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Collagen matrices have been developed as possible connective tissue graft substitutes to overcome patient discomfort, undesired palatal healing, and the limited amount of donor tissue. The aim of this case series is to assess a coronally advanced flap (CAF) with a volume-stable collagen matrix (VCMX) to treat single gingival recessions (GRs) associated with partially restored noncarious cervical lesions (NCCLs). Twelve patients diagnosed with single GRs (type 1; RT1) + NCCL (B+) were included in this study and received a restorative approach (partial composite resin with an apical margin 1 mm beyond the estimated cementoenamel junction [CEJ]) and a surgical approach (CAF+VCMX). Clinical and patient-centered assessments were recorded from 10 patients at baseline and 6 months postoperatively. Significant recession reduction (2.1 mm), clinical attachment level gain (1.34 mm), and combined defect coverage (51.67%) were observed at 6 months. The estimated root coverage was 69.48%, obtained using the estimated CEJ. No difference in keratinized tissue width was observed over time. A 0.42-mm gain in gingival thickness was observed after 6 months (P = .002) as well as an improvement in patient satisfaction due to better esthetics (P < .001). Within the present study's limitations, CAF+VCMX provided a significant improvement in treating single GRs combined with a partially restored NCCL (B+). [ABSTRACT FROM AUTHOR]

Background: This study focused on whether the effectiveness of nonsurgical periodontal therapy (NSPT) on second molars (M2s) varies with the status of adjacent nonimpacted third molars (N-M3s)., Methods: In this retrospective cohort study, 776 regions from 268 patients were evaluated. Based on the adjacent N-M3 status, quadrants with M2s were categorized into three groups: N-M3 group (present N-M3), A-M3 group (absent M3), and R-M3 group (removed N-M3). The probing depth reduction (ΔPD) and the percentage of reversed deep pockets (PD5+ [probing depth ≥5 mm] turned to PD5-) after NSPT were analyzed among the three groups. The Wilcoxon nonparametric test was employed to compare the N-M3 group with the A-M3 group, with a mixed-effect model utilized to adjust for confounding factors. Further, the R-M3 group and the matched N-M3 group were compared using the Wilcoxon nonparametric test., Results: After isolating confounding factors (M2 baseline gingival recession, tooth mobility, sex, and follow-up interval), the ΔPD of M2s was significantly lower in the N-M3 group (0.93 ± 1.25 mm) compared with the A-M3 group (1.09 ± 1.30 mm, p < 0.001). Moreover, the percentage of reversed deep pockets in the N-M3 group (35.56%) was lower than in the A-M3 group (42.98%, p<0.001). Similarly, compared with the N-M3 group, M2s in the R-M3 group manifested better outcomes in terms of periodontal indices., Conclusion: Retained N-M3s may hamper the outcome of NSPT on adjacent M2s. Additionally, the removal of N-M3 is associated with an enhanced response of M2s to NSPT., Plain Language Summary: The second molar is crucial for chewing, but it is often lost due to periodontitis. Periodontal treatment for the second molar is not always effective, and many factors contribute to this. One factor that has gained attention is the impact of a nonimpacted third molar on the periodontal health of the adjacent second molar. In this study, we examined how the presence of a nonimpacted third molar affects the outcome of nonsurgical periodontal therapy for the second molar. We analyzed 776 second molars from 268 patients. The results showed that when the nonimpacted third molar was absent or removed during periodontal therapy, the second molar's condition improved more than when the nonimpacted third molar was present. The data indicated that even with nonsurgical periodontal treatment, the periodontitis of the second molar could not be effectively controlled if an adjacent nonimpacted third molar was present. Therefore, the negative impact of the nonimpacted third molar should be considered to prevent the loss of the second molar., (© 2025 American Academy of Periodontology.)

Objectives: The purpose of this study was to propose a new difficulty score for the treatment of multiple gingival recessions (GRs) with Modified Coronally Advanced Tunnel (MCAT), and to test the score's reliability., Material and Methods: A difficulty score was developed for the assessment and grading of 13 relevant anatomical parameters at baseline. Six experienced dental practitioners evaluated existing GRs in three patients. The scale was assessed at two levels: for each single tooth, and seven days later for whole quadrants. Accuracy was estimated using Fleiss' kappa statistics and intraclass correlation coefficients (ICC) to determine the inter- and intra-examiner agreement., Results: During the evaluation of individual teeth, all parameters exhibited very good to excellent agreement, with Fleiss' kappa statistics ranging between 0.74 and 1. Only recession type, CEJ detectability, and cervical step displayed minor variations. The total MCAT score also produced a minor discrepancy (kappa = 0.78). During the evaluation of whole quadrants, excellent reproducibility was recorded for individual parameters (kappa 0.9-1). Minor variation was observed for recession type and CEJ detectability. Excellent reliability in the total MCAT scores was noted between examiners (kappa = 0.9). Overall intra-examiner agreement values were very high (0.75-1)., Conclusions: The reliability of the proposed difficulty score was assessed between very good and excellent. Some difficulties arose in the evaluation of recession type, CEJ detectability and cervical step., Clinical Relevance: The presented score may be considered for assessing the difficulty of multiple GRs treatment using MCAT in order to improve the process of clinical decision-making., Competing Interests: Declarations. Ethics approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was reviewed and approved by the Bioethics Committee of Medical University of Warsaw, Poland (Bioethics Committee of Medical University of Warsaw: AKBE/96/2023). An informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Sarcopenia is a prevalent condition associated with aging. Inflammation and pyroptosis significantly contribute to sarcopenia. Methods: Two sarcopenia-related datasets (GSE111016 and GSE167186) were obtained from the Gene Expression Omnibus (GEO), followed by batch effect removal post-merger. The "limma" R package was utilized to identify differentially expressed genes (DEGs). Subsequently, LASSO analysis was conducted on inflammation and pyroptosis-related genes (IPRGs), resulting in the identification of six hub IPRGs. A novel skeletal muscle aging model was developed and validated using an independent dataset. Additionally, Gene Ontology (GO) enrichment analysis was performed on DEGs, along with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and gene set enrichment analysis (GSEA). ssGSEA was employed to assess differences in immune cell proportions between healthy muscle groups in older versus younger adults. The expression levels of the six core IPRGs were quantified via qRT-PCR. Results: A total of 44 elderly samples and 68 young healthy samples were analyzed for DEGs. Compared to young healthy muscle tissue, T cell infiltration levels in aged muscle tissue were significantly reduced, while mast cell and monocyte infiltration levels were relatively elevated. A new diagnostic screening model for sarcopenia based on the six IPRGs demonstrated high predictive efficiency (AUC = 0.871). qRT-PCR results indicated that the expression trends of these six IPRGs aligned with those observed in the database. Conclusion: Six biomarkers—BTG2, FOXO3, AQP9, GPC3, CYCS, and SCN1B—were identified alongside a diagnostic model that offers a novel approach for early diagnosis of sarcopenia. [ABSTRACT FROM AUTHOR]

Introduction: The middle mesial canal (MMC) of mandibular molars is of particular interest in endodontics due to its complexity. This study investigated the association between MMC presence in first and second mandibular molars and the radiolucency in the furcation area using cone-beam computed tomography (CBCT) scans. Materials and Methods: CBCT scans of 400 patients referred to the largest radiology center in Kerman City from January 1, 2022, to January 1, 2023, were examined. All CBCT scans were assessed for radiolucency in the furcation area and the presence of MMC. Variables, including age, gender, tooth number, and MMC presence were recorded. Chi-squared tests and logistic regression analyses were employed to compare MMC frequency and its impact on furcation radiolucency. Results: Of 201 examined teeth, 37 (18.4%) had MMC, and 23 (11.4%) exhibited furcation radiolucency. However, teeth with a mesial canal showed a higher prevalence of furcation lesions compared to those without (38% vs. 5.2%) (P<0.001). A significant association was observed between a mesial canal and furcation radiolucency, with odds of furcation radiolucency at 12.7 after controlling for age and gender (P<0.001). Conclusion: A strong association exists between MMC presence in first and second mandibular molars and furcation radiolucency, unaffected by age and gender. [ABSTRACT FROM AUTHOR]

Background: Alveolar ridge resorption following tooth loss poses a significant challenge for successful dental implant placement. In cases of severe atrophy, bone augmentation is required to restore sufficient bone volume. This technical note outlines a detailed, stepwise surgical protocol for horizontal and vertical alveolar ridge augmentation using customized titanium mesh. Materials and Methods: The procedure includes precise mesh fitting, autologous bone grafting, and the application of bioactive agents to promote bone regeneration. Emphasis is placed on the technique's feasibility, predictability, and the critical steps necessary for preventing complications. Results: The use of customized mesh ensures stability and improved bone regeneration outcomes, enabling clinicians to achieve successful implant placement even in severely atrophic ridges. Conclusions: The described protocol has demonstrated predictable results in both clinical and radiographic evaluations, offering an effective solution for complex bone augmentation cases. [ABSTRACT FROM AUTHOR]

The concurrent complicated horizontal crown-root fracture and complicated vertical crown fracture are rarely delineated in the literature. This case report suggests a twophase singlevisit treatment to reinstate the maxillary lateral incisor with bioinspired materials. In Stage 1, endodontic therapy was given, followed by fracture fragment stabilization innovatively in Stage 2. At 2 years of follow-up, clinical examinations revealed satisfactory periodontal condition without mobility or discoloration of the tooth. Cone-beam computed tomography revealed a close approximation of the vertical fracture line and healing of the horizontal crown-root fracture with a type II pattern. This case report concludes that a minimally invasive procedural approach with biomimetic materials can be performed instead of extensive therapy like extraction. [ABSTRACT FROM AUTHOR]

Hyaluronic acid (HA) has received considerable attention in the reconstruction of lost periodontal tissues. HA has been proposed to play a role in cell proliferation, differentiation, migration, and cell–matrix as well as cell–cell interactions. Although various studies have been conducted, further research is needed to expand our knowledge based on HA such as its effects on cell proliferation and osteogenic differentiation. The aim of this study is to assess, in single- and multi-culture plate models, the effect of HA on the proliferation, viability, and function of periodontal ligament fibroblasts, osteoblasts, and gingival epithelial cells. A novel multi-culture cell plate was chosen to simulate a cell–cell communication as close as possible to a real clinical condition in an in vitro setting. We found that HA exclusively enhanced epithelial cell proliferation, while intercellular communication stimulated the proliferation and osteogenic potential of the osteoblasts, independently from HA use. The proliferation and function of the periodontal ligament fibroblasts were not changed by HA or the cellular interplay. The use of multi-culture plates could represent a promising method to investigate and compare dental biomaterials in experiments mimicking an in vivo environment. [ABSTRACT FROM AUTHOR]

Background: Newer generation platelet concentrates, such as advanced platelet-rich fibrin plus (A-PRF+) obtained following low-speed centrifugation concept and horizontal platelet-rich fibrin (H-PRF) obtained from swing out and bucket system, showed increased platelet entrapment and growth factor release in the in-vitro studies. This prospective study aimed to evaluate and compare the clinical outcomes of A-PRF+ and H-PRF membranes in the treatment of gingival recession defects. The objectives of this study were to compare the changes in the recession height (RH) and the mean root coverage percentage (MRC%) between and within the research groups., Methods: Forty-four systemically healthy patients diagnosed with 84 Cairo's RT 1 and RT 2 gingival recession defects in the maxillary anterior and premolars were randomly treated with a combination of the coronally advanced flap (CAF) and A-PRF+ membrane (n = 22 subjects) or H-PRF membrane (n = 22 subjects). Patients were reviewed at 3 and 6 months postoperatively. Parameters including RH, MRC%, complete root coverage (CRC), gingival thickness, keratinized tissue height, and root coverage esthetic scores were documented., Results: Both treatments resulted in a significant reduction in RH (p < 0.001). The CAF + A-PRF+ group demonstrated a reduction in RH from 2.47 ± 1.00 mm to 0.59 ± 0.52 mm and the MRC% was 76.33 ± 22.54%, at 6 months. In the CAF+H-PRF group, the mean RH decreased from 2.43 ± 1.01 mm to 0.38 ± 0.59 mm and the MRC% was 85.51 ± 19.87%. Three- and six-month intergroup analysis revealed statistically insignificant differences in the observed clinical parameters between the groups (p > 0.05)., Conclusions: The study found that both CAF + H-PRF and CAF + A-PRF+ protocols resulted in similar clinical outcomes while treating maxillary gingival recession defects., Plain Language Summary: Numerous modifications have been proposed to improve the growth factor content in the platelet concentrates and thereby therapeutic potential. This study compared platelet-derived membranes obtained by two different spin protocols in the treatment of gum recession. Forty-four patients were treated with either platelet-derived membrane obtained by horizontal spin protocol (test group) or low-speed spin concept (control group). Both treatment methods resulted in satisfactory healing. At the end of 6 months, no differences were noted with regard to the changes in clinical measurements and root coverage percentage indicating similar clinical efficacy of both preparatory techniques., (© 2025 American Academy of Periodontology.)

Background: Gingival recession has a multifactorial etiology, involving various predisposing and precipitating factors. Non-carious cervical lesions (NCCLs) are often associated with gingival recession and pose challenges due to their complex pathodynamics. There is limited evidence regarding tunnel-based procedures combined with connective tissue grafts (CTGs) for treating recession-associated NCCLs. This case study illustrates a periodontal-restorative approach for addressing multiple adjacent recession-associated NCCLs., Methods: A healthy, non-smoking 55-year-old Asian male presented with generalized mucogingival conditions, including gingival recessions and lack of keratinized tissue on the facial aspect of the maxillary right first molar through the left first molar, accompanied by physiological gingival pigmentation. The recessions were classified as Cairo RT I. NCCLs were evident in all six maxillary anterior teeth. After restoring the NCCLs to the maximum root coverage (MRC) level with composite resin, the patient underwent a mucogingival procedure via a double-vestibular incision subperiosteal tunnel access (double-VISTA) approach with autogenous CTG for treating the recession defects. Due to limited CTG availability, the maxillary left side was treated first, followed by the right side 3 months later., Results: Post-surgical healing was uneventful, except for mild facial swelling for 5 days, which subsided within a week. After 12 months, all treated teeth exhibited complete coverage to the predetermined MRC level, with a thick gingival phenotype. At the 2-year follow-up, all treated teeth maintained a stable root coverage outcome with harmonious gingival margins., Conclusion: This case study demonstrates that the double-VISTA technique for treating recession-associated NCCLs is promising in achieving complete coverage at sites where the MRC level was predetermined., Key Points: This case study introduces a modified vestibular incision subperiosteal tunnel access (VISTA) technique, termed double-VISTA, which employs two distant vestibular incisions to enhance access for instrumentation and recipient site preparation in the treatment of multiple adjacent recession defects. A periodontal-restorative approach is detailed in this case study, demonstrating a step-by-step process for managing multiple adjacent recession-associated non-carious cervical lesions using the double-VISTA technique with a promising treatment outcome. The advantages and disadvantages of the double-VISTA technique are further discussed in this case study. Limitations of this technique include shallow vestibular depth and close proximity to the mental nerve, necessitating careful attention during recipient site preparation under these conditions., Plain Language Summary: Gingival recession, where gums recede and expose tooth roots, can result from various causes. Non-cavity lesions on the tooth necks (NCCLs) are often associated with this condition and are challenging to treat. Limited evidence exists on using tunnel-based procedures with connective tissue grafts (CTGs) for NCCLs. This case study presents a method to treat multiple adjacent NCCLs in a healthy 55-year-old Asian man with gum recession on his upper teeth and pigmented gums. The patient had non-cavity lesions on all six upper front teeth. Initially, the exposed root necks were covered with composite resin, followed by a double-vestibular incision subperiosteal tunnel access (double-VISTA) surgical approach with CTGs to address the recession. Due to limited graft availability, the left side was treated first, then the right side 3 months later. The patient experienced mild facial swelling for 5 days, which resolved within a week. After 12 months, all treated teeth showed complete coverage with thickened gums, and the results remained stable with even gum margins at the 2-year check-up. This case study suggests that the double-VISTA technique for treating NCCLs shows promising results for achieving complete coverage, offering a viable treatment option for these dental conditions., (© 2025 The Author(s). Clinical Advances in Periodontics published by Wiley Periodicals LLC on behalf of American Academy of Periodontology.)