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Objective: To clinically and histologically evaluate the potential effect of a cross-linked, high molecular weight hyaluronic acid (xHyA) on the outcomes of guided bone regeneration performed with a demineralized bovine bone mineral (DBBM) covered with a natural collagen membrane. Method and materials: Eleven patients (eight females and three males, mean age53years) with a total of 27 surgical sites were treated. Treatments were performed with either DBBM and natural collagen membrane fixed with tacks (group A) or DBBM mixed with xHyAand subsequently covered with natural collagen membrane (group B). Clinical evaluations were made at baseline (Tl), immediately after guided bone regeneration (T2), and at the time of implant placement (T3). Additionally, at the time of implant placement, core biopsies were retrieved and submitted for histologic analysis. Results: Healing was uneventful in all cases. At 6months, group B revealed a statistically significantly higher crestal ridge dimension compared to group A (P =.007). The histologic analysis revealed a tendency for greater mineralized tissue formation in group B compared to group A (67.5% versus 41.6%) and contained a higher amount of new bone (37.2%) and less DBBM residues (20.9%) than group A (12.8% new bone and 28.8% DBBM residues, respectively). Conclusions: Within their limits, the present data indicate that, during guided bone regeneration with natural collagen membrane, the combination of DBBM and xHyA may improve the qualityand quantityof boneformed with DBBM alone. [ABSTRACT FROM AUTHOR]

Implant-based rehabilitation is a clinical challenge, especially in the esthetic area. Numerous factors influence the outcome of the rehabilitation; however, the two main factors are the bone and soft-tissue deficiencies at the intended implant site. Peri-implant soft tissue complications can arise from a combination of factors that can be summarized as two categories: diagnostic errors and surgical planning management errors. Most of the complications can be corrected after each step of the treatment and even after the delivery of the prosthetic restoration with adequate soft tissue management in order to give the patient an esthetically pleasing outcome. The aims of this article were: to present the current literature, to propose a clinical checklist to guide clinicians in evaluating the prognosis of the treatment utilizing soft tissue grafting, and to illustrate a case series partially employing the proposed clinical checklist. The proposed checklist could be helpful in evaluating the prognosis of the treatment utilizing only soft tissue grafting. In clinical cases in which the prognosis is classified as good, soft tissue management could be a viable treatment option before attempting more radical procedures like implant removal. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The objectives of this study were to determine the quantitative changes after different ridge preservation techniques (primary aim) and to assess the possibility of placing a dental implant, the bone quality, and the need for bone augmentation (secondary aim). A total of 35 patients who required extraction of at least one tooth (incisor, canine, or premolar) provided 35 single-gap extraction sites. After minimally invasive tooth removal, the sockets were randomly scheduled for one of four treatment modalities: placement of a deproteinized bovine bone mineral (DBBM; Endobon, Biomet 3i) covered with a soft tissue punch from the palate (T1); placement of DBBM alone (T2); placement of DBBM covered with a resorbable collagen membrane (OsseoGuard, Biomet 3i) (T3); or no additional treatment (T4). Silicone impressions were taken before and 6 months after extraction for quantitative-volumetric evaluation (primary outcome). The possibility of placing an implant, bone quality, and need for further bone augmentation were also noted (secondary outcomes). During the study period, no adverse events were observed. No statistically significant difference was found between the four treatments regarding the primary and secondary outcome parameters (P > .05). However, T4 showed double the buccal contour change, with the highest variance compared to the other three groups (T1 –0.874 ± 0.713; T2 –0.968 ± 0.344; T3 –1.26 ± 0.942; T4 –2.15 ± 1.349). Although no statistically significant difference was found between the four treatment modalities, placement of DBBM resulted in only half the contour change (< 1 mm) compared to control sites (> 2 mm). Ridge preservation with a DBBM with or without soft tissue punch should be considered in esthetically demanding cases and delayed or late implant placement. [ABSTRACT FROM AUTHOR]

Copyright of Parodontologie: die Zeitschrift für die Praxis (Berlin, Germany) is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To evaluate the relationship between gingival phenotype and tooth location based on selected index teeth ("Ramfjord") and assess possible differences between women and men. Material and Methods: Thirty‐six women and 20 men voluntarily participated in this investigation with an average age of 23 years (min: 19; max: 37). Gingival phenotypes (GP) were assessed by transparency of a periodontal probe through the buccal gingival margin. Results: A comparable and similar GP on all index teeth was only found in seven out of the 56 subjects, that is, thin or thick only: Five participants (three male/two female) showed a uniform and constantly thick and two females a constantly thin GP. While the majority of molars (94.6%; p = 0.006) showed a thick GP, premolars (61.6%; p = 0.09) as well as incisors (70.5%; p = 0.046) were predominantly categorized as thin. In addition, significantly thicker GP was in general observed for maxillary teeth (p = 0.001) but without differences between genders (p = 0.722). Conclusion: No constant GP can be expected within one dentition. The use of the "Ramfjord teeth" may serve as a quick overview and reliable method to screen GP distribution. [ABSTRACT FROM AUTHOR]

Objective: To present the application of two different soft tissue grafts around dental implants during stage-two surgery. Furthermore, the ultrastructure of these materials is shown and discussed using scanning electron microscopy (SEM). Summary: Although soft tissue autografts may be currently regarded as the gold standard, harvesting of these grafts might lead to higher morbidity, longer chair time, and intra-/postoperative complications at the donor site. New developments in collagen scaffolds have provided an alternative to successfully replace autologous grafts in clinical practice. The SEM pictures clearly show the different composition of a bilayer scaffold (collagen matrix, CM) and a porcine acellular dermal matrix (ADM). These distinctive properties lead to different possible indications. Within the presented cases, ADM was used to augment the ridge contour and was placed into a buccal pouch to achieve complete coverage and an uneventful closed healing. On the other side, CM was left exposed to the oral cavity to successfully gain keratinized mucosa around and between two dental implants. [ABSTRACT FROM AUTHOR]

Objective: To study the clinical applicability of porcine dermal matrix for treatment of recession type defects. Method and Materials: Twenty-eight gingival recessions in six patients were selected for root coverage procedures using a modified tunneling technique and porcine dermal matrix. As primary outcome, depth and width of gingival recession were assessed at baseline and at 6 and 12 months postoperatively. As a secondary outcome, the width of keratinized tissue was studied. Results: At 6 and 12 months postoperatively, mean root coverage was 65.52% and 56.82%, respectively. Complete root coverage was achieved in 42.86% of the treated defects.Conclusion: Porcine dermal matrix may potentially be used as a replacement material for autologous tissue. However, complete root coverage was only achieved in less than half of the studied defects. [ABSTRACT FROM AUTHOR]

The necessity of surgical root coverage is often encountered in daily clinical practice, mainly because of esthetic reasons. Despite the variety of available surgical techniques, delicate clinical scenarios may require refined surgical therapy approaches. The presented double sliding flap technique is designed to meet the special requirements encountered in the often-fragile incisal mandibular area. This surgical approach combines two laterally repositioned flaps with the dissection of the frenulum, to cover two deep neighboring recessions in the area of the central incisors. Providing that correct indication and adequate surgical tissue handling are used, this complex and advanced technique may have the potential to achieve complete longterm root coverage and an esthetically satisfying treatment outcome. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the relationship between gingival biotypes and gingival thickness based on probe transparency through the gingival margin and to assess the sensitivity of a novel classification method. Material and methods: Sixty adult Caucasian subjects were stratified by their gingival biotype (GB) as defined by the transparency of a prototype double-ended periodontal probe through the buccal gingival margin into 'thin' (30 subjects), 'moderate' (15 subjects), and 'thick' (15 subjects) GB. Three additional parameters were also assessed: gingival thickness (GT), probing depth (PD), and gingival width (GW). Results: Median GT was 0.43 mm ( P 0.32; P 0.58) for thin, 0.74 mm ( P 0.58; P 0.81) for moderate, and 0.83 mm ( P 0.74; P 0.95) for thick GB, respectively. GT was statistically significant different for thin versus moderate and thin versus thick, respectively (Kruskal-Wallis test, p < 0.05; Dunn's test, thin versus moderate: p = 0.002; thin versus thick: p < 0.001; moderate versus thick: p = 0.089). GW was directly correlated with GT (Spearman correlation p < 0.01). The sensitivity of the new classification tool for diagnosing a thin GB was 91.3%. No adverse events or complications were reported. Conclusion: GT differs significantly between the presented GB groups, hence, an alternative classification especially focusing on thin biotypes based on a modified periodontal probe might be advantageous. In addition, the presence of a thick gingiva is associated with a wide band of keratinized tissue. Clinical relevance: This clinical setting might to be useful to identify high-risk patients with a very thin biotype and, consequently, higher risk for gingival recession after dental treatments. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study were to determine the quality of life of periodontally compromised patients after implant treatment (primary aim) and their satisfaction with the restoration and treatment approach (secondary aim)., Material and Methods: In this study, 61 adult subjects were evaluated following non-surgical periodontal treatment, under regular maintenance and implant therapy with a fixed restoration. Oral health-related quality of life (OHQoL) was assessed using the German short form of the Oral Health Impact Profile (OHIP-G14). Patient satisfaction with the restoration and treatment procedure was investigated applying a self-designed questionnaire focusing on social-psychological aspects. Statistical analysis of the collected data was performed using Kruskal-Wallis and Man-Whitney U test for the relationship between OHIP score and number of implants, patient age and level of education., Results: The average OHIP-G14 score of the examined study population was 2.78 (SD ±4.2), while the item pain had the biggest influence on the number of points. No statistical significance was detected between the relationship of OHIP-G14 score and the number of placed implants (p = 0.98). Furthermore, there was no statistically significant correlation between OHIP-G14 score and patient age (p = 0.67) or for level of education (p = 0.39). The questionnaire focusing on patient satisfaction showed a high level of contentment in this study population. All patients declared that they would repeat the treatment and most (98.4%) would recommend it to their friends. Furthermore, a high level of satisfaction with aesthetics, stability, cleanability and speech comprehension was reported., Conclusion: The examined study population showed a quality of life after implant therapy comparable to pre-existing reference values of a healthy non-restored population. There was no statistical significance between OHIP-G 14 score and the number of implants, patients' age and education level. Analysis of the satisfaction with the realized implant therapy provided consistently positive results., Clinical Relevance: When restoring periodontally compromised patients, implant treatment should be considered to achieve potentially higher oral health-related quality of life compared to for example removable dentures. This needs to be investigated in randomized controlled clinical trials.