Clinical Advances in Periodontics最新文献

{"title":"Soft tissue grafting in healing chronic wounds: Two case studies","authors":"Francisco J. Otero-Cagide, Oscar Rodríguez-Estévez","doi":"10.1002/cap.10360","DOIUrl":"10.1002/cap.10360","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A chronic wound occurs when it fails to heal resulting in a prolonged wound healing process. Traumatic and surgically induced wounds that do not heal as expected can be included in the term chronic wound. There is limited information about the management of this type of wound involving the periodontal tissues. These case studies show how soft tissue grafting may be used as a strategy to assist in the closure and enhancement of large wounds that present a chronic and complicated healing process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Results</h3>\u0000 \u0000 <p>Two healthy adult patients presented open wounds induced by trauma following the dental treatment. These wounds were treated with autogenous soft tissue grafting to enhance and stimulate the healing process. In one case, enamel matrix derivative was applied in conjunction with a gingival graft. Both cases demonstrated a successful and rapid wound closure at the 1-week post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using autogenous soft tissue grafting should be considered a treatment alternative when dealing with a chronic and problematic open wound. This study describes the success of two cases utilizing this approach. However, an understanding of the biological process of wound healing is critical when selecting a surgical technique for the treatment of a chronic wound.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>There is limited information in the periodontal literature about the management of chronic wounds caused by trauma.</li>\u0000 \u0000 <li>Critical understanding of the biological process of wound healing and application of surgical principles are essential in using autogenous soft tissue grafts to treat these wounds.</li>\u0000 \u0000 <li>Surgical factors such as extent, location of wound, and limited amount of autogenous donor tissue are primary limitations to the successful treatment of these cases.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>Two cases that presented chronic wounds related to the periodontal tissues which were the result of surgical trauma are reported. These complicated healing wounds were managed with free autogenous soft tissue grafts. The grafts assisted the problematic wounds in healing by replacing missing tissue and providing growth factors. This mode of treatment for a chronic wound proved to be a successful approach in the management ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"288-294"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservation therapy for vertically fractured teeth with periodontal tissue regeneration using FGF-2","authors":"Masaichiro Iwasaki, Masahide Takedachi, Keigo Sawada, Koji Miki, Shinya Murakami","doi":"10.1002/cap.10357","DOIUrl":"10.1002/cap.10357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Vertically fractured teeth often have a poor prognosis, and extraction is considered the most predictable treatment. Conventional management has consisted of preservation therapy involving extraction, bonding, root restoration, and replantation of fractured teeth. However, these methods fail to adequately address the periodontal tissue damage associated with root fractures. This report describes successful periodontal tissue regeneration using basic fibroblast growth factor (FGF-2) combined with a carbonate apatite-based bone graft material (CaAp) as a scaffold during the replantation of vertically fractured teeth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Our series included four patients: a 57-year-old woman, a 59-year-old woman, a 45-year-old man, and a 41-year-old woman, all diagnosed with vertically fractured teeth. The fractured teeth were extracted, bonded using 4-methacryloxyethyl trimellitate anhydride in methyl methacrylate initiated by tri-n-butyl borane (4-META/MMA-TBB) resin, and replanted. CaAp was applied to the extraction sockets; FGF-2 was administered to the periodontal ligament-deficient root areas prior to replantation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In all cases, periodontal pocket depths were reduced to 3 mm or less, and no signs of inflammation were evident. Cone-beam computed tomography revealed substantial regeneration of periodontal tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The combination of FGF-2 and CaAp during the replantation of vertically fractured teeth promotes periodontal tissue regeneration and demonstrates potential for long-term tooth preservation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>What new information do these cases provide?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>This is the first report to our knowledge demonstrating that replantation of a root-fractured tooth, historically considered suitable only for extraction, can achieve substantial periodontal tissue regeneration. This regeneration was accomplished by bonding and restoring the tooth using 4-methacryloxyethyl trimellitate anhydride in methyl methacrylate initiated by tri-n-butyl borane (4-META/MMA-TBB) resin in combination with fibroblast growth factor (FGF-2) and carbonate apatite-based bone graft material (CaAp).</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"270-278"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10357","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735605","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":"Treatments of unesthetic amalgam tattoo: A literature review and a case report","authors":"Lucrezia Parma-Benfenati, Saeed A. Elrefaei, Hom-Lay Wang, Muhammad H. A. Saleh","doi":"10.1002/cap.70000","DOIUrl":"10.1002/cap.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>An amalgam tattoo is an iatrogenic lesion that can lead to esthetic concerns. This paper presents a literature review aimed at exploring treatment options available to clinicians for addressing this unesthetic issue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The initial search identified 209 potentially relevant publications. After applying specific inclusion and exclusion criteria, 18 papers were analyzed and summarized in a comprehensive table, highlighting significant aspects for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The findings indicate various treatment options reported in the existing literature. Additionally, this paper includes a case report detailing the procedure performed on a 47-year-old female with an amalgam tattoo on the buccal aspect of her upper right premolars. Following muco-abrasion to remove the oral pigmented lesion, a bilaminar mucogingival procedure was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>At the 8-year follow-up, the gingival color and texture blended well with the surrounding soft tissues, the periodontal structures appeared healthy, and the patient was satisfied with the esthetic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <p>Discoloration of the oral mucosa caused by amalgam can result in esthetic dissatisfaction for patients. A review of the literature indicates that the bilaminar technique is a more reliable surgical approach for achieving cosmetic results in a single operation. An 8-year follow-up case report supports this finding, detailing a procedure that involved muco-abrasion of the lesion followed by a sliding pedicle flap.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>An amalgam tattoo is an iatrogenic lesion associated with esthetic concerns. This paper reviews treatment options for this issue, analyzing 18 relevant publications from an initial search of 209. Additionally, a case report details the treatment of a 47-year-old female patient with an amalgam tattoo on her upper right premolars. After muco-abrasion to remove the lesion, a plastic surgery procedure with a connective tissue graft from the palate was performed. At the 8-year follow-up, the gingival color and texture matched the surrounding tissues, the periodontal structures appeared healthy, and the patient was satisfied with the resul","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"365-373"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746123","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":"Root coverage using a microsurfaced acellular dermal matrix: A retrospective case series","authors":"Yu-Chang Wu, Guo-Liang Cheng, Shaun Rotenberg","doi":"10.1002/cap.10361","DOIUrl":"10.1002/cap.10361","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acellular dermal matrices (ADMs) have been used for root coverage for over 25 years, yet few advancements have improved clinical outcomes or reduced complications. This case series evaluated the use of a novel microsurfaced ADM (mADM), which features a microtextured surface designed intended to promote healing and improve graft integration, for treating gingival recession defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eleven RT1 gingival recession defects from five patients were treated using mADM between January and May 2023 by a single surgeon (S.R.). A modified vestibular incision subperiosteal tunnel access technique was used for multiple recession defects, while a subperiosteal pouch technique was performed for single-tooth recession defects. Clinical outcomes were assessed at baseline and 12 months. Pair <i>t</i>-tests were utilized to compare changes overtime.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean recession depth reduced from 3.64 ± 0.50 mm to 0.73 ± 0.79 mm after 12 months. Keratinized tissue width increased from 2.32 ± 0.81 mm to 3.36 ± 0.92 mm. Gingival phenotype remained thick for all the cases. Significant root coverage was achieved (<i>p</i> < 0.05) with no graft exposure; complete root coverage was observed in 45.5% (5/11). Patients reported minimal discomfort and satisfactory healing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Within the limits of this retrospective case series, mADM may be considered a viable option for the treatment of RT1 gingival recession defects. Future randomized clinical trials should be performed to compare this matrix with other options to deal with recession defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>In this case study, the novel microsurfaced acellular dermal matrices (mADM) demonstrated significant root coverage improvements in RT1 gingival recession defects, with a mean recession reduction from 3.64 to 0.73 mm at 12 months, achieving 80% root coverage and complete coverage in 45.5% of treated sites.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>The mADM may serve as a promising alternative to autogenous grafts, but larger-scale randomized clinical trials are necessary to confirm long-term efficacy and patient-reported outcomes.</p>\u0000 ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"295-305"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10361","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735606","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":"Surgical management of persistent gingival recession after sepsis-associated gingival necrosis in a patient with systemic lupus erythematosus: A case report.","authors":"Risako Mikami, Koji Mizutani, Ruriko Mizuno, Yuji Kabasawa, Koichiro Matsuo","doi":"10.1002/cap.70077","DOIUrl":"https://doi.org/10.1002/cap.70077","url":null,"abstract":"<p><strong>Background: </strong>Sepsis-associated gingival necrosis is an uncommon oral manifestation that may result in extensive gingival recession after the resolution of the acute phase.</p><p><strong>Methods: </strong>This report presents the 2-year follow-up of periodontal management in a 38-year-old woman with systemic lupus erythematosus, who developed septic shock accompanied by extensive gingival purpura and necrosis that resulted in widespread gingival necrosis during septic shock and subsequently underwent periodontal plastic surgery for persistent gingival recession. After recovery from the acute systemic condition, marked gingival recession persisted. Although pronounced spontaneous coronal migration of the gingival margin was observed during the first 6 months of follow-up, an esthetically unfavorable recession corresponding to Cairo recession type 1 persisted after 1 year.</p><p><strong>Results: </strong>Connective tissue grafting was performed in the maxillary anterior region using a minimally invasive approach to minimize postoperative risk. Healing was uneventful, with no postoperative infection or adverse events despite the patient's immunosuppressed status. Satisfactory esthetic root coverage was achieved.</p><p><strong>Conclusion: </strong>This case suggests that periodontal plastic surgery may be a safe and effective treatment option for sepsis-associated gingival necrosis, even in patients with an immunocompromised status, when careful interdisciplinary collaboration and appropriate perioperative management are required.</p><p><strong>Key points: </strong>Sepsis-associated gingival necrosis can lead to severe recession that may not fully resolve spontaneously, especially in esthetic zones. A year of observation may reveal spontaneous coronal migration of the gingival margin, but surgical intervention should be considered when esthetic demands and functional stability persist. Well-timed periodontal plastic surgery can achieve stable and esthetic root coverage even in medically compromised patients with careful interdisciplinary management.</p><p><strong>Plain language summary: </strong>This case report describes the treatment and recovery of severe gum damage in a woman with systemic lupus erythematosus, an autoimmune disease. The patient developed septic shock, which was accompanied by extensive gum tissue damage. Although the acute condition improved, significant gum recession remained. Over the following months, the gum tissue showed gradual natural healing, but visible recession on the front surfaces persisted. After 1 year, periodontal plastic surgery was performed to restore the gum line, resulting in complete root coverage and satisfactory esthetic outcomes. This case highlights that some degree of gum recovery may occur naturally after severe tissue damage, particularly within the first year. However, surgical treatment may still be necessary to achieve optimal results. The findings also emphasize the importance of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254667","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-modified coronally advanced flap: Novel digital approach to treat multiple gingival recessions. Workflow and case study","authors":"Mauro Pedrine Santamaria, Ana Carolina Ferreira Bonafé, Amanda Rossato, Manuela Maria Viana Miguel, Andrews Porto da Costa, Ingrid Fernandes Mathias-Santamaria, Marcelo Pereira Nunes, Lucas Araújo Queiroz","doi":"10.1002/cap.10362","DOIUrl":"10.1002/cap.10362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gingival recession (GR) poses esthetic and functional challenges for patients, particularly in cases of multiple adjacent defects. Traditional surgical approaches, such as the modified coronally advanced flap (MCAF) with connective tissue grafts (CTG), demand high levels of precision and skill, making outcomes reliant on clinician expertize. The integration of digital technologies, including cone-beam computed tomography (CBCT) and computer-aided design and manufacturing (CAD–CAM), offers a novel, standardized approach to enhance procedural accuracy and predictability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case study describes the use of the guided-modified coronally advanced flap (g-MCAF) for the treatment of multiple GR defects. A patient whose main concern was the esthetic appearance of her teeth was treated. Using an intraoral scanner, CBCT data, and CAD-CAM software, surgical guides were designed and 3D printed using a dedicated resin, assuring precise adaptation to the patients’ teeth. The guides delineated MCAF oblique incisions and free gingival graft dimensions tailored to fit into the area, facilitating flap design, and graft harvesting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The guided MCAF (g-MCAF) procedure successfully achieved complete root coverage. At the 6-month follow-up, recession reduction was observed, measuring 2.22 mm for tooth #5, 2.59 mm for tooth #6, and 2.26 mm for tooth #7. Gingival thickness also increased, reaching 1.23, 1.16, and 1.45 mm, respectively. Additionally, the patient reported improved esthetics and reduced hypersensitivity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The g-MCAF technique may have the potential to serve as a reliable aid to execute MCAF in the management of multiple GR defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>A guided surgical approach (g-MCAF) using digital technologies allows for precise flap design and graft harvesting, which may help control variability and minimize errors during root coverage procedures.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>The integration of CBCT, intraoral scanning, and CAD–CAM technologies supports preoperative planning, potentially contributing to safer and more predictable outcomes, particularly in cases requiring connective tissue grafts.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>This innova","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"306-313"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095842","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":"A rare mental foramen variation and the role of cone-beam computed tomography in preventing nerve injury: A case report","authors":"Magdalena Orlowska, Hend Abulatifa, Muhammad H. A. Saleh, Hom-Lay Wang","doi":"10.1002/cap.70002","DOIUrl":"10.1002/cap.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The interforaminal space is frequently used for dental implant placement due to its strategic location between the bilateral mental foramina. However, neurosensory disturbances following surgical intervention near the mental foramen (MF) can occur in up to 43% of cases. Understanding anatomical variations of the MF is crucial to preventing surgical complications. Traditional two-dimensional radiographs have limitations in accurately visualizing anatomical structures, whereas cone-beam computed tomography (CBCT) provides high-resolution three-dimensional imaging that enhances diagnostic accuracy and clinical decision making. This case report highlights such a scenario.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 54-year-old male referred for implant placement underwent preoperative evaluation with CBCT, which revealed a rare anatomical variation: the MF was positioned distal to the right mandibular second incisor (distal to #25) roughly 3 mm from the crest of the ridge, rather than its typical between the apices first and second premolars. The mental nerve exhibited an aberrant course, traversing in a superficial, buccal direction along the alveolar crest of site #25. This variability placed the neurovascular bundle at an extremely high risk for intraoperative injury. Consequently, the implant treatment plan was modified to reposition the implants away from the nerve pathway, and a customized CBCT-based surgical guide was utilized to facilitate accurate implant placement while preserving neurovascular integrity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient exhibited no neurosensory disturbances postoperatively, and a 2-week follow-up showed normal healing. The adjusted implant placement strategy successfully avoided nerve injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Conventional radiographs are limited in detecting neurovascular structures and anatomical variations. CBCT serves as an essential diagnostic tool for identifying rare variations of the MF, ensuring precise implant placement, and preventing surgical complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>Before placing dental implants, its important to know exactly where key structures are located to avoid causing injury. This case reports on a 54-year-old man who needed dental implants in his lower front jaw. The mental nerve was not identified with conventional radiography, but this was not a crucia","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"374-380"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.70002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735576","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":"Voclosporin-induced gingival enlargement: A case report","authors":"Francesca Racca, Jessica M. Greco, Dimitris N. Tatakis","doi":"10.1002/cap.10369","DOIUrl":"10.1002/cap.10369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Drug-influenced gingival enlargement (DIGE) is a recognized adverse effect of certain medications, particularly immunosuppressants like cyclosporin and tacrolimus. However, there have been no documented cases of DIGE associated with voclosporin, a newer calcineurin inhibitor used primarily to treat lupus nephritis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This report describes the case of a 27-year-old female with systemic lupus erythematosus and lupus nephritis who developed significant gingival enlargement within 2 months of initiating voclosporin therapy. The patient presented with generalized gingival swelling, spontaneous bleeding, and difficulty eating, leading to her referral to a periodontics clinic. Nonsurgical periodontal therapy was initially attempted, followed by a biopsy to confirm the diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite nonsurgical interventions, the gingival enlargement persisted. Surgical therapy was offered but declined by the patient. Following interdisciplinary consultation, the voclosporin dosage was gradually reduced, and the drug was eventually discontinued. Marked clinical improvement was observed within 1 month after drug discontinuation, with reduced enlargement and diminished pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case appears to be the first to document gingival enlargement associated with voclosporin therapy. The findings emphasize the need for awareness of this potential adverse effect and highlight the importance of interdisciplinary care in managing such cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>Voclosporin may cause gingival enlargement, similar to other calcineurin inhibitors, such as cyclosporin.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>With voclosporin emerging as a promising alternative for nephrologists in managing lupus nephritis, its prescription rates are likely to rise, which accentuates the importance of dental professionals being informed and vigilant about associated adverse effects on gingival tissues.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Discontinuation of voclosporin should be considered, in consultation with the patient's medical team, if its oral adverse e","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"338-343"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499439","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":"Periodontal reconstructive surgery with improved papilla architecture: Case report with 24 months of follow-up","authors":"Michele Perelli, Rodrigo Neiva, Roberto Abundo, David Barack","doi":"10.1002/cap.10354","DOIUrl":"10.1002/cap.10354","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontal defect reconstruction often relies on bone or bone substitutes to fill defects, membranes to exclude tissues unsupportive of new bone and attachment, and biologics to stimulate cells for healing and tissue formation. The scaffold we used is a nonparticulate osteoconductive bone substitute for repairing defects without migration of particles and maintaining volume above the walls and confines of the periodontal treatment site. This may provide a more predictable option for rebuilding lost supporting bone, especially in less contained defects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A case of periodontitis stage III grade A at tooth no. 5 treated with intentional defect overfill to sustain interdental papilla with filling of the defect. Established guided tissue regeneration techniques were used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 15 days, complete soft tissue closure at the defect site and root coverage at tooth 6 due to coronal advancement of the flap were observed. After 1 year, the papilla between teeth 6 and 5 filled the interproximal space, recession at 6 and 5 was 0 mm, and clinical attachment level gain at 5 was 4 mm. Soft-tissue maturation continued over 2 years, showing increasing thickness and healthy aspect. Over 24 months, increasingly defined bone-like imagery of the infrabony defect was obtained on X-ray without probing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Using a cross-linked, completely resorbable collagen scaffold covered with a membrane based on the same engineering promoted tissue growth above the walls of the defect. This was effective in bone regeneration of an intrabony defect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why is this case new information?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>This is a case report describing the use of a completely resorbable ossifying collagen sponge with intentional overfill of the periodontal defect. This surgical technique allowed the clinician to improve the reduced interdental papilla architecture together with filling of the defect. This outcome represents a difficult and unpredictable goal for traditional periodontal reconstructive therapy.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the keys to successful management of this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>Proper diagnosis and treatment planning</li>\u0000 \u0000 <li>Adequate and m","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"244-250"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labial overlay cervical composite for containment of partially exposed connective tissue graft","authors":"Jonathan H. Do","doi":"10.1002/cap.70004","DOIUrl":"10.1002/cap.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Placement of a connective tissue graft (CTG) in the facial abutment‒socket gap without any flap/pouch preparation has been demonstrated to effectively increase mucosal thickness and maintain midfacial marginal stability. At sites where the mucosal margin must be coronally advanced to improve esthetics, a flapless/pouchless approach requires the graft to be left partially exposed, which increases the risk of graft necrosis. The purpose of this report is to introduce the labial overlay cervical composite (LOCC) to provide graft containment and stabilization in these challenging situations to improve graft survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 67-year-old healthy, nonsmoking, Caucasian female presented with tooth #10 having external resorption that had progressed to the pulp, and the gingival margin 3‒4 mm apical to the gingival margin of the contralateral incisor. The tooth was extracted, and an immediate implant was placed flapless. The provisional restoration was fabricated ∼2 mm short of the mucosal margin. The implant‒socket gap was grafted with bone, and the abutment‒socket gap was grafted with a CTG, which was ∼2 mm exposed. The LOCC was fabricated by bonding flowable composite to the midfaciocervical surface of the provisional crown and extending it apically to cover the graft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The exposed CTG covered by the LOCC survived. Twenty-one months post-treatment, the midfacial mucosal margin remained consistent with the contralateral gingival margin, and the convex facial tissue contour was preserved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The LOCC may effectively enhance graft survival and overall esthetic outcome when the CTG must be left exposed by providing containment and stabilization of the graft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>Labial overlay cervical composite (LOCC) is a simple addition to the provisional crown during treatment and can be easily removed during post-op.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>LOCC may effectively enhance graft survival and overall esthetic outcome when the connective tissue graft must be left partially exposed by providing containment and stabilization of the graft.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language sum","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"387-394"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735577","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}