Editors-in-Chief: Gustavo Avila-Ortiz & Oscar Gonzalez-Martin
This highly regarded, frequently cited journal integrates clinical and scientific data to improve methods and results of oral and maxillofacial implant therapy, compiles research, technology, clinical applications, reviews of the literature, and new developments in reconstructive dentistry and implant techniques.
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Fernando Suárez-López del Amo, Gustavo Avila-Ortiz, Gonzalo Blasi
Giorgio Pagni, Michele Modoni, Giulio Rasperini, Gustavo Avila-Ortiz
Periodontal therapy remains a cornerstone of dental practice. However, effectively managing periodontitis patients throughout the continuum of care can be challenging. This article proposes a communication framework and an integrated fee model designed to support evidence-based comprehensive treatment protocols while enhancing patient education, motivation, and long-term adherence. By emphasizing prevention and patient-centered care, the proposed approach contrasts with the dominant reactive model, often focused on surgical interventions and the extraction of salvageable teeth. Instead, this approach advocates for a shift toward a proactive, value-based paradigm that prioritizes periodontal health maintenance, aligns clinician and patient goals, and fosters sustained engagement throughout treatment. Int J Periodontics Restorative Dent 2025;45:569–577. doi: 10.11607/prd.2025.5.c
Vincent Ronco
Constant efforts are made to achieve simpler, faster, and less-invasive surgical approaches for harvesting autologous connective tissue grafts. While the palate is considered a gold-standard harvesting site, its association with complications and patient discomfort have led clinicians to explore alternative sites, like the tuberosity. However, current tuberosity harvesting techniques face several limitations. Through a multiple-recessions clinical case intended as a proof of concept, this article describes a novel harvesting technique based on a gingivectomy that triggers the tuberosity tangentially. Clinical, esthetic, and patient outcomes were monitored at 7 days, 14 days, 1 month, and 3 years at the grafted site as well as at the tuberosity. Multiple harvests were conducted at the tuberosities, offering connective tissue grafts suitable for micrografting. Harvested tuberosities healed completely without complication, and the patient reported no discomfort. At the grafted site, both esthetic and functional results were maintained for up to 3 years. The Slice Harvesting Technique offers a promising alternative for tuberosity tissue harvesting, with critical advantages such as a high indication rate, simplicity, speed, safety, and the ability to provide user-friendly connective tissue grafts. Further, the technique appears to be sustainable and could also favor tuberosity regrowth for multiple rounds of harvesting. Int J Periodontics Restorative Dent 2025;45:579–588. doi: 10.11607/prd.7465
Diogo Moreira Rodrigues, Gustavo Avila-Ortiz, Eliane Porto Barboza, Leandro Chambrone, Manrique Fonseca, Emilio Couso-Queiruga
This study aimed to characterize gingival thickness (GT) and determine correlations with other local phenotypic features. CBCT scans from adult subjects involving the maxillary anterior teeth were obtained to assess buccal GT at different apicocoronal levels, periodontal supracrestal tissue height (STH), the distance (CEJ–BC) from the cementoenamel junction (CEJ) to the alveolar bone crest (BC), and buccolingual tooth dimensions. A total of 100 subjects and 600 maxillary anterior teeth comprised the study sample. Variations in mean GT values were observed as a function of apicocoronal level, tooth type, and gender. GT progressively increased apically. Maxillary central incisors and men generally exhibited thicker GT. Contrarily, women exhibited thinner GT and shorter STH. Tooth dimensions were negatively correlated with GT, as a narrower tooth crown/root in the buccolingual dimension indicated thicker gingiva. GT at the CEJ level was dichotomized to differentiate between thin (< 1 mm) and thick (≥ 1 mm) gingival phenotypes (GP). Teeth with a thin GP displayed greater CEJ–BC and buccolingual tooth width dimensions. Conversely, teeth with a thick GP generally exhibited taller STH and narrower tooth dimensions. Int J Periodontics Restorative Dent 2025;45:589–599. doi: 10.11607/prd.7265
Sofia Aroca, Giovanni Zucchelli, Giovanna Laura Di Domenico, Massimo de Sanctis
The multiple coronally advanced flap (MCAF) and the modified coronally advanced tunnel technique (MCAT) are the most commonly used methods for treating multiple gingival recessions. However, treating multiple defects is very complex due to various biologic and anatomical factors, and there is no clear guideline on the major or minor determinants that influence surgical decisions. The aim of the present article is to discuss a decision tree to suggest to clinicians the most relevant anatomical factors to consider when evaluating the choice between an MCAT and an MCAF. In the proposed decision-making process, the first crucial step involves the evaluation of the interdental clinical attachment loss according to the new EFP/AAP classification. The next step is to assess the dimensions of the lateral keratinized tissue (LKT)—that is, the keratinized tissue located laterally to the recession defect. When the amount of LKT is insufficient, the interdental papillae size, including base, height, and coronal width, must also be evaluated. Int J Periodontics Restorative Dent 2025;45:601–615. doi: 10.11607/prd.7290
Istvan A. Urban, Maria Di Martino, Rodrigo F. Rangel, Jessica Latimer, Andras Forster, Lorenzo Tavelli
A 45-year-old woman presented with a lack of interimplant papilla after a partially edentulous anterior area was rehabilitated with dental implants. The soft tissue phenotype and interimplant papilla were augmented using the “iceberg” connective tissue graft (iCTG), followed by a second surgical procedure wherein a strip gingival graft was combined with a CTG inserted underneath a pouch prepared into the previous iCTG at the level of the crest (the garage approach), further enhancing soft tissue volume in that region. This technique aims to improve mucosal thickness and supracrestal tissue height while addressing esthetic concerns associated with multiple implants placed in the anterior region. The final esthetic outcome was excellent and achieved harmonious soft tissue with appropriate thickness, symmetry with adjacent teeth, well-shaped interdental and interimplant papillae, and high patient satisfaction, making this approach a valuable addition to the surgical armamentarium. Future clinical studies are needed to evaluate the performance of this novel approach. Int J Periodontics Restorative Dent 2025;45:617–625. doi: 10.11607/prd.7179
David Palombo, Tommaso Mascetti, Giovanni Zucchelli, Mariano Sanz
The management of severe mucogingival deformities surrounding malpositioned implants represents a complex issue with a high risk of esthetic failure. The present case report describes a mucogingival and restorative approach for the treatment of severe localized peri-implant tissue deficiencies with interproximal bone loss combined with an interproximal gingival recession on the adjacent natural tooth. This approach consists of maintaining a nonrestorable malpositioned implant, submerging it through one or multiple vertical soft tissue augmentations according to the defect severity, and delivering a tooth-supported bridge involving the adjacent natural teeth. The step-bystep surgical technique adopted for implant submergence and vertical soft tissue grafting, as well as the subsequent surgical and prosthetic interventions, are described, presenting results at 5 years from implant submergence and 3 years from prosthetic finalization. Int J Periodontics Restorative Dent 2025;45:627–641. doi: 10.11607/prd.7286
Andoni Jones
This case report shows how to place and restore dental implants in just 6 months in a patient requiring vertical and horizontal hard and soft tissue augmentation, including a lateral window sinus elevation. It highlights the utilization of pure autogenous bone, including the sinus elevation, to shorten the reentry time to just 3 months, as well as the subsequent soft tissue grafting during implant placement to avoid a third surgery. After the bone augmentation, the soft tissue thickness was inadequate for implant placement and the mucogingival line was distorted due to flap advancement. Understanding the available hard tissue grafting techniques and biomaterials is essential for proper treatment planning. Incorporating soft tissue management protocols into implant placement surgeries will reduce the number of surgeries and overall treatment time. Int J Periodontics Restorative Dent 2025;45:643–651. doi: 10.11607/prd.7264
Ignacio Pedrinaci, German O. Gallucci, Alejandro Lanis, Bernard Friedland, Kevser Pala, Adam Hamilton
Computer-assisted implant planning allows for a comprehensive treatment plan by combining radiographic data provided by CBCT with surface optical scan data that includes the patient’s intraoral situation and the intended restorative planning. Integrating a tailored restorative design with the patient’s anatomical conditions through virtual implant planning allows for an ideal biorestorative treatment planning that maximizes biologic, functional, and esthetic outcomes. This article discusses dataset registration techniques that combine radiographic CBCT data with restorative information as the main path to create a virtual patient. The described techniques include the use of removable radiographic templates with radiopaque markers, the dual scan technique, and direct digital file registration of intraoral scans using anatomical references. Depending on the individual clinical situation, different factors must be considered to appropriately select methods that achieve an optimal registration of diverse datasets. An inherent challenge lies in the presence of scattering artifacts in CBCT scans. Two approaches are proposed for these situations: the use of chairside-fabricated composite resin markers or adhesive spot-markers fabricated for use with computed tomography scans. Both techniques exhibit limitations that must be considered. Further approaches should be developed for situations involving scattering in CBCT scans. Int J Periodontics Restorative Dent 2025;45:653–665. doi: 10.11607/prd.7127
Yoshihiro Ono, Myron Nevins, Satoko Rubin, Toshiya Kuwahara, Magda Feres, Anahat Khehra
The necessity of a minimum volume of keratinized tissue around implants to maintain tissue stability remains a matter of debate. This case series aims to showcase the outcomes and long-term maintenance of implants that received soft tissue augmentation. Three cases of stage-two surgery following implant placement were evaluated to determine the amount of keratinized tissue around the implant. Based on the Ono-Nevins classification described herein, treatment was rendered, including keratinized tissue grafting. The cases were followed for 10, 18, and 28 years. Each case demonstrated maintenance of the soft and hard tissue profiles around the implants with no incidence of peri-implantitis, as evidenced on clinical examination and periapical radiographs. Soft tissue management around implants may play a key role in the long-term maintenance of peri-implant health and prevention of peri-implantitis. Int J Periodontics Restorative Dent 2025;45:666–672. doi:10.11607/prd.7303
Adria Jorba-Garcia, Oscar Gonzalez-Martin, Leandro Chambrone, Manrique Fonseca, Emilio Couso-Queiruga
Several treatment-oriented classifications for the management of peri-implant marginal mucosal defects (PMMDs) have been published to date. While each classification provides valuable insights into key diagnostic and therapeutic aspects, there is a marked heterogeneity regarding the recommended clinical guidelines to achieve success in specific scenarios. The purpose of this review was to critically analyze and organize the similarities and differences enclosed in the available classifications linked with treatment recommendations on the management of PMMDs at nonmolar single-implant sites with the purpose of providing an overview of recommended interdisciplinary treatment options to facilitate clinical decision-making processes. Int J Periodontics Restorative Dent
2025;45:673–687. doi: 10.11607/prd.7257