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P MK, Nagate RR, Chaturvedi S, Al-Ahmari MMM, Al-Qarni MA, Gokhale ST, Ahmed AR, Bariqi AA, Cicciù M, Minervini G. Importance of periodontal phenotype in periodontics and restorative dentistry: a systematic review. BMC Oral Health 2024; 24:41. [PMID: 38191372 PMCID: PMC10773067 DOI: 10.1186/s12903-023-03777-3] [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: 09/28/2023] [Accepted: 12/14/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Periodontal phenotype is regarded to be one of the key factors influencing the efficacy of restorative therapies in dental practice. The objective of the systematic review was to explore the importance of thin and thick periodontal phenotypes and how they affect the outcome of periodontal and restorative therapies by looking at a number of academic publications from various online databases. METHODS Following the PRISMA guidelines (Preferred Reporting Items for Systematic Review standards), relevant data will be searched and retrieved from three significant scientific databases, including PubMed, EBSCO, and Scopus. The articles with full texts that matched the keywords and published in English between 2018 and 2023 were taken into consideration. RESULTS The majorities of these articles were based on the type of periodontal phenotype and their impact on periodontal and restorative treatment outcomes were selected. The initial search yielded a total of 530 articles. Only 273 were relevant to the review's objectives, and these were considered for determining eligibility. Only 20 publications were eligible for analysis. CONCLUSION Understanding these anatomical aspects of periodontal phenotype is crucial to both periodontology and restorative dentistry. The clinical outcome of restorative, prosthetic, orthodontic, surgical, and periodontal therapies is determined in large part by the periodontal phenotype, which also plays a significant role in clinical failure or success in dental treatments. TRIAL REGISTRATION This study protocol registered with the International Prospective Register of Systematic Reviews (PROSPERO) dated 16th June 2023 with the registration ID CRD42023432568.
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Affiliation(s)
- Mohan Kumar P
- Department of Periodontics and Implantology, Vishnu Dental College, West Godavari, Vishnupur, Bhimavaram, 534202, Andhra Pradesh, India.
| | - Raghavendra Reddy Nagate
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Saurabh Chaturvedi
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
| | - Manae Musa Musleh Al-Ahmari
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed A Al-Qarni
- Consultant in Restorative Dentistry, College of Dentistry, King Khalid University, P.O.Box 3263, Abha, 61471, Saudi Arabia
| | - Shankar T Gokhale
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Abdul Razzaq Ahmed
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Al Bariqi
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Caserta, 81100, Italy.
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Lin CY, Kuo PY, Chiu MY, Chen ZZ, Wang HL. Soft tissue phenotype modification impacts on peri-implant stability: a comparative cohort study. Clin Oral Investig 2023; 27:1089-1100. [PMID: 36048254 PMCID: PMC9433516 DOI: 10.1007/s00784-022-04697-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/21/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Soft tissue phenotype modification (STPM) could be performed to maintain peri-implant health. Therefore, the aim of the study was to analyze tissue alteration around implants following soft tissue phenotype modification during implant uncovering surgery. MATERIALS AND METHODS Patients who had STPM (either pouch roll or modified roll technique) during implant second-stage surgery with at least 12-month follow-up were included. Clinical and radiographic parameters including mucosal tissue thickness (MTT), recession (REC), keratinized mucosa width (KMW), probing pocket depth (PPD), marginal bone loss (MBL), emergence profile, and emergence angle were extracted from 2-week, 2-month, and 12-month visits after second-stage surgery. RESULTS Twenty-eight patients with 33 implants that fulfilled the inclusion criteria were included. After soft tissue phenotype modification, at 2 weeks, REC was negatively correlated to mean MTT at mid-buccal site (r = - 0.41, p = 0.018) and borderline correlated at mid-lingual site (r = - 0.343, p = 0.051). Stable KMW was maintained from 2 weeks to 12 months with minimal shrinkage rate (3 ~ 14%). MBL change was limited (0.24 ~ 0.47 mm) after STPM. All implants had shallow PPD (≤ 3 mm) with the absence of bleeding on probing. Emergence angle at the mesial side, however, was significantly correlated to surgical techniques, which indicated pouch roll technique would have 6.96 degrees more than modified roll technique (p = 0.024). CONCLUSIONS Soft tissue phenotype modification, either pouch roll or modified roll technique, during uncovering surgery resulted in favorable clinical outcomes. Thin mucosal tissue thickness and pouch roll technique are the factors related to more recession at 2 weeks. Pouch roll technique could influence the restorative design by having a wide emergence angle at the mesial side. CLINICAL RELEVANCE Modified and pouch roll techniques during uncovering surgery were viable methods to yield favorable peri-implant health, while the preciseness of pouch roll technique was required to avoid mucosal recession and inadequate restorative design.
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Affiliation(s)
- Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan. .,Chang Gung University, Taoyuan city, Taiwan.
| | - Pe-Yi Kuo
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Meng-Yao Chiu
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Zhao-Zhao Chen
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Lin CY, Kuo PY, Chiu MY, Wang HL. Depth of mucosal tunnel in peri-implant health during 12-month follow-up in patients with controlled periodontitis. J Periodontol 2023; 94:66-76. [PMID: 35661355 DOI: 10.1002/jper.21-0680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/05/2022] [Accepted: 05/24/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND The association between thickness of peri-implant mucosa, known as mucosal tunnel (MT) and related clinical parameters in bone-level implants has not been investigated. METHODS Posterior implants, in patients with controlled periodontitis, were evaluated at different time intervals: during uncovering surgery (T0 ), 2-month after uncovering surgery (T2M ) and 12-month after placement (T12M ). Clinical parameters including vertical soft tissue height (VSTH), MT, tooth-implant discrepancy of bone level (DBL), pocket depth (PD), peri-implant marginal bone loss (MBL), emergence profile and emergence angle (EA) were collected, and the correlation were assessed at different time points. RESULTS Forty-two patients with 60 implants were recruited, and 81.7% of the patients were Stage III-IV, Grade B-C generalized periodontitis. MT presented no significant difference in PD, VSTH, and MBL. Periodontitis Grade C and absence of bone regeneration were significant predictors for deep MT (>3 mm), and 5.850 less EA at mesial side of implants (p = 0.02).The regression of analysis implied the increase of DBL 1 mm would cause 0.26 mm deeper MT, 1.7 times higher risk of having deep MT (p = 0.041; OR = 1.731; 95% CI:1.02-2.93) and 2.1 times higher risk of having circumferential PD > 4 mm (p = 0.019; OR = 2.1; 95% CI:1.13-3.92). CONCLUSIONS In bone-level implants, a correlation between MT and clinical parameters at 12-month follow-up was not found. However, history of periodontitis Grade C, absence of bone regeneration and tooth-implant discrepancy of bone level might define the depth of MT. Additionally, the depth of MT played a critical role in determining restorative design.
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Affiliation(s)
- Cho-Ying Lin
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan.,Chang Gung University, Taoyuan City, Taiwan
| | - Pe-Yi Kuo
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Meng-Yao Chiu
- Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
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Saliba V, Nader N, Berberi A, Chamoun WT. Collagen Versus Xenograft Bovine Bone Inserted Into Extraction Sockets: Healing and Pain Management. J Maxillofac Oral Surg 2022; 21:1101-1111. [PMID: 36896064 PMCID: PMC9989051 DOI: 10.1007/s12663-020-01411-1] [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: 12/17/2019] [Accepted: 07/06/2020] [Indexed: 10/23/2022] Open
Abstract
Background Different materials can be used in filling the extraction socket to achieve an alveolar ridge preservation. The present study compared the wound healing potential and pain management efficacy of the collagen and the xenograft bovine bone, covered by a cellulose mesh, inserted into the socket of extracted teeth. Materials and Methods Thirteen patients were willingly chosen to enter our split-mouth study. It was a clinical trial of crossover design with a minimum of two teeth to be extracted for each patient. Randomly, one of the alveolar sockets was filled with collagen material as Collaplug®, and the second alveolar socket was filled with xenograft bovine bone substitute Bio-Oss® and covered with a cellulose mesh Surgicel®. Post-extraction follow-up was observed at day 3, 7 and 14, and each participant was told to document his/her pain experience in our prepared Numerical Rating Scale (NRS) document for 7 consecutive days. Results Clinically, the differential wound closure potential between the two groups was significant in the buccolingual (P = 0.045) but not significant in the mesiodistal (P = 0.204) mouth areas. The pain expressed as rated in the NRS was higher in the case of the Bio-Oss®, but there was no significant difference upon comparing the two procedures for 7 consecutive days (P = 0.397) except on day 5 (P = 0.004). Conclusions Collagen appears to support faster wound healing rate, higher potential influence on socket healing and decreased pain perception than xenograft bovine bone.
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Affiliation(s)
- Vincent Saliba
- Neuroscience Research Center NRC, School of Medical Sciences, Lebanese University, Beirut, Lebanon
- Prosthodontic Department, School of Dentistry, Lebanese University, Beirut, Lebanon
| | - Nabih Nader
- Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Antoine Berberi
- Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, P.O. Box 5208-116, Beirut, Lebanon
| | - Wafaa Takash Chamoun
- Neuroscience Research Center NRC, School of Medical Sciences, Lebanese University, Beirut, Lebanon
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Malpartida-Carrillo V, Tinedo-Lopez PL, Guerrero ME, Amaya-Pajares SP, Özcan M, Rösing CK. Periodontal phenotype: A review of historical and current classifications evaluating different methods and characteristics. J ESTHET RESTOR DENT 2020; 33:432-445. [PMID: 32955762 DOI: 10.1111/jerd.12661] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To review the historical and current periodontal phenotype classifications evaluating methods and characteristics. Moreover, to identify and classify the methods based on periodontal phenotype components. OVERVIEW Several gingival morphology studies have been frequently associated with different terms used causing confusion among the readers. In 2017, the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions recommended to adopt the term "periodontal phenotype". This term comprises two terms, gingival phenotype (gingival thickness and keratinized tissue width) and bone morphotype (buccal bone plate thickness). Furthermore, gingival morphology has been categorized on "thin-scalloped", "thick-scalloped" and "thick-flat" considering the periodontal biotype. However, by definition, the term phenotype is preferred over biotype. Periodontal phenotype can be evaluated through clinical or radiographic assessments and may be divided into invasive/non-invasive (for gingival thickness), static/functional (for keratinized tissue width), and bi/tridimensional (for buccal bone plate thickness) methods. CONCLUSIONS "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal biotypes were identified. These three periodontal biotypes have been considered in the World Workshop but the term periodontal phenotype is recommended. Periodontal phenotype is the combination of the gingival phenotype and the bone morphotype. There are specific methods for periodontal phenotype evaluation. CLINICAL SIGNIFICANCE The term periodontal phenotype is currently recommended for future investigations about gingival phenotype and bone morphotype. "Thin-scalloped," "thick-scalloped," and "thick-flat" periodontal phenotypes can be evaluated through specific methods for gingival thickness, keratinized tissue width, and buccal bone plate thickness evaluation.
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Affiliation(s)
| | - Pedro Luis Tinedo-Lopez
- Department of Periodontology, School of Stomatology, Universidad Privada San Juan Bautista, Lima, Peru
| | - Maria Eugenia Guerrero
- Medico Surgical Department, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Silvia P Amaya-Pajares
- Department of Restorative Dentistry, School of Dentistry, Oregon Health and Science University, Portland, OR, USA
| | - Mutlu Özcan
- Center of Dental Medicine, Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Zhang Y, Hong G, Zhang Y, Sasaki K, Wu H. Minimally invasive procedures for deficient interdental papillae: A review. J ESTHET RESTOR DENT 2020; 32:463-471. [PMID: 32519508 DOI: 10.1111/jerd.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 04/11/2020] [Accepted: 05/15/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Deficient interdental papillae cause a series of problems, including food impaction, phonetic difficulties, and esthetic concerns. The purpose of this article is to provide valid clinical recommendations for clinicians to address these problems in a predictable and less invasive way. OVERVIEW Numerous treatments are available for interdental papillae reconstruction, but most of them involve surgery and yield unpredictable outcomes. Minimally invasive treatments have the advantages of being effective, predictable, and involving only slight injury as compared to surgical treatments. We included 66 studies obtained after searching for relevant papers in PubMed and Web of Science. The etiology and classification of deficient interdental papillae are explained and minimally invasive procedures for deficient interdental papillae reconstruction are summarized. CONCLUSIONS Minimally invasive procedures are promising ways to reconstruct deficient interdental papillae, and have the advantages of slight pain and rapid recovery. It should be noticed that some of the minimally invasive treatments still require further long-term observation to confirm their efficacy. CLINICAL SIGNIFICANCE Familiarity with etiology and classification of deficient interdental papillae can help clinicians to choose the appropriate minimally invasive approach as well as help with case collection to enhance esthetics status in patients with deficient interdental papillae.
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Affiliation(s)
- Yiding Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China.,Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Guang Hong
- Division for Globalization Initiative, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Yifan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China.,Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Graduate School of Dentistry, Tohoku University, Sendai, Japan
| | - Hongkun Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hosepital of Stomatology, Sichuan University, Chengdu, Sichuan, P.R. China
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Lin G, Curtis DA, Kapila Y, Velasquez D, Kan JY, Tahir P, Avila‐Ortiz G, Kao RT. The significance of surgically modifying soft tissue phenotype around fixed dental prostheses: An American Academy of Periodontology best evidence review. J Periodontol 2019; 91:339-351. [DOI: 10.1002/jper.19-0310] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Guo‐Hao Lin
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Donald A. Curtis
- Department of Preventive and Restorative Dental Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Yvonne Kapila
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
| | - Diego Velasquez
- Graduate Periodontics Department of Periodontics & Oral Medicine School of Dentistry University of Michigan Ann Arbor MI
| | - Joseph Y.K. Kan
- Department of Restorative Dentistry School of Dentistry Loma Linda University Loma Linda CA
| | - Peggy Tahir
- University of California San Francisco Library CA
| | - Gustavo Avila‐Ortiz
- Department of Periodontics College of Dentistry University of Iowa Iowa City IA
| | - Richard T. Kao
- Department of Orofacial Sciences School of Dentistry University of California San Francisco San Francisco CA
- Private Practice Cupertino CA
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