Soft tissue substitutes improve patient-reported outcomes in peri-implant soft tissue augmentation.

Data Sources: Five electronic databases (PubMed, Embase, Central, Web of Science, and Epistemonikos) and grey literature were systematically searched up to November 22, 2021 to identify studies relevant to patient-reported outcome measures (PROMs) in peri-implant soft tissue augmentation.

Study Selection: Two authors independently reviewed the title, abstrac (screening phase), and full text (eligibility phase) of the articles after removing the duplicates, based on the pre-established inclusion criteria. A total of 29 clinical studies (19 randomized clinical trials, 7 non-randomized studies, and 3 case series) fulfilled the eligibility criteria based on the PICO framework.

Short-term patient-reported outcomes correlate with clinical parameters in guided bone regeneration.

Design: The prospective observational study aimed to record the short-term patient-reported outcomes (PROMs) like pain, swelling, difficulty in mouth opening, and oral health quality of life (oral health impact profile-14), following a single-site tooth extraction and guided bone regeneration(GBR) using resorbable membrane and bone allograft. Correlation of PROMs with clinical/intra-surgical parameters like flap advancement, gingival and mucosal thickness, surgery duration, and wound opening were observed. PROMs and clinical parameters were assessed pre-operatively and on days 2,4,7 and 14 during the postoperative two weeks.

Similar patient-reported satisfaction and professional appraisal of implant-supported fixed dental prosthesis fabricated by different workflows.

Design: A triple-armed, double-blind randomized controlled trial with cross-over design investigated patient-reported satisfaction and objective dental evaluation of a 3-unit, monolithic zirconium dioxide (ZrO2), implant-supported fixed dental prosthesis (iFDP) fabricated with 2 completely digital workflows and 1 mixed analog-digital workflow.

Case Selection: Participants enrolled required rehabilitation of 2 dental implants in posterior region of either of the arches with a 3-unit, ZrO2 iFDP. A total of 20 participants received the 3 types of ZrO2, iFDP fabricated by 3 different methods.

A conservative approach for keratinized tissue augmentation: Report of two cases.

Background: Free gingival graft harvested from the palate is considered the most predictable method to augment the keratinized tissue (KT). However, the anatomical limitations of the palate, and associated patient morbidity and complications restrict clinicians from performing these procedures in adolescents. Color mismatch with the native tissues resulting in poor esthetic appearance is another concern.

Expression of wound healing markers in gingival crevicular fluid following root-coverage procedures: A systematic review of randomized clinical trials.

Objective: Although several surgical techniques have been developed for treatment of gingival recession (GR), the underlying wound healing process remains relatively unexplored. This systematic review aimed to investigate the expression of wound healing markers in gingival crevicular fluid (GCF) before and after surgical treatment of GR.

Design: Randomized clinical trials (RCTs) reporting changes in the expression of GCF markers following any root coverage surgical procedure were identified from 4 electronic databases and manual searches followed by data extraction and result synthesis.

Indian Society of Periodontology Good Clinical Practice Recommendations for Peri-implant Care.

Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country.

Chitosan-based dressing for management of palatal donor site: A randomized clinical trial.

Aims: This study aimed to evaluate the effectiveness of a chitosan-based dressing (CD) in achieving early wound healing and hemostasis at palatal donor sites in patients undergoing free gingival graft (FGG) surgery.

Methods: Thirty-two patients requiring FGG were treated in this randomized controlled clinical trial. Complete epithelialization (CE) and color match (CM) at donor sites were assessed by a blinded examiner on postoperative days 7, 14, 21, and 28.

Effect of initial periodontal therapy on metallothionein levels in smokers and non-smokers with periodontitis.

The aim of this study was to determine the effect of non-surgical periodontal therapy (NSPT) on mRNA expression of metallothionein (MT) and its levels in serum, saliva and gingival crevicular fluid (GCF) of smokers (S) and non-smokers (NS) with periodontitis (P).A total of 100 participants were included: 48 periodontally healthy (PH) subjects (24 S [PH + S] and 24 NS [PH + NS]) and 52 patients with P (27 S [P + S] and 25 NS [P + NS]). Clinical parameters were recorded, and biofluids (serum, saliva and GCF) and gingival tissue samples were obtained at baseline in all groups and 3 months after NSPT in P groups.

Use of a hybrid soft tissue autograft for gingival phenotype modification lingual to mandibular incisors.

Presence of adequate dimensions of keratinized/attached gingiva (KT/AG) and gingival thickness (GT) is considered necessary to maintain optimal periodontal health and long-term stability of gingival margin. Gingival phenotype modification therapies to increase these two dimensions (GT and KT/AG) on the buccal aspect of teeth have been widely reported, but the literature on lingual gingival augmentation is scarce. The purpose of this paper is to report the outcomes of a case treated with an envelope flap combined with a hybrid soft tissue autograft (subepithelial connective tissue graft with an epithelial collar) for phenotype modification of gingiva lingual to mandibular incisors presenting with thin gingiva (<1 mm) and lack of AG in tooth # 31 and 42.

Evidence-based suggestions to improve the methodological issues in reporting of prevalence studies on gingival recession.

Gingival recession (GR) is considered a public health problem which is highly prevalent across different populations. Accuracy of psychometric properties of prevalence estimates of GR reported in epidemiological studies is important to facilitate setting public health goals, planning of public health programs, implementation of best practices and thereby developing public health policy. However, the reported prevalence estimates are influenced by the methodological variations among different studies, as observed in our recently published systematic review and meta-analysis on the global prevalence of GR.

Clinicopathological and immunohistochemical analysis of plasma cell gingivitis- A retrospective study.

Background: This study aims to describe the demographics and clinicopathological characteristics of the cases of plasma cell gingivitis (PCG) reported in our institute, supported by a review of pertinent literature. Further, we investigated the role of the cluster of differentiation CD138, Ki67, CD56, and CD117 immunoexpression in the differential diagnosis of PCG from plasma cell dyscrasias.

Materials And Methods: All histopathologically confirmed cases of PCG, whose relevant details could be obtained, were included in this study.

Global prevalence of gingival recession: A systematic review and meta-analysis.

Objective: This systematic review and meta-analysis aimed to estimate the global prevalence of gingival recession (GR) in the general population.

Materials And Methods: Population-based observational studies reporting the prevalence of GR and published from 1991 to 2021 were identified from five electronic databases and manual searches. Risk of bias was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Studies.

Distribution of biopsied gingival lesions according to the proceedings from the 2017 World Workshop classification: A three-year retrospective study.

Background: The gingiva is a common site for neoplastic or non-neoplastic lesions. Neoplasms refer to progressive autonomous growth that can have either a benign or a malignant course. On the other hand, non-neoplastic lesions are mainly inflammatory, or occur as a reaction to some kind of irritation or lowgrade injury.

Fibrosarcoma: Origin, differential diagnosis, and report of a case in the mandible.

Fibrosarcoma (FS) is a malignant neoplasm of mesenchymal cells with no specific line of differentiation. Histologically, it mimics the wide spectrum of benign and malignant spindle cell neoplasms creating diagnostic conundrum. Immunohistochemistry plays a crucial role in the diagnosis which relies on various antibodies reacting with different antigens expressed by heterogeneous cells.

A Modified Suturing Protocol for Tripod Stabilization of Connective Tissue Graft and Coronal Advancement of Tunnel Flap for Treatment of Isolated Gingival Recession.

Preserving a sufficient blood supply and maintaining wound stability during the healing phase are the most crucial factors for success in root coverage procedures. Selecting the surgical technique and suturing protocol used to achieve these goals is therefore indispensable for predictable treatment outcomes. Tunneling flap procedures have evolved as a technical advancement in periodontal plastic surgery, particularly focusing on improving the vascular supply at the surgical site.

Successful management of a large mucosal fenestration at 18-months follow-up.

Objectives: Mucosal fenestrations are infrequent and often challenging to treat depending on the extent of soft and hard tissue destruction. This article presents the successful management of a relatively larger mucosal fenestration associated with complete absence of buccal bone plate in a mandibular incisor secondary to trauma-induced periapical pathosis.

Clinical Considerations: After non-surgical endodontic therapy, surgery was performed for debridement of the osseous defect, root resection/shaping, connective tissue graft (CTG) placement on the affected root surface and platelet rich fibrin (PRF) in periapical osseous defect rather than use of bone graft and/or barrier membrane.

A novel approach of combining the tunnel technique with a double papilla flap or a coronally positioned flap for the treatment of multiple adjacent gingival recessions: report of two cases.

The treatment of multiple gingival recessions (GRs) is often challenging for clinicians, mainly due to a larger avascular surface, limited blood supply, differences in recession depth, and residual keratinized tissue. Considering these factors, it may be prudent to take advantage of one surgical technique and overcome its limitations by combining it with another technique in certain clinical situations. The present clinical report describes the treatment of multiple GRs of different depths with a combination of the tunnel technique (TUN) and pedicle flap (PED) - double papilla flap (DPF) or coronally positioned flap (CPF) - in conjunction with deepithelialized connective tissue grafts in two patients.

Efficacy of modified coronally advanced flap in the treatment of multiple adjacent gingival recessions: a systematic review and meta-analysis.

Objective: This systematic review (SR) aims to evaluate the efficacy of modified coronally advanced flap (mCAF) on clinical and patient-reported outcomes in the treatment of multiple adjacent gingival recessions (MAGRs).

Materials And Methods: Randomized controlled trials (RCTs), case-series and prospective clinical studies on treatment of Miller class I/II or RT1 MAGRs with ≥ 6 months follow-up were identified from the electronic databases and hand-searched journals. Complete root coverage (CRC) was the primary outcome variable.

Metallothionein levels in gingival crevicular fluid, saliva, and serum of smokers and non-smokers with chronic periodontitis.

Background: Metallothionein (MT), a cysteine rich protein is involved as a radical scavenger in several pathological conditions associated with oxidative stress; however, its role in periodontal disease still remains elusive. The aim of this cross-sectional study is to determine the serum, saliva and gingival crevicular fluid (GCF) levels of MT in smokers (S) and non-smokers (NS) with chronic periodontitis (CP), and compare them with those of periodontally healthy (PH) individuals.

Methods: A total of 85 participants were enrolled: 45 patients with CP (23 S [CP+S] and 22 NS [CP+NS]) and 40 PH individuals (20 S [PH+S] and 20 NS [PH+NS]).

Inflammatory myofibroblastic tumor manifesting as recurrent generalized gingival enlargement: Report of a rare case.

Oral inflammatory myofibroblastic tumor (IMT) is extremely rare and its manifestation as generalized gingival enlargement (GGE) has never been reported. We are reporting the case of 50-year-old female patient presenting with recurrent GGE for 4 years. Panoramic radiograph revealed severe bone loss in posterior sextants and root resorption in some teeth.

Periodontal Microsurgical-Assisted Pouch and Tunnel Approach in Combination with Subepithelial Connective Tissue Graft for the Management of Class IIB and IIC Multiple Adjacent Gingival Recessions in Mandibular Anterior Segment.

Gingival recession (GR) is an early and common clinical expression found in a majority of the population which increases with age. Different factors contribute to its etiology. It is a matter of concern for the patient which may be due to altered function and esthetics etc.

Periodontal microsurgery: Reaching new heights of precision.

The use of magnification to perform various procedures in medical and dental field, particularly endodontics has long been recognized. Unfortunately, its application in periodontics is not widely popularized. The objective of this article is to emphasize the application of microsurgical principles in various periodontal surgical procedures and to reinforce the incorporation of microscope into periodontal practice.

Leukocyte adhesion defect-I: rare primary immune deficiency.

Leukocyte adhesion defect I is a rare disorder (1:1,000,000) caused by diminished expression of CD-18 β2 integrins on leukocytes leading to abnormal adhesion, migration, and chemotaxis. Clinical manifestations include delayed separation of umbilical cord, omphalitis, recurrent severe infections, impaired wound healing, persistent oral ulcers, and severe periodontitis in primary and permanent dentition. A 5-year-old girl, second-born child to parents with consanguinity, presented with pain and mobility of lower teeth.

Cryotherapy as a conservative treatment modality for gingival enlargement in a patient with Sturge-Weber Syndrome.

This case report describes a case of Sturge-Weber syndrome reported for unilateral gingival enlargement and bleeding from gingiva in maxillary left region. Initial treatment in the form of scaling and root planing was done but recurrence was observed after one year of follow up. Instead of performing conventional surgery, an alternative conservative treatment was planned in the form of cryotherapy with the help of closed nitrous oxide probe.

An unusual case of idiopathic gingival fibromatosis.

Idiopathic gingival fibromatosisis, a condition of undetermined cause can develop as an isolated disorder, but mostly it is associated with some syndrome. It usually begins at the time of eruption of permanent teeth but can develop with the eruption of deciduous dentition and rarely present at birth. This case report describes an unusual case of non-syndromic generalized idiopathic gingival fibromatosis in a 15-year-old male present since birth.