International Journal of Periodontics & Restorative Dentistry, Pre-Print
DOI: 10.11607/prd.6879, PubMed-ID: 3765597331. Aug. 2023,Seiten: 1-27, Sprache: EnglischCouso-Queiruga, Emilio / Avila-Ortiz, Gustavo / Barboza, Eliane Porto / Chambrone, Leandro / Keceli, Huseyn Gencay / Yilmaz, Birtain Tolga / Rodrigues, Diogo Moreira
This study aimed at determining the correlation between gingival stippling (GS) and other phenotypical characteristics. Adult subjects in need of cone-beam computed tomography scans (CBCT) and comprehensive dental treatment in the maxillary anterior region were recruited. Facial gingival thickness [GT] and buccal bone thickness [BT] were assessed utilizing CBCT. Standardized intraoral photographs were obtained to determine keratinized tissue width (KTW), presence of GS in all facial and interproximal areas between the maxillary canines, and other variables of interest, such as gingival architecture (GA), tooth shape, and location. Statistical analyses to assess different correlations among recorded variables were conducted. A total of 100 participants and 600 maxillary anterior teeth constituted the study population and sample, respectively. Facial GS was observed in 56% of males and 44% of females, and it was more frequently associated with flat GA, triangular and square/tapered teeth, central incisors, and males. Greater mean values of GT, BT, and KTW were observed in facial areas that exhibited GS. Interdental GS was present in 73% of the sites and it was more frequently observed in males, the central incisor region, and when facial GS was present. Multilevel logistic regression revealed a statistically significant association between the presence of GS and KTW, BT measured at 3mm apical to the bone crest, and tooth type. This information can be used in the recognition of common periodontal phenotypical patterns associated with specific features of great clinical significance.
International Journal of Periodontics & Restorative Dentistry, 3/2024
DOI: 10.11607/prd.2024.3.c, PubMed-ID: 38787713Seiten: 252-255, Sprache: EnglischBrown, Evans / Stuhr, Sandra / Chambrone, Leandro / Childs, Christopher A. / Avila-Ortiz, Gustavo / Elangovan, Satheesh
CommentaryClinicians, researchers, and policymakers often rely on the available scientific evidence to make strategic decisions. Systematic reviews (SRs) occupy an influential position in the hierarchy of scientific evidence. The findings of wellconducted SRs may provide valuable information to answer specific research questions1,2 and identify existing gaps for future research.3 Therefore, it is of supreme importance that SRs are published promptly, reducing as much as possible the time elapsed between the last date of the search for primary studies and the actual publication date. A study published in 2014 assessed the publication delay of SRs in orthodontics, revealing that the median time interval from the last search to publication was more than 1 year (13.2 months).4 Delays in the publication of SRs or original research articles may depend on author-related factors (eg, timing of resubmission after receiving feedback from reviewers) or journal-related factors (eg, time taken to process a submission).5–7 Regardless of the reasons, clinical recommendations and translation of SR findings may be affected by publication delay. We assessed the extent of publication delay of systematic reviews in dentistry with the purpose of addressing its implications and presenting potential solutions.
Quintessence International, 2/2023
DOI: 10.3290/j.qi.b3512007, PubMed-ID: 36437805Seiten: 100-110, Sprache: EnglischPalma, Luiz Felipe / Joia, Cristiano / Chambrone, Leandro
Objective: To evaluate the effectiveness of the use of adjuvant ozone therapy in the healing process of wounds resulting from periodontal and peri-implant surgical procedures by answering the following focused question: “Can adjuvant ozone therapy improve wound healing outcomes related to periodontal and peri-implant surgical procedures?”.
Method and materials: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched, without language restriction, for peer-reviewed articles published until 23 March 2022, in addition to manual search. Only controlled clinical trials (randomized or not) were considered. The risk of bias was evaluated by the Cochrane risk-of-bias tool for RCTs – version 1 (RoB1). Data were pooled into evidence tables and a descriptive summary was presented.
Results: Of the 107 potentially eligible records, only seven studies were included. Four addressed free/deepithelialized gingival grafts with a palatal donor area, two evaluated implant sites, and one comprised gingivectomy and gingivoplasty. A total of 225 patients were evaluated in the included studies, considering control and test groups (ozone and other adjuvant therapies for comparison). Ozone therapy had a positive effect on outcomes directly or indirectly related to periodontal/peri-implant surgical wound healing. Furthermore, it could also increase the stability of immediately loaded single implants installed in the posterior mandible.
Conclusion: In general, ozone therapy seems to both accelerate the healing processes of periodontal/peri-implant wounds and increase the secondary stability of dental implants; however, considering the limited evidence available and the risk of bias in the included studies (none classified as low risk), a definitive conclusion cannot be drawn. (Quintessence Int 2023;54: 100–110; doi: 10.3290/j.qi.b3512007)
Schlagwörter: dental implants, ozone, ozone therapy, periodontal surgery, wound healing/surgery
The International Journal of Oral & Maxillofacial Implants, 1/2023
DOI: 10.11607/jomi.9990, PubMed-ID: 37099577Seiten: 29-36e, Sprache: EnglischMendes, Polianne Alves / Silva, Vânia Eloisa de Araújo / da Costa, Danilo Viegas / de Pinho, Matheus Morais / Chambrone, Leandro / Zenóbio, Elton Gonçalves
Purpose: To evaluate the effectiveness of extra-short implants compared to standard-length implants in graft regions at different longitudinal follow-up times.
Materials and Methods: A systematic review was performed, following PRISMA criteria. LILACS, MEDLINE/PubMed, Cochrane Library, and Embase databases, including gray literature and manual searches, were conducted without language or date restrictions. Study selection, risk of bias (Rob 2.0), quality of evidence (GRADE), and data collection were performed by two independent reviewers. Disagreements were resolved by a third reviewer. Data were combined using the random-effects model.
Results: A total of 1,383 publications were identified, including 11 publications from 4 randomized clinical trials that evaluated 567 implants (276 extra-short and 291 regular implants with graft) in 186 patients. The meta-analysis showed that losses (risk ratio [RR]: 1.24; 95% CI: 0.53 to 2.89; P = .62; I2: 0%) and prosthetic complications (RR: 0.89; 95% CI: 0.31 to 2.59; P = .83; I2: 0%) were similar in both groups. Biologic complications were significantly higher in regular implants with graft (RR: 0.48; CI: 0.29 to 0.77; P = .003; I2: 18%), which also had lower peri-implant bone stability in the mandible at the 12-month follow-up (mean deviation [MD]: –0.25; CI: –0.36 to 0.15; P < .00001; I2 = 0%).
Conclusion: Extra-short implants showed similar effictiveness compared to standard-length implants placed in grafted regions at different longitudinal follow-up times and present reduced biologic complications, shorter treatment times, and greater peri-implant bone crest stability. Int J Oral Maxillofac Implants 2023;38:29–36. doi: 10.11607/jomi.9990
Schlagwörter: biomechanical phenomena, bone grafting, dental implants, implant-supported dental prosthesis, metaanalysis, systematic review
International Journal of Periodontics & Restorative Dentistry, 5/2022
DOI: 10.11607/prd.6188Seiten: 605-611, Sprache: EnglischDi Gianfilippo, Riccardo / Chambrone, Leandro / Prato, Giovanpaolo Pini / Nevins, Myron / Franceschi, Debora
Making treatment decisions in dental implantology has evolved over the last five decades. These decisions and the clinical management of sites thereafter are selected based on recent changes, including the achievement of osseointegration, reestablishment of biologic width bone remodeling, the peri-implant soft tissue phenotype, the way peri-implantitis is defined, and advancements in digital technology. This article discusses these key aspects and their effects and influence on implant therapy.
Quintessence International, 2/2022
DOI: 10.3290/j.qi.b2091279, PubMed-ID: 34595905Seiten: 170-178, Sprache: EnglischBhatavadekar, Neel B. / Gharpure, Amit S. / Chambrone, Leandro
Objectives: The objective of this retrospective study was to compare the 7-year outcomes of coronally advanced flap with vertical incisions (CAF) and the envelope type of flap (e-CAF), using a subepithelial connective tissue graft (SCTG) in the treatment of multiple recession defects.
Method and materials: Twenty-two patients (13 CAF and 9 e-CAF) with at least two adjacent recession defects in the esthetic zone contributed to a total of 50 sites (29 CAF and 21 e-CAF). Complete root coverage (CRC), mean root coverage (MRC), and keratinized tissue (KT) width were recorded over the course of the study.
Results: In the short term (8 months), CRC, MRC, and KT outcomes were similar between the groups (P > .05). However, at the 3-year follow-up, the e-CAF group displayed significantly higher KT, MRC (100%), and CRC (100% at both tooth- and patient-levels) than the CAF group (MRC 91.43%; CRC 79.31% at tooth-level and 69.23% at patient-level). Similarly, at the 7-year follow-up, statistically significantly superior KT, MRC (94.24%), and CRC (87.71% at tooth-level and 77.78% at patient-level) values were recorded for the e-CAF group compared to the CAF group (MRC 68.98%; CRC 31.03% at tooth-level and 15.38% at patient-level).
Conclusions: Despite similar treatment outcomes recorded by both surgical procedures in the short term, sites treated with e-CAF showed better stability of the gingival margin and superior KT width in the medium (3 years) and long term (7 years).
Schlagwörter: connective tissue, gingival recession, surgical flaps, tooth root
Quintessence International, 9/2021
DOI: 10.3290/j.qi.b1702145, PubMed-ID: 34235906Seiten: 772-778, Sprache: EnglischKahn, Sérgio / Araújo, Ilana Tajra Evangelista / Dias, Alexandra Tavares / Souza, Alex Balduíno
de / Chambrone, Leandro / Fernandes, Gustavo Vicentis de Oliveira
Objective: The aim of this pilot randomized controlled trial was to assess the efficacy of macro- and microsurgical procedures in removing the epithelial tissue layer of subepithelial connective grafts (SCTGs) harvested by the parallel incision method.
Method and materials: Sixteen patients were randomized to receive macro-SCTG harvesting (n = 10, control group) or micro-SCTG harvesting (n = 10, test group) by the parallel incision technique. Histologic and histomorphometric analysis of the SCTG evaluated the percentage remnant of epithelium and connective tissue. The presence of remnant portions of the epithelium was identified in eight samples (three in the macro- and five in the microsurgery groups).
Results: Sixteen participants with 20 sites were included and 20 SCTG were collected and analyzed. SCTG harvested by microsurgical approaches displayed more portions of remnant epithelium compared to the conventional removal (50% versus 30%). There were no significant differences in mean remnant epithelial thickness for test (147.3 ± 89.3 μm) and control (209.0 ± 127.5 μm) groups (P = .57). Likewise, nonsignificant differences were identified in terms of the connective tissue thickness (macrosurgery: 1,511.0 ± 1,160.0 μm; microsurgery: 1,472.0 ± 1,063.0 μm) between groups (P = .96).
Conclusion: The samples harvested by microsurgery had greater remaining epithelial portions than those harvested by macrosurgery, and similar connective layer thickness.
Schlagwörter: gingival recession, histology, microsurgery, plastic surgery
The International Journal of Oral & Maxillofacial Implants, 6/2021
DOI: 10.11607/jomi.9132Seiten: 1104-1110, Sprache: EnglischGaspar, João / Proença, Luís / Botelho, João / Machado, Vanessa / Chambrone, Leandro / Neiva, Rodrigo / Mendes, José João
Purpose: This systematic review aimed to appraise the available evidence on the clinical characteristics produced by osseodensification drilling compared with the conventional drilling technique.
Materials and methods: Five databases (PubMed, Google Scholar, LILACS, EMBASE, and CENTRAL) were searched up to July 2020. Randomized clinical trials (RCTs) and nonrandomized studies of interventions (NRSIs) that compared osseodensification drilling with conventional drilling in humans were included. Random-effects meta-analyses of standardized mean difference (MD) with 95% confidence intervals (CI) and risk ratio were performed.
Results: Three NRSIs fulfilled the inclusion criteria, and all were scored as low risk of bias. Meta-analysis showed that the osseodensification drilling technique presented higher average implant stability quotient (ISQ) scores at baseline (MD: 13.1, 95% CI: 10.0 to 16.1, P < .0001) than conventional drilling, with complete homogeneity (I2 = 0.0%). Furthermore, osseodensification drilling presented higher average ISQ scores at follow-up (MD: 5.99, 95% CI: 1.3 to 10.6, P < .0001) than conventional drilling, with high homogeneity (I2 = 73.0%).
Conclusion: This systematic review showed that osseodensification presented consistently higher ISQ at baseline and at 4 to 6 months after implant placement compared with conventional drilling. However, these results should be carefully interpreted since only three studies were selected in this meta-analysis. In the future, RCTs will be necessary to confirm the consistency of these results.
Schlagwörter: biomechanics, bone, conventional drilling techniques, implant site preparation, meta-analysis, osseodensification, systematic review
International Journal of Periodontics & Restorative Dentistry, 3/2021
Seiten: 443-448, Sprache: EnglischFranceschi, Debora / Giuliani, Valentina / Giuntini, Veronica / Prato, Giovan Paolo Pini / Chambrone, Leandro
Retrograde peri-implantitis (RPI) is a periapical lesion that develops after implant insertion in which the coronal portion of the implant achieves a normal bone-toimplant interface. The most common etiology of RPI is the presence of an adjacent endodontic lesion. In most of the case reports available in the literature, the diagnosis of RPI occurred between 1 week and 4 years after implant placement. This case report illustrates the treatment of RPI that occurred more than 15 years ater implant loading, caused by endodontic infection of the adjacent tooth.
International Journal of Oral Implantology, 4/2020
PubMed-ID: 33491365Seiten: 321-342, Sprache: EnglischChambrone, Leandro / Rincón-Castro, Maria Victoria / Poveda-Marín, Ana Esmeralda / Diazgranados-Lozano, Maria Paulina / Fajardo-Escolar, Carlos Eduardo / Bocanegra-Puerta, Maria Carolina / Palma, Luiz Felipe
Purpose: The purpose of this systematic review was to assess the histological healing outcomes at the bone–titanium interface of loaded and unloaded dental implants placed in humans.
Materials and methods: An electronic search was conducted using the PubMed, Embase and Cochrane Central Register of Controlled Trials (Central) databases up to and including April 2020 to identify clinical trials reporting human histological data of bone healing around titanium dental implants placed in healed alveolar ridges. The search was conducted by two independent reviewers with no language restrictions. The risk of bias of each included study was assessed using the Cochrane Collaboration’s domain-based, two-part tool.
Results: Of the 4564 potentially eligible articles, only 25 were included in this systematic review (13 randomised and 12 controlled clinical trials), with a total of 548 micro/transitional implants evaluated. The marked heterogeneity between studies did not allow the data to be combined for meta-analyses. In general, based on mean values of bone-to-implant contact (range 9% to 73%), bone density outside the threaded area (range 14.9% to 31.6%), bone density in the threaded area (range 17.9% to 56.9%) and osteocyte index (range 19.79 to 37.88 cells/mm2), all implant surface modifications demonstrated osseointegration potential. Furthermore, immediate loading was related to higher bone-to-implant contact, bone density outside the threaded area and osteocyte index; longer healing periods to higher bone-to-implant contact; and smoking to lower bone-to-implant contact, bone density in the threaded area and bone density outside the threaded area.
Conclusions: Despite the fact that several modifications were made to the implant surface, when considering the values for bone-to-implant contact, bone density in the threaded area, bone density outside the threaded area and osteocyte index, machined surfaces showed the worst healing outcomes. Nevertheless, osseointegration was improved by both immediate loading and longer healing periods and worsened by smoking.
Schlagwörter: dental implants, endosseous, osseointegration, wound healing
The authors report no conflict of interest related to this study.