The RES system may be a useful tool to assess the esthetic outcome following root-coverage procedures.

Background This retrospective study evaluated and assigned scores to six prognostic factors and derived a quantitative scoring system used to determine the periodontal prognosis on molar teeth. Methods Data were gathered on 816 molars in 102 patients with moderate to severe periodontitis. The six factors evaluated, age, probing depth, mobility, furcation involvement, smoking, and molar type, were assigned a numerical score based on statistical analysis. The sum of the scores for all factors was used to determine the prognosis score for each molar. Only patients with all first and second molars at the initial examination qualified for the study. All patients were a minimum of 15 years post treatment. Results The post treatment time ranged from 15 to 40 years and averaged 24 years. When the study was completed, 639 molars survived (78%), and of those surviving molars, 566 survived in health (89%). In molars with lower scores (1,2,and 3) the 15-year survival rates ranged from 99% to 96%. For scores 4, 5, 6 the 15 year survival rates ranged was 95% to 90% and for molars with scores of 7, 8, 9, and 10 the survival rates ranged from 86% to 67%. Conclusions Our results indicate that the periodontal prognosis on molars diagnosed with moderate to severe periodontitis can be calculated using an evidence-based scoring system.

Within the limits of this case series, the results indicate that an ADMA seeded with autologous gingival fibroblasts by tissue-engineering technology may be explored as a substitute to an SCTG for the treatment of Miller Class I and II recession defects.

Although not a new procedure, coronal positioning of existing gingiva may be used to enhance esthetics and reduce sensitivity. Unfortunately when recession is minimal and the marginal tissue is healthy, many periodontists do not suggest treatment. This article outlines a simple surgical technique with the criteria for its use which results in a high degree of predictability and patient satisfaction.

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The purpose of this study is to describe a modification in the apically repositioned flap technique. Unlike the original technique, this technique preserves the marginal gingiva thus avoiding the risk of recession. It is recommended in cases where an increase in attached gingiva is desired. This study reports on the results of 54 single buccal areas consecutively treated in 38 healthy patients. The increase in the amount of attached gingiva, the impact on marginal tissue recession, and the impact on probing depth were analyzed. All 54 areas were evaluated at 8 weeks; 21 areas were analyzed for 24 weeks; and 19 areas for a period of 72 weeks. The final measurements were compared to baseline values. The analysis of variance of measurement (ANOVA) shows a significant increase of keratinized and attached gingiva (P <0.001). There was no statistical change in marginal tissue recession (P = 0.370) or probing depth. The results of this study demonstrate that this modification of the apically repositioned flap is effective and efficient for increasing the height of attached gingiva. This surgical procedure produces minor surgical trauma and does not require palatal donor tissue or membrane placement. It is simpler since it is less time-consuming, requires no suturing, and results in an ideal color match of tissue.

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In many cases it is necessary to perform a frenectomy to prevent reopening of a midline diastema following closure by orthodontic therapy. Often the loss of the interdental papilla between the maxillary incisors during the classic frenectomy creates an unacceptable esthetic result. A surgical technique combining a frenectomy with a laterally positioned pedicle graft is presented. The interdental papilla is left surgically undisturbed if it is of physiologic size. If it is enlarged, gingivoplasty is performed to reduce it to an appropriate size. Closure across the midline by laterally positioning gingiva and healing by primary intention results in attached gingiva across the midline. This attached gingiva may have a bracing effect and thus aid in preventing orthodontic relapse (reopening of the diastema). Twenty-seven cases were treated. No relapse was found in 24 cases and in 3 cases only minimal relapse was noted (less than 1 mm). The esthetic result is superior to that obtained with the classic frenectomy technique.