The Ball Technique for Peri-implant Soft Tissue Augmentation Using a Xenogeneic Collagen Matrix: A Technical Report.

In the maxillary anterior region, augmentation to correct a soft tissue deficiency is often required for an esthetic outcome and long-term implant therapy success. This case series of three patients presents a novel approach for soft tissue augmentation using xenogeneic collagen matrix balls in the esthetic zone around the implants. This technique avoids a secondary donor site compared to autogenous connective tissue graft. With this technique, a horizontal soft tissue volume increase (range: 3 to 5 mm) was observed postsurgically and maintained at later follow-ups. The described ball technique offers a viable method for peri-implant mucosal augmentation in the maxillary anterior region.

Clinical classification of tooth position in the alveolar bone housing with periodontal defects.

A new classification of tooth position in the alveolar bone housing, which indicates the width of alveolar bone for buccolingual direction, with bone defects caused by periodontal disease is proposed. This classification highlights the importance of tooth position in the alveolar bone housing in terms of the progression of the regenerative process and the factors that may affect the prognosis of compromised teeth after regenerative surgery. Tooth positions were divided into two groups: (i) The whole tooth is centrally positioned in the existing alveolar bone housing (Grade I) and (ii) A part of the tooth is exposed out of the existing alveolar bone housing (Grade II). Grade II is further divided into two subgroups according to situations encountered in clinical practice. The following subclasses are suggested: Subgroup A, where the alveolar bone housing is broader than the tooth, and Subgroup B, where the alveolar bone housing is narrower than the tooth. These subgroups represent a discrepancy between tooth size and alveolar bone dimensions in the buccolingual orientation. This classification could be useful for planning the correct regenerative treatment for each type of the tooth position in the alveolar bone housing with periodontal defects.

Influence of antihypertensive medications on the clinical parameters of anodized dental implants: a retrospective cohort study.

BACKGROUND: Hypertension is a chronic medical condition in which blood pressure in the arteries is elevated. Given the large proportion of dental implant patients using antihypertensive medications, it is crucial to evaluate the effects of these drugs on the clinical parameters of osseointegrated implants. The aim of the present retrospective cohort study was to evaluate the influence of antihypertensive medications on clinical peri-implant tissue parameters. METHODS: Thirty-five patients received a total of 77 anodized dental implants. Based on the history of the use of antihypertensive medications, the patients were divided into two groups: the group taking antihypertensive medications (AH group) and the group of healthy patients (H group). Implants were followed up clinically and radiologically, with a focus on the peri-implant soft tissue parameters probing pocket depth, bleeding on probing, modified plaque index, and marginal peri-implant bone level stability. RESULTS: None of the implants were lost, and no technical failures occurred. The mean follow-up duration was 7 years and 1 month. A significant difference was observed in the probing pocket depth 3.8 ± 1.3 mm in the AH group and 3.0 ± 0.7 mm in the H group. In the AH and H groups, 26.5% (9/34) and 4.7% (2/43) of the patients were diagnosed with peri-implantitis at the implant level, respectively. CONCLUSIONS: Our findings suggest some correlations between antihypertensive medication use and clinical parameters in anodized peri-implant tissue.

Bidirectionally positioned flap surgery: a case report with 3-year follow-up.

A new technique to cover recessions to take advantage of connective tissue grafts and coronally advanced flaps is proposed. A 34-year-old woman presented with a 2-mm Class I recession on the buccal aspect of her maxillary right canine. A full-thickness flap was placed coronally to cover the exposed root, and a partial thickness flap was positioned apically. Complete root coverage was obtained, and the width of keratinized tissue had increased from 2 to 4 mm at the 6-month postoperative visit. These clinical outcomes were maintained for 3 years. This single surgical approach benefits from obtaining not only complete root coverage but also increasing width of keratinized tissue, without requiring a second surgical site.

Periodic exacerbation of gingival inflammation during the menstrual cycle.

Sex hormones are believed to be a risk factor for periodontitis because of their ability to proliferate specific periodontal microorganisms and affect host immunologic response. In this case report, gingival redness and swelling occurred during the menstrual cycle, although the patient maintained good oral hygiene during periodontal treatment. Medical history revealed that exacerbation of gingival inflammation corresponded to the menstrual cycle and occurred during the ovulation period, when estrogen levels are high. Mean bleeding index of the ovulation period (18.9%) showed higher levels than that during the menstrual phase (5.3%). This case indicates that frequent and effective maintenance should be provided while considering the influence of the menstrual cycle, as sex hormones may be involved in exacerbating gingival inflammation.

New biomarker evidence of oxidative DNA damage in whole saliva from clinically healthy and periodontally diseased individuals.

BACKGROUND: There is an increasing body of evidence implicating reactive oxygen species in the pathogenesis of periodontal tissue destruction. 8-Hydroxy-deoxyguanosine (8-OHdG) is one of the most commonly used markers to evaluate oxidative damage in a number of disorders including chronic inflammatory diseases. The aim of the present study was to evaluate 8-OHdG levels in whole saliva of patients with periodontitis and to assess the changes after initial treatment. METHODS: Saliva samples were collected from 78 patients with untreated periodontitis and 17 healthy control subjects. Clinical parameters and levels of 8-OHdG were assessed first to establish a baseline and again after initial periodontal treatment from 15 patients. 8-OHdG levels were determined by enzyme-linked immunosorbent assay. RESULTS: The mean value of 8-OHdG in the saliva of periodontally diseased subjects, 4.28 +/- 0.10 ng/ml, was significantly higher (P<0.01) than that of clinically healthy subjects (1.56 +/- 0.10 ng/ml). A significant decrease in salivary 8-OHdG was observed after therapy (P<0.01). CONCLUSION: In the present study, we evaluated for the first time 8-OHdG levels in whole saliva of patients with periodontitis and assessed changes after initial periodontal treatment. Our study indicated that 8-OHdG levels in saliva appear to reflect the status of periodontal health.