Diagnostic reproducibility of the 2018 Classification of Gingival Recessions: Comparing photographic and in-person diagnoses.

Background: To assess how the diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects (GRD) could be applied when comparing in-person chairside measurements with photographic measurements.

Methods: Thirty-four GRD were photographed and evaluated by 4 masked operators. For each case, the operators measured twice recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento-enamel junction (CEJ), and presence of root steps (RSs), chairside, and on photographs.

A clinical dilemma: Performing or avoiding root instrumentation in the treatment of the acute phase of endodontic-periodontal lesions? A case report.

Background: This study presents the diagnois, management, and tissue response to an acute periodontal lesion with deep pocketing affecting a maxillary central incisor in a young patient devoid of caries or a history of periodontitis.

Methods: Clinical and radiographic examinations facilitated the diagnosis of the pathology as an endoperiodontal lesion (EPL) with root damage, exhibiting supracrestal invasive root resorption. Orthograde endodontic therapy was employed to decontaminate and seal the endodontic space.

Translational approach to tooth autotransplantation: A 27-year case study.

Background: The aim of this case report was to present a translational approach to tooth autotransplantation using jiggling forces to enlarge the periodontal ligament (PDL) space before autotransplantation, with the goal of improving treatment success and long-term survival.

Methods: A 23-year-old patient, undergoing orthodontic therapy and with an unrestorable maxillary first molar, was proposed to have a healthy and fully-erupted maxillary third molar transplanted in the socket of the first molar. Jiggling forces were applied to the third molar to enlarge the PDL space and facilitate the preservation of PDL fibers on the root surfaces during the extraction.

Challenges and success in periodontal plastic surgery.

To truly understand a field of study, one must delve into its past and examine the challenges and successes that have shaped its current practices. In the case of periodontal plastic surgery, recognizing how challenges induced changes over the last 70 years-from the 1950s to today-is essential to fully comprehend its evolution. This editorial provides a perspective on the field, highlighting the interrelationships between influential surgical techniques and advancements in research methodology.

Longevity of teeth in patients susceptible to periodontitis: Clinical outcomes and risk factors associated with tooth loss after active therapy and 30 years of supportive periodontal care.

Aim: (i) To evaluate the efficacy of active periodontal therapy supplemented by supportive periodontal care (SPC) in retaining dentition during a 30-year follow-up period in patients susceptible to periodontitis, and (ii) to assess the prognostic factors associated with tooth loss.

Materials And Methods: One-hundred and fifty-four patients with periodontitis, retrospectively classified as stage I-IV and grade B-C periodontitis, treated between 1984 and 1986 in a private practice, were enrolled in this study. After periodontal assessment, patients received non-surgical treatment followed by surgical periodontal therapy, orthodontic treatment, and tooth-splinting, where appropriate.

Diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects and Gingival Phenotype: A multicenter inter- and intra-examiner agreement study.

Background: The aim of this study was to investigate the inter- and intra-examiner agreement among international experts on the diagnosis of gingival recession defects using the 2018 Classification of Gingival Recession Defects and Gingival Phenotype as proposed in the 2017 World Workshop.

Methods: Standardized intraoral photographs from 28 gingival recession defects were evaluated twice by 16 expert periodontists. Recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento-enamel junction (CEJ), and presence of root steps (RS) were recorded and used for the analysis.

Paradigm Shifts in the Evolution of Implant Therapy.

Making treatment decisions in dental implantology has evolved over the last five decades. These decisions and the clinical management of sites thereafter are selected based on recent changes, including the achievement of osseointegration, reestablishment of biologic width bone remodeling, the peri-implant soft tissue phenotype, the way peri-implantitis is defined, and advancements in digital technology. This article discusses these key aspects and their effects and influence on implant therapy.

Short- and Long-Term Outcomes of Treatment of Multiple Lingual Recessions Using the Bilaminar Subperiosteal Tunnel Technique.

Treatment of gingival recession defects on the lingual surface of mandibular anterior teeth is a challenge for the periodontist because of the region's unique anatomical features. Although there are no esthetic issues, lingual recessions should be considered seriously, especially on mandibular incisors, because they are frequently associated with periodontitis and dental hypersensitivity. The treatments and the long-term outcomes (5 years) of three clinical cases of multiple lingual recessions are presented.

Periodontal Plastic Surgery for Reshaping the Mucogingival Junction Following Grafting Procedures: Case Reports.

The present clinical and histologic case reports describe the periodontal plastic approaches used for the correction of gingival deformities following free gingival grafting (FGG) procedures. Five patients with poor esthetic and functional outcomes following soft tissue grafting voluntarily requested corrective treatment due to differences in color, texture, thickness, and mucogingival junction (MGJ) alignment between grafted and adjacent tissue, or because of food retention apical to the grafted site. Plastic surgical approaches included eliminating the thick borders the graft, aligning the MGJ, and reducing the excessive apicocoronal dimension of the graft.

Brain abscess and periodontal pathogens (). Report of a case.

Patients who develop brain abscesses must be evaluated through a complete set of diagnostic tests including a microbiological and clinical periodontal assessment. A genetic comparison of the pathogens from intracranial/extracranial sites is necessary.

On the value of the 2017 classification of phenotype and gingival recessions.

The 2017 World Workshop completely restructured knowledge in periodontology with a series of official consensus statements jointly agreed upon by the American Academy of Periodontology and the European Federation of Periodontology. Among them, the 2017 classification of phenotype and gingival recession successfully incorporated the most relevant previous classifications into a treatment-oriented diagnostic matrix. Despite the significant advantages related with the implementation of this new classification of gingival recessions, recent articles still report data based on previous outdated systems.

Periodontal Pocket: An Ecologic Niche Promoting the Germination of a Plant Seed.

During a scaling and root planing procedure, a large, actively germinating seed was removed from a deep periodontal pocket. The histologic examination confirmed that it was a germinating tomato seed (). Since all seeds inside their fruits are in a quiescent stage, this seed was quiescent when the patient ate the tomato.

Short-term comparison of two non-surgical treatment modalities of peri-implantitis: Clinical and microbiological outcomes in a two-factorial randomized controlled trial.

Aim: To compare the efficacy of two different therapies (amino acid glycine abrasive powder and a desiccant material) and their combination in the non-surgical treatment of peri-implantitis.

Materials And Methods: This was an examiner-blind randomized clinical trial, with 2-factorial design with a follow-up of 6 months. The combination of the two factors resulted in four interventions: (a) non-surgical debridement alone (C); (b) non-surgical debridement and a desiccant material (H); (c) non-surgical debridement and glycine powder (G); and (d) non-surgical debridement, desiccant material and glycine powder (HG).

Biologic Remodeling of Periodontal Dimensions of Areas Treated With Gingival Augmentation Procedure: A 25-Year Follow-Up Observation.

Background: The role of keratinized tissue (KT) for maintenance of periodontal health has been debated for many years. This study assesses the long-term "biologic remodeling" of periodontal dimensions of teeth treated with free gingival grafts (FGGs) compared with adjacent/untreated teeth.

Methods: Seventy-four patients with at least one site showing absence or a reduced amount of attached gingiva associated with gingival recession (GR) at baseline were treated with FGGs in a private practice.

Commentary: A Translational Medicine Approach to Tooth Transplantation.

The autogenous tooth transplantation approach to replace missing teeth has been in use for a long time. Different surgical techniques have been developed to improve prognosis and longevity of transplanted teeth with complete root formation. Many factors reportedly affected short- and long-term success of the procedure: complications such as ankylosis and root resorption up to the tooth exfoliation have occurred frequently.

Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial: tooth retention, periodontitis recurrence and costs.

Aim: Compare the long-term outcomes and costs of three treatment modalities in intra-bony defects.

Materials And Methods: Forty-five intra-bony defects in 45 patients had been randomly allocated to receive: modified papilla preservation technique with titanium-reinforced expanded-polytetrafluoroethylene (ePTFE) membranes (MPPT Tit, N = 15); access flap with expanded-PTFE membranes (Flap-ePTFE, N = 15) and access flap alone (Flap, N = 15). Supportive periodontal care (SPC) was provided monthly for 1 year, then every 3 months for 20 years.

Periodontal Conditions of Sites Treated With Gingival Augmentation Surgery Compared With Untreated Contralateral Homologous Sites: An 18- to 35-Year Long-Term Study.

Background: The aim of this split-mouth study is to compare long-term (18 to 35 years) periodontal conditions of sites treated with gingival augmentation procedures (GAPs) and untreated homologous contralateral sites.

Methods: Forty-seven patients with 64 sites (test group), with lack of attached gingiva associated with recessions, were treated with marginal or submarginal free gingival grafts. Sixty-four contralateral homologous sites (control group), with or without gingival recession (GR) and with attached gingiva, were left untreated.

Thirty-year stability after regeneration of a deep intrabony defect: a case report.

Aims: Report clinical improvements and 30-year stability of clinical outcomes of an intrabony defect treated with non-resorbable barriers and mucogingival surgery.

Methods: A 18-year-old male presenting with a very severe intrabony defect at the upper right central incisor was treated with periodontal regeneration with non-resorbable barriers and a fibrin-fibronectin glue. The barriers were removed after 3 months.

Nonsurgical Treatment of Peri-implantitis Using the Biofilm Decontamination Approach: A Case Report Study.

The aim of this preliminary study is to show the effect of the biofilm decontamination approach on peri-implantitis treatment. Clinical cases showing peri-implantitis were treated using an oral tissue decontaminant material that contains a concentrated aqueous mixture of hydroxybenzenesulfonic and hydroxymethoxybenzenesulfonic acids and sulfuric acid. The material was positioned in the pocket around the implant without anesthesia in nonsurgically treated cases.

Treatment of Acute Periodontal Abscesses Using the Biofilm Decontamination Approach: A Case Report Study.

The aim of this preliminary study was to show the treatment effect of the biofilm decontamination approach on acute periodontal abscesses. Clinical cases showing acute periodontitis were treated using an oral tissue decontaminant material that contains a concentrated aqueous mixture of hydroxybenzenesulfonic and hydroxymethoxybenzene acids and sulfuric acid. The material was positioned into the pocket on the root surface and left in the site for 30 seconds.

Critical Evaluation of Complete Root Coverage as a Successful Endpoint of Treatment for Gingival Recessions.

Two differing evaluation criteria for complete root coverage (CRC) were used to compare incidence of CRC after root coverage procedures. Clinical records of 363 patients (386 single recessions) treated between 1984 and 2012 were screened. CRC was assessed 1 year after surgery using two separate evaluation criteria: CRC1, in which the gingival margin was at or above the cementoenamel junction (CEJ), measured using a periodontal probe directly on patients by a single examiner; and CRC2, in which the gingival margin was above the CEJ, rendering it completely invisible based on a visual assessment of high-magnification digitalized images by two calibrated examiners.

Influence of inter-dental tissues and root surface condition on complete root coverage following treatment of gingival recessions: a 1-year retrospective study.

Aim: To explore the influence of inter-dental tissues and root surface condition on complete root coverage following surgical treatment of gingival recessions.

Methods: Three hundred and eighty-six single recessions treated over 28 years were assessed. Patient-level and periodontal variables, presence/loss of inter-dental tissues, and presence/absence of non-carious cervical lesions (NCCLs) were recorded.

Surgical treatment of single gingival recessions: clinical guidelines.

Purpose: The purpose of this clinical guidelines project was to determine the most appropriate surgical techniques, in terms of efficacy, complications, and patient opinions, for the treatment of buccal single gingival recessions without loss of interproximal soft and hard tissues.

Methods: Literature searches were performed (electronically and manually) for entries up to 28 February, 2013 concerning the surgical approaches for the treatment of gingival recessions. Systematic reviews (SRs) of randomised controlled trials (RCTs) and individual RCTs that reported at least 6 months of follow-up of surgical treatment of single gingival recessions were included.

Evaluation of the literature: evidence assessment tools for clinicians.

The progressive improvement in the quality of scientific articles has led to an increase in difficulty in reading and interpreting them so that now clinical knowledge and experience must be complemented by methodological, statistical and computer skills. The aim of this article is to offer practitioners the tools, the simplest keys, that will allow them to understand and critically judge the results of scientific studies. The "peer-review" process of a clinical article submitted to a journal is described and the Science Citation Index and the Impact Factor are presented to the reader as essential instruments to evaluate a specific article's impact and the impact of a given journal on the scientific world, respectively.

Coronally advanced flap with and without connective tissue graft for the treatment of single maxillary gingival recession with loss of inter-dental attachment. A randomized controlled clinical trial.

Background: The aim of this randomized clinical trial (RCT) was to evaluate the adjunctive benefit of Connective Tissue Graft (CTG) to Coronally Advanced Flap (CAF) for the treatment of gingival recession associated with inter-dental clinical attachment loss equal or smaller to the buccal attachment loss (RT2).

Material And Methods: A total of 29 patients with one recession were enrolled; 15 patients were randomly assigned to CAF+CTG while 14 to CAF alone. Measurements were performed by a blind and calibrated examiner.