Search Results (2)

Guided bone regeneration surgery always leads to a deformation of the soft tissues consequent to passivation of the flap. In this article, a graftless technique for the restoration of the vestibular depth and for the augmentation of adherent soft tissue, called the “white layer approach”, is proposed after a vertical GBR procedure in posterior areas. Six patients (five males and one female) with vertical bone atrophy were enrolled in the study and underwent three-dimensional bone augmentation with titanium barriers. After 6 months, during the second-stage surgery, a 0.5 mm thick layer of white pseudo-periosteum was observed underneath the titanium barrier and over the newly formed bone. The buccal portion of the pseudo-periosteum was left intentionally exposed, in order to promote the spontaneous formation of new adherent gingiva and the restoration of the original depth of the fornix. The implant insertion was then planned 3 months after the WLA in a conventional procedure. The buccal adherent soft tissue height was measured from the crestal point to the most apical point, using a periodontal probe, before the barrier removal at 3 months after the white layer approach (WLA). In all patients, a gain in adherent soft tissue varying from 5 to 8 mm was observed; the average adherent soft tissue gain (ASTG) was 6.75 mm. The vertical bone height was measured by CT scans at baseline and before the implant placement, and showed an average vertical bone gain (AVBG) of 4.08 mm. Within the limitations of this study, vertical GBR with titanium occlusive barriers (OTB) associated with the white layer approach (WLA) may represent a simplified technique for hard and soft tissue augmentation in posterior areas, even without a free gingival graft. Full article

Little is known about whether the depth of the vestibular fornix influences people’s ability to access their teeth to remove plaque during oral hygiene measures at home. This study aimed to investigate the association between vestibular fornix depth and periodontal health. The study included 100 adults in good periodontal health, with a plaque index (PI) ≤15%, bleeding on probing (BOP) ≤10%, and a pocket probing depth (PPD) ≤3 mm. Using a periodontal probe and a digital caliper, we measured PI, BOP, PPD, gum phenotype, gum recession, the width of keratinized gingiva, and the vestibular fornix depth. Adjustment for multiple testing was performed using the Benjamini-Hochberg procedure. Results: Vestibular fornix depth was associated with width of keratinized gingiva (ρ 0.60, p < 0.0001). Median BOP was 1.39% in participants with a vestibular fornix depth ≥7 mm, and 0.00% in those with a vestibular fornix depth <7 mm (p = 0.62). Vestibular fornix depth and the width of keratinized gingiva did not seem to be associated with the level of periodontal health. Participants with a shallower vestibular fornix depth should be given advice on how best to ensure good oral hygiene at home. Full article