Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2021 dental literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to coverage of this broad topical area. Specific subject areas addressed, in order of the appearance in this report, include COVID-19 and the dental profession (new); prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence daily dental treatment decisions with an emphasis on future trends in dentistry. With the tremendous volume of dentistry and related literature being published daily, this review cannot possibly be comprehensive. Rather, its purpose is to update interested readers and provide important resource material for those interested in pursuing greater details on their own. It remains our intent to assist colleagues in negotiating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the patients and dental problems they encounter.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.

The digital POIP concept: Preorthodontic implant placement.

OBJECTIVE: The aim of this report is to present an interdisciplinary treatment involving periodontics, orthodontics, dental implant placement, and prosthodontics with a fully digital dentistry approach. CLINICAL CONSIDERATIONS: The patient presented with an edentulous ridge on the area of the lower left lateral incisor as well as gingival recession on the adjacent teeth. After performing a digital orthodontic setup and indirect bonding bracket placement, a dental implant placement was carried out before orthodontic treatment in combination with guided bone regeneration (GBR), connective tissue graft (CTG) and periodontal accelerated osteogenic orthodontics (PAOO). In a 6-month period, orthodontic treatment was fully completed and the dental implant was restored at 8 months. Following one-and-a-half years, significant gingival recession reduction was accomplished and soft tissue augmentation around the dental implant appeared stable with a good functional and esthetic result. CONCLUSION: The use of the digital POIP concept with a proper diagnosis and careful planning is crucial for reducing treatment time and enhancing precision.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry.

This comprehensive review of the 2019 restorative dental literature is offered to inform busy dentists regarding remarkable publications and noteworthy progress made in the profession. Developed by the Scientific Investigation Committee of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to 1 of 8 sections of the report: (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information likely to influence day-to-day dental treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source material when greater detail is desired. As the profession moves toward evidence-based clinical decision-making, an incredible volume of potentially valuable dental literature continues to increase. It is the intention of this review and its authors to provide assistance in negotiating the extensive dental literature published in 2019. It is our hope that readers find this work useful in the clinical management of dental patients.

A Report of Three Cases from an Ongoing Prospective Clinical Study on a Novel Pink Biomimetic Implant System.

While, overall, dental implants are highly efficacious, consistently achieving predictable esthetic results can pose color-driven challenges at the implant/soft-tissue interface, particularly in the esthetic zone. An ongoing, 5-year, multicenter (eight sites) prospective study is following a total of 168 implants placed in 120 patients using a novel biomimetic (osteoconductive) implant system with pink collars and abutments that afford better gingival color matching, enhanced design variability, and streamlined fabrication and customization of the abutment/implant-tissue interface. The full results of this study will be published at the 3-year and 5-year timepoints; however, clinical analyses of the 18-month interim survival rates, marginal bone and soft-tissue level changes, and esthetics have been completed, showing an overall success rate among all of the implanted sites of 95.8%. For the three representative cases described in this article (two anterior, one posterior), all of the implant site probing depths were ≤ 3 mm at the final crown placement as well as at 6, 12, and 18 months after implant placement. Facial soft-tissue heights were stable or increased by ≥ 0.86 mm; lingual soft-tissue heights were reduced by ≤ 1.11 mm. Facial and lingual attached-gingiva widths were reduced by ≤ 1.20 mm and ≤ 0.63 mm, respectively. Interproximal marginal alveolar bone levels were stable (gain/loss range: +0.40 to -1.1 mm) from the start of the study through 18 months. Gingival inflammation, bleeding on probing, and plaque were infrequently observed, and esthetic results were uniformly excellent at the 18-month follow-up visit.

Full-thickness flap/subepithelial connective tissue grafting with intramarrow penetrations: three case reports of lingual root coverage.

Three case reports are presented that demonstrate the use of full-thickness flap/subepithelial connective tissue grafting for root coverage on the lingual surfaces of the mandibular anterior teeth. This is accomplished using an envelope full-thickness flap technique with intramarrow penetrations at the recipient site. Miller Class I, II, and III gingival recession defects and gingival perforation defects were treated. Complete root coverage was achieved in two Miller Class I gingival recession defects, in one Miller Class II gingival recession defect, and in two gingival perforation defects in areas that exhibited no radiographic evidence of bone loss. Partial root coverage was achieved in two Miller Class III gingival recession defects in an area that exhibited radiographic evidence of bone loss. Although the majority of the exposed root surface was covered in these two Miller Class III defects, about 1 mm of root surface remained exposed, which seemed to closely correspond to the amount of bone loss that was noted radiographically. A grafting technique has been presented that can be used to restore the functional properties of the lingual gingiva of the mandibular anterior teeth by repairing gingival defects and re-establishing the continuity and integrity of the zone of keratinized gingiva. Our clinical impression is that this has made it easier for the three patients presented in this report to maintain the lingual surfaces of the mandibular anterior teeth with routine oral hygiene measures.

Periodontal Regeneration - Furcation Defects: Practical Applications From the AAP Regeneration Workshop.

Focused Clinical Question: How should periodontal furcation defects be managed via periodontal regenerative therapy, and what parameters should be used for treatment selection? Summary: The treatment of furcation defects can vary based on the type and location of the furcation involvement. Attaining predictable regenerative outcomes is dependent on the control of local and systemic factors. A combined treatment approach (barrier and bone replacement graft with or without biologic) generally offers the better therapeutic outcome over monotherapy. Class I furcation defects can be managed via conventional periodontal non-surgical and/or surgical therapy, whereas Class II furcation defects generally attain better outcomes with regenerative therapy. There is weak evidence, limited to case reports, that Class III furcation defects can be treated successfully with regenerative therapy. Conclusions: In Class I furcation defects, regenerative therapy might be beneficial in certain clinical scenarios, although most Class I furcation defects can be treated successfully with non-regenerative therapy. For successful treatment of maxillary and mandibular molars with Class II furcation defects, systemic and local factors should be controlled, and surgical debridement and postoperative maintenance should be performed adequately. Although there is limited evidence for regeneration of Class III furcation defects, there may be a modest improvement allowing for tooth retention. Ultimately, the benefit of tooth retention and cost should be considered in the indication of therapy for teeth with severe furcation involvement.

Periodontal regeneration - furcation defects: a consensus report from the AAP Regeneration Workshop.

BACKGROUND: Treatment of furcation defects is a core component of periodontal therapy. The goal of this consensus report is to critically appraise the evidence and to subsequently present interpretive conclusions regarding the effectiveness of regenerative therapy for the treatment of furcation defects and recommendations for future research in this area. METHODS: A systematic review was conducted before the consensus meeting. This review aims to evaluate and present the available evidence regarding the effectiveness of different regenerative approaches for the treatment of furcation defects in specific clinical scenarios compared with conventional surgical therapy. During the meeting, the outcomes of the systematic review, as well as other pertinent sources of evidence, were discussed by a committee of nine members. The consensus group members submitted additional material for consideration by the group in advance and at the time of the meeting. The group agreed on a comprehensive summary of the evidence and also formulated recommendations for the treatment of furcation defects via regenerative therapies and the conduction of future studies. RESULTS: Histologic proof of periodontal regeneration after the application of a combined regenerative therapy for the treatment of maxillary facial, mesial, distal, and mandibular facial or lingual Class II furcation defects has been demonstrated in several studies. Evidence of histologic periodontal regeneration in mandibular Class III defects is limited to one case report. Favorable outcomes after regenerative therapy for maxillary Class III furcation defects are limited to clinical case reports. In Class I furcation defects, regenerative therapy may be beneficial in certain clinical scenarios, although generally Class I furcation defects may be treated predictably with non-regenerative therapies. There is a paucity of data regarding quantifiable patient-reported outcomes after surgical treatment of furcation defects. CONCLUSIONS: Based on the available evidence, it was concluded that regenerative therapy is a viable option to achieve predictable outcomes for the treatment of furcation defects in certain clinical scenarios. Future research should test the efficacy of novel regenerative approaches that have the potential to enhance the effectiveness of therapy in clinical scenarios associated historically with less predictable outcomes. Additionally, future studies should place emphasis on histologic demonstration of periodontal regeneration in humans and also include validated patient-reported outcomes. CLINICAL RECOMMENDATIONS: Based on the prevailing evidence, the following clinical recommendations could be offered. 1) Periodontal regeneration has been established as a viable therapeutic option for the treatment of various furcation defects, among which Class II defects represent a highly predictable scenario. Hence, regenerative periodontal therapy should be considered before resective therapy or extraction; 2) The application of a combined therapeutic approach (i.e., barrier, bone replacement graft with or without biologics) appears to offer an advantage over monotherapeutic algorithms; 3) To achieve predictable regenerative outcomes in the treatment of furcation defects, adverse systemic and local factors should be evaluated and controlled when possible; 4) Stringent postoperative care and subsequent supportive periodontal therapy are essential to achieve sustainable long-term regenerative outcomes.

Guided tissue regeneration for the treatment of periodontal intrabony and furcation defects. A systematic review.

BACKGROUND: Many clinical studies have demonstrated that guided tissue regeneration (GTR) is a successful treatment modality of periodontal reconstructive surgery and it has become an accepted procedure in most periodontal practices. RATIONALE: The purpose of this structured review was to assess the efficacy of guided tissue regeneration (GTR) procedures in patients with periodontal osseous defects compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes. It extends the scope of previous GTR systematic reviews, which were limited to randomized controlled studies, by the scope of outcome measures examined, and the duration of the study. FOCUSED QUESTION: In patients with periodontal osseous defects, what is the effect of physical barriers compared with surgical controls on clinical, radiographic, adverse, and patient-centered outcomes? SEARCH PROTOCOL: An electronic search of the Cochrane Oral Health Group Trials Register and MEDLINE databases was performed. Manual searching of journals included Journal of Clinical Periodontology, Journal of Periodontology, and Journal of Periodontal Research up to January 2002. This manual search also included review of relevant bibliographies. Two manufacturers of GTR devices were contacted regarding unpublished data. INCLUSION CRITERIA: Studies were selected for review if the evidence level was 3B (cohort) or above, at least 6 months duration, and compared a test GTR intervention with a surgical control. EXCLUSION CRITERIA: Studies with experimental design problems; histologic or microbiological investigations; or those with outcome measurements, study populations, or study duration not consistent with the inclusion criteria were excluded. Primary outcome measures for intrabony defects were: clinical attachment level (CAL) gain, probing depth reduction (PD), gingival recession (REC) reduction; for furcation defects: vertical probing attachment level (VPAL) gain, vertical probing depth reduction (VPD), horizontal probing depth reduction (HPD), horizontal open probing attachment level gain (HOPA), and vertical open probing attachment level gain (VOPA). Meta-analysis was performed to compare GTR procedures to other surgical treatments and to examine the resulting clinical outcomes. MAIN RESULTS: 1. For the primary outcome variables, in both intrabony-defect and furcation-defect studies, GTR was favored over open flap debridement (OFD) therapies (P < 0.0001). 2. No differences were detected among barrier types, but barrier types could explain some heterogeneity in the results. 3. Augmentation of the GTR barrier with a particulate graft enhanced VPD (P < 0.05), VPAL, and HOPA, but none of the intrabony outcomes. REVIEWER'S CONCLUSIONS: Overall, GTR is consistently more effective than OFD in the gain of clinical attachment and probing depth reduction in the treatment of intrabony and furcation defects.