Objectives: Recent research has suggested the contour of the prosthesis and the vertical height of the peri‐implant mucosa as important parameters that can influence the long term health and stability of the peri‐implant tissue. In particular, overcontouring of the prosthesis has been correlated with an increased risk for peri‐implantitis, while reduced soft tissue height has been associated with marginal bone loss, recession, and other soft tissue complications. Although these two parameters have been investigated as independent in the current literature, clinical experience points toward a close interrelation between transmucosal tissue height and prosthesis contour angle. It is often found that a reduced vertical height of the implant supracrestal complex is the main reason for overcontouring of the prosthesis. At the same time, achieving a favorable contour of 30o or less is not possible unless the clinician has ensured an adequate vertical height of the soft tissue. The purpose of this short communication is to establish the relation between tissue vertical height and prosthesis contour by utilizing a theoretical geometry equation based on the Pythagorean theorem. In doing so, one can use the dimensions of the implant as well as those of the prosthesis at the mucosal margin to calculate the essential vertical height for achieving a favorable prosthesis contour.Conclusions: As the treatment plan of the implant supracrestal complex is “top‐down,” in case of deficient vertical height, subcrestal placement of the implant should be considered to achieve a proper prosthesis contour.

Algirdas Puisys, DDS, Spec Perio, PhD/Saulius Zukauskas, DDS/Ricardas Kubilius, DDS, PhD/Mike Barbeck, PhD/Dainius Razukevičius, DDS, PhD/Laura Linkevičiene, DDS, PhD/Tomas Linkevičius, DDS, Dip Pros, PhD: This case series aimed to clinically and histologically evaluate porcine-derived membrane used for vertical thickening of thin soft tissues. Twenty porcine-derived collagen membranes and bone-level implants were placed in 20 patients. After 2 months, thickened soft tissues were measured and biopsy samples were harvested. All xenografts healed successfully. The average thickness of thin soft tissue before vertical thickening was 1.65 ? 0.36 mm, while tissue thickness increased to 3.45 ? 0.52 mm after the procedure (P < .001); the mean thickness increase was 1.8 ? 0.13 mm. Histologic analysis showed complete integration of the graft and no differences (P = .4578) in vascularization between the host (39.74 ? 17.15 vessels/mm²) and graft (30.43 ? 11.26 vessels/mm²). It can be concluded that porcine-derived membrane can be used for vertical soft tissue thickening with substantial gain in tissue height.

The mesenchymal stem cell (MSC) secretome has been considered an innovative therapeutic biological approach, able to modulate cellular crosstalk and functionality for enhanced tissue repair and regeneration. This study aims to evaluate the functionality of the secretome isolated from periosteum-derived MSCs, from either basal or osteogenic-induced conditions, in the healing of a critical size calvarial bone defect in the rabbit model. A bioceramic xenograft was used as the vehicle for secretome delivery, and the biological response to the established biocomposite system was assessed by clinical, histological, histomorphometric, and microtomographic analysis. A comparative analysis revealed that the osteogenic-induced secretome presented an increased diversity of proteins, with emphasis on those related to osteogenesis. Microtomographic and histological morphometric analysis revealed that bioceramic xenografts implanted with secretomes enhanced the new bone formation process, with the osteogenic-induced secretome inducing the highest bone tissue formation. The application of the MSC secretome, particularly from osteogenic-induced populations, may be regarded as an effective therapeutic approach to enhance bone tissue healing and regeneration.