Clinical Advances in Periodontics最新文献

{"title":"Root coverage of type 2/3 gingival recession using recombinant human fibroblast growth factor-2 in combination with carbonate apatite granules: A case study.","authors":"Akiyoshi Funato, Akihiko Katayama, Chihiro Ishikura, Yusuke Katsuda, Akira Hasuike","doi":"10.1002/cap.70031","DOIUrl":"https://doi.org/10.1002/cap.70031","url":null,"abstract":"<p><strong>Background: </strong>One of the most challenging aspects of the treatment of Cairo Recession Type (RT) 2/3 gingival recession is the loss of adjacent interdental tissue. Successful treatment can be achieved by repositioning the interdental tissue and applying a connective tissue graft (CTG).</p><p><strong>Methods and results: </strong>Two patients with RT2/3 gingival recession were treated using the vertical incision tunnel (VIT) technique. Recombinant human fibroblast growth factor-2 (rhFGF-2)-soaked carbonate apatite (CO₃Ap) was placed in the interdental space, while rhFGF-2-soaked CTG was used to cover the exposed root surfaces. Over a follow-up period of up to 2 years, complete or significant root coverage was achieved in both cases. Interdental papillae were successfully reconstructed; however, complete papillary filling was not achieved.</p><p><strong>Conclusions: </strong>The combination of rhFGF-2-soaked CO₃Ap in the interdental space and rhFGF-2-soaked CTG for root coverage represents an effective approach for treating RT3 gingival recessions.</p><p><strong>Plain language summary: </strong>Gum recession is a common dental condition where the gums pull away from the teeth, leaving the roots exposed. This can lead to tooth sensitivity, increased risk of decay, and esthetic concerns. Treating advanced forms-classified as Type 2 and Type 3-is especially difficult because not only are the roots exposed, but the gum tissue between the teeth is also lost. In this case report, two patients with these advanced types of gum recession were treated using a novel approach that combines regenerative materials with a minimally invasive surgical technique. A tissue-regenerating protein called rhFGF-2 was applied to both a synthetic bone substitute (CO₃Ap) placed between the teeth and to soft tissue taken from the roof of the mouth. This tissue was used to cover the exposed roots. Over the course of follow-up, the treated areas healed well: most of the roots became re-covered with healthy gum tissue, and the tissue between the teeth, although not fully restored, showed clear signs of regeneration. While further studies are needed, this technique may provide a promising new option for patients with difficult-to-treat gum recession, especially in cases where traditional treatments have limited success due to loss of supporting structures.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proliferative verrucous leukoplakia: Case study of 24 years and outcome of treatment with CO₂ laser.","authors":"Charles M Cobb, Nabil E Beaini, Jessica Scully, Tanya M Gibson","doi":"10.1002/cap.10320","DOIUrl":"10.1002/cap.10320","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a rare and refractory form of oral leukoplakia. The etiology of PVL remains unknown. The lesion is characterized by a high rate of malignant transformation. There is no definitive treatment for PVL.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This case study presents a patient diagnosed in 2000 with a localized hyperkeratinized/verrucous lesion involving the facial gingivae of teeth #6-#8. Over the next 24 years, the lesion was biopsied five times. Further, two attempts to ablate the lesion with a CO&lt;sub&gt;2&lt;/sub&gt; laser (10.6 µm wavelength) were performed. Both ablation treatments were unsuccessful as the lesion recurred and progressed to involve more areas of gingival tissue. To date, biopsy has not revealed transformation into verrucous or squamous cell carcinoma (SCCA).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This case study demonstrates that two attempts at ablation of PVL using a CO&lt;sub&gt;2&lt;/sub&gt; laser had no short- or long-term benefit. The patient eventually lost all maxillary teeth due to root caries and inability to maintain adequate oral hygiene. The PVL lesion currently involves the entire maxillary edentulous ridge, extending from the 2nd molar site to the opposite corresponding site. During the 24 years encompassed by this report, the patient has not experienced a malignant transformation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of CO&lt;sub&gt;2&lt;/sub&gt; laser ablation of the PVL lesion in this case provided no short- or long-term benefit. Given the potential for a sinister outcome, PVL patients require frequent clinical evaluation and biopsy for early detection of a malignant transformation into oral verrucous or SCCA.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a clinical diagnosis and represents a refractory form of multifocal oral mucosal leukoplakia of unknown origin. Currently, there is no reliable and successful treatment for PVL. PVL may undergo transformation to a verrucous or squamous cell carcinoma, thereby necessitating frequent oral examination and biopsy of sinister-appearing mucosal sites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Proliferative verrucous leukoplakia (PVL) is a rare disorder that affects the gum tissue around the teeth. PVL is a pre-cancerous disorder for which the cause is unknown and there is no treatment that yields a consistently successful result. This case study presents a patient diagnosed in 2000 with PVL involving the facial gum tissue of the upper right cuspid, lateral, and central incisor teeth. Over the next 24 years, the lesion was biopsied five times and two attempts to irradicate the lesion with a CO&lt;sub&gt;2&lt;/sub&gt; laser were performed. All attempts at treatment were unsuccessful and the lesion slowly progressed to involve more areas of gum tissue. The last biopsy taken in February 2024 did not reveal any areas of developing cancer. During the 24 years covered in this report, the patient did not deve","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"329-336"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Root coverage using recombinant human fibroblast growth factor-2 treated connective tissue graft: Case studies.","authors":"Guo-Liang Cheng, Satoru Urano, Yu-Chang Wu, Rami Alsabbagh, Hsun-Liang Chan","doi":"10.1002/cap.10323","DOIUrl":"10.1002/cap.10323","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This case study documents the application of connective tissue graft (CTG) combined with biologics on treating challenging gingival recession cases of mandibular anterior teeth caused by orthodontic tooth movement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Three patients presented for periodontal consultation due to gingival recession resulting from orthodontic treatment. The patients reported esthetic concerns and discomfort while brushing their teeth. The gingival defects were mainly localized to the mandibular incisors, with recession depths ranging from 1 to 5 mm and complicated by loss of papilla and a lack of keratinized tissue. RT2 gingival recession with thin gingival phenotype was confirmed. All gingival defects were managed using recombinant human fibroblast growth factor-2 (rhFGF-2) treated CTG. The recipient sites were prepared using tunnel or modified tunnel techniques. CTG harvested from the hard palate was treated with rhFGF-2 for 3 min then inserted into the prepared tunnel space and secured with a sling suture technique for coronal advancement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The three patients were followed from 6 months to 6 years. Generally, initial wound healing was within normal limits during the first several weeks. The recession defects were successfully covered, achieving a nearly 100% root coverage rate. The combination of CTG+rhFGF-2 resulted in satisfying recession depth reduction, papilla augmentation, and gain of keratinized tissue. Patients were satisfied with the improvement of esthetics and function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This innovative approach demonstrates that rhFGF-2 treated CTG significantly improves the mucogingival problems caused by orthodontic treatment. Successful phenotype modification provides functional and esthetic improvement as well as long-term stability of periodontal health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Receding gums are a common complication after wearing dental braces, which sometimes can be severe if the initial gum tissue is thin. This complication could cause tooth sensitivity, discomfort when brushing, and compromised esthetics. To regenerate the lost tissue, a connective tissue graft (CTG) harvested from the roof of the oral cavity is very commonly used as a transplantation option with substantial supporting evidence. However, for cases of severe gum recession, CTGs still have limitations on treatment. Therefore, clinicians and researchers are dedicated to improving treatment outcomes by adding biomaterials to the graft to enhance clinical outcomes. A relatively new material, recombinant human fibroblast growth factor-2 (rhFGF-2), has proven to be effective in periodontal regenerative treatments and could potentially augment the soft tissue regenerative capacity of the graft. This case study documents the application of rhFGF-2 in combination with CTGs for treating severe gum recession in three patients. The treatment results demonstr","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"354-363"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662983","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":"Effective treatment of a molar-incisor pattern periodontitis patient utilizing recombinant human platelet-derived growth factor: A case report.","authors":"Arsalan Danesh, Arman Danesh, Saynur Vardar, Theofilos Koutouzis","doi":"10.1002/cap.70022","DOIUrl":"10.1002/cap.70022","url":null,"abstract":"<p><strong>Background: </strong>Molar incisor pattern periodontitis (MIPP) poses many challenges in the field of periodontics. Emerging evidence has shown promising results in regenerative therapy while treating such a patient population. The present case study demonstrates an effective implementation of recombinant human platelet-derived growth factor (rh-PDGF) for the successful regeneration of infrabony defects associated with MIPP.</p><p><strong>Methods: </strong>A 17-year-old African-American male patient presented to the Periodontics Clinic at Nova Southeastern University, requiring periodontal evaluation prior to the initiation of orthodontic therapy. Upon examination, the patient was diagnosed as a localized stage III, grade C MIPP. Initially, the patient underwent phase I therapy. Subsequently, surgeries consisted of regenerative procedures including a combination of allograft bone graft, rh-PDGF, and collagen membrane. The patient was seen for regular follow-ups and supportive periodontal therapy during the healing periods.</p><p><strong>Results: </strong>The regenerative procedures resulted in significant improvement in all periodontal parameters, including probing depth, clinical attachment level, radiographic bone levels, and clinical and radiographic furcation closure, allowing the patient to retain all compromised teeth.</p><p><strong>Conclusion: </strong>The combination of surgical debridement with rh-PDGF serves as a plausible treatment approach for infrabony defects in patients with MIPP. Further investigation through well-designed randomized controlled clinical trials is warranted to provide clearer insights.</p><p><strong>Key point: </strong>rh-PDGF combined with an allograft is a successful treatment option in MIPP patients.</p><p><strong>Plain language summary: </strong>Molar incisor pattern periodontitis (MIPP) is a severe form of periodontal disease, often affecting specific teeth in the periodontium of young patients. The nature of the disease requires early diagnosis and treatment to avoid potential complications, including tooth loss. This case report highlights the diagnosis and management of a patient with MIPP affecting seven teeth. Upon completion of the referral to the Periodontics Department at Nova Southeastern University, the patient was treatment planned for phase 1 therapy, including oral hygiene instructions, localized deep cleaning, and reevaluation of results in a short follow-up. Following the reevaluation appointment, the patient underwent a surgical phase via regenerative therapies utilizing bone grafts, biologics, and membranes. All surgical procedures resulted in significant improvements in clinical and radiographic parameters and remained stable over a 2-year follow-up period. This case report highlights the successful use of rh-PDGF in the treatment of MIPP-associated periodontal defects. Further investigation through well-designed clinical trials is warranted to provide clearer insights.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"387-394"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of peri-implant soft tissue dehiscence with combined prosthetic-surgical approach: A case report.","authors":"Omran Bishbish Zeino, Yoon Jeong Kim","doi":"10.1002/cap.70039","DOIUrl":"10.1002/cap.70039","url":null,"abstract":"<p><strong>Background: </strong>This case report presents the management of an esthetic complication of a peri-implant soft tissue dehiscence (PSTD) through a combined prosthetic-surgical approach.</p><p><strong>Methods and results: </strong>A 53-year-old healthy Hispanic male presented to our practice for the treatment of an implant esthetic complication. A diagnosis of PSTD class III C was established. The abutment and crown were first modified to accommodate the tissue graft and support the coronally advanced flap (CAF). Then, a CAF with tuberosity connective tissue graft was performed. A definitive abutment and crown were fabricated 8 months after healing. Significant improvement of the PSTD, improvement of the peri-implant soft tissue dimensions, and patient satisfaction have been achieved.</p><p><strong>Conclusion: </strong>A combined prosthetic-surgical approach constitutes a valid treatment modality for PSTD class III C where there is abundant interproximal tissue available.</p><p><strong>Key points: </strong>Integrated treatment approach: A combined prosthetic-surgical technique offers an effective solution for managing peri-implant soft tissue dehiscence (PSTD), ensuring improved tissue thickness and stability.</p><p><strong>Clinical considerations: </strong>The bucco-lingual implant position and interproximal tissue quality are key factors in determining the optimal treatment strategy. Predictable outcomes: Coronally advanced flap combined with connective tissue grafting can enhance esthetic and functional results for management of PSTD.</p><p><strong>Plain language summary: </strong>Peri-implant soft tissue complications can affect both the function and appearance of dental implants. This case study explores an approach that combines surgical and prosthetic techniques to improve the gingival tissue surrounding an implant. A 53-year-old patient had an esthetic concern due to gum recession around his implant. To correct this, his dental crown and abutment were adjusted. Then, a gingival grafting procedure to reposition the gingival tissue and enhance its thickness was performed. After healing for eight months, the implant was permanently restored with a final crown. The results showed significant improvements in gingival tissue health, thickness, and appearance, leading to patient satisfaction. The findings highlight how combining surgical techniques with prosthetic adjustments can help manage similar cases, offering a predictable solution to improve both the appearance and stability of dental implants.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"395-401"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558194","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":"Odontogenic keratocyst management using guided tissue regeneration: Literature review - Two case reports.","authors":"Bassam M Kinaia, Mirranda Kinaia, Joshua Graham, Naiomy Perez Villaneuva, David Van Winkle, Anmar Dawood, Anthony L Neely","doi":"10.1002/cap.10316","DOIUrl":"10.1002/cap.10316","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Odontogenic cysts of the jaws are pathologies that require timely recognition and management. The initial diagnosis is based on clinical and radiographic appearance and dental history. A variety of surgical treatments are used for odontogenic keratocyst (OKC) depending on the clinical and radiographic presentation. The aim of this report and literature review is to highlight methods to treat OKC combined with guided tissue regeneration (GTR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two cases with similar clinical presentations are included. Case 1 was a 60-year-old healthy Caucasian female who presented with jaw expansion around teeth #'s 21 and 22. Initial exam revealed clinical gingival health on an intact periodontium. The patient presented with enlarged gingival tissue between teeth #'s 21 and 22 measuring 9 × 12 mm and vital teeth without root displacement radiographically. Case 2 had a similar clinical and radiographic presentation located between teeth #'s 5-6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Case 1 treatment included excisional biopsy with complete enucleation of the cystic lesion. Thereafter, GTR was performed using allograft internally then covered with a xenograft externally, resorbable collagen membrane (RCM), and primary closure. Case 2 was managed with excisional biopsy with lesion enucleation, GTR with allogenic bone graft, enamel matrix derivative and RCM, and primary closure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;OKC enucleation combined with GTR using mineralized allograft, enamel matrix derivative, and collagen membrane or a layering technique of allograft internally and xenograft externally covered by a collagen membrane showed proper regeneration with stable periodontium at 6-36 months.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Guided tissue regeneration is an acceptable treatment for management of OKC. Complete enucleation of an OKC lesion is important to reduce recurrence. The use of allograft with xenograft or allograft with enamel matrix derivative and RCM can provide proper bone fill after OKC removal.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Odontogenic cysts are growths that can form in the jaw or soft tissues around the teeth. If not treated, they can grow larger, damage the bone, and even push teeth out of place. To prevent this, it's important to diagnose and remove them early. The most common way to treat these cysts is through a surgical method called enucleation, where the cyst is carefully removed. In these two cases, enucleation was used along with guided tissue regeneration, a technique to help the bone and tissue heal better after surgery. In the first case, a bone graft (made from human and animal bone) and a special material called a resorbable collagen membrane were used to protect and support the healing area. In the second case, a mineralized bone graft along with a substance that helps repair tissues called an enamel matrix derivative, and the same collagen membrane were used. Both p","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"312-321"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of peri-implantitis with a reconstructive approach: Guided bone regeneration using the open membrane technique - A case study.","authors":"Hsin-Chiang Lee","doi":"10.1002/cap.70001","DOIUrl":"10.1002/cap.70001","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The restoration of the healthy peri-implant tissue and re-osseointegration represent the goals of reconstructive procedures for treating peri-implantitis. Peri-implant regeneration is a field that requires further optimization to increase predictability. The submerged approach has been shown to yield superior defect fill compared to the non-submerged approach. Nevertheless, primary closure in the submerged approach can result in diminished keratinized tissue. This case study presents an alternative approach to managing advanced peri-implantitis, with the use of open membrane technique.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 71-year-old female presented with #30 peri-implantitis, exhibiting 10 mm probing depth, suppuration upon probing, and severe bone loss. The implant prosthesis was removed prior to the surgery to gain access to instrumentation. Subsequent to the debridement of the defect and implant detoxification, a mix of xenograft and enamel matrix derivatives was used to fill the defect. High-density polytetrafluoroethylene membrane was placed over the defect. The flaps were replaced without attempting primary closure, and the membrane was intentionally left exposed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Disease resolution with significant radiographic bone fill was achieved and remained stable with 20 months follow-up. In addition, keratinized tissue was adequately preserved after surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Reconstructive surgery using the open membrane approach can be an alternative for managing advanced peri-implantitis defects, with the advantages of preserving keratinized tissue and reducing intrasurgical trauma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;The open membrane technique may serve as a viable alternative to primary closure in guided bone regeneration for peri-implant reconstructive procedures. Advantages include reduced surgical trauma, shorter procedure time, and preservation of keratinized tissue. Careful case selection is essential for achieving predictable outcomes. Factors to consider include defect configuration, the number of remaining bony walls, and the size of the wound opening. In more challenging cases, combination therapy and the adjunctive use of biologics may be considered to enhance regenerative potential and improve clinical results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case study presents the regenerative treatment of chronic inflammation and bone loss around a dental implant using the open membrane technique. To manage the condition, the crown portion of the dental implant was removed, and the implant surface was thoroughly cleaned and disinfected. The space around the implant was then filled with bone graft and biological agents and covered with a membrane. Unlike typical regenerative procedures, the membrane was intentionally left partially exposed rather than being fully covered by the gum during healing. After the procedure, the infection was resolved, and ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"373-379"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735601","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 and analog techniques for cemento-enamel junction reconstruction: A case study.","authors":"Juan Carlos Durán, Valeria Gómez, Cristian Aguilera, Rodrigo Pino, Vasco Sáiz, Nicolás González, Yuri Cataldo, Murir Gauro, Iván Urzúa, Fernando Solanes, Catalina Madariaga","doi":"10.1002/cap.10315","DOIUrl":"10.1002/cap.10315","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Non-carious cervical lesions (NCCLs) refer to the loss of dental hard tissue in the cervical region due to physical and/or chemical factors, often associated with the disappearance of the cemento-enamel junction (CEJ), posing challenges in both diagnosis and treatment of gingival recessions (GR). This case study introduces two protocols for multidisciplinary CEJ reconstruction prior to the root coverage therapy (RCT).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two patients with GR and NCCLs were treated using two CEJ reconstruction techniques: both, analogically and digitally guided. For each case, the position of the therapeutic CEJ was predetermined using a combination of the methods described by Zucchelli and Cairo. Then, an analog or digital diagnostic wax-up was performed accordingly. In the analogically guided technique, a transparent silicone guide matrix was used to transfer information from the dental wax-up. In contrast, the digitally guided technique employed a rigid, translucent resin prosthetic guide matrix that was designed and printed. Restorations were fabricated using direct composite resin and RCT was performed 1 week later in both techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At 6 months, both cases demonstrated complete root coverage and effective healing of the soft tissues surrounding the restorations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Dimensional changes in materials and precise guide adjustment in the analog technique are operator-dependent and can affect the outcomes. Digital procedures, though effective, are costly and may limit their use. The usage of these two CEJ reconstruction techniques enhances communication within the multidisciplinary team and ensures optimal aesthetic outcomes and precise placement of the gingival margin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;There are no established clinical protocols described in the literature for reconstructing the cemento-enamel junction (CEJ) once the position of a therapeutic CEJ has been predetermined and prior root coverage therapy (RCT). Performing a diagnostic wax-up (analogically or digitally) to reconstruct the therapeutic CEJ is crucial and facilitates the creation of a prosthetic guide that accurately reproduces the defined CEJ position. The reconstruction of the CEJ may improve the prognosis of RCT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This study looked at a dental issue called non-carious cervical lesions, which happens when the hard tissue near the gum line of a tooth wears away, making it harder to treat gum recession. Two different approaches were tested to rebuild the lost tissue in the gum area before performing a procedure to cover the exposed roots. One approach used traditional methods with physical guides to help place the new tissue, while the other used advanced digital techniques to create a precise guide using 3D printing. After 6 months, both methods successfully covered the exposed roots and helped the gums heal properl","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"299-311"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal phenotype modification in surgically facilitated orthodontics: A case report.","authors":"Francesco Tironi, Stavros Sofos, Jason Wong, Megan Leyva, Gisella Contasti, Myron Nevins, Saynur Vardar-Sengul","doi":"10.1002/cap.10321","DOIUrl":"10.1002/cap.10321","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic treatment in adults with thin periodontal phenotype presents challenges such as lengthy treatment time and increased risk for gingival recessions. In this case, surgically facilitated orthodontic treatment (SFOT) was proposed to accelerate orthodontic tooth movement while modifying the periodontal phenotype.</p><p><strong>Methods: </strong>An orthodontic patient was referred for periodontal evaluation of lower anterior teeth, which presented a thin gingival phenotype and bone dehiscence. SFOT was performed on the mandible using particulate allograft combined with platelet rich fibrin (PRF) and collagen membrane to augment soft and hard tissue, thereby preventing future recessions, while accelerating the treatment times.</p><p><strong>Results: </strong>Six-month and 3-year follow-ups confirmed radiographic bone fill, absence of gingival recession and thick band of keratinized gingiva. SFOT also resulted in a shorter treatment time where desired tooth movements were achieved within 6 months with periodontal stability.</p><p><strong>Conclusions: </strong>SFOT provided clinical benefits by accelerating orthodontic movement, improving periodontal phenotype, preventing the displacement of teeth beyond the alveolar housing and minimizing the risk for development of dehiscences and gingival recessions.</p><p><strong>Key points: </strong>Orthodontic movements can create recessions and dehiscence in thin periodontal phenotypes. SFOT can help prevent bone dehiscence and creates a thicker gingival phenotype while accelerating treatment time.</p><p><strong>Plain language summary: </strong>Adults who face lengthy orthodontic treatments and have thin gums have risks of gum problems. Surgically facilitated orthodontic treatment (SFOT) can help by speeding up tooth movements and improving gum health and thickness. A patient with thin gums and lack of bone in the lower front teeth was evaluated. The SFOT procedure involved using a bone graft, healing factors, and a collagen membrane to strengthen the gums and bones. This approach aimed to prevent future gum problems and speed up orthodontic treatment. Follow-ups at 6 months and 3 years after treatment showed good healing of the gums and bones, with no signs of gum recession and healthier, thicker gums. The desired tooth movements were achieved within 6 months, resulting in a shorter treatment time. The patient's gums remained stable throughout this period. SFOT offered significant clinical benefits, including faster tooth movement and improved gum health. It also helped prevent teeth from moving out of place and minimized the risk of gum recession and bone issues. This approach can be a valuable option for adults with thin gums undergoing orthodontic treatment.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"337-345"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Master Clinician Editorial.","authors":"Myron Nevins, David M Kim","doi":"10.1002/cap.70034","DOIUrl":"10.1002/cap.70034","url":null,"abstract":"","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"297-298"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643110","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}