Implant associated soft tissue defects in the anterior maxilla: a randomized control trial comparing subepithelial connective tissue graft and acellular dermal matrix allograft.

INTRODUCTION: This randomized controlled clinical pilot trial compared the efficacy of 2 soft tissue grafting methods for correcting esthetic discrepancies associated with definitively restored implant crowns. METHODS: Thirteen patients presenting with implants displaying recession, thin biotype, concavity defects, or a combination thereof associated with single crowned dental implants randomly received subepithelial connective tissue grafts (SCTG) in the control group (N = 7) or acellular dermal matrix (ADM) allografts in the test group (N = 6), both under coronally positioned flaps. Data regarding soft tissue, hard tissue, esthetics, and quality of life (QoL) parameters were collected over 6 months. RESULTS: Both groups gained tissue thickness (SCTG: 63% and ADM: 105%), reduced concavity measures (SCTG: 82% and ADM: 96%), and improved recessions (SCTG: 40% and ADM: 28%) from baseline to 6 months. Clinicians determined improvement in esthetics for both groups (P = 0.001), unlike patients who did not change their esthetic ratings. No statistical differences were noted for QoL assessment; however, ADM subjects had more eventful wound healing (P = 0.021). CONCLUSIONS: Within the limitations of this study, both SCTG and ADM result in increased mucosal thickness, reduction in concavity dimensions, and have a potential for recession reduction on definitively restored dental implants.

Adolescent patients' treatment motivation and satisfaction with orthodontic treatment. Do possible selves matter?

OBJECTIVE: To determine whether adolescents' satisfaction with orthodontic treatment outcomes is correlated with the degree to which (1) the adolescents focused on and (2) were energized by imagining their posttreatment possible selves before the treatment, and whether parents' assessments of their children's pretreatment motivation would correlate with their children's posttreatment satisfaction. METHODS: Data were collected from 75 former adolescent orthodontic patients (28 male, 47 female; 60 European American, 14 other) and from 72 parents (59 female, 12 male, 1 missing) with mailed questionnaires. Satisfaction with the treatment outcome was assessed with a revised version of Kiyak's Post-Surgical Patient Satisfaction Questionnaire. RESULTS: The more the patients had focused on the posttreatment esthetics and functioning and the more they were energized by thinking about their posttreatment possible selves before the treatment, the more satisfied they were with the outcomes (r = .337, P = .004; r = .231, P = .053; r = .465, P < .001). The more the parents believed that their children were energized by thinking about posttreatment possible selves, the more satisfied the parents were with the outcomes (r = .326, P = .007). CONCLUSIONS: Increasing adolescents' possible self considerations before orthodontic treatment is likely to increase their own and their parents' posttreatment satisfaction.