Search

Background: Minimally invasive dentistry is now becoming the forefront of restorative dentistry, involving less traumatic treatment protocols, conservation of tooth structure and surrounding tissues, enhancing the long-term survivability of treated teeth, and improving the overall quality of life for patients. Objective: The current case report was conducted to evaluate acquiring deep subgingival interproximal carious lesions by the mean of thermacut bur gingivectomy, in terms of patient satisfaction through pain evaluation, Bleeding on Probing, Pocket Depth, Crestal Bone Level evaluation, and restoration evaluation using modified USPHS criteria. Material and methods: A patient with a deep proximal cavity in the posterior tooth was thoroughly examined and underwent Thermacut Bur Gingivectomy (TBG) after caries removal followed by direct resin composite restoration of the prepared cavity. Patient Satisfaction using a Visual Analogue Scale (VAS) as a primary outcome. Bleeding on Probing (BoP), Probing Depth (PD), and Crestal Bone Level (CBL) as secondary outcomes, and Marginal Integrity using Modified USPHS Criteria as a tertiary outcome, were evaluated at the baseline, immediate post-operative, 6 month, 12 month and 22 month follow-up intervals. Results: Thermacut bur gingivectomy revealed minimal immediate post-operative pain, minimal time-consuming procedure, minimal (BoP), appropriate (PD) and no need for extra specialty involvement in the treatment of deep interproximal carious lesions in addition to preservation of the alveolar bone crest with excellent restoration margin at different time intervals. Conclusions: Thermacut bur gingivectomy can be considered a valid treatment for managing of deep subgingival interproximal carious lesions in vital teeth. Thermacut bur gingivectomy can be introduced as an easy technique for clinicians in the management of deep subgingival interproximal carious lesions, without the need to refer patients to periodontists and without the need for special devices. [ABSTRACT FROM AUTHOR]

The purpose of this clinical study was to assess the feasibility of forced orthodontic extrusion with the Tissue Master Concept to retain subgingivally fractured teeth as abutments for which extraction and replacement would be equal treatment opportunities. Participants were recruited from a group of consecutive patients in need of prosthodontic rehabilitation. In total, 36 deeply destroyed teeth in 31 patients underwent forced orthodontic extrusion with forces exceeding 50 g to reestablish biologic width and ensure a 2-mm dentin-ferrule design prior to single-crown restoration. The primary endpoint was the success of the extrusion in terms of the ability to restore the respective abutment tooth. Information about overall treatment time, frequency, and reasons for failure were collected. Four patients dropped out of the treatment. For the remaining 27 participants, data were fully collected. The amount of extrusion ranged between 2 and 6 mm (3.5 ± 0.9 mm), and the mean duration until retention was 20 ± 12 days. On average, patients returned three (± 3) times for control visits after extrusion. Adhesive failure (n = 6) and orthodontic relapse (n = 2) were the most frequent complication types. Forced orthodontic extrusion may be a useful tool to restore teeth evaluated as nonrestorable. [ABSTRACT FROM AUTHOR]

Hassina Shadab,1 Aisha Nawabi,1 Abdurrahman Anwari,2 Mohammad Bashir Nejabi,3 Elaha Somaya Ghafari,1 Sajeya Karimi,1 Mohammad Eissa Ahmadi1 1Periodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan; 2Operative/ Restorative Dentistry and Endodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, Afghanistan; 3Prosthodontics Department, Kabul University of Medical Sciences (KUMS), Kabul, AfghanistanCorrespondence: Abdurrahman Anwari, Operative/ Restorative Dentistry and Endodontics Department, Kabul University of Medical Sciences (KUMS), Jamal Mena, 3rd District, Kabul, Afghanistan, Tel +93795125522, Email yammamyama@gmail.comAbstract: Hereditary gingival fibromatosis (HGF) is an uncommon genetic condition marked by gradual and progressive overgrowth of fibrous tissue in the gums, which is benign in nature. It is a genetic disorder inherited in an autosomal dominant pattern, known for its considerable genetic diversity. The marginal, attached, and interdental gingivae are affected by this condition. The affected area appears pink, does not bleed easily, and exhibits a firm, fibrotic texture. Additionally, it displays a hard, widespread nodular growth that is smooth to stippled and has little bleeding tendency. Nevertheless, in certain instances, the enlargement may feel so dense and firm that it resembles bone upon palpation. Accordingly, esthetics and functions related to a healthy gingiva is also affected. The choice of treatment modality often depends on factors such as the severity of gingival overgrowth, available resources, and patient-specific considerations. Laser techniques and electrosurgery have emerged as valuable options, providing benefits like reduced discomfort and enhanced precision. However, traditional surgical methods remain highly effective, particularly when advanced technologies are not available. This article reports on three cases of hereditary gingival fibromatosis (HGF) treated with conventional gingivectomy, flap procedures, and resective osseous surgery (osteoplasty and osteotomy). The aim is to support the efficacy of these interventions in addressing patient complaints and preparing the groundwork for managing additional issues, such as speech and mastication difficulties, delayed eruption of permanent teeth, and malocclusion. The surgical treatment led to significant improvements: masticatory function was markedly enhanced, aesthetic outcomes were notably better, and oral hygiene significantly improved. Additionally, the procedures created favorable conditions for future treatments, including orthodontics, implants, or prosthetics, by providing a more manageable and functional oral environment.Keywords: hereditary gingival fibromatosis, gingivectomy, osteoplasty, gingival enlargement, case series

Objective: This article describes an interdisciplinary treatment that helped a patient with displaced upper anterior teeth. A gingivectomy, root canal therapies, digital smile design, digital wax‐up, and guided tooth preparations were applied. Clinical Considerations: A patient with pathologically migrated teeth asked for treatment without orthodontic involvement due to a primary failed orthodontic treatment history. A smile photo was taken and superimposed with the dentition in a CAD software to accomplish a digital smile design. The jaw movements were recorded with two different methods, a mechanical articulator and an intraoral scanner with Patient‐Specific‐Motion function. The occlusal contacts during protrusive and lateral movements were compared and the digital wax‐up was designed according to the later occlusal data. An aesthetic crown lengthening and pre‐op root canal treatment were carried out in advance accordingly. After guided tooth preparation with a silicone index, the final fixed restorations were manufactured and cemented. A 2‐year follow‐up showed that our prosthesis functions well. Conclusions: This clinical report revealed that an intraoral scanner with Patient‐Specific‐Motion function can effectively record individual dynamic occlusal patterns and these data can be integrated into the CAD/CAM process to enhance the fulfillment of clinical requirements. Clinical Significance: This clinical procedure with a 2‐year follow‐up demonstrated that a prosthodontic‐based interdisciplinary treatment of pathologically migrated teeth using dynamic occlusal recording with an intraoral scanner could achieve satisfactory esthetics in a relatively short treatment period. The Patient Specific Motion module may be used to record a personalized functional movement and the data can be integrated into the design process of the final restorations. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Key points Drug‐induced gingival enlargement (DIGE) is a common side effect of medications such as anticonvulsants, calcium channel blockers, and immunosuppressants. The treatment of choice for the condition is drug withdrawal or substitution in combination with the nonsurgical phase. In some cases, additional internal or external bevel gingivectomy is needed to achieve periodontal health. Special approaches may be needed in severe DIGE cases superimposed on periodontitis. The aim of this report is to describe the dual‐flap internal gingivectomy (DFIG) approach for the simultaneous management of soft and hard tissues via the simultaneous reduction of the connective tissue bulkiness from the superficial flap and preservation of keratinized tissues.A generalized Stage IV grade C periodontitis with DIGE was treated.  An initial partial thickness flap was elevated and thinned out to a thickness of 1.0–1.5 mm. Then, a second partial‐thickness flap was raised, and a thick band of connective tissue was removed. Proper positioning of the primary flap onto the periosteum was obtained and flap adaptation was achieved with localized gingivoplasty.Healthy soft tissue was developed with DFIG by debulking the enlarged connective tissues and apical gingival margin positioning with a predictable wide band of keratinized attached gingiva was achieved.   The DFIG surgical approach provides adequate access for root instrumentation and preserves KT width. The procedure effectively reduces soft tissue thickness and improves soft tissue contours, in DIGE cases superimposed to periodontitis. Gingival enlargement is related to excessive production and deposition of collagen in the inner layer of the connective tissue and the surface of the alveolar bone. The dual‐flap internal gingivectomy (DFIG) approach allows for targeted excision of the inner layer of the connective tissue from the buccal primary flap while preserving the width of the keratinized tissue. Adequate soft tissue contours and volume are obtained following the DFIG procedure. Gingival enlargement is related to excessive production and deposition of collagen in the inner layer of the connective tissue and the surface of the alveolar bone.The dual‐flap internal gingivectomy (DFIG) approach allows for targeted excision of the inner layer of the connective tissue from the buccal primary flap while preserving the width of the keratinized tissue.Adequate soft tissue contours and volume are obtained following the DFIG procedure. [ABSTRACT FROM AUTHOR]

Background: Hereditary gingival fibromatosis (HGF) is a rare hereditary condition characterized by abnormal enlargement of the gingival tissue with a variable clinical manifestation. Typically, the hyperplastic gingiva is normal in color and consistency, and the tendency of bleeding is minimal. The swelling may be limited to a particular location or generalized over the whole gingiva. Usually, the symptoms appear during and after the eruption of permanent dentition. Gingival proliferation in HGF causes a variety of esthetic and practical issues. Depending on the size and intensity of the overgrowth, speech and chewing may be impaired. Moreover, diastema and prolonged primary dentition retention may occur. Case Reports: This article describes the identification, management, and treatment approaches of four cases affecting a Syrian family who lived in Arbat refugee camp in Sulaymaniyah, Kurdistan, Iraq. Conclusion: Proliferative fibrous outgrowth of the gingival tissue, with different degrees of involvement, is a hallmark of HGF. Surgery is frequently necessary to restore function and appearance, though varying degrees of recurrence is anticipated. Nonetheless, the psychological advantages of cosmetic improvement exceed the dangers of recurrence by a wide margin, especially in teenagers. [ABSTRACT FROM AUTHOR]

Objectives: Esthetic crown lengthening (ECL) is commonly advocated to treat patients with altered passive eruption (APE). Since the introduction of the minimally invasive surgical concept, a limited number of studies have investigated this technique in a standardized manner, with further studies required to verify the validity and predictability of the minimally invasive FL‐technique. The current randomized trial compares a minimally invasive (ECL), using piezosurgery with flapless‐approach (FL), versus an open‐flap (OF) approach in the management of patients with APE Type 1B. Materials and Methods: Twenty‐four patients diagnosed with APE Type 1B were randomly assigned into test (FL) with tunneling approach or control (OF) group with minimally invasive flap reflection (n = 12/group). Postoperative pain was assessed during the first 48 h. Gingival margin (GM) level relative to a custom‐made stent (rGM) and patient satisfaction were assessed preoperative, immediately after surgery, at 3 and 6 months postsurgically. Postoperative swelling was reported for the first week postsurgically. Plaque index (PI), bleeding on probing (BoP), clinical attachment level (CAL), pocket depth (PD) and pink esthetic score (PES), were evaluated at baseline and 6 months. Linear regression analysis was conducted for pain. Results: OF‐group reported significantly higher pain and swelling scores than FL‐group during the first 48 h (p < 0.05). FL‐group showed no significant differences regarding rGM between 3 and 6 months, in contrast to OF‐group, where a significant decrease in rGM was notable (p < 0.05). No significant differences in PI, BoP, CAL, PD, PES, and patient satisfaction scores were evident between groups (p > 0.05). Regression analysis demonstrated that treatment and gender were significant predictors for pain (p < 0.05). Conclusions: Within the current study's limitations, piezo‐surgical ECL with FL‐approach presented significantly lower postoperative pain, swelling, and early GM stability compared to OF‐approach. Clinical Significance: Piezosurgical ECL with a FL‐approach can be considered a predictable technique with advantages over the OF‐approach in the management of patients with APE Type1B. [ABSTRACT FROM AUTHOR]

Gingival overgrowth is a frequent complication during orthodontic treatment, potentially hindering progress and affecting patient outcomes. Diode lasers have gained traction in this context due to their ability to reduce postoperative pain, inflammation, and expedite healing, making them an effective tool for improving clinical results in orthodontic care. The purpose of this paper is to describe the well-synchronized periodontal surgery using laser and orthodontic treatment of a gingival overgrowth case. A 29-year-old female presented with dental spacing and gum enlargement during orthodontic treatment using standard edgewise brackets. She expressed concerns about her gum health and aesthetics. To address her condition, diode laser gingivectomy was performed, which enabled the continuation of her orthodontic treatment. After 23 months, she exhibited significant improvements in facial aesthetics, dental occlusion, and a refined soft tissue profile. Post-treatment radiographs confirmed enhanced skeletal and dental parameters, including better positioning of the upper and lower lips. Diode laser gingivectomy plays a crucial role in managing gingival overgrowth during orthodontic treatment. This technique facilitates precise tissue removal while minimizing damage to surrounding areas, leading to faster recovery and improved patient comfort. The integration of diode lasers into orthodontic care contributes significantly to improving patient satisfaction and clinical success, emphasizing its value in modern orthodontic practice. [ABSTRACT FROM AUTHOR]

Background and Aim: Cementation for attaching crowns to implants has found wider use due to various reasons, including clinical advantages and aesthetic preservation. However, cement-retained prostheses have drawbacks such as the possibility of excess cement and its leakage into the surrounding tissues of the implant, which can lead to inflammatory complications in these tissues. The use of the extra-oral cementation technique can minimize excess cement. Accordingly, in this laboratory study, two extra-oral methods, PIA (Putty Index Analogue) and LBA (Light Body Analogue), and the conventional intra-oral cementation method were compared in terms of the amount of excess cement leakage when placing a crown on an implant model. Materials and Methods: In this laboratory study, 30 zirconia frameworks were fabricated on three abutmentanalogue sets for three study groups. The control group underwent the conventional intra-oral cementation method. The LBA group used a light body condensation silicone. The PIA group used a silicone putty for cementation. In each group, after cementation, the excess cement around the abutment-crown connection was manually removed using a dental scaler and weighed with a digital scale with an accuracy of ±0.01 mg. Results: The excess cement in the control group was reported as 85.23 ± 13.07 mg, in the LBA group as 1.70 ± 0.55 mg, and in the PTA group as 7.11 ± 1.45 mg. The average excess cement in the LBA and PTA groups was significantly lower than in the control group (both groups with p value < 0.001). However, the difference in average excess cement between the LBA and PTA groups was not statistically significant (p value = 0.265). Conclusion: The extra-oral cementation techniques, PIA and LBA, significantly reduced the amount of excess cement compared to the conventional technique in implant-based restorations, which may limit the adverse effects of excess cement on surrounding tissues.. [ABSTRACT FROM AUTHOR]

The balance between the dentogingival structures is essential for the construction of a harmonious smile. The asymmetry between this set negatively affects the presentation of the individual in society. Gummy smile can compromise smile aesthetics, well-being and patient satisfaction. The present study aims to report a clinical case in which gingivectomy was performed in a patient who had an inharmonious periodontal relationship, with gummy smile and discrepancy in the length of the clinical crowns of the anterior teeth. Resective periodontal surgery was performed in the upper and lower arch using the internal bevel and external bevel techniques respectively. Therefore, to improve the aesthetics of the smile, the closure of the diastema of tooth 11 with direct restoration in composite resin. After the surgical procedure, the patient was followed up for a period of 6 months, obtaining satisfactory results and a more apical gingival level. Personal satisfaction reports confirmed the success of using the surgical technique for aesthetic purposes. [ABSTRACT FROM AUTHOR]

Background: Wound healing is a multifactorial process, and the wound environment is in a constant state of flux. Periodontal wound healing can be hampered by a number of local factors and to minimize this, the practice of application of periodontal dressings was undertaken. Materials and Methods: This systematic review aims to gather and evaluate all available data about postoperative healing with and without periodontal dressings in patients undergoing periodontal therapy. An extensive search was conducted using databases such as PubMed/MEDLINE, Cochrane, EBSCO, CTRI, and hand search of a list of archived articles published from January 1974 to June 2022. Randomized controlled trials were searched, using plaque index, sulcular bleeding index, postoperative bleeding, swelling, volume of gingival crevicular fluid, gingival inflammation, pocket depth, pain and the outcomes were evaluated with a minimum follow-up of 24 h. The risk of bias was estimated after data extraction. Results: The results from our systematic review showed that periodontal dressings do not help in healing after routine flap surgeries, and hence, its use is restricted. Periodontal dressings lead to plaque accumulation, which in turn causes inflammation and irritates the healing tissues. Periodontal dressings may be placed after certain procedures such as apically displaced flaps, free gingival graft surgeries, and also procedures where protection of denuded bone is needed. Conclusion: Periodontal dressings are not indicated after flap surgeries. However, their usage after certain procedures such as apically displaced flaps, free gingival graft surgeries, and procedures where protection of denuded bone is required is recommended. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of photobiomodulation of diode laser on the healing of gingiva following gingivectomy. Material and Methods: 15 patients with inflammatory gingival enlargement in the age group 18-65 years were enrolled for the study according to the inclusion and exclusion criteria and were divided into two groups, i.e., control and test, with a total of 30 sites. Gingivectomy was performed with a scalpel, and the test site was irradiated with a diode laser, which was repeated after 7 days, finally, the patients were recalled after 21 days for re-evaluation. Soft tissue parameters were recorded at baseline and 21 days, and visual analog scale was recorded at 7 days. Also, tissue was excised and sent for histological analysis both at baseline and 21 days, and the data was subjected to statistical analysis. Results: A clinically significant improvement was observed in patient response to pain in the test group compared to the control group (p=0.001). There was an observable improvement in tissue color in the soft tissue analysis (p=0.001) and a significant reduction in the inflammatory component in the histological analysis in the test group as compared to the control group (p=0.001). Conclusion: Diode laser has a photobiomodulation effect on wound healing after gingivectomy, thus enhancing the rate of healing and decreasing post-operative pain.

Marius Marcello Utomo Koerniadi,1 Fatimah Maria Tadjoedin,2 Dimas Ilham Hutomo,2 Ette Soraya S Tadjoedin,2 Muhammad Ihsan Rizal,3 Benso Sulijaya2 1Undergraduate Program, International Class, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia; 2Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia; 3Department of Oral Biology, Faculty of Dentistry, Universitas Trisakti, Jakarta, IndonesiaCorrespondence: Benso Sulijaya, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Salemba Raya No. 4, Jakarta Pusat, 10430, Indonesia, Email bensosulijaya@gmail.com; benso.sulijaya87@ui.ac.idBackground: Gingivectomy has been the preferred method since the findings in 1884. It evolved from “blind” subgingival scaling to “the excision of the soft tissue”. The use of these techniques is no longer mandatory in clinical situations; therefore, researchers have searched for numerous publications that have been registered regarding gingivectomy. This research aims to fill the niche area by assessing more about gingivectomy and it’s trend among the periodontology topic of discussion.Methods: Descriptive and analytical observation by evaluating the result of the VOS viewer mapping and calculation throughout the bibliographic data from publications obtained from SCOPUS in July 2022.Results: There are 660 publications from six types of publication. Related keywords are compiled and visualized by network mapping. There is a significant gap among the contributing countries in the number of documents and number of citations per journal. However, a minimal gap is seen in other objectives, such as authors, journals, and institutions on their contribution towards the publication of gingivectomy topics.Conclusion: A total of 660 of 1914 articles were included in the analysis after the filtering process, and these articles were cited 5910 times, with an average of 9 citations per article.Keywords: gingivectomy, gingival excision, periodontal surgery, oral surgery, bibliometric analysis, scientific review, performance analysis, dentistry, periodontology

Objective: To evaluate the effectiveness of the use of adjuvant ozone therapy in the healing process of wounds resulting from periodontal and peri-implant surgical procedures by answering the following focused question: "Can adjuvant ozone therapy improve wound healing outcomes related to periodontal and peri-implant surgical procedures?". Method and materials: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched, without language restriction, for peer-reviewed articles published until 23 March 2022, in addition to manual search. Only controlled clinical trials (randomized or not) were considered. The risk of bias was evaluated by the Cochrane risk-of-bias tool for RCTs - version 1 (RoB1). Data were pooled into evidence tables and a descriptive summary was presented. Results: Of the 107 potentially eligible records, only seven studies were included. Four addressed free/deepithelialized gingival grafts with a palatal donor area, two evaluated implant sites, and one comprised gingivectomy and gingivoplasty. A total of 225 patients were evaluated in the included studies, considering control and test groups (ozone and other adjuvant therapies for comparison). Ozone therapy had a positive effect on outcomes directly or indirectly related to periodontal/peri-implant surgical wound healing. Furthermore, it could also increase the stability of immediately loaded single implants installed in the posterior mandible. Conclusion: In general, ozone therapy seems to both accelerate the healing processes of periodontal/peri-implant wounds and increase the secondary stability of dental implants; however, considering the limited evidence available and the risk of bias in the included studies (none classified as low risk), a definitive conclusion cannot be drawn. [ABSTRACT FROM AUTHOR]

Computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry have significantly changed workflows in recent years. Restorations and devices can now be digitally designed and 3D-printed for dental care purposes. This clinical case report provides straightforward protocols for the digital design and 3D manufacture of gingivectomy and tooth preparation guides. These types of guides improved the gingival architecture of the anterior teeth and provided controllable tooth preparations prior to labial ceramic veneers. Thoughtful clinical evaluation started with listening to the patient's chief complaint and extra- and intra-oral evaluations. Then a digital wax-up was performed, followed by an intra-oral mock-up, to evaluate the shape of the proposed restorations. After patient acceptance, the clinical procedure started with the gingivectomy and tooth preparation. Hand-crafted porcelain veneers were bonded under rubber dam isolation to avoid any contamination and maximize the bonding protocol. The esthetic and functional demands were fully satisfied. Predictable outcomes can be obtained whenever a meticulous evaluation and execution of all the steps are performed. Three dimensional printing technology allows the fabrication of devices such as gingivectomy and tooth reduction guides that help accomplish the desired results. [ABSTRACT FROM AUTHOR]

The amount of keratinized gingiva around teeth/prostheses is a crucial factor to consider before placing the crowns and bridges around implants or edentulous teeth. Keratinized gingiva around teeth, edentulous sites or implants is an important as it improves aesthetics, helps to maintain good oral hygiene around prosthesis, and prevents postoperative exposure of implant threads. The presence of adequate keratinized tissue around implants/prostheses is vital for good peri-implant health and should be augmented before implant treatment to improve the overall prognosis of the implants. The attached gingiva can be augmented using a free gingival graft (FGG) or AlloDerm®. However, procurement of FGG is surgically demanding as it requires procurement of the tissue graft from the palate. Moreover, it creates a second surgical site with an increased risk of post-operative discomfort and bleeding. To overcome these limitations, this case report presents a novel non-invasive simple, surgical technique to augment keratinized tissue using partially excised pedicled gingivectomy tissue for augmentating attached gingiva before prosthetic rehabilitation. [ABSTRACT FROM AUTHOR]

Background and Aim: Periodontal surgeries complications and related factors are one of the most important things that surgeons in each clinic should be aware of to prevent them. Therefore, the aim of this study was to determine and compare the frequency, severity and trend of complications after periodontal flap surgeries with and without ostectomy and related factors in the periodontics department of Tehran University of Medical Sciences. Materials and Methods: patients in the periodontics department of Tehran University of Medical Sciences, who underwent periodontal flap surgery or gingivectomy, were included in this prospective study. The pain, swelling, and bruising levels were asked on the same day, one and three days later. At the follow-up session on the seventh day, the pain, swelling and bruising levels were asked again, the tenderness and swelling levels were recorded by the surgeon, and flap dehiscence and pus presence were assessed. The difference between the complications’ levels on different days and also the difference in their trends between different surgeries was measured by GEE test, alongside testing the association of background and surgery characteristics with the complications’ levels by MannWhitney and correlation tests. Results: The pain and swelling means on days 0 and 1 respectively were significantly higher than other days. The trend of means for complications were not different between the two groups of flap surgery with and without ostectomy. Tenderness, swelling, flap dehiscence and pus were present in 31%, 31%, 1% and 0% of patients after one week, respectively. Conclusion: Complications after periodontal flap surgeries were uncommon, except for mild pain and swelling. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to assess the efficacy of diode lasers (810-980 nm) in treating gingival enlargement caused by orthodontic appliances. Additionally, to compare the outcomes of diode laser treatment with the conventional method (scalpel) in managing gingival enlargement. Materials and Methods: For this study, a total of 20 patients ranging in age from 14 to 28 years old were included. These individuals were divided into two groups: the laser group and the conventional group. In the laser group, surgery was performed on 10 patients using an 810–980 nm diode laser in continuous wave mode with energy settings of 1.5–2 watts. On the other hand, the conventional group also consisted of 10 patients who underwent gingival enlargement management due to an orthodontic appliance using a scalpel. To assess pain and discomfort, patients were provided with a questionnaire to record their experiences daily for the first seven days following the surgery. Pain and discomfort were evaluated using a verbal rating scale. During follow-up visits, plaque index, bleeding on probing, healing, and swelling were assessed. Additionally, the duration of the surgery and bleeding scores were recorded during the surgical procedure. Results: The initial postoperative bleeding score was significantly lower in the laser group compared to the conventional group. The duration of the procedure was shorter in the laser group than in the conventional group. Additionally, the laser group exhibited lower levels of PI and BOP percentages compared to the conventional group. Notably, there was a significant different in the percentage of BOP, with a P=0.03 in the first week, and a P=0.002 in the fourth week, as determined by T-tests. When comparing individuals in the laser group to those in the conventional group, it was observed that the pain and discomfort scores decreased. Furthermore, the swelling score was significantly lower in the laser group compared to the conventional group, particularly in the third week (Chi square statistic = 4.9, P=0.05). Lastly, there was a significant variation in healing scores in the laser group throughout all weeks of follow-up, as indicated by the T-test (P< 0.05). Conclusion: Based on the results obtained, it can be concluded that diode lasers operating within the range of 810-980 nm, when set at the appropriate power level, prove to be an effective method for managing gingal enlargement caused by orthodontic appliances.

This study aimed to determine whether administering botulinum toxin type A (BT) prior to surgery would stabilize surgical lip repositioning. A randomized controlled parallel-group clinical trial was performed. A total of 18 participants with excessive gingival display (EGD) were divided into two groups. For the test group (TG), BT was injected into the smile muscle locations 15 days before the surgical procedure. For the control group (CG), only lip repositioning surgery was performed. Gingival display (GD) and upper lip displacement (LD) were measured 3 and 6 months postoperatively. Data were submitted to ANOVA, Tukey, and t tests. For GD and LD, the changes were statistically significant between the measurements taken at the baseline, 3-month, and 6-month marks. The GD presented a reduction of 5.2 ± 1.1 mm in TG and 3.2 ± 1.4 mm in CG after 6 months. The LD measurements reduced 45% for TG and 26% for CG in 6 months. The injection of BT 15 days before lip repositioning surgery provided more stable results and effectively reduced the GD at 6 months. [ABSTRACT FROM AUTHOR]

Maxillary canines are the second most commonly impacted teeth, with mandibular third molars being the most commonly impacted teeth. One-third of the impacted maxillary canines are labially impacted, and the remaining two-thirds are palatally impacted. Palatally impacted canines (PICs) comprise approximately 1% to 2.5% of the general population. These impactions can be managed with preventive, interceptive techniques or surgical uncovering. If preventive or interceptive measures are unsuccessful in allowing the canine to erupt, there are many techniques that can be employed to uncover the PIC. Canines that are very superficially impacted can be uncovered with a simple gingivectomy. Canines that are more deeply impacted will require flap reflection, bone removal, and the placement of some type of orthodontic bracket. Most often, the surgeon will attach a chain to the impacted tooth so the orthodontist can immediately begin movement with some form of traction device. The preorthodontic uncovering technique (POUT) allows spontaneous eruption of the impacted tooth without active orthodontic force. When this technique is employed early (approximately 6 months before orthodontic treatment is initiated), it will save considerable time and trauma in erupting these teeth. Research has shown that this technique decreases orthodontic treatment time to properly position these teeth. In addition, this technique has been shown to be healthier for the bone and root structure of the impacted tooth and surrounding teeth. This article elucidates the benefits of the POUT when uncovering simple and very complicated PICs. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF), concentrated growth factors (CGF), and autologous fibrin glue (AFG) application on early wound healing after gingivectomy and gingivoplasty operations. Method and materials: In this split-mouth study, gingivectomy and gingivoplasty surgery were performed on 19 patients. The postoperative PRF, CGF, and AFG applied areas were compared with the control regions. On days 0, 7, 14, and 28, the surgical area was stained with a plaque-disclosing agent and evaluated in the ImageJ program. Wound healing was evaluated with H2O2 test, visual analog scale for pain, and Landry, Turnbull, and Howley (LTH) wound healing index on days 7, 14, and 28. The patients were asked to evaluate their esthetic perceptions on a visual analog scale. Results: The amount of staining at days 7 and 14 was found to be significantly higher in the control group than in the test groups, but there was no difference between the test groups. LTH index values of the control group at days 7, 14, and 28 were found to be significantly lower than the test groups. There was no significant difference between the groups in the epithelialization assessment performed with the H2O2 test. It was observed that the use of platelet concentrate at day 7 reduced postoperative early pain. Patients were highly satisfied with postoperative esthetics. Conclusion: After gingivectomy and gingivoplasty operations, PRF, CGF, and AFG application were found to have positive effects on wound healing. However, PRF, CGF, and AFG applications were not superior to each other in terms of secondary wound healing. [ABSTRACT FROM AUTHOR]

Objective: This clinical study aimed to evaluate the effect of virtual reality (VR) technology on anxiety and pain levels in patients undergoing gingivectomy and gingivoplasty procedures. Materials and Methods: The patients were randomized into test (surgery with VR glasses) and control (surgery without VR glasses) groups. Before the surgery, the anxiety level was measured using the modified dental anxiety scale (MDAS), and anticipated pain (AP) was measured by a visual analog scale (VAS). Immediately after the surgery, the pain and discomfort associated with the surgery (VASP), procedure time (T), and time perception (TP) were evaluated. The patients in the test group were requested to assess the immersion (VASI), satisfaction (VASS), perception of reduced anxiety (VASA), and perceived control (VASC). One week after surgery, MDAS was applied to all patients. Results: This trial was conducted with 41 female and 17 male subjects with a mean age of 29.69 ± 12.32. There were no significant differences between the groups in terms of age, sex, preoperative MDAS, or AP. After surgery, MDAS, VASP, T, and TP failed to differ significantly between the groups. The subject age was positively correlated with VASI, VASS, VASA, and VASC (r = 0.60, p = 0.00; r = 0.44, p = 0.02; r = 0.46, p = 0.02; r = 0.50, p = 0.01, respectively) and negatively correlated with VASP (r = 0.47, p = 0.04). Conclusions: VR application did not affect anxiety and pain levels in patients undergoing periodontal surgery. More studies are needed to evaluate VR distraction in periodontal surgeries with diverse age samples and video options. Clinical Significance: VR does not affect anxiety and pain levels during gingivectomy and gingivoplasty surgeries in the young adult population. It should be evaluated in older age groups. Trial registration ClinicalTrials.gov Identifier: NCT06092177. [ABSTRACT FROM AUTHOR]

Objective: To explore the feasibility of the usage of digital guides in combination with low‐ and high‐power lasers for the treatment of excessive gingival display, also known as "gummy smile". Clinical Considerations: Excessive gingival display due to altered passive eruption can affect patient's perception of their own esthetics and consequently have an impact on self‐confidence. Therefore, the management of this condition should offer a predictable and stable long‐lasting solution. To attain these objectives, digital planning emerges as a tool in optimizing the outcomes of crown lengthening surgery for this condition by enhancing precision through the use of surgical guides. Additionally, the usage of high‐ and low‐powered lasers can provide a safe approach because of their tissue selective removal properties. Conclusions: The technique described showed satisfactory clinical results in the short‐ and long‐term follow‐up, leading to an improvement in patients' self‐esteem. This approach integrates digital and laser technologies to deliver a surgical treatment characterized by precision, efficiency, and safety. Clinical Significance: Digital dentistry has contributed to innovative dental procedures, as personalizing surgical guides for patients, assisting and guiding incisions of the gingival margins, as well as the extension of the osteotomy, during the procedures for increasing the clinical crown. Furthermore, smile esthetics are directly related to an individual's improved emotional and social quality of life. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The aim of this study was to evaluate the effects of wound healing using injectable platelet-rich fibrin (IPRF) after gingivectomy and gingivoplasty. Materials and methods: In this clinical study, 46 systemically healthy patients with chronic inflammatory gingival enlargement were randomly treated with gingivectomy-gingivoplasty + I-PRF (n=23) or gingivectomy-gingivoplasty alone (n=23). The primary outcome was to evaluate the effect of I-PRF on wound healing over a 3-week follow-up period. Samples collected from gingival crevicular fluid (GCF) were processed using enzyme-linked immunosorbent assay (ELİSA) to measure VEGF and FGF-10 biomarkers. The surgical areas were stained with Mira-2 tone and evaluated in ImageJ. Wound healing was evaluated with Modified Manchester Scar (MMS) scale and Landry, Turnbull, and Howley (LTH) index. Results: VEGF values of the control group at baseline, week 2, and week 3 were significantly higher than the test group. In weeks 2 and 3, FGF-10 values were found to be significantly higher in the control group than the test group. The amount of staining was found to be significantly higher in the control group than in the test group on days 3, 7, and 14. LTH values of the control group were significantly lower than the test group and MMS values were significantly higher than those of the test group. Conclusions: I-PRF applications revealed positive effects on epithelial wound healing after gingivectomy and gingivoplasty operations. Clinical relevance: Platelet concentrates such as I-PRF accelerate wound healing and contribute to the patient’s comfort and quality of life. I-PRF application may have positive effects on wound healing after gingivectomy and gingivoplasty operations. [ABSTRACT FROM AUTHOR]

Objective: This article presents technical guidelines for perio‐restorative esthetic crown lengthening, along with a discussion of the biologic rationale. A classification system is proposed to assist in treatment planning and sequencing the surgical and restorative phases. Clinical Considerations: When esthetic crown lengthening is performed as an adjunct to restorative therapy, the surgical approach must be determined by the anticipated position of the restorative margins. The removal of sufficient bone to achieve the desired clinical crown length and preserve the supracrestal gingival tissue dimensions is facilitated by the use of a surgical guide fabricated according to the design of the restorations. A staged approach allows sequencing the provisional restoration to minimize unesthetic sequelae during the healing period. Inadequate bone resection and/or alteration of the soft tissue dimensions results in delayed healing, leading to coronal gingival rebound and biologic width impingement. Conclusion: The identification and preservation of appropriate restorative and biologic landmarks is essential for success in pre‐prosthetic esthetic crown lengthening treatment. A staged approach improves the esthetic management during the postsurgical healing and maturation period. Clinical Significance: A restorative driven classification system for sequencing and staging adjunctive esthetic crown lengthening procedures is presented. Technical guidelines to enhance gingival margin predictability are suggested, accompanied by relevant evidence. In addition, wound healing timelines following gingival and osseous resection are provided. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this case series is to present the potential applications of the GingivalStat approach, that is, the use of temporary gingival stabilizers, to favor early gingival margin remodeling and prevent the occurrence of gingival rebound following esthetic clinical crown lengthening. Clinical Considerations: Four patients requiring clinical crown lengthening were treated for esthetical and functional reasons. The surgical approach included: (a) gingival margin recontouring; (b) full‐thickness flap elevation; (c) osteotomy (to achieve an adequate dimension between the alveolar bone crest and the CEJ) and osteoplasty (to reduce the bone thickness and improve the buccal bone anatomic profile, where indicated); (d) temporary gingival stabilizer placement using a block‐out resin or a composite (the GingivalStat approach); and (e) flap repositioning, adaptation, and suture. One‐ to five‐year follow‐ups, reported in the different case scenarios, show evidence of clinically stable gingival margins around the treated teeth. Conclusions: Within the limits of this case series, it can be concluded that the GingivalStat approach appears as a further maneuver to cope with clinical crown lengthening procedures at esthetic sites. GingivalStat seems to favor gingival margin contour remodeling during the early phase of healing as well as prevent the occurrence of gingival rebound. Clinical Significance: GingivalStat approach may guide gingival margin remodeling and prevent gingival rebound after wound healing of sites submitted to esthetic clinical crown lengthening. [ABSTRACT FROM AUTHOR]

Hereditary gingival fibromatosis (HGF) has been defined as a rare disorder characterized by a benign, nonhemorrhagic, fibrous gingival overgrowth that can appear in isolation or as part of a syndrome. Because it has no specific cause, it is also known as idiopathic gingival fibromatosis. HGF starts in its mildest form and progresses very slowly to reach a severe form that can cover the teeth, causing severe functional and cosmetic problems. Clinically, it appears as diffuse or localized gingival overgrowth, pinkish, and firm in consistency that could be seen in both the buccal and lingual gingiva of both the mandible and maxilla. There could be ulceration and bleeding secondary to traumatic biting on the lesion. We report a case of a 12-year-old boy who presented with 5-year history of multiple gingival lesions clinically diagnosed with HGF. The relevant literature and important aspect in the management of this condition has also been discussed. [ABSTRACT FROM AUTHOR]

This case report aims to present the result of the association between dental bleaching, gingivectomy and esthetic remodelling with composite resin in a case of smile harmonization. Patient, female, showing a diastema between the two maxillary central incisors, inadequate restoration in tooth 21, and alterations on color, shape and size of the anterior maxillary teeth, attended the Group of Studies in Dentistry (UFC - Sobral) complaining about her smile's aesthetic. After anamnesis, diagnosis and acceptance of the treatment proposed, the staff performed buccal adequation through supragingival scalling and dental prophylaxis, followed by the gingivectomy, which included the external besel technique. After the healing period, the patient started the supervised dental bleaching protocol (carbamid peroxide 16%, 2h/day, 20 days). [ABSTRACT FROM AUTHOR]

Marfan syndrome (MFS) is an autosomal dominant and multisystemic disorder affecting the connective tissues. Patients with MFS may exhibit characteristic oral features including maxillary protrusion, high palate, crowded teeth, and fragility of the temporomandibular joint. Periodontal manifestations may include a higher prevalence of gingivitis and/or periodontitis owing to the high concentration of elastic fibres in the periodontal ligament. This case report describes the management of gingival enlargement associated with MFS. The patient was successfully managed with non-surgical and surgical periodontal therapy. In patients with oral manifestations of systemic disorders, patient motivation and effective treatment planning are able to achieve the optimum periodontal and oral health outcomes. [ABSTRACT FROM AUTHOR]

Lip repositioning surgery is a predictable surgical technique that provides a solution for patients with excessive gingival smile. This case series presents four patients with 6 to 8 mm of excessive gingival display who received a modified surgical technique using internal horizontal mattress sutures to immobilize the labial superior elevator muscle. None of the patients exhibited complications, and their healing was uneventful. All patients demonstrated predictable results and presented with stability over an average of 3.5 years of follow-up. The modified lip repositioning surgery with internal horizontal mattress sutures seems to provide reliable long-term results in patients with an excessive gingival display. [ABSTRACT FROM AUTHOR]

Computer-aided design and computer-aided manufacturing (CAD/CAM) dentistry have significantly changed workflows in recent years. Restorations and devices can now be digitally designed and 3D-printed for dental care purposes. This clinical case report provides straightforward protocols for the digital design and 3D manufacture of gingivectomy and tooth preparation guides. These types of guides improved the gingival architecture of the anterior teeth and provided controllable tooth preparations prior to labial ceramic veneers. Thoughtful clinical evaluation started with listening to the patient’s chief complaint and extra- and intra-oral evaluations. Then a digital wax-up was performed, followed by an intra-oral mock-up, to evaluate the shape of the proposed restorations. After patient acceptance, the clinical procedure started with the gingivectomy and tooth preparation. Hand-crafted porcelain veneers were bonded under rubber dam isolation to avoid any contamination and maximize the bonding protocol. The esthetic and functional demands were fully satisfied. Predictable outcomes can be obtained whenever a meticulous evaluation and execution of all the steps are performed. Three dimensional printing technology allows the fabrication of devices such as gingivectomy and tooth reduction guides that help accomplish the desired results.

Background: Surgical gingivectomy can be considered the gold standard treatment for gingival enlargement. The healing of wound site after gingivectomy occurs slowly by secondary intention. To accelerate the wound healing process, several studies have been conducted evaluating the effect of various treatment modalities. Photobiomodulation therapy (PBMT) was proposed to provide minimally invasive and painless treatment as well as to decrease discomfort of the patient following the surgical process. Another factor that is expected to improve the healing after surgery is topical application of chemotherapeutic agents such as Hyaluronic acid (HA). This study aims to assess the effect of topically applied HA gel after PBMT on the healing of wound site after surgical gingivectomy. Methods: This randomized controlled clinical trial included twenty-six surgical gingivectomy wound sites, equally divided into two groups, Group-I (test group): the surgical sites after gingivectomy were irradiated with a diode laser (980 nm, 0.2 W) then covered by 2% HA gel loaded in a special custom-made soft transparent tissue guard appliance for each patient. Group II (control group): the surgical sites were irradiated with a diode laser (980 nm, 0.2 W) only. Wound healing was assessed subjectively by Landry healing index on the 3rd, 7th, 14th and 21st days after surgery, and pain perception was assessed by the patients using visual analog scale (VAS) throughout the 21 days of the follow up period. Comparisons between the two study groups were performed using Mann-Whitney U test, while comparisons between different time points were performed using Friedman test. Significance was inferred at p value < 0.05. Results: By the end of the follow-up period, surgical sites of the test group showed excellent healing compared to the control group. There were no significant differences in VAS scores between both groups (p > 0.05). Conclusions: Application of 2% HA gel as an adjunctive to PBMT was found to have significant clinical effects and higher power of repair among test group when compared to that achieved by PBMT alone in control group. Trial registration: This study was retrospectively registered on ClinicalTrials.gov and first posted on 28th of March 2023 with an identifier number: NCT05787912. [ABSTRACT FROM AUTHOR]

Objective: To describe a strategy using digital technologies for improving the diagnosis, treatment planning, and surgical execution of patients with excessive gingival display (EGD) due to altered passive eruption (APE). Clinical Considerations: An important component for successful patient's management is to fulfill their esthetic expectations whilst delivering predictable and long‐term therapeutic outcomes. To achieve this goal in patients with excessive gingival display due to altered passive eruption, it is essential to perform an accurate diagnosis and to communicate to the patient the expected customized results using digital technologies. Computer‐aided designed and manufactured multifunctional anatomical prototypes (MAPs) may contribute to these purposes. Additionally, they can guide the surgical crown lengthening procedure or serve as a reference during the surgical guide fabrication providing information of the required anatomical landmarks. Conclusions: This novel strategy protocol for diagnosis, communication, and treatment management of patients with excessive gingival display follows functional and biological principles within the frame of a digital workflow, which improves the diagnostic capabilities, enhances communication, and guides the surgical treatment as shown in the 12 months follow‐up of the reported case. Clinical Significance: Developing a virtual patient by combining multiple digital data sets including cone‐beam computed tomography (CBCT), intra‐oral scans and digital photography, supports the clinician and the patient to achieve a comprehensive diagnosis and to better communicate the expected results to the patient. Furthermore, this digital treatment exercise based on anatomical and biological principles will facilitate the surgical precision and the achievement of successful outcomes, thus fulfilling the patient needs and expectations. [ABSTRACT FROM AUTHOR]

We live in a society that appreciates beauty. More than just restoring the teeth, naturally attractive, confident smiles mean restoring and increasing overall quality of life. Making efforts to improve one's physical appearance is now regarded as an investment in one's health and well-being. Superior periodontal health is the cornerstone for an individual's aesthetic regeneration. As an outcome, perio-aesthetics is a comprehensive strategy that improves the appearance of the smile while maintaining long-term dental health. Hence, getting the ideal aesthetic effect is both difficult and gratifying. Crown lengthening is a feasible option for improving aesthetic appearance or aiding restorative therapy. Yet, before planning a crown lengthening operation, the patient's overall periodontal status and cleanliness habits should be assessed. Furthermore, for enhanced, conservative, and predictable results in aesthetic areas, a precise diagnostic and interdisciplinary strategy is essential. This article attempts to discuss guidelines for treating individuals with excessive gingival display, as well as treatment options, using two case reports as examples. [ABSTRACT FROM AUTHOR]

Aim This study aims to evaluate the effects of concentrated growth factors (CGF) membrane application on initial wound healing after gingivectomy and gingivoplasty surgeries. Methods and materials 20 patients with gingival enlargement who need gingivectomy or gingivoplasty surgery were selected to participate in this study. They were randomly divided into two groups of 10 patients each. Group-1 (Control group): where the gingivectomy sites were covered by a non-eugenol periodontal pack. Group-2 (Test group): were covered by the CGF membrane under the non-eugenol periodontal pack, postoperatively. Assessment of postoperative pain for both groups was recorded using the Visual Analog Scale for a period of 7 days. Laundry healing index, papillary bleeding index, and gingival index (GI) were also assessed at 7, 14, 21, and 28 days postoperatively. Results All patients experienced a decrease in postoperative pain throughout the study evaluation period, with no statistically significant differences between the two groups (P > 0.05), except for days 3 and 4, where there were statistically significant differences in favor of the test group (P < 0.05). On days 7 and 21, there was no difference in the healing index, but on days 14 and 28, there was a statistically significant difference (P < 0.05). The Papillary bleeding index (PBI) and gingival index of the two analyzed groups improved during the research period. At 21 days, the intergroup comparison showed a significant difference in PBI between the two studied groups (P > 0.05) in favor of the study group. Conclusion CGF membrane improved wound healing and reduced postoperative pain following gingivectomy or gingivoplasty surgery. [ABSTRACT FROM AUTHOR]

Background and objective: Some studies support the superiority of diode laser gingivectomy to scalpel surgery and nonsurgical treatments. However, a systematic review on this topic is lacking. This study aimed to compare gingivectomy with diode laser versus the conventional scalpel surgery and nonsurgical periodontal therapy (NSPT) in the treatment of orthodontic treatment-induced gingival enlargement (GE). Materials and methods: In this systematic review, an electronic search of the relevant literature was conducted in Web of Science, Medline/PubMed, Scopus, Cochrane Central Register of Controlled Trials, and ProQuest with no language restriction. Randomized clinical trials published between 1985 and 2020 on comparative treatment of orthodontic treatment-induced GE by diode laser gingivectomy and scalpel surgery or NSPT regarding intraoperative and postoperative bleeding and/or pain were included. Risk of bias was assessed by the Cochrane 1 tool. Results: Of the initially retrieved 288 articles, 40 were duplicates and excluded; 236 articles were excluded following title and abstract screening, and 5 others were excluded following full-text assessment. Finally, 7 studies underwent systematic review. In the risk-of-bias assessment, 5 studies scored 2, and 2 studies scored 3 out of 6. Intraoperative and postoperative bleeding and pain were found to be significantly lower in the laser group. Conclusions: Within the limitations of this systematic review and with respect to the quality of evidence, the present results revealed lower level of pain and bleeding in diode laser gingivectomy compared with the conventional scalpel surgery and NSPT for treatment of orthodontic treatment-induced GE. [ABSTRACT FROM AUTHOR]

Determining the appropriate technique for diastema closure is challenging, and the decision must be evidence based. The objective of these case reports is to describe different approaches to diastema closure using direct and indirect techniques, focusing on the characteristics of the patient and clinical requirements to guide treat-ment. In the first case, a 16-year-old patient had multiple diastemas in the maxillary anterior dentition. The clinical evaluation revealed microdontia of the lateral incisors and malpositioned teeth. The treatment included tooth whitening and placement of composite resin veneers using a direct technique. In the second case, a 54-year-old patient displayed a disharmonious and esthetically compromised smile due to small teeth, color changes, multiple diastemas, incisai wear, and severe dentogingi-val disproportion. Based on the patient's expectations, the patient's age, and the presence of a "black triangle" interdental space, a multidisciplinary restorative treatment was proposed, including gingivoplasty, tooth whitening, and placement of ceramic laminate veneers using an indirect technique. Both approaches achieved successful esthetic rehabilitation and diastema closure with minimal intervention. The choice of procedure and restorative material, as well as the need for tooth preparation, varied based on the clinical requirements, patient expectations, and financial constraints. Careful treatment planning avoided lengthy and inefficient procedures. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hereditary gingival fibromatosis (HGF) is an uncommon, inherited condition with slow and progressive fibrous hyperplasia of the gingiva. The fibrous nature of the enlargement interferes with eruption, mastication, speech, and occlusion. This condition is more commonly noted during the transition from deciduous to permanent dentition. This can have overbearing effects on the psychology and function of the individual, thus making early diagnosis and precise management important. The conventional mode of treatment includes scalpel gingivectomy (external/internal bevel). In young patients, gingivectomies involving the entire dentition can be a therapeutic challenge. Lasers have proven themselves as viable substitutes for conventional gingival surgeries. The use of Light amplification by the stimulated emission of radiation (LASER) for gingivectomy may also present added advantages such as lack of bleeding, increased patient cooperation, and better compliance. This case report presents the diagnosis and treatment of HGF in a 9-year-old girl emphasizing the unique advantage of LASER in the clinical scenario. [ABSTRACT FROM AUTHOR]

The pathogenesis of hereditary gingival fibromatosis (HGF) is largely unknown; however, the removal of excess tissue may often be necessary as it often causes aesthetic and functional problems. Gingivectomy is usually a treatment option that can be performed using a scalpel, cryotherapy, electrosurgery, or laser. This paper aims to evaluate the results of HGF treatments using a diode laser of five people from the same family. Three members of a family of five (two females and three males; 9–36 years old) underwent gingivectomy with a 3 W 300‐micron fiber‐tipped diode laser (Doctor Smile, Vicenza, Italy) at 810 nm wavelength. While all teeth of one member were extracted, the other member refused treatment. Relapse occurred in three members due to poor oral hygiene. The diode laser was reapplied and oral hygiene instructions were repeated. Patients were followed during the postoperative period for up to two years. HGF is a rare condition that clinicians should pay attention to in the diagnosis, treatment, and follow‐ups. Since recurrences are due to dental plaque, oral hygiene instructions are essential and compliance is mandatory. Although there are many treatment approaches, the diode laser is the most indicated method due to many advantages such as providing a bloodless and more sterile operation field, performing an atraumatic surgery, ensuring earlier and ideal recovery, and minimizing postoperative pain. [ABSTRACT FROM AUTHOR]

Background and Aim: Nowadays, facial esthetics has become the main concern for many people. Gummy smile (GS) is a common complaint that affects the esthetics and psychological status of patients. The aim of this study was to review GS treatment options. Materials and Methods: An electronic search was conducted in three databases of PubMed, Wiley and Cochrane Library from January 2015 up to August 2021. According to the eligibility criteria, a total of 41 relevant papers were retrieved and reviewed. Results: Based on the available data, several techniques have been reported for GS treatment, such as lip repositioning, crown lengthening, orthognathic surgery, laser application, botulinum toxin (BT) injection, hyaluronic acid injection, and micro autologous fat transplantation (MAFT). Combination of two or three of these techniques may yield a better result. Conclusion: A wide variety of procedures are available based on the cause of GS. The new, less invasive, faster and safer alternative techniques were shown to be feasible with a long-lasting result and minimal postoperative sequelae. Such treatment options for various types of GS can lead to significant improvement in smile esthetics with high patient satisfaction.

Aim: To investigate the spontaneous regeneration of the implanto‐mucosal and dento‐gingival unit after complete removal of keratinized tissue (KT). Materials and Methods: One hemi‐mandible per dog (n = 4) was allocated to receive three dental implants (test sites, premolar region), whereas three premolars on the contralateral side were controls. After osseointegration, the entire KT (buccal + lingual) was surgically excised on all test and control sites, leaving the bone exposed. Clinical measurements were performed before excision (T0) and after 12 weeks (T1). Following healing, the animals were euthanized, and the specimens were histologically processed. Descriptive statistical analyses were performed. Results: Clinical measurements revealed that at T1, on all teeth, a band of KT was spontaneously regenerated (mean width: 2.60 ± 0.66 mm), whereas on implants, KT was detected only occasionally at mesial or distal but not at buccal sites (mean total: 0.35 ± 0.53 mm; p <.0001). Histologically, spontaneous regeneration of the dento‐gingival unit was evident, displaying masticatory mucosa. At the implant sites, on the other hand, the implanto‐mucosal unit was characterized by a non‐keratinized epithelium and elastic fibres, indicating the characteristics encountered in alveolar mucosa. Conclusion: After excision of KT at implant sites, the spontaneous regeneration of the soft tissue is characterized by a non‐keratinized epithelium typical for alveolar mucosa, while at tooth sites the spontaneous regeneration was characterized by soft tissue resembling gingiva. [ABSTRACT FROM AUTHOR]

Introduction: Aesthetics has been one of the most discussed and explored subjects in today's dentistry. Therefore, the search for procedures aimed at facial harmonization has been more frequent in dental offices. The gingival smile is characterized by excessive gingival exposure to the smile being one of the main complaints of the patients who seek a dental surgeon in order to obtain facial aesthetics, being able to present different causes. It is extremely important to correctly diagnose each case so that the correct etiology is stable and successful in the treatment to be performed. Objective: In the present paper, two clinical cases of patients with complaints of gingival smile and short teeth were reported in which the etiology of both was type IB altered passive eruption. Case report: Due to the individual characteristics of each patient, each case was solved with different surgical approaches. In the first case, the patient had a thick periodontium and therefore the clinical crown lenghtening procedure was performed through the internal bevel gingivoplasty with osteotomy and osteoplasty. In the second case, the patient had a thin periodontium, and it was possible to perform a clinical crown lenghtening using the flapless technique. Conclusion: Therefore, although both cases present the same etiology, different periodontal surgical techniques were used, which allowed for satisfactory results for the patients. [ABSTRACT FROM AUTHOR]

Clinical crown of the tooth is the distance from the gingival margin to the incisal edge or occlusal surface of the tooth. Many causes can be attributed to a short clinical crown. Maintaining a healthy periodontium during teeth restoration procedures is an indispensable condition for obtaining regular functioning and aesthetics. Crown lengthening is a surgical procedure designed to increase the extent of the supragingival tooth structure so that the clinician can restore the tooth and correct aesthetic defects. The crown lengthening procedure (CLP) is used to maintain the dentogingival complex in optimal condition. [ABSTRACT FROM AUTHOR]

Abstract Objective To compare the efficacy of three surgically assisted permanent anterior tooth eruption methods (laser surgery, electrosurgery and routine surgery) in children. Method Sixty-three orthodontic children with retarded permanent anterior tooth were selected and according to the random number table divided into three groups: laser surgery group (group A), electrosurgery group (group B) and routine surgery group (group C). The total operative time (min), the duration of pain after gingival excision (d), Visual Analogue Scale (VAS) pain intensity scores (0–10 cm), and gingival healing time (d) were all recorded. Six months after treatment, periodontal indexes of the three groups, including gingival indexes (GI), plaque indexes (PLI), probing depth (PD) were checked by the same periodontist and recorded. Results Surgical records showed that compared with group C, there were statistically significant differences in operative time, pain duration, pain intensity and healing time in group A and B (P

Background and Aim: Lasers can serve as a new powerful tool in dentistry. High intensity laser therapy is becoming the treatment of choice compared with conventional periodontal therapy due to accurate incision and soft and hard tissue ablation, hemostasis, reduction of postoperative pain and infection, optimal debridement, and enhanced healing. Although high intensity laser therapy assumes to provide better results compared with conventional treatments, a significant variation exists in the applied laser parameters such as different wavelengths and energy densities of laser. The objective of this study was to collect preliminary information about the type and parameters of surgical lasers and how to use them technically based on the available literature on this topic. Materials and Methods: After initial screening of 152 potentially relevant articles identified through an electronic search, 44 articles were selected based on the eligibility criteria by three independent reviewers. The inclusion criteria included studies on the outcomes of periodontal high intensity laser therapy in humans published in English between 2013 and 2021 in journals indexed in PubMed Central, Science Direct, Wiley Online Library, Springer or Google Scholar. Results: The results showed that diode, Nd:YAG, Er:YAG, Er;Cr:YAG and CO2 lasers had the highest efficacy for frenectomy, gingivectomy, and osteotomy with specific wavelength, power density, frequency, and pulse mode. Various lasers have been suggested for the abovementioned purposes, and the method of choice depends on the efficacy and availability of laser. Conclusion: This study confirmed higher efficacy of different laser types compared with conventional treatments.

The erbium-trium aluminum garnet (Er:YAG) is a short-pulse laser that can be used for hard tissue ablation, soft tissue debridement and root canal decontamination. It can be effectively used in deciduous teeth removal, resin bonding, superordinate teeth extraction, lingual lacunae extension, root canal washing and other aspects. Because the operation is painless, it is more acceptable to children, hence it is very common in pediatric stomatology application research. This article reviews the application of Er:YAG in pediatric stomatology from the above aspects. [ABSTRACT FROM AUTHOR]