Clinical Advances in Periodontics最新文献

{"title":"Periosteal-guided bone regeneration on severely damaged sockets with simultaneous implant placement: The cortical shield cross-sectional study.","authors":"Fernando Verdugo, Antonio D'Addona, Theresia Laksmana, Agurne Uribarri","doi":"10.1002/cap.10364","DOIUrl":"https://doi.org/10.1002/cap.10364","url":null,"abstract":"<p><strong>Background: </strong>Bone regeneration and simultaneous implant placement in severely damaged sockets are challenging and may require multiple grafting. Periosteal-guided bone regeneration enhances osteogenesis and wound healing shortening immediate and delay implant protocols. Clinical outcomes of a group of individuals that entered a longitudinal clinical trial from 2019 to 2021 are reported describing a novel surgical approach of simultaneous reconstruction and implant placement.</p><p><strong>Methods and results: </strong>Eight individuals requiring an implant and presenting severe facial bone loss were followed for 2-4 years (37-month average) after the completion of a 12-month longitudinal clinical trial NCT04827693. Socket reconstruction and simultaneous implant placement were performed by encasing the implant in a customized shield of autogenous cortical bone. Peri-implant tissues and pink esthetics data were assessed following established success criteria. Mean healing time, before second stage surgery, after implant placement and reconstruction, was 12.5 ± 0.9 weeks (range: 12-14 weeks). Success rates were 100% at 2-4 years. Cone beam computed tomography (CBCT) data showed stable facial cortical bone >2.1 mm in thickness. Pink esthetic scores (PESs) were above optimal (9.5 ± 0.5, range: 9-10), with no significant difference between delayed and immediate individuals (p > 0.05). Facial implant transparency at follow-up was absent and all had a band of keratinized tissue >2 mm with healthy probing depths ranging from 3 to 4 mm.</p><p><strong>Conclusion: </strong>Facial bone regeneration and simultaneous implant placement are feasible through periosteal-guided bone regeneration after a short healing period in severely damaged sockets following immediate or delay protocols. The assisted regenerated intrasocket bone provides high pink esthetics and functional implant stability.</p><p><strong>Key points: </strong>Regeneration and simultaneous implant placement of severely damaged sockets is feasible. Periosteal-guide bone regeneration can shorten healing times. Teeth with fragile alveolar foundation can be successfully reconstructed achieving high pink esthetics.</p><p><strong>Plain language summary: </strong>Simultaneous dental implant placement and bone regeneration are possible in severely damaged sockets that require reconstruction achieving, after a short healing period, highly esthetic outcomes.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095859","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":"Laterally positioned flap with connective tissue graft to treat deep isolated gingival recessions in the mandibular anterior region: A retrospective case series with 10-year follow-up.","authors":"Lucrezia Parma-Benfenati, Stefano Parma-Benfenati","doi":"10.1002/cap.10358","DOIUrl":"https://doi.org/10.1002/cap.10358","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To evaluate the efficacy and long-term clinical outcomes of the one-stage procedure for covering isolated deep gingival recessions (GRs) in the mandibular anterior region employing a laterally positioned flap (LPF) with a connective tissue graft (CTG), with a retrospective case series.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Nine patients presenting 11 isolated mid-facial recessions, where no loss of attachment level or the interproximal loss is equal to or less than the buccal one, received a LPF with CTG. The study's primary outcome was the percentage of mean gingival recession coverage (mGRC) and its stability over time. Secondary endpoints included the frequency of complete gingival recession coverage (CGRC), changes in keratinized tissue width (KTW) over time, and final root coverage aesthetic score (RES).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean of CGRC was 0.7, 0.4, and 0.5 mm for each time point with a mean up to 90% after the first year and up to 95% for 5- and 10-year follow-ups expressed in percentage, reporting an increase in KTW as well. At 1-, 5-, and 10-year follow-ups, the mean of the RESs was, respectively, 8, 7.04, and 7.09.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The present results suggest that the LPF + CTG is a valuable approach for treating deep isolated mandibular single recession type 1 (RT1) and RT2 GRs. It results in a favorable mean of CGRC, stable clinical outcomes over time, and an increase in KTW, with undisputed patient benefits and great clinician satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;This study highlights the effectiveness of a one-stage procedure using a laterally positioned flap (LPF) and connective tissue graft (CTG) for treating isolated deep gingival recessions (GR) in the mandibular anterior region. The primary outcome measured was the mean gingival recession coverage (mGRC) over time, while secondary metrics included complete gingival recession coverage (CGRC), keratinized tissue width (KTW), and root coverage aesthetic scores (RES). The mean CGRC was 90% after 1 year and 95% at 5 and 10 years; the mean RES scores were 8, 7.04, and 7.09 at the 1-, 5-, and 10-year follow-ups, respectively; KTW also increased significantly. These results confirm that the LPF + CTG technique is not only effective for treating recession type 1 (RT1) and RT2 GRs but also offers substantial benefits for patients and high satisfaction for clinicians, making it a recommended approach in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case series aims to describe the effectiveness of the laterally positioned flap as a reliable and predictable technique for root coverage in cases of single isolated mandibular recession. The paper evaluates the mean rates of complete root coverage and increases in keratinized tissue following the surgical procedure, assessed at 1, 5, and 10 years postoperation. The results demonstrate good aesthetic outcomes and favorable clinical stability of the tissues ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027296","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 reconstructive surgery with improved papilla architecture: Case report with 24 months of follow-up.","authors":"Michele Perelli, Rodrigo Neiva, Roberto Abundo, David Barack","doi":"10.1002/cap.10354","DOIUrl":"https://doi.org/10.1002/cap.10354","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Periodontal defect reconstruction often relies on bone or bone substitutes to fill defects, membranes to exclude tissues unsupportive of new bone and attachment, and biologics to stimulate cells for healing and tissue formation. The scaffold we used is a nonparticulate osteoconductive bone substitute for repairing defects without migration of particles and maintaining volume above the walls and confines of the periodontal treatment site. This may provide a more predictable option for rebuilding lost supporting bone, especially in less contained defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A case of periodontitis stage III grade A at tooth no. 5 treated with intentional defect overfill to sustain interdental papilla with filling of the defect. Established guided tissue regeneration techniques were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After 15 days, complete soft tissue closure at the defect site and root coverage at tooth 6 due to coronal advancement of the flap were observed. After 1 year, the papilla between teeth 6 and 5 filled the interproximal space, recession at 6 and 5 was 0 mm, and clinical attachment level gain at 5 was 4 mm. Soft-tissue maturation continued over 2 years, showing increasing thickness and healthy aspect. Over 24 months, increasingly defined bone-like imagery of the infrabony defect was obtained on X-ray without probing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Using a cross-linked, completely resorbable collagen scaffold covered with a membrane based on the same engineering promoted tissue growth above the walls of the defect. This was effective in bone regeneration of an intrabony defect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Why is this case new information? This is a case report describing the use of a completely resorbable ossifying collagen sponge with intentional overfill of the periodontal defect. This surgical technique allowed the clinician to improve the reduced interdental papilla architecture together with filling of the defect. This outcome represents a difficult and unpredictable goal for traditional periodontal reconstructive therapy. What are the keys to successful management of this case? Proper diagnosis and treatment planning Adequate and minimally invasive nonsurgical preoperative preparation of the soft tissues Graft trimming and proper adaptation Soft tissue management with mucogingival approach (split thickness papilla incision-flap elevation-sutures) What are the primary limitations to success in this case? Inadequate preoperative nonsurgical therapy Poor handling of soft tissue Inadequate graft shaping Strict adherence to pre- and postoperative oral hygiene and maintenance PLAIN LANGUAGE SUMMARY: Bone or bone substitutes can be used to rebuild lost supporting bone in dental repairs. A female patient at risk of tooth loss because of gum infection and with a gap between two of her teeth was surgically treated with an ossifying collagen sponge (OSSIX Bone, Dentsply Sirona/Regenera","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046525","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":"Soft tissue grafting in healing chronic wounds: Two case studies.","authors":"Francisco J Otero-Cagide, Oscar Rodríguez-Estévez","doi":"10.1002/cap.10360","DOIUrl":"https://doi.org/10.1002/cap.10360","url":null,"abstract":"<p><strong>Background: </strong>A chronic wound occurs when it fails to heal resulting in a prolonged wound healing process. Traumatic and surgically induced wounds that do not heal as expected can be included in the term chronic wound. There is limited information about the management of this type of wound involving the periodontal tissues. These case studies show how soft tissue grafting may be used as a strategy to assist in the closure and enhancement of large wounds that present a chronic and complicated healing process.</p><p><strong>Methods and results: </strong>Two healthy adult patients presented open wounds induced by trauma following the dental treatment. These wounds were treated with autogenous soft tissue grafting to enhance and stimulate the healing process. In one case, enamel matrix derivative was applied in conjunction with a gingival graft. Both cases demonstrated a successful and rapid wound closure at the 1-week post-treatment.</p><p><strong>Conclusion: </strong>Using autogenous soft tissue grafting should be considered a treatment alternative when dealing with a chronic and problematic open wound. This study describes the success of two cases utilizing this approach. However, an understanding of the biological process of wound healing is critical when selecting a surgical technique for the treatment of a chronic wound.</p><p><strong>Key points: </strong>There is limited information in the periodontal literature about the management of chronic wounds caused by trauma. Critical understanding of the biological process of wound healing and application of surgical principles are essential in using autogenous soft tissue grafts to treat these wounds. Surgical factors such as extent, location of wound, and limited amount of autogenous donor tissue are primary limitations to the successful treatment of these cases.</p><p><strong>Plain language summary: </strong>Two cases that presented chronic wounds related to the periodontal tissues which were the result of surgical trauma are reported. These complicated healing wounds were managed with free autogenous soft tissue grafts. The grafts assisted the problematic wounds in healing by replacing missing tissue and providing growth factors. This mode of treatment for a chronic wound proved to be a successful approach in the management of this type of chronic wound.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041510","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":"Mesh-assisted regenerated site for alveolar ridge preservation: A case report.","authors":"John Zaki","doi":"10.1002/cap.10356","DOIUrl":"https://doi.org/10.1002/cap.10356","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The proposed technique utilizes the osteoconductive regenerative properties of bone-substitute materials (BSMs) and the space-maintaining function of titanium mesh to restore the alveolar ridge at extraction sites with lost labial plates in a single procedure. This approach may reduce the need for extensive ridge augmentation procedures, shorten treatment duration, minimize complications, and potentially lower overall costs for patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Both patients presented with hopeless dentition, characterized by chronic infection and loss of the labial plates. To regenerate the alveolar ridge, a titanium mesh was utilized in combination with a layered application of xenograft and allograft BSMs. The success of this technique depended on mesh stabilization, thorough site debridement, and the absence of soft-tissue tension.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The technique effectively restored the lost labial plates and regenerated sufficient bone to accommodate dental implants. Significant bone regeneration was achieved in both cases, with minimal complications. In one case, a minor mesh exposure occurred; however, it did not affect the healing and was managed during the re-entry surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The presented technique effectively regenerated the lost labial plates. It represents a novel alveolar ridge preservation approach to restore the alveolar ridge at extraction sites with lost labial bone plates, even in the presence of chronic infection. However, future studies with sound methodology, larger sample sizes, and long follow-up periods are recommended to validate these findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The Mesh-Assisted Regenerated Site (MARS) technique restores the alveolar ridge at sites with lost labial plates by combining the osteoconductive properties of bone substitutes with the space-maintaining function of titanium mesh in a single procedure. This approach may reduce the need for extensive augmentation, shorten treatment duration, minimize complications, and potentially lower long-term treatment costs. The success of this approach depends on minimally traumatic extraction, meticulous socket debridement, careful soft tissue management, and precise placement of titanium mesh and bone substitutes under optimal magnification. Although effective, this technique has limitations, including potential vertical bone loss, time-consuming procedures, possible need for additional augmentation, occasional challenges with mesh retrieval, and infection risk, all of which may compromise regeneration and implant success. Proper case selection and precise application of the technique are essential to mitigate these challenges and optimize clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;When teeth are removed, the surrounding bone can shrink. Techniques to preserve this area, known as alveolar ridge preservation, help prevent this shrinkage. This nove","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010681","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":"Digital analysis of periodontal phenotype in the maxillary anterior region.","authors":"Wenxin Li, Tingting Xu, Haiqi Zhang, Yang Lü, Qiao Yang, Jing Zhu, Yanan Xu, Yi Peng","doi":"10.1002/cap.10353","DOIUrl":"https://doi.org/10.1002/cap.10353","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Accurate assessment of the periodontal phenotype is crucial for optimizing esthetic outcomes in dental practice. This study systematically evaluated key periodontal parameters in the maxillary anterior region and analyzed their interrelationships to enhance diagnostic precision and inform personalized treatment planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Sixty-two periodontally healthy volunteers were included. Labial papilla height (PH), gingival zenith (GZ), the distance between the GZ of the lateral incisor and the gingival line (LID), height of contact surface (CS), crown width (CW), and crown length (CL) were measured using plaster models, intraoral photographs, and digital models obtained via intraoral scanning. Keratinized gingiva width (KGW) was assessed using a periodontal probe. Labial gingival thickness (GT) was measured at three locations-1 mm apical to the gingival margin, at the alveolar crest, and 2 mm apical to the crest-while labial alveolar bone thickness (BT) was evaluated at the alveolar crest and 2 mm apical to the crest, both using cone beam computed tomography (CBCT). Correlations among periodontal phenotype parameters were analyzed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Parameters measured from intraoral scanned digital models showed no statistically significant differences compared to plaster models (NS, P&gt;0.05). Varying degrees of correlation were identified among components of the periodontal phenotype, including GT, BT, KGW, PH, GZ, LID, and the ratios of CW to CL (CW/CL) and CS to CL (CS/CL).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Digital technology enables noninvasive, rapid, and precise assessment of periodontal phenotype, supporting risk assessment, and personalized treatment planning in aesthetic dentistry.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Digital methods yield precise periodontal phenotype analysis in aesthetic zones. Intraoral scanning and CBCT provide detailed periodontal phenotype parameters, revealing correlations with key esthetic factors like papilla height and gingival zenith. Correlation analysis between periodontal phenotype and key esthetic factors in the anterior maxilla enhances understanding of phenotype's impact on aesthetic outcomes and improves treatment planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This study aimed to improve how dentists assess the surrounding tissues in the front upper teeth, which is essential for achieving natural-looking and aesthetically pleasing results in dental treatments. Researchers analyzed the gum, tooth, and bone characteristics of 62 healthy volunteers using traditional plaster models, intraoral photographs, and digital scans. They measured key parameters including gum thickness, bone thickness, and other relevant features. The study found that digital scans provided results as accurate as the traditional plaster models. Furthermore, the researchers identified connections between different gum and tooth characteristics, such as how","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694422","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":"Vital root resection with regenerative retrograde vital pulp therapy: A case report.","authors":"Yi-Chu Wu, Constance Kang-Ting Teoh, Se Young Ryoo, Philip Kang, Leonard Garfinkel, Sahng G Kim","doi":"10.1002/cap.10346","DOIUrl":"https://doi.org/10.1002/cap.10346","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Vital root resection is a surgical procedure that involves the selective removal of a root of a multi-rooted tooth to preserve the remaining tooth structure and pulp, maintaining the vitality and function of the tooth. When combined with regenerative retrograde vital pulp therapy (rVPT), it may offer a less invasive and more cost-effective alternative to traditional root resection methods. The purpose of this article is to report the techniques and outcomes of vital root resection and rVPT for the periodontally involved fractured mesiobuccal (MB) root in a maxillary first molar.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This case report describes the treatment of a 56-year-old patient with a chief complaint of swelling and pain in her upper right quadrant and with the periodontally involved MB root of tooth #3 using vital root resection combined with rVPT. Tooth #3 was diagnosed as normal pulp and acute periodontal abscess with a suspected root fracture in the MB root. Upon root fracture detection, root resection and rVPT with amnion-chorion membrane and bioceramic material were performed, followed by guided tissue regeneration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Tooth #3 remained asymptomatic with confirmed osseous healing at 6 months, and gingival recession on the adjacent distobuccal root was successfully treated via connective tissue graft. Tooth #3 remained vital at 18 months without clinical and radiographic signs and symptoms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This case report highlights the potential of vital root resection using rVPT as a less invasive treatment modality that may preserve the tooth's vitality and function, offering a cost-effective alternative to more traditional methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The preservation of tooth function and vitality may be achieved through vital root resection combined with regenerative retrograde vital pulp therapy. Regenerative retrograde vital pulp therapy may be performed using a bioactive scaffold and bioceramic material. This biologically oriented approach may provide a less invasive and more cost-effective alternative to traditional root resection methods that require orthograde endodontic therapy followed by a permanent full-coverage restoration.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case report presents a minimally invasive dental procedure to preserve tooth function and vitality. A 56-year-old patient reported swelling and pain in the upper right part of her mouth. Examination of tooth #3 revealed an acute gum infection and a likely root fracture in one of the roots. The treatment involved vital root resection, which removes only the damaged root, and regenerative pulp therapy to enhance healing. The regenerative pulp therapy used bioactive materials, including an amnion-chorion membrane and bioceramics, to support tissue regeneration. After 6 months, the patient showed successful bone healing, and gum recession around the treated area was","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694424","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":"Guided transpositional bone blocks in esthetic zone: Surgical technique and case report.","authors":"Ming-Fu Ye, Dumitru Chele, Javier Calatrava, Abdusalam Alrmali, Wen-Xia Huang, Hom-Lay Wang","doi":"10.1002/cap.10352","DOIUrl":"https://doi.org/10.1002/cap.10352","url":null,"abstract":"<p><strong>Background: </strong>The ultimate objective of implant dentistry is to position the implant in a three-dimensional, prosthetic-driven location. This case highlights a guided approach for harvesting and positioning an autogenous bone block to restore a horizontal bone defect in the anterior maxilla.</p><p><strong>Methods: </strong>This case report describes a 55-year-old patient with horizontal bone deficiency in the anterior maxilla following teeth loss. Using specialized software, a surgical guide was designed to facilitate the harvesting of an autogenous bone block from the subnasal region in the same location where implants were planned to be placed. The graft was then repositioned and fixed with titanium screws, and the gaps were grafted with xenogenic bone particles and covered with an absorbable collagen membrane. After 6 months, the implants were placed, followed by prosthetic restoration.</p><p><strong>Results: </strong>A one-stage implant placement was performed after an uneventful healing period. The bone augmentation resulted in a ridge width of 8 mm for a net gain of 5 mm. After 4 months, the implants were loaded with a screw-retained zirconia bridge.</p><p><strong>Conclusion: </strong>Guided transpositional bone blocks offer a predictable approach to treating horizontal bone defects in the esthetic zone. Utilizing digital planning and surgical guides enhances precision, making the result more predictable.</p><p><strong>Key points: </strong>This case provides new information as it highlights a novel guided approach for harvesting and positioning an autogenous bone block to restore a horizontal bone defect in the anterior maxilla using a surgical guide. The keys to successful management of this case include using precise digital planning, the design and use of a surgical guide to accurately harvest the autogenous bone block, proper fixation of the graft and ensuring an uneventful healing period before implant placement and prosthetic restoration. The primary limitations to success in this case could involve the challenge of having adequate distance away from the nasal floor for harvesting and repositioning the autogenous bone block and potential complications during the healing period.</p><p><strong>Plain lanuage summary: </strong>This report describes a modern technique for addressing bone loss in the upper front part of the mouth, crucial for placing dental implants correctly. A 55-year-old patient with insufficient bone was treated using a digital plan to precisely guide the movement of a bone piece from a nearby area to where it was needed. This guided approach involved designing a custom guide with computer software, securely attaching the bone, and using special materials to aid healing. After 6 months, the dental implants were successfully placed and fitted with new teeth, resulting in a stable and natural-looking outcome.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659449","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":"Gingival odontogenic keratocyst presenting as pseudoinfection: Inclusion of demonstrative case report and review.","authors":"John K Brooks, Sami Abu Alhuda, Pareesa Malik, Jeffery B Price, Camille E Alexander, Ahmed S Sultan","doi":"10.1002/cap.10350","DOIUrl":"https://doi.org/10.1002/cap.10350","url":null,"abstract":"<p><strong>Background: </strong>The peripheral odontogenic keratocyst (POKC) is a rare developmental odontogenic cyst and represents the soft tissue counterpart of the more common intraosseous variant. Although the majority of POKCs have been discovered on the gingiva, scant information is available in the periodontal literature.</p><p><strong>Methods: </strong>A 69-year-old man presented with a painless, red fluctuant-like papular lesion on the maxillary anterior labial gingiva. The adjacent teeth had vital pulpal responses and normal gingival probing depths. A subtle radiolucency with corticated borders was evident overlying the apical third of the roots. The patient recalled receiving local anesthesia in this site 3 months ago in conjunction with dental restorative treatment.</p><p><strong>Results: </strong>An excisional biopsy was performed and pus-like material extruded from the surgical specimen. The histopathologic diagnosis was POKC.</p><p><strong>Conclusion: </strong>With the inclusion of this report, at least 31% (14/45) of cases of gingival OKC have mimicked infection by exhibition of a fluctuant consistency and/or extrusion of thick luminal fluid that contains keratin and resembles purulence. Due to the high recurrence rate, affected patients should be followed for at least 5-7 years.</p><p><strong>Plain language summary: </strong>This article features a rare example of the peripheral odontogenic keratocyst (POKC) on the gingiva. The lesion was initially suspected to be an infection and appeared as a painless, red compressible growth on the maxillary anterior labial gingiva of an older adult male. A dental radiograph revealed a subtle radiolucency with corticated borders. A biopsy was performed to determine the diagnosis. Affected patients must continue to be monitored for lesional recurrence.</p><p><strong>Key points: </strong>The gingival odontogenic keratocysts may be adherent to the overlying mucosa and warrant supraperiosteal dissection during excisional biopsy to reduce lesional recurrence. At least 31% of published cases of gingival odontogenic keratocysts have featured an infection-like clinical presentation. Due to the high rate of lesional recurrence, affected patients should undergo yearly follow-up clinical assessments for at least 5 years, as informed by the current evidence.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574431","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":"Tenting screw-assisted membranes alveolar ridge augmentation in the anterior mandible.","authors":"Fabrizio Belleggia","doi":"10.1002/cap.10348","DOIUrl":"https://doi.org/10.1002/cap.10348","url":null,"abstract":"<p><strong>Background: </strong>Vertical ridge augmentation with a guided bone regeneration procedure in the anterior mandible requires membrane lingual stabilization. Until now, the only predictable way was the use of titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membranes stabilized with self-drilling screws, which require large flaps for both placement and removal. This case report introduces a technique that does not require any membrane lingual fixation.</p><p><strong>Methods: </strong>A tenting screw was placed in the middle of an anterior mandibular defect. A small TR-dPTFE membrane was bent 90° to take an L shape and be positioned crestally and lingually to the defect. Then, a larger collagen membrane (CM) was sutured with absorbable stitches to its more lingual and apical part. The TR-dPTFE membrane was stabilized on top of the tenting screw with its cap screw. A mixture of autogenous and porcine bone in a 1:1 ratio filled the defect. Then, the CM was moved toward the buccal side and stabilized with pins. After 8 months, the site was re-opened, the TR-dPTFE membrane and the tenting screw were removed with a small lingual envelope flap, two implants were inserted in the augmented bone and healing abutments applied.</p><p><strong>Results: </strong>A screw-retained bridge was delivered 6 weeks after implant insertion and the 2.5-year follow-up showed perfectly maintained hard and soft tissues.</p><p><strong>Conclusions: </strong>The stabilization of both membranes to the tenting screw reduced morbidity at re-entry avoiding a large lingual flap, while CM allowed graft revascularization from the periosteum, and resulted in optimal quality of the regenerated bone.</p><p><strong>Key points: </strong>Titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membranes require stabilization with pins or screws at the recipient site and large flaps for both placement and removal. On the lingual side of the anterior mandible the use of miniscrews is difficult and invasive, while the use of a tenting screw, placed vertically in the middle of the defect, allows for a simple and easy membrane stabilization and removal. Two membranes are utilized: a small TR-dPTFE membrane, that is stabilized to the tenting screw with its cap screw, and that does not allow to a collagen membrane (CM), that is sutured to the TR-PTFE membrane to cover the exposed part of the defect, to collapse over the bone deficiency. The CM, that covers the majority of the defect, after its biodegradation, allows graft revascularization from the periosteum, and results in optimal quality of the regenerated bone.</p><p><strong>Plain language summary: </strong>Vertical bone defects of the jaws require bone augmentation procedures to allow the correct implants insertion to rehabilitate the masticatory function and aesthetics of patients. Among these techniques, guided bone regeneration is one of the most widely used. This technique is based on the use of non-absorbable t","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}