Clinical Advances in Periodontics最新文献

{"title":"The connective tissue cube for treatment of papillary deficiencies: A case report","authors":"Giuseppe Carvelli, Elli Anna Kotsailidi, Alexandra Tsigarida, Shalom Benzaquen, Konstantinos Chochlidakis, Carlo Ercoli, Jack G. Caton","doi":"10.1002/cap.10371","DOIUrl":"10.1002/cap.10371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prevention and treatment of interproximal recessions after periodontal therapy has been challenging and is important because the resulting black triangles are unesthetic. Traditional treatment options include orthodontic, restorative, surgical, and combined approaches. This case report aims to describe an approach using periodontal plastic surgery combined with prosthetic treatment for the management of a papillary deficiency in the esthetic zone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A healthy, 64-year-old female presented with esthetic concerns related to a black triangle between the maxillary right canine and first premolar as a result of periodontal therapy. A Class III recession defect was present. A de-epithelialized connective tissue graft harvested from the maxillary tuberosity was placed interproximally and combined with a coronally advanced flap and enamel matrix derivative. Following 6 months, the restorative phase was initiated including diagnostic wax-up, direct composite restoration the mesial of the premolar, followed by facial veneer preparation on the canine using an incisal butt joint design. After the provisional phase, a lithium disilicate ceramic veneer was fabricated and cemented with adhesive technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following 18 months of follow-up, we observed a nearly complete closure of the embrasure space.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The successful closure of the interproximal tissue deficiency, as evidenced by this case report, demonstrates the potential of this approach utilizing an interproximal connective tissue graft along with prosthetic treatment to manage significant papillary defects; this report reinforces the role combined prosthodontic and periodontic approaches may have in treatment outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>The connective tissue cube technique showed potential for treatment of severe papillary deficiencies.</li>\u0000 \u0000 <li>Combined surgical–restorative approaches might be needed for complete closure of black triangles.</li>\u0000 \u0000 <li>Further clinical studies with stronger level of evidence are needed.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Plain language summary</h3>\u0000 \u0000 <p>This case report discusses a treatment for a common issue after periodon","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"356-364"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287862","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":"Oral injury from Calotropis procera: A case report on inadvertent gingival damage","authors":"Maria Sharon Velraj, Balaji Ganesh Subramanian, Kaarthikeyan Gurumoorthy","doi":"10.1002/cap.70003","DOIUrl":"10.1002/cap.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemical burns of the oral cavity and esophagus are frequently reported in southeast Europe, often resulting from the improper use of pharmaceutical or non-pharmaceutical substances. <i>Calotropis procera</i> (Apple of Sodom, Giant milkweed), a plant known for its toxic latex, has been associated with various dermatological and mucosal injuries. The objective of this case report is to describe a rare instance of gingival chemical burn caused by direct application of <i>C. procera</i> latex and to raise awareness about the potential risks of plant-based self-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 49-year-old female presented with a painful lesion in the mandibular vestibule following direct application of <i>C. procera</i> latex. Clinical examination revealed a white, scrapable patch with irregular borders localized to the lower right alveolar mucosa and gingival region, extending from tooth #29 to tooth #31. The diagnosis was made based on history, clinical presentation, and exclusion of other potential etiologies. The patient was prescribed Curnext oral gel 2%, primarily composed of curcumin, the active polyphenol derived from <i>Curcuma longa</i> (turmeric), to be applied thrice daily for 1 week to 10 days. Supportive oral prophylaxis was provided, and the patient was educated on appropriate oral hygiene measures</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The patient demonstrated 94% adherence based on self-reported feedback and a log diary, with no adverse effects noted from Curnext oral gel 2%. By day 7, symptoms had resolved significantly, and a 3-month follow-up confirmed complete recovery without recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This case illustrates the risk of chemical burns associated with exposure to <i>C. procera</i> latex and the essential role of patient education in mitigating the dangers of unverified traditional remedies. Timely diagnosis, appropriate management, and comprehensive preventive counselling are critical in promoting healing and preventing long-term complications, thereby enhancing patient outcomes and contributing to public health efforts aimed at reducing preventable oral injuries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div><b>Why is this case new information?</b><ul>\u0000 \u0000 <li>Despite the fact that Calotropis is one of the most widely utilized plants in India, there have never been any case reports of chemical burns to our knowledge.</li>\u0000 </ul>\u0000 </div>\u0000 \u0000","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"381-386"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735603","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":"Intraosseous sarcoidosis imitating peri-implantitis: A case study","authors":"Magdalena Orlowska, David S. Gottlieb, Kenneth S. Kornman","doi":"10.1002/cap.10355","DOIUrl":"10.1002/cap.10355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sarcoidosis is a multisystem granulomatous disorder of unknown cause, typically affecting the lungs and lymph nodes, but it can also involve the eyes, skin, heart, bones, and other organs. The exact cause is unclear, but genetic factors and environmental triggers like infections, chemicals, or dust may play a role. Although it may resolve on its own in some cases, sarcoidosis can cause long-term organ damage. There is no definitive cure, but many people manage the condition with minimal or no treatment, depending on the severity and organs affected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 40-year-old healthy male patient was referred for a periodontal consultation with a suspected diagnosis of peri-implantitis. The patient had a generally healthy periodontium, but significant mandibular bone loss was observed around dental implants. Although bone involvement in sarcoidosis is rare, occurring in 1%–13% of patients, the patient's initial presentation was marked by alveolar bone loss, a potential first sign of intraosseous sarcoidosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This case reports a rare occurrence of intraosseous sarcoidosis around mandibular implants, which was initially misdiagnosed as peri-implantitis due to overlapping symptoms and radiographic features. Ultimately, the correct diagnosis was established, leading to appropriate management and a better understanding of the condition's impact on implant outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intraosseous sarcoidosis of the jaw is an uncommon condition that can mimic periodontitis or peri-implantitis due to its characteristic rapid alveolar bone loss. Dentists should be vigilant and consider sarcoidosis in differential diagnoses when encountering unexplained bone loss around implants. Early recognition and proper referral for further investigation are essential for appropriate management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key points</h3>\u0000 \u0000 <div>\u0000 <ul>\u0000 \u0000 <li>Intraosseous sarcoidosis can mimic periodontitis or peri-implantitis due to rapid bone loss.</li>\u0000 \u0000 <li>Dentists should consider sarcoidosis in cases of unexplained implant bone loss.</li>\u0000 \u0000 <li>Early diagnosis and referral are essential for proper management.</li>\u0000 </ul>\u0000 </div>\u0000 </","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":"16 2","pages":"251-259"},"PeriodicalIF":1.3,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cap.10355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146222343","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":"Digitally guided corticotomy using a customized surgical template (Suya corticotomy utility template): A technique report.","authors":"Yosuke Tsukiboshi, Jaewon Choi, Takuma Fukumoto, Ryo Nakajima","doi":"10.1002/cap.70009","DOIUrl":"10.1002/cap.70009","url":null,"abstract":"<p><strong>Background: </strong>Precise control of corticotomy lines is critical in surgically facilitated orthodontic therapy. The Suya method is traditionally performed freehand, which introduces risks of root damage and procedural inconsistency. A digitally guided protocol may address these limitations by enhancing safety and technical predictability.</p><p><strong>Methods: </strong>A digital workflow based on the Suya method was developed using cone-beam computed tomography (CBCT) and intraoral scanning data to generate a three-dimensional (3D) integrated model of the maxilla. Vertical and apical osteotomy lines were virtually planned between roots and in the apical region. A customized surgical template (Suya corticotomy utility template) was designed using free software and fabricated via 3D printing. Guided corticotomy was performed using a piezoelectric device, followed by controlled chisel application along both vertical and apical cuts.</p><p><strong>Results: </strong>In a 32-year-old female patient, the digitally guided corticotomy was executed with high accuracy and reproducibility. Piezoelectric cortical incisions followed the preplanned paths without deviation. Chisel application along the guide-defined paths resulted in controlled fracturization. Postoperative CBCT confirmed that all osteotomies were positioned safely between roots, with no evidence of root contact or damage.</p><p><strong>Conclusions: </strong>This digitally guided Suya method provides a reproducible and biologically sound approach for performing root-sensitive corticotomy with enhanced surgical control. The use of 3D-printed guides tailored to piezoelectric instrumentation may improve safety, accuracy, and standardization of corticotomy procedures in interdisciplinary periodontal care.</p><p><strong>Key points: </strong>A digitally guided corticotomy protocol based on the Suya method enables root-sensitive osteotomy with improved surgical accuracy and safety. CBCT and IOS integration allows for precise virtual planning of osteotomy lines, which can be transferred intraoperatively using a customized 3D-printed guide (Suya corticotomy utility template). The workflow supports reproducible corticotomy in adult patients with dense cortical bone, minimizing the risk of root damage and surgical variability.</p><p><strong>Plain language summary: </strong>Orthodontic treatments in adults can take a long time due to slower bone remodeling. To speed this up, surgeons may perform a procedure called corticotomy, where small cuts are made in the bone around the teeth to stimulate faster movement. However, doing this by hand can be tricky and risky, especially near tooth roots and nerves. In this report, we describe a new method that uses digital planning and a custom-made surgical guide (called the Suya corticotomy utility template) to help perform these bone cuts with much more precision. The guide is created by combining three-dimensional (3D) images from dental scans and ca","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"428-434"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13269201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979865","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":"Digital analysis of periodontal phenotype in the maxillary anterior region.","authors":"Wenxin Li, Tingting Xu, Haiqi Zhang, Yang Lü, Qiao Yang, Jing Zhu, Yanan Xu, Yi Peng","doi":"10.1002/cap.10353","DOIUrl":"10.1002/cap.10353","url":null,"abstract":"<p><strong>Background: </strong>Accurate assessment of the periodontal phenotype is crucial for optimizing esthetic outcomes in dental practice. This study systematically evaluated key periodontal parameters in the maxillary anterior region and analyzed their interrelationships to enhance diagnostic precision and inform personalized treatment planning.</p><p><strong>Methods: </strong>Sixty-two periodontally healthy volunteers were included. Labial papilla height (PH), gingival zenith (GZ), the distance between the GZ of the lateral incisor and the gingival line (LID), height of contact surface (CS), crown width (CW), and crown length (CL) were measured using plaster models, intraoral photographs, and digital models obtained via intraoral scanning. Keratinized gingiva width (KGW) was assessed using a periodontal probe. Labial gingival thickness (GT) was measured at three locations-1 mm apical to the gingival margin, at the alveolar crest, and 2 mm apical to the crest-while labial alveolar bone thickness (BT) was evaluated at the alveolar crest and 2 mm apical to the crest, both using cone beam computed tomography (CBCT). Correlations among periodontal phenotype parameters were analyzed.</p><p><strong>Results: </strong>Parameters measured from intraoral scanned digital models showed no statistically significant differences compared to plaster models (NS, P>0.05). Varying degrees of correlation were identified among components of the periodontal phenotype, including GT, BT, KGW, PH, GZ, LID, and the ratios of CW to CL (CW/CL) and CS to CL (CS/CL).</p><p><strong>Conclusions: </strong>Digital technology enables noninvasive, rapid, and precise assessment of periodontal phenotype, supporting risk assessment, and personalized treatment planning in aesthetic dentistry.</p><p><strong>Key points: </strong>Digital methods yield precise periodontal phenotype analysis in aesthetic zones. Intraoral scanning and CBCT provide detailed periodontal phenotype parameters, revealing correlations with key esthetic factors like papilla height and gingival zenith. Correlation analysis between periodontal phenotype and key esthetic factors in the anterior maxilla enhances understanding of phenotype's impact on aesthetic outcomes and improves treatment planning.</p><p><strong>Plain language summary: </strong>This study aimed to improve how dentists assess the surrounding tissues in the front upper teeth, which is essential for achieving natural-looking and aesthetically pleasing results in dental treatments. Researchers analyzed the gum, tooth, and bone characteristics of 62 healthy volunteers using traditional plaster models, intraoral photographs, and digital scans. They measured key parameters including gum thickness, bone thickness, and other relevant features. The study found that digital scans provided results as accurate as the traditional plaster models. Furthermore, the researchers identified connections between different gum and tooth characteristics, such as how","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"446-456"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694422","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 novel polycaprolactone mesh for buccal bone augmentation with simultaneous implant placement: A feasibility report of three cases.","authors":"Hung-Teng Hsu, Zong-Ting Lai, Guo-Hao Lin, Shou-Yen Kao, Hsuan-Hung Chen","doi":"10.1002/cap.70007","DOIUrl":"10.1002/cap.70007","url":null,"abstract":"<p><strong>Background: </strong>Polycaprolactone (PCL) is a synthetic, biocompatible, and biodegradable thermoplastic polyester. Three-dimensionally (3D) printed PCL meshes have demonstrated the ability to conform to the defect morphology, providing stable space maintenance and promoting angiogenesis during hard tissue healing. While PCL has shown promise across various medical applications, clinical studies evaluating its effectiveness for hard tissue augmentation in implant dentistry remain limited.</p><p><strong>Methods: </strong>This case study included three patients with four implants placed simultaneously with lateral bone augmentation using thermally shaped and trimmed PCL mesh and autogenous bone graft. Cone-beam computed tomography scans were obtained preoperatively, immediately post-augmentation, and at 1-year follow-up. Voxel-based registration was used to standardize measurements, evaluating bone width changes at the implant shoulder level, and 1, 3, 5, and 7 mm apical to the implant shoulder.</p><p><strong>Results: </strong>At 1 year, all implants remained clinically stable with no adverse events or significant crestal bone loss. Bone width increased at all measured levels post-augmentation. Mean bone gain reached 2.13 mm (1.74-2.70 mm) at 1 mm apical and 1.59 mm (0.78-2.33 mm) at 3 mm apical to the implant shoulder. Final buccal bone thickness exceeded 2 mm in 62.5% of sites (5 out of 8) at the implant shoulder level and 1 mm apical to the implant shoulder.</p><p><strong>Conclusions: </strong>PCL mesh demonstrated clinical feasibility for simultaneous bone augmentation during implant placement. However, further clinical trials with extended follow-up periods are needed to validate these findings and fully explore the potential of PCL mesh in implant dentistry.</p><p><strong>Key points: </strong>Polycaprolactone (PCL) mesh provides a stable, resorbable scaffold for buccal bone augmentation during simultaneous implant placement, offering a minimally invasive alternative to autogenous bone block harvesting. Consistent horizontal bone gain was achieved, particularly near the implant shoulder, with 62.5% of sites exhibiting buccal bone thickness greater than 2 mm at or near the implant shoulder, supporting its clinical effectiveness.</p><p><strong>Plain language summary: </strong>This case study looked at three patients who had areas in their jaws where the bone was too thin or missing to support dental implants. To rebuild the bone, doctors used a special medical material called polycaprolactone (PCL) mesh, a flexible, moldable plastic that can be shaped to fit the bone defect. This mesh was combined with bone graft material to help stimulate new bone growth. Each patient received 3D scans before surgery, right after the procedure, and again 1 year later to monitor progress. In all three cases, the jawbone successfully grew back within 4 months, providing enough support for stable dental implants. The results suggest that PCL mesh can ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"417-427"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979740","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":"Basal bone anchorage for immediate loading in the atrophic maxilla: A technical note with surgical case series.","authors":"Luigi Tomaselli, Enrica Giammarinaro, Roberta Grassi","doi":"10.1002/cap.70012","DOIUrl":"10.1002/cap.70012","url":null,"abstract":"<p><strong>Background: </strong>This clinical study presents a novel technique for basal bone anchorage, a surgical approach designed for immediate loading in the atrophic maxilla, specifically in Cawood Class VI cases. By leveraging the structural integrity of basal bone, this method eliminates the need for invasive bone grafting procedures, reducing patient morbidity, shortening treatment timelines, and enhancing overall patient acceptance.</p><p><strong>Methods: </strong>A single-arm clinical investigation, involving a carefully selected cohort of seven patients, assessed the feasibility, functional outcomes, and implant stability over a 24-month period.</p><p><strong>Results: </strong>Between 2022 and 2024, seven patients received fixed implant-supported rehabilitations with 47 implants (4 mm diameter, 11.5-25 mm length). The average follow-up was 4 years and all implants demonstrated 100% survival and success rates. No failures or complications occurred, except for minor prosthetic chipping in one patient, easily repaired. Postoperative pain was minimal, and patients reported improved confidence, speech, and mastication.</p><p><strong>Conclusion: </strong>The present technique presents certain challenges and limitations. The surgical approach requires advanced expertise in basal bone anchorage, meticulous case selection, and precise execution to avoid complications. Despite these challenges, the present technique offers significant advantages for managing atrophic maxillae, providing a minimally invasive alternative to zygomatic implant placement. This approach holds substantial promise for advancing oral rehabilitation and improving outcomes in complex implantology cases.</p><p><strong>Key points: </strong>Basal bone anchorage provides a graftless solution for immediate loading in atrophic maxillae, leveraging dense cortical structures for high primary stability. The BAT technique distributes long implants in transnasal, pterygoid, and spinal sites, maximizing anterior-posterior spread and enabling predictable cross-arch stabilization. This approach may reduce morbidity and streamline rehabilitation, though it demands advanced surgical skills and further long-term evaluation.</p><p><strong>Plain language summary: </strong>This study presents a new surgical approach for placing dental implants in patients with severely resorbed upper maxilla, where conventional methods often require complex bone grafting or zygomatic implants. The technique relies on anchoring implants in the basal bone a more stable and resorption-resistant area allowing for immediate loading without additional bone reconstruction. In this clinical case series, seven patients received a total of 47 implants and were followed for an average of four years. The results showed excellent outcomes, with 100% implant survival and success, minimal postoperative discomfort, and high patient satisfaction in terms of speech, function, and confidence. While the method requires surgical","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"435-445"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979858","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 treatment with an open barrier double membrane technique (collagen + dense polytetrafluoroethylene).","authors":"Fabrizio Belleggia, Luca Signorini, Mirko Martelli, Marco Gargari","doi":"10.1002/cap.70006","DOIUrl":"10.1002/cap.70006","url":null,"abstract":"<p><strong>Background: </strong>Reconstructive treatments of peri-implantitis are carried out with the principles of guided bone regeneration, with a non-submerged or with a submerged approach. The authors describe a new technique for the reconstruction of intra-bony vertical defects caused by peri-implantitis, which requires the removal of the prosthetic superstructure to have better access to the surgical site, in order to perform the defect debridement and the implant surface decontamination and detoxification, before placing the reconstructive biomaterials.</p><p><strong>Methods: </strong>A 2 mm high cap screw was connected to the implant with the aim of not letting a cross-linked collagen membrane to collapse over the implant threads. This membrane covered the implant and the whole defect, filled with a porcine bone graft wet with hyaluronic acid. A second membrane, made of dense polytetrafluoroethylene (dPTFE), was placed over the previous one and left exposed, avoiding a second intervention for its removal, which occurred after a 5-week healing time by grasping the membrane with forceps and removing it with a gentle tug. After cap screw removal, it was possible to insert an healing abutment.</p><p><strong>Results: </strong>The augmented bone remained stable 2.5 years after prosthetic superstructure re-insertion. Soft tissue architecture was maintained since the flaps were not repositioned coronally, the mucogingival line and the fornix were not distorted, and there was no reduction of keratinized mucosa.</p><p><strong>Conclusions: </strong>The benefits of this technique include the reliable defect isolation and containment of graft particles, ease of membrane placement, simplified dPTFE membrane removal, and preservation of mucogingival architecture.</p><p><strong>Key points: </strong>The prosthetic superstructure removal provides better access to the surgical site in order to perform the defect debridement and the implant surface decontamination and detoxification, before placing the reconstructive biomaterials. The use of a 2 mm high closure cap or a short healing abutment prevents membrane collapse on the implant threads. Since the dense polytetrafluoroethylene membrane is not buried, but intentionally left exposed, its removal after a 5-6-week healing period doesn't require a second surgery. Furthermore, it is also possible to re-insert the prosthetic superstructure, reducing the overall treatment time generally respected with the conventional submerged approach, which involves uncovering the implant after a healing period of 6-9 months.</p><p><strong>Plain language summary: </strong>The authors describe a new technique for the reconstruction of intra-bony vertical defects caused by peri-implantitis, which requires the removal of the prosthetic superstructure to have better access to the surgical site, in order to perform the defect debridement and the implant surface decontamination and detoxification, before placing the reconstructiv","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"404-416"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144786032","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":"Periosteal-guided bone regeneration on severely damaged sockets with simultaneous implant placement: The cortical shield cross-sectional study.","authors":"Fernando Verdugo, Antonio D'Addona, Theresia Laksmana, Agurne Uribarri","doi":"10.1002/cap.10364","DOIUrl":"10.1002/cap.10364","url":null,"abstract":"<p><strong>Background: </strong>Bone regeneration and simultaneous implant placement in severely damaged sockets are challenging and may require multiple grafting. Periosteal-guided bone regeneration enhances osteogenesis and wound healing shortening immediate and delay implant protocols. Clinical outcomes of a group of individuals that entered a longitudinal clinical trial from 2019 to 2021 are reported describing a novel surgical approach of simultaneous reconstruction and implant placement.</p><p><strong>Methods and results: </strong>Eight individuals requiring an implant and presenting severe facial bone loss were followed for 2-4 years (37-month average) after the completion of a 12-month longitudinal clinical trial NCT04827693. Socket reconstruction and simultaneous implant placement were performed by encasing the implant in a customized shield of autogenous cortical bone. Peri-implant tissues and pink esthetics data were assessed following established success criteria. Mean healing time, before second stage surgery, after implant placement and reconstruction, was 12.5 ± 0.9 weeks (range: 12-14 weeks). Success rates were 100% at 2-4 years. Cone beam computed tomography (CBCT) data showed stable facial cortical bone >2.1 mm in thickness. Pink esthetic scores (PESs) were above optimal (9.5 ± 0.5, range: 9-10), with no significant difference between delayed and immediate individuals (p > 0.05). Facial implant transparency at follow-up was absent and all had a band of keratinized tissue >2 mm with healthy probing depths ranging from 3 to 4 mm.</p><p><strong>Conclusion: </strong>Facial bone regeneration and simultaneous implant placement are feasible through periosteal-guided bone regeneration after a short healing period in severely damaged sockets following immediate or delay protocols. The assisted regenerated intrasocket bone provides high pink esthetics and functional implant stability.</p><p><strong>Key points: </strong>Regeneration and simultaneous implant placement of severely damaged sockets is feasible. Periosteal-guide bone regeneration can shorten healing times. Teeth with fragile alveolar foundation can be successfully reconstructed achieving high pink esthetics.</p><p><strong>Plain language summary: </strong>Simultaneous dental implant placement and bone regeneration are possible in severely damaged sockets that require reconstruction achieving, after a short healing period, highly esthetic outcomes.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"457-465"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095859","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":"Treatment of \"ring around the collar\" and other gingival leukoplakias with high-power diode laser: A single-center case series.","authors":"Daniel L F Ferraz, Caique M Pedroso, Alan R Dos Santos-Silva, Pablo A Vargas, Marcio Ajudarte Lopes","doi":"10.1002/cap.70005","DOIUrl":"10.1002/cap.70005","url":null,"abstract":"<p><strong>Background: </strong>Oral leukoplakia is the most common oral potentially malignant disorder. Currently, there is still no consensus on the best approach for its treatment. Marginal gingival cases (\"ring around the collar\") can pose an additional challenge for treatment, being associated with high recurrence rates. This case series report 10 patients with \"ring around the collar\" lesions treated with diode laser excision in a single center.</p><p><strong>Methods: </strong>Ten patients diagnosed with marginal gingival leukoplakia were treated with high-power diode laser excision. The demographic data were extracted from the medical charts and the patients were followed up every 3 months after treatment.</p><p><strong>Results: </strong>Of the 10 patients, three were men and seven were women, with a mean age of 64.4 years. Five had a history of tobacco smoking and one reported alcohol consumption. Eight had multifocal lesions, with all of them being homogeneous. Eight cases were diagnosed as proliferative verrucous leukoplakia and two had previously undergone treatment for gingival squamous cell carcinoma. Postoperative complications were limited to mild pain within the first week. During an average follow-up of 27.4 months, seven patients experienced recurrence, occurring after a mean of 8.6 months, with smaller, homogeneous, and clinically less aggressive lesions. No malignant transformation was observed.</p><p><strong>Conclusions: </strong>Marginal gingival leukoplakias, often associated with proliferative verrucous leukoplakia, are challenging to manage due to their high recurrence rates and malignant transformation risk. This case series suggests that high-power diode laser excision may offer better lesion control while minimizing gingival recession. However, further research is necessary to improve knowledge of this entity.</p><p><strong>Key points: </strong>Marginal gingival leukoplakias, especially the \"ring around the collar\" type, are relatively uncommon, but can show an aggressive nature, being associated with high recurrence rates. Removing these lesions with a high-power diode laser, even with the chance of recurrence, may be a better option than more aggressive modalities. This method helps control recurring lesions and might reduce the chances of gingival recession.</p><p><strong>Plain language summary: </strong>This case series suggests that removing these lesions with a high-power diode laser, even with the chance of recurrence, may be a better option than more aggressive modalities. This method helps control recurring lesions and might reduce the chances of gingival recession.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"395-403"},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735608","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}