The International journal of periodontics & restorative dentistry最新文献

{"title":"3D-Printed Mucoguide Surgical Template to Increase Predictability in Mucogingival Surgery: Technical Note and Case Report.","authors":"Federico Rivara, Luca Toselli","doi":"10.11607/prd.7453","DOIUrl":"10.11607/prd.7453","url":null,"abstract":"<p><p>Mucogingival surgery is a reliable technique to treat both functional and esthetic issues on teeth. In particular, the treatment success of gingival recessions depends on the flap design, as an inaccurate flap design could lead to surgical failure. For this reason, a new software-guided tool to design and perform mucogingival incisions was proposed. After selecting a flap design in accordance with the mucogingival technique, a template is designed that allows the clinician to guide the mucogingival flap in terms of incision line positions and blade inclination. The guide also incorporated the palatal box to collect a connective tissue graft. The printed guide is stabilized via tooth support, and the 45-degree inclination of the edges allows a beveled incision that follows the flap design. Afterward, the guide is removed, and the surgery is completed with papillae deepithelialization, connective tissue grafting, and flap closure. At 12 months, both sites achieved successful coverage according to the planning. This new digital tool to transfer flap design from the screen to the surgical field reduces the surgical time and number/frequency of mistakes that could lead to a negative outcome.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"472-481"},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576082","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":"Timing of Implant Placement in the Esthetic Area: Diagnostic Algorithm for Clinical Decision-Making.","authors":"Matteo Antonio Deflorian, Fabio Galli, Riccardo Scaini, Enrico Maria Strappa, Tiziano Testori","doi":"10.11607/prd.7541","DOIUrl":"10.11607/prd.7541","url":null,"abstract":"<p><p>Immediate implant placement in the esthetic area is a challenging surgical procedure. In the anterior maxilla, the esthetic outcome and the tissue stability over time are highly emphasized. A thorough preoperative analysis of the local site anatomy is essential to choosing the most suitable surgical and prosthetic protocol. Due to the heterogenous data from the literature, a diagnostic algorithm was developed to assist the clinician in the decision-making process for single-tooth implant rehabilitation in the anterior maxilla. The treatment options were based on the predictability of implant primary stability, integrity of the buccal bone wall, gingival phenotype, and absence or presence of gingival recessions. Within its limitations, this approach may reduce the incidence of complications and failures.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"443-459"},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576085","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":"Long-Term Pulp Vitality Preservation by Root Debridement Excluding the Apical 2 mm in Severe Periodontal Bone Defect Beyond the Root Apex: A 5-Year Case Report.","authors":"Yuichiro Ihara, Satoru Morikawa, Taneaki Nakagawa","doi":"10.11607/prd.7582","DOIUrl":"10.11607/prd.7582","url":null,"abstract":"<p><p>Periodontal regenerative therapy offers new options for treating teeth with severe bone loss. However, debate persists over preventive root canal treatment when bone resorption extends beyond the root apex. This report examines periodontal regeneration and pulp vitality preservation, challenging conventional treatment. A 65-year-old man presented with 10-mm periodontal pockets and bone resorption extending beyond the root apex of the mandibular right lateral incisor. Pulp vitality was confirmed, and periodontal regenerative therapy was performed without preventive root canal treatment. Root debridement was performed, excluding the apical 2 mm, and verified using CBCT, followed by application of enamel matrix derivative (Emdogain), deproteinized bovine bone (Bio-Oss), and a collagen membrane. At 6 months, probing depths decreased from 10 mm to 3 mm without bleeding on probing. Radiographs showed bone regeneration. At 5 years, probing depths remained stable at ≤ 3 mm, and CBCT confirmed long-term bone stability. Pulp vitality tests remained positive. The findings from this case suggest that root debridement excluding the apical 2 mm and precise regenerative techniques can promote periodontal regeneration and maintain pulp vitality, questioning the need for routine preventive endodontics. Further research is needed to establish protocols for complex cases.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"482-491"},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560506","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":"Prevalence of Stable and Successfully Treated Periodontitis Subjects: A Service Evaluation of a Single Hospital Center.","authors":"Varkha Rattu, Luigi Nibali","doi":"10.11607/prd.7565","DOIUrl":"10.11607/prd.7565","url":null,"abstract":"<p><p>This evaluation aimed to identify the prevalence of meeting the endpoints for (1) stable periodontitis (defined as: probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, and no BoP at 4-mm PPD sites), (2) endpoints of therapy (no PPD > 4 mm with BoP, PPD ≥ 6 mm), (3) controlled periodontitis (≤ 4 sites with PPD ≥ 5 mm), (4) PPD < 5 mm, and (5) PPD < 6 mm at the start of supportive periodontal care (SPC). The evaluation also aimed to identify any variables that may affect the achievement of meeting the endpoints. Consecutive patients entering SPC between 2020 and 2022 at Guy's Hospital, London, were assessed. The collected data included periodontal parameters (PPD and full-mouth bleeding and plaque scores) at both baseline and the final active periodontal treatment (APT) visit and were analyzed using SPSS 29.0 for descriptive and quantitative statistics. Logistic regressions utilized univariate and multivarite models to examine associations between clinical variables and outcomes. A total of 141 subjects were included (mean age: 45.4 ± 1.1 years; 64.5% women; 58.9% Caucasian). Most subjects (93.6%) had generalized Stage III/IV periodontitis. At SPC entry, 12.77% of subjects exhibited stable periodontitis, and 48.23% met the endpoints of therapy. Relative percentage changes from baseline to the end of APT in achieving stable periodontitis/endpoints of therapy in teeth were as follows: all teeth (66.25%/90.97%), anterior teeth (81.75%/97.12%), premolars (74.20%/94.69%), and molars (52.40%/86.01%). Regression analyses confirmed associations between age and extent of disease with endpoints but explained limited variance (R2 ≤ 0.267). Periodontal treatment significantly improved clinical parameters at site and tooth levels, though molars demonstrated lower endpoint achievement, highlighting localized treatment challenges. Age and extent of disease influenced outcomes, but predictor variables explained only modest variance, highlighting the complexity of achieving therapeutic success in periodontitis management.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"492-501"},"PeriodicalIF":1.1,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576084","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 Mixed Vertical Preparation Approach for Crown Replacement: A Concept-Driven Clinical Report.","authors":"David Gerdolle, Fernando Marcos Soto, François Vigouroux","doi":"10.11607/prd.8174","DOIUrl":"https://doi.org/10.11607/prd.8174","url":null,"abstract":"<p><p>Full circumferential application of biologically oriented preparation concepts in prosthetic retreatment remains highly technique sensitive and may compromise prosthetic margin control. This concept-driven clinical report describes a mixed vertical preparation strategy that differentiates cervical objectives by tooth surface to balance periodontal tissue conditioning with prosthetic predictability. Based on a selective literature review and one illustrative clinical case, a vertical preparation performed according to Biologically Oriented Preparation Technique (BOPT) principles, combined with provisional-driven biologically oriented tissue conditioning, is confined to the vestibular surface where esthetic integration is most critical. A VertiPrep-type preparation is applied on proximal and palatal surfaces to preserve epithelial attachment and ensure a controlled prosthetic margin. The provisional restoration is central to the therapeutic mechanism, guiding soft tissue maturation over a 6 to 8-week healing period. Vestibular tissue conditioning allowed localized modulation of marginal tissue thickness. Proximal and palatal VertiPrep facilitated precise margin positioning and improved communication with the dental laboratory. This mixed vertical preparation approach represents a pragmatic option for selected crown retreatment scenarios, particularly when attempting to balance vestibular soft tissue conditioning with proximal/palatal margin control. Further prospective controlled studies are required to confirm its clinical predictability and long-term outcomes.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-17"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341746","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":"Gingival Margin Stability in Esthetic Crown Lengthening Surgery Using Electronic Versus Conventional Scalpel: A Pilot Split-Mouth Randomized Clinical Trial.","authors":"André Vilela, Bruna Mueller, Michelle Sousa, Renato Sartori, Hélio Doyle, Gabriel Leonardo Magrin, Gabriela Giro","doi":"10.11607/prd.8126","DOIUrl":"https://doi.org/10.11607/prd.8126","url":null,"abstract":"<p><p>This pilot split-mouth randomized clinical trial aimed to compare the stability of the gingival margin following esthetic clinical crown lengthening surgery performed with electronic scalpel versus conventional scalpel blade. Patients indicated for esthetic crown lengthening in non-molar area of the maxilla were selected. Gingivoplasty was performed using an electronic scalpel (test) and a conventional scalpel blade (control) in contralateral quadrants. Intraoral scanning was conducted preoperatively and postoperatively at 15 and 180 days. Gingival margin migration between 15 and 180 days of follow up was measured in millimeters using 3D model superimposition. Patient-reported outcomes were assessed using visual analogue scales. Fourteen patients were enrolled, and ten completed the 180-day follow-up. Gingival margin migration was minimal and comparable between groups, with no significant intra- or inter-group differences for any tooth type (p > 0.05). Median migration was 0.26 mm for the electronic scalpel group and 0.20 mm for the conventional scalpel group. Patient-reported outcomes were similar, with most participants reporting greater comfort with the electronic scalpel. Both electronic and conventional scalpels resulted in stable gingival margin positioning over 180 days, with minimal migration from early healing stages. These findings support the clinical use of either technique for esthetic crown lengthening procedures.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-21"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341740","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":"Standardized Direct Full Mouth Rehabilitation of a Worn Dentition Through 'Composite Ball Technique': A Case Report.","authors":"Maciej Zarow, Gianluca Paniz, Malgorzata Klara-Godowska, Louis Hardan, Julia Gebel","doi":"10.11607/prd.8071","DOIUrl":"https://doi.org/10.11607/prd.8071","url":null,"abstract":"<p><p>The rehabilitation of worn dentition involves both indirect and direct techniques. Although direct techniques are becoming popular, standardized protocols are lacking and often the final esthetic and functional outcome is extremely technique sensitive. This article describes a new standardized approach to full-mouth direct rehabilitation using the \"Composite Ball Technique.' The method offers improved stabilization of a transparent silicone index, ensures accurate transfer of the planned wax-up and facilitates composite excess removal during the restoration procedure.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-26"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341687","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":"Anatomical and Histological Foundations of Mucogingival Surgery of the Anterior Mandible Focusing on the Mentalis-Incisivus Labii Inferioris Muscle Complex.","authors":"Norio Kitagawa, Yuto Narukawa, Shion Hama, Michitsuna Katafuchi, Peter O Cabrera, Shogo Kikuta, R Shane Tubbs, Joe Iwanaga","doi":"10.11607/prd.8070","DOIUrl":"https://doi.org/10.11607/prd.8070","url":null,"abstract":"<p><strong>Background: </strong>Successful root coverage with or without connective tissue graft (CTG) in the mandibular anterior region is influenced by multiple factors, including flap mobility, stability, and the effectiveness of periosteal and mucosal releasing incisions. However, the underlying musculature-particularly the mentalis (MT) and incisivus labii inferioris (ILI)- has been described macroscopically but remains insufficiently characterized histologically. This study aimed to clarify the anatomical structures relevant to these procedures.</p><p><strong>Methods: </strong>Twelve hemi-mandibles from six adult cadaveric heads were examined using gross dissection (n = 4 hemi-mandibles) and histological analysis (n = 8 hemi-mandibles). The morphology of the MT and ILI were assessed following standardized dissection and Masson trichrome staining protocols.</p><p><strong>Results: </strong>The MT and ILI consistently originated from the alveolar bone of the central and lateral incisors, with no midline attachment. The MT comprised two distinct portions: a superior part that integrated with the orbicularis oris and an inferior part that ran toward the subcutaneous tissue. Histological findings corroborated gross anatomy. The broad muscular attachments suggest limited flap extensibility in the mandibular anterior region, while the absence of major neurovascular structures within MT indicates that deeper releasing incisions may be anatomically feasible; however, such approaches should be undertaken with caution under direct visualization, and with awareness of adjacent neurovascular structures.</p><p><strong>Conclusions: </strong>Recognizing these anatomical features of the MT/ILI complex provides an anatomical basis for understanding flap stability and predictability in mandibular anterior mucogingival surgery.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-28"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341707","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":"Clinical, Volumetric and Microcirculatory Outcomes of Multiple Gingival Recession Treatment with a Porcine Acellular Dermal Matrix: A Case Series.","authors":"Andrea Dobos, Eszter Molnár, Barbara Mikecs, Kristóf Somodi, János Vág, Mariano Sanz, Bálint Molnár, Péter Windisch","doi":"10.11607/prd.8113","DOIUrl":"https://doi.org/10.11607/prd.8113","url":null,"abstract":"<p><strong>Background: </strong>Recession Type 1 (RT1) multiple adjacent gingival recessions (MAGR) represent a clinically relevant condition and may compromise esthetics and function. Connective tissue grafts (CTG) remain the reference treatment but involve donor-site morbidity. Porcine acellular dermal matrices (PADM) have been proposed as substitutes. This prospective exploratory case series evaluated the clinical performance of the modified coronally advanced tunnel (MCAT) combined with a PADM, while also exploring microcirculatory behavior assessed by laser speckle contrast imaging (LSCI) and volumetric soft tissue changes.</p><p><strong>Methods: </strong>Fifteen patients with 92 RT1 recession defects were treated using MCAT and a PADM (NovoMatrix®) in this prospective, single-center exploratory case series. The primary clinical outcome was site-level mean root coverage (MRC) at 6 months and 1 year, with recession sites clustered within patients. Key secondary outcomes were microcirculatory perfusion assessed by laser speckle contrast imaging (LSCI) in 53 sites, volumetric soft tissue change, and complete root coverage (CRC).</p><p><strong>Results: </strong>At 6 months and 1 year, MRC was 73.2%, and CRC was achieved at 52.2% of sites. Recession depth and width decreased significantly (p < 0.001), while keratinized tissue width remained stable. Volumetric gain averaged 71.0 ± 37.4 mm³ at 6 months and 46.2 ± 23.5 mm³ at 1 year; values remained significantly above baseline at both time points, while volumetric gain decreased significantly from 6 months to 1 year (p < 0.001). Microcirculatory measurements showed an early reduction in perfusion followed by partial recovery over time, although some regions remained below baseline at later follow-up time points. Modest but significant site-level correlations were observed between day-30 perfusion and MRC at 6 months and 1 year.</p><p><strong>Conclusions: </strong>Within the limitations of this prospective exploratory case series, MCAT with PADM was associated with clinically relevant root coverage and supportive volumetric and microcirculatory findings in RT1 MAGRs.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-33"},"PeriodicalIF":1.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059198","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":"PerioTAG: A Reconstructive Surgical Technique for the Management of Non-Contained Vertical Periodontal Defects.","authors":"Juan Zufía, Leticia Sala","doi":"10.11607/prd.8102","DOIUrl":"https://doi.org/10.11607/prd.8102","url":null,"abstract":"<p><strong>Background: </strong>Periodontal regenerative approaches have demonstrated predictable outcomes mainly in contained intrabony defects, where residual bony walls provide space maintenance and wound stability. Non-contained vertical periodontal defects lack these anatomical prerequisites and are therefore generally considered unsuitable for regenerative treatment, often leaving resective approaches or tooth extraction as the only therapeutic options.</p><p><strong>Objective: </strong>The objective of this proof-of-concept report was to describe a novel reconstructive surgical technique =(PerioTAG (tuberosity autogenous graft for periodontal reconstruction) designed to recreate a stable three-dimensional compartment to support periodontal reconstruction and defect stabilization, and to illustrate its clinical feasibility through representative cases.</p><p><strong>Materials and methods: </strong>Three patients presenting with non-contained vertical periodontal defects in the anterior maxilla were treated using the PerioTAG technique. This approach involves reconstruction of the defect with an autogenous corticocancellous block graft harvested from the maxillary tuberosity and rigidly fixed to re-establish a three-dimensional bony compartment. Clinical and radiographic outcomes were evaluated over follow-up periods of up to three years.</p><p><strong>Results: </strong>In all cases, the PerioTAG technique allowed stabilization of non-contained vertical periodontal defects, contributing to the preservation of the affected teeth and maintenance of periodontal support. Healing was uneventful, and clinical and radiographic follow-up demonstrated stable periodontal conditions with minimal impact on the esthetic appearance.</p><p><strong>Conclusions: </strong>Within the limitations of this proof-of-concept report, the PerioTAG technique may represent a reconstructive option for the management of non-contained vertical periodontal defects not amenable to conventional regenerative or resective approaches. Further controlled studies are required to assess its predictability and long-term stability.</p>","PeriodicalId":94231,"journal":{"name":"The International journal of periodontics & restorative dentistry","volume":"0 0","pages":"1-24"},"PeriodicalIF":1.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148059243","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}