Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction

Journal of Periodontology, Год журнала: 2019, Номер 91(1), С. 9 - 16

Опубликована: Авг. 28, 2019

Abstract This state‐of‐the‐art review presents the latest evidence and current status of autogenous soft tissue grafting for augmentation recession coverage at teeth dental implant sites. The indications predictability free gingival graft connective (CTG) techniques are highlighted, together with their expected clinical esthetic outcomes. CTGs can be harvested from maxillary tuberosity or palate different approaches that have an impact on quality patient morbidity. influence thickness keratinized width also discussed.

Язык: Английский

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Peri‐implant soft tissue phenotype modification and its impact on peri‐implant health: A systematic review and network meta‐analysis

Journal of Periodontology, Год журнала: 2020, Номер 92(1), С. 21 - 44

Опубликована: Июль 25, 2020

Abstract Background The peri‐implant soft tissue phenotype (PSP) encompasses the keratinized mucosa width (KMW), mucosal thickness (MT), and supracrestal height (STH). Numerous approaches to augment volume around endosseous dental implants have been investigated. To what extent PSP modification is beneficial for health has subject of debate in field implant dentistry. aim this systematic review was analyze evidence regarding efficacy augmentation procedures aimed at modifying their impact on health. Methods A comprehensive search performed identify clinical studies that involved reported findings KMW, MT, and/or STH changes. effect intervention also assessed. Selected articles were classified based general type surgical approach increase PSP, either bilaminar or an apically positioned flap (APF) technique. network meta‐analysis including only randomized‐controlled trials (RCTs) reporting outcomes conducted assess compare different techniques. Results total 52 included qualitative analysis, 23 RCTs as part meta‐analysis. Sixteen therapy with techniques, whereas 7 use APF. analysis showed techniques combination grafts (connective graft [CTG], collagen matrix [CM], acellular dermal [ADM]) resulted a significant MT compared non‐augmented sites. In particular, CTG ADM associated higher gain CM However, no differences KMW observed across via utilizing effects marginal bone level stability. APF‐based free gingival (FGG), CTG, CM, APF alone, FGG exhibited significantly gain. any evaluated reduction probing depth, dehiscence plaque index sites loss preservation inconclusive. Conclusions Bilaminar involving obtained highest amount gain, most effective technique increasing KMW. index, regardless grafting material employed,

Язык: Английский

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Extracellular matrix‐based scaffolding technologies for periodontal and peri‐implant soft tissue regeneration

Journal of Periodontology, Год журнала: 2019, Номер 91(1), С. 17 - 25

Опубликована: Сен. 2, 2019

Abstract The present article focuses on the properties and indications of scaffold‐based extracellular matrix (ECM) technologies as alternatives to autogenous soft tissue grafts for periodontal peri‐implant plastic surgical reconstruction. different processing methods creation cell‐free constructs resulting in preservation matrices influence characteristics behavior scaffolding biomaterials. aim this review is discuss properties, clinical application, limitations ECM‐based scaffold augmentation when used grafts.

Язык: Английский

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Gingival phenotype modification therapies on natural teeth: A network meta‐analysis

Journal of Periodontology, Год журнала: 2020, Номер 91(11), С. 1386 - 1399

Опубликована: Май 11, 2020

Abstract Background The periodontal phenotype consists of the bone morphotype, keratinized tissue (KT), and gingival thickness (GT). latter two components, overlying bone, constitute phenotype. Several techniques have been proposed for enhancing or augmenting KT GT. However, how modification therapy (PMT) affects health whether obtained outcomes are maintained over time not elucidated. aim present review was to summarize available evidence in regard utilized approaches PMT assess their comparative efficacy KT, GT improving using autogenous, allogenic, xenogeneic grafting approaches. Methods A detailed systematic search performed identify eligible randomized clinical trials (RCTs) reporting on changes (primary outcomes). selected articles were segregated into type approach based having a root coverage, non‐root coverage procedure. network meta‐analysis (NMA) conducted each compare among different treatment arms primary outcomes. Results total 105 RCTs included. 95 pertaining (3,539 treated recessions [GRs]), 10 procedures (699 sites). analysis showed that all investigated (the acellular dermal matrix [ADM], collagen [CM], connective graft [CTG]) able significantly increase GT, compared with flap alone. only increased use CTG ADM. Early post‐treatment found inversely predict future GR. For procedures, could be analyzed; groups (ADM, CM, free [FGG], living cellular construct [LCC], combination an apically positioned [APF]), resulted more than APF Additionally, augmented shown sustained, displayed incremental time. Conclusions Within its limitations, it observed any material enhance while enhanced ADM, FGG, LCC autogenous soft (CTG/FGG) proved superior comparisons both KT.

Язык: Английский

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Epidemiology of mid‐buccal gingival recessions in NHANES according to the 2018 World Workshop Classification System

Journal Of Clinical Periodontology, Год журнала: 2020, Номер 47(10), С. 1180 - 1190

Опубликована: Авг. 4, 2020

Abstract Aim There are no nationally representative epidemiological studies available reporting on the different recession types according to 2018 classification system or focusing aesthetic zone. The aims of this cross‐sectional study were (a) provide estimates prevalence, severity and extent mid‐buccal GRs (b) identify their risk indicators in adult U.S. population from NHANES database. Materials Methods Data 10,676 subjects, 143.8 millions adults, retrieved 2009–2014 GR prevalence was defined as presence at least one ≥1 mm. categorized following World Workshop (RT1, RT2, RT3) cut‐offs. An analysis for also performed, selecting subjects without periodontitis. Results patient‐level (all types) 91.6%, while it decreased 70.7% when considering only When RT1 GRs, (whole mouth) 12.4%, 5.8% majority considered mild (1–2 mm). whole‐mouth RT2 RT3 88.8% 55.0%, respectively. Age (35–49 years), gender (female), ethnicity (non–Hispanic Whites), last dental visit (>6 months before), tooth type (incisors) arch (mandible) resulted associated with GR. Conclusions Mid‐buccal affect almost entire US population. Age, gender, ethnicity, care exposure, identified GRs.

Язык: Английский

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Wound healing dynamics, morbidity, and complications of palatal soft‐tissue harvesting

Periodontology 2000, Год журнала: 2022, Номер 92(1), С. 90 - 119

Опубликована: Дек. 30, 2022

Abstract Palatal‐tissue harvesting is a routinely performed procedure in periodontal and peri‐implant plastic surgery. Over the years, several surgical approaches have been attempted with aim of obtaining autogenous soft‐tissue grafts while minimizing patient morbidity, which considered most common drawback palatal harvesting. At same time, treatment errors during may increase not only postoperative discomfort or pain but also risk developing other complications, such as injury to greater palatine artery, prolonged bleeding, wound/flap sloughing, necrosis, infection, inadequate graft size quality. This chapter described complications techniques, together for reducing morbidity accelerating donor site wound healing. The role biologic agents, photobiomodulation therapy, local systemic factors, genes implicated healing are discussed.

Язык: Английский

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Soft tissue phenotype modification predicts gingival margin long‐term (10‐year) stability: Longitudinal analysis of six randomized clinical trials

Journal Of Clinical Periodontology, Год журнала: 2022, Номер 49(7), С. 672 - 683

Опубликована: Май 13, 2022

Abstract Aim To assess the prognostic value of soft tissue phenotype modification following root coverage procedures for predicting long‐term (10‐year) behaviour gingival margin. Materials and Methods Participants from six randomized clinical trials on at University Michigan were re‐invited a longitudinal evaluation. Clinical measurements obtained by two calibrated examiners. A data‐driven approach to model selection with Akaike information criterion (AIC) was carried out via multilevel regression analyses partial plotting changes in level margin over time interactions early (6‐month) results phenotypic modification. Results One‐hundred fifty‐seven treated sites 83 patients re‐assessed recall. AIC‐driven demonstrated that 6‐month keratinized width (KTW) thickness (GT) influenced trajectory similarly concave manner; however, GT driving determinant predicted significantly less relapse treatments, stability beyond values 1.46 mm. Conclusions Among compliant patient cohort, irrespective rendered therapy, presence least 1.5 mm KTW correlated

Язык: Английский

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Do soft tissue augmentation techniques provide stable and favorable peri‐implant conditions in the medium and long term? A systematic review

Clinical Oral Implants Research, Год журнала: 2023, Номер 34(S26), С. 28 - 42

Опубликована: Сен. 1, 2023

Abstract Objectives To review the available literature on medium‐ and long‐term effects of soft tissue augmentation (STA) at implant sites to explore different approaches clinical‐, patient‐reported, health‐related parameters. Materials Methods A comprehensive electronic manual search was performed identify prospective clinical studies that assessed (≥36 months) outcomes following STA, including number maintaining peri‐implant health developing disease, incidence complications, stability clinical, volumetric, radiographic parameters, patient‐reported outcome measures (PROMs). Results Fifteen were included in qualitative analysis. STA with either a bilaminar‐ or an apically positioned flap (APF) approach, combination autogenous grafts (free gingival graft [FGG] connective [CTG]) substitutes (acellular dermal matrix [ADM] xenogeneic cross‐linked collagen [CCM]). An overall high survival rate observed. Most augmented maintained medium long term, mucositis peri‐implantitis ranging from 0% 50% 7.14%, respectively. The position margin APF + FGG bilaminar involving CTG CCM found be stable over time. No substantial changes reported for plaque score/index, bleeding probing/bleeding index, probing depth between early time points visits. CTG‐based procedures resulted increased dimension keratinized mucosa width (KMW) mucosal thickness (MT)/volumetric time, when compared follow‐ups. described marginal bone levels grafted professionally esthetic results points. Conclusions Implants received showed relatively low term. Augmented seem maintain level while non‐augmented implants may exhibit apical shift margin. favorable obtained are increase KMW MT expected CTG‐augmented sites.

Язык: Английский

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The Effect of Time on Root Coverage Outcomes: A Network Meta-analysis

Journal of Dental Research, Год журнала: 2019, Номер 98(11), С. 1195 - 1203

Опубликована: Авг. 5, 2019

The stability of root coverage outcomes has gained a great deal interest. However, insufficient evidence is available, mainly due to limited direct comparisons among different techniques and the small sample size clinical trials. Therefore, aim this study was propose mixed-models network meta-analysis (NMA) that includes novelty assessing time on while simultaneously comparing surgical approaches. A literature search performed by 2 individual reviewers identify randomized trials (RCTs) reporting procedures at least points estimate slopes treatment primary were changes in for recession depth (REC), keratinized tissue width (KTW), attachment level. Sixty RCTs with total 2,554 gingival recessions (1,864 patients) included NMA. Connective graft (CTG) enamel matrix derivative (EMD) approaches provided superior initial REC reduction compared flap advancement alone. only CTG-based effective maintaining margin over time, EMD, acellular dermal matrix, collagen alone showed similar tendency recurrence. Baseline KTW earliest postoperative recall predictors margin. In addition, geographic center effect observed KTW. While limitations present linear mixed-modeling approach should be considered as it refers estimation comparison based an examined framework, designed NMA tool simultaneous multiple taking into account critical element time.

Язык: Английский

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Recombinant Human Platelet–Derived Growth Factor: A Systematic Review of Clinical Findings in Oral Regenerative Procedures

JDR Clinical & Translational Research, Год журнала: 2020, Номер 6(2), С. 161 - 173

Опубликована: Май 11, 2020

Aim: The use of recombinant human platelet-derived growth factor–BB (rhPDGF) has received Food and Drug Administration approval for the treatment periodontal orthopedic bone defects dermal wound healing. Many studies have investigated its regenerative potential in a variety other oral clinical indications. aim this systematic review was to assess efficacy, safety, benefit factor alveolar and/or soft tissue regeneration. Material Methods: Comprehensive electronic manual literature searches according PRISMA guidelines were performed identify interventional observational evaluating applications rhPDGF-BB. primary outcomes overall rhPDGF procedures. Results: Sixty-three (mean ± SD follow-up period 10.7 3.3 mo) included qualitative analysis. No serious adverse effects reported any 63 studies, aside from postoperative complications routinely associated with surgical therapy. Use shown be beneficial when combined allografts, xenografts, alloplasts (the latter tricalcium phosphate [β-TCP]) gingival recession. also led favorable allografts or xenografts guided regeneration (GBR) ridge preservation. While results support combination plus allograft xenograft GBR, ARP, sinus floor augmentation, current data (e.g., β-TCP) only Conclusions: Based on evidence, is safe provides benefits used xenograft, β-TCP intrabony furcation recession GBR ARP (PROSPERO CRD42020142446). Knowledge Transfer Statement: Clinicians should aware that effective approach With consideration cost patient preference, result could lead more appropriate therapeutic decisions.

Язык: Английский

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