The International journal of periodontics & restorative dentistry最新文献

The purpose of this retrospective study was to assess facial and palatal alveolar wall thickness (AWT) in relation to sagittal root position (SRP) of maxillary anterior teeth using CBCT. A total of 102 CBCT images (60 women, 42 men) of maxillary anterior teeth were reviewed. SRP was classified according to Kan's classification, and AWT was evaluated at coronal (4 mm from the CEJ), mid-root, and apical (2 mm from the apex) levels of the facial and palatal aspects. Sex, age, and tooth type were analyzed as secondary variables. The SRP distribution was 76.6% class I, 11.3% class II, 0.8% class III, and 11.3% class IV. AWT, from thickest to thinnest, was found in palatal apical, then mid-root, then coronal levels, followed by facial coronal, then mid-root, then apical levels. AWT was thickest in SRP class II, followed by classes I and III, and least thick in class IV at all measured areas (P < .05). A significantly higher AWT was associated with class I in central incisors, class II in canine teeth and in men, and class IV in central incisors and canines.

Current concepts in periodontology emphasize the interproximal attachment as an important distinguishing aspect with significant influence, making it a key diagnostic and prognostic factor. Complete regeneration of the interproximal clinical attachment has become a primary determinant of periodontal success. Since the mid-20th century, numerous articles have been published on root coverage procedures, mostly for nonproximal gingival recessions. When it comes to the interdental area, the literature does not inspire the same level of confidence. This case series introduces an innovative 3D tunneling surgical technique for gingival papilla reconstruction and supra-alveolar interproximal attachment regeneration. The technique is described step by step and shown with three selected clinical cases of multiple bilateral adjacent gingival recessions (types 2 and 3) in the anterior mandible with 6.5 years of follow-up. A total of 18 proximal, midbuccal, and midlingual recessions were treated simultaneously. Up to 88.9% of mean root coverage was achieved in the proximal area. Within its limits, this case series demonstrates the possibility of treating gingival recessions with deficient papillae in the anterior mandible, achieving a significant clinical improvement with long-term stability.

A clinical observation usually encountered after vestibuloplasty, or after interventions aiming to deepen the vestibule with or without simultaneous free epithelialized grafts in the posterior ridges, is that the vestibule can be subjected to major dimensional changes attributed to the buccinator fiber attachment. Therefore, this study aimed to assess the attachment of the buccinator muscles in relation to other anatomical landmarks. An ex vivo study was performed in cadaver heads to explore the association of fiber attachment in relation to the distance from the crestal aspect of the edentulous alveolar process (CAP) and the vestibular depth (VD), crestal band of keratinized mucosa (KM), and ridge height (RH). Interestingly, VD and KM were found to be strongly correlated. Likewise, VD/ KM and CAP-BUC (CAP to the most coronal insertion of the buccinator muscle) were also correlated. CAP-BUC was negatively correlated with RH. Accordingly, the more atrophic the alveolar ridge (ie, more noticeable in the mandible), the shallower the vestibule, the smaller the crestal band of KM, and the greater crestal attachment of the buccinator muscular fibers. This may be the reason why the graft is subjected to major dimensional changes whenever a free epithelialized graft is performed in the posterior ridges to enhance the peri-implant soft tissue phenotype and deepen the vestibule.

This study evaluated the impact of using calcium hydroxide or antioxidant agents on the bond strength of adhesive restorations to bleached dentin. A total of 40 teeth were prepared and allocated into eight groups, first divided according to the surface treatment after bleaching (no treatment or application of calcium hydroxide, 10% sodium ascorbate, or 5% sodium thiosulfate for 10 minutes) and then according to the time of final restoration after treatment (immediate or after 7 days). Sodium perborate with 20% hydrogen peroxide was applied for 3 weeks using a developed artificial pulp chamber, with peroxide replacements provided every week. Composite resin restoration was performed, followed by a microtensile test. Then, specimens were analyzed using a stereomicroscope and scanning electron microscopy (SEM). Data were submitted to Kruskal-Wallis and Dunn tests (P < .05). The bond strength of nonbleached teeth was similar to the groups restored after 7 days of bleaching (P < .05). The lowest bond strength values were seen in groups restored immediately after bleaching (P < .05). In all groups, there was a considerable predominance of adhesive fractures. Delaying the final restoration of teeth submitted to nonvital bleaching by 7 days increased the bond strength. The immediate restoration of bleached teeth after using 10% sodium ascorbate or 5% sodium thiosulfate for 10 minutes showed unsatisfactory results. Irrespective of the dentin protocol applied before adhesion, bond strength values will be satisfactory when delaying the final restoration and unsatisfactory when immediately performing the final restoration. Therefore, after nonvital tooth bleaching, clinicians should always delay the final restoration for a minimum period of 7 days.

Collagen matrices have been developed as possible connective tissue graft substitutes to overcome patient discomfort, undesired palatal healing, and the limited amount of donor tissue. The aim of this case series is to assess a coronally advanced flap (CAF) with a volume-stable collagen matrix (VCMX) to treat single gingival recessions (GRs) associated with partially restored noncarious cervical lesions (NCCLs). Twelve patients diagnosed with single GRs (type 1; RT1) + NCCL (B+) were included in this study and received a restorative approach (partial composite resin with an apical margin 1 mm beyond the estimated cementoenamel junction [CEJ]) and a surgical approach (CAF+VCMX). Clinical and patient-centered assessments were recorded from 10 patients at baseline and 6 months postoperatively. Significant recession reduction (2.1 mm), clinical attachment level gain (1.34 mm), and combined defect coverage (51.67%) were observed at 6 months. The estimated root coverage was 69.48%, obtained using the estimated CEJ. No difference in keratinized tissue width was observed over time. A 0.42-mm gain in gingival thickness was observed after 6 months (P = .002) as well as an improvement in patient satisfaction due to better esthetics (P < .001). Within the present study's limitations, CAF+VCMX provided a significant improvement in treating single GRs combined with a partially restored NCCL (B+).

The aim of this PRISMA-compliant systematic review was to analyze the evidence pertaining to disease resolution after the treatment of peri-implant diseases with the following PICO question: What is the rate of disease resolution following nonsurgical and surgical therapy for peri-implant diseases in adult human subjects? A literature search to identify studies that fulfilled preestablished eligibility criteria was conducted. Data on primary therapeutic outcomes, including treatment success and rate of disease resolution and/or recurrence, as well as a variety of secondary outcomes were extracted and categorized. A total of 54 articles were included. Few studies investigated the efficacy of different nonsurgical and surgical therapies to treat peri-implant diseases using a set of predefined criteria and with follow-up periods of at least 1 year. The definition of treatment success and disease resolution outcomes differed considerably among the included studies. Peri-implant mucositis treatment was most commonly reported to be successful in arresting disease progression for ≤ 60% of the cases, whereas most studies on peri-implantitis treatment reported disease resolution occurring in < 50% of the implants. Disease resolution is generally unpredictable and infrequently achieved after the treatment of peri-implant diseases. A great variety of definitions have been used to define treatment success. Notably, percentages of treatment success and disease resolution were generally underreported. The use of standardized parameters to evaluate disease resolution should be considered an integral component in future clinical studies.

This retrospective study evaluated the incidence of complications to determine the long-term survival rate of teeth with severely compromised clinical crowns treated with minimally invasive crown lengthening (MICL) and restorative treatment. A sample of 112 teeth in 86 patients was treated with MICL and restorative dentistry. Endodontic and orthodontic therapies were applied when needed. Clinical outcomes were assessed at baseline, 1 year, and in the long term. The application of MICL resulted in very limited radiographic bone resection (RBR; 1 ± 0.1 mm on average). Limited local inflammation and shallow probing depths were detected at 1 year (2.6 ± 0.5 mm) and in the long term (2.9 ± 1.0 mm). Most of the teeth (76.8%) maintained good dental and periodontal health over time. The negative events observed in 26 teeth were caries (8.9%), fractures (7.1%), endodontic problems (1.8%), periodontal problems (4.5%), and restoration problems/complications (0.9%). The survival rate was 90.2%. The outcomes of this long-term retrospective analysis (mean: 8.9 ± 0.9 years; range: 8 to 10 years) show high tooth survival rates and low incidence of complications for teeth treated with MICL and restoration of the clinical crown.

Bone reconstruction surgeries such as the autogenous and allogeneic shell techniques, wherein cortical laminates are used to regenerate bone defects, require time and expertise to adapt and fix the laminated cortical blocks onto the defect area. This case report illustrates the process of customizing and fixing an allogeneic cortical laminate (ACL) to reconstruct a horizontal bone defect with guided surgical stents. Two types of surgical stents were designed: one to aid in cutting a prefabricated ACL into the desired shape for the defect to be regenerated, and one to assist in the positioning and fixation of the resulting laminates. These stents enabled the clinician to regenerate a horizontal defect with reduced surgical time and increased precision and safety during laminate fixation. After 5 months of healing, a dental implant could be placed in the regenerated site. The use of surgical stents in this type of bone regeneration surgery can be helpful, especially in more complex bone defects where precision is key. Further clinical studies are needed to validate this technique.