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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Alveolar ridge preservation: Complications and cost‐effectiveness

Periodontology 2000, Год журнала: 2022, Номер 92(1), С. 235 - 262

Опубликована: Дек. 29, 2022

Abstract Alveolar ridge preservation is routinely indicated in clinical practice with the purpose of attenuating postextraction atrophy. Over past two decades numerous studies and reviews on this topic have populated literature. In recent years focus has primarily been analyzing efficacy outcomes pertaining to dimensional changes, whereas other relevant facets alveolar therapy remained unexplored. With premise, we carried out a comprehensive evidence‐based assessment complications associated different modalities modeled cost‐effectiveness therapeutic as function changes width height. We conclude that, among allogeneic xenogeneic bone graft materials, increased expenditure does not translate into effectiveness therapy. On hand, significant association between barrier membrane reduced horizontal vertical resorption was observed, though only certain degree, beyond which return investment significantly diminished.

Язык: Английский

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Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications

Zeitschrift für Medizinische Physik, Год журнала: 2023, Номер 33(3), С. 336 - 386

Опубликована: Март 13, 2023

Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It an adjunct tool for diagnosing pathologies the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand soft tissue has led to continuous improvements on transducer miniaturization spatial resolution. The aims this study are (1) create comprehensive overview literature ultrasonic relating dentistry, (2) provide view onto investigations with immediate, intermediate, long-term impact periodontology implantology. A rapid review was performed using two broad searches conducted PubMed database, yielding 576 757 citations, respectively. rating established within citation software (EndNote) 5-star classification. search citations allowed high sensitivity whereas subsequent added specificity. critical applications ultrasound dentistry provided focus role as developing dental diagnostic reviewed. Specific uses such hard imaging, longitudinal monitoring, well anatomic physiological evaluation were discussed. Future efforts should be directed towards transition ultrasonography from research tool. Moreover, dedicated effort needed introduce education community ultimately improve quality patient care.

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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Diagnostic methods/parameters to monitor peri‐implant conditions

Periodontology 2000, Год журнала: 2024, Номер 95(1), С. 20 - 39

Опубликована: Июнь 1, 2024

The diagnostic accuracy of clinical parameters, including visual inspection and probing to monitor peri-implant conditions, has been regarded with skepticism. Scientific evidence pointed out that primary tools (chairside) seem be highly specific, while their sensitivity is lower compared use in monitoring periodontal stability. Nonetheless, given the association between pocket depth at teeth implant sites aerobic/anaerobic nature microbiome, it seems plausible for indicative disease progression or tissue In addition, understanding inflammatory diseases, reasonable advocate bleeding, erythema, ulceration, suppuration might reliable indicators pathology. Nevertheless, single spots bleeding on may not reflect disease, since implants are prone exhibit related force. On other side, smokers lacks owing decreased angiogenic activity. Hence, dichotomous scales general population, contrast indices feature profuseness time after probing, lead false positive diagnoses. definitive distinction mucositis peri-implantitis, though, relies upon radiographic progressive bone loss can assessed by means two- three-dimensional methods. Accordingly, objective this review evaluate existing parameters/methods conditions.

Язык: Английский

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The use of digital technologies in peri‐implant soft tissue augmentation – A narrative review on planning, measurements, monitoring and aesthetics

Clinical Oral Implants Research, Год журнала: 2024, Номер 35(8), С. 922 - 938

Опубликована: Фев. 2, 2024

To identify the different uses and modalities of digital technologies to diagnose, plan monitor peri-implant soft tissue conditions aesthetics.

Язык: Английский

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Ultrasonographic Tissue Perfusion in Peri-implant Health and Disease

Journal of Dental Research, Год журнала: 2021, Номер 101(3), С. 278 - 285

Опубликована: Сен. 13, 2021

Color flow ultrasonography has played a crucial role in medicine for its ability to assess dynamic tissue perfusion and blood variations as an indicator of pathologic condition. While this feature ultrasound is routinely employed various medical fields, intraoral application the assessment at diseased versus healthy dental implants never been explored. We tested hypothesis that quantified power Doppler correlates with clinically assessed inflammation implants. Specifically, we designed discordant-matched case-control study which patients nonadjacent different clinical diagnoses (healthy, peri-implant mucositis, or peri-implantitis) were scanned analyzed real-time ultrasonography. Forty-two posterior 21 included. Ultrasound scans obtained implant regions midbuccal, mesial/distal (averaged interproximal), transverse compute velocity- power-weighted color pixel density from velocity (CV) (CP), respectively. Linear mixed effect models then used relationship between CV CP. Overall, results strongly suggested ultrasound’s CP directly correlate diagnosis health, peri-implantitis. This showed first time can be applicable disease act valuable tool evaluating degree sites.

Язык: Английский

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Prevalence and risk indicators of midfacial peri‐implant soft tissue dehiscence at single site in the esthetic zone: A cross‐sectional clinical and ultrasonographic study

Journal of Periodontology, Год журнала: 2021, Номер 93(6), С. 857 - 866

Опубликована: Ноя. 17, 2021

Esthetic complications of dental implants in the esthetic zone can have a major negative impact on patients' quality life and perception implant therapy. The aim present study was to evaluate prevalence peri-implant soft tissue dehiscence (PSTD) clinical ultrasonographic risk indicators for this condition.Subjects with ≥1 healthy single area were identified recruited. Clinical measurements, including PSTD class subclass, probing depth, keratinized mucosa width (KMW), mucosal thickness (MT) at 1 mm 3 mm, buccal bone distance (BBD) thickness, evaluated PSTD.A total 153 subjects 176 included. 54.2% 56.8% patient level, respectively. most frequent type one characterized by having both an implant-supported crown longer than homologous tooth visible abutment/implant fixture exposed oral cavity. multivariate analysis showed that presence adjacent implant, time function, limited MT, reduced KMW, increased BBD significantly associated PSTD.PSTDs are common findings region. Several condition, such as function higher BBD, lower MT identified.

Язык: Английский

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Soft tissue features of peri‐implant diseases and related treatment

Clinical Implant Dentistry and Related Research, Год журнала: 2022, Номер 25(4), С. 661 - 681

Опубликована: Ноя. 29, 2022

Abstract Background The need for soft tissue grafting at implant sites preventing and treating peri‐implant diseases is a currently investigated debated topic. Purpose aim of this manuscript to explore the inflammatory mechanisms compartment, distinguish structural components phenotype their role on health, appraise clinical indications expected outcomes augmentation procedures diseased sites. Materials Methods This narrative review depicts biomarkers mediators in crevicular fluid utilized diagnose disease that have been shown be associated with modification resolution. impact phenotype, involving keratinized mucosa (KM) width, attached (AM), mucosal thickness (MT), supracrestal height (STH), esthetic, patient's comfort prevention are discussed. also illustrates use ultrasonography detection health/disease evaluation treatment following surgical therapies. Results Current evidence indicates inadequate KM AM MT can beneficial promoting health improving hygiene procedures. Treatment approaches from available literature combination conventional techniques mucositis or peri‐implantitis presented discussed detail. Conclusions Soft diseases. Clinical recommendations based disease, characteristics bone defect morphology provided comprehensive hard‐ soft‐tissue‐oriented disease.

Язык: Английский

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Coronally advanced flap versus tunnel technique for the treatment of peri‐implant soft tissue dehiscences with the connective tissue graft: A randomized, controlled clinical trial

Journal Of Clinical Periodontology, Год журнала: 2023, Номер 50(7), С. 980 - 995

Опубликована: Март 20, 2023

To evaluate the efficacy of coronally advanced flap (CAF) versus tunnel technique (TUN) in covering isolated mid-facial peri-implant soft tissue dehiscences (PSTDs).Twenty-eight participants presenting with non-molar implants exhibiting PSTDs were enrolled and randomized to receive either CAF or TUN, both a connective graft (CTG). The primary outcome study was percentage mean PSTD coverage at 12 months. Secondary endpoints included frequency complete coverage, changes keratinized mucosa width (KMW) horizontal mucosal thickness (MT), as assessed transgingival probing, 3D optical scanning ultrasonography, professional aesthetic evaluation patient-reported measures (PROMs).At months, TUN groups 90.23% 59.76%, respectively (p = .03). CAF-treated sites showed substantially higher .07), together significantly greater gain KMW .01), increase MT .02), volumetric < .01) outcomes .01). Both interventions an improvement aesthetics reduction anxiety related appearance implant compared baseline, group obtaining scores .03 for PROMs).CAF + CTG resulted superior outcomes, MT, better PROMs than treatment (ClinicalTrials.gov NCT03498911).

Язык: Английский

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