Long-term outcome of implants exhibiting buccal soft tissue dehiscence in the esthetic zone.

OBJECTIVE: Increasing aesthetic demands require that the color and contour of the peri-implant soft tissues be in harmony with the neighboring teeth. Recession, migration toward the apical, is a frequent clinical finding. Its presence can lead to inflammation and increased marginal bone loss. These complications, in addition to affecting the aesthetic results of our treatment, are difficult to treat and can threaten the survival of the implant. There are fewer studies showing the outcome of treatment of soft-tissue defects around implants. The aim of this article is to describe the treatment of a soft-tissue defect around an implant-supported prosthesis treatment, performed on two neighboring implants, in the esthetic zone in a patient with a high smile and to evaluate both the coverage achieved and the patient's esthetic satisfaction. CLINICAL CONSIDERATIONS: This study showed that a mucogingival approach, using a surgical technique designed for the treatment of alveolar ridge defects, together with tissue management with temporaries and a new restoration, achieved an optimal result. CONCLUSIONS: The case has been closely followed up, for 10 years, and the authors have been able to confirm the long-term stability of the result. CLINICAL SIGNIFICANCE: The following paper shows the result of an innovative approach. Connective tissue platform technique, usually performed for soft-tissue augmentation, was used for a defect in soft-tissue dehiscence. The authors followed the results for 10 years, and the results achieved were satisfactory in terms of esthetic.

Regeneración periodontal en defectos intraóseos de 2-3 paredes con tres membranas diferentes: Un ensayo clínico randomizado / Periodontal regeneration in two and three-wall intrabony defects by the use of three different barrier membranes. A randomized clinical study

Fundamento: El objetivo del presente artículo es valorar la eficacia clínica, medida en términos de ganancia de inserción clínica, de dos membranas reabsorbibles, frente a un control positivo, membrana no reabsorbible, en el tratamiento de defectos intraóseos de 2-3 paredes. Pacientes y método: Seleccionamos 36 pacientes en los que detectamos 43 lesiones intraóseas de 2-3 paredes. Previamente a la cirugía se registró la profundidad de sondaje y la recesión gingival (nivel de inserción clínica). Tras el abordaje con un colgajo de espesor total, el desbridamiento y medición de los defectos y la instrumentación de la pared radicular, se colocó la membrana. Se realizó un seguimiento clínico a las 1, 2, 4, 6, 8 semanas, 3, 6 y 12 meses, y radiográfico a los 6 y 12 meses. Resultados: Finalizaron el estudio 36 defectos, correspondientes a 30 pacientes. Al año hubo una reducción en la media de la profundidad de sondaje de 3,98 mm, un incremento de la recesión de 0,17 mm y la ganancia clínica de inserción (NCI) fue de 3,97 mm. No encontramos diferencias significativas entre las diferentes membranas utilizadas (AU)

Background: A study is made to evaluate the clinical efficacy, in terms of clinical attachment gained, of two resorbable membranes versus a positive control (non-resorbable membrane), in the treatment of two-three wall intrabony defects. Patients and method: We selected 36 patients in whom 43 two-three wall intrabony lesions were detected. Prior to surgery we recorded pocket depth and gingival recession (clinical attachment level). After a full thickness flap approach, debridement and measurement of the defects, and instrumentation of the root wall, the membrane was placed. Clinical follow-up was carried out after 1, 2, 4, 6 and 8 weeks, and 3, 6 and 12 months, with radiological controls after 6 and 12 months. Results: A total of 36 defects completed the study, corresponding to 30 patients. After one year a mean reduction in pocket depth of 3.98 mm was recorded, with a 0.17 mm recession increment and a clinical attachment gain (NCI) of 3.97 mm. No significant differences were observed between the different membranes used (AU)

Colutorios para el control de placa y gingivitis basados en la evidencia científica / Mouthrinses with evidence-based control of plaque and gingivitis

La alta incidencia de enfermedad periodontal entre los adultos indica que en la mayoría de casos la higiene oral diaria podría y debería ser mejorada considerablemente. Las limitaciones de las prácticas de higiene cotidianas sugieren que se necesita la aplicación de otras estrategias. Los colutorios, en particular, la clorhexidina y los aceites esenciales disminuyen la formación de placa y la gingivitis, incluso en zonas de difícil acceso, teniendo excelentes características de seguridad y tolerabilidad. Además, de la clorhexidina y los aceites esenciales, entre los antisépticos comunes en los colutorios se incluyen, el triclosán, la hexetidina, los compuestos de amonio cuaternario, el delmopinol, la sanguinarina, y otros. Existe evidencia científica que los enjuagues con colutorios pueden desempeñar un papel clave y de un valor significativo como coadyuvantes de los métodos mecánicos para la prevención y tratamiento de las enfermedades periodontales. No obstante, en ningún caso pueden sustituir al control mecánico de la placa sino que actuarán como coadyuvante del mismo

The high incidence of periodontal disease among adults indicates that in most cases oral hygiene could and should be considerably improved. The limitations of routine hygiene practices suggest that the application of other strategies is required. Mouthrinses, particularly chlorhexidine and essential oils, reduce the formation of plaque and gingivitis, even in areas of difficult access, and are characterized by their excellent safety and tolerability. Apart from chlorhexidine and essential oils, the antiseptics commonly found in mouthrinses include among others triclosan, hexetidine, quaternary ammonium compounds, delmopinol, and sanguinarine. There is scientific evidence that indicates that mouthrinses can play a key role and have a significant value as an adjunct to mechanical methods for the prevention and treatment of periodontal diseases. However, they under any circumstance cannot be a substitute for mechanical oral-care methods