{"title":"Effects of Soft Tissue Augmentation Procedures Around Dental Implants With Epithelial Embossed Connective Tissue Graft Using Coronally Shifted Strip Graft Technique: A Case Report With 2 Years Follow Up.","authors":"Pavel Yaroshevich, Algirdas Puisys","doi":"10.11607/prd.7603","DOIUrl":"https://doi.org/10.11607/prd.7603","url":null,"abstract":"<p><p>The clinical case demonstrates soft tissue augmentation after GBR in addressing an initially insufficient level of keratinized tissues using a graft with high-quality collagen obtained from the maxillary molar area to increase the volume of soft tissues in a single surgery. This augmentation protocol includes the use of an epithelial embossed connective tissue graft harvested from the maxillary molar area as well as the principle of flap formation involving a= displacement of the initial volume of keratinized tissues lingually and fixation of the graft under full thickness flap on the buccal side.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-18"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532204","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}
Teresa Pinho, Jorge André Cardoso, Paulo Campos, Manuel Neves
{"title":"Implant Malposition with Severe Anterior Periodontal Tissue Loss: An Interdisciplinary Treatment Strategy.","authors":"Teresa Pinho, Jorge André Cardoso, Paulo Campos, Manuel Neves","doi":"10.11607/prd.7636","DOIUrl":"https://doi.org/10.11607/prd.7636","url":null,"abstract":"<p><p>This case report describes the interdisciplinary management of a 58-year-old female patient with a misaligned dental implant in the left maxillary lateral incisor region, causing aesthetic and functional challenges. Initial assessments revealed significant bone loss around the compromised implant, an asymmetric smile, and excessive gingival display. The treatment included slow orthodontic extrusion to reposition adjacent teeth, promoting bone and periodontal regeneration, and orthodontic intrusion on the contralateral side to correct occlusal cant, and improve gingival aesthetics. Aligners with mini-screw anchorage ensured precise tooth movement and improved conditions for soft tissue grafting. Periodontal procedures enhanced tissue architecture and supported long-term stability, while the final prosthetic rehabilitation successfully restored function and aesthetics, emphasizing the importance of interdisciplinary collaboration for complex cases.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-30"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532206","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}
Kotaro Nakata, Zhaozhao Chen, Istvan A Urban, Hom-Lay Wang
{"title":"Enhancing Peri-Implant Papilla: A Minimally Invasive Approach with Integrated Prosthetic Solutions.","authors":"Kotaro Nakata, Zhaozhao Chen, Istvan A Urban, Hom-Lay Wang","doi":"10.11607/prd.7604","DOIUrl":"https://doi.org/10.11607/prd.7604","url":null,"abstract":"<p><p>The reconstruction of interproximal papilla around implants is considered challenging with limited predictability due to the anatomical constraints and reduced blood supply to the interproximal area. This report introduces a minimally invasive tunneling approach, assisted by an operating microscope, to augment interproximal papillae and improve soft tissue contours. Four cases are included: Cases 1 and 2 demonstrate soft tissue grafting around adjacent implants, performed either during the second stage or after provisionalization, while Cases 3 and 4 address implant-pontic scenarios. After conditioning the peri-implant tissues using provisionals, all cases achieved satisfactory outcomes, maintaining stability over a period of six to nine years. The described microsurgical tunnel technique, with the combination of buccal and interproximal subepithelial connective tissue graft, appears to be a promising approach for reconstructing peri-implant papillae with reliable long-term stability.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-23"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532205","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}
Dragana Rakasevic, Antonio Liñares, Hong Jin Tan, Jakoba Natasa Nikolic, Miguel Tiago Marques, Juan Blanco
{"title":"Bone Exostosis After Soft Tissue Augmentation Procedures Around Teeth and Implants. Case Series Study and Literature Review.","authors":"Dragana Rakasevic, Antonio Liñares, Hong Jin Tan, Jakoba Natasa Nikolic, Miguel Tiago Marques, Juan Blanco","doi":"10.11607/prd.7723","DOIUrl":"https://doi.org/10.11607/prd.7723","url":null,"abstract":"<p><p>Buccal bone exostosis (BBE) is a late postoperative complication following soft tissue augmentations (STA), defined as localized peripheral benign bone overgrowth. While its occurrence has been reported after skin or free gingival grafts, its association with sub epithelial connective tissue grafts (sCTG) around teeth is less documented. To date, no cases of BBE following autologous tissue grafts, sCTG or de-epithelialized free gingiva grafts (DFGG), around dental implants have been reported. This case series presented five cases of BBE (two around implants, three around teeth) following STA around teeth and implants utilizing either sCTG or DFGG. The BBEs were surgically removed in three cases, and no recurrences were observed after four months to ten years postoperatively. Histological examinations were not conducted. Based on the fact that all cases involved partial-thickness flap, it could be speculated that periosteal tear during STA coupled with autologous tissue grafts triggers osteoinduction and osteoproliferation mechanisms, leading to BBE development.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-27"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532203","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}
Ronaldo Hirata, Sidney Kina, Rafaelly Cubas Camargo, João Luiz Bittencourt De Abreu
{"title":"Esthetic Solutions for Anterior Teeth: Resin Composites or Dental Ceramics?","authors":"Ronaldo Hirata, Sidney Kina, Rafaelly Cubas Camargo, João Luiz Bittencourt De Abreu","doi":"10.11607/prd.7656","DOIUrl":"https://doi.org/10.11607/prd.7656","url":null,"abstract":"<p><p>This article reviews and contrasts resin composites and dental ceramics for anterior esthetic restorations, highlighting their fundamental properties, indications, and clinical performance. Resin composites excel in minor or localized cases-such as class III and IV cavities, minor contour modifications, or closure of small diastemas-owing to their straightforward application, color-matching capabilities, and minimal tooth preparation requirements. However, they are vulnerable to issues like discoloration, wear, and marginal staining, and often need periodic repolishing or repair. Dental ceramics demonstrate superior longevity, color stability, and resistance to wear, making them the preferred choice for extensive rehabilitations, larger restorations, and compromised teeth requiring crowns or bridges. While ceramics generally involve more invasive preparations and demand meticulous bonding procedures, their inert nature and high mechanical strength often result in outstanding long-term outcomes when properly executed. Clinical decision-making should account for factors such as tooth structure, occlusion, patient's age and habits (e.g., parafunctions), staining risk, and esthetic demands. Ultimately, striking the right balanc between biology, function, and esthetics is essential to avoid overtreatment and preserve natural dentition. Through illustrative case studies and a synthesis of relevant literature, this article provides practical guidelines for selecting the most appropriate material for each clinical scenario.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328294","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 Concept of Crown Shortening: Combination of Vertical Edgeless Preparation Technique and Modified Coronally Advanced Tunnel.","authors":"Olivier Carcuac, Nazifa Yakubova","doi":"10.11607/prd.7720","DOIUrl":"https://doi.org/10.11607/prd.7720","url":null,"abstract":"<p><p>This case report describes an interdisciplinary approach to the aesthetic rehabilitation in a 45-year-old woman bothered by excessively long anterior teeth. Digital Smile Analysis (DSA) guided treatment planning, ensuring optimal proportions and soft tissue integration. Vertical Edgeless Preparation Technique (VEP) was used to establish the correct vertical position of the finishing line. Modified Coronally Advanced Tunnel (MCAT) combined with modified-Connective Tissue Grafts (Micro- and Split-CTG) was performed for root coverage and soft tissue augmentation. After uneventful healing, final ceramic restorations were seated. The integration of BOPT and MCAT optimized periodontal and prosthetic outcomes, achieving a natural, harmonious smile. This approach highlights the synergy between periodontal plastic surgery and prosthodontics in an aesthetically challenging case.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-16"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328296","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}
Chia-Ming Kuo, Kuo Yuan, Giovanni Zucchelli, Martina Stefanini, Ilham Mounssif
{"title":"Surgical Procedure to Optimize the Esthetic and Osseous Outcomes for Young Adults with Large Periradicular Defects: Two Case Report.","authors":"Chia-Ming Kuo, Kuo Yuan, Giovanni Zucchelli, Martina Stefanini, Ilham Mounssif","doi":"10.11607/prd.7669","DOIUrl":"https://doi.org/10.11607/prd.7669","url":null,"abstract":"<p><p>Teeth exhibiting internal root resorption or those with persistent large periapical lesions after non-surgical endodontic treatment are generally considered to have an unfavorable prognosis. Extraction of teeth with unfavorable prognosis, followed by dental implant placement, has become an acceptable treatment option. However, dental implants are not indicated for young people with growing jaws. Consequently, it is recommended that clinicians prioritize the preservation of natural dentition in younger patients and defer implant therapy until skeletal growth has ceased. In cases where tooth preservation is attempted despite severe periradicular defects, a surgical approach is often required to manage associated symptoms. However, modern periradicular surgery frequently leads to unaesthetic complications such as conspicuous scar formation or gingival recession. The introduction of novel combinatory surgery, including guided tissue regeneration (GTR), de epithelialized free gingival graft (DFGG), and coronally advanced flap (CAF) optimizes the clinical outcomes, addressing both the functional and aesthetic needs of the patient.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-31"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328295","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}
Naheed Mohamed, Olivier Carcuac, François Vigouroux
{"title":"An Innovative Microsuturing Technique for Stabilization of a Free Gingival Graft: The 'Fishnet Suture'.","authors":"Naheed Mohamed, Olivier Carcuac, François Vigouroux","doi":"10.11607/prd.7737","DOIUrl":"https://doi.org/10.11607/prd.7737","url":null,"abstract":"<p><p>The stability and vascular integration of a free gingival graft (FGG) are critical for achieving predictable outcomes. The success of the technique relies on precise recipient site preparation, meticulous graft handling, and an optimized suturing protocol to ensure firm adaptation and immobilization to prevent micro-movements that could compromise healing. This case report introduces the 'Fishnet suture,' a novel microsuturing technique designed to enhance graft stabilization and provide uniform tension distribution. The approach utilizes a continuous interlocking suture with both vertical and horizontal components, creating a mesh-like pattern that anchors the graft to the periosteal bed, eliminating dead spaces, and promoting revascularization. The technique was applied in three clinical cases: a patient with multiple adjacent gingival recession defects in the anterior region of the mandible, a patient presenting peri-implant soft tissue deficiencies, and a patient with an insufficient width of keratinized tissue at an edentulous ridge. Postoperative healing was uneventful throughout, resulting in significant increase in keratinized tissue width. We interpret the favourable outcomes to be a result of effective graft stabilisation, facilitated by this novel suturing approach.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328293","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}
Ashley B Hoders, Kevin G Murphy, Marianna Evans, George A Mandelaris
{"title":"Phenotype Driven Treatment Planning for the Interdisciplinary Patient. Part II. A Clinical Case Series.","authors":"Ashley B Hoders, Kevin G Murphy, Marianna Evans, George A Mandelaris","doi":"10.11607/prd.7715","DOIUrl":"https://doi.org/10.11607/prd.7715","url":null,"abstract":"<p><p>Skeletal diagnosis and upper airway health should be the foundation of risk assessment for the interdisciplinary patient, as diagnosis impacts treatment planning and treatment outcomes. Currently, there is an epidemic of jaw deficiencies with multi-factorial etiology contributing to dentofacial disharmony malocclusions. Assessing each dimension of periodontal phenotype and in the context of the planned intervention, as outlined in Part I of this series termed Phenotype Driven Treatment Planning (PDTP) for the Interdisciplinary Patient, offers an opportunity to evolve our treatment planning concepts and allows for selection of the appropriate management protocol and sequence of treatment. The purpose of this case series is to highlight the application of the recently introduced systematic process of PDTP and to build on the existing evidence/reported advantages of phenotype modification for the interdisciplinary patient. This case series will emphasize comprehensive diagnosis for achieving optimized periodontal phenotype dimensions in interdisciplinary dentofacial therapy (IDT). Establishing an accurate and comprehensive diagnosis coupled with the innovations available can help our patients correct the etiology of their problems with less compromise and compensation treatment, promoting health systemically, structurally, and functionally.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-31"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289722","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}
Matteo Di Lorenzo, Marco Degidi, Diego Nardi, Giuseppe Daprile, Paolo Domeniconi
{"title":"Conometric Single Restorations with Prosthetic Margin Below the Bone Crest: A Case Series.","authors":"Matteo Di Lorenzo, Marco Degidi, Diego Nardi, Giuseppe Daprile, Paolo Domeniconi","doi":"10.11607/prd.7701","DOIUrl":"https://doi.org/10.11607/prd.7701","url":null,"abstract":"<p><p>The purpose of this prospective case series is to present radiographic and clinical results of single implant-prosthetic rehabilitation with conometric retention, in which the connection abutment - prosthetic crown is located below the bone level. A total of 10 sites with single edentulism were rehabilitated with subcrestal implants and prosthetic crowns with conometric retention. Crestal bone levels and peri-implant soft tissue conditions were evaluated for each implant. Hard tissue measurements were performed using parallel intraoral radiographs immediately after implant insertion, at the placement of the restoration, after 1 year and 2 years of full functional load. After 2 years of follow-up all the rehabilitations appear clinically and radiographically stable. Mean vertical bone loss was 0.1 mm after 2 years of loading. Mean horizontal bone loss from the abutment-cap interface was 0.59 mm for distal side and 0.21 mm for the mesial side. Within the limitations of this study, the results suggest that conometric connection both at the implantabutment and abutment-crown interface allows us the freedom to position the margin of the prosthetic connection even below the bone crest.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-21"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289721","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}