Clinical Realities - Papilla and Free Gingival Margin Preservation in Multiple-Tooth Extraction
Alejandro James, DDS, MsD, FID; Jose L. Castellanos, DDS
Surgical Crown Lengthening in a Population With Human Immunodeficiency Virus: A Retrospective Analysis
This report investigates the outcome of CLS procedures performed at an urban dental school in a population of
individuals with HIV. Specifically, this retrospective clinical analysis evaluates the healing response after crown lengthening surgery (CLS). Of the 21 patients with HIV examined after CLS, none had postoperative complications, such as delayed healing, infection, or prolonged bleeding. Variations in viral load, CD4 cell count, smoking, platelets, and neutrophils did not impact surgical healing. In addition, variations in medication regimens
(highly active anti-retroviral therapy; on pro-tease inhibitors; no medications had an impact. The results of this retrospective analysis show the absence of postoperative complications after CLS in this population with HIV. Additional investigation into this area will help health care practitioners increase the range of surgical services provided to this group of patients.
Periodontal Photo Essay
Dr. Daniel J. Melker presents a Periodontal Photo Essay. Question: Why do we barrel in furcations?
Management of the Compromised Implant Site With Small-Diameter Implants
The use of the ANEW titanium alloy implant for the treatment of compromised tooth-tooth spaces is a viable treatment option.
Excessive Gingival Display Managed by Surgical Lip Reposition, Aesthetic Crown Lengthening and Veneers
Excessive gingival display can be managed by a variety of treatment modalities, depending on the etiology. Mild and moderate gummy smiles can be successfully treated by periodontal plastic surgery, however for excessive gingival display as in cases of VME II or III with 5 to 8 mm or more of gingival exposure this procedure is not enough. Many patients decline the more invasive Le Fort osteotomy and opt for a less invasive surgical lip repositioning procedure. Currently Botox is used as alternative, but this is only a temporary treatment with very short effectiveness. That is why we suggest surgical lip repositioning as an effective procedure to reduce gingival display by positioning the upper lip in a more coronal location. The long-term stability of the results remains to be seen, but it holds promise as an alternative treatment to more invasive procedures.
Periodontal Regeneration – State of the Art
The latest research and clinical options in periodontal regeneration.
Restoration of Optimal Esthetics in Complex Clinical Situations
Patients often neglect or delay dental care for an extended time because of their negative experiences with and fear of dental treatments. This neglect may result in the advance of periodontitis with severe bone loss, a substantial number of missing teeth, and problems with the remaining teeth. Preexisting malocclusion can aggravate this condition. This case report
demonstrates an interdisciplinary strategic approach, in combination with the use of biologically grounded, clinically proven, and viable techniques and technologies to restore optimal esthetics and function in such complex cases. The authors emphasize the importance of carefully planning the timing and sequence of performing periodontal, orthodontic, and implant therapies. The advanced techniques and technologies successfully implemented in this case report include the growth factor and titanium mesh (Ti mesh)-assisted bone augmentation; ovate pontic-mediated, noninvasive soft tissue contouring; and photofunctionalization
Tissue Engineering and Platelet Derived Growth Factors: Evidence Based Therapy
Platelet derived growth factors are now routinely utilized in reconstructive therapy. This presentation describes very detailed and evidence based guidelines for clinicians interested in enhancing their abilities in tissue engineering, especially as it relates to bone augmentation. Specifically, while successful bone augmentation requires the standard surgical parameters of space maintenance, low pressure on the grafts and tension-free flap closure, optimization of this goal requires management and enhancement of the local biological conditions with growth factors. Towards that end, platelet concentrates through the constant release of growth factors are able to promote and enhance new vascularization, provide plasma protein, normal lipidemia, as well as increased collagen and fibrin activity.
Hard and Soft Tissue Augmentation: Optimizing Esthetic Results for the Restorative Dentist
Contemporary patient expectations have made esthetics a major requisite of all treatment plans, especially in situations where there is a high smile line. Although new restorative materials have highly improved predictability and esthetic outcomes, soft and hard tissue management play a fundamental role when working in esthetic areas. To achieve ideal esthetics, preservation of the natural soft and hard tissue architecture is a primary clinical objective. These new proposed techniques illustrate the importance of pre-prosthetic soft and hard tissue management when working in highly esthetic compromised areas.
Peri-Implantitis: Diagnosis, Etiology and Treatment
The dental implant therapy has evolved both in implant surface and design. The reason for the initial crestal bone loss has been proven and the risks of having a peri-implantitis have increased due to the early exposure of roughened surface. The prevalence of peri-implantitis is at a range of 28 to 56%.
The role of dental professionals nowadays is to know how to interpret the signs of inflammation and establish the diagnosis of peri-implantitis, which is the most challenging, and be able to treat it properly since this is becoming a more needed therapy.
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