Nicola Baldini

Treatment of gingival recession defects with a coronally advanced flap and a xenogeneic collagen matrix: a multicenter randomized clinical trial

AIM To evaluate the clinical outcomes of the use of a xenogeneic collagen matrix (CM) in combination with the coronally advanced flap (CAF) in the treatment of localized recession defects. MATERIAL & METHODS In a multicentre single-blinded, randomized, controlled, split-mouth trial, 90 recessions (Miller I, II) in 45 patients received either CAF + CM or CAF alone. RESULTS At 6 months, root coverage (primary outcome) was 75.29% for test and 72.66% for control defects (p = 0.169), with 36% of test and 31% of control defects exhibiting complete coverage. The increase in mean width of keratinized tissue (KT) was higher in test (from 1.97 to 2.90 mm) than in control defects (from 2.00 to 2.57 mm) (p = 0.036). Likewise, test sites had more gain in gingival thickness (GT) (0.59 mm) than control sites (0.34 mm) (p = 0.003). Larger (≥3 mm) recessions (n = 35 patients) treated with CM showed higher root coverage (72.03% versus 66.16%, p = 0.043), as well as more gain in KT and GT. CONCLUSIONS CAF + CM was not superior with regard to root coverage, but enhanced gingival thickness and width of keratinized tissue when compared with CAF alone. For the coverage of larger defects, CAF + CM was more effective.

Deproteinized bovine bone in periodontal and implant surgery

OBJECTIVES To review the histological and clinical outcomes of deproteinized bovine bone in different procedures: periodontal regeneration, socket preservation, peri-implant reconstruction and alveolar bone augmentation. METHODS Histological animal studies and clinical trials on humans regarding the performances of a bone substitute of natural origin, deproteinized bovine bone, have been evaluated. Different procedures have been examined separately. RESULTS Osteoconductive properties of the material are accepted by the majority of authors. In periodontal regeneration deproteinized bovine bone seems to be effective with or without barrier membranes in favorable containing defects, resulting in histological evidence of periodontal regeneration, with a prevalence of bone repair. Although some reports describe a lower reduction in socket height and width with various techniques and the grafting of deproteinized bovine bone, there is no evidence to recommend socket filling or manipulation to preserve its dimensions. Peri-implant reconstruction and alveolar ridge augmentation utilizing deproteinized bovine bone are supported by favorable reports but these procedures are affected by a significant amount of adverse events that may jeopardize the success of the treatment. SIGNIFICANCE Deproteinized bovine bone possesses osteoconductive properties that may improve bone regeneration of favorable containing periodontal defects. No evidence supports socket filling and peri-implant reconstruction.

Esthetic Outcomes of Single-Tooth Implant-Supported Restorations Using Metal-Ceramic Restorations with Zirconia or Titanium Abutments: A Randomized Controlled Clinical Study.

The aim of this study was to test whether zirconia abutments exhibit the same clinical and esthetic outcomes as titanium abutments in single-tooth implant restorations in the esthetic area. The 24 treated patients were randomly assigned to a test (zirconia abutment) or control (titanium abutment) group. Objective evaluations were carried out using the Implant Crown Aesthetic Index (ICAI) and the Papilla Index (PI) at the 1-month and 12-month follow-up examinations after crown cementation. No significant differences, either in ICAI or in other periodontal or radiographic measurements, were observed. At 1 year, zirconia and titanium abutments exhibited the same esthetic outcomes.

Peri-implant Soft Tissue Stability After Single Implant Restorations Using Either Guided Bone Regeneration or a Connective Tissue Graft: A Randomized Clinical Trial

The purpose of the present study was to compare two different surgical procedures, connective tissue graft and guided bone regeneration, when applied in conjunction with implant placement. Probing pocket depth and the recession depth were recorded at the implant site after crown placement (T₁) and at the 1-year follow-up (T₂), while the keratinized tissue height and the buccal mucosa thickness were recorded at three different time points: at the time of implant surgery (T₀), after crown placement, and at the 1-year follow-up. No statistically significant differences in peri-implant mucosa thickness, recession, or other periodontal parameters were recorded at adjacent teeth.