The main goal of dental therapy is to enhance and maintain the general health and well-being of patients (Chapple & Wilson, 2014). Dental extraction is indicated when teeth cannot be maintained in a status compatible with adequate aesthetics, function and/or health, or for strategic reasons (Kao, 2008 ; Tonetti et al., 2000). Beyond its potential impact in quality of life, tooth extraction causes a local physiologic disruption that results in an initial inflammatory response and, subsequently, a variable degree

Background Alveolar ridge preservation via socket grafting (ARP‐SG) is indicated to attenuate physiologic alveolar bone resorption as a consequence of tooth extraction. However, a specific bone grafting material that is patently superior has not been identified yet. The aim of this randomized controlled trial was to evaluate the efficacy of a moldable alloplastic graft, Poly Lactic‐Co‐Glycolic Acid‐Coated β‐Tricalcium Phosphate (PLGA‐β‐TCP), for ARP purposes [Group A] compared to freeze‐dried bone allograft (FDBA) particles covered with a rapidly absorbable collagen dressing (RACD) (Group B) in function of a panel of radiographic, histomorphometric, and implant‐related outcomes. Methods Patients in need of extraction of a single posterior tooth (premolar or molar) and subsequent replacement with a dental implant were recruited and randomly allocated into one of the two treatment groups. Follow‐up visits took place at 1, 2, 4, 8, and 16 weeks. Cone‐beam Computed Tomography (CBCT) scans were obtained at baseline and at 16 weeks. Sites were re‐entered at 20 weeks for bone core biopsy harvesting and subsequent implant placement. After delivery of the final implant‐supported restoration, follow‐up visits were scheduled at 6 and 12 months to monitor peri‐implant tissue health and marginal bone levels using standardized intraoral periapical radiographs. Results A total of 45 patients were initially enrolled in the study, of whom 43 received an implant and 32 completed the study. Healing was uneventful in all sites after ARP‐SG and implant placement. No site required bone augmentation to allow for implant placement. CBCT scan analyses showed no statistically significant differences between groups in terms of reduction of horizontal width, midbuccal / midlingual height and ridge volume. Histomorphometric assessments revealed a statistically significant difference between both groups in terms of mineralized tissue formation (Group A = 27.0% ± 22.1% versus Group B = 38.2% ± 12.5%; P < 0.05). On the contrary, no significant differences were observed regarding percent of remaining bone grafting material and non‐mineralized tissue. No implant failed throughout the study period and marginal bone level change was negligible in both groups. Conclusions Although a higher proportion of mineralized tissue was associated with the use of FDBA+RACD compared to PLGA‐β‐TCP alone, both ARP‐SG approaches rendered comparable outcomes in terms of maintenance of alveolar bone dimensions, feasibility of implant placement, implant survival, and peri‐implant bone level stability up to 12 months post‐loading.

Obesity, defined as a body mass index of >30 kg/m 2 , 1 occurs when excess fat accumulation (regionally and/or globally) increases adverse health risks. With a global surge in prevalence, obesity and its associated comorbidities exert a significant economic and health burden on our society. Obesity is known to increase the risk of several chronic conditions, including type 2 diabetes, cancer, and cardiovascular diseases. 2 Additionally, new evidence is emerging to show a potential bidirectional relationship between obesity and periodontal disease. 3,4 The recent 2017 classification of periodontal diseases and conditions recognized obesity as a systemic factor affecting periodontal health. In particular, the role of obesity in worsening periodontal inflammation and in increasing the risk of developing periodontitis has been recognized. 5 Exploring the potential link between obesity and periodontal disease is currently an area of active research, and the shared molecular and environmental underpinnings between obesity and periodontal disease have been comprehensively reviewed by several groups. 3,[6][7][8][9][10] However, literature on the logistics of managing this special cohort remain scarce.With more than one-third of US adults being overweight or obese, encountering these patients in periodontal practices is a routine occurrence. Therefore, in addition to reviewing the biologic interlinks between obesity and periodontal disease, this review delineates practical considerations for managing these patients in an everyday periodontal practice setting.

Background: Autologous connective tissue graft (CTG) is generally considered the gold standard for peri-implant soft tissue phenotype modification and root coverage therapy. The presence of epithelial remnants in CTG has been associated with complications after soft tissue augmentation surgery. However, a specific method for de-epithelization that is patently superior has not been identified yet. This study aimed to evaluate the effectiveness of two different approaches to de-epithelialize CTG samples harvested from the posterior palate.Methods: Patients in need of periodontal or implant-related surgery that required harvesting a CTG from the posterior palate region were recruited.CTG samples harvested with an indirect approach were de-epithelialized using either an intraoral (IO group) or an extraoral (EO group) method. Tissue specimens were subsequently processed for histological analysis. The presence or absence of oral epithelial remnants was determined by two examiners using light microscopy. Results: Twenty-four patients, who provided a total of 46 analyzable CTG samples, were enrolled in this study. Histological assessment revealed that 19 out of 22 samples in the IO group were free of epithelial remnants. In the EO group, 20

ObjectiveTo develop a comprehensive decision‐making tree for evaluating mid‐facial peri‐implant soft tissue dehiscence in the esthetic zone and provide a systematic approach for assessing various clinical case scenarios, determining appropriate treatment strategies, and considering factors such as the need for soft tissue augmentation, prosthetic changes, or implant removal.Clinical ConsiderationsThis clinical decision tree illustrates numerous case scenarios with various esthetic complications around an esthetically compromised, but clinically healthy single implant and provides clinicians with possible solutions as a predictable map for horizontal and vertical soft tissue augmentation in order to manage different clinical circumstances. According to current evidence, the key to treating such esthetic complications is the use of an adequate pre‐surgical prosthetic interdisciplinary approach with proper surgical techniques in order to optimize soft tissue dimensions and create better esthetic results. This may be accomplished through a purely surgical, combination of surgical and prosthetic, or purely prosthetic approaches.ConclusionsThe present report describes a series of successfully treated peri‐implant esthetic complication cases in accordance with the decision‐making tree that the authors recommend in order to achieve better long‐term esthetic outcomes.Clinical SignificanceThe combination of adequate pre‐surgical prosthetic interdisciplinary collaboration and proper surgical technique is critical in the optimization of sufficient soft tissue dimensions and contributes to a more highly esthetic result. This study demonstrates a clinical decision‐making tree to provide comprehensive, effective therapy of an esthetically compromised dental implant by using one of the following approaches: purely prosthetic, purely surgical, or a combination of surgical and prosthetic with or without abutment removal.

Periodontal probing is the gold standard procedure for assessing clinical parameters used to diagnose periodontal status. Consensus indicates that comprehensive periodontal assessment should be conducted at initial assessment and thereafter should occur at least annually for patients in dental practice (American Academy of Peridontology, 2011). Evidence suggests that inaccuracies are inherent in periodontal probing measurements, due to various factors related to practitioners, patient and procedure. Among these are probing pressure/probing force (Freed, Gapper, & Kalkwarf, 1983), which may influence the final apical position of the probe within the pocket, thus affecting the accuracy of measurements (Caton, Proye,