Objective: Measuring soft tissue thickness after mucogingival surgery has traditionally been performed by means of a calibrated transgingival probe. The main aim of this study was to apply a non‐invasive technique based on digital images formatted as Standard Tessellation Language (STL) files to quantify soft tissue volume after connective tissue grafting.Clinical Innovation Report: Ten patients who presented Cairo Class I gingival recession were selected for connective tissue grafting using the tunnel technique. In all patients, the initial position of the gingiva and quantity of keratinized tissue were recorded, and gingival recession was scanned with an intra‐oral scanner. Six months after surgery, the same intra‐oral parameters were recorded and compared with the initial registers using digital volumetric analysis software.Results: Complete root coverage was obtained in most patients (90%), mean coverage being of 2.70 mm with a mean increase in volume of 115.49 mm3 in the treated areas. No pattern was identified that indicated a statistically significant relation between gingival recession and coverage volume in mm3.Conclusions: Digital processing of pre‐ and post‐treatment images makes it possible to measure the volume of tissue gained after tissue graft surgery simply and non‐invasively. The technique is an objective and reproducible method for measuring soft tissue thickness.
Background: The aim of this systematic review and meta-analysis was to determine the wear sustained in the natural antagonist tooth in cases of full-coverage fixed-base prosthetic restorations or monolithic zirconia tooth-supported crowns, as well as to determine the wear in the restoration itself, both in the short- and medium-term and considering the factors that may influence wear. Material and methods: A systematic literature review and meta-analysis, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, of clinical studies that evaluated wear in antagonist teeth in relation to fixed-prosthesis monolithic zirconia crowns. A total of 5 databases were consulted in the literature search: Pubmed-Medline, Cochrane, Scopus, Embase and Web of Science (WOS). After eliminating duplicated articles and applying the inclusion criteria, eight articles were selected for the qualitative analysis and four for the quantitative analysis. Results: Mean maximum wear of the antagonist tooth in relation to monolithic zirconia crowns of magnitude 95.45 µm (CI at 95% 79.57–111.33) was observed. By using a meta-regression model (R2 = 0.92) the significant effect of time in maximum wear rate (p < 0.001) was observed, estimated at 6.13 µm per month (CI at 95% 3.99–8.27). Furthermore, monolithic zirconia crowns are subject to a mean maximum wear of 58.47 µm (CI 95% 45.44–71.50). By using a meta-regression model (R2 = 0.53) the significant effect of time in the maximum wear value was observed (p = 0.053), estimated at 3.40 µm per month (CI al 95% −0.05–6.85). Conclusions: Monolithic zirconia crowns lead to a progressive maximum wear of the antagonist tooth over time which is greater than the maximum wear sustained in the crown itself. It is not possible to establish an objective and quantitative objection in relation to natural enamel wear or metal–ceramic crowns.
Background: Calculus accumulation varies widely between individuals. Dental calculus has been associated with the principal periodontal diseases. The aim of this study was to analyze individual characteristics, and salivary and microbiological parameters among patients considered to be rapid calculus formers and patients who form calculus slowly. Methods: Individual characteristics were recorded in a sample of 74 patients (age, sex, smoking, periodontal diagnosis, and dental crowding), as well as salivary parameters (unstimulated saliva flow, pH, and biochemical analysis of saliva) and microbiological parameters (by means of semi-quantitative polymerase chain reaction (PCR) analysis). Results: A statistically significant association (p = 0.002) was found between the rate of calculus formation and the diagnosis of periodontal disease. A greater presence of dental crowding was observed among the group of rapid calculus formers. Urea and phosphorus levels were higher among rapid calculus formers. Regarding microbiological parameters, differences were found in Streptococcus mutans, this being higher in the group of slow formers. Conclusions: Rapid calculus formation appears to be linked to patients diagnosed with more severe periodontal diseases. Rapid calculus-forming patients present more dental crowding and a lower proportion of S. mutans.
Background: This systematic review and meta-analysis aimed to evaluate the wear of the antagonist tooth in ceramic restorations. Material and methods: This study was carried out based on Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) recommendations; it was also registered in PROSPERO (register number: CRD42022316252). Three databases were consulted in the literature search, Embase, Scopus, and Web of Science. The citation searching was conducted by two researchers independently. The clinical studies that evaluated wear in antagonist teeth concerning ceramic restoration were included. Twelve articles were selected after eliminating duplicates ones and applying the inclusion criteria, and two were chosen through citation. Fourteen articles were considered for the qualitative and quantitative analysis (meta-regression and meta-analysis). Results: The mean linear wear of the antagonist tooth in relation to feldspathic was 8.914 μm, for lithium disilicate it was 0.018 μm, and for zirconia it was 0.257 μm. The mean volumetric wear of the antagonist tooth in relation to feldspathic was 0.273 mm3, for hybrid ceramic it was 0.030 mm3, for lithium disilicate it was 0.018 mm3, and for zirconia it was 0.014 mm3. The mean natural tooth wear was 0.7974 μm per month. Tooth wear caused by zirconia at six months was 31.755 μm, at 12 months it was 24.648 μm, and at 24 months it was 20.662 μm. Conclusions: Feldspathic produces greater wear of the antagonist tooth from ceramic restorations linearly and volumetrically. In addition, zirconia generates the least wear that will decrease over time, and it will be equal to or less than the natural wear in the tooth.
Objective: The aim of the systematic review and meta-analysis carried out was to evaluate the effects of changing the prosthetic platform on peri-implant tissue after 1 year of prosthetic loading. Material and methods: In November 2020, an electronic search was carried out in PubMed, EMBASE, Web of Science, and Scopus databases with the aim of obtaining all the randomized clinical trials that had been published in the preceding 10 years comparing the effects on the peri-implant tissue of implants with a prosthetic platform change and implants with a conventional platform for at least 1 year after prosthetic loading. Randomized model meta-analyses of the selected studies were performed to compare the results of the two implant groups in terms of vertical maintenance of bone level and increased probing depth. Results: Nine studies were included, summing up a total of 475 implants with prosthetic platform exchange and 462 implants with a conventional platform. Implants with prosthetic platform exchange had less peri-implant bone loss than implants with a conventional platform (mean difference of 0.255 mm, statistically significant) but suffered a greater increase in probing depth (mean difference of 0.082 mm, not statistically significant). However, the probing depth from One Study Remove revealed a statistically significant increase of 0.190 mm in the prosthetic platform exchange group compared to the conventional platform group. Conclusion: Implants with platform switching suffer less peri-implant bone loss after 1 year of loading than implants with a conventional platform. Further long-term studies are required to observe how these differences vary over time.
Objective: The main objective of this study aimed to evaluate the response to treatment in implants with peri-implantitis regarding the presence or absence of keratinized mucosa. Materials and Methods: One hundred implants with peri-implantitis were treated non-surgically at the Prosthodontics and Occlusion Teaching Unit of the University of Valencia. Records were registered at day zero (recession, bleeding on probing, suppuration, probing depth, bone loss and plaque index), at 1, 3 and 6 months. Results: In both groups, a slight increase in recession and disappearance of suppuration took place, and no bone loss was observed during the following 6 months. However, after an initial reduction, probing depth, bleeding on probing and plaque index increased again in the group without keratinized mucosa (KM). Conclusions: Implants with KM presented better results after non-surgical treatment as well as in their medium-term evolution, although it would be advisable to increase the number of samples in order to achieve greater scientific evidence and standardization in the treatment protocol. Clinical relevance: The role of keratinized mucosa in the development of peri-implantitis has been mentioned in many publications, but less has been emphasized regarding its influence on the success of the treatment of this pathology. The presence of keratinized mucosa has been found to play a key role in the evolution of the non-surgical treatment of peri-implantitis. The amount of keratinized mucosa should be considered in the treatment of peri-implantitis, as well as when planning connective tissue grafts accompanying the decontamination of implants in the absence of keratinized mucosa.