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Ding Y, Zhu Z, Zhang X, Wang J. Novel Functional Dressing Materials for Intraoral Wound Care. Adv Healthc Mater 2024:e2400912. [PMID: 38716872 DOI: 10.1002/adhm.202400912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/05/2024] [Indexed: 05/22/2024]
Abstract
Intraoral wounds represent a particularly challenging category of mucosal and hard tissue injuries, characterized by the unique structures, complex environment, and distinctive healing processes within the oral cavity. They have a common occurrence yet frequently inflict significant inconvenience and pain on patients, causing a serious decline in the quality of life. A variety of novel functional dressings specifically designed for the moist and dynamic oral environment have been developed and realized accelerated and improved wound healing. Thoroughly analyzing and summarizing these materials is of paramount importance in enhancing the understanding and proficiently managing intraoral wounds. In this review, the particular processes and unique characteristics of intraoral wound healing are firstly described. Up-to-date knowledge of various forms, properties, and applications of existing products are then intensively discussed, which are categorized into animal products, plant extracts, natural polymers, and synthetic products. To conclude, this review presents a comprehensive framework of currently available functional intraoral wound dressings, with an aim to provoke inspiration of future studies to design more convenient and versatile materials.
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Affiliation(s)
- Yutang Ding
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Zhou Zhu
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xin Zhang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jian Wang
- State Key Laboratory of Oral Diseases, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
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2
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Halim FC, Sulijaya B. Allogenic Acellular Dermal Matrix and Xenogeneic Dermal Matrix as Connective Tissue Graft Substitutes for Long-Term Stability Gingival Recession Therapy: A Systematic Review and Meta-Analysis. Eur J Dent 2024; 18:430-440. [PMID: 37848072 PMCID: PMC11132762 DOI: 10.1055/s-0043-1772778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Connective tissue graft (CTG) serves as a gold standard for gingival recession therapy. Yet the availability of CTG is limited, and it increases patient morbidity. Allogenic acellular dermal matrix (AADM) and xenogeneic dermal matrix (XDM) have been proven to be effective substitutes of CTG although the long-term stability is unclear. The aim of this study was to analyze the long-term stability outcome of gingival recession therapy using AADM and XDM compared to CTG. This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted independently from several online databases (PubMed, Scopus, and Embase). Five of 233 publications were included for final qualitative analysis and meta-analysis focusing on the mean difference of clinical parameters such as recession depth (RD), recession width (RW), probing depth (PD), clinical attachment loss (CAL), tissue thickness (TT), keratinized tissue width (KTW), and mean root coverage (MRC). Meta-analyses of RD, RW, CAL, TT, KTW, and MRC display an overall mean of 0.2 mm (95% confidence interval [CI]: -0.45 to -0.05), 0.29 mm (95% CI: -0.65 to 0.08), 0.2 mm (95% CI: -0.69 to 0.29), 0.25 mm (95% CI: -0.53 to 0.03), 0.26 mm (95% CI: -0.5 to 0.02), and 9.19% (95% CI: -13.95 to -4.43]), respectively, favoring the CTG. PD was the only parameter that favored the AADM or XDM with an overall mean of 0.03 mm (95% CI: -0.05 to 0.11). In all, if the long-term stability is the goal, the CTG is considered superior for gingival recession therapy. However, if it is contraindicated, the AADM and XDM might be considered as alternatives.
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Affiliation(s)
- Felita Clarissa Halim
- Periodontology Specialist Program, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Benso Sulijaya
- Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
- Dental Division, Universitas Indonesia Hospital, Depok, West Java, Indonesia
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3
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Zegarra-Caceres L, Orellano-Merluzzi A, Muniz FWMG, de Souza SLS, Faveri M, Meza-Mauricio J. Xenogeneic collagen matrix vs. connective tissue graft for the treatment of multiple gingival recession: a systematic review and meta-analysis. Odontology 2024; 112:317-340. [PMID: 37898589 DOI: 10.1007/s10266-023-00863-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/03/2023] [Indexed: 10/30/2023]
Abstract
The aim of this systematic review (SR) compared the effect of xenogeneic collagen matrix (XCM) vs. connective tissue graft (CTG) for the treatment of multiple gingival recession (MGR) Miller Class I and II or Cairo type I. Five databases were searched up to August 2022 for randomized clinical trials (RCTs) comparing the clinical effects of XCM vs. CTG in the treatment of MGR. The random effects model of mean differences was used to determine reduction of gingival recession (GR), gain in keratinized tissue width (KTW), gain in gingival thickness (GT) and gain in clinical attachment level (CAL). The risk ratio was used to complete root coverage (CRC) at 6 and 12 months. 10 RCTs, representing 1095 and 649 GR at 6 and 12 months, respectively, were included in this SR. The meta-analysis showed no statistically significant difference in GR reduction, KTW gain GT gain or CAL gain between groups at 6 months. However, at 12 months of follow-up, differences favoring the control group were observed (p < 0.05). CRC was significantly higher in the CTG group at 6 and 12 months. Regarding dentine hypersensitivity (DH), no statistically significant differences were found between groups at 6 and 12 months of follow-up (p < 0.05). At 12 months, CTG showed significantly superior clinical results in the treatment of MGR: however, this difference was not observed in the decrease of DH.
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Affiliation(s)
- Lorena Zegarra-Caceres
- School of dentistry Universidad Cientifica del Sur Lima, Calle Cantuarias 398, Miraflores, Lima, 15048, Peru
| | - Ariana Orellano-Merluzzi
- School of dentistry Universidad Cientifica del Sur Lima, Calle Cantuarias 398, Miraflores, Lima, 15048, Peru
| | | | - Sérgio Luis Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Marcelo Faveri
- Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos, Guarulhos, SP, Brazil
| | - Jonathan Meza-Mauricio
- School of dentistry Universidad Cientifica del Sur Lima, Calle Cantuarias 398, Miraflores, Lima, 15048, Peru.
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Balice G, Paolantonio M, Serroni M, De Ninis P, Rexhepi I, Frisone A, Di Gregorio S, Romano L, Sinjari B, Murmura G, Femminella B. 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. Dent J (Basel) 2024; 12:86. [PMID: 38667998 PMCID: PMC11049079 DOI: 10.3390/dj12040086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/27/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024] Open
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 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.
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Affiliation(s)
- Giuseppe Balice
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Michele Paolantonio
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Paolo De Ninis
- “Luisa D’Annunzio” Institute for High Culture, Pescara, Italy;
| | - Imena Rexhepi
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Alessio Frisone
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Stefania Di Gregorio
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Luigi Romano
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Bruna Sinjari
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Giovanna Murmura
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
| | - Beatrice Femminella
- Department of Innovative Technologies in Medicine and Dentistry, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy; (G.B.); (M.S.); (I.R.); (A.F.); (S.D.G.); (L.R.); (B.S.); (G.M.); (B.F.)
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Rotundo R, Pancrazi GL, Grassi A, Ceresoli L, Di Domenico GL, Bonafede V. Soft Tissue Substitutes in Periodontal and Peri-Implant Soft Tissue Augmentation: A Systematic Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1221. [PMID: 38473691 DOI: 10.3390/ma17051221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/27/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Different extracellular matrix (ECM)-based technologies in periodontal and peri-implant soft tissue augmentation have been proposed in the market. The present review compared the efficacy of soft tissue substitutes (STSs) and autogenous free gingival grafts (FGGs) or connective tissue grafts (CTGs) in mucogingival procedures to increase keratinized tissue (KT) width around teeth and implants. METHODS Two independent examiners performed an electronic search on MEDLINE and the Cochrane Library based on the following PICOS format: (P) adult patients; (I) soft tissue substitutes and FGGs/CTGs; (C) STSs vs. CTGs; STSs vs. FGGs; STSs vs control; (O) KT width gain; (S) systematic reviews, randomized controlled trials. Studies published before November 2023 were included. RESULTS Around teeth, all biomaterials showed superior performance compared to a coronally advanced flap (CAF) alone for treating gingival recessions. However, when compared to CTGs, acellular dermal matrices (ADMs) yield the most similar outcomes to the gold standard (CTGs), even though in multiple recessions, CTGs continue to be considered the most favorable approach. The use of STSs (acellular matrix or tissue-engineered) in combination with apically positioned flaps (APF) resulted in significantly less gain in KT width compared to that achieved with FGGs and APFs. Around dental implants, free gingival grafts were deemed more effective than soft tissue substitutes in enhancing keratinized mucosa width. CONCLUSIONS Based on the available evidence, questions remain about the alternative use of soft tissue substitutes for conventional grafting procedures using free gingival grafts or connective tissue grafts around teeth and implants.
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Affiliation(s)
- Roberto Rotundo
- Periodontology Unit, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, Italy
| | - Gian Luca Pancrazi
- Oral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, Italy
| | - Alessia Grassi
- Oral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, Italy
| | - Lara Ceresoli
- Oral Surgery, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, Italy
| | | | - Vanessa Bonafede
- Periodontology Unit, University Vita-Salute and IRCCS San Raffaele, 20132 Milan, Italy
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Barakat SO, Tawfik OK, Kholy SE, ElNahass H. Evaluation of advanced platelet-rich fibrin compared to subepithelial connective tissue graft in the surgical management of interdental papilla recession: a randomized controlled trial. Clin Oral Investig 2024; 28:87. [PMID: 38206354 DOI: 10.1007/s00784-023-05486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES The current study aims to compare advanced-platelet-rich fibrin membrane (A-PRF) to connective tissue graft (CTG) using Han and Takei's approach. MATERIALS AND METHODS The defective papilla was randomly allocated to either the control group (CTG) or to the experimental group (A-PRF). Papilla height (PH) and percent change in the gingival black triangle (GBT) area were recorded at 1, 3, 6, 9, and 12 months. RESULTS Thirty-two deficient IDPs with an initial papilla presence index (PPI) of 2 or 3 were included. At 12 months, the papilla-fill significantly increased in both groups (p < 0.001) without a significant difference between the study groups (p = 0.637). A mean gain in IDP height of 2.25 mm (± 0.97) in the CTG group and 1.86 mm (± 0.7) in the A-PRF group were recorded with a nonsignificant difference. Gingival black triangle fill showed a 57.98% fill in the CTG and 54.65% fill in the A-PRF group, with no statistically significant difference between the groups (0.956). Regarding postoperative pain patients, the CTG group consumed significantly more analgesics than the A-PRF group (11.75 ± 3.51 and 8 ± 3.08, respectively, with p = 0.003). CONCLUSION Both CTG and A-PRF were found to be equally effective in increasing deficient IDP height with Han and Takei's surgical technique, with no significant difference. Within the current study's limitations, A-PRF seems to be a viable alternative to CTG in the treatment of GBTs. CLINICAL RELEVANCE Multilayered A-PRF membrane can be used as a choice in the augmentation of receded papillae, using Han and Takei's technique.
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Affiliation(s)
| | - Omnia K Tawfik
- Oral Medicine and Periodontology, Cairo University, Cairo, Egypt
| | - Samar El Kholy
- Oral Medicine and Periodontology, Cairo University, Cairo, Egypt
| | - Hani ElNahass
- Oral Medicine and Periodontology, Cairo University, Cairo, Egypt.
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Montagner AF, Angst PDM, Raggio DP, VAN DE Sande FH, Tedesco TK. Methodological quality of network meta-analysis in dentistry: a meta-research. Braz Oral Res 2023; 37:e062. [PMID: 37436290 DOI: 10.1590/1807-3107bor-2023.vol37.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/27/2023] [Indexed: 07/13/2023] Open
Abstract
This meta-research aimed to provide an overview of the methodological quality and risk of bias of network meta-analyses (NMA) in dentistry. Searches for NMA of randomized clinical trials with clinical outcomes in dentistry were performed in databases up to January 2022. Two reviewers independently screened titles/abstracts, selected full texts, and extracted the data. The adherence to PRISMA-NMA reporting guideline, the AMSTAR-2 methodological quality tool, and the ROBIS risk of bias tool were assessed in the studies. Correlation between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results was also investigated. Sixty-two NMA studies were included and presented varied methodological quality. According to AMSTAR-2, half of the NMA presented moderate quality (n = 32; 51.6%). The adherence to PRISMA-NMA also varied. Only 36 studies (58.1%) prospectively registered the protocol. Other issues lacking of reporting were data related were data related to the NMA geometry and the assessment of results consistency, and the evaluation of risk of bias across the studies. ROBIS assessment showed a high risk of bias mainly for domains 1 (study eligibility criteria) and 2 (identification and selection of studies). Correlation coefficients between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results showed moderate correlation (rho < 0.6). Overall, NMA studies in dentistry were of moderate quality and at high risk of bias in several domains, especially study selection. Future reviews should be better planned and conducted and have higher compliance with reporting and quality assessment tools.
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Affiliation(s)
| | | | | | | | - Tamara Kerber Tedesco
- Univesidade Cruzeiro do Sul - Unicsul, Graduate Program in Dentistry, São Paulo, SP, Brazil
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Abu-Ta'a M, Adler JR. Advanced Platelet-Rich Fibrin and Connective Tissue Graft for Treating Marginal Tissue Recessions: A Randomized, Controlled Split-Mouth Study. Cureus 2023; 15:e35761. [PMID: 36879584 PMCID: PMC9985511 DOI: 10.7759/cureus.35761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2023] [Indexed: 03/07/2023] Open
Abstract
OBJECTIVES This study aimed to evaluate and compare the clinical outcomes of advanced platelet-rich fibrin (A-PRF) and connective tissue graft (CTG) in treating marginal tissue recessions. MATERIALS & METHODS Fifteen patients with isolated bilateral maxillary gingival recessions were recruited for the study, with 30 defects. The defects were classified as Miller's class I/II gingival recession on the canine or premolar region. Patients were randomly divided into two groups, each receiving one of the two treatment techniques (A-PRF or CTG) on a different side of the maxilla in a split-mouth design. Clinical parameters such as recession height (RH), recession width (RW), probing pocket depth (PPD), clinical attachment level (CAL), a width of attached gingiva (WAG), and keratinized tissue height (KTH) were evaluated at baseline, 3, and 6 months. Changes in biotype, Recession Esthetic Score (RES), and Visual Analogue Score-Esthetics (VAS-E) were also evaluated at 6 months. TRIAL REGISTRATION Ethics approval number (Helsinki): PHRC/HC/877/21 and registered at the Clinical Trials Registry under the number NCT05267015 Results: At the end of 6 months, there was a statistically significant reduction in RH and RW in both groups, with the mean RC% of 69.2±22.91, and 88.66±33.18 in Groups I and II, respectively. Intergroup analysis showed statistically significant differences in recession parameters between groups at 3 and 6 months, with better outcomes for the CTG group. CONCLUSIONS This study demonstrates that A-PRF and CTG effectively manage gingival recession defects. However, CTG resulted in better clinical outcomes in terms of reduction in recession height and width.
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Affiliation(s)
| | - John R Adler
- Dentistry, Arab American University, Ramallah, PSE
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Michels R, Magrin GL, Cruz ACC, Magini RS, Benfatti CAM. Functionalization of a Volume-Stable Collagen Matrix Using Liquid Platelet-Rich Fibrin: A Case Report Presenting a New Approach for Root Coverage. Case Rep Dent 2023; 2023:3929269. [PMID: 37006702 PMCID: PMC10060066 DOI: 10.1155/2023/3929269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 01/29/2023] [Accepted: 02/04/2023] [Indexed: 04/04/2023] Open
Abstract
This case report presents a novel approach for root coverage of multiple gingival recessions with a volume-stable collagen matrix functionalized with injectable platelet-rich fibrin (i-PRF). A patient with multiple gingival recessions in the anterior maxilla was submitted to root coverage by coronally advanced flap with split-full-split incisions. Blood collection was performed before surgery and i-PRF was obtained after centrifugation (relative centrifugal force (RCF) 400 g, 2700 rpm, 3 minutes). A volume-stable collagen matrix was soaked with i-PRF and applied as a substitute for autogenous connective tissue graft. A mean root coverage of 83% was observed after a 12-month follow-up period, and only slight modifications were detected in a 30-month follow-up consultation. The association of a volume-stable collagen matrix with i-PRF successfully treated multiple gingival recessions with reduced morbidity since a connective tissue collection was avoided.
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Affiliation(s)
- Roberta Michels
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Gabriel Leonardo Magrin
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - ACC Cruz
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - RS Magini
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Cesar Augusto Magalhães Benfatti
- Center for Education and Research on Dental Implants (CEPID), Post-Graduate Program in Dentistry (PPGO), Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
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10
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Velloso G, Zimmermann D, Shibli JA, Dias AT, Moraschini V. A multifunctional guided surgery to assist in the 3-dimensional positioning of dental implants and in obtaining a palatal gingival graft. J Prosthet Dent 2023; 129:29-33. [PMID: 33933268 DOI: 10.1016/j.prosdent.2021.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/12/2021] [Accepted: 03/12/2021] [Indexed: 01/18/2023]
Abstract
Parameters such as the correct 3-dimensional positioning and the quality of peri-implant soft tissues are fundamental to the success of implant-supported restorations. Digital planning and guided surgery techniques can make the implant placement more accurate, and modifying the periodontal phenotype is often fundamental to increasing esthetics and peri-implant health, mainly in esthetic areas. This article describes a guided surgery technique that assists in the 3-dimensional positioning of implants and identifies the best anatomic area (volume and safety) for obtaining a palatal gingival graft.
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Affiliation(s)
- Glauco Velloso
- Professor, Department of Implantology, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Diego Zimmermann
- Graduate student, Department of Implantology, School of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Jamil Awad Shibli
- Professor, Department of Periodontology and Oral Implantology, Dental Research Division, University of Guarulhos (UNG), São Paulo, Brazil
| | - Alexandra Tavares Dias
- Professor, Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil
| | - Vittorio Moraschini
- Professor, Department of Periodontology, Dental Research Division, School of Dentistry, Veiga de Almeida University (UVA), Rio de Janeiro, Brazil.
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11
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Lahham C, Ta'a MA. Clinical comparison between different surgical techniques used to manage advanced gingival recession (Miller's class III & IV). Heliyon 2022; 8:e10132. [PMID: 36033300 PMCID: PMC9404267 DOI: 10.1016/j.heliyon.2022.e10132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/07/2022] [Accepted: 07/27/2022] [Indexed: 11/07/2022] Open
Abstract
Advanced gingival recession is considered a complex soft tissue problem, which is increased in severity with age, and has multiple etiological factors. Therefore, the treatment is very complicated with low predictability. However, in the last decade, many clinical trials have shown highly predictable results when managing advanced recession cases by surgical intervention. The present review shows different surgical techniques with their clinical outcomes in order to choose the most suitable technique required by the clinical condition. Although there are relatively few studies, modified tunnel technique and coronal advanced flap (CAF) showed the highest percentage of root coverage (%RC) during the first year (up to 86%). These techniques are primarily indicated to manage advanced recession in the esthetic zone. Pedicle buccal fat pad (PBFP) also had a good percentage of root coverage when used in the maxillary posterior area, as it has a high blood supply with minimal risk for infection and necrosis. Free gingival graft (FGG) can be used in the mandibular anterior area, as it creates a band of keratinized tissue that can resist recession with a fair percentage of root coverage. However, color match and graft shrinkage are the main problems of this procedure.
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Affiliation(s)
- Cezar Lahham
- Dental Science Department, Faculty of Graduate Studies, Arab American University, Palestine
| | - Mahmoud Abu Ta'a
- Dental Science Department, Faculty of Graduate Studies, Arab American University, Palestine
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12
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Zeng A, Li H, Liu J, Wu M. The Progress of Decellularized Scaffold in Stomatology. Tissue Eng Regen Med 2022; 19:451-461. [PMID: 35320505 PMCID: PMC9130370 DOI: 10.1007/s13770-022-00432-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 10/18/2022] Open
Abstract
The oral and maxillofacial region contains oral organs and facial soft tissues. Due to the complexity of the structures and functions of this region, the repair of related defects is complicated. Different degrees of defects require different repair methods, which involve a great combination of medicine and art, and the material requirements are extremely high. Hence, clinicians are plagued by contemporary oral repair materials due to the limitations of bone harvesting, immune rejection, low osteogenic activity and other problems. Decellularized extracellular matrix has attracted much attention as a bioactive scaffold material because of its nonimmunogenic properties, good osteogenic properties, slow release of growth factors, promotion of seed cell adhesion and maintenance of stem cell characteristics. This article reviews the sources, preparation methods, application and research progress of extracellular matrix materials in the repair of oral and maxillofacial defects to provide an overview for fundamental research and clinical development.
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Affiliation(s)
- Ailin Zeng
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China
| | - Huiru Li
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China
| | - Jianguo Liu
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China.
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China.
| | - Mingsong Wu
- School of Stomatology, Zunyi Medical University, No. 6 West Xuefu Road, Xinpu District, Zunyi, 563006, Guizhou, China.
- Special Key Laboratory of Oral Disease Research of Higher Education Institution of Guizhou Province, Zunyi Medical University, Zunyi, Guizhou, China.
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13
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Panda S, Khijmatgar S, Arbildo-Vega H, Das AC, Kumar M, Das M, Mancini L, Del Fabbro M. Stability of biomaterials used in adjunct to coronally advanced flap: A systematic review and network meta-analysis. Clin Exp Dent Res 2021; 8:421-438. [PMID: 34845864 PMCID: PMC8874057 DOI: 10.1002/cre2.461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/23/2021] [Accepted: 05/05/2021] [Indexed: 12/26/2022] Open
Abstract
AIM The objective of this network meta-analysis was to rank different biomaterials used in adjunct to coronally advanced flap (CAF), based on their performance in root-coverage for Miller's Class I and II gingival recessions. MATERIALS AND METHODS An electronic database search was carried out in PUBMED, CENTRAL, SCOPUS, and EMBASE to identify the eligible articles and compiled into the citation manager to remove the duplicates. The primary outcome was keratinized gingival tissue width (KGW) and percentage of root coverage (%RC). The treatment effect of different biomaterials was estimated using predictive interval plots and ranked based on biomaterials performance, using multidimensional scale ranking. RESULTS CAF + connective tissue graft (CTG), CAF + platelet concentrate matrix (PCM) and acellular dermal matrix (ADM) ranked at the top positions in performance in improving KGW. The highest ranked materials in improving percentage of root coverage in gingival recession were CAF + collagen matrix (CM) + gingival fibroblasts (GF), CAF + ADM + platelet rich plasma (PRP) and CAF + ADM, as compared to CAF alone. CONCLUSION CTG, ADM, platelet concentrates, and CM + GFs, when used in adjunct to CAF, showed improved stability over ≥12 months of follow-up, better percentage of root coverage, and improved keratinized gingival width.
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Affiliation(s)
- Sourav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Department of Oral Biology and Genomic Studies, Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, Mangalore, India
| | - Heber Arbildo-Vega
- Department of General Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo, Peru
| | - Abhaya Chandra Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Manoj Kumar
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Mohit Das
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha O Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, India
| | - Leonardo Mancini
- Department of life health and environmental sciences, University of L'Aquila, Italy
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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14
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Cosgarea R, Kantarci A, Stavropoulos A, Arweiler N, Sculean A. Soft Tissue Regeneration at Natural Teeth. Dent Clin North Am 2021; 66:87-101. [PMID: 34794556 DOI: 10.1016/j.cden.2021.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This article provides an overview of the best-documented surgical techniques for recession coverage and draws conclusions for the clinician. Use of a connective tissue graft with either coronally advanced flap (CAF) or tunnel is the most predictable technique for the treatment of single and multiple gingival recessions. Long-term results exist only for CAF with/without connective tissue graft providing evidence for long-term stability with only minor relapses. Soft tissue replacement materials and biologics may represent a valuable modality to additionally improve the clinical outcomes obtained with CAF alone or, in certain clinical situations, to serve as an alternative to autogenous tissue.
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Affiliation(s)
- Raluca Cosgarea
- Department of Periodontology, Operative and Preventive Dentistry, University of Welschnonnenstr. 17, 53125 Bonn, Bonn, Germany; Department of Periodontology and Peri-Implant Diseases, Philipps University of Marburg, Georg-Voigt. Str. 3, Marburg 35039, Germany; Department of Prosthetic Dentistry, University Iuliu Hatieganu Cluj-Napoca, Str. Clinicilor nr 32, Cluj-Napoca 400056, Romania
| | | | - Andreas Stavropoulos
- Department of Periodontology, University of Malmö, Carl Gustafs väg 34, 214 21 Malmö, Sweden
| | - Nicole Arweiler
- Department of Periodontology and Peri-Implant Diseases, Philipps University of Marburg, Georg-Voigt. Str. 3, Marburg 35039, Germany
| | - Anton Sculean
- Department of Periodontology, University of Bern, Freiburgstrasse, 7, Bern CH-3010, Switzerland.
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15
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Samson DJ, Gachabayov M, Latifi R. Biologic Mesh in Surgery: A Comprehensive Review and Meta-Analysis of Selected Outcomes in 51 Studies and 6079 Patients. World J Surg 2021; 45:3524-3540. [PMID: 33416939 DOI: 10.1007/s00268-020-05887-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND In recent decades, biologic mesh (BM) has become an important adjunct to surgical practice. Recent evidence-based clinical applications of BM include but are not limited to: reconstruction of abdominal wall defects; breast reconstruction; face, head and neck surgery; periodontal surgery; other hernia repairs (diaphragmatic, hiatal/paraesophageal, inguinal and perineal); hand surgery; and shoulder arthroplasty. Prior systematic reviews of BM in complex abdominal wall hernia repair had several shortcomings that our comprehensive review seeks to address, including exclusion of laparoscopic repair, assessment of risk of bias, use of an acceptable meta-analytic method and review of risk factors identified in multivariable regression analyses. MATERIALS AND METHODS We sought articles of BM for open ventral hernia repair reporting on early complications, late complications or recurrences and included minimum of 50. We used the quality in prognostic studies risk of bias assessment tool. Random effects meta-analysis was applied. RESULTS This comprehensive review selected 62 articles from 51 studies that included 6,079 patients. Meta-analytic pooling found that early complications are present in about 50%, surgical site occurrences (SSOs) in 37%, surgical site infections (SSIs) in 18%, reoperation in 7%, readmission in 20% and mortality in 3%. Meta-analytic estimates of late outcomes included overall complications (42%), SSOs (40%) and SSIs (22%). Specific SSOs included seroma (14%), hematoma (4%), abscess (10%), necrosis (5%), dehiscence (8%) and fistula formation (5%). Reoperation occurred in about 17%, mesh explantation in 9% and recurrence in 36%. CONCLUSION Estimates of nearly all outcomes from individual studies were highly heterogeneous and sensitivity analyses and meta-regressions generally failed to explain this heterogeneity. Recurrence is the only outcome for which there are consistent findings for risk factors. Bridge placement of BM is associated with higher risk of recurrence. Prior hernia repair, history of reintervention and history of mesh removal were also risk factors for increased recurrence.
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Affiliation(s)
- David J Samson
- Department of Surgery, Westchester Medical Center, 100 Woods Road, Taylor Pavilion, Suite D-353, Valhalla, NY, 10595, USA
| | - Mahir Gachabayov
- Department of Surgery, New York Medical College, School of Medicine, Valhalla, NY, 10595, USA
| | - Rifat Latifi
- Department of Surgery, Westchester Medical Center, 100 Woods Road, Taylor Pavilion, Suite D-353, Valhalla, NY, 10595, USA. .,Department of Surgery, New York Medical College, School of Medicine, Valhalla, NY, 10595, USA.
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