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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Christian W. Haase
Leandro Chambrone, Gustavo Avila-Ortiz
Giovanni Zucchelli, Ilham Mounssif, Claudio Mazzotti, Valentina Bentivogli, Alexandra Rendon, Matteo Sangiorgi, Martina Stefanini
Impairment or loss of the interdental papilla is a common issue in patients with periodontal disease, leading to phonetic, functional, and esthetic concerns. Numerous techniques have been explored to reconstruct and regenerate interdental papillae, but consistent success remains challenging. This article presents a novel surgical approach that applies the principles of the connective tissue graft (CTG) wall technique to enhance papilla volume when interdental clinical attachment loss is present in the esthetic zone. The case of a 35-year-old woman with an RT3 recession defect associated with loss of interdental hard and soft tissues is discussed. The patient underwent a procedure involving palatal incisions, application of amelogenins, and a trapezoid-shaped CTG fixed at the base of the papilla under a coronally advanced flap. This approach aimed to stabilize the blood clot and prevent soft tissue collapse into the defect area, enhancing the position and volume of the interdental papilla. Results at the 6- and 12-month follow-ups indicated significant improvement in papilla appearance and complete root coverage. This case suggests that the modified CTG wall technique can effectively treat buccal and interdental gingival recessions associated with horizontal or infrabony defects. Further clinical trials are necessary to confirm these findings and establish the most effective approach for interdental papilla reconstruction. Int J Periodontics Restorative Dent 2025;45:703–713. doi: 10.11607/prd.7346
Maria das Graças Cruz Najar, Leandro Chambrone
This case report presents a papillary reconstructive surgical procedure based on the use of a double subepithelial connective tissue pedicle graft (SCTPG) in conjunction with a coronally advanced tunnel flap (CATF) for root coverage of gingival recession defects (GRDs) with interproximal tissue loss and adjacent collapsed papillae. Two GRDs (teeth 12 and 13; FDI numbering system) with interproximal tissue loss and collapsed papillae were treated by means of a bilaminar approach, based on the use of a palatal double SCTPG rotated and inserted into a palatal-buccal tunnel flap at the level of the mesial and distal papillae of the maxillary right lateral incisor, associated with a CATF. Seven months after surgery, complete root coverage was achieved in both GRDs. Concerning the reconstruction of tooth 12’s papillae, the distance from the contact point to the tip of the distal and mesial papillae decreased from 5 to 2 mm and from 4 to 2 mm, respectively. Overall, the patient was highly satisfied with the outcome. Within the limits of this case report, it could be demonstrated that the double SCTPG + CATF promoted prominent clinical and esthetic improvements to the baseline conditions of both the GRDs and collapsed papillae. Int J Periodontics Restorative Dent 2025;45:715–723. doi: 10.11607/prd.7326
Taito Watanabe, Akira Hasuike, Yudai Ogawa, Shayan Barootchi, Shuichi Sato, Lorenzo Tavelli
This case report details the successful treatment of multiple recession type (RT) 3 gingival recessions in periodontally compromised mandibular anterior teeth with limited keratinized tissue. A 35-year-old man with stage III, grade C periodontitis underwent a two-stage intervention. Initially, a modification of the connective tissue graft (m-CTG) wall technique was used as part of phenotype modification therapy. The CTG acted as a protective “wall,” securing space for periodontal regeneration and thereby enhancing root coverage, soft tissue thickness, and keratinized mucosal width. Recombinant human fibroblast growth factor-2 and carbonate apatite promoted periodontal regeneration. This procedure successfully facilitated periodontal regeneration, resulting in the transition from RT3 to RT2 gingival recession and achieving adequate keratinized mucosal width. Eighteen months later, the second surgery used a tunneled coronally advanced flap (TCAF) for root coverage. TCAF involved combining a coronally advanced flap and tunnel technique by elevating the trapezoidal surgical papilla and using a deepithelialized CTG inserted beneath the tunneled flap. Root conditioning with ethylenediaminetetraacetic acid and enamel matrix derivative gel application were performed. Consequently, the mean clinical attachment level gain was 5.3 mm, mean root coverage was 4.5 mm in height, and the gingival phenotype at the treated sites had improved at the 12-month follow-up. This staged approach addresses the challenges of treating RT3 gingival recession with promising outcomes. Int J Periodontics Restorative Dent 2025;45:724–733. doi: 10.11607/prd.7218
Yosuke Tsukiboshi, Seiko Min
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
Peter Cabrera, Gustavo Vicentis Oliveira Fernandes
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
Marco Ronda, Viviana Desantis, Diego Bruno, Luca Veneriano, Camilla Elli, Alberto Pispero
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
Anina N. Zuercher, Sven Mühlemann, Edwin Ruales-Carrera, Jenni Hjerppe, Ronald E. Jung, Daniel S. Thoma
This analysis aimed to assess clinical and radiographic outcomes of single-tooth posterior implants with a dehiscence defect treated with or without guided bone regeneration (GBR). In a randomized clinical trial of 59 patients, single-tooth posterior implants were placed. For the subanalysis of 16 patients with a buccal dehiscence defect (≤ 5 mm), the implants were randomly assigned to GBR or spontaneous healing (SH). In 8 patients, the implants were surrounded by native bone. A transmucosal healing approach was chosen for all sites. Patients were examined at restoration delivery (RD) and at 1 year, and the following measurements were included: soft tissue thickness (STT), bone tissue thickness (BTT), and buccal contour, based on CBCT imaging, optical scans, and clinical parameters. All data were analyzed descriptively. The mean STT at the implant shoulder (IS) showed gains of 0.15 mm (Q1: –0.16 mm, Q3: 0.49 mm) for the GBR group and 0.03 mm (Q1: 0.49 mm, Q3: 0.13 mm) for the SH group. The mean BBT at 1 mm below the IS showed losses of 0.25 mm (Q1: –0.85 mm, Q3: –0.09 mm) for the GBR group and 0.04 mm (Q1: –0.14 mm, Q3: 0.17 mm) for the SH group. All peri-implant soft tissue parameters indicated healthy peri-implant tissues with no clinically relevant differences between the groups. Patient-reported outcomes regarding pain at 1 day postsurgery were similar among the study groups. The present subanalysis resulted in a similar buccal contour, radiographic outcomes, and peri-implant health for sites treated with or without GBR. Int J Periodontics Restorative Dent 2025;45:773–783. doi: 10.11607/prd.7138
Michael R. Norton
The growth in bone reconstructive surgery has been unsurpassed in recent decades. However, most bone-regenerative products lack any potential for delivering site-specific morphologically driven augmentation. It was therefore the purpose of this study to evaluate the histologic and clinical incorporation of a novel CAD/CAM allogeneic block bone graft for the reconstruction of complex 3D alveolar defects. In addition, the clinical outcome of dental implants subsequently placed and loaded within these grafts was assessed after up to 5 years in function. Results demonstrated that 4 of the initial 17 blocks failed (23.5%). The remaining 13 blocks plus an additional 2 replacement blocks were fully or partially incorporated within the recipient bone site (79%). Of the 32 implants placed within the integrated blocks, no failures occurred after up to 5 years in function, with a recorded mean marginal bone loss of –0.5 mm per implant. Int J Periodontics Restorative Dent 2025;45:785 795. doi: 10.11607/prd.7231
Khaled Abid Althaqafi
This study explores the effect of Er,Cr:YSGG laser tooth etching vs that of conventional tooth surface treatment on the shear bond strength of ceramic laminate veneers. A total of 76 maxillary premolars were assigned to two groups (n = 38 per group) according to the type of enamel surface treatment approach: Group 1 comprised samples treated with the conventional acid-etch protocol, and Group 2 comprised samples subjected to Er,Cr:YSGG laser. Light-curing resin cement was used to bond the restoration to the tooth, and specimens were thermocycled for 30,000 cycles. Shear bond strength testing was conducted on all specimens. The samples were observed using a scanning electron microscope to record enamel topography and a stereomicroscope to monitor the mode of failure. P ≤ .05 was considered significant. There were no statistically significant differences between the acid-etch and laser enamel surface treatment groups for the shear bond strength values at maximum load (P = .627). There was a significantly higher proportion of cohesive failure in the acid-etch group compared to the laser treatment group and a significantly lower proportion of mixed failure in Group 1 compared to Group 2 (P = .022). Concerning the laminate veneer bond strength, the effects of laser and traditional acid etching on the enamel surface were the same. Enamel surfaces can be successfully etched using a laser as an alternative to the traditional acid-etch method. Int J Periodontics Restorative Dent 2025;45:797–804. doi: 10.11607/prd.7384
Juan Francisco Peña-Cardelles, Jovana Markovic, André De Souza, Adam Hamilton, Alejandro Lanis, German O. Gallucci
This study explores the effect of Er,Cr:YSGG laser tooth etching vs that of conventional tooth surface treatment on the shear bond strength of ceramic laminate veneers. A total of 76 maxillary premolars were assigned to two groups (n = 38 per group) according to the type of enamel surface treatment approach: Group 1 comprised samples treated with the conventional acid-etch protocol, and Group 2 comprised samples subjected to Er,Cr:YSGG laser. Light-curing resin cement was used to bond the restoration to the tooth, and specimens were thermocycled for 30,000 cycles. Shear bond strength testing was conducted on all specimens. The samples were observed using a scanning electron microscope to record enamel topography and a stereomicroscope to monitor the mode of failure. P ≤ .05 was considered significant. There were no statistically significant differences between the acid-etch and laser enamel surface treatment groups for the shear bond strength values at maximum load (P = .627). There was a significantly higher proportion of cohesive failure in the acid-etch group compared to the laser treatment group and a significantly lower proportion of mixed failure in Group 1 compared to Group 2 (P = .022). Concerning the laminate veneer bond strength, the effects of laser and traditional acid etching on the enamel surface were the same. Enamel surfaces can be successfully etched using a laser as an alternative to the traditional acid-etch method. Int J Periodontics Restorative Dent 2025;45:797–804. doi: 10.11607/prd.7384