Clinical Advances in Periodontics最新文献

{"title":"Polymethyl methacrylate-based bone cement using a prototype for gingival smile: A case report.","authors":"Biancca Rodriguez-Mannucci, Alberto Rios-Arango, Andrea Vergara-Buenaventura","doi":"10.1002/cap.10322","DOIUrl":"10.1002/cap.10322","url":null,"abstract":"<p><strong>Background: </strong>The treatment of gummy smile (GS) with polymethyl methacrylate (PMMA)-based implants is suggested in specific cases such as those in which there is a lack of lip support due to a marked depression of the anterior maxillary process; however, it can be associated with certain complications related to the material and the surgical approach.</p><p><strong>Methods: </strong>A patient with a GS of combined etiology was treated with clinical crown lengthening and lip repositioning surgery with placement of a PMMA-based bone cement implant to fill the subnasal depression. Surgical planning was performed using a 3-dimension resin-printed model to achieve an optimal fit of the PMMA implant to the geometry of the bone defect and to avoid any damage related to heat exposure from the polymerization process and any possible damage to the tooth roots with the fixation screws. In addition, the use of an antibiotic cement can help prevent any possible infection.</p><p><strong>Results: </strong>The patient reported edema and mild pain. After 5 months an increase in the length of the dental crowns, a reduction of the exposed gingiva to 1 mm and a new support of the upper lip were clinically observed. Cone-beam computed tomography showed proper PMMA implant fit.</p><p><strong>Conclusions: </strong>The use of PMMA-based bone cement appears to be an effective technique for the treatment of cases of GS associated with hypermobile upper lip and maxillary subnasal depression. The use of a printed resin model avoids complications during curing of the material, such as high exothermic reactions and associated infections.</p><p><strong>Key points: </strong>Identification of the etiologic factors of gummy smile is fundamental to the treatment of gummy smile. Once the diagnosis is established, therapy focuses on the treatment of these factors, which may be single or combined. The use of a PMMA-based bone cement implant in conjunction with clinical crown lengthening surgery is an effective treatment option for the management of EGD related to upper lip hypermobility, passive altered eruption and, maxillary subnasal depression. A possible clinical dilemma could arise when considering some complications associated with the use of PMMA implants such as allergies or infections. However, the use of a 3D printed resin model facilitates handling and fitting outside the mouth by eliminating heat exposure from the polymerization of the cement and to avoid any possible damage to the tooth roots with the fixation screws. In addition, the use of an antibiotic cement can help prevent any possible infection.</p><p><strong>Plain language summary: </strong>The treatment of gummy smile will depend on its etiological factor. In some cases of combined etiology, the use of polymethyl methacrylate (PMMA) implants has been suggested, such as those in which there is a lack of lip support due to a marked depression of the maxillary anterior process; however, the use of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"346-353"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383518","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 laterally closed coronally advanced flap: A case study.","authors":"Jochen Tunkel, Jessica M Latimer, Luca de Stavola, Peer W Kämmerer","doi":"10.1002/cap.10319","DOIUrl":"10.1002/cap.10319","url":null,"abstract":"<p><strong>Background: </strong>Several methods have been described for treating deep Cairo Class RT1 recessions. Most involve relieving incisions, which cause scar tissue formation or use a tunneled approach. This report introduces a modified technique for treating a single deep recession beyond the mucogingival margin. The approach uses a laterally closed coronally advanced flap (LCAF) without relieving incisions, combined with a subepithelial connective tissue graft and enamel matrix derivative.</p><p><strong>Methods: </strong>A 28-year-old woman was referred to our periodontal practice for the treatment of a progressive deep Cairo Class I recession with hypersensitivity and limited access to hygiene measures. The root coverage procedure was performed using a modified LCAF, combined with a connective tissue graft from the palate and enamel matrix derivative. The case was followed for 6 months.</p><p><strong>Results: </strong>The healing process was uneventful. Six months after surgery, the root surfaces remained completely covered. Hypersensitivity resolved entirely, and there was only a slight formation of visible scar tissue.</p><p><strong>Conclusions: </strong>This modified technique of an LCAF is a feasible and effective method for treating single deep RT1 recessions. By avoiding visible relieving incisions, scar tissue formation is minimized. The preparation of an LCAF allows for adequate coronal advancement.</p><p><strong>Key points: </strong>As far as our knowledge, this is the first description of a laterally closed coronally advanced flap (LCAF) combining the advantage of a minimalized scarring root coverage with a simplified coronally advancement for recessions exceeding the mucogingival junction. This modified technique combines the advantages of a lateral closing with a CAF for covering deep class RT1 recessions. Meticulous handling of the delicate pedicles combined with a coronal advancement of at least 2 mm beyond the cemento-enamel junction is the key factor for the successful adaption of this technique.</p><p><strong>Plain language summary: </strong>Deep gum recessions originating from traumatic hygiene measures can cause hypersensitivity and limit patients´ access to oral hygiene. Especially in deep recessions, the common surgical techniques have shortcomings due to a post-surgical lack of keratinized gingiva or visible scar tissue formation. This case study shows the treatment of a 28-year-old woman´s deep recession on a mandibular front tooth introducing a modified surgical technique for covering deep gum recessions exceeding the area of the keratinized gingiva (so-called deep Cairo RT1 recessions). This new technique uses a \"laterally closed coronally advanced flap\" (LCAF), which combines a curtain-similar lateral closing of the flap pedicles with a coronal advancement to cover the recession without making cuts that can lead to scars. It is combined with a tissue graft from the patient's palate and a special protein to rege","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"322-328"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648770","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-year follow-up of periodontal regenerative therapy for multiple severe intrabony defects: A case report.","authors":"Lan-Lin Chiou, Yusuke Hamada","doi":"10.1002/cap.70008","DOIUrl":"10.1002/cap.70008","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of periodontal regenerative therapy has been well-documented in the literature, with various factors influencing treatment outcomes. This case report illustrates the successful management of a systemically healthy patient diagnosed with Generalized Stage III Grade C periodontitis through the application of periodontal regenerative therapy.</p><p><strong>Methods: </strong>Following nonsurgical periodontal therapy, including oral hygiene instructions and scaling and root planing, the patient underwent full-mouth regenerative treatment secondary to persistent deep probing depths (PDs), radiographic evidence of intrabony defects (primarily 1- to 2-wall defects), and degree II furcation defects associated with the maxillary first molars. Treatment consisted of a combination of bone grafts, biologics, and absorbable barrier membranes utilized to maximize the regeneration of alveolar bone, periodontal ligament, and cementum.</p><p><strong>Results: </strong>At the 6-month follow-up, significant improvements relative to reductions in PDs, gains in clinical attachment levels, minimal bleeding on probing, and radiographic bone fill were observed. Additionally, the prognosis of affected teeth improved, and the risk of disease progression was reduced. These outcomes have been well maintained for 3 years with appropriate supportive periodontal treatment.</p><p><strong>Conclusions: </strong>Within the parameters of this single case report, we can propose that there is the possibility that periodontal defects with a potentially poor regenerative likelihood can be successfully managed with regenerative therapy utilizing open flap debridement, bone grafts, biologic mediators, and barrier membranes. It is noteworthy that careful consideration and management of factors influencing the outcomes of periodontal regenerative therapy are crucial for treatment success.</p><p><strong>Key points: </strong>Severe periodontal defects with limited regenerative potential can be successfully treated with periodontal regenerative therapy using the combination approach. Periodontal regenerative therapy can improve tooth prognosis and reduce a patient's overall periodontal risk. Careful management of etiology and risk factors, along with patient compliance with periodontal maintenance, are critical to achieving favorable treatment outcomes.</p><p><strong>Plain language summary: </strong>This case report presents medium-term outcomes of periodontal regenerative therapy aimed at restoring tooth-supporting structures lost to periodontal disease. A combination approach using bone grafts, biologic mediators, and barrier membranes can effectively treat multiple periodontal defects with limited regenerative potential, thereby restoring periodontal health. The therapy improved tooth prognosis and reduced the patient's risk of future periodontal disease progression. Treatment success depends on various factors, including proper management of","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"380-386"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of severe gingival recession using a double papilla connective tissue graft: A 2-year follow-up case study.","authors":"Yu-Chang Wu, Oscar Duran-Garnica, Hsun-Liang Chan, Dimitris N Tatakis","doi":"10.1002/cap.10368","DOIUrl":"10.1002/cap.10368","url":null,"abstract":"<p><strong>Background: </strong>This case study presents the treatment of a 7 mm deep and 5 mm wide RT1 gingival recession on the mandibular left canine in a 30-year-old systemically and periodontally healthy female, with the defect being associated with a self-injurious habit.</p><p><strong>Methods: </strong>Following counseling, self-injurious habit cessation, and oral hygiene reinforcement, a double papilla flap (DPF) plus subepithelial connective tissue graft (SCTG) procedure (DPF+SCTG) was performed. After de-epithelialization of the gingival margin, horizontal and vertical incisions were made, and a partial-thickness DPF was elevated. The SCTG was placed at the cementoenamel junction level and covered by the DPF.</p><p><strong>Results: </strong>Nearly complete root coverage was achieved, with recession depth reduced to 1 mm and keratinized tissue width increased from 1 mm to 6 mm. Ultrasound imaging confirmed successful graft integration and thick gingiva. At 2-year follow-up, creeping attachment was observed after the patient discontinued the self-injurious habit, despite a prior recurrence that had caused additional trauma. The successful surgical outcome resulted in patient satisfaction, plaque control improvement, and prevention of further recession, benefiting the ongoing orthodontic treatment.</p><p><strong>Conclusions: </strong>DPF+SCTG is an effective approach for treating an isolated deep and wide RT1 recession, providing long-term benefits, particularly when combined with behavior modification in patients with self-injurious habits.</p><p><strong>Key points: </strong>Technique choice and patient behavior management: The combination of double papilla flap and subepithelial connective tissue graft effectively achieved significant root coverage and increased keratinized tissue width in a patient with self-injurious habit. However, patient behavior management was crucial in preventing recurrence. Long-term stability and creeping attachment: Despite a relapse due to the patient's habit, the thickened gingiva facilitated natural healing through creeping attachment, reinforcing the importance of both surgical intervention and behavioral modifications in maintaining long-term stability. Ultrasound for non-invasive monitoring: Ultrasound imaging confirmed successful graft integration and determined tissue thickness, highlighting its potential as a non-invasive periodontal healing monitoring tool.</p><p><strong>Plain language summary: </strong>Gum recession is a common condition where the gum tissue pulls away from the teeth, exposing the roots and making them more prone to damage. This report describes the treatment of a 30-year-old woman who had severe gum recession on her lower left canine tooth, caused by her long-term habit of scratching the gums with her fingernail. To restore the lost tissue and protect the tooth, a double papilla flap (a surgical technique that moves nearby tissue) along with a connective tissue graft (transplanted ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":"364-372"},"PeriodicalIF":0.9,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12780478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303711","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":"Unusual co-occurrence of cheilitis granulomatosa and plasma cell gingivitis: A case report.","authors":"Lata Goyal, Mehak Gupta, Gargi Kapatia, Amanurrahman Zubair Ahemad, Shipra Gupta","doi":"10.1002/cap.70016","DOIUrl":"https://doi.org/10.1002/cap.70016","url":null,"abstract":"<p><strong>Background: </strong>Cheilitis granulomatosa (CG) and plasma cell gingivitis (PCG) are uncommon inflammatory conditions affecting the oral regions. CG manifests as chronic lip swelling with granulomatous inflammation, while PCG presents as erythematous gingiva or gingival enlargement linked to hypersensitivity reactions. Their simultaneous occurrence is exceedingly rare, posing diagnostic and therapeutic challenges.</p><p><strong>Methods: </strong>A 32-year-old woman presented with recurrent upper lip swelling and gingival enlargement. Clinical examination revealed erythematous gingiva with a cobblestone texture and angular cheilitis. Biopsies confirmed orofacial granulomatosis with epithelioid granulomas and PCG with plasma cell infiltration. Management consists of diet modification and periodontal intervention. Postoperative outcomes demonstrated significant improvement, and allergen elimination strategies were implemented to reduce recurrence.</p><p><strong>Results: </strong>At 9 months of follow-up of the patient, there was significant improvement in signs and symptoms with no signs of recurrence.</p><p><strong>Conclusion: </strong>This case highlights the rare co-existence of CG and PCG, emphasizing the need for a comprehensive diagnostic approach to exclude systemic causes. Successful management requires pharmacological treatment, surgical interventions, and dietary modifications. Long-term follow-up is essential to monitor recurrences and maintain clinical stability.</p><p><strong>Key points: </strong>Because of the rare co-occurrence of cheilitis granulomatosis (CG) and plasma cell gingivitis (PCG), which creates unique diagnostic and therapeutic hurdles, this case offers new information. Additionally, it presents an effective treatment plan that concurrently addresses both problems. A comprehensive strategy is necessary for the successful management of PCG and CG. Systemic disorders must be ruled out since they might exhibit similar symptoms. Dietary changes, nonsurgical, and surgical periodontal therapy are all part of the therapy plan. In order to avoid recurrence and guarantee a long-lasting recovery, long-term monitoring and regular elimination of allergens and irritants are essential. The possibility of the problem recurring is one of the main obstacles to this case's success. Reducing the chance of recurrence requires adhering to dietary changes and getting rid of allergens. Additionally, before initiating any kind of treatment, systemic disorders must be ruled out.</p><p><strong>Plain language summary: </strong>Cheilitis granulomatosa (CG) and plasma cell gingivitis (PCG) are two uncommon conditions that affect the oral cavity. In this case report, a 32-year-old female patient presented with swelling of the lip and enlargement of the gums. There was a presence of cracks at the corners of the mouth, along with redness of gums with uneven texture. Investigations were done to rule out other possible causes of the same. His","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145410918","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":"Intentional replantation of periodontally compromised teeth with concentrated growth factors.","authors":"Nabeel Ayappali Kalluvalappil, R Saravana Kumar, Tamer Hamed Hassan","doi":"10.1002/cap.70017","DOIUrl":"https://doi.org/10.1002/cap.70017","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intentional replantation (IR) has been described as a potential treatment modality for periodontally compromised anterior teeth deemed hopeless, particularly when combined with regenerative biomaterials such as concentrated growth factor (CGF). However, high-level evidence documenting cone-beam computed tomography (CBCT)-based outcomes in such cases remains limited. This paper evaluates the clinical and radiographic outcomes of IR using CGF in anterior teeth with advanced periodontal bone loss over a 1-year follow-up period.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ten patients with single-rooted anterior teeth exhibiting advanced periodontal disease underwent atraumatic extraction, extraoral debridement, CGF application to both socket and root surface, and immediate replantation followed by semi-rigid splinting for 4 weeks. Clinical parameters (probing depth [PD], mobility, and gingival index), patient-centered outcomes (pain scores and oral health-related quality of life), and CBCT imaging were assessed at baseline and 12 months postoperatively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;All cases showed favorable clinical healing, with significant reductions in mobility and PD. CBCT analysis revealed a mean gain in alveolar bone height of 2.58  ±  0.43 mm from baseline to 12 months. Pain was reduced significantly (mean pain scores (Visual Analog Scale) changed from 6.1 ± 0.7 to 0.6 ± 0.5). Oral Health Impact Profile-14 (OHIP-14) scores improved from 18.9 ± 1.32 to 4.6 ± 0.54. No cases of root resorption or ankylosis were observed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Within the limitations of this case study without controls, IR using CGF was associated with clinically stable outcomes and radiographic evidence of bone fill at 1 year in these selected cases. This approach may be considered a potential alternative to extraction in specific clinical scenarios.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;NCT06893107; US National Institutes of Health Clinical Trials Registry KEY POINTS: Intentional replantation (deliberate removal of teeth, extraoral treatment, and reinsertion into the same socket) can be considered a conservative approach to preserve anterior teeth with severe periodontal compromise. The addition of concentrated growth factor during this clinical approach resulted in clinical stability and radiographic bone fill at 12 months. Controlled long-term studies are needed before clinical adoption, as the findings from the current small case series are descriptive.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Sometimes, badly damaged front teeth are removed because they seem beyond saving. But what if we could carefully take them out, clean them, add natural healing material, and put them back? In this study, 10 patients with severely loose front teeth due to gum disease had their teeth gently extracted and treated with a substance made from their blood called concentrated growth factor (CGF). The teeth were cleaned, coated wit","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287901","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":"Patient satisfaction among periodontally stable patients with veneer restorations-A retrospective study.","authors":"Amelie M Bäumer, Christoper T Riemer, Christopher Büsch, Gerd A Körner, Johanna A Gaß","doi":"10.1002/cap.70020","DOIUrl":"https://doi.org/10.1002/cap.70020","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Successful periodontal therapy may yield poor esthetic outcomes, impacting patient satisfaction, and while adhesive ceramic veneers demonstrate success in esthetically compromised cases, their effectiveness in periodontally compromised patients' satisfaction remains unexplored. Therefore, this retrospective study assesses patient-reported quality of life and satisfaction in periodontally healthy and stable patients with anterior ceramic veneer restorations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients, both periodontally healthy and stable, who received anterior veneer restorations at least 5 years ago, participated in the study. Satisfaction data, Oral Health Impact Profile (OHIP-G14), and Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) scores were collected, and groups were categorized based on periodontal diagnosis (healthy, stage I/II, stage III/IV). Veneers were evaluated using pink esthetic score (PES) and white esthetic score (WES) criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Analysis of 68 patients and 312 veneers with an average 8-year follow-up revealed high satisfaction with anterior veneer restorations. The study indicates that veneers positively impact oral health-related quality of life (OHRQoL) for patients with and without severe attachment loss, with mild periodontitis potentially enhancing satisfaction. The PES score is lower in patients with severe periodontitis (mean ± SD: 7.33 ± 1.78, p &lt; 0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results emphasize the positive impact on functionality and esthetic quality, suggesting that veneer restorations in the anterior region are a beneficial treatment option for improving OHRQoL, independent from attachment loss due to periodontitis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Veneer restorations significantly improve patient satisfaction and oral health-related quality of life (OHRQoL), even in patients with a history of periodontitis. This suggests veneers are a viable esthetic solution regardless of previous periodontal attachment loss. While patients with severe periodontitis may exhibit lower pink esthetic scores (PES), the white esthetic outcome (WES) and overall patient satisfaction remain high. This underlines the importance of managing expectations regarding soft tissue esthetics without compromising the perceived success of the treatment. Anterior ceramic veneers should be considered a reliable treatment option for esthetic rehabilitation in both periodontally healthy and previously compromised patients, when periodontal stability is achieved.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Periodontal disease can compromise both the function and appearance of anterior teeth, and even after successful treatment, patients may remain dissatisfied with esthetic outcomes. This study evaluated whether anterior ceramic veneers could improve patient-reported outcomes, particularly oral health-related quality of life (OHRQoL), in individuals with varyi","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287852","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":"Novel overlapping rotated double flap: A modified pedicle technique for root coverage in isolated RT1 gingival recession-Case study of two patients.","authors":"Ritika Arora, Sakshi Verma, Ridhima Singhal, Nitika Monga, Rajinder K Sharma, Shikha Tewari","doi":"10.1002/cap.70018","DOIUrl":"https://doi.org/10.1002/cap.70018","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This case report presents a modified pedicle flap technique-the novel overlapping rotated double (NORD) flap-as an alternative to conventional approaches such as coronally advanced flap with subepithelial connective tissue graft (SCTG). While SCTG offers predictable outcomes, it involves a second surgical site, increasing patient morbidity. In contrast, the NORD flap uses adjacent pedicle flaps in an overlapping design, with one flap mimicking a connective tissue graft, thereby enhancing tissue thickness and vascularity without donor site complications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two systemically healthy patients-a 35-year-old female with a thick gingival phenotype and a 40-year-old male with a thin phenotype-presenting with isolated recession type 1 (RT1) gingival recessions were treated using the NORD flap. All procedures were performed under local anesthesia with standard postoperative protocols. Follow-ups were conducted at 14 days, 1 month, 6 months, and 12 months. Clinical outcomes were assessed using the root coverage esthetic score and patient-reported outcome measures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Over 90% root coverage was achieved in both cases, regardless of phenotype. The technique eliminated graft harvesting, minimized complications, and was associated with minimal postoperative pain, requiring only two analgesic doses in 48 h.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The NORD flap offers a conservative and effective alternative for managing isolated gingival recessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case report introduces the novel overlapping rotated double (NORD) flap, a modified pedicle-based approach designed to overcome limitations associated with conventional root coverage procedures. Although the subepithelial connective tissue graft is considered the gold standard due to its predictability, the technique necessitates harvesting from a secondary donor site, thereby increasing patient morbidity and postoperative discomfort. The NORD flap provides a biologically driven alternative by utilizing two adjacent pedicle flaps in an overlapping configuration, one of which functions analogously to a connective tissue graft. This design enhances gingival thickness, vascularization, and stability of the flap while obviating the need for graft procurement. Two cases presenting with isolated RT1 recessions were managed using this approach. All surgeries were performed under local anesthesia, followed by routine postoperative care, and evaluated. Clinical parameters, including the root coverage esthetic score, and patient-reported outcome measures demonstrated favorable results, with &gt;90% root coverage achieved in both cases. The technique was associated with minimal pain, rapid healing, and elimination of donor site morbidity, underscoring its potential as a conservative and effective alternative for isolated recession defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Value of innovation: ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287908","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 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":"https://doi.org/10.1002/cap.10371","url":null,"abstract":"<p><strong>Background: </strong>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><p><strong>Methods: </strong>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><p><strong>Results: </strong>Following 18 months of follow-up, we observed a nearly complete closure of the embrasure space.</p><p><strong>Conclusions: </strong>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><p><strong>Key points: </strong>The connective tissue cube technique showed potential for treatment of severe papillary deficiencies. Combined surgical-restorative approaches might be needed for complete closure of black triangles. Further clinical studies with stronger level of evidence are needed.</p><p><strong>Plain language summary: </strong>This case report discusses a treatment for a common issue after periodontal therapy: black triangles (open gingival embrasures) between teeth that can be unappealing. The patient, a 64-year-old woman, had a black triangle between her maxillary right canine and first premolar due to loss of interproximal periodontal support. The treatment combined surgery (tissue and bone grafting with biologic material) and restorative treatment. After 6 months, dental restorations were complete, with a provisional period prior to definitive restoration to evaluate tissue fill and esthetics. The restorative treatment involved the use of a single veneer and single interproximal composite restoration. Eighteen months postsurgical therapy, the gap was nearly closed and remained stable for an additional 6 months. The report highlights that com","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-14","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":"Customized three-dimensional-printed titanium mesh for alveolar bone augmentation: Retrospective consecutive case series.","authors":"Kaio Henrique Soares, Catherine King, Daniel Palkovics, Raul Perez, Marcia Mbadu, Wagner R Duarte, Karin C Schey, Poliana M Duarte","doi":"10.1002/cap.70015","DOIUrl":"https://doi.org/10.1002/cap.70015","url":null,"abstract":"<p><strong>Background: </strong>This retrospective case series evaluated linear and volumetric bone changes in alveolar bone defects treated with guided bone regeneration (GBR) using a next-generation customized three-dimensional (3D)-printed titanium mesh.</p><p><strong>Methods: </strong>Medical history, surgical details, and cone beam computed tomography (CBCT) data were collected from patients undergoing GBR with the customized 3D-printed titanium mesh. CBCT subtraction analysis was performed using 3D digital models, created via spatial registration and semi-automatic segmentation. Outcomes included complication rates, linear bone measurements, volumetric hard tissue gain, graft volume stability, and augmentation efficacy.</p><p><strong>Results: </strong>Nine cases were included: five combined large defects, two vertical large defects, and two combined medium defects. Two cases showed no complications, while seven had mesh exposure. Two cases experienced complete early mesh exposure (22.2%), resulting in total graft loss and premature removal. The mean linear vertical bone gain at the defect's middle plane was 5.7 ± 2.3 mm for large defects, 2.7 ± 0.5 mm for medium defects, and 4.8 ± 2.4 mm for both. The overall volumetric gain was 0.49 ± 0.20 cm³, with graft volume stability at 87.9 ± 19.5% and augmentation efficacy of 0.037 ± 0.012 cm³/mm.</p><p><strong>Conclusions: </strong>Customized 3D-printed titanium mesh is a feasible and effective option for augmenting defective edentulous ridges, providing predictable outcomes in linear and volumetric gains. Mesh exposure is the most common complication.</p><p><strong>Key points: </strong>Novelty and Contribution of These Cases This case series provides important insights into GBR using customized 3D-printed titanium meshes. These devices aim to overcome several limitations commonly associated with traditional non-resorbable membranes and conventional titanium meshes. The inclusion of comprehensive, CBCT-based linear and volumetric measurements of hard tissue gain adds valuable quantitative data to the field, supporting the clinical utility of customized titanium meshes in alveolar ridge augmentation. Key Factors for Successful Case Management Successful outcomes in these cases were associated with several critical factors: Thorough preoperative planning Precise execution of the surgical technique Effective management of potential postoperative mesh exposure Primary Limitations to Treatment Success The main limitations that impacted treatment outcomes included: Compromised systemic health or medical history Improper adaptation or seating of the mesh Premature and complete mesh exposure during the healing period PLAIN LANGUAGE SUMMARY: This study looked at a new way to rebuild lost bone in the jaw using a custom-made, three-dimensional (3D)-printed titanium mesh. Nine patients with different types of bone defects were treated, and detailed scans were taken before and after surger","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276709","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}