Background: Few investigations can be found the literature on the histological nature of the attachment of connective tissue grafts to root surfaces previously exposed by recession.Methods: In this case report, a 24‐year‐old patient was treated with a connective tissue graft combined with a partial‐thickness coronally positioned flap for root coverage of Class I Miller recessions at the maxillary right and left canines and first premolars. The treated sites exhibited 83% and 100% root coverage on the right and left sides, respectively. Twelve months later, the case required extraction of all 4 first premolars for orthodontic reasons. Two conservative block sections including the maxillary first premolars with the buccal soft tissues were obtained and processed histologically in a bucco‐palatal plane.Results: Histological analysis showed that healing occurred via a long juctional epithelium throughout the major portion of the previous recession site. Only minimal signs of new cementum‐like tissue formation could be seen in the apical portion of the recession area coronal to the base of the instrumented root surface. No root resorption or ankylosis could be detected in any of the serial sections.Conclusions: The findings of this case report outline the possible variations in the histological outcome of connective tissue grafts. These variations can be attributed to differences in size and shape of the recession defects and flap positioning at the end of surgery. J Periodontol 2001;72:1607‐1615.
1 March 2013 in The International Journal of Oral and Maxillofacial Implants
Maurizio Silvestri, DDS/Paolo Martegani, DDS/Ferdinando D?Avenia, DDS/Mauro Farneti, DDS/Diego Capri, DDS, CAGS/Guerino Paolantoni, DDS/Luca Landi, DDS, CAGS: Purpose: Sinus elevation via the lateral approach for implant rehabilitation of atrophic posterior maxillae is considered a safe and predictable therapy. Several xenogeneic biomaterials of different biologic origin have been used as valid and predictable alternatives to autogenous bone. This multicenter randomized controlled double-blind prospective clinical trial aimed to compare histomorphometrically two xenogeneic grafting materials used for sinus elevation with simultaneous implant placement. Materials and Methods: Seven private practices in Italy were involved. Patients presenting at least one site with a residual bone crest height between 2 and 4 mm were treated. Control sites were grafted with 100% deproteinated particulated bovine bone (DPBB), while test sites were grafted with prehydrated corticocancellous porcine bone (PCPB). Root-form implants were placed simultaneously. Insertion torque and clinical stability were assessed and recorded. At 6 months, a biopsy specimen was harvested from each site, and histomorphometric analyses were performed. Results: Thirty-seven patients received 42 sinus elevations (24 test and 18 control). Eighty-two implants with adequate primary stability were placed. Fifty-five implants were placed in residual bone crests greater than 2 mm but less than 4 mm (average 2.7 mm) and achieved an average insertion torque of 22.8 ? 11.3 N/cm. Nineteen implants were placed in ridges greater than 3 mm but less than 5 mm, and eight were placed in ridges with more than 5 mm remaining. After 6 months, three implants had failed to integrate, leading to a survival rate of 96.34%. Forty-two specimens were analyzed histomorphometrically. No significant differences in total bone volume (PCPB 37.43%, DPBB 37.52%) or residual grafting material (PCPB 13.55%, DPBB 16.44%) were detected. Conclusions: In this study, PCPB compared well with DPBB as a grafting material for lateral sinus elevation. Int J Oral Maxillofac Implants 2013;28:543?549. doi: 10.11607/jomi.2647
6 January 2023 in High Blood Pressure & Cardiovascular Prevention
TGthe Italian working group on Hypertension and Periodontitis (Hy-Per Group)
the Italian working group on Hypertension and Periodontitis (Hy-Per Group)
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Arterial hypertension (AH) and periodontitis are among the most common non-communicable chronic diseases worldwide. Besides sharing common risk factors, an increasing body of evidence supports an independent association between the two conditions, with low-grade systemic inflammation acting as the plausible biological link with increased cardiovascular risk. In 2021, the Italian Society of Arterial Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) have joined forces and published a joint report on the relationships between AH and periodontitis, reviewing the existing scientific evidence and underlining the need to increase awareness of the strong connection between the two conditions and promote treatment strategies for the control of gums inflammation in patients with AH. The current document extends the previous joint report, providing clinical practical guidelines aimed to support clinicians in the management of patients who suffer from or are at risk of being affected by both conditions. These recommendations are based on careful consideration of the available evidence as well as of the current guidelines on the management of periodontitis and AH and are supported by SIIA and SIdP.
Background: The purpose of this study was to evaluate the reliability and accuracy in the assignment of the case definitions of peri‐implant health and diseases according to the 2018 Classification of Periodontal and Peri‐implant Diseases and Conditions.Methods: Ten undergraduate students, 10 general dentists, and 10 experts in implant dentistry participated in this study. All examiners were provided with clinical and radiographic documentation of 25 dental implants. Eleven out the 25 cases were also accompanied by baseline readings. Examiners were asked to define all cases using the 2018 classification case definitions. Reliability among examiners was evaluated using the Fleiss kappa statistic. Accuracy was estimated using percentage of complete agreement and quadratic weighted kappa for pairwise comparisons between each rater and a gold standard diagnosis.Results: The Fleiss kappa was 0.50 (95% CI: 0.48 to 0.51) and the mean quadratic weighted kappa value was 0.544. Complete agreement with the gold standard diagnosis was achieved in 59.8% of the cases. Expertise in implantology affected accuracy positively (p < 0.001) while the absence of baseline readings affected it negatively (p < 0.001).Conclusion: Both reliability and accuracy in assigning case definitions to dental implants according to the 2018 classification were mostly moderate. Some difficulties arose in the presence of specific challenging scenarios.