Is a soft tissue graft harvested from the maxillary tuberosity the approach of choice in an isolated site?

Soft tissue augmentation procedures are becoming more popular these days. Different soft tissue graft harvesting approaches have been proposed. Nonetheless, the location of the donor site (whether anterior-, lateral-, superficial-, deep-palate or the maxillary tuberosity) can affect the graft shape and its composition. Soft tissue grafts from the maxillary tuberosity are rich in connective tissue fibers, with minimal presence of fatty or glandular components. Clinical, histological, and molecular evidence shows that a soft tissue graft obtained from the maxillary tuberosity has unique properties. In addition, harvesting from this area presents minimal risk for intra- or postoperative complications, leading to reduced patient morbidity. The aim of this commentary is to discuss the advantages and disadvantages of harvesting a soft tissue graft from the tuberosity and to compare it with the traditional palatal graft, while highlighting functional, esthetic, and patient-related outcomes.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151301/1/jper10300_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151301/2/jper10300.pd

Experimental Animal Models in Periodontology: A Review

In periodontal research, animal studies are complementary to in vitro experiments prior to testing new treatments. Animal models should make possible the validation of hypotheses and prove the safety and efficacy of new regenerating approaches using biomaterials, growth factors or stem cells. A review of the literature was carried out by using electronic databases (PubMed, ISI Web of Science). Numerous animal models in different species such as rats, hamsters, rabbits, ferrets, canines and primates have been used for modeling human periodontal diseases and treatments. However, both the anatomy and physiopathology of animals are different from those of humans, making difficult the evaluation of new therapies. Experimental models have been developed in order to reproduce major periodontal diseases (gingivitis, periodontitis), their pathogenesis and to investigate new surgical techniques. The aim of this review is to define the most pertinent animal models for periodontal research depending on the hypothesis and expected results

Patient experience of autogenous soft tissue grafting has an implication for future treatment: A 10‐ to 15‐year cross‐sectional study

BackgroundPatient- reported outcomes have received a great deal of interest in periodontal plastic procedures. However, their evaluation has mainly been short- term. Thus, the aim of this study was to evaluate the impact of soft tissue grafting procedures conducted over a decade ago on the willingness of a patients to undergo the surgery again.MethodsSubjects that received an autogenous soft tissue graft over 10 years ago were screened and invited for a survey. Their response was only analyzed if they were able to correctly identify the sites of the surgical procedures. Dichotomous questions and visual analogue scales (VASs) were used to assess self- reported pain, willingness to retreat and satisfaction.ResultsFifty- two patients were included in the analyses. Higher pain was reported for mandibular sites, and treated areas including - ¥ 3 teeth (P < 0.01). Willingness to retreatment was 84.6% and it was negatively associated with self- reported pain measures, the arch location (mandible), and number of treated sites (- ¥3 teeth) (P < 0.01). Mean satisfaction rate was 86.9 ± 13.65 (VAS) and showed a positive correlation with willingness to retreat (P < 0.01). Having a complete root coverage at the recall visit was also significantly associated with higher patient satisfaction scores (P < 0.01).ConclusionsPatient experience of previous autogenous soft tissue grafting has an influence on their decision to undergo future treatment. Willingness to retreat was negatively affected by mandibular sites, larger treated areas and the perceived pain, while presenting with complete root coverage was significantly associated with patient satisfaction.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/167778/1/jper10653_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/167778/2/jper10653.pd

Root‐retained overdentures: Survival of abutment teeth with precision attachments on root caps depends on overdenture design

BACKGROUND Root-retained overdentures (OD) are one treatment option for partially edentulous patients. However, the available evidence regarding factors influencing abutment survival in root-retained ODs is limited. PURPOSE This retrospective study included clinical examinations and evaluated the survival rate of roots restored with precision attachments soldered to post-and-core (gold cap) retained ODs, analysed with respect to various patient- and prosthesis-related factors. METHODS Patients receiving at least one OD with gold caps in the past were invited for comprehensive clinical examinations. The primary outcome parameter was the abutment survival rate over the observation period (2002-2016). Possible contributing factors (eg closed vs open OD design) were analysed. Analyses included Kaplan-Meier estimators, Cox regressions and hazard ratios (HR). RESULTS 114 patients with 128 ODs originally retained by 280 abutments, with a cumulative total exposure time of 2035.4 years, were examined. Twenty-seven abutment teeth (9.6%) were lost after a mean observation period of 7.9 ± 3.4 years. Significant factors associated with abutment loss were a closed, compared to an open OD design (HR 8.38 (95% CI 1.11-63.59), P = .040), which was independent of the number of abutments per OD. Furthermore, the loss rate was higher when the denture was not worn day-and-night (HR 3.52 (95% CI 1.32-9.40), P = .012). Oral hygiene behaviour was associated with higher HRs. CONCLUSIONS ODs remain a viable treatment option for patients with few teeth remaining in the dental arch. It is advisable to choose an open design for the OD, irrespective of the number of abutment teeth. Furthermore, gold cap-retained ODs should not be removed overnight

Reconstrução do seio maxilar atrófico com enxerto autólogo de crista ilíaca: avaliação por tomografia computadorizada e radiografia panorâmica

OBJETIVOS: As dificuldades para a utilização de implantes dentários osteointegrados em pacientes portadores de atrofia do seio maxilar justificaram o emprego de enxerto autólogo não vascularizado de crista ilíaca isolado ou associado à hidroxiapatita (HA) em 14 pacientes submetidos a 25 procedimentos no Hospital das Nações, Curitiba, Paraná, portadores de atrofia do sinus maxilar. O objetivo foi avaliar comparativamente a precisão da tomografia computadorizada e da radiografia panorâmica, através da quantificação da neoformação óssea nesta estrutura. MÉTODOS: Foram selecionadas pacientes edentados, com altura óssea residual do rebordo gengival ao soalho do seio maxilar menor que 5mm. O enxerto medular de crista ilíaca fragmentada isolado ou misturado com HA foi colocado através da parede lateral no soalho atrófico da cuba maxilar por via submucosa. A avaliação quantitativa e qualitativa foi feita através da radiografia panorâmica e tomografia computadorizada, sendo utilizado na análise estatística a distribuição t de Student (prevalência de 0,05) para análise das variâncias, considerado que a leitura dos laudos radiológicos foi feita por dois especialistas, medindo a distância entre os pontos inferiores e superiores do enxerto no soalho do seio maxilar. RESULTADOS: Tivemos um ganho médio de 14,8mm em todos os procedimentos, com um erro maior que 3mm em 16 procedimentos (64%) e incorporação satisfatória do enxerto ósseo suficiente para futuro implante dentário. CONCLUSÕES: A tomografia computadorizada foi o método de escolha na avaliação qualitativa e quantitativa da incorporação de enxerto autólogo não vascularizado em seio maxilar atrófico