The International journal of periodontics & restorative dentistry最新文献

This case series assessed the efficacy of Orthodontic Implant Site Development with Labial Root Torque (OISD-LRT) as a nonsurgical technique for addressing labial bone deficiencies in seven patients. The procedure involved strategically placing a multi-bracket of 2-3 mm apically on the hopeless teeth, gradually shifting them with Ni-Ti wires at the rate of 2 mm per month and maintaining overcorrection for 2 months before extraction. OISD-LRT consistently augmented tissue for flapless guided implant surgery, with an average treatment duration of 404Å}311.7 days. Cone-beam computed tomography (CBCT) scans at various stages revealed increases in both vertical and horizontal bone dimensions, especially in the sockets with complete labial bone loss. Despite inevitable post-extraction reductions in bone height and width, sufficient dimensions were maintained to ensure long-term implant stability. This case series highlights the effectiveness of OISD-LRT as a valuable method for horizontal bone augmentation, particularly in patients with labial bone deficiency. This approach provides a robust foundation for subsequent implant placement, showcasing its success in addressing challenging anatomical conditions and contributing to the broader field of implant dentistry.

Polynucleotides and Hyaluronic Acid (PN-HA) mixture showed several effects in modulation of healing process. The aim of this study was to assess the safety and clinical performance of PN-HA alone or in association with Deproteinized Bovine Bone Mineral (DBBM) with papillary preservation flaps (PPF) in the treatment of residual pockets. A total of 43 patients with 55 infra-bony defects were recruited; 30% were smokers. The mean baseline Probing Depth (PD) was 7.7 ±1.9 mm with a corresponding mean recession (Rec) of 1.9± 1.3 mm. The depth of infra-bony defect at the surgical measurement was 5.2±2.1 mm. DBBM was applied at 56% of the defects considered as not-containing based on clinical judgment. Healing was uneventful at all sites. After one year, PD reduction was 4.4±1.8 mm with a Rec increase of 1.0 ±0.8 mm. Detected bone fill at x-ray was 3.5 ± 1.9mm. The multilevel analysis showed that absence of smoking habits was associated with improved PD reduction (P =0.026) and bone gain (P= 0.039). PN-HA mixture is a safe product for periodontal surgery and seems to promote clinical benefit in the treatment of residual pockets associated to infra-bony defects.

Oral rehabilitation of the atrophic maxilla using prostheses anchored on zygomatic implants is a well-documented process. To prevent the risk of sinusitis and or oro-antral communications, the placement of zygomatic implants with an externalized path has been proposed. In these cases where the sealing of the implant neck depends exclusively on a hemidesmosomal junction, there is a risk of dehiscence of the soft tissue. This can lead to esthetic problems, bone resorption, oro antral communication, cellulitis, and even orbital infection. To avoid soft tissue recession when implants are placed in a buccal position to the remaining ridge, different procedures have been proposed, the simplest being a good buccal coverage of the implant by keratinized tissue. In this technical note, we propose the use of a double pedicle palatal flap to increase the keratinized tissue buccal to the implant and, at the same time, to facilitate the incision closure by initial intention.

Introduction: Maxillary sinus floor augmentation is a procedure known for its long-term success and predictable outcomes. However, the perforation of the Schneiderian membrane remains the most common complication associated with this procedure.

Objective: This systematic review aims to determine the presence of complications during maxillary sinus floor augmentation procedures using CAD-CAM surgical templates.

Material and methods: An electronic search was carried out in MEDLINE (via PubMed), Web of Science, and Scopus. A descriptive analysis of the data was performed. Studies that have performed lateral sinus floor augmentation were included in the inclusion criteria. The CAD-CAM surgical template design and the intraoperative complications were registered.

Results: A total of 13 studies were included. Seven were case reports, four were case series, and two were randomized clinical trials. A total of 94 lateral SFA procedures were included (84 using CADCAM templates and 10 without using templates). Three of the 84 maxillary sinus floor augmentation procedures using a CAD-CAM template presented intraoperative complications.

Conclusions: Maxillary sinus floor augmentation performed by using CAD-CAM surgical templates could be related to low rates of complications, however, due to the heterogeneity of the articles included, more standardized studies are needed to confirm these outcomes.

Primary wound closure is the most important factor in successful periodontal tissue regeneration when using biomaterials. However, in the distal region of the last molar, there is concern that direct surgical access to an intraosseous defect may induce the leakage of biomaterials, impair the blood supply, and make healing difficult. This case series introduces the last molar-entire pad preservation technique (L-EPPT), which was designed to preserve the gingiva of the last molar centrum and secure the operative field of the furcation and distal bone defects, thereby providing an optimal environment for wound healing for regenerative therapy. This technique for preservation of the distal gingiva was applied in two cases involving the combination of a buccal class II furcation defect and a 2-3-wall intrabony defect in the last molar for the use of a combination of bone graft and enamel matrix derivatives in periodontal regeneration. Clinical outcomes were recorded at 18 months (case 1) and 8 months (case 2) after surgery. In both cases, the class II furcation defects were completely closed, and the probing pocket depth was improved to < 3 mm with no bleeding on probing. Further research is warranted to verify the efficacy of this technique.

Background: Current concepts in periodontology emphasize an important distinguishing aspect of the interproximal attachment, assigning its major influential significance as a key diagnostic and prognostic factor. A complete regeneration of the interproximal clinical attachment has become a primary determinant of the periodontal success. Since mid - 20th century have been published numerous articles on root coverage procedures but mostly for non-proximal gingival recessions. When it comes to the interdental area, literature does not inspire the same level of confidence.

Objectives: This study is aimed to introduce an innovative 3D - Tunneling Surgical Technique for the gingival papilla reconstruction and supra-alveolar interproximal attachment regeneration.

Materials and methods: The technique is described step by step and shown on three selected clinical cases of multiple bilateral adjacent gingival recessions type 2 and 3 in the lower anterior area with follow - up results of up to 6.5 years.

Results: A total of 18 proximal, mid-buccal and mid-lingual recessions were treated simultaneously. Mean root coverage up to 88.9% has been achieved in the proximal area.

Conclusion: Within its limits, this study demonstrates a possibility of treating gingival recessions with deficient papilla in the mandibular anterior region, achieving a significant clinical improvement with the long-term stability.

This study evaluated the impact of using calcium-hydroxide or the antioxidant agents on the bond strength of adhesive restorations to bleached dentin. Forty teeth were prepared and allocated into 8 groups according to the surface treatment after bleaching (application or not of calcium hydroxide, 10% sodium ascorbate and 5% sodium thiosulphate for 10min), and the time of final restoration (immediate or after 7-days). Sodium perborate with 20% hydrogen peroxide was applied for 3 weeks using a developed artificial pulp chamber, with replacement every week. Composite resin restoration was performed and microtensile test was performed. Then, specimens were analyzed using a stereomicroscope and SEM. Data was submitted to Kruskal-Wallis and Dunn tests (p<0.05). The bond strength of non-bleached teeth was similar to the groups restored after 7 days of bleaching (p<0.05). The lowest values of bond strength were showed by groups restored immediately after bleaching (p<0.05). In all groups, there was a considerable predominance of adhesive fractures. Delaying the final restoration of teeth submitted to nonvital bleaching for 7 days permits an increase in bond strength. The immediate restoration of bleached teeth after the use of 10% sodium ascorbate or 5% sodium thiosulfate for 10 minutes showed unsatisfactory results. Clinical relevance Irrespective of the dentin protocol applied before adhesion, a satisfactory and an unsatisfactory result of bond strength values will be obtained delaying the final restoration or immediately performing the final restoration, respectively. Therefore, after nonvital tooth bleaching, clinicians should always delay the final restoration for a minimum period of 7 days.

The use of Artificial Intelligence (AI) is rapidly expanding. While it comes with some drawbacks, it also offers numerous advantages. One significant application of AI is chatbots, which utilize natural language processing and machine learning to provide information, answer queries, and assist users. AI has various applications and dentistry is no exception. The authors conducted an experiment to assess the application of AI, particularly OpenAI's ChatGPT and Google Apps Script, in various stages of information gathering and manuscript preparation in parallel with conventional human-driven approaches. AI can serve as a valuable instrument in manuscript preparation; however, relying solely or predominantly on AI for manuscript writing is insufficient if the goal is to produce a high-quality article for publication in a peer-reviewed, high-impact journal that can contribute to the advancement of science and society.

Bone reconstruction surgeries such as the autogenous and allogenic shell techniques where cortical laminates are used to regenerate bone defects, requires 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 allogenic 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 the other type of stent, was used 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, 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 surgeries can be helpful specially in more complex bone defects where precision is key. Further clinical studies are needed to validate this technique.

Regenerative periodontal surgery is an effective procedure for the treatment of intrabony defects. Various flap designs preserving the defect-associated interdental papilla have been proposed to improve early wound stability. This case report describes the long-term results of a regenerative treatment in severely compromised mandibular canine using entire papilla preservation technique. Surgical access was provided by a single buccal vertical incision without any papilla incision. Combination of autogenous bone harvested from the same surgical site and recombinant human fibroblast growth factor-2 was applied to non-contained intrabony defect following the granulation tissue removal. Surgical site was closed with single interrupted sutures. The clinical outcomes and 5-year stability of pocket closure with no increase in gingival recession show the potential of entire papilla preservation technique with the use of combined biomaterials.