties. Limited studies have been conducted using the novel platelet preparations in the management of receding gums. This study compared the effects of advanced platelet-rich fibrin membrane with conventional soft tissue harvested from the palate in the treatment of gum recession. Twenty-three patients requiring gum augmentation were recruited and treated with either platelet-derived membrane (test group) or tissue harvested from their palate (control group). Clinical parameters were measured at baseline (before intervention), 3 months, and 6 months. Both treatment modalities resulted in significant gum coverage at the end of 6 months. On comparison, the control sites had significantly greater improvements in all the measured clinical parameters indicating t","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585193","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":"Proliferative verrucous leukoplakia: Case study of 24 years and outcome of treatment with CO₂ laser.","authors":"Charles M Cobb, Nabil E Beaini, Jessica Scully, Tanya M Gibson","doi":"10.1002/cap.10320","DOIUrl":"https://doi.org/10.1002/cap.10320","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a rare and refractory form of oral leukoplakia. The etiology of PVL remains unknown. The lesion is characterized by a high rate of malignant transformation. There is no definitive treatment for PVL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This case study presents a patient diagnosed in 2000 with a localized hyperkeratinized/verrucous lesion involving the facial gingivae of teeth #6-#8. Over the next 24 years, the lesion was biopsied five times. Further, two attempts to ablate the lesion with a CO&lt;sub&gt;2&lt;/sub&gt; laser (10.6 µm wavelength) were performed. Both ablation treatments were unsuccessful as the lesion recurred and progressed to involve more areas of gingival tissue. To date, biopsy has not revealed transformation into verrucous or squamous cell carcinoma (SCCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This case study demonstrates that two attempts at ablation of PVL using a CO&lt;sub&gt;2&lt;/sub&gt; laser had no short- or long-term benefit. The patient eventually lost all maxillary teeth due to root caries and inability to maintain adequate oral hygiene. The PVL lesion currently involves the entire maxillary edentulous ridge, extending from the 2nd molar site to the opposite corresponding site. During the 24 years encompassed by this report, the patient has not experienced a malignant transformation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of CO&lt;sub&gt;2&lt;/sub&gt; laser ablation of the PVL lesion in this case provided no short- or long-term benefit. Given the potential for a sinister outcome, PVL patients require frequent clinical evaluation and biopsy for early detection of a malignant transformation into oral verrucous or SCCA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a clinical diagnosis and represents a refractory form of multifocal oral mucosal leukoplakia of unknown origin. Currently, there is no reliable and successful treatment for PVL. PVL may undergo transformation to a verrucous or squamous cell carcinoma, thereby necessitating frequent oral examination and biopsy of sinister-appearing mucosal sites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a rare disorder that affects the gum tissue around the teeth. PVL is a pre-cancerous disorder for which the cause is unknown and there is no treatment that yields a consistently successful result. This case study presents a patient diagnosed in 2000 with PVL involving the facial gum tissue of the upper right cuspid, lateral, and central incisor teeth. Over the next 24 years, the lesion was biopsied five times and two attempts to irradicate the lesion with a CO&lt;sub&gt;2&lt;/sub&gt; laser were performed. All attempts at treatment were unsuccessful and the lesion slowly progressed to involve more areas of gum tissue. The last biopsy taken in February 2024 did not reveal any areas of developing cancer. During the 24 years covered in this report, the patient did not deve","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513555","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}