Clinical Advances in Periodontics最新文献

{"title":"Histologic wound healing in studies using different ridge preservation protocols: A review","authors":"Brian L. Mealey, Francis Keeling, A. Archontia Palaiologou","doi":"10.1002/cap.10281","DOIUrl":"10.1002/cap.10281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Alveolar ridge preservation (ARP) procedures are designed to lessen dimensional changes in the alveolar ridge after tooth extraction. Wound healing after ridge preservation involves the formation of new vital bone in the former socket, and this vital bone is important in the osseointegration of dental implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A series of ARP studies have been performed to help clinicians better understand the wound-healing events that occur following tooth extraction and ridge preservation. Different protocols have been examined using various materials and periods of healing time prior to implant placement. The primary aim of these studies was to ascertain the relative percentage of vital bone formation, residual graft material, and connective tissue (CT)/other at the healing site using histomorphometric examination of bone core biopsies obtained during osteotomy preparation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For allografts, the use of demineralized bone alone or in combination with mineralized is associated with more vital bone formation than the use of mineralized allograft alone. For mineralized allografts, the use of cortical versus cancellous bone has only minimal impact on new bone formation. Xenografts from bovine and porcine sources appear to have similar vital bone formation. Longer healing times prior to implant placement are associated with increased vital bone formation and decreased residual graft material. The most stable component in most studies is the percentage of CT/other.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The percentage of vital bone and residual graft at ARP sites is dependent on the materials used and the length of healing time prior to obtaining core biopsies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Points</h3>\u0000 \u0000 <div><b>What factors may affect the amount of new bone at the ARP site?</b>\u0000 \u0000 <ol>\u0000 \u0000 <li>At a time point about 4 months after ARP, the type of graft material used for ARP plays a large role in new bone formation.</li>\u0000 \u0000 <li>Studies focus on means and standard deviations, but patients often do not “follow the mean.” Even if a single ARP protocol is used for all patients, there is great interindividual variability in new bone formation, and there is often variability between sites within a single patient.</li>\u0000 </ol>\u0000 </div>\u0000 \u0000 <div><b>How long after ARP with an allograft should I wait ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 1","pages":"52-62"},"PeriodicalIF":0.7,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051108","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":"Epithelial cyst following subepithelial connective tissue graft: A case report","authors":"Julien de Paula, Luise A. B. da Silva, Mariane A. S. Wayar, Eduardo B. Campagnoli, Fábio A. dos Santos","doi":"10.1002/cap.10284","DOIUrl":"10.1002/cap.10284","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Various surgical approaches have been employed to manage gingival recession, including subepithelial connective tissue grafting, which has yielded favorable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>We present the case of a 17-year-old patient who developed gingival recession on tooth #6 following an esthetic crown lengthening procedure. The recession was treated with a subepithelial connective tissue graft; however, this case details the occurrence of two epithelial cysts adjacent to the region subjected to the surgical procedure, 6 months after surgery. The treatment involved periodontal surgical intervention, during which the lesions were completely excised and the associated osseous defect was filled using an inorganic bovine bone matrix along with a collagen membrane. The healing progressed without any complications. Histopathological analysis revealed the presence of cystic lesions, which were characterized by a cystic cavity lined with stratified orthokeratinized epithelium with cuboidal cells in some areas surrounded by fibrous connective tissue. The patient's progress was monitored through tomography performed 6 months, 1 year, and 5 years post-procedure, all of which demonstrated the absence of any signs of lesion recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case study emphasizes the effectiveness and predictability of subepithelial connective tissue grafting in the treatment of gingival recession. However, dental professionals should be cautious about the potential risk of gingival recession following esthetic crown lengthening procedures and recognize the potential complications associated with subepithelial connective tissue grafting, such as the observed development of epithelial cysts in this specific case.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <p><b>Why is this case new information?</b></p>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>We present a case of an epithelial cyst following a subepithelial connective tissue graft, which resulted in buccal cortical bone resorption. The treatment involved excisional biopsy and the use of an inorganic bovine bone matrix with a collagen membrane.</li>\u0000 </ul>\u0000 <b>What are the keys to the successful management of this case?</b></div>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Successful treatment included periodontal surgery, bone defect filling using an inorganic bovine bone matrix and a collagen membrane, and regular monitoring with CT scans at 6 months, 1 y","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"290-299"},"PeriodicalIF":0.9,"publicationDate":"2024-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013770","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 assessment of supracrestal tissue attachment and its correlation with dentogingival components","authors":"Hesham H. Abdulkarim, Nathan M. Antoine, Mary Ying-Fang Wang, Elio Reyes Rosales, D. Douglas Miley","doi":"10.1002/cap.10280","DOIUrl":"10.1002/cap.10280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study is to measure, in vivo, the supracrestal tissue attachment dimensions (STADs) by means of a noninvasive digital method and to investigate the association between STADs and gingival thickness (GT), tooth position, tooth length, tooth width, keratinized tissue width (KTW), buccal bone thickness (BBT), and bone crest (BC) level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nineteen periodontally healthy subjects who previously received full mouth periodontal charting, cone beam computed tomography, and intraoral scan for the purpose of implant planning were included in the study. A digital imaging software was used for the superimposition of Digital Imaging and Communications in Medicine and stereolithography files, along with hard and soft tissue measurements. Pearson's correlation and ANOVA statistical analyses were used to investigate potential trends between STADs and other dentogingival components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 203 teeth were assessed, with an average STADs of 2.05 mm (±0.99 mm). STADs were larger in mandibular than maxillary teeth (<i>p</i>-value <0.001) and decreased from anterior to posterior teeth. STADs exhibited an inverse relationship with BBTs and GTs (<i>p</i>-value <0.001) and the KTW (<i>p</i>-value = 0.05). Positive correlations were found between GT and BBT (<i>p</i>-value <0.001), whereas both were negatively correlated with the distance between the cementoenamel junction and BC (<i>p</i>-values 0.019 and 0.006, respectively) and positively correlated with KTW (<i>p</i>-value <0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlighted the dynamic nature of STA relative to tooth position. Additionally, it explored the intricate relationships of STADs with various dentogingival components.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>To the best of the authors’ knowledge, this study represents the first application of CBCTs, intraoral scans, and clinical probe depths for noninvasive supracrestal tissue attachment measurements.</li>\u0000 \u0000 <li>This study advocates for a personalized assessment of supracrestal attachments, incorporating tooth position and other dentogingival components.</li>\u0000 \u0000 <li>The study emphasizes the importance for practition","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"310-318"},"PeriodicalIF":0.9,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725140","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":"Microsurgical approach for the management of gingival cleft: A case series and decision-making process","authors":"Saravanan Sampoornam Pape Reddy, Balaji Manohar","doi":"10.1002/cap.10277","DOIUrl":"10.1002/cap.10277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival clefts, once known as “Stillman's Cleft”, now considered an obsolete phenomenon, cannot be neglected in clinical practice, especially when it is persistent and epithelialized. The attached gingiva and alveolar mucosa are composed of epithelial layers with subjacent connective tissue. Gingival clefts, notwithstanding their intrinsic differences, may exhibit keratinized or non-keratinized tissue. Coupled with additional risk factors, it can result in progressive attachment loss and gingival recession.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two cases with three distinct types of gingival clefts were described. Case 1 was identified as having a 2 mm white cleft coupled with lack of attached gingiva, while Case 2 was described as having a 3 mm white and red cleft which were treated with gingival cleft approximation subsequent to connective tissue grafting, non-surgical periodontal therapy and cleft approximation, respectively. The diagnostic confirmation was verified using an operating microscope set at a magnification of 5×, while the subsequent surgical stages were carried out with a magnification of 8×. These treatments yielded complete elimination and closure of the gingival clefts in addition to increased width of attached gingiva and soft tissue phenotype in Case 1 where bilaminar approach was utilized. The three clefts were effectively addressed using an operating microscope for both non-surgical and surgical interventions in the cleft management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All the three clefts exhibited complete elimination and closure of the gingival cleft. At 3 years follow up, there was reduction of the probing depth (1 mm) and attachment gain (1 mm) in all the three clefts. There was increase in width of attached gingiva to 3 mm and increase in soft tissue thickness in Case 1, where connective tissue graft was utilized. As microsurgical treatment approach was employed, the patients did not manifest with any intra-operative or postoperative complications. The first case showed the presence of soft tissue bulk at the treated site warranting debulking at 12 months postoperatively. The stability of the width of attached gingiva was maintained over the course of the 3-year follow-up period. The use of a microsurgical method in these settings enhances the predictability of outcomes than a macrosurgical approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The utilization of microsurgical techniques for the closure of gingival clefts allows for the accurate and meticulous insertion and placement of grafts, resulting in improved outcomes and enhanced a","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"259-268"},"PeriodicalIF":0.9,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492778","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":"Uncovering of transplanted connective tissue graft: Clinical and histological evaluation","authors":"Adriano Fratini, Leonardo Mancini, Margherita G Liguori, Stefano Gotti, Enrico Marchetti","doi":"10.1002/cap.10278","DOIUrl":"10.1002/cap.10278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontal plastic surgery aims to restore recessions and dehiscence around teeth and implants. Several techniques, such as subepithelial connective tissue graft (CTG), were proposed with the main outcome of improving volume and root coverage. Nevertheless, this surgery might not improve the keratinized tissue width. Thus, the primary aim of this case report was to describe the possible increase in keratinized tissue after a subepithelial CTG and simultaneously use the previously harvested graft as a source for covering an adjacent tooth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 38-year-old patient presented brushing discomfort 2 years after undergoing periodontal plastic surgery with a CTG from the palate to cover a recession. Despite the increased thickness of the soft tissue, brushing discomfort was not reduced because the tissue quality remained unchanged. Therefore, a surgical procedure in the area of teeth 3.2–3.4 was performed to remove the more superficial masticatory mucosa and to induce keratinization of the previously grafted connective tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 6 months, the epithelium appears to be clinically and histologically keratinized, with characteristics comparable to those of the original tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The connective tissue grafted maintains the potential to induce keratinization over time, if it is exposed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p><b>Why is this case new information?</b></p>\u0000 \u0000 <p>To the best of our knowledge, this is the first case report in the literature with a histological evaluation in a human of the tissue grafted exposed after 2 years.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p><b>What are the keys to successful management of this case?</b></p>\u0000 \u0000 <p>The graft covered by the alveolar mucosa did not induce keratinization of the epithelium of the overlying mucosa.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div>\u0000 <ul>\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"269-275"},"PeriodicalIF":0.9,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492782","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":"Treatment of single gingival recessions using biofunctionalized collagen matrix: A case series","authors":"Amanda Rossato,&nbsp;Manuela Maria Viana Miguel,&nbsp;Ana Carolina Ferreira Bonafé,&nbsp;Ingrid Fernandes Mathias-Santamaria,&nbsp;Marcelo Pereira Nunes,&nbsp;Mauro Pedrine Santamaria","doi":"10.1002/cap.10276","DOIUrl":"10.1002/cap.10276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Connective tissue graft substitutes have been used widely to overcome autogenous graft limitations. Nevertheless, they do not provide comparable results in the treatment of periodontal and peri-implant soft tissue defects. Based on the principles of tissue-engineered materials, injectable platelet-rich fibrin (i-PRF) has been combined with collagen matrices (CMs) to enhance their clinical efficacy. To the best of our knowledge, this is the first case series demonstrating the use of i-PRF for the biofunctionalization of a volume-stable collagen matrix (VCMX) as an adjunct to coronally advanced flap (CAF) to treat single gingival recession (GR) defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods &amp; Results</h3>\u0000 \u0000 <p>The study included 10 patients. Bleeding on probing, probing depth, GR height, clinical attachment level, esthetics, and dentin hypersensitivity were evaluated. After 6 months, a significant GR reduction (RecRed: 2.15 ± 0.7 mm; <i>p</i> = 0.005) and percentage of root coverage (% RC) of 81.13% were observed. Additionally, 40% of the sites showed complete root coverage. Gingival thickness increased 0.64 mm. Patient-centered evaluations demonstrated dentin hypersensitivity and esthetics improvements by the end of follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VCMX biofunctionalized with i-PRF associated with CAF technique showed promising clinical outcomes in the treatment of single RT1 GR defects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 3","pages":"180-184"},"PeriodicalIF":0.9,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812286","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":"Surgical reconstruction of peri-implantitis with adjunctive antimicrobial photodynamic therapy: A case report with 5-year follow-up","authors":"Ardavan Etemadi,&nbsp;Hamoun Sabri,&nbsp;Mahsa Enssi","doi":"10.1002/cap.10275","DOIUrl":"10.1002/cap.10275","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Peri-implantitis poses a significant challenge in dental implantology due to its potential to result in the loss of supporting tissue around dental implants. Surgical reconstruction is often recommended for intrabony defects, accompanied by various adjunctive therapies, such as antimicrobial photodynamic therapy (aPDT), for bacterial decontamination. However, the long-term efficacy of such treatments remains unclear.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This clinical report presents a case of peri-implantitis management in a healthy 55-year-old male using guided bone regeneration principles and surface decontamination via aPDT. The patient exhibited peri-implantitis with probing pocket depths (PPD) of 7 mm at buccal sites, 5 mm at palatal sites, and significant bone loss around implant #12. The reconstructive approach involved preservation of the existing implant and following a non-submerged healing protocol. The surgical phase included meticulous debridement, chemical detoxification with hydrogen peroxide, and aPDT using a 670 nm diode laser with methylene blue as the photosensitizer. Xenogenic bone graft and a resorbable collagen membrane were applied and the patient was followed up to through a 5-year period.&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;Postsurgery the patient exhibited normal healing, and long-term follow-up at 5 years showed reduced PPD (2 mm buccally, 3 mm mid-palatally), complete intrabony defect fill, and stable bone levels, indicating successful treatment.&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;This case report demonstrates the potential long-term success of a reconstructive approach with adjunctive aPDT in peri-implantitis management. However, it highlights the need for standardized protocols and further clinical trials to establish the clinical benefits of aPDT in surgical reconstruction of peri-implantitis defects, serving as valuable pilot data for future research.&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;Provides a rare 5-year insight into peri-implantitis intrabony defect reconstruction, offering extended success and outcomes not frequently documented.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Demonstrates the efficacy of aPDT with a 670-nm diode laser in achieving successful long-term outcomes, contributing ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 3","pages":"185-191"},"PeriodicalIF":0.9,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pattern of peri-implantitis affecting middle implants in 3-implant splinted prostheses","authors":"Braedan RJ Prete,&nbsp;Michael AJ Silva,&nbsp;Brian C. Wong,&nbsp;Douglas A. Deporter","doi":"10.1002/cap.10274","DOIUrl":"10.1002/cap.10274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous investigators have noted an increased risk of crestal bone loss and failure of the middle implant of 3-implant-splinted (3-IS) fixed dental prostheses (FDPs). Possible causes have included ill-fitting prostheses, unhygienic prosthetic contours, and discrepancies in prosthetic platform heights.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods &amp; Results</h3>\u0000 \u0000 <p>We identified four cases in which the middle implant of a 3-IS multiunit FDP suffered advanced bone loss, ultimately leading to implant removal. While more than one possible risk for implant failure existed in each case, a common thread was that the prosthetic platform of the middle implant for all patients was coronally positioned relative to the corresponding mesial and/or distal implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Splinting three adjacent implants into one prosthesis may add risk for a variety of reasons possibly including small differences in the heights of the three prosthetic tables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why are these cases new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Our observations suggest that discrepancies between implant prosthetic platforms supporting 3-implant splinted, multiunit FDPs may be an added risk factor for middle implant failure.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of these cases?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>It is possible that small differences in apico-coronal implant positioning with 3-implant splinted multiunit FDPs may affect the success of the middle implants.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the primary limitations to success in these cases?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>There is limited literature involving precise protocols and long-term outcomes of 3-implant splinted implant restorations.</li>\u0000 \u0000 <li>Studies comparing 3-implant splinted FDPs to other configurations are needed.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 4","pages":"284-289"},"PeriodicalIF":0.9,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441780","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":"Histological and whole-genome sequencing analysis of coronally advanced flap with connective tissue graft for the treatment of gingival recession—A case study","authors":"Saravanan Sampoornam Pape Reddy,&nbsp;Balaji Manohar","doi":"10.1002/cap.10273","DOIUrl":"10.1002/cap.10273","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;Oral tissue morphogenesis is innately determined and genetically controlled by underlying connective tissue. The connective tissue graft (CTG) harvested from palatal donor sites originally retains “regional specificity” and is considered to be responsible for epithelial keratinization.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This case study presents histological and genomic outcomes of coronally advanced flap (CAF) with CTG for the management of marginal tissue recession (MTR). The tissue samples harvested at 12-month postoperative period, during the debulking procedure of the treated site were subjected to Masson's trichrome staining (MTS) and whole-genome sequencing (WGS).&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;Clinically, the mean root coverage as compared to baseline at 6 months (90%), 12 months (95%), and 24 months (95%) postoperatively was achieved. Overbulking of treated site was evident even after 12 months. Nevertheless, clinically discernible alterations in epithelial keratinization were not present. Although MTS revealed areas of non-keratinization and para-keratinization, WGS revealed a significant expression of keratinization genes, neural crest, and positional marker genes.&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;CAF with CTG is still considered the “gold standard” in treatment of MTR. The keratinization of overlying epithelium at sites hitherto where non-keratinized mucosa is advanced over CTG may not be complete even after 12 months. It is evident from the analysis of the reported case that clinically such sites may appear non-keratinized despite the expression of genes for keratinization. The complex interplay between genomic and phenotypic expressions serves as a foundation of biological concepts. Nevertheless, it is imperative to acknowledge that the phenotype of an organism is not solely determined by genetic expression and is often influenced by a complex interaction between genetic background and environmental factors.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Key Summary&lt;/h3&gt;\u0000 \u0000 &lt;div&gt;The connective tissue serves as a medium for transmitting the genetic code and exerting an influence on the properties of the overlying epithelial tissue.\u0000\u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Concrete evidence implies connective tissue plays a significant role in influencing the keratinization process of the overlying epithelium.&lt;/li&gt;\u0000 \u0000 &lt;li&gt;Epithelial keratinization following a coronally advanced flap with connective tissue graft is also gover","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 3","pages":"192-200"},"PeriodicalIF":0.9,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178092","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":"Translational approach to tooth autotransplantation: A 27-year case study","authors":"GiovanPaolo Pini Prato,&nbsp;Debora Franceschi,&nbsp;Riccardo Pace,&nbsp;Riccardo Di Gianfilippo","doi":"10.1002/cap.10272","DOIUrl":"10.1002/cap.10272","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 aim of this case report was to present a translational approach to tooth autotransplantation using jiggling forces to enlarge the periodontal ligament (PDL) space before autotransplantation, with the goal of improving treatment success and long-term survival.&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 23-year-old patient, undergoing orthodontic therapy and with an unrestorable maxillary first molar, was proposed to have a healthy and fully-erupted maxillary third molar transplanted in the socket of the first molar. Jiggling forces were applied to the third molar to enlarge the PDL space and facilitate the preservation of PDL fibers on the root surfaces during the extraction.&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;Jiggling forces induced hypermobility and widened PDL space of the third molar. The autotransplantation was successful and the patient was followed regularly over a 27-year period. At the 27-year visit, the patient showed optimal chewing function, oral plaque control, and absence of gingivitis. The transplanted molar exhibited periodontal health and absence of mobility. Probing depth of 5 mm and radiographic external root resorption was noted on a localized area of the transplanted tooth which had experienced traumatic and unintentional removal of PDL fibers during the extraction.&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;A translational approach was proposed by integrating knowledge from the fields of orthodontics, trauma from occlusion, and replantation. It validated the crucial importance of maintaining healthy PDL fibers on the root surface and demonstrated clinically the successful autotransplantation of a fully formed third molar into the socket of a first molar with a retention of 27 years.&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 case provided evidence of successful autotransplantation of a molar with complete root formation. It reported the longest-term follow-up (27 years) present in the literature. Most importantly, it used a translational medicine approach to apply concepts from the fields of orthodontics and traumatic occlusion to improve the success of the autotransplantation procedure.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the keys to the successful management of this case?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Jiggling forces induced tooth ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"14 3","pages":"165-171"},"PeriodicalIF":0.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138178094","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}