Clinical Advances in Periodontics最新文献

{"title":"A conservative approach for keratinized tissue augmentation: Report of two cases","authors":"Vikender S. Yadav, Kanika Makker, Razia Haidrus, Nitesh Tewari","doi":"10.1002/cap.10309","DOIUrl":"10.1002/cap.10309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Free gingival graft harvested from the palate is considered the most predictable method to augment the keratinized tissue (KT). However, the anatomical limitations of the palate, and associated patient morbidity and complications restrict clinicians from performing these procedures in adolescents. Color mismatch with the native tissues resulting in poor esthetic appearance is another concern. To overcome these limitations, this article reports a surgical approach known as labial gingival graft (LGG) as an alternative to palatal graft.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two adolescent patients presenting with absence of attached gingiva and shallow gingival recession in the mandibular incisor region were treated with LGG harvested from the labial KT of teeth adjacent to those requiring KT augmentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The procedure was well tolerated by the patients. At the final follow-up (3.5- and 2 years from baseline), a significant gain in KT with complete root coverage was achieved in both patients. Both professional and patient-centered esthetic evaluations revealed excellent color match making the grafted area imperceptible from the adjacent mucosa.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The proposed technique was found to be simple and predictable, and was associated with minimal morbidity and no complications. Clinicians may consider performing LGG procedure when sufficient KT can be harvested from adjacent donor site. The selection of such techniques is of particular relevance in children who are vulnerable to complications associated with more invasive procedures.</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>To the best of our knowledge, this article is the first to present the use of labial gingival graft harvested from adjacent keratinized mucosa in adolescent patients.</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>Proper case selection in terms of sufficient amount of keratinized tissue to harvest as labial gingival graft from adjacent teeth.</li>\u0000 \u0000 <li>Use of smaller instruments, small-sized needles, and sutures under magnification to minimize trauma to the tissues /graft.</li>\u0000 \u0000 <","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 3","pages":"223-228"},"PeriodicalIF":0.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127486","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":"Three- to 4-year follow-up of the reverse palatal pedicle graft for maxillary palatal recessions","authors":"Thomas T. Nguyen, David T. Wu, Bradley F. Weinstein","doi":"10.1002/cap.10313","DOIUrl":"10.1002/cap.10313","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study evaluates the long-term stability and clinical outcomes of the reverse palatal pedicle graft (RPPG) technique in treating maxillary molar palatal recessions over a 3 to 4-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three patients with palatal recession defects on maxillary molars were treated using the RPPG technique. Clinical parameters including recession depth, probing depth, and clinical attachment levels (CALs) were recorded at baseline, 2 months, and 3–4 years postoperatively. Healing outcomes, tissue perfusion, and soft tissue thickness were assessed through clinical examination, cone beam computed tomography (CBCT), and ultrasonography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients demonstrated significant CAL gain and partial root coverage. The RPPG technique resulted in significant improvements in attachment gain (41%–67%) and root coverage (44%–83%). In addition, a CBCT scan of one grafted site at a 4-year follow-up (Case 1) demonstrates a gain in soft tissue thickness and partial root coverage. Ultrasound imaging of another grafted site at a 4-year follow-up (Case 2) demonstrates a gain in soft tissue thickness and adequate graft perfusion. The outcomes suggest stable graft sites with some evidence of creeping attachment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The RPPG technique provides a viable option for treating maxillary molar palatal recessions, demonstrating promising long-term stability and clinical improvements. Further studies with larger sample sizes and frequent follow-ups are needed to better understand the dynamics of creeping attachment and refine clinical guidelines for palatal grafting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>The reverse palatal pedicle graft (RPPG) is a surgical technique providing a viable solution for the treatment of maxillary molar palatal root coverage for a single recession site with 3–4 years of follow-up demonstrating a degree of predictability.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Clinical indications for the application of the RPPG technique include severe palatal recession with little to no interproximal attachment loss (RT1 or RT2), palatal root sensitivity, and a sufficient amount of keratinized tissue on the pala","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 3","pages":"255-262"},"PeriodicalIF":0.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://aap.onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127487","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":"Ten-year follow-up after peri-implantitis treatment using resective surgery: A case report","authors":"João Batista César Neto, Isabella Neme Ribeiro dos Reis, Rafael Oliveira Lazarin, Nadja Naenni, Cristina Cunha Villar, Claudio Mendes Pannuti","doi":"10.1002/cap.10310","DOIUrl":"10.1002/cap.10310","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peri-implantitis poses significant challenges in clinical practice, necessitating effective therapeutic strategies. This case report presents a comprehensive treatment approach for managing peri-implantitis, focusing on resective surgery, including implantoplasty and long-term maintenance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We describe the case of a 50-year-old female patient with peri-implantitis affecting a maxillary full-arch implant-supported rehabilitation. The treatment strategy involved resective surgery with implantoplasty, a new maxillary overdenture, and a regular maintenance care schedule of three to four visits per year. Clinical and radiographic assessments were performed over a 10-year follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Post-treatment, all maxillary implants demonstrated no probing depths exceeding 4 mm, absence of bleeding on probing or suppuration, minimal plaque accumulation, and no further bone loss. Resective surgery with implantoplasty seems to have effectively provided submucosal decontamination and created a supra-mucosal implant surface conducive to oral hygiene. Despite regular maintenance, some mandibular implants exhibited bone loss during the follow-up period and were managed using the same approach as for the maxillary implants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The comprehensive treatment approach yielded favorable long-term clinical and radiographic outcomes, underscoring the effectiveness of the combined strategies in managing peri-implantitis. Nevertheless, the potential for recurrence or the development of peri-implantitis in new implants, even after a decade of successful treatment and strict maintenance, highlights the importance of ongoing, diligent care and regular evaluations to promptly diagnose and address these issues.</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>\u0000 <p>The long-term effectiveness of peri-implantitis treatments, particularly involving implantoplasty, remains under-documented. This case provides insights from a 10-year follow-up on the efficacy of a comprehensive approach for managing peri-implantitis. Furthermore, these findings illustrate the potential for new peri-implantitis to develop, regardless of sustained peri-implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 3","pages":"229-237"},"PeriodicalIF":0.9,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908482","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":"Immediate implant placement in extraction sockets with buccal bone dehiscence: A case study","authors":"Panagiotis Dragonas","doi":"10.1002/cap.10307","DOIUrl":"10.1002/cap.10307","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immediate implant placement (IIP) has been associated with a higher risk of esthetic complications and particularly buccal mucosal recession, which can be more pronounced in non-intact sockets or in the presence of thin phenotype in the esthetic zone. Nevertheless, multiple techniques have been published to address IIP in non-intact alveolar sockets with favorable outcomes. The purpose of this study is to present an approach on IIP in sites with buccal bone dehiscence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three patients requiring extraction of one or multiple teeth in the presence of buccal bone dehiscence were treated with flapless extractions, IIP, guided bone regeneration (GBR), and connective tissue grafting (CTG) through a tunneling approach with a simultaneous use of custom healing abutments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All sites exhibited 1–2 mm of buccal bone thickness at the level of the implant platform, as well as significant buccal soft tissue thickness with no recession and a favorable development of the emergence profile at 4 months to a year post implant placement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IIP in sockets with buccal bone dehiscence can be managed by means of a flapless extraction, GBR and CTG through a tunneling approach exhibiting favorable hard and soft tissue responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>When placing immediate implants in non-intact sockets, simultaneous connective tissue grafting is recommended, especially in the esthetic zone.</li>\u0000 \u0000 <li>Bone grafting in immediate implants in sockets with buccal bone dehiscence can be performed through a tunneling approach without the need for open flap approaches.</li>\u0000 \u0000 <li>Placement of CHAs over immediate implants may help promote maintenance of the buccolingual ridge contours and overall hard and soft tissue responses.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>Placing dental implants right after tooth extraction can lead to more visible aesthetic issues, especially gum recession. This is more common when the tooth socket is not intact or the gum tissue is thin. However, several techniques have shown good results even in these challenging situations. This study explores a method for implant placement r","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 3","pages":"213-222"},"PeriodicalIF":0.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141794168","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":"Key themes in periodontal treatment: Lessons learned from 40-year experiences","authors":"Joseph M. Montesano, Ronald M. Fried, Irina F. Dragan","doi":"10.1002/cap.10308","DOIUrl":"10.1002/cap.10308","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Periodontitis is one of the most prevalent oral diseases with significant implications for systemic health. This study aims to explore themes influencing successful long-term outcomes in periodontal treatment through a historical lens, focusing on various factors influencing the longevity of periodontal health and dentition stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Utilizing an inductive qualitative thematic analysis approach, this study utilized a retrospective chart review of 19 patient records spanning, on average, 40 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four major themes contributing to periodontal stability were identified: (1) adequate patient plaque control; (2) regular periodontal maintenance; (3) collaboration between hygienists and periodontists; and (4) the application of various periodontist/dentist-performed procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Current findings underscore the importance of these factors in preserving patients’ periodontal health by emphasizing conservative treatment approaches in the maintenance and retention of the natural dentition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>\u0000 <p>Adequate patient plaque control is essential for maintaining a patient's periodontal health and dentition long-term.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>A regular periodontal maintenance schedule should be assigned and modified as necessary for each individual patient's care.</p>\u0000 </li>\u0000 \u0000 <li>\u0000 <p>Collaborative care with hygienist colleagues and ensuring there are flexible treatment options for patients can lead to successful treatment outcomes when hygiene alone is not sufficient.</p>\u0000 </li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>Periodontitis is a widespread oral disease with significant systemic health implications. This study examined patient records to identify factors contributing to long-term periodontal stability and maintenance of teeth. By analyzing 19 patient charts over an average of 40 years using a qualitative approach, four key themes were identified in successful patient treatments: effective patient plaque control, regular periodontal maintenance, collab","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"169-178"},"PeriodicalIF":0.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The innovative double or triple dental abutment-implant: Case study with a 3- to 12-year follow-up","authors":"Luciana Silva Colepícolo,&nbsp;Maria Auxiliadora Mourão Martinez,&nbsp;Andrea Augusto Rodrigues,&nbsp;Leonardo Silveira Baeta,&nbsp;Fernando Oliveira Costa","doi":"10.1002/cap.10300","DOIUrl":"10.1002/cap.10300","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this case study is to present the rationality and scientific evidence of a new design for a double (DA) and triple (TA) dental abutment-implant with their specific new concept of biodynamic optimized peri-implant tissue (BOPiT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The innovative design of these abutments with a paraboloid geometry was based on BOPiT, simultaneously involving the principles of mechanobiology, biotensegrity, and mechanotransduction. Thus, 37 consecutive individuals/43 cases rehabilitated with single dental implant using the innovative DA (<i>n</i> = 28) and TA (<i>n</i> = 15) on 43 implants were included in this case study. The DA and TA support 2 or 3 dental crowns on a single implant, respectively. Clinic and radiographic examinations were presented at T1 (loading after 4 months) and T2 [final examination with an average follow-up time of 7.2 years (&gt;3 to 12 years)].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At T2, mean scores for plaque index, peri-implant bleeding on probing, and peri-implant probing depth were low, depicting healthy peri-implant conditions. All radiographic images showed insignificant annual marginal bone loss (0.022 ± 0.05 mm) when compared to T1, reflecting great bone stability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DA and TA, based on the BOPiT concept, represent an advantageous, simple and non-invasive mechanism for the longevity and healthy regulation of the peri-implant tissues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 3","pages":"200-212"},"PeriodicalIF":0.9,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735784","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":"Peri-implantitis as a rare local manifestation of actinomycosis: A case report","authors":"Daniel Hawkins,&nbsp;Janina Golob Deeb","doi":"10.1002/cap.10295","DOIUrl":"10.1002/cap.10295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Actinomycosis can be caused by periapical endodontic infection, trauma, or surgical dental procedures. Due to its rare occurrence in a healthy adult patient, persistent actinomycotic osteomyelitis around implants presenting as severe peri-implantitis may be challenging to diagnose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 26-year-old male patient with non-contributory medical history presented to the Oral and Maxillofacial Surgery Clinic in 2018 with pain and edema associated with endodontically treated maxillary premolar teeth with poor prognosis. Oral examination revealed fair oral hygiene, heavily restored dentition, multiple carious teeth, failing restorations, endodontic treatments in both maxillary quadrants, and normal periodontal examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two years following extractions and restoration with implants, the patient returned with a bony sequestrum and fistula in the buccal gingiva adjacent to the implants. The patient reported shifting of implants and slight change in his occlusion. Clinical, radiographic, and endodontic examinations did not demonstrate a clear origin of the fistula. A periodontist was consulted regarding the possibility of peri-implantitis and tracing of the fistula suggested intraosseous involvement of the implant surface. Flap surgery, biopsy, culture, implant removal, and surgical debridement were performed. Histologic examination revealed colonies of actinomycotic organisms and confirmed likely diagnosis of actinomycosis. The patient was placed on a long course of penicillin VK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The occurrence of actinomycosis in a healthy adult patient is rare. This case report describes persistent actinomycosis presenting as osteomyelitis with severe peri-implantitis in a healthy patient, which may have been associated with a previously existing periapical endodontic infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"118-123"},"PeriodicalIF":0.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332545","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":"Correlations of gingival biotype with clinical crown and periodontal parameters in maxillary and mandibular jaws","authors":"Nidhi Pradeep Gadge,&nbsp;Ruhee Chawla,&nbsp;Sunil Ronad,&nbsp;Shreya Vikas Bhole,&nbsp;Pawan Kumar,&nbsp;Puttaraj Tukaram Kattimani","doi":"10.1002/cap.10302","DOIUrl":"10.1002/cap.10302","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 gingival biotype (GB) influences treatment planning and clinical outcomes in several dental specialties. This study aimed to investigate the associations between the GB and various clinical crown and periodontal parameters, such as probing depth (PD), papillary height (PH), keratinized tissue width (KTW), crown width/crown length ratio (CW/CL), and gingival thickness (GT). The secondary objective was to evaluate the optimal cutoff values for all parameters to determine the GB in both the maxillary and mandibular anterior teeth.&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 cross-sectional study included 50 healthy individuals (26 men and 24 women) aged between 20 and 35 years. The GB was determined as a binary variable based on the transparency of a periodontal probe through the buccal gingival margin (TRAN). The clinical crown and periodontal parameters, such as PH, PD, KTW, GT (free gingival thickness [FGT] and attached gingival thickness [AGT]), and the CW/CL ratio were measured. The associations between different variables were evaluated by the chi-square test. Correlations between various clinical parameters and GB were assessed using point-biserial correlation analyses. Receiver operating characteristic (ROC) analysis and the Youden index were used to calculate the optimal cutoff values for the PH, PD, KTW, FGT, AGT, and CW/CL ratio to discriminate GB. The statistical significance level was set at &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The mean age of the males was 28.23 ± 2.81 years, while that of the females was 27.08 ± 2.85 years. Thick GB was present in 56% of individuals, and thin GB was present in 44% of individuals. Compared with females, males had a predilection for thick GB compared with females. According to the ROC analysis, the cutoff values to discriminate GB for mandibular anterior teeth were 3.4 mm for PH, 1.96 mm for PD, 4.21 mm for KTW, 0.98 mm for FGT, 0.43 mm for AGT, and 0.91 for the CW/CL ratio. Similarly, the cutoff values for discriminating the GB for maxillary anterior teeth were 4.02 mm for PH, 1.92 mm for PD, 3.89 mm for KTW, 1.02 mm for FGT, 0.42 mm for AGT, and 0.83 for the CW/CL ratio. PH, PD, and FGT showed strong positive correlations with GB, whereas KTW, AGT, and the CW/CL ratio showed weak positive correlation with GB.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Within the limitations of the present study, a significant association between all clinical crown and periodontal parameters with the GB has been confirmed. FGT for mandibular anterior teeth and PH for the mandibular anterior teeth have emerged as the mo","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 1","pages":"77-85"},"PeriodicalIF":0.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The wingspan suspension approach: A modified semilunar technique for multiple areas of recession","authors":"Allison N. Rascon,&nbsp;Bradley Lander,&nbsp;Joseph P. Fiorellini,&nbsp;Rodrigo Neiva","doi":"10.1002/cap.10296","DOIUrl":"10.1002/cap.10296","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Gingival recession can be considered an undesirable condition that results in the exposure of the root surface. There are many techniques that can be employed to address gingival recession; however, they frequently involve a second surgical site. Other approaches have been introduced in the past to address this concern, and this case study discusses the use of a modified technique to achieve root coverage.&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 patient presented to the periodontics clinic with concerns regarding gingival recession. A modification to the semilunar technique was employed to address the recession, whereas double sling sutures were utilized to maintain the coronal repositioning of the flap.&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;Maxillary central incisors initially presented with 2–3 mm of facial recession and root coverage was achieved by use of a modified surgical semilunar approach. No rebound noted over a 6-month period, newly established gingival margin deemed clinically stable.&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 study provides an alternative to addressing gingival recession in the maxillary anterior region, when &lt;3 mm of recession is noted. Avoidance of a second surgical procedure and/or donor site is of particular benefit, as well as maintenance of the blood supply.&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;There is insufficient evidence on the use of a modified wingspan incision design Phenotype modification with elimination of a second surgical site is most ideal for the patient.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the keys to successful management of this case?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Comprehensive diagnosis and proper case selection Meticulous flap management and adequate release to allow for repositioning without tension Appropriate use ofsuture and suturing technique.&lt;/li&gt;\u0000 &lt;/ul&gt;\u0000 &lt;/div&gt;\u0000 \u0000 &lt;div&gt;&lt;b&gt;What are the primary limitations to success in this case?&lt;/b&gt;\u0000 \u0000 &lt;ul&gt;\u0000 \u0000 &lt;li&gt;Thin periodontal phenotype Poor oral hygiene and plaque accumulat","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"124-129"},"PeriodicalIF":0.9,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10296","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319077","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":"The distally anchored connective tissue graft platform for papilla enhancement: A case report","authors":"Gonzalo Blasi,&nbsp;Lory Abrahamian,&nbsp;Alvaro Blasi","doi":"10.1002/cap.10299","DOIUrl":"10.1002/cap.10299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As the need for using dental implants to replace single missing teeth grows, so does the demand for greater esthetic results. However, achieving complete interproximal papillae fill in single-tooth implant restorations remains a challenge. The distally anchored connective tissue platform is a novel soft tissue augmentation technique that consists of harvesting an autogenous connective tissue graft from the palate, folding it, and positioning it at the level of the distal occlusal and buccal surfaces with the help of a distal sling suture to the adjacent distal tooth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This case report describes how a maxillary central incisor with compromised hard and soft tissues were replaced using a comprehensive treatment plan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The clinical outcomes showed stable mucosal margin levels and complete papillae fill. The patient expressed satisfaction with the achieved results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The distally anchored connective tissue graft platform performed at the time of implant placement emerges as a viable and effective soft tissue augmentation technique that yields highly esthetic results.</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>To the best of our knowledge, this is the first case report in the literature using the distally anchored connective tissue platform.</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>Adequate diagnosis and decision-making, resulting in a treatment plan focused on reconstructing both soft and hard tissues in a single-tooth implant within the esthetic area, yield favorable clinical, radiological, and patient-reported outcomes.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000 <div><b>What are the primary limitations to success in this case?</b>\u0000 \u0000 <ul>\u0000 \u0000 <li>The primary limitation of this study is its reliance on a single case report.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"15 2","pages":"150-159"},"PeriodicalIF":0.9,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297383","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}