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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Edgar El Chaar
Luca De Stavola, Govanni Zucchelli
Soft tissue management in bone augmentation is critical to ensuring the predictability of new bone formation. The flap elongation, by way of a periosteum releasing incision, determines an anatomical alteration of the existing soft tissue architecture. In particular, both the vestibule position and the mucogingival line are moved coronally. The correction of the vestibule position is usually performed by a partial flap preparation very close to the periosteum layer, reducing the overall supracrestal tissue volume. The presented technique defines a strategy to obtain flap elongation, potentially without the loss of the vestibule position. Clear anatomical reference points are introduced and described to render the technique predictable and repeatable. Int J Periodontics Restorative Dent 2026;46:421–431. doi: 10.11607/prd.7600
Ignacio Sanz-Martin, DDS, MS, PhD; Inpyo Hong, DDS, PhD; Jin-Young Park, BDS, PhD; Lorenzo Tavelli, DDS, MS, PhD; Alberto Monje, DDS, MS, PhD; Ignacio Sanz-Sanchez, DDS, MS, PhD; Jae-Kook Cha, DDS, MS, PhD
The peri-implant mucosal barrier “seal” plays a significant role in maintaining peri-implant health, but its efficacy in the presence of inflammation is lower than that of natural teeth, primarily due to the absence of collagen fiber insertion into the implant/abutment surface. To test the influence of cementum on collagen fiber insertion/orientation after tooth removal, a customized root cementum abutment was fabricated using a fragment from a natural tooth root. An extracted root fragment, preserving both the cementum and periodontal ligament, was cemented to the titanium abutment and used as a healing abutment for an immediate implant placed into the fresh extraction socket. Three months after implant placement, firm resistance to probing was noted clinically, and histologic and FE-SEM analyses confirmed perpendicular collagen fibers embedded into the root cementum abutment surface. This proof-of-concept unveils the role of cementum in fiber insertion/orientation and sheds light on the relevance of enhancing the seal of the peri-implant mucosal barrier to protect the underlying bone by utilizing a customized abutment that allows for the insertion of connective tissue fibers. Int J Periodontics Restorative Dent 2026;46:433–442. doi: 10.11607/prd.7552
Matteo Antonio Deflorian, DDS; Fabio Galli, MD, DDS; Riccardo Scaini, DDS, MSc; Enrico Maria Strappa, DDS, MSc; Tiziano Testori, MD, DDS
Immediate implant placement in the esthetic area is a challenging surgical procedure. In the anterior maxilla, the esthetic outcome and the tissue stability over time are highly emphasized. A thorough preoperative analysis of the local site anatomy is essential to choosing the most suitable surgical and prosthetic protocol. Due to the heterogenous data from the literature, a diagnostic algorithm was developed to assist the clinician in the decision-making process for single-tooth implant rehabilitation in the anterior maxilla. The treatment options were based on the predictability of implant primary stability, integrity of the buccal bone wall, gingival phenotype, and absence or presence of gingival recessions. Within its limitations, this approach may reduce the incidence of complications and failures. Int J Periodontics Restorative Dent 2026;46:443–459. doi: 10.11607/prd.7541
Yudai Ogawa, DDS; Serhat Aslan, DDS, PhD; Hiroaki Goto, DDS; Dai Kawanabe, DDS; Takahiko Nagai, DDS, PhD; Shogo Maekawa, DDS, PhD; Tomohiro Ishikawa, DDS; Atsushi Saito, DDS, PhD; Pierpaolo Cortellini, DDS, MD; Kentaro Imamura, DDS, PhD
The Double-sided Entire Papilla Preservation (DEPP) technique was designed to allow access into a bone defect without compromising the integrity of the papilla when the defect extends to the palatal/lingual side. This case series aimed to evaluate the clinical and radiographic outcomes of periodontal regenerative therapy using the DEPP technique for infrabony defects. DEPP was performed with vertical incisions on both the buccal and palatal sides to access the bone defect. After debridement, recombinant human fibroblast growth factor-2 or enamel matrix derivative was used in combination with carbonate apatite or deproteinized bovine bone mineral to treat the defect. Periodontal parameters were evaluated at baseline and at 6 and 12 months postoperatively. Clinical attachment level (CAL) and probing depth (PD) values were significantly improved compared to baseline at 6 months (P < .05) and 12 months (P < .01). At 12 months, the mean PD reduction was 5.0 ± 1.4 mm and CAL gain was 5.3 ± 1.8 mm. According to the composite outcome measure, the outcomes of the treated sites were considered successful. This case series demonstrates that DEPP can be effectively combined with regenerative therapy for the treatment of infrabony defects that extend to the palatal/lingual side, yielding favorable clinical outcomes with minimal surgical complications. Int J Periodontics Restorative Dent 2026;46:461–471. doi: 10.11607/prd.7532
Federico Rivara, DDS, MS, PhD; Luca Toselli, DDS
Mucogingival surgery is a reliable technique to treat both functional and esthetic issues on teeth. In particular, the treatment success of gingival recessions depends on the flap design, as an inaccurate flap design could lead to surgical failure. For this reason, a new software-guided tool to design and perform mucogingival incisions was proposed. After selecting a flap design in accordance with the mucogingival technique, a template is designed that allows the clinician to guide the mucogingival flap in terms of incision line positions and blade inclination. The guide also incorporated the palatal box to collect a connective tissue graft. The printed guide is stabilized via tooth support, and the 45-degree inclination of the edges allows a beveled incision that follows the flap design. Afterward, the guide is removed, and the surgery is completed with papillae deepithelialization, connective tissue grafting, and flap closure. At 12 months, both sites achieved successful coverage according to the planning. This new digital tool to transfer flap design from the screen to the surgical field reduces the surgical time and number/frequency of mistakes that could lead to a negative outcome.
Int J Periodontics Restorative Dent 2026;46:473–481. doi: 10.11607/prd.7453
Yuichiro Ihara, DDS; Satoru Morikawa, DDS, PhD; Taneaki Nakagawa, DDS, PhD
Periodontal regenerative therapy offers new options for treating teeth with severe bone loss. However, debate persists over preventive root canal treatment when bone resorption extends beyond the root apex. This report examines periodontal regeneration and pulp vitality preservation, challenging conventional treatment. A 65-year-old man presented with 10-mm periodontal pockets and bone resorption extending beyond the root apex of the mandibular right lateral incisor. Pulp vitality was confirmed, and periodontal regenerative therapy was performed without preventive root canal treatment. Root debridement was performed, excluding the apical 2 mm, and verified using CBCT, followed by application of enamel matrix derivative (Emdogain), deproteinized bovine bone (Bio-Oss), and a collagen membrane. At 6 months, probing depths decreased from 10 mm to 3 mm without bleeding on probing. Radiographs showed bone regeneration. At 5 years, probing depths remained stable at ≤ 3 mm, and CBCT confirmed long-term bone stability. Pulp vitality tests remained positive. The findings from this case suggest that root debridement excluding the apical 2 mm and precise regenerative techniques can promote periodontal regeneration and maintain pulp vitality, questioning the need for routine preventive endodontics. Further research is needed to establish protocols for complex cases. Int J Periodontics Restorative Dent 2026;46:483–491. doi: 10.11607/prd.7582
Varkha Rattu, BDS, MClinDent Periodontology; Luigi Nibali, Dip Dent, MSc, PhD
This evaluation aimed to identify the prevalence of meeting the endpoints for (1) stable periodontitis (defined as: probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, and no BoP at 4-mm PPD sites), (2) endpoints of therapy (no PPD > 4 mm with BoP, no PPD ≥ 6 mm), (3) controlled periodontitis (≤ 4 sites with PPD ≥ 5 mm), (4) PPD < 5 mm, and (5) PPD < 6 mm at the start of supportive periodontal care (SPC). The evaluation also aimed to identify any variables that may affect the achievement of meeting the endpoints. Consecutive patients entering SPC between 2020 and 2022 at Guy’s Hospital, London, were assessed. The collected data included periodontal parameters (PPD and full-mouth bleeding and plaque scores) at both baseline and the final active periodontal treatment (APT) visit and were analyzed using SPSS 29.0 for descriptive and quantitative statistics. Logistic regressions utilized univariate and multivarite models to examine associations between clinical variables and outcomes. A total of 141 subjects were included (mean age: 45.4 ± 1.1 years; 64.5% women; 58.9% Caucasian). Most subjects (93.6%) had generalized Stage III/IV periodontitis. At SPC entry, 12.77% of subjects exhibited stable periodontitis, and 48.23% met the endpoints of therapy. Relative percentage changes from baseline to the end of APT in achieving stable periodontitis/endpoints of therapy in teeth were as follows: all teeth (66.25%/90.97%), anterior teeth (81.75%/97.12%), premolars (74.20%/94.69%), and molars (52.40%/86.01%). Regression analyses confirmed associations between age and extent of disease with endpoints but explained limited variance (R2 ≤ 0.267). Periodontal treatment significantly improved clinical parameters at site and tooth levels, though molars demonstrated lower endpoint achievement, highlighting localized treatment challenges. Age and extent of disease influenced outcomes, but predictor variables explained only modest variance, highlighting the complexity of achieving therapeutic success in periodontitis management.
Int J Periodontics Restorative Dent 2026;46:492–501. doi: 10.11607/prd.7565
Young K. Kim
Full-arch implant rehabilitation—necessitating a holistic, transdisciplinary approach—has been one of the most rapidly advancing disciplines in implant dentistry, driven by rising standards and modern technologic advancements. Despite indicated cases and genuine efforts to improve efficiency, the current trend of an immediacy (or “teeth-in-a-day”) protocol may have unintentionally veiled a more conservative, predictable, and practical potential in wound healing process, esthetics, and occlusion. Through an approach that is more phased and utilizes terminal dentitions as strategic abutments, this case report with 3 years of follow-up emphasizes the leverage of natural biologic phenomena in tissue maturation, remodeling, and condensation, along with prosthetic sophistications focusing on its meticulousness in execution and long-range trajectory success. This workflow actualizes a high-quality level of craftsmanship with surgical and prosthetic innovations, introduced as a “retightening bilateral sling periosteal mattress suture” concept for intermittent tensocompressive mechanotransduction-induced guided bone regeneration and “LegOvate” protocol for seamless loading of prosthetic conversions, emphasizing the intricate reciprocity between physiology and biomechanics for a primary goal of a nondestructive equilibrium. Int J Periodontics Restorative
Dent 2026;46:503–517. doi: 10.11607/prd.7518
Adam S. Goldberg, DDS; David A. Goldberg, DMD; Paul S. Rosen, DMD, MS, PC
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