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Objective Current approaches for soft tissue thickness evaluation and visualization still represent a challenge for full extent evaluation and visualization. The aim of this clinical technique article is to introduce a novel approach for comprehensive visualization and precise evaluation of oral soft tissue thickness utilizing a fusion of optical 3D and cone-beam computed tomography (CBCT) images. Clinical considerations 3D models of the maxilla were obtained by CBCT imaging and intraoral scanning. The CBCT images were reconstructed to standard tessellation language (STL) file format models by segmentation of teeth and bone using implants planning software. 3D soft tissues and teeth models were obtained by intraoral scanning and were exported in STL file format as well. 3D multimodal models were then superimposed using best-fit matching on teeth. Soft tissue thickness was then visualized and evaluated with a 3D color-coded thickness map of gingival and palatal areas created by surface comparison of both 3D models. Additionally, threshold color-coding was used to increase comprehensibility. Palatal areas were further visualized and evaluated for the optimal donor site. Conclusions A novel approach for 3D evaluation and visualization of masticatory mucosa thickness presents all available 3D data in a comprehensible, "clinician-friendly" manner, using threshold regions and clinically relevant views. Clinical significance Proposed approach could provide comprehensive presurgical treatment planning in periodontal plastic surgery and implantology without additional invasive procedures for the patient, resulting in more predictable treatment, improved outcomes, and reduced risk for complications.

Replantation and retention of ankylosed tooth after pubertal growth spurt enables stepwise replacement of both central incisors with implants. Partial extraction contributes to natural gingival contour., Replantation and retention of ankylosed tooth after pubertal growth spurt enable stepwise replacement of both central incisors with implants. Partial extraction contributes to natural gingival contour.

Proinflammatory cytokine tumor necrosis factor alpha (TNF-alpha) was found in inflamed periodontal tissues and many studies pointed to its significant role in development of periodontal disease. In this study, the influence of subcutaneously administered recombinant human TNF-alpha (rhTNF-alpha) on inflammatory reaction and periodontal breakdown in rats was analyzed during experimental periodontitis, induced by placing silk ligatures around the maxillary right second molar tooth. The rats were divided into two groups with five animals in each; the first group was infused subcutaneously with rhTNF-alpha via osmotic pumps for 2 weeks and the second group was infused with phosphate-buffered saline (PBS) in the same manner. Inflammatory reaction and periodontal breakdown was evaluated morphometrically on hematoxylin and eosin stained sections. Serum ionized calcium and inorganic phosphates were monitored colorimetrically. Serum calcium and phosphate levels were similar in rats receiving rhTNF-alpha and PBS. Ligation resulted in accelerated periodontal breakdown, while subcutaneous rhTNF-alpha administration by itself had no significant effect. Combined effect of subcutaneous rhTNF-alpha administration and ligation resulted in a significantly greater inflammatory reaction and periodontal breakdown then either treatment alone. We concluded that the subcutaneous administration of rhTNF-alpha accelerates the progression of experimental periodontitis in rats.

Background: In vitro studies demonstrated that proinflammatory cytokine tumor necrosis factor alpha (TNF-α) modulates bone metabolism. Objective: The aim of our study was to confirm the ability of TNF-α to induce osteoclastogenesis and bone resorption in an in vivo experiment, with the use of calvarial model in mice. Materials and methods: Twenty C57-Black mice were divided into four groups with five animals in each. The first group was infused subcutaneously on their back with recombinant mouse (rm) TNF-α via osmotic minipumps for 3 d, the second group was similarly infused with phosphate-buffered saline (PBS), the third group was infused with rmTNF-α to the region above the parietal bone and the fourth group with PBS in the same manner. Number of osteoclasts on parietal bone was determined morphometrically. Serum calcium and phosphates were monitored colorimetrically. Results: Serum calcium level and number of osteoclasts on parietal bone were significantly greater after infusion of rmTNF-α above the parietal bone, whereas after subcutaneous delivery these parameters were similar to the control group. Conclusion: We are concluding that TNF-α has the ability to change the bone metabolism in a paracrine manner only.