Interproximal attachment gain: The challenge of periodontal regeneration

Abstract

The new classification of periodontal diseases recognizes the key role of the interdental clinical attachment for defining the periodontal status and the extent of disease severity. Regenerating interdental clinical attachment not only improves the prognosis of the tooth, but it also lessens the severity of the disease condition. This manuscript provides a state-of-the-art review on surgical reconstructive approaches for treating papillary deficiency associated with soft and hard tissue interproximal defects. Combination therapy of papilla preservation, connective tissue grafting, and coronally advanced flaps may result in regeneration of the intrabony defect coupled with root coverage. Future research highlighted here may have the potential, especially in combination approaches, to repair challenging interproximal soft and hard tissue deficiencies.

Apical approach in periodontal reconstructive surgery with enamel matrix derivate and enamel matrix derivate plus bone substitutes: a randomized, controlled clinical trial

“…Evidence suggests that residual PD > 4 mm is a risk factor for periodontal disease progression [ 58 ]. However, in the surgical treatment of periodontal defects, it is important not only to resolve the periodontal pocket, but also to achieve a CAL gain coupled with minimal soft tissue recession [ 6 , 59 ]. Tissue collapse reduces, and even eliminates, the periodontal pocket but limits the CAL gain to the intrabony component [ 26 , 27 ].…”

“…Periodontal prognoses depend on the interproximal attachment, and therefore, interproximal CAL gain may improve the periodontal disease status [ 6 ]. CAL gain is recorded taking CEJ as a reference.…”

“…A periodontal lesions are configured by a periodontal pocket in the underlying bone, forming supra-alveolar or intrabony defects. In severe periodontal lesions, there is a deep interproximal clinical attachment loss that modulates the disease evolution, prognosis, and choice of treatment [ 6 ].…”

“…Residual defects may be unfavorable anatomically and a reservoir for dental plaque accumulation [ 8 ]. The resolution of interproximal periodontal pockets associated with papilla preservation and the reconstruction of supra-alveolar type defects are the major challenge and objective in periodontal reconstructive surgical treatment [ 6 ].…”

Polyblend Nanofibers to Regenerate Gingival Tissue: A Preliminary In Vitro Study

“…Patients' aesthetic expectation and awareness about oral health have considerably increased in last years. The regeneration of small periodontal defects has been considered an important and challenging issue for dental practitioners (Hatayama et al, 2017;Rasperini et al, 2020). Periodontal plastic surgery is the gold standard for correcting the morphology of gingival defects.…”