Pre-augmentation soft tissue expansion: An overview

Objectives: The aim of this study was to explore the development of soft tissue expanders, their different types and their potential applications prior to bone augmentation and implant placement. Material and Methods: A review of pertinent literature was performed using PubMed to comprehend the dynamics of soft tissue expanders and determine the current position of their pre-augmentation applications. Results: There is promising, albeit preliminary information regarding the benefits of pre-augmentation soft tissue expansion. Findings cannot be generalised due to relatively small sample size. Conclusions: Further clinical trials with larger sample sizes and long-term follow-up are needed before soft tissue expanders can be confidently applied in everyday clinical practice

Surgical Approaches Based on Biological Objectives: GTR versus GBR Techniques

Guided tissue regenerative (GTR) therapies are performed to regenerate the previously lost tooth supporting structure, thus maintaining the aesthetics and masticatory function of the available dentition. Alveolar ridge augmentation procedures (GBR) intend to regain the alveolar bone lost following tooth extraction and/or periodontal disease. Several biomaterials and surgical approaches have been proposed. In this paper we report biomaterials and surgical techniques used for periodontal and bone regenerative procedures. Particular attention will be adopted to highlight the biological basis for the different therapeutic approaches

120 Infrabony Defects Treated With Regenerative Therapy : Long Term Results

Background: The aim of this study is to evaluate the long-term benefits of regenerative therapy and which factors (smoking, oral hygiene (OH), radiographic angle, tooth, clinical center, bio-material) influence the results. Methods: One hundred-twenty infrabony defects were treated with Guided Tissue Regeneration (GTR), using resorbable and non-resorbable membranes with graft, or enamel matrix derivative proteins (EMD). At the baseline smoking, x-ray angle, pocket depth (PPD), recession and clinical attachment (CAL) were recorded. CAL was measured 1 year after surgery and every 2 years for up to 16 years. Patients' participation in the OH protocols was recorded. Results: Baseline CAL was 8.5 \ub1 2.3 mm, PPD 7.8 \ub1 2.1 mm and x-ray angle 31.8 \ub1 8.9 \ub0. One year after CAL gain was 4.1 \ub1 2.1 mm. EMD was used in 47 defects, resorbable membranes with deprotenized bovine bone in 41 cases, non-resorbable membranes in 7, resorbable membranes and autogenous bone in 5 and combination in 20 defects. 10% were smokers and 20% didn't participate in the OH program. Average follow up was 9 years. 90% of teeth survival was achieved at 13 years and the CAL gained was maintained at 82% for 11 years. Statistical analysis demonstrated that both smoking and OH maintenance influences long-term outcomes. X-ray angle, tooth, clinical center and bio-materials didn't influenced the results. Conclusions: Regenerative therapy provides a high percentage of long-term success. Smoking and non-participation in OH maintenance negatively influence the prognosis, while other factors didn't affect long term results

Impact of orthodontic treatment on periodontal tissues : A narrative review of multidisciplinary literature

The aim of this review is to describe the most commonly observed changes in periodontium caused by orthodontic treatment in order to facilitate specialists' collaboration and communication. An electronic database search was carried out using PubMed abstract and citation database and bibliographic material was then used in order to find other appropriate sources. Soft and hard periodontal tissues changes during orthodontic treatment and maintenance of the patients are discussed in order to provide an exhaustive picture of the possible interactions between these two interwoven disciplines

Role of multidisciplinary approach in a case of Langerhans cell histiocytosis with initial periodontal manifestations

INTRODUCTION: Langerhans cell histiocytosis (LCH) is a rare inflammatory myeloid neoplasia of unknown etiology occurring in both children and adults. This condition is characterized by an abnormal proliferation of Langerhans cells that may virtually affect all sites in the human body. Oral manifestations of LCH could be the first clinical sign of disease and its periodontal localization could be easily mistaken for other more common entities, such as chronic periodontitis, aggressive periodontitis, and necrotizing ulcerative periodontitis. CASE PRESENTATION: A 32-years old female visited a private dental practice with a chief complaint of sensitivity in the mandibular left first molar. Clinical and radiographic examination revealed deep periodontal pocket, recession, furcation involvement, mobility, severe alveolar bone destruction and a diagnosis of aggressive periodontitis was rendered. Multiple tooth extractions were carried out due to progressive periodontal destruction with impaired healing and development of ulcerative lesions. Multidisciplinary investigation demonstrated that the periodontal involvement was a manifestation of an underlying systemic disease. A biopsy of a bone lesion was therefore performed, revealing the presence of multifocal single system LCH. CONCLUSION: The identification of periodontal LCH is not trivial given that it may clinically resemble other periodontal disease entities. The dentist can be the first health care personnel to unravel the presence of an underlying systemic LCH

Immediate vs. Delayed Implant Placement after Anterior Single Tooth Extraction: The Timing Randomised Controlled Clinical Trial.

to compare need for bone augmentation, surgical complications, periodontal, radiographic, aesthetic and patient reported outcomes in subjects receiving implant placement at the time of extraction (IMI) or 12 weeks thereafter. METHODS: Subjects requiring single tooth extraction in the anterior and premolar areas were recruited in 7 private practices. Implant position and choice of platform were restoratively driven. Measurements were performed by calibrated and masked examiners. RESULTS: IMI was unfeasible in 7.5% of cases. 124 subjects were randomized. One implant was lost in the IMI group. IMI required bone augmentation in 72% of cases compared with 43.9% for delayed (P=0.01), while wound failure occurred in 26.1% and 5.3% of cases, respectively (P=0.02). At 1 year, IMI had deeper probing depths (4.1±1.2 mm vs. 3.3±1.1 mm, P<0.01). A trend for greater radiographic bone loss was observed at IMI over the initial 3-year period (Ptrend<0.01). Inadequate pink aesthetic scores were obtained in 19% of delayed and in 42% of IMI implant cases (P=0.03). No differences in patient reported outcomes were observed. CONCLUSIONS: Immediate implant placement should not be recommended when aesthetics are important, IMI should be limited to selected cases. Longer follow-up is needed to assess differences in complication rates. This article is protected by copyright. All rights reserved

3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications Farah

To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on "3D-printed" ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration

Immediate versus delayed implant placement after anterior single tooth extraction: the timing randomized controlled clinical trial

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