Bücher und Digitale Medien

Impairment or loss of interdental papilla is a common issue in patients with periodontal disease, leading to phonetic, functional, and aesthetic concerns. Numerous techniques have been explored to reconstruct and regenerate interdental papillae, but consistent success remains challenging. This article presents a novel surgical approach that applies the principles of the Connective Tissue Graft (CTG) wall technique to enhance papilla volume when interdental clinical attachment loss is present in the aesthetic zone. The case of a 35-year-old woman with an RT3 recession defect associated with loss of interdental hard and soft tissues is discussed. The patient underwent a procedure involving palatal incisions, application of amelogenins, and a trapezoidal shape CTG fixed at the base of the papilla under a coronally advanced flap. This approach aimed to stabilize the blood clot and prevent soft tissue collapse into the defect area, enhancing the position and volume of the interdental papilla. Results at 6- and 12-months follow-up indicated significant improvement in papilla appearance and complete root coverage. This case suggests that the modified CTG wall technique can effectively treat buccal and interdental gingival recessions associated with horizontal or infrabony defects. Further clinical trials are necessary to confirm these findings and establish the most effective approach for interdental papilla reconstruction. Schlagwörter: interdental papilla, connetive tissue graft, periodontal therapy, amelogenins, connective tissue graft-wall technique, papilla reconstruction

Teeth exhibiting internal root resorption or those with persistent large periapical lesions after non-surgical endodontic treatment are generally considered to have an unfavorable prognosis. Extraction of teeth with unfavorable prognosis, followed by dental implant placement, has become an acceptable treatment option. However, dental implants are not indicated for young people with growing jaws. Consequently, it is recommended that clinicians prioritize the preservation of natural dentition in younger patients and defer implant therapy until skeletal growth has ceased. In cases where tooth preservation is attempted despite severe periradicular defects, a surgical approach is often required to manage associated symptoms. However, modern periradicular surgery frequently leads to unaesthetic complications such as conspicuous scar formation or gingival recession. The introduction of novel combinatory surgery, including guided tissue regeneration (GTR), de epithelialized free gingival graft (DFGG), and coronally advanced flap (CAF) optimizes the clinical outcomes, addressing both the functional and aesthetic needs of the patient. Schlagwörter: young adult, periapical diseases, case reports, coronally advanced flap, de-epithelialized free gingival graft, guided tissue regeneration

Gingivarezessionen haben eine ganze Reihe unangenehmer Folgen, die das Wohlbefinden der Patienten stark beeinträchtigen können. Häufigster Anlass für die Behandlung gingivaler Rezessionen sind in der Regel Beschwerden oder ästhetische Bedenken der Patienten. Die Reduktion der sichtbaren Zahnlänge auf ein ästhetisch ansprechendes Maß ist nur mithilfe chirurgischer Techniken zur Wurzeldeckung möglich. Primäres Ziel der Behandlung von Rezessionsdefekten ist eine möglichst vollständige Deckung der Wurzel. Chirurgische Verfahren zur Wurzeldeckung lassen sich in zwei Hauptgruppen unterteilen: Techniken zur Behandlung einzelner Rezessionsdefekte (koronaler Verschiebelappen, lateraler Verschiebelappen, vertikal und koronal verschobener Lappen, lateral geschlossener Tunnellappen) und solche zur Behandlung mehrerer benachbarter Defekte (koronaler Verschiebelappen für multiple Rezessionen, Tunneltechnik, modifizierter koronal verschobener Tunnellappen). Im Rahmen chirurgischer Wurzeldeckungstechniken werden darüber hinaus häufig Bindegewebetransplantate verwendet, die vorwiegend in bilaminären Konfigurationen zum Einsatz kommen. Der vorliegende Beitrag gibt einen aktuellen Überblick zur Behandlung gingivaler Rezessionen mit chirurgischen Verfahren zur Wurzeldeckung. Schlagwörter: Gingivarezession, Wurzeldeckung, ästhetische Ansprüche, koronaler Verschiebelappen, Tunneltechnik, Bindegewebetransplantat

Implant esthetic complications can negatively affect a patient's perception of implant therapy and their quality of life. This article discusses the etiology, prevalence, and strategies for the treatment of peri-implant soft tissue dehiscences/deficiencies (PSTDs). Three common scenarios of implant esthetic complications were identified and described, in which PSTDs could be managed without removing the crown (scenario I), with the surgical-prosthetic approach (crown removal; scenario II), and/or with the horizontal and vertical soft tissue augmentation and submerged healing (scenario III).