Recent Advances in Periodontics and Dental Implantology: Part II

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Dentistry and Oral Health".

Deadline for manuscript submissions: 30 September 2024 | Viewed by 18315

Special Issue Editor


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Guest Editor
Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Interests: bone; bone biology; tissue engineering; stem cells; instrumentation; enzyme kinetics; bone regeneration; dental implants; biomaterials; oral health
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Special Issue Information

Dear Colleagues,

With the advancement of technology, great progress has been made in the periodontology field. The prevalence of periodontal disease is relatively high and has been reported at 20­–45% or higher. Various treatments and biomaterials have been applied to increase the effectiveness of periodontal treatment. The long-term effects of periodontal treatment have been published. Despite advances in periodontal treatment, tooth extraction and further implant placement are being made. A protocol to increase the success rate of implants has been proposed. Various methods have been proposed that can be used in areas where the placement of dental implants is difficult. Stem cells and growth factors have been used as various biomaterials.

The scope of this Special Issue will serve as a forum for papers addressing the following concepts:

  • Understanding and mechanisms of periodontal disease;
  • Treatment of periodontal disease;
  • Short- and long-term effects of periodontal treatment;
  • Various soft and hard tissue regeneration methods;
  • Clinical outcome of dental implants;
  • Enhancement of efficacy with application of growth factors;
  • Cell therapy in periodontal and implant treatment.

Dr. Jun-Beom Park
Guest Editor

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Keywords

  • periodontitis
  • inflammation
  • epidemiology
  • oral health
  • bone regeneration
  • bone biology
  • tissue engineering
  • dental implants
  • biomaterials
  • stem cells

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Published Papers (11 papers)

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23 pages, 7594 KiB  
Article
Influence of Framework Material and Abutment Configuration on Fatigue Performance in Dental Implant Systems: A Finite Element Analysis
by Meryem Erdoğdu, Mehmet Gökberkkaan Demirel, Reza Mohammadi, Neslihan Güntekin and Masoud Ghanbarzadeh Chaleshtori
Medicina 2024, 60(9), 1463; https://doi.org/10.3390/medicina60091463 - 6 Sep 2024
Viewed by 267
Abstract
Background and Objectives: This study uses finite element analysis to evaluate the impact of abutment angulation, types, and framework materials on the stress distribution and fatigue performance of dental implant systems. Materials and Methods: Three-dimensional models of maxillary three-unit fixed implant-supported [...] Read more.
Background and Objectives: This study uses finite element analysis to evaluate the impact of abutment angulation, types, and framework materials on the stress distribution and fatigue performance of dental implant systems. Materials and Methods: Three-dimensional models of maxillary three-unit fixed implant-supported prostheses were analyzed. Abutments with different angles and types were used. Two different framework materials were used. Conducted on implants, a force of 150 N was applied obliquely, directed from the palatal to the buccal aspect, at a specific angle of 30 degrees. The distribution of stress and fatigue performance were then assessed, considering the types of restoration frameworks used and the angles of the abutments in three distinct locations. The simulation aspect of the research was carried out utilizing Abaqus Software (ABAQUS 2020, Dassault Systems Simulation Corp., Johnston, RT, USA). Results: In all models, fatigue strengths in the premolar region were higher than in the molar region. Maximum stress levels were seen in models with angled implants. In almost all models with the zirconia framework, fatigue performance was slightly lower. Conclusions: According to the findings of this study, it was concluded that the use of metal-framework multi-unit restorations with minimum angulation has significant positive effects on the biomechanics and long-term success of implant treatments. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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15 pages, 2226 KiB  
Article
Comparative Effectiveness of an Autologous Dentin Matrix for Alveolar Ridge Preservation
by Nikolai Redko, Alexey Drobyshev, Thanh Hieu Le, Dmitry Lezhnev, Roman Deev, Ilya Bozo, Andrey Miterev, Sergey Shamrin, Yaroslav Skakunov and Davronbek Meliev
Medicina 2024, 60(8), 1280; https://doi.org/10.3390/medicina60081280 - 8 Aug 2024
Viewed by 583
Abstract
An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar [...] Read more.
An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone’s volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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14 pages, 589 KiB  
Article
Milk Consumption and Its Association with Dental Caries: Gender-Specific Insights from the Korea National Health and Nutrition Examination Survey (2013–2015)
by Eun Jeong Min, EunKyung Park and Jun-Beom Park
Medicina 2024, 60(6), 967; https://doi.org/10.3390/medicina60060967 - 11 Jun 2024
Viewed by 742
Abstract
Background and Objectives: This study aims to bridge these gaps by utilizing data from the Korea National Health and Nutrition Examination Survey (2013–2015), examining the nuanced associations between milk consumption’s quantity, frequency, and type and the prevalence of dental caries. Materials and Methods: [...] Read more.
Background and Objectives: This study aims to bridge these gaps by utilizing data from the Korea National Health and Nutrition Examination Survey (2013–2015), examining the nuanced associations between milk consumption’s quantity, frequency, and type and the prevalence of dental caries. Materials and Methods: Utilizing data from the Korea National Health and Nutrition Examination Survey (2013–2015), this study explores the association between milk consumption and the prevalence of dental caries in a sample of 4843 subjects (weighted n = 15,581), including 2856 males and 1987 females; weighted sample sizes were 6656 and 8925 for men and women, respectively. The prevalence of dental caries was assessed by evaluating the number of decayed, filled, and missing teeth. Results: The analysis demonstrated a significant positive association between increased milk consumption and the risk of developing dental caries, with an overall odds ratio of 1.653 (95% CI: 1.153–2.370, p < 0.05). The association was more pronounced in females, exhibiting an odds ratio of 1.865 (95% CI: 1.157–3.006, p < 0.05), and age was identified as a significant variable, particularly among participants aged 50 and above. In contrast, the relationship among the male group, though positive (odds ratio: 1.613, 95% CI: 0.991–2.625), was not statistically significant (p = 0.054). Conclusion: These findings suggest that milk consumption may be a potential risk indicator for dental caries, particularly among women, emphasizing the need for targeted dietary recommendations in dental health practices. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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10 pages, 282 KiB  
Article
Assessing the Reliability of Miller’s Classification and Cairo’s Classification in Classifying Gingival Recession Defects: A Comparison Study
by Hammam I. Fageeh, Hytham N. Fageeh, Ashok Kumar Bhati, Abdulaziz Yahay Thubab, Haitham Mohammed Hassan Sharrahi, Yahya Sulaiman Aljabri and Faisal Ibrahim Alotaibi
Medicina 2024, 60(2), 205; https://doi.org/10.3390/medicina60020205 - 25 Jan 2024
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Abstract
Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type [...] Read more.
Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller’s classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller’s classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller’s classification to classify gingival recession. Cairo’s classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller’s and Cairo’s classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller’s classification and the other two examiners classified recession defects according to Cairo’s classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen’s kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo’s classification was 0.86 and 0.82, whereas for Miller’s classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo’s classification was 0.82 and 0.8, whereas for the Miller’s classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo’s classification is clearer and more reliable than Miller’s classification in the assessment of gingival recession. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
12 pages, 1609 KiB  
Article
Bone Morphogenetic Protein-9 Promotes Osteogenic Differentiation and Mineralization in Human Stem-Cell-Derived Spheroids
by Sung-Bin Lee, Hyun-Jin Lee and Jun-Beom Park
Medicina 2023, 59(7), 1315; https://doi.org/10.3390/medicina59071315 - 16 Jul 2023
Viewed by 1344
Abstract
Background and Objectives: Alkaline phosphatase activity, mineralized matrix, and osteogenic-related gene expression have been shown to increase in response to bone morphogenetic protein-9 (BMP-9). In this study, spheroids derived from human gingival stem cells were used to determine the effects of BMP-9 on [...] Read more.
Background and Objectives: Alkaline phosphatase activity, mineralized matrix, and osteogenic-related gene expression have been shown to increase in response to bone morphogenetic protein-9 (BMP-9). In this study, spheroids derived from human gingival stem cells were used to determine the effects of BMP-9 on cell survival, osteogenesis, and mineralization. Materials and Methods: Human gingival stem cells were used to produce spheroids and then grown to concentrations of 0, 0.1, 1, 10, and 100 ng/mL with BMP-9. On days 1, 3, 5, and 7, morphological examination was carried out. A live/dead assay and Cell Counting Kit-8 was used to assess the vitality of cells. On days 7 and 14, alkaline phosphatase activity assays were carried out using a commercially available kit to examine the osteogenic differentiation of cell spheroids. Alizarin Red Staining was performed on the 7th and 14th days to evaluate mineralization, and RUNX2 and COL1A1 expression levels were evaluated on the 7th and 14th days using real-time polymerase chain reactions. Results: The BMP-9 added at the measured quantities did not appear to alter the shape of the well-formed spheroids produced by stem cells on day 1. In addition, treatment with BMP-9 at doses of 0, 0.1, 1, 10, or 100 ng/mL did not significantly alter cell diameter. Throughout the whole experimental process, viability was maintained. On day 14, the alkaline phosphatase activity in the groups dosed with 0.1, 1, 10, or 100 ng/mL was statistically higher than that in the unloaded control group (p < 0.05). According to qPCR data, the mRNA expression level of RUNX2 with 1 ng/mL dosing was higher on day 7 compared to that of the unloaded control group (p < 0.05). Conclusions: These findings suggest that BMP-9 can be employed to stimulate early osteogenic differentiation in stem cell spheroids. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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12 pages, 8185 KiB  
Case Report
Surgical Drainage and Simultaneous Sinus Floor Augmentation in Patients with Chronic Maxillary Sinusitis
by Won-Bae Park, Hye-Kyoung Seol, Seungil Shin and Ji-Youn Hong
Medicina 2024, 60(8), 1256; https://doi.org/10.3390/medicina60081256 - 2 Aug 2024
Viewed by 677
Abstract
Chronic maxillary sinusitis accompanied by severe thickening of the sinus mucosa, blockage of the ostium, and patient-reported symptoms requires preoperative assessment and treatment by an otolaryngologist before maxillary sinus floor augmentation (MSFA). Prescription of antibiotics and nasal saline irrigation are the first choice [...] Read more.
Chronic maxillary sinusitis accompanied by severe thickening of the sinus mucosa, blockage of the ostium, and patient-reported symptoms requires preoperative assessment and treatment by an otolaryngologist before maxillary sinus floor augmentation (MSFA). Prescription of antibiotics and nasal saline irrigation are the first choice of treatment; however, endoscopic sinus surgery is considered when the treatment’s effect is limited and drug resistance is observed. Nevertheless, MSFA performed in the presence of sinus pathologies have been reported to have favorable results when the lesions are managed properly. This report presents cases of two patients who required MSFA but were diagnosed with chronic maxillary sinusitis (case 1 with nasal sinusitis and case 2 with dental sinusitis). After 2 weeks of antibiotic therapy, endoscopic surgery was recommended due to minimal changes in the size of the sinus lesion; however, the patients refused because of improved self-reported symptoms. Therefore, intraoral surgical drainage was planned as an alternative treatment. A large bony window was prepared at the lateral wall of the maxillary sinus, and a long intentional incision was made to improve access for the suction tip in various directions and depths into the sinus cavity. Thorough suction of the purulent exudate and saline irrigation were performed through this access. The size of the perforated area was reduced along with the elevation of the Schneiderian membrane from the sinus floor, and simultaneous bone grafting with implant placement was performed. Prosthesis was delivered after 6–8 months. At 1-year follow-up after loading, favorable outcomes of implant survival and maintenance of augmented bone height were observed, with no recurrence of postoperative sinusitis. Within the limitations of the present case report, thorough sinus drainage and saline irrigation during maxillary sinus floor augmentation resolved sinus infection in patients with chronic maxillary sinusitis with short-term clinical outcomes. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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10 pages, 22454 KiB  
Case Report
Large Peripheral Osteomas and Dental Implants: A Case Report
by Won-Bae Park, Wonhee Park, Joo-An Kim, Seungil Shin and Ji-Youn Hong
Medicina 2024, 60(7), 1181; https://doi.org/10.3390/medicina60071181 - 20 Jul 2024
Viewed by 712
Abstract
Peripheral osteoma of the jaw is a rare, benign, slow-growing lesion, which usually appears as a unilateral, pedunculated, radiopaque mass protruding from the periphery and is generally solitary. Multiple osteomas without any syndromic involvement are rare. In the present case, a 75-year-old male [...] Read more.
Peripheral osteoma of the jaw is a rare, benign, slow-growing lesion, which usually appears as a unilateral, pedunculated, radiopaque mass protruding from the periphery and is generally solitary. Multiple osteomas without any syndromic involvement are rare. In the present case, a 75-year-old male patient underwent implant placement in the edentulous posterior ridges of the maxilla and mandible. Over 7 years, multiple masses gradually proliferated in the buccal bone of the implant in three different sextants of the posterior region, reaching a size of 2.0 cm. Clinically and radiologically, these lesions were presumed to be peripheral osteomas and were surgically removed because the large mass made self-performed oral hygiene and maintenance of peri-implant health difficult. The histopathological evaluation confirmed that peripheral osteomas were both compact and cancellous. The patient did not exhibit any other clinical manifestations of Gardner syndrome. Whether dental implant placement and loading are involved in the occurrence of peripheral osteomas is unclear, but they might have affected the consistent growth of the mass as a reactive mechanism. After resection, the functional abilities of chewing and self-cleansing significantly improved. No recurrence of peripheral osteoma was observed after 1 year of follow-up, and peri-implant health was well maintained. Within the limitations of the present case report, multiple peripheral osteomas can occur adjacent to dental implants without any syndromic issues, and a large mass of PO can harm peri-implant health which requires surgical removal. It is speculated that dental implants may be associated with the slow and consistent growth of PO. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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13 pages, 6958 KiB  
Case Report
Restoring Severely Atrophic Edentulous Ridge of Mandible Using Self-Expanding Tissue Expander—A Case Report
by Chiyun Won
Medicina 2024, 60(5), 759; https://doi.org/10.3390/medicina60050759 - 2 May 2024
Viewed by 2759
Abstract
This report describes the use of Self Inflating Tissue Expanders (SITEs) to rehabilitate severely atrophic edentulous mandibular ridges, enabling successful bone grafting and implant placement. The treatment resulted in stable and complication-free implants over a seven-year follow-up, demonstrating SITEs’ effectiveness in providing sufficient [...] Read more.
This report describes the use of Self Inflating Tissue Expanders (SITEs) to rehabilitate severely atrophic edentulous mandibular ridges, enabling successful bone grafting and implant placement. The treatment resulted in stable and complication-free implants over a seven-year follow-up, demonstrating SITEs’ effectiveness in providing sufficient bone volume and soft tissue coverage for dental implants. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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15 pages, 4076 KiB  
Case Report
A Novel Approach for the Treatment of Recurrent Oroantral Fistula Occurring at an Infected Sinus Augmentation Site
by Won-Bae Park, Min-Soo Bae, Wonhee Park, Hyun-Chang Lim and Ji-Young Han
Medicina 2024, 60(2), 343; https://doi.org/10.3390/medicina60020343 - 19 Feb 2024
Viewed by 1274
Abstract
Closing a recurrent oroantral fistula (OAF) that occurs at an infected sinus augmentation site is a challenge for clinicians. The recurrent OAF has a detrimental impact on bone regeneration and subsequent implant placement. This case report includes three cases in which sinus graft [...] Read more.
Closing a recurrent oroantral fistula (OAF) that occurs at an infected sinus augmentation site is a challenge for clinicians. The recurrent OAF has a detrimental impact on bone regeneration and subsequent implant placement. This case report includes three cases in which sinus graft infection and OAF occurred after maxillary sinus augmentation (MSA). In these cases, treatments to control sinus infection were performed using an otolaryngologist; then, intraoral interventions comprising mucosal flap procedures, bone grafts, and barrier membrane applications were performed 2–5 times by oral surgeons. Nevertheless, OAF recurred persistently. The failure to stop OAF recurrence may be due to the inability to effectively block air pressure at the OAF site. Following a comprehensive debridement of the infected tissue at the previous sinus augmentation site, a pouch was created through sinus mucosal elevation. The perforated sinus mucosa at the OAF site was covered with a non-resorbable membrane in one case and with resorbable collagen membranes in the other two cases, followed by bone grafting within the pouch. Lastly, this procedure was completed by blocking the entrance of the pouch with a cortical bone shell graft and a resorbable collagen membrane. The cortical bone shell graft, obstructing the air pressure from the nasal cavity, facilitated bone formation, and, ultimately, allowed for implant placement. Within the limitations of the present case report, the application of a guided bone regeneration technique involving a cortical bone shell graft and a barrier membrane enabled the closure of the recurrent OAF and subsequent implant placement. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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10 pages, 5601 KiB  
Case Report
Oral Lichenoid Lesion following Dental Implant Placement and Successful Management with Free Gingival Graft: A Case Report with 10-Year Follow-Up
by Won-Bae Park, Junghun Moon, Seungil Shin and Ji-Youn Hong
Medicina 2023, 59(12), 2188; https://doi.org/10.3390/medicina59122188 - 17 Dec 2023
Viewed by 1402
Abstract
Titanium and metal alloys are widely used in implants, crowns, and bridges in implant dentistry owing to their biocompatibility. In this case report of a 45-year-old female patient, multiple implants were placed in five different sextants at different time points. Notably, oral lichenoid [...] Read more.
Titanium and metal alloys are widely used in implants, crowns, and bridges in implant dentistry owing to their biocompatibility. In this case report of a 45-year-old female patient, multiple implants were placed in five different sextants at different time points. Notably, oral lichenoid lesions (OLL) occurred in three sextants following implant placement, strongly suggesting that the dental implants or prostheses were the causative factors for OLL. The lesion was of the reticular type with erythematous surroundings and was symptomatic. Although several conservative treatments, including repeated topical application of corticosteroids, were repeatedly continued, no discernible improvement or alleviation of symptoms was observed. Consequently, surgical excision and replacement of the lesion with a free gingival graft (FGG) harvested from the palatal soft tissue were performed. No clinical symptoms or recurrence of lesions were observed during 10 years of follow-up post-FGG. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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9 pages, 557 KiB  
Systematic Review
Relationship between Deep Marginal Elevation and Periodontal Parameters: A Systematic Review
by Mohammed Fareed Felemban, Osama Khattak, Thani Alsharari, Abdulrahman H. Alzahrani, Kiran Kumar Ganji and Azhar Iqbal
Medicina 2023, 59(11), 1948; https://doi.org/10.3390/medicina59111948 - 3 Nov 2023
Cited by 1 | Viewed by 3194
Abstract
Background and Objectives: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. Materials and Methods: A review of the literature was carried out using the following online databases: Embase, The [...] Read more.
Background and Objectives: This review focuses on reviewing studies from the literature regarding the effects of deep margin elevation on the surrounding periodontium. Materials and Methods: A review of the literature was carried out using the following online databases: Embase, The Cochrane Library, MEDLINE-PubMed and Google Scholar. Our search was limited to articles from 2010 to 2023. The search terms consisted of keywords and MeSH terms, which were ‘deep margin elevation’, ‘coronal margin relocation’, ‘periodontium’ and ‘periodontal tissues’. The literature was searched thoroughly by two reviewers. Initially, the titles of the articles were extracted. After removing irrelevant and duplicate articles, abstracts were assessed for relevant articles. Finally, the reviewers analyzed full-text articles. Results: A total of twelve articles, including one randomized clinical trial, three systematic reviews, two prospective cohort, three case series, one a clinical study, one pilot study and one a retrospective study, were selected and analyzed. Conclusions: The review suggests potential benefits of Deep Margin Elevation (DME) over surgical crown lengthening due to reduced invasiveness, yet conclusive effects on periodontal tissue remain unclear, warranting further studies on clinical parameters and inflammatory biomarkers. Full article
(This article belongs to the Special Issue Recent Advances in Periodontics and Dental Implantology: Part II)
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