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Keywords = gingival recession (GR)

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18 pages, 5393 KiB  
Systematic Review
Autogenous Periosteal Graft Along with Open Flap Debridement Versus Open Flap Debridement Alone for the Treatment of Grade II Furcation Defect in Chronic Periodontitis Patients: A Systematic Review and Meta-Analysis
by Swapna A. Mahale, Prasad Dhadse, Sumedha Thosar, Vedant Bhandari, Akhil Patil, Sadatullah Syed, Ranjeet Ajit Bapat, Tanay Chaubal, Sumaiya Zabin Eusufzai and Shahabe Saquib Abullais
Medicina 2025, 61(5), 905; https://doi.org/10.3390/medicina61050905 - 16 May 2025
Viewed by 625
Abstract
Background and Objectives: Periodontal regeneration involves techniques intended at restoring the lost supporting tissue around a periodontally weakened tooth. These regenerative methods frequently utilize periosteal grafts to stimulate the evolvement of vital adjacent tissues. This paper intended to evaluate the use of [...] Read more.
Background and Objectives: Periodontal regeneration involves techniques intended at restoring the lost supporting tissue around a periodontally weakened tooth. These regenerative methods frequently utilize periosteal grafts to stimulate the evolvement of vital adjacent tissues. This paper intended to evaluate the use of autogenous periosteal grafts in treating grade II furcation defects (Glickman Classification 1953) in patients with chronic periodontitis. Materials and Methods: The databases MEDLINE (via PubMed), Cochrane, EBSCO, and Google Scholar were searched for papers published in English from January 1991 till December 2022. Three individuals examined the reclaimed articles according to the inclusion norms. Randomized controlled trials (RCTs) assessing the efficacy of autogenous periosteal grafts for treating Grade II furcation defects in chronic periodontitis patients were involved. Only four related studies were identified for data extraction, involving 80 patients aged 18 to 52 years. Outcome variables measured included horizontal bone loss (HD), vertical bone loss (VD), pocket depth (PD), clinical attachment level (CAL), bone height (BH), gingival recession (GR), plaque index (PI), and gingival index (GI). Data were examined using RevMan 5.4.1 software. Mean differences and 95% confidence intervals were employed to estimate effect sizes. Results: Both groups showed similar results for reductions in PI, GI, and BOP. However, The periosteal graft also yielded better outcomes for CAL gain, BH, and GR. The meta-analysis showed a significant overall effect of Periosteal Barrier Membrane (PBM) on horizontal and vertical bony change levels, but subgroup differences between unilateral and bilateral applications were not statistically significant due to high heterogeneity. Although the bilateral subgroup demonstrated significant benefits of PBM treatment, the overall findings across the clinical attachment level group remain inconclusive. Conclusion: Current evidence suggests that while PBM may benefit bilateral mandibular sites, and autogenous periosteal grafts offer no added advantage over OFD alone in Grade II furcation defects, the overall findings remain inconclusive. Full article
(This article belongs to the Special Issue Current and Future Trends in Dentistry and Oral Health)
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13 pages, 5550 KiB  
Case Report
Entire Papilla Preservation Technique with Enamel Matrix Proteins and Allogenic Bone Substitutes for the Treatment of Isolated Intrabony Defects: A 3-Year Follow-Up of a Prospective Case Series
by Bartłomiej Górski, Sylwia Jakubowska and Beata Wyrębek
J. Clin. Med. 2025, 14(7), 2374; https://doi.org/10.3390/jcm14072374 - 30 Mar 2025
Cited by 2 | Viewed by 1770
Abstract
Background: This study aimed to assess the effectiveness of a modified entire papilla preservation technique (MEPPT) for treating isolated intrabony defects in patients with stage III periodontitis. Material and Methods: Fifteen patients with 15 interdental intrabony defects were treated with a [...] Read more.
Background: This study aimed to assess the effectiveness of a modified entire papilla preservation technique (MEPPT) for treating isolated intrabony defects in patients with stage III periodontitis. Material and Methods: Fifteen patients with 15 interdental intrabony defects were treated with a MEPPT using enamel matrix derivative and allogenic bone. Their probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (GR), keratinized tissue width (KTW), defect depth (DD), full-mouth plaque score (FMPS), full mouth bleeding score (FMBS), radiographic images (radiographic angles, BF and LDF) and intrasurgical parameters were assessed at baseline and 3 years postsurgery. Standardized measurements were taken to evaluate the defect characteristics and treatment outcomes. Results: At 3 years, significant improvements from baseline were maintained. Probing pocket depth (PPD) decreased from 7.03 ± 1.61 mm to 3.33 ± 0.89 mm (p < 0.0001), clinical attachment level (CAL) improved to 3.08 ± 1.16 mm (p < 0.001) and defect depth (DD) decreased from 4.59 ± 1.24 mm to 0.38 ± 0.31 mm (p < 0.001). The changes in gingival recession and keratinized tissue were not statistically significant. The results demonstrate sustained clinical stability over a 3-year period. Conclusions: Within the limitations of this study, the findings suggest that the modified entire papilla preservation technique (MEPPT) in conjunction with enamel matrix proteins and allogenic bone grafting is an effective approach for the treatment of intrabony defects, leading to statistically significant and sustained clinical improvements over a 3-year period. The study protocol was registered in ClinicalTrials.gov ID NCT05029089. Full article
(This article belongs to the Special Issue Dental Care: Oral and Systemic Disease Prevention)
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16 pages, 3453 KiB  
Article
Multiple Recessions Coverage Using the Modified Tunnel Technique and Connective Tissue Graft with or Without Cross-Linked Hyaluronic Acid: 2-Year Outcomes of RCT
by Bartłomiej Górski, Izabela Maria Skierska, Andrea Gelemanović, Marija Roguljić and Darko Bozic
J. Funct. Biomater. 2025, 16(3), 87; https://doi.org/10.3390/jfb16030087 - 4 Mar 2025
Viewed by 3184
Abstract
There is continuing interest in using biologics in root coverage procedures. The aim of the present study was to explore the 2-year outcomes following multiple gingival recessions (GRs) coverage using the application of cross-linked hyaluronic acid (HA) in combination with modified coronally advanced [...] Read more.
There is continuing interest in using biologics in root coverage procedures. The aim of the present study was to explore the 2-year outcomes following multiple gingival recessions (GRs) coverage using the application of cross-linked hyaluronic acid (HA) in combination with modified coronally advanced tunnel (MCAT) together with subepithelial connective tissue graft (SCTG). Adopting a split-mouth design, 266 GRs were randomly allocated to either a test (MCAT + SCTG + HA) or control group (MCAT + SCTG). The main outcome variable was the stability of the obtained mean root coverage from 6 months to 24 months. Twenty-four patients were evaluated at the 2-year follow-up. Comparisons between test and control sides at the same time points were evaluated using the t-test for independent variables. The changes in time were compared by one-way analysis of variance with the Tukey post hoc test separately for the test and control groups. The study protocol was registered at ClinicalTrials.gov (NCT05045586). At 2 years, around ninety percent of recessions showed complete root coverage (87.02% of the test group and 91.90% of the control group). Mean root coverage did not differ between the two sides, with 81.37 ± 37.17% (test) and 84.63 ± 35.33% (control), respectively. Significant improvements in the reduction of gingival recession height, clinical attachment level gain, gingival thickness increase, and the root esthetic score were found in both groups after 2 years, but no statistically significant difference was observed between the groups. The adjunctive application of HA significantly improved soft tissue texture (STT, 0.94 ± 0.23 for the test group vs. 0.71 ± 0.46 for the control group). Treatment of multiple gingival recessions with MCAT + SCTG with or without HA yielded marked and comparable 2-year clinical outcomes, which could be maintained over a period of 24 months. The clinical relevance of the demonstrated significant difference in STT between groups may be minimal. Full article
(This article belongs to the Special Issue Role of Dental Biomaterials in Promoting Oral Health)
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11 pages, 1706 KiB  
Case Report
The Treatment of Gingival Recessions in the Lower Anterior Region Associated with the Use/Absence of Lingual-Fixed Orthodontics Retainers: Three Case Reports Using the Laterally Closed Tunnel Technique and Parallel Incision Methods
by Alexandra Tavares Dias, Jessica Figueiredo Lopes, Juliana Campos Hasse Fernandes and Gustavo Vicentis Oliveira Fernandes
Dent. J. 2025, 13(3), 93; https://doi.org/10.3390/dj13030093 - 21 Feb 2025
Cited by 3 | Viewed by 1631
Abstract
Background: The prevalence of gingival recessions (GRs) in the global population is 78%. A long-term study showed a 47% increase in the prevalence of GRs five years post-orthodontic treatment, particularly in the lower anterior region. It can be caused and/or exacerbated after [...] Read more.
Background: The prevalence of gingival recessions (GRs) in the global population is 78%. A long-term study showed a 47% increase in the prevalence of GRs five years post-orthodontic treatment, particularly in the lower anterior region. It can be caused and/or exacerbated after orthodontic treatment, where the retainer placed can induce tooth movement or when it fails to maintain a passive position upon bonding. Thus, the goal of this case report was to present treatments for gingival recessions, with the approaches of the laterally closed tunnel technique and parallel incision methods, after orthodontic treatment in patients using non-passive lingual retainers. Methods: This case report adhered to the CARE guidelines. Three healthy patients were referred due to GR defects in the lower anterior region (RT1 and RT2). All patients had GR associated with deficient lingual-fixed orthodontics retainers. The same experienced periodontist (ATD) developed the surgeries and aimed to achieve root coverage using the connective tissue graft associated with a coronally advanced flap (CAF) and modify the recipient area’s gingival phenotype. Results: In all cases, a new orthodontic treatment was not possible due to anatomical or patient-related factors. Outcomes after six months, three years, and five years are presented, encompassing clinical and esthetic evaluations. Conclusions: GRs must always be addressed by orthodontic therapy or lingual-fixed orthodontic retainers. In cases where dental elements are positioned outside the bone envelope, orthodontic treatment may be considered before root coverage surgery. Therefore, surgical intervention should be undertaken for the keratinized tissue and volume gain, independently of the tooth position. Modifying the phenotype in these situations is vital for the long-term maintenance of periodontal health. Full article
(This article belongs to the Special Issue Orthodontics and New Technologies: 2nd Edition)
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20 pages, 565 KiB  
Review
Laser Application for Periodontal Surgical Therapy: A Literature Review
by Stefanos Zisis, Vasileios Zisis and Andreas Braun
Oral 2025, 5(1), 11; https://doi.org/10.3390/oral5010011 - 8 Feb 2025
Cited by 1 | Viewed by 2023
Abstract
Objectives: The aim of this article is to examine the effectiveness and capabilities of laser use in periodontal surgical therapy by analyzing the existing literature that focuses on laser use alone or as a supplement to the already existing periodontal surgical techniques, comparing [...] Read more.
Objectives: The aim of this article is to examine the effectiveness and capabilities of laser use in periodontal surgical therapy by analyzing the existing literature that focuses on laser use alone or as a supplement to the already existing periodontal surgical techniques, comparing it to conventional periodontal surgical therapy, with the intent to reach a better understanding of the efficiency and therapeutic potential of lasers in periodontal surgery. Methods: An electronic search of the PubMed, Embase, and Cochrane databases was performed between October 2023 and December 2023 to identify all of the articles published in the last 15 years and investigate information about the application of Diode, Erbium:yttrium–aluminum–garnet (Er:YAG), Carbon Dioxide (CO2), and Neodymium yttrium–aluminum–garnet (Nd:YAG) lasers to surgical periodontal therapy in human trials. Results: The database search yielded 18 studies. All of the databases showed a clinical improvement in pocket depth (PD), clinical attachment level (CAL), gingival recession (GR), and bleeding on probing (BOP) in both the test and control groups, with results from five articles showing statistically better PD reduction in the laser group compared to the control group. CAL gain was statistically higher in the laser group in six articles, while one study indicated better PD and CAL results in the control group. Improved GR reduction with a laser was noted in two articles, while one article reported a negative influence from a laser in GR. BOP was significantly better with laser in one study, while the remaining two studies reported the same results as the control group. Conclusions: Laser application in resective surgery exhibits additional benefits to the already established techniques, while in regenerative surgery, more investigation is needed. Diode laser use in periodontal surgery is already widespread and shows clinical efficacy, while low-level laser therapy (LLLT) has an exceptional potential for a variety of applications, promoting better wound healing and less post-surgical complications. However, more trials and studies are needed to further examine the maximum efficiency of each laser type in periodontal surgical therapy. Full article
(This article belongs to the Special Issue Lasers in Oral Sciences)
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12 pages, 280 KiB  
Article
The Prevalence of Gingival Recession According to the Cairo Classification in a Population from the North of Portugal
by Beatriz Moura, Filomena Salazar, Rosana Costa, Cristina Cabral and Cátia Reis
Dent. J. 2024, 12(12), 376; https://doi.org/10.3390/dj12120376 - 22 Nov 2024
Cited by 1 | Viewed by 2721
Abstract
Background/Objectives: Gingival recession (GR) has a multifactorial etiology, resulting from the interaction of various factors. It affects aesthetics and comfort, and has negative consequences for quality of life. The main objective of this study is to investigate the prevalence of gingival recession in [...] Read more.
Background/Objectives: Gingival recession (GR) has a multifactorial etiology, resulting from the interaction of various factors. It affects aesthetics and comfort, and has negative consequences for quality of life. The main objective of this study is to investigate the prevalence of gingival recession in a sample of the population in northern Portugal, according to the classification system proposed by Cairo. The secondary objective is to investigate possible risk factors for the prevalence of gingival recession. Methods: This observational study analyzed 50 patients who met all our inclusion criteria. Participants underwent a clinical periodontal examination and completed a questionnaire. Results: On the lingual/palatine side, recession type 2 (RT2) was the most prevalent (39.1%), and on the buccal side, recession type 3 (RT3) was the most prevalent (37.7%). Statistically significant differences were found in the occurrence of RT3 on both sides, buccal and lingual/palatine, which was higher in patients over 65. Buccal side RT2 and buccal and lingual/palatine side RT3 were more prevalent in males. Buccal side RT2 was more prevalent in ex-smokers compared to nonsmokers. RT3 was more prevalent in ex-smokers compared to smokers and nonsmokers. Most patients have gingival recession with loss of interproximal attachment. Conclusions: Older age, male gender, high plaque levels, and smoking habits are considered risk factors. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
14 pages, 1417 KiB  
Article
Tunnel Technique and Subepithelial Connective Tissue Graft, With or Without Cross-Linked Hyaluronic Acid, in the Treatment of Multiple Gingival Recessions: Prognostic Parameters for Clinical Treatment Outcomes of Randomized Controlled Trial
by Bartłomiej Górski, Izabela Maria Skierska, Kacper Nijakowski and Aniela Brodzikowska
J. Clin. Med. 2024, 13(22), 6758; https://doi.org/10.3390/jcm13226758 - 10 Nov 2024
Viewed by 2257
Abstract
Objectives: This study aimed to investigate factors that influence the 12-month outcomes after the treatment of multiple gingival recessions (GRs) with a modified coronally advanced tunnel (MCAT) and a subepithelial connective tissue graft (SCTG), with cross-linked hyaluronic acid (HA, tests) or without (controls). [...] Read more.
Objectives: This study aimed to investigate factors that influence the 12-month outcomes after the treatment of multiple gingival recessions (GRs) with a modified coronally advanced tunnel (MCAT) and a subepithelial connective tissue graft (SCTG), with cross-linked hyaluronic acid (HA, tests) or without (controls). Materials and Methods: Twenty-four patients with 266 GRs were treated. A logistic regression model was set to identify the baseline parameters that could predict the 12-month outcomes. The study protocol was registered at ClinicalTrials.gov (ID No. NCT05045586). Results: The evaluated clinical and esthetic parameters showed marked improvement in both groups without any statistically significant differences between the groups, with the exception of the soft tissue texture (STT). The STT was in favor of the HA group (0.96 versus 0.73, p = 0.0091). The likelihood of an MRC > 85%, of achieving CRC, and of gaining an RES = 10 was the highest for the incisors (reference group) and the lowest for the molars (OR = 0.046, p = 0.005). With each 1 mm increase in the baseline clinical attachment level, the odds of failure (MRC < 85%, not achieving CRC) increased, whereas each 1 mm increase in the baseline keratinized tissue width (KTW) improved the chances of an MRC > 85%, of achieving CRC, and of gaining an RES = 10. The application of HA increased the likelihood of a perfect RES more than twofold (OR = 2.683, p = 0.001). Conclusions: The application of HA improved the 12-month esthetic outcomes after the treatment of GRs with the MCAT technique. The baseline CAL, KTW, and tooth type predicted the 12-month MRC, CRC, and RES. An evaluation of the baseline characteristics of the surgical area might help clinicians develop individualized treatment plans. Full article
(This article belongs to the Special Issue Clinical Challenges and Advances in Periodontology and Oral Surgery)
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14 pages, 1837 KiB  
Article
Interdisciplinary Approaches by Polish Orthodontists, Periodontists, and Oral Surgeons to Soft Tissue Augmentation in Adult Patients: A Survey Study
by Edyta Kalina, Monika Machoy and Bartłomiej Górski
Appl. Sci. 2024, 14(21), 9647; https://doi.org/10.3390/app14219647 - 22 Oct 2024
Viewed by 1170
Abstract
This study evaluates the preferences of dentists regarding the interdisciplinary treatment of patients with gingival recession (GR) and a thin periodontal phenotype, based on their specialization. A cross-sectional study was conducted among Polish dentists, between May and October 2022, using an online survey. [...] Read more.
This study evaluates the preferences of dentists regarding the interdisciplinary treatment of patients with gingival recession (GR) and a thin periodontal phenotype, based on their specialization. A cross-sectional study was conducted among Polish dentists, between May and October 2022, using an online survey. The dentists were first asked to provide details regarding their specialization and the length of their professional career. In the second part of the survey, they responded to questions about the preferred timing of a consultation and soft tissue augmentation in patients who planned to undertake orthodontic treatment (OT). Moreover, factors undermining the decision-making process regarding soft tissue augmentation and the methods used for the evaluation of periodontal tissues were assessed. In total, 554 dentists completed the survey, among whom 328 were orthodontists and 226 were periodontists/oral surgeons. A third of the surveyed periodontists/oral surgeons (33%) reported that they receive referrals from orthodontists prior to OT and 39% of orthodontists indicated that they refer patients for soft tissue augmentation before commencing OT. The majority of periodontists/oral surgeons (51%) and the most significant proportion of orthodontists (45%) agreed that the ideal timing of soft tissue augmentation is dependent on each specific case. Both groups of surveyed dentists considered “planned tooth movement” as the most important factor in clinical decision-making. Among the periodontists/oral surgeons, the most popular methods to assess periodontal tissues were: 3D radiological examination, the visual method, and gingival transparency with the use of a periodontal probe. On the other hand, the surveyed orthodontists preferred the visual method, followed by 2D radiological examination, and then by 3D radiological examination. The majority of surveyed periodontists/oral surgeons and orthodontists agreed that the ideal timing of soft tissue augmentation in patients undertaking orthodontic treatment should be decided on a case-by-case basis, with planned tooth movement being the determining factor. Full article
(This article belongs to the Special Issue Orthodontic Treatment in Oral Health)
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17 pages, 2715 KiB  
Article
Treatment of Unfavorable Intrabony Defects with Autogenous Bone Graft in Combination with Leukocyte- and Platelet-Rich Fibrin or Collagen Membranes: A Non-Inferiority Study
by Giuseppe Balice, Michele Paolantonio, Paolo De Ninis, Imena Rexhepi, Matteo Serroni, Alessio Frisone, Luigi Romano, Bruna Sinjari, Giovanna Murmura and Beatrice Femminella
Medicina 2024, 60(7), 1091; https://doi.org/10.3390/medicina60071091 - 3 Jul 2024
Cited by 3 | Viewed by 1963
Abstract
Background and Objectives: Unfavorable intrabony defects (IBDs) are associated with the progression of periodontal disease and tooth loss. Growing scientific evidence has demonstrated the effectiveness of platelet concentrations in periodontal treatment. The aim of our study was to demonstrate the non-inferiority of [...] Read more.
Background and Objectives: Unfavorable intrabony defects (IBDs) are associated with the progression of periodontal disease and tooth loss. Growing scientific evidence has demonstrated the effectiveness of platelet concentrations in periodontal treatment. The aim of our study was to demonstrate the non-inferiority of an autogenous bone graft (ABG) associated with leukocyte- and platelet-rich fibrin (L-PRF) compared to ABG + Collagen Membrane in the treatment of IBDs. Material and Methods: Sixty-four patients with at least one IBD were randomly assigned to two groups: ABG+L-PRF and CM+ABG. Clinical and radiographic evaluations were performed at baseline and 12-month follow-up. Clinical attachment level (CAL), gingival recession (GR), probing pocket depth (PPD), and radiograph defect bone level (DBL) were compared between the two treatments. To evaluate the effectiveness of ABG+L-PRF, a non-inferiority margin of =1 mm (−1 mm for GR) was chosen; a second non-inferiority margin of =0.5 mm (−0.5 mm for GR) was set for clinical relevance. Results: At 12-month follow up, both treatments showed clinical and radiographic improvements. The 90% confidence intervals of the CM+ABG–L-PRF+ABG mean difference for CAL gain (−0.0564 mm [−0.316 to 0.203]), DBL gain (−0.433 mm [−0.721 to −0.145]), and PPD reduction (0.232 mm [0.015 to 0.449]) were below the 0.5 mm non-inferiority margin; the GR increase (0.255 mm [0.0645 to 0.445]) stayed above the −0.5 mm. Conclusions: the L-PRF+ABG treatment of unfavorable IBDs is non-inferior with respect to the CM+ABG therapy for CAL gain, but with a lower GR, a slightly higher PPD, and DBL gain. Full article
(This article belongs to the Section Dentistry and Oral Health)
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16 pages, 2695 KiB  
Article
Healing of Periodontal Suprabony Defects following Treatment with Open Flap Debridement with or without Hyaluronic Acid (HA) Application
by Octavia Carolina Vela, Marius Boariu, Darian Rusu, Vincenzo Iorio-Siciliano, Luca Ramaglia, Simina Boia, Viorelia Radulescu, Ioana Ilyes and Stefan-Ioan Stratul
Medicina 2024, 60(5), 829; https://doi.org/10.3390/medicina60050829 - 17 May 2024
Cited by 3 | Viewed by 3793
Abstract
Background and Objectives: This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Materials and Methods: Sixty systemically healthy patients [...] Read more.
Background and Objectives: This randomized, double-arm, multicentric clinical trial aims to compare the clinical outcomes following the treatment of suprabony periodontal defects using open flap debridement (OFD) with or without the application of hyaluronic acid (HA). Materials and Methods: Sixty systemically healthy patients with at least two teeth presenting suprabony periodontal defects were randomly assigned with a 1:1 allocation ratio using computer-generated tables into a test (OFD + HA) or control group (OFD). The main outcome variable was clinical attachment level (CAL). The secondary outcome variables were changes in mean probing pocket depth (PPD), gingival recession (GR), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS). All clinical measurements were carried out at baseline and 12 months. Results: Sixty patients, thirty in each group, were available for statistical analysis. The mean CAL gain was statistically significantly different (p < 0.001) in the test group compared with the control group (3.06 ± 1.13 mm vs. 1.44 ± 1.07 mm). PPD reduction of test group measurements (3.28 ± 1.14 mm) versus the control group measurements (2.61 ± 1.22 mm) were statistically significant (p = 0.032). GR changes were statistically significant only in the test group 0.74 ± 1.03 mm (p < 0.001). FMBS and FMPS revealed a statistically significant improvement mostly in the test group. Conclusions: Suprabony periodontal defects could benefit from the additional application of HA in conjunction with OFD in terms of improvement of the clinical parameters compared with OFD alone. Full article
(This article belongs to the Special Issue Advances in Clinical Periodontology)
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16 pages, 2528 KiB  
Systematic Review
Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies
by Alessandro Campagna, Giacomo Baima, Federica Romano, Federico Amoroso, Federico Mussano, Giacomo Oteri, Mario Aimetti and Matteo Peditto
Dent. J. 2024, 12(5), 145; https://doi.org/10.3390/dj12050145 - 16 May 2024
Cited by 3 | Viewed by 3260
Abstract
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide [...] Read more.
The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?”. Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (−0.88, 2.97) p = 0.29] and PPD reduction [MD = 1.32; 95% CI (−0.25, 2.88) p = 0.10]. The same also applied to GR [MD = −0.08; 95% CI (−0.79, 0.63) p = 0.83] and RBG [MD = 0.50; 95% CI (−0.88, 1.88) p = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures. Full article
(This article belongs to the Special Issue Periodontal Health: Disease Prevention and Treatment)
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14 pages, 9114 KiB  
Article
Platelet-Rich Fibrin in Non-Surgical Periodontal Therapy: A Split-Mouth Randomized Controlled Clinical Trial
by Simran R. Parwani, Kaustubh S. Thakare, Kshipra P. Kawadkar, Nishita Jaju Soni, Rajkumar Parwani, Himanshu Dadlani, Dhanashree S. Chaudhary, Dipanshu Pahuja, Gianrico Spagnuolo and Niccolò Giuseppe Armogida
Dent. J. 2024, 12(5), 135; https://doi.org/10.3390/dj12050135 - 9 May 2024
Cited by 10 | Viewed by 3577
Abstract
This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test [...] Read more.
This clinical trial investigated the efficacy of platelet-rich fibrin (PRF) as an adjunct to conventional scaling and root planing (SRP) in non-surgical periodontal therapy. In a split-mouth randomized controlled trial with 13 patients and 26 periodontal pocket sites, PRF was inserted in test group pockets alongside SRP, while control group pockets received SRP alone. Measurements at baseline and six weeks included probing pocket depths (PPDs), clinical attachment loss (CAL), gingival recession (GR), the plaque index, and the gingivitis index. The wound healing index was assessed at six weeks. The results show statistically significant improvements in the SRP+PRF group compared to SRP alone, demonstrating a better CAL gain (SRP+PRF group: 2.69 ± 0.63; SRP alone group: 4.15 ± 0.69—p-value: 0.001), PPD reduction (SRP+PRF group: 2.62 ± 0.65; SRP alone group: 3.85 ± 0.80—p-value: 0.001), and GR minimization (SRP+PRF group: 0.46 ± 0.62; SRP alone group: 0.81 ± 0.72—p-value: 0.21). The adjunctive use of PRF enhanced healing, reduced pocket depths, decreased tissue morbidity, and minimized gingival recession. This study concludes that PRF placement is effective in 5–6 mm pockets, potentially reducing the number of periodontal treatment sessions needed for pocket closure. Full article
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20 pages, 4347 KiB  
Article
Treatment of Multiple RT1 Gingival Recessions Using a Coronally Advanced Flap Associated with L-PRF or Subgingival Connective Tissue Graft from Maxillary Tuberosity: A Randomized, Controlled Clinical Trial
by Giuseppe Balice, Michele Paolantonio, Matteo Serroni, Paolo De Ninis, Imena Rexhepi, Alessio Frisone, Stefania Di Gregorio, Luigi Romano, Bruna Sinjari, Giovanna Murmura and Beatrice Femminella
Dent. J. 2024, 12(4), 86; https://doi.org/10.3390/dj12040086 - 28 Mar 2024
Viewed by 3340
Abstract
The goal of plastic periodontal surgery is to obtain complete root coverage, increasing gingival thickness (GT), a positive prognostic factor for gingival margin stability over time. The aim of this study was to compare the effectiveness of the Coronally Advanced Flap (CAF) in [...] Read more.
The goal of plastic periodontal surgery is to obtain complete root coverage, increasing gingival thickness (GT), a positive prognostic factor for gingival margin stability over time. The aim of this study was to compare the effectiveness of the Coronally Advanced Flap (CAF) in RT1 (GR; gingival recession with no loss of interproximal attachment) when associated with a connective tissue graft from the maxillary tuberosity (tCTG) or with leukocyte and platelet-rich fibrin (L-PRF) membranes in obtaining root coverage and increasing the thickness and width of the keratinized tissue, along with aesthetic improvement, taking into account a number of patient-related outcomes. Thirty patients with two adjacent RT1 GRs (GRs with no loss of interproximal attachment) were each treated using CAF associated with tCTG (15 patients) or L-PRF. The main outcome was a GT increase; secondary outcomes were keratinized tissue width (KT), gingival recession (GR), probing depth (PD), clinical attachment level (CAL), root coverage percentage (RC%), complete root coverage (CRC), and root coverage esthetic score (RES). Patient-reported outcomes were discomfort (D), dentine hypersensitivity (DH), patient-related esthetic score (PRES), and overall treatment satisfaction (OTS). After 12 months, clinical and patient-reported parameters did not show significant differences between groups, with the only exception being a GT gain, which was significantly greater in the CAF + tCTG group. Our results showed that both techniques were effective in treating RT1 GRs, with comparable patient-related outcomes. However, the use of tCTG produces significantly thicker tissue, covering the exposed root surface. Full article
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14 pages, 1096 KiB  
Article
Changes in Dickkopf-1, but Not Sclerostin, in Gingival Crevicular Fluid Are Associated with Peroral Statin Treatment in Patients with Periodontitis
by Kristina Duspara, Renata Sikora, Ana Petrovic, Lucija Kuna Roguljic, Anita Matic, Kristina Kralik, Hrvoje Roguljic, Tomislav Kizivat, Mirjana Duspara, Dunja Igrec, Kristina Bojanic, Robert Smolic, Aleksandar Vcev, Magdalena Wyszyńska, George Y. Wu and Martina Smolic
Medicina 2024, 60(3), 508; https://doi.org/10.3390/medicina60030508 - 20 Mar 2024
Cited by 1 | Viewed by 1916
Abstract
Background and Objectives: Periodontitis is marked by the destruction of alveolar bone. Sclerostin (SOST) and dickkopf-1 (DKK-1) act as inhibitors of the Wingless-type (Wnt) signaling pathway, a key regulator of bone metabolism. Recent studies have suggested that statins play a role in [...] Read more.
Background and Objectives: Periodontitis is marked by the destruction of alveolar bone. Sclerostin (SOST) and dickkopf-1 (DKK-1) act as inhibitors of the Wingless-type (Wnt) signaling pathway, a key regulator of bone metabolism. Recent studies have suggested that statins play a role in bone resorption and formation by influencing Wnt signaling. The aim of this study was to determine the levels of SOST and DKK-1 in periodontal patients with and without peroral statins treatment in their therapy. Materials and Methods: A total of 79 patients with diagnosed periodontitis were divided into two groups: 39 patients on statin therapy (SP group) and 40 patients without statin therapy as a control group (P group). The periodontal clinical examination probing (pocket) depth (PD) and gingival recession (GR) were measured, and approximal plaque was detected, while vertical and horizontal bone resorption was measured using a panoramic radiograph image. Clinical attachment loss (CAL) values were calculated using PD and GR values. Gingival crevicular fluid (GCF) was collected and used for measuring SOST and DKK-1 levels. A questionnaire was used to assess lifestyle habits and statin intake. Patients’ medical records were used to obtain biochemical parameters. Results: There was no significant difference in sclerostin concentration between the SP and P group. DKK-1 values were significantly higher in the SP group compared to the control group (p = 0.04). Also, PD (p = 0.001) and GR (p = 0.03) were significantly higher in the SP group. The level of DKK-1 had a positive relationship with the PD, the greater the PD, the higher the level of DKK-1 (Rho = 0.350), while there was no significant association with other parameters. Conclusions: Peroral statins in periodontal patients are associated with GCF levels of DKK-1 but not with sclerostin levels. Full article
(This article belongs to the Section Dentistry and Oral Health)
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15 pages, 260 KiB  
Article
Association between Gingival Phenotype and Periodontal Disease Severity—A Comparative Longitudinal Study among Patients Undergoing Fixed Orthodontic Therapy and Invisalign Treatment
by Mansour M. Alasiri, Abdullah Almalki, Saud Alotaibi, Abdullah Alshehri, Alhanouf A. Alkhuraiji and Julie Toby Thomas
Healthcare 2024, 12(6), 656; https://doi.org/10.3390/healthcare12060656 - 14 Mar 2024
Cited by 6 | Viewed by 2366
Abstract
This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full [...] Read more.
This longitudinal study aimed to compare the association between gingival phenotype (thin vs. thick) and periodontal disease severity in patients undergoing fixed orthodontic therapy (FOT) and Invisalign treatment over a six-month follow-up period. Clinical periodontal parameters, including full mouth plaque score (FMPS), full mouth bleeding score (FMBS), gingival index (GI), probing pocket depth (PPD), clinical attachment loss (CAL), gingival recession (GR), keratinized tissue width (KTW), transgingival probing, and gingival biotype assessment, were recorded at baseline and 6 months into treatment for both orthodontic groups and a control group. Statistical analysis evaluated differences in parameters between groups and across time points. In the thick phenotype, both Invisalign and FOT groups showed a significant mean reduction in FMPS (baseline to 6 months) by −24.8707 and −12.3489, respectively (p < 0.05). The gingival index decreased significantly for both groups, with Invisalign and FOT showing reductions of −0.83355 and −1.10409, respectively (p < 0.05). FMBS (baseline to 6 months) decreased significantly for Invisalign and FOT, with mean differences of −9.10298 and −12.6579 (p < 0.05). Probing pocket depth (baseline to 6 months) was also significantly reduced for both Invisalign and FOT groups while CAL showed non-significant differences in both groups (p > 0.05). Similar changes were seen in the thin phenotype too. This study highlights the positive influence of both Invisalign and fixed orthodontic therapy on periodontal health, particularly in patients with thin and thick gingival biotypes. These findings, with significant reductions in key periodontal parameters, offer valuable insights to guide orthodontic treatment decisions and enhance patient outcomes. Full article
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