Risk indicators for gingival recession in the esthetic zone: A cross‐sectional clinical, tomographic, and ultrasonographic study

Mascardo, Kathleen Chloe; Tomack, Justin; Chen, Chia‐Yu; Mancini, Leonardo; Kim, David M.; Friedland, Bernard; Barootchi, Shayan; Tavelli, Lorenzo

doi:10.1002/jper.23-0357

Cited by 3 publications

(1 citation statement)

References 57 publications

(208 reference statements)

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“…However, the US is less available than CBCT in a dentist's office. The operator's experience is very important and affects the accuracy of the test [22,[48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Soft Tissue Retraction Maneuver in Cone Beam Computed Tomography Prior to Crown-Lengthening Procedure—A Technical Note

Adamska,

Stasiak,

Dąbrowski

et al. 2024

JCM

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Background: An accurate determination of the biological width and the relationship of the cemento-enamel junction with the border of the alveolar bone is crucial during a clinical crown-lengthening (CCL) procedure. The aim of this study was to present a technical note about the retraction techniques in cone beam computed tomography (CBCT) prior to CCL, highlighting the significant enhancement in procedural accuracy and predictability that these techniques offer. Methods: Clinical and radiological examinations should be performed before a CCL procedure. It is necessary to determine the length of the tooth crowns, the periodontal pockets’ depth, and the phenotype of the gingiva. The ideal CBCT examination should be performed with soft tissue retraction. This can be achieved using retractors or cotton rolls. Results: Retraction of the lips, cheeks, and tongue allows one to assess the marginal gingiva, the cemento-enamel junction, and the alveolar bone. A detailed plan of the CCL procedure, which involves retraction, ensures both the aesthetic appeal and the achievement of a newly defined gingival zenith, enhancing the overall visual harmony. Conclusions: Compared with conventional radiographic imaging, the soft tissue retraction maneuver in CBCT prior to CCL surgery offers an effective approach to the evaluation and diagnosis of soft and hard tissue. This is because of the detailed planning of the aesthetic CCL procedure. Such an approach leads to superior aesthetic outcomes in dentistry, contributing to the advancement of aesthetic dentistry through a harmonious blend of art and science.

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“…However, the US is less available than CBCT in a dentist's office. The operator's experience is very important and affects the accuracy of the test [22,[48][49][50][51].…”

Section: Discussionmentioning

confidence: 99%

Soft Tissue Retraction Maneuver in Cone Beam Computed Tomography Prior to Crown-Lengthening Procedure—A Technical Note

Adamska,

Stasiak,

Dąbrowski

et al. 2024

JCM

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Soft tissue elasticity at teeth and implant sites. A novel outcome measure of the soft tissue phenotype

Tavelli,

Barootchi

2024

J of Periodontal Research

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AimTo assess ultrasonographic tissue elasticity at teeth and implant sites and its variation after peri‐implant soft tissue augmentation with a connective tissue graft (CTG).MethodsTwenty‐eight patients, each contributing with one clinically healthy dental implant exhibiting a soft tissue dehiscence (PSTD), were included. Implant sites were augmented with CTG and monitored over 12 months. Ultrasonographic strain elastography, expressed as strain ratios (SR1, SR2, and SR3, respectively) was assessed at baseline, 6‐, and 12‐month, and compared with the corresponding contralateral homologous natural tooth. SR1 assessed the strain/elasticity of the midfacial coronal portion of the soft tissue in comparison to the natural tooth crown/implant‐supported crown, SR2 evaluated the strain of the midfacial coronal soft tissue in relation to the one of the alveolar mucosa, while SR3 depicted the strain of the midfacial soft tissue in relation to the interproximal soft tissue on the transverse ultrasound scan.ResultsSR1 in natural dentition and at implant sites was 0.20 ± 0.08 and 0.30 ± 0.14, respectively (p = .002), indicating that the coronal portion of the soft tissue around teeth is generally more elastic than its counterpart around dental implants. Soft tissue augmentation with CTG promoted an increased stiffness of the midfacial coronal portion of the soft tissue over 12 months (p < .001 for SR1, SR2, and SR3). Strain ratios at the 12‐month time points were significantly higher than the values observed at 6 months (p < .001). Regression analysis demonstrated that strain elastography ratios in natural dentition were significantly associated with keratinized gingiva width, and gingival thickness. At implant sites, SR1 was significantly associated with keratinized mucosa width and mucosal thickness (p < .001 for both correlations), SR2 was significantly associated with keratinized mucosa width (p = .013), and SR3 was significantly associated with the surgical technique performed in combination with CTG (p = .022).ConclusionUltrasound strain elastography captures and quantifies tissue elasticity and its changes after soft tissue augmentation. A different baseline tissue elasticity was observed between teeth and dental implants in the most coronal aspect of the soft tissue. The main factors affecting tissue elasticity‐related outcomes were the keratinized tissue width, and mucosal thickness.

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Comparison of techniques for root coverage of localized recessions: A 12-month follow-up randomized controlled trial

Borges,

Araújo,

Gomes

et al. 2024

Preprint

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Objectives To compare two techniques for the root coverage of unilateral, single type-1 gingival recessions. Materials and methods This randomized controlled trial evaluated thin-gingival phenotype individuals with unilateral and single RT1 undergoing root coverage procedures. The study compared the combinations of subepithelial connective tissue graft (SeCTG) with a coronally-advanced flap (CAF; control group) and with the tunnel technique (TT; test group). The main parameters assessed were probing depth (PD), gingival recession height (GH), keratinized tissue (KTW), gingival thickness (GT), and percentage of root coverage (RC). Patient-reported outcome measures (PROMs), such as postoperative pain, cervical dentin hypersensitivity (CDH), esthetics, satisfaction level, and quality of life were also assessed, over 12 months of follow-up. Data were statistically analyzed using paired Student’s t-test, Chi-square, McNemar, and Split-Plot Analysis of Variance with post hoc t-test (α = 5%). Results Forty-six subjects completed the study (CAF + SeCTG: 23; TT + SeCTG: 23). Significant reductions for GH and gains in CAL, KTW, and GT were observed in the intragroup analysis for both groups. No differences were found between techniques. RC increased significantly, but no intergroup differences were observed (CAF + SeCTG: 89.4%; TT + SeCTG: 87.1%; p = 0.071). Intragroup analysis indicated a modification in gingival phenotype (GP) from thin to thick (p < 0.001). Both treatment protocols improved PROMs (p < 0.001), with no differences between the techniques. Conclusions The two surgical approaches resulted in significant improvements with similar clinical efficacy regarding RC, including GH, CAL, KTW, gingival thickness, and PROMs. Clinical relevance CAF + SeCTG versus TT + SeCTG showed similar clinical, esthetic and patient-related outcomes; however, CAF + SeCTG had a shorter surgical time.

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Risk indicators for gingival recession in the esthetic zone: A cross‐sectional clinical, tomographic, and ultrasonographic study

Cited by 3 publications

References 57 publications

Soft Tissue Retraction Maneuver in Cone Beam Computed Tomography Prior to Crown-Lengthening Procedure—A Technical Note

Soft Tissue Retraction Maneuver in Cone Beam Computed Tomography Prior to Crown-Lengthening Procedure—A Technical Note

Soft tissue elasticity at teeth and implant sites. A novel outcome measure of the soft tissue phenotype

Comparison of techniques for root coverage of localized recessions: A 12-month follow-up randomized controlled trial

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