Clinical Advances in Periodontics最新文献

{"title":"Utilizing partially demineralized dentin plate for horizontal ridge augmentation: A case report","authors":"Pooyan Refahi, Samar Shaikh","doi":"10.1002/cap.10291","DOIUrl":"10.1002/cap.10291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This article intends to showcase a case of guided bone regeneration (GBR) utilizing a partially demineralized dentin plate processed from an extracted second molar for horizontal augmentation of the posterior ridge for implant placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>A 60-year-old patient presented with horizontal ridge deficiency at site #30 and an endodontically treated tooth #31 with recurrent decay. A treatment plan was proposed to extract tooth #31 and utilize a dentin graft from the tooth for ridge augmentation at site #30. Following the atraumatic extraction of tooth #31, it was sectioned into a 1 mm thick dentin plate, sterilized, and processed to obtain a demineralized dentin graft. Following a mid-crestal incision and full-thickness flap elevation, the dentin plate was adapted on the buccal defect of site #30 with 10 mm fixation screws, and the gap between the plate and the buccal bone was filled with 0.5 cc of 50/50 cortico-cancellous bone allograft hydrated with saline, covered with collagen membrane followed by primary closure. At 6 months, a postoperative cone-beam computed tomography (CBCT) was obtained to evaluate the ridge width revealing sufficient ridge width for optimal implant placement. The radio-opaque dentin plate was visible on the CBCT depicting integration with the alveolar ridge. Following surgical implant preparation protocol, a 4 mm diameter and 8.5 mm length implant was placed in a restoratively driven position.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case reports favorable outcomes for GBR using a partially demineralized dentin plate as an alternative to an autogenous bone block graft for horizontal ridge augmentation for future implant placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>This case introduces a novel method utilizing partially demineralized dentin plates derived from extracted teeth for guided bone regeneration, showcasing its potential efficacy in addressing ridge deficiencies.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Success, in this case, relies on meticulous sectioning of the tooth and processing of the dentin graft, precise adaptation and fixation of the graft to the residual ridge, and achieving primary closure for undisturbed healing.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Limitations to success include the availability of teeth for extraction coinciding with the need for ridge augmentatio","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"63-68"},"PeriodicalIF":0.9,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867724","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":"Tooth autotransplantation outcomes using platelet-rich fibrin: A promising approach; case study","authors":"Fatemeh SamavatiJame,&nbsp;Abdusalam Alrmali,&nbsp;Pablo Galindo-Fernandez,&nbsp;Sandra Stuhr,&nbsp;Hom-Lay Wang","doi":"10.1002/cap.10287","DOIUrl":"10.1002/cap.10287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Autogenous tooth transplantation refers to a surgical procedure involving the relocation of a tooth within the same individual. Incorporating platelet-rich fibrin (PRF) in this procedure holds the potential to improve healing, accelerate recovery, and optimize treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this article, the authors illustrate a PRF-based approach for autogenous tooth transplantation through two case scenarios. These cases outline the surgical steps of tooth transplantation and demonstrate the potential role of PRF in enhancing soft tissue healing. Furthermore, the article provides insights from a long-term follow-up spanning over 7 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tooth transplantation in young adults is promising but depends on factors such as root development stage and donor tooth size matching. Including PRF may improve healing, at least in the short term, due to its rich concentration of growth factors and cytokines, promoting effective tissue regeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Autogenous tooth transplantation has shown to be a viable treatment option for replacing the missing dentition. Adding PRF to the autogenous tooth transplantation procedure may speed up and enhance the treatment outcome. While the favorable results of these cases might be partially attributed to the use of PRF, the contribution of PRF to the healing process of tooth transplant remains conjectural and requires validation through additional research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <p>Tooth autotransplantation can be performed in younger patients without requiring root canal treatment, while also potentially benefiting from the incorporation of platelet-rich fibrin (PRF).</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"31-38"},"PeriodicalIF":0.9,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869084","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":"Soft and hard tissue evaluation of guided socket shield implant cases","authors":"Pedro M. Trejo,&nbsp;Raysa Rivas,&nbsp;Corletta C. Trejo,&nbsp;Seiko Min,&nbsp;Arisa Nishikawa","doi":"10.1002/cap.10290","DOIUrl":"10.1002/cap.10290","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The socket-shield (SS) technique results in long-term functional osseo- and dento-integration, preserving the dimensional stability of hard and soft tissues over time. This study aimed to describe the successful implementation of a surgical technique to facilitate “SS” cases.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cases included males and females aged 32–81 years consecutively treated between 2020 and 2023 (longest follow-up, 3.5 years). For each case, pre- and post-operative cone-beam computed tomography (Digital Imaging and Communications in Medicine files) and intraoral optical scans (IOS; STL files) were performed. Digital immediate implant placement and simultaneous tooth extraction and SS production were planned using an implant planning software. Implants were planned considering sagittal-ridge and tooth-root angular-configuration. Surgical guides were used to perform the digitally-supported SS technique. All cases were planned and surgically performed by one operator (Pedro M. Trejo). Preoperative digital IOS-models were superimposed to post-operative models to assess soft-tissue changes. Pre and post sagittal views were used to assess the radiographic buccal-plate thickness at various healing times. An investigator not involved with case planning or treatment performed measurements.&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;Results reflected soft-tissue stability with minimal mean thickness change at 0-, 1-, 2-, and 3-mm measurement levels of 0.03, -0.2, 0.14, -0.07, and 0.04 mm, respectively, with a mean gingival-margin change of 0.04 mm. The free gingival-margin change ranged from a 0.58-mm gain in height to a -0.57-mm loss. The mean radiographic buccal-plate thickness post-operatively was 2.04 mm (range, 0.7–2.9 mm).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The digitally-supported guided SS technique enables predictable immediate implant-placement positions and stable buccal peri-implant soft and hard tissues over time.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Why are these cases new information?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;The uniqueness of the surgical technique described herein is that it results in favorable positions of immediate, socket-shielded (SSed), implant placements, with soft- and hard-tissue stability as the byproduct.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the keys to successful management of these cases?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"54-62"},"PeriodicalIF":0.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674631","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":"Correcting mucogingival deformities for pescatarian patients: A clinical case study","authors":"Hyung Jae Jung,&nbsp;Nadeem Karimbux,&nbsp;Irina F. Dragan","doi":"10.1002/cap.10289","DOIUrl":"10.1002/cap.10289","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 clinical case study is to highlight the improvement of periodontal health of mandibular canines using a soft tissue alternative of fish origin, a piscine graft.&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 37-year-old female patient was referred to a periodontal practice for evaluation of mucogingival deformities around teeth #22 and #27 that were also diagnosed with recession, lack of keratinized tissue (KT), and bilateral high frenum attachment. Multiple soft tissue treatment options were presented to the patient, including autogenous, allograft, or xenograftporcine or piscine.&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;Given the patient's dietary preference, piscine option was preferred. The procedures were completed one at a time, first #22 and later #27, using the standard of care procedures for correcting mucogingival deformities using soft tissue alternatives. Post-surgical visits were scheduled at regular intervals (2, 4, 12, 24, 52 weeks) to evaluate the clinical outcomes. Healing was uneventful and clinical outcomes reveal correction of the mucogingival deformities. The amount of KT at the 52 weeks healing time, measured using an intraoral scanner was 2.12 mm on #22 and 1.78 mm on #27.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Within this clinical case's scope, piscine xenograft demonstrates to be a safe and effective soft tissue alternative to correct mucogingival deformities, increasing the KT width and achieving recession coverage. In addition, integration of patient's preference may lead to increased case acceptance and patient compliance.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What new information is this case providing?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;The use of a soft tissue alternative of piscine origin that was selected based on the patient's preference to correct bilateral combined mucogingival deformities (recession, lack of KT, and aberrant frenum attachment) around teeth.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What is a key step to integrating this soft tissue alternative in clinical practice?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;The pre-hydration of the soft tissue alternative is preferred, compared to other soft tissue alternatives that might not require hydration (xenograft bovine origin).&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the limitations to success in this case?&lt;/b&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"48-53"},"PeriodicalIF":0.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140672172","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":"Maxillary sinus augmentation via the bone lid technique: A prospective, radiographic case series","authors":"Rossana Izzetti,&nbsp;Chiara Cinquini,&nbsp;Marco Nisi,&nbsp;Niccolò Baldi,&nbsp;Filippo Graziani,&nbsp;Antonio Barone","doi":"10.1002/cap.10288","DOIUrl":"10.1002/cap.10288","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Maxillary sinus augmentation is one of the most performed procedures to increase the bone quantity of the atrophic maxilla to allow implant placement. The aim of the present case series was to describe a surgical protocol to perform maxillary sinus augmentation with the “bone lid technique,” and its outcomes in a cohort of patients eligible for the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>After the initial clinical evaluation, a cone-beam computed tomography (CBCT) examination was performed for preoperative assessment. Patients were then scheduled for surgical intervention. At 6–9 months follow-up, patients underwent a second CBCT scan to evaluate bone height following bone graft and to schedule implant placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 patients were enrolled in the study with a total of 13 sinus lift procedures. Membrane perforation was registered in 4 cases (30.76%). Mean surgical time was 67.69 min (SD 6.51). Postoperative period was uneventful in all patients, in the absence of complications. The mean graft volume increase was 2.46 cm³ (SD 0.85), and the mean height increase was 14.27 mm (SD 3.18). Mean membrane thickness was 1.40 mm (SD 0.75). In all the 4 cases with sinus membrane perforation, the membrane had a thickness lower than 1 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present study highlights that the maxillary sinus augmentation with bone lid repositioning could provide repeatable results in terms of bone height increase. The technique appears reliable both in terms of bone gain and absence of complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>The bone lid technique for maxillary sinus augmentation provides repeatable results in terms of bone height increase. The favorable clinical outcomes can be related to an enhancement of bone formation due to the unique osteoconductive and osteoinductive properties of autogenous bone, along with a reduction of soft tissue ingrowth.</li>\u0000 \u0000 <li>Complications were not observed in any of the patients following the surgical procedures.</li>\u0000 \u0000 <li>The risk of Schneiderian membrane perforation is inversely proportional to membrane thickness; the thinner the membrane is, the higher the risk to perforate it.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"39-47"},"PeriodicalIF":0.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140676117","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":"Enhancing root coverage and esthetic outcomes in isolated gingival recession using orthodontic intervention and lateral closed tunnel technique: An interdisciplinary prospective case series","authors":"Neelima Katti,&nbsp;Rimsha KP,&nbsp;Ashish Kumar Barik,&nbsp;Surya Kanta Das,&nbsp;Srivani Peri,&nbsp;Devapratim Mohanty","doi":"10.1002/cap.10285","DOIUrl":"10.1002/cap.10285","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;Gingival recession (GR) in malposed tooth in association with bone dehiscence and/or fenestration poses a challenge for successful root coverage treatment. Lateral closed tunnel (LCT) technique is particularly useful in isolated GR in mandibular anterior region, where the shallow vestibular depth prevents tension-free coronal mobilization of tissues.&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;Twenty patients with GR associated with tooth malposition were treated using a combined orthodontic—periodontic approach with a torquing auxiliary spring followed by LCT technique.&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;The two techniques resulted in a combined recession depth reduction from 3.75 ± 1.14 mm to 0.40 ± 0.50 mm at the end of 6-month study period. The orthodontic intervention led to an increase in labial marginal bone levels, as assessed through cone beam computed tomography (CBCT), while the LCT achieved closure of residual recession defect. Also, an increase of keratinized tissue width from 0.81 ± 0.88 mm at baseline to 3.30 ± 0.67 mm at 6 months was achieved. Mean root coverage percentage (MRC%) of 91.40% + 10.25% was seen, with 11 out of 20 sites (55%) showing complete root coverage (CRC).&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;Single tooth orthodontic repositioning followed by LCT technique proved effective in successfully managing isolated recession defects in the mandibular anterior gingival region, which often presents challenging mucogingival conditions. The precise single tooth repositioning resulted in labial marginal bone augmentation, while the LCT surgical approach allowed residual defect closure.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Why are these cases new information?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Correction of single tooth malposition is achieved before recession coverage treatment to achieve a favorable environment for graft uptake. The reduction in denuded root surface along with the bone remodeling results in increasing the ratio of vascular to avascular region, thus improving the overall prognosis of the treatment.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the keys to successful management of these cases?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;The lateral closed tunnel technique involves creating a mucoperiosteal tunnel to close the recession site. Precision is crucial to avoid damage to surrounding tissues. The rec","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"14-24"},"PeriodicalIF":0.9,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified coronally advanced flap technique in the treatment of fibrous epulis: A case report with 1-year follow-up","authors":"Kaixin Zheng,&nbsp;Yuan Zhang","doi":"10.1002/cap.10286","DOIUrl":"10.1002/cap.10286","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;Currently, the treatment of epulis is primarily surgical excision, which would greatly affect the aesthetics of patients if happened in the anterior region. It's challenging for clinicians to balance the aesthetic after surgery and less surgical trauma. To overcome this disadvantage, the authors propose the modified coronally advanced flap technique which applies the principles of minimally invasive surgery to provide satisfactory therapeutic results in fibrous epulis.&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;We report a case of an 18-year-old female with the chief complaint of a gingival swelling in the right upper anterior region. After the initial periodontal therapy, the modified surgical approach was applied to this patient. Unlike conventional coronally advanced flap technique, an additional incision was made, and the free portion was rotated into the adjacent space to completely cover the trauma, which avoided the use of the second operative zone.&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;The gingiva recovered with normal color, contour, and consistency after surgery, the papilla filled up the proximal space well and was in good harmony with the adjacent papillae. The surgical results remained stable during the follow-up period.&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 use of modified coronally advanced flap technique allows the clinician to successfully resume the natural appearance of gingiva in the treatment of fibrous epulis, as well as simplify the surgical approach, shorten the operative time, and demonstrate no tendency of recurrence.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Why is this case new information?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;This novel technique not only removes the epulis, but also takes into account the postoperative aesthetics of the surgery at the same time.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This minimally invasive surgical technique reduces operative time and increases patient comfort.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;p&gt;Keys to successful management of this case are as follows: (i) Adequate preoperative assessment of the location of the additional incision; (ii) tension-free coronal flap advancement.&lt;/p&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the primary limitations to success in this case?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Clinical studies with long-term outcomes of this approach are needed.&lt;/l","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"25-30"},"PeriodicalIF":0.9,"publicationDate":"2024-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208323","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 nasal spine suture: A novel approach for membrane stabilization","authors":"William E. Bane,&nbsp;Gary M. Blyleven,&nbsp;Adam R. Lincicum,&nbsp;Brian W. Stancoven,&nbsp;Kimberly A. Inouye,&nbsp;Thomas M. Johnson","doi":"10.1002/cap.10279","DOIUrl":"10.1002/cap.10279","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;Current evidence acknowledges guided bone regeneration (GBR) as a predictable therapeutic modality in the augmentation of a deficient alveolar ridge. Such deficiencies often reveal inadequate bone volume to support implant placement in a position amenable to prosthetic reconstruction. Additionally, an evolving body of literature demonstrates that membrane fixation may lead to improved clinical bone gain through positively influencing blood clot formation, stability, and the eventual osteogenic potential of the defect. Alternative benefits to membrane fixation, such as reduced graft displacement and reduction in wound micromotion, have also been cited as mechanisms for an increased regenerative response.&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;The aim of this report was to present a case, including diagnosis, treatment, and follow-up for the reconstruction of a horizontal ridge deficiency. The patient's deficiency in ridge volume was found to be a developmental sequelae of lateral incisor agenesis, resulting in an underdeveloped midfacial region of the alveolar process subjacent to sites #7 and #10. The fixation protocol outlined in this report demonstrated adequate horizontal ridge augmentation to facilitate future prosthetic reconstruction with the use of implants.&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;Numerous protocols have been established in an attempt to achieve effective barrier membrane stabilization for bone augmentation procedures. However, some techniques are poorly suited for the anatomically challenging region of the anterior maxilla. A case report describing the utilization of the anterior nasal spine for anchorage of a membrane-stabilizing suture may present a novel, safe, and effective technique for stabilizing the intended region of augmentation, as well as preventing graft migration beyond the membrane–maxilla interface.&lt;/p&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;Regarding guided bone regeneration (GBR) procedures, micromotion of the membrane or of the underlying particulate graft may negatively influence the volume of the augmented site.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;The ability to adequately stabilize the graft–membrane interface is recognized as a necessary prerequisite to predictably achieve optimal surgical outcomes.&lt;/p&gt;\u0000 &lt;/li&gt;\u0000 \u0000 &lt;li&gt;\u0000 &lt;p&gt;To the authors’ knowledge, there is no","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"300-309"},"PeriodicalIF":0.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133361","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":"Non-surgical and guided-bone-regeneration surgical management of Type-3b dens invaginatus with an apico-marginal defect: A case report","authors":"Aaliya Rahman,&nbsp;Sharique Alam,&nbsp;Afaf Zia,&nbsp;R. K. Tiwari,&nbsp;S. Mukhtar Un Nisar Andrabi,&nbsp;Maahin Mahmood","doi":"10.1002/cap.10283","DOIUrl":"10.1002/cap.10283","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;Dens invaginatus (DI), an unusual developmental anomaly is a challenge for the operating dentist with regard to its diagnosis and treatment. This case report presents the successful management of a Type-3b DI in a permanent maxillary lateral incisor associated with a large radicular cyst and communicating apico-marginal defect (Von Arx type IIb).&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 19-year-old female patient reported pain and palatal swelling. During the clinical examination, tooth #12 exhibited tenderness to percussion, and presented a deep periodontal pocket depth (PPD) of 12 mm, along with grade I mobility. Radiographic examination revealed a large peri-radicular radiolucency with atypical tooth morphology. Cone beam computed tomography clarified the complicated root canal anatomy to be Type-3b DI associated with an apico-marginal defect. The case was managed successfully by non-surgical endodontic therapy followed by surgical intervention utilizing a guided bone regenerative (GBR) approach. Eighteen-month follow-up showed an asymptomatic and functional tooth with a significant reduction in pocket depth. The periapical radiographs showed continued healing of the osseous defect.&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 successful healing outcome of a challenging case, characterized by a complex DI morphology, a large peri-radicular lesion, a through-and-through defect, and a combined endodontic-periodontal apico-marginal defect was achieved through accurate diagnosis, treatment planning, and execution using contemporary endodontic and periodontal treatment techniques. The application of GBR techniques during the surgical phase of treatment may have contributed to the improved regenerative healing outcome in this case, which was initially considered prognostically questionable.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key points&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Why is this case new information?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Type-3b DI exhibits a complex root canal structure, each case displaying unique characteristics, necessitating a case-specific treatment plan. In this case report the Type-3b DI morphology was associated with a large peri-radicular, through and through defect and combined endodontic periodontal apico-marginal defect. The treatment approach involved incorporating guided bone regenerative (GBR) principles during the surgical phase. This case report contributes to the existing evidence on the diagnosis and successful management of Type-3b DI with a concurrent apico-marginal defect.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"276-283"},"PeriodicalIF":0.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141221","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 coronally advanced flap to treat gingival recession: Digital workflow and case report","authors":"Mauro Pedrine Santamaria,&nbsp;Amanda Rossato,&nbsp;Manuela Maria Viana Miguel,&nbsp;Ingrid Fernandes Mathias-Santamaria,&nbsp;Marcelo Pereira Nunes,&nbsp;Lucas Araújo Queiroz","doi":"10.1002/cap.10282","DOIUrl":"10.1002/cap.10282","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The inherently technique-sensitive nature of periodontal plastic procedures demands a significant level of skill and expertise. The incorporation of three-dimensional (3D) printing technologies emerges as a potential strategy to optimize and simplify surgical procedures. This case report describes the digital workflow and presents the clinical outcomes achieved using a guided coronally advanced flap for the treatment of a single gingival recession (GR).&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 female patient with a gingival recession type 1 (RT1 B-) defect on the mandibular second left premolar underwent successful treatment using a guided coronally advanced flap (g-CAF) and de-epithelized connective tissue graft (CTG). The digital planning included intraoral scanning of the mandible and hard palate using an intraoral scanner, with resulting polygon format (PLY) files exported for virtual model creation. The CAF guide was meticulously designed to orient horizontal and vertical incisions at the papillae base adjacent to the GR defect. For the donor site, a guide was specifically created, positioning the graft area 2 mm apically to the premolars' gingival margins. The delineation of this area involved two horizontal and vertical incisions, meticulously based on the dimensions of the GR. The digitally designed guides were then 3D-printed using a surgical guide-specific resin, contributing to the precise execution of the innovative surgical approach. Complete root coverage was achieved.&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 demonstrates that g-CAF can be a promising approach for the treatment of single GR.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Highlights&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;Why is this case new information?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;To the best of the authors' knowledge, this is the first manuscript to report a guided procedure for the treatment of gingival recession.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;This report provides the digital workflow for the fabrication of a guide to perform the coronally advanced flap for single recession defects.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the keys to successfully manage this case?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;It is necessary to adequately scan the recession defect area and palate.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Properly not only design the guide using specific software but also print it.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;The guide","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"7-13"},"PeriodicalIF":0.9,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095217","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}