Autogenous platelet concentrates for treatment of intrabony defects-A systematic review with meta-analysis.

To provide an overview of the use of autogenous platelet concentrates (APCs) in periodontal regeneration and to conduct a systematic review (SR) of the treatment outcomes of periodontal intrabony defects by using platelet-rich fibrin (PRF) compared with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with that of other modalities. Studies were classified into 21 categories and into five different groups as follows: Group I (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD versus Titanium-PRF (T-PRF) Group II, (3) Comparative PRF protocols (PRF vs.

Periodontal regeneration using platelet-rich fibrin. Furcation defects: A systematic review with meta-analysis.

The objective of the study was to compare the treatment outcomes of periodontal furcation defects by using platelet-rich fibrin (PRF) with other commonly utilized modalities. The eligibility criteria comprised randomized controlled trials (RCTs) comparing the clinical outcomes of PRF with those of other modalities for the treatment of furcation defects. Studies were classified into 11 categories in 3 different groups as follows: Group I (addition of PRF): (1) open flap debridement (OFD) alone versus OFD/PRF, (2) OFD/bone graft (OFD/BG) versus OFD/BG/PRF; Group II (comparative studies to PRF): (3) OFD/BG versus OFD/PRF, (4) OFD/collagen membrane versus OFD/PRF, (5) OFD/PRP versus OFD/PRF, (6) OFD/rhBMP2 versus OFD/PRF; and Group III (addition of biomaterial/biomolecule to PRF): OFD/PRF versus … (7) OFD/PRF/BG, (8) OFD/PRF/amniotic membrane (AM), (9) OFD/PRF/metformin, (10) OFD/PRF/bisphosphonates, (11) OFD/PRF/statins.

Training in the use of the water jet and cold atmospheric plasma jet for the decontamination of dental implants.

Objectives: Clinical trials testing new devices require prior training on dummies to minimize the "learning curve" for patients. Dentists were trained using a novel water jet device for mechanical cleaning of dental implants and with a novel cold plasma device for surface functionalisation during a simulated open flap peri-implantitis therapy. The hypothesis was that there would be a learning curve for both devices.

Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: a case series.

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis.

Method And Materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement.

Management of Teeth with Grade 3 Endo-Periodontal Lesions by Combined Endodontic and Regenerative Periodontal Therapy.

(1) Background: Severely compromised teeth affected by endo-periodontal lesions are often assigned a "hopeless" prognosis, however, there is only limited evidence available. (2) Methods: In a retrospective study, we evaluated the long-term effectiveness of combined endodontic and regenerative periodontal therapy in teeth with advanced endo-periodontal lesions: 35 patients (age 47-83 years) with a total of 39 teeth diagnosed with grade 3 endo-periodontal lesions were treated by endodontists using an operating microscope followed by regenerative periodontal surgery. (3) Results: Changes in radiographic bone levels (rBl) and probing pocket depths (PPDs) were evaluated after 1 year (T) and up to 7 years postoperatively (T).

Complications and treatment errors related to regenerative periodontal surgery.

Regenerative periodontal surgical procedures are an important component in the treatment of advanced periodontitis. They aim to improve the long-term prognosis of teeth that are periodontally compromised by the presence of intrabony and/or furcation defects, resulting biologically in formation of root cementum, periodontal ligament, and alveolar bone and evidenced clinically by reduction of deep pockets to maintainable probing depths and/or improvements of vertical and horizontal furcation depth. Over the last 25 years, substantial clinical evidence has been accumulated to support the value of regenerative procedures in periodontally compromised dentitions.

Efficacy of a collagen matrix for soft tissue augmentation after implant placement compared to connective tissue grafts: A multicenter, noninferiority, randomized controlled trial.

Objectives: To test whether soft tissue volume augmentation using a collagen matrix (VCMX) leads to noninferior results in terms of gain of mucosal thickness at single implant sites, compared to connective tissue grafts (SCTG).

Methods: The study was designed as a multi-center randomized controlled clinical trial. Subjects in need of soft tissue volume augmentation at single tooth implant sites were consecutively recruited at nine centers.

Synergy of Regenerative Periodontal Surgery and Orthodontics Improves Quality of Life of Patients with Stage IV Periodontitis: 24-Month Outcomes of a Multicenter RCT.

In stage IV periodontitis patients with pathologic tooth migration (PTM), interdisciplinary treatment includes regenerative periodontal surgery (RPS) with an application of biomaterials and orthodontic therapy (OT) to restore function, esthetics and thereby quality of life (QoL). In a 24-month randomized trial we explored the synergy between regenerative medicine and biomechanical force application. The following methods were used: Forty-three patients had been randomized to a combined treatment comprising RPS and subsequent OT starting either 4 weeks (early OT) or 6 months (late OT) post-operatively.

Long-term stability of regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: 10-year data of a retrospective study.

Background: This study aimed to evaluate the long-term effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic therapy (OT) in stage IV periodontitis.

Methods: Twenty-two patients with a total of 256 intra-bony defects were analyzed after regenerative surgery followed by OT initiated 3 months later. Changes in radiographic bone level (rBL) and probing pocket depths (PPD) were evaluated after 1 year (T1), final splinting (T2), and 10 years (T10).

Complications and treatment errors involving periodontal tissues related to orthodontic therapy.

In this review, typical clinical complications involving periodontal tissues are illustrated that can be encountered in conjunction with orthodontic therapy (OT). Special considerations are given for various clinical scenarios, such as the patient presenting in periodontal health, with periodontitis, or with mucogingival conditions. While some of the complications are seen as common side effects of OT, other, more severe, problems that could have been avoided may be viewed as treatment errors.

Biomechanical properties of periodontal tissues in non-periodontitis and periodontitis patients assessed with an intraoral computerized electronic measurement device.

Objective: To identify tooth mobility (TM) by time-dependent tooth displacement using an electronic intra-oral loading device (ILD) in periodontally healthy and periodontally compromised patients.

Materials And Methods: Twenty-eight untreated periodontitis and 20 periodontally healthy patients [25 female and 26 male; ages: 20-81 years], contributing with 68 teeth (periodontitis: n = 28; non-periodontitis: n = 40), participated in the study. TM was measured in vivo by displacing central or lateral incisors to a maximum of 0.

Efficacy of mechanical/physical approaches for implant surface decontamination in non-surgical submarginal instrumentation of peri-implantitis. A systematic review.

Aim: To evaluate the efficacy of non-surgical submarginal peri-implant instrumentation with mechanical/physical decontamination compared to non-surgical submarginal instrumentation alone or with placebo decontamination in patients with peri-implantitis.

Materials And Methods: Three focused questions were addressed, and a systematic search for randomized controlled clinical trials (RCTs), controlled clinical trials, and prospective cohort studies with definitions of peri-implantitis and a minimal follow-up of 6 months was conducted. The main outcome variables were reduction in pocket probing depth (PD) and bleeding on probing (BOP).

Reliability of probing depth assessments at healthy implant sites and natural teeth.

Aim: To evaluate the intra- and inter-examiner reliability in the assessment of probing depth (PD) measurements at healthy dental implant sites and periodontally healthy natural teeth.

Materials And Methods: Five patients exhibiting 21 dental implants were enrolled in the study. Eight experienced examiners performed duplicate PD measurements at six sites of all implants and of preselected natural teeth.

Prevalence and Antibiotic Susceptibility Trends of Selected , , and in the Subgingival Microbiota of German Periodontitis Patients: A Retrospective Surveillance Study.

The periodontal microbiota is ecologically diverse and may facilitate colonization by bacteria of enteric origin (, ) and co-infections with , possibly producing subgingival biofilms with high antimicrobial tolerance. This retrospective surveillance study followed periodontitis-associated superinfection profiles in a large patient sample. From 2008 to 2015, biofilm samples from deep periodontal pockets were collected from a total of 16,612 German adults diagnosed with periodontitis.

The effect of timing of orthodontic therapy on the outcomes of regenerative periodontal surgery in patients with stage IV periodontitis: A multicenter randomized trial.

Aim: To compare the outcomes after early (4 weeks post surgery) or late (6 months post surgery) orthodontic therapy (OT) following regenerative surgery of intra-bony defects (IDs).

Materials And Methods: In a multi-center, parallel-group, randomized clinical trial, 43 patients with stage IV periodontitis were randomized to receive either early (n = 23) or late OT (n = 20) following regenerative surgery of IDs. Primary outcome was change in clinical attachment level (CAL) in one target ID at 12 months after surgery.

Prevalence and antibiotic susceptibility trends of periodontal pathogens in the subgingival microbiota of German periodontitis patients: A retrospective surveillance study.

Objective: This retrospective surveillance study aimed to follow periodontitis-associated bacterial profiles and to identify time-dependent changes in antibiotic susceptibility patterns.

Materials And Methods: From 2008 to 2015, bacterial specimen from deep periodontal pockets were collected from a total of 7804 German adults diagnosed with periodontitis. Presence of selected bacteria was confirmed by anaerobic culture and nucleic acid amplification.

Regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: A retrospective practice-based cohort study.

Aim: Evaluation of the effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic tooth movements in stage IV periodontitis.

Material And Methods: A total of 526 intra-bony defects in 48 patients were analysed after regenerative therapy using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic tooth movement initiated 3 months after surgery. Changes in radiographic bone levels (BL) and probing pocket depths (PPD) were evaluated after 1 year and up to 4 years.

Vital root resection in severely furcation-involved maxillary molars: Outcomes after up to 7 years.

Aims: To introduce a novel therapeutic approach for the treatment of furcation-involved maxillary molars by vital root resection and report longer-term outcomes of a case series.

Methods: Eleven patients with 15 maxillary molars affected by double/triple class II (n = 10) or single/double class III (n = 5) furcation defects and advanced vertical bone loss around one root participated. Teeth were treated with deep pulpotomy using a calcium silicate-based cement.

Long-Term Stability of Root Coverage by Coronally Advanced Flap Procedures.

Background: This study compared 6-month and 3-year outcomes for root coverage (RC) by coronally advanced flap (CAF) procedures in localized gingival recessions.

Methods: Two centers, that had participated in a 6-month multinational multicenter randomized clinical trial (RCT), followed up 18 patients with 36 Miller Class I and II defects that had been treated in a split-mouth design with CAF procedures or CAF + xenogeneic collagen matrix (CMX). Percentage of RC, complete root coverage (CRC), width, and thickness of keratinized tissue were assessed by the same masked examiners as after the 6-month RCT.

Patient-reported outcomes and aesthetic evaluation of root coverage procedures: a 12-month follow-up of a randomized controlled clinical trial.

Aim: To assess patient-reported outcome measures (PROMs), aesthetics and stability of root coverage procedures from a previous 6-month RCT after 1 year.

Material & Methods: Forty-five patients (90 recessions) had received a coronally advanced flap (CAF = control) only or a xenogeneic collagen matrix in addition (CAF + CMX = test). Visual analogue scales (VAS) and questionnaires were used for PROMs and the root coverage aesthetic score (RES) for professional aesthetic evaluations.

Antibiotics/antimicrobials: systemic and local administration in the therapy of mild to moderately advanced periodontitis.

This review gives an update of the current scientific evidence on the efficacy of the adjunctive use of systemic and local antibiotics/antimicrobials in the treatment of periodontitis. In particular, it addresses whether their use can improve the results of nonsurgical mechanical therapy in mild-to-moderate forms of the disease. Large numbers of randomized clinical trials and systematic reviews with meta-analyses have clearly established that adjunctive systemic antibiotics, combined with mechanical debridement, offer clinical improvements additional to those obtained with scaling and root planing alone.

EFP Delphi study on the trends in Periodontology and Periodontics in Europe for the year 2025.

Aim: The aim was to assess the potential trends in Periodontology and Periodontics in Europe that might be anticipated by the year 2025, using the Delphi method.

Material And Methods: The expert opinion of 120 experts was sought through the use of an open-ended questionnaire, developed by an advisory group, containing 40 questions concerning the various trends in periodontology.

Results: The experts (113 responders) expect a stabilization of the prevalence of periodontitis, both for the chronic as well as the aggressive cases, but an increase in implant-related diseases up to the year 2025.

Management of a Central Incisor with Horizontal Root Fracture for Esthetic and Functional Rehabilitation.

Severely traumatized incisors in young adults are a very common problem, and one that is difficult to treat because healing of these teeth is not always predictable and implant placement has to be delayed until adulthood. This case report of a horizontal root fracture in an avulsed central incisor illustrates the ability to maintain crucial tooth structure. A lateral socket augmentation procedure after extraction of a root fragment combined with an endodontic and regenerative periodontal treatment approach could preserve natural esthetics and function, which are directly related to quality of life.

Esthetic and functional rehabilitation of a severely compromised central incisor: an interdisciplinary approach.

This case report of a patient with a central incisor with rapid destruction of periodontal tissues associated with pathologic tooth migration illustrates the esthetic and functional reconstruction of a severely compromised tooth. An interdisciplinary approach, including resolution of the infection and regenerative periodontal surgery followed by orthodontic tooth movement, transformed a hopeless tooth with high mobility, attachment loss approaching the apex, and a Miller Class IV recession into a clinically healthy tooth. Treatment planning for periodontally involved anterior teeth with pathologic migration should consider a multidisciplinary approach for preservation of the natural dentition.

Clinical concepts for regenerative therapy in furcations.

Furcation involvements present one of the greatest challenges in periodontal therapy because furcation-involved molar teeth respond less favorably to conventional periodontal therapy compared with noninvolved molar or nonmolar teeth. Various regenerative procedures have been proposed and applied with the aim of eliminating the furcation defect or reducing the furcation depth. An abundance of studies and several systematic reviews have established the effectiveness of membrane therapy (guided tissue regeneration) for buccal Class II furcation involvement of mandibular and maxillary molars compared with open flap surgery.