Soft Tissue Conditioning for the Surgical Therapy of Peri-implantitis: A Prospective 12-Month Study.

The significance of keratinized mucosa around dental implants for the prevention of biologic complications has been a subject of controversy. Agreement, however, exists on the benefits provided to achieve more satisfactory oral hygiene measures and reduced clinical inflammation. A prospective interventional case series of 14 patients (31 implants) were examined every 3 months for up to 12 months.

Labial Strip Gingival Graft for the Reconstruction of Severely Distorted Mucogingival Defects: A Prospective Case Series.

Several techniques involving the harvesting of a soft tissue graft from the palate have been proposed for regenerating keratinized mucosa (KM) at implant sites. However, patient morbidity and poor esthetic outcomes are considered the main drawbacks of these approaches. Therefore, the aim of this study was to describe and evaluate a new technique for harvesting keratinized tissue from the adjacent labial site (labial gingival graft [LGG]), in combination with a xenogeneic collagen matrix (XCM) or a connective tissue graft (CTG).

Clinical Remarks on the Significance of Tooth Malposition and Papillae Dimension on the Prediction of Root Coverage.

When it comes to complete root coverage of exposed root surfaces, several limiting factors have been suggested. Although tooth malposition and papillae dimension are capable of influencing root coverage, they have not received sufficient emphasis in the literature. Therefore, the aim of the present commentary is to discuss the impact of tooth malposition and papillae dimension on root-coverage outcomes.

Impact of mucosal phenotype on marginal bone levels around tissue level implants: A prospective controlled trial.

Background: The aim of this 1-year prospective clinical trial was to compare clinical parameters and marginal bone levels (MBLs) around tissue level implants with a partially smooth collar between patients with thin (≤2 mm) and thick (>2 mm) vertical mucosal phenotypes.

Methods: Thirty patients needing a single dental implant were recruited and allocated to thin (n = 14) or thick (n = 16) phenotype groups. Post-restoration, clinical (probing depth, recession, width of keratinized mucosa, bleeding on probing, suppuration, implant mobility, plaque index, and gingival index) and radiographic bone level measurements were recorded at different timepoints for 1 year.

Evaluation of length and location of the maxillary sinus intraosseous artery using computerized tomography.

Background: The intraosseous artery is a branch of the posterior superior alveolar artery that supplies the lateral wall of the maxillary sinus. The present study seeks to analyze the location of the intraosseous artery and its site of termination.

Methods: Cone beam computed tomography was used to evaluate 200 patients making up 400 maxillary sinuses.

Staging and Grading Discussion of Borderline Cases in Gray Zones.

Introduction: Staging and grading for chronic periodontal disease, as described in 2018, is designed to focus on key distinctions with the recognition that there is a subset of individuals who are on a different clinical trajectory of disease. The staging and grading framework aids the clinician in generating a periodontal diagnosis, however, some cases fall into gray zones in which the simple diagnostic parameters make it challenging to categorize the patient. These cases do not present with clear clinical findings and medical and dental histories that fit within the simple guidelines defined in the staging and grading tables and subsequent algorithms.

Challenges and Decision Making for the Classification of Two Complex Periodontal Cases.

Focused Clinical Question: What are the fundamental debates and questions related to the newly developed two-vector system for classification of periodontal diseases that have emerged as to how to accurately assign, stage, and grade periodontitis cases? The aim of the present manuscript is to demonstrate the essential thought processes that are needed in utilizing the new periodontitis classification system to diagnose two gray zone cases.

Summary: Clinical case 1 includes an 83-year-old male diagnosed with periodontitis and classified as Stage III Generalized Grade B periodontitis, while clinical case 2, a 73-year-old male was classified as presenting Stage IV Generalized Grade B periodontitis. Although clinical and radiographic evaluations revealed similarities between the cases, the thought process that includes clinical judgment is described to guide a more accurate diagnosis following the guidelines of the new classification system.

Clinical sequelae and patients' perception of dental implant removal: A cross-sectional study.

Background: A cross-sectional study was designed to shed light on the clinical sequelae and patient satisfaction after dental implant removal (IR).

Methods: Patients undergoing ≥1 IRs were eligible. The reasons for implant failure, clinical and radiological parameters before and after IR, and the surgical and prosthetic treatments offered after IR was assessed.

Does a fully digital workflow improve the accuracy of computer-assisted implant surgery in partially edentulous patients? A systematic review of clinical trials.

Background: Accurate implant placement is essential in reducing post-treatment complications and in ensuring a successful treatment outcome.

Purpose: To compare the accuracy of fully-guided static computer-assisted implant surgery (s-CAIS) using partially- and fully-digital workflows.

Materials And Methods: Electronic and manual literature searches were performed to collect evidence concerning the accuracy of fully-guided s-CAIS procedures utilizing tooth-supported guides.

Patient experience of autogenous soft tissue grafting has an implication for future treatment: A 10- to 15-year cross-sectional study.

Background: Patient-reported outcomes have received a great deal of interest in periodontal plastic procedures. However, their evaluation has mainly been short-term. Thus, the aim of this study was to evaluate the impact of soft tissue grafting procedures conducted over a decade ago on the willingness of a patients to undergo the surgery again.

Influence of restorative design on the progression of peri-implant bone loss: A retrospective study.

Background: Clinical data on the restorative designs affecting the early progression of peri-implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g.

Development of a nomogram for the prediction of periodontal tooth loss using the staging and grading system: A long-term cohort study.

Aim: To develop and internally validate a nomogram built on a multivariate prediction model including parameters from the new classification of periodontal diseases, able to predict, at baseline, the occurrence of tooth loss due to periodontal reason (TLP).

Materials And Methods: A total of 315 individuals diagnosed with periodontal disease and receiving a minimum of one annual supportive periodontal therapy visit were included in the study. Patients were staged and graded based upon baseline data.

Bone modifications around porous trabecular implants inserted with or without primary stability 2 months after tooth extraction: A 3-year controlled trial.

Purpose: Implant primary stability has long been considered a prerequisite for successful osseointegration. However, achieving stability may be difficult when placing implants in wide postextractive bone defects. The purpose of this study was to conduct a clinical and radiographic investigation of bone modifications at porous-structured implants inserted with or without primary stability.

Indirect Digital Workflow for Virtual Cross-Mounting of Fixed Implant-Supported Prostheses to Create a 3D Virtual Patient.

Mounting dental casts in an articulator is an important prerequisite for prosthodontic rehabilitation cases where the design of an accurate static and dynamic occlusion is needed. Virtual mounting can be achieved through the superimposition of various 3D images acquired from the hard and soft tissues of the patient. The purpose of this technical report is to describe a digital cross-mounting technique for patients undergoing implant-supported fixed prosthetic treatment.

Breaking the wave of peri-implantitis.

Peri-implant diseases are prevalent with a weighted mean prevalence rate of 43% across Europe and 22% across South and North America. Although the main etiologic agent is bacterial biofilm, a myriad of factors influence the initiation and progression of the disease. Unfortunately, the treatment of peri-implant diseases is at best favorable in the short term with a high rate of persistent inflammation and recurrence.

Virtual Articulators and Virtual Mounting Procedures: Where Do We Stand?

A virtual articulator is a computer software tool that is capable of reproducing the relationship between the jaws and simulating jaw movement. It has gradually gained research interest in dentistry over the past decade. In prosthodontics, the virtual articulator should be considered as an additional diagnostic and treatment planning tool to the mechanical articulator, especially in complex cases involving alterations to the vertical dimension of occlusion.

Laser-assisted regenerative surgical therapy for peri-implantitis: A randomized controlled clinical trial.

Background: Different surgical approaches have been proposed to treat peri-implantitis defects with limited effectiveness and predictability. Laser has been proposed as an effective tool to assist in bacterial decontamination and modulating peri-implant tissue inflammation. The aim of this pilot clinical trial was to evaluate the adjunctive benefits of Er:YAG laser irradiation for regenerative surgical therapy of peri-implantitis-associated osseous defects.

Atypical Healing Related to Irritable Bowel Disease.

Introduction: Irritable bowel disease (IBD) is a gastrointestinal disorder characterized by chronic granulomatous inflammation of the entire digestive system, which includes the oral cavity. Oral manifestations of IBD includes aphthous ulcerations which may appear spontaneously and resemble episodes of active flare ups of IBD. The presence of oral mucosal ulcerations, in addition with other systemic symptoms and exclusion of other etiological causes, requires an interdisciplinary team approach to diagnose and manage.

Acellular dermal matrix for root coverage procedures: 9-year assessment of treated isolated gingival recessions and their adjacent untreated sites.

Background: The long-term outcomes of acellular dermal matrix (ADM) for the treatment of isolated gingival recessions has not yet been evaluated. Thus, the aim of this study was to observe the root coverage outcomes of coronally advanced flap with ADM over time, and compare them with their adjacent untreated sites.

Methods: Twelve patients (from 20) were available at the 9-year recall.

Suppuration as diagnostic criterium of peri-implantitis.

Background: Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore performed to investigate the patient, implant, and site characteristics among individuals exhibiting SUP.

Methods: Demographic characteristics and clinical parameters were recorded.

Peri-implant soft tissue phenotype modification and its impact on peri-implant health: A systematic review and network meta-analysis.

Background: The peri-implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal tissue height (STH). Numerous approaches to augment soft tissue volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial for peri-implant health has been subject of debate in the field of implant dentistry.

Potential of Using an Implant Fixture as a Ridge Expander for Minor Ridge Augmentation: An Ex Vivo Randomized Controlled Study.

To place implants with minimal trauma is what the patient and clinician are seeking. Hence, the aim of this study was to quantify the potential of using an implant fixture as a ridge expander in an underprepared osteotomy. Thirty-eight edentulous sites in 12 human cadaver jaws with ridge widths ranging from 4 to 6 mm and with type 3 or type 4 bone density were randomly assigned into 2 groups.

Aesthetic-And patient-related outcomes following root coverage procedures: A systematic review and network meta-analysis.

Background: Aim of this systematic review (SR) of randomized controlled trials (RCTs) was to evaluate effect of different flap designs and graft materials for root coverage, in terms of aesthetics, patient satisfaction and self-reported morbidity (post-operative pain/discomfort).

Material And Methods: A comprehensive literature search was performed. A mixed-modelling approach to network meta-analysis was utilized to formulate direct and indirect comparisons among treatments for Root Coverage Esthetic Score (RES), with its individual components, and for subjective patient-reported satisfaction and post-operative pain/discomfort (visual analogue scale (VAS) of 100).

Influence of implant mucosal thickness on early bone loss: a systematic review with meta-analysis.

Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs.

Dose-dependent effect of smoking and smoking cessation on periodontitis-related tooth loss during 10 - 47 years periodontal maintenance-A retrospective study in compliant cohort.

Aim: We retrospectively explored effects of smoking on tooth loss due to periodontitis (TLP) in long-term compliant patients.

Materials And Methods: Chart data were collected from 258 patients undergoing post-non-surgical periodontal treatment (mean 2.24 visits/year) for 10-47.