Regenerative Surgery of Mandibular Class II Furcation Defects: A Comparison of Two Techniques in a Randomized Clinical Trial with 3D CBCT Measurements at 24 Months.

The aim of the present study was to evaluate, clinically and via CBCT, the long-term efficacy of a bioresorbable polylactic acid membrane combined with deproteinized bovine bone graft (DBBM) and compare it to enamel matrix derivative (EMD) combined with DBBM graft in the treatment of class II furcation defects. Sites were randomly assigned to the test group (Guidor Matrix Barrier + Bio-Oss) or the control group (Emdogain + Bio-Oss). Probing pocket depth (PPD), clinical attachment level (CAL), gingival recession (REC), and keratinized tissue (KT) width were assessed at 12 and 24 months, and radiographic bone gain was investigated at 24 months via CBCT. Both groups showed a significant radiographic bone fill and clinical gain. The combination of Emdogain + Bio-Oss showed better clinical outcomes and less complications, though this difference was not statistically significant.

The Influence of Gingival Phenotype on the Outcomes of Coronally Advanced Flap: A Prospective Multicenter Study.

The goal of this study was to evaluate the influence of gingival phenotype (GPh) on the clinical outcomes of coronally advanced flap (CAF). In this prospective study, 24 gingival recessions (recession type RT1 class or Miller Classes I and II) in 21 patients were treated with CAF alone. Patients were classified as having thin, medium, thick, or very thick GPh using a color-coded probe. At 6 months, the lowest mean root coverage (mRC; 60.4% ± 28.8%) and complete root coverage (CRC; 25%) were found in patients with thin GPh compared to patients with medium (mRC: 86.4% ± 17.6%; CRC: 60%), thick (mRC: 93.3% ± 14.9%; CRC: 83.3%), and very thick (mRC: 86.7% ± 26.7%; CRC: 80%) GPh. Regression analysis showed a statistically significant difference (P < .05) between thin and thick/very thick GPh in the likelihood of achieving CRC. Higher RES values were observed in patients with thick and very thick GPh (8.2 ± 1.5 and 8.4 ± 1.4, respectively), while thin GPh was related to the lowest RES score (6.3 ± 2.2). CAF performed in patients with thick or very thick GPh resulted in superior clinical and esthetic outcomes than thin and medium GPh. In particular, thin GPh was associated with the lowest mRC, CRC, and root coverage esthetic scores.

Graftless Tunnel Technique for the Treatment of Multiple Gingival Recessions in Sites with Thick or Very Thick Biotype: A Prospective Case Series.

Tunnel (TUN) technique is normally performed in combination with soft tissue grafts, either autogenous connective tissue graft (CTG) or substitutes, regardless of a patient's biotype. The aim of this study was to investigate the efficacy of graftless TUN in the treatment of multiple gingival recessions (GRs) characterized by thick or very thick biotype. Twenty-seven GRs were treated in seven patients using graftless TUN. At 6-month postoperative evaluations, the mean root coverage (mRC) was 84.57% ± 31.1%, while complete root coverage (CRC) was achieved in 77.8% of treated GR sites and in six out of seven patients. On average, the esthetic evaluation performed using the root coverage esthetic score (RES) resulted in a final score of 9.1 ± 1.4. Sixteen sites achieved the maximum RES score, and in six patients, an RES ≥ 9 was observed in all sites. Graftless TUN showed predictable root coverage and improved esthetics in treating GRs in patients with a thick or very thick biotype. Nevertheless, further studies with a large number of subjects are needed to support these preliminary outcomes.