Clipping da Literatura Cientítica - Novembro - Dezembro 2010

Atualização sempre importante para manutenção de trabalho de alto nível. Confiram:

Dahlin C, Simion M, Hatano N. Long-term follow-up on soft and hard tissue levels following guided bone regeneration treatment in combination with a xenogeneic filling material: a 5-year prospective clinical study. Clin Implant Dent Relat Res 2010;12(4):263-270.
A total of 41 implants were placed conjunction with GBR in 20 patients and followed up for 5 years. The cumulative survival rate was 97.5% and the reduction in mean bone height was from -3.51 mm to -2.38 mm. Marginal soft tissue level was stable throughout the 5-year period. GBR in conjunction with implant placement is therefore a viable treatment option to maintain hard and soft tissue levels.

Balleri P, Ferrari M, Veltri M. One-year outcome of implants placed strategically in the retrocanine bone triangle. Clin Implant Dent Relat Res 2010;12(4):324-330.
A total of 40 implants were placed in the bone anterior to the sinus wall in 20 patients with atrophic posterior maxillae. Three-unit screw-retained FPDs were placed after 6 months. After 1 year of loading, there were no implant failures or biological or mechanical complications, and there were no differences in bone level between axial and tilted implants. Three-unit FPDs supported by two implants therefore showed positive outcomes in the maxillary retrocanine region.

Van Der Bilt A, Burgers M, Van Kampen FMC, Cune MS. Mandibular implant-supported overdentures and oral function. Clin Oral Implants Res 2010;21(11):1209-1213.
Patients who had received two mandibular implants and an overdenture with magnet, ball-socket or bar-clip attachments were evaluated for oral function 10 years after participation in a clinical trial. Of the original 18 patients, 14 were evaluated at the 10-year follow-up. Maximum bite force increased from 162 N to 341 N after implant treatment, and the number of chewing cycles decreased from 55 to 27; no significant changes were seen after 10 years. The improvement in oral function with implant-supported overdentures was therefore maintained for a long time.

Beitlitum I, Artzi Z, Nemcovsky CE. Clinical evaluation of particulate allogeneic with and without autogenous bone grafts and resorbable collagen membranes for bone augmentation of atrophic alveolar ridges. Clin Oral Implants Res 2010;21(11):1242-1250.
Vertical and/or lateral ridge deficiencies of ≤ 3 mm in 50 patients were treated with either particulate mineralized freeze-dried bone allograft (FDBA) alone or with bi-layered autogenous bone chips and covered with a cross-linked collagen barrier membrane. Mean vertical and horizontal bone gain were 3.47 ± 1.25 mm and 5 ± 1.28 mm, respectively, for FDBA alone and 3.5 ± 1.2 mm and 3.6 ± 1.72 mm, respectively, for FDBA + bone chips. The addition of autogenous bone chips therefore had no significant effect.

Urban T, Wenzel A. Discomfort experienced after immediate implant placement associated with three different regenerative techniques. Clin Oral Implants Res 2010;21(11):1271-1277.
In 92 patients requiring single implants in then molar region. Resulting peri-implant defects were treated with autogenous bone chips, Ossix membrane, or a combination of both. The post-operative course was recorded using visual analogue scales for pain, swelling and bleeding from the wound on the day of surgery and after 1, 2 and 3 days. Peak pain occurred 5-6 hours after surgery, while peak swelling and bleeding occurred after 1 day. Pain scores were higher for smokers than non-smokers, with a significant difference from 1 to 3 days. Pain was also significantly higher in younger (< 50 years) than older patients.

Wahlström M, Sagulin GB, Jansson LE. Clinical follow-up of unilateral, fixed dental prosthesis on maxillary implants. Clin Oral Implants Res 2010;21(11):1294-1300.
Patients who had received FDPs on implants, in function for at least 3 years, were asked to participate in a follow-up evaluation. Of 50 patients invited, 46 were examined. Prior to treatment, tooth extraction was due to periodontal disease in 80% of cases. There was one implant fracture after 3 years and another after 6.5 years. Veneer fractures and loose bridge crews were the most common mechanical complications. Bleeding was more frequent in patients with peri-implant mucositis, and deep periodontal pockets around the remaining teeth were more frequent in patients with peri-implantitis. Fewer teeth, more periodontal pockets ≥ 4 mm, and greater marginal bone loss was found in smoking versus non-smoking patients.

Çehreli MC, Kökat AM, Uysal S, Akca K. Spontaneous early exposure and marginal bone loss around conventionally and early-placed submerged implants: a double-blind study. Clin Oral Implants Res 2010;21(12):1327-1333.
A total of 46 patients received 103 implants by either conventional or early placement protocols. Plaque index, cover screw exposure and marginal bone level change were recorded prior to second-stage surgery. Marginal bone level change was higher with early placement, and the use of an interim prosthesis led to higher marginal bone level changes with early placement but not conventional placement. There were significantly more exposed implants with early placement, and the mean plaque score was 11.5 times higher than with early placement. There appeared to be a correlation between screw exposure and early crestal bone loss; more perforations and bone loss was observed with early placement.

Suarez-Feito J-M, Sicilia A, Angulo J, Banerji S, Cuesta I, Millar B. Clinical performance of provisional screw-retained metal-free acrylic restorations in an immediate loading protocol: a 242 consecutive patients’ report. Clin Oral Implants Res 2010;21(12):1360-1369.
A retrospective analysis was performed for 242 patients who received a total of 1011 implants to support 311 immediate provisional screw-retained restorations. After an healing period of 3 months, at least one fracture was observed in 23 restorations in 20 patients; in 12 cases, the fracture occurred within 4 weeks. The probability of cumulative survival was significantly greater in the mandible, in restorations without cantilever, and in restorations opposed by full restorations or natural teeth. The risk of fracture increased 4.7-fold with an opposing implant-supported prosthesis, while positions in the maxilla increased the risk of fracture 3.4-4.5-fold. However, 92.6% of the restorations remained intact, so the technique was considered reliable.

Yoon H-I, Yeo I-S, Yang J-H. Effect of a macroscopic groove on bone response and implant stability. Clin Oral Implants Res 2010;21(12):1379-1385.
Twelve rabbits each received four anodized titanium implants, either with or without a macroscopic groove. No difference in BIC was found between the two implant types after 2 and 6 weeks, but implant stability was significantly higher for the grooved implants after 6 weeks and resistance to reverse torque was significantly higher after 2 and 6 weeks. The groove may therefore increase adhesion at the interface with the bone and resistance to shear load.

Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical trial. Clin Oral Implants Res 2010;21(12):1394-1403.
In 60 patients with edentulous posterior mandibles (residual bone height 7-8 mm), either short implants (7 mm) were placed without augmentation or ≥ 10-mm-long implants were placed 5 months after augmentation with anorganic bovine bone blocks. Provisional prostheses were placed after 4 months, replaced by definitive prostheses after a further 4 months. There was insufficient bone to place longer implants in two mandibles due to breakage of the bone blocks, and prostheses could not be placed in one and three patients in the short and augmented groups, respectively, due to implant failure. Wound dehiscence occurred during graft healing in four cases in the augmented group, compared to none in the short implant group. Mean bone loss after 1 year was approximately 1 mm in both groups. Short implants may therefore be a preferable option to augmentation for residual mandibular bone height of 7-8 mm.

Ettl T, Gerlach T, Schüsselbauer T, Gosau M, Reichert TE, Driemel E. Bone resorption and complications in alveolar distraction osteogenesis. Clin Oral Investig 2010;14(5):481-489.
A total of 36 alveolar distraction procedures were performed in 30 patients, 11 in the maxilla and 25 in the mandible. After a mean consolidation period of 4.5 months, a total of 82 implants were placed. Mean alveolar height achieved was 6.4 mm and the mean resorption was 1.8 mm at the time of implant placement. Implant survival was 95.1% after a mean follow-up of 45.8 months. Them main complications observed were displacement of the transport segment and inadequate soft tissue extension. Mean peri-implant bone resorption of 3.5 mm was recorded after a mean follow-up of 50.4 months. Alveolar distraction osteogenesis is therefore effective but can have complications, and there may be further bone resorption after implant placement.

Heinz B, Kasaj A, Teich M, Jepsen S. Clinical effects of nanocrystalline hydroxyapatite paste in the treatment of intrabony periodontal defects: a randomized controlled clinical study. Clin Oral Investig 2010;14(5):525-531.
Paired intrabony defects in 14 patients were treated with papilla preservation flap alone or in combination with a nanocrystalline HA paste. Probing depth and probing bone levels were measured at baseline and after 6 months. Significant improvements from baseline were seen in both groups, with significantly greater reduction of probing depth and gain of probing bone level in the nano-HA group. Treatment with the nano-HA paste therefore led to improved clinical outcomes versus papilla preservation flap alone.

Grecchi F, Zingari F, Raffaella B, Zollino I, Casadio C, Carinci F. Implant rehabilitation in grafted and native bone in patients affected by ectodermal dysplasia: evaluation of 78 implants inserted in 8 patients. Implant Dent 2010;19(5):400-408.
A retrospective analysis of 78 implants in eight patients with ectodermal dysplasia was performed, and patient-, implant-, surgical- and prosthetic-related variables were investigated. The implants replaced 19 incisors, 19 cuspids, 21 premolars and 19 molars. There was one implant loss, and implant length, grafted sites and type of loading appeared to have an influence on the analysis. Dental implant rehabilitation is therefore valuable in patients with ectodermal dysplasia.

Sohn D-S, Kim W-S, Lee W-H, Jung H-S, Shin I-H. A retrospective study of sintered porous-surfaced dental implants in restoring the edentulous posterior mandible: up to 9 years of functioning. Implant Dent 2010;19(5):409-418.
A total of 43 patients with 122 sintered porous-surfaced implants (either 4.1 mm or 5.0 mm in diameter) were retrospectively analyzed; all implants were restored with fixed prostheses. Radiographic analysis was performed. The mean follow-up time was 55.8 months. The cumulative implant survival rate was 97.5%; survival rates were 100% and 91.2% for the 4.1 mm diameter and 5.0 mm diameter implants, respectively, indicating a significant difference. However, there was no significant difference in survival rates for implants of different lengths. No implant failures occurred when the crown-to-implant ratio was < 1.0 or between 1.5 and 2.0, but the failure rate was 6.7% where the crown-to-implant ratio was between 1.0 and 1.4; the difference was significant.

Winter W, Möhrle S, Holst S, Karl M. Bone loading caused by different types of misfits of implant-supported fixed dental prostheses: a three-dimensional finite element analysis based on experimental results. Int J Oral Maxillofac Implants 2010;25(5):947-952.
Two finite element models were created to simulate strain values of three-unit FPDs on two implants using horizontal, vertical and angular misfits. Horizontal misfit of 36 μm and vertical misfit of 79 μm were required to simulate the experimental strain value results, and comparable levels were obtained from an angular misfit of 0.083°. Bone loading ranged from 50-90 MPa in the cortical area and 2-5 MPa in trabecular bone around implants for horizontal and vertical misfit and up to 20 MPa in the cortical layer and 1 MPa in the cervical part of the trabecular bone for angular misfit. Comparable loading patterns were observed around both implants for horizontal and vertical misfit, and bone loading under angular misfit was mainly where the misfit had been introduced.

Hinze M, Thalmair T, Bolz W, Wachtel H. Immediate loading of fixed provisional prostheses using four implants for the rehabilitation of the edentulous arch: a prospective clinical study. Int J Oral Maxillofac Implants 2010;25(5):1011-1018.
Each of 37 patients received four implants to support immediately loaded mandibular or maxillary full-arch fixed prostheses, with definitive reconstructions delivered after 6 months. Follow-up visits were performed 6 and 12 months after prosthetic loading and every year for 5 years. Implant survival after 1 year for axial and tilted implants was 96.0% and 94.6%, respectively, and for maxillary and mandibular implants was 96.6% and 98.7%, respectively. The mean bone loss around axial and tilted implants after 1 year was 0.82 ± 0.31 mm and 0.76 ± 0.49 mm, respectively. Four implants supporting a full-arch fixed prosthesis is therefore a viable treatment option.

Cho-Lee J-Y, Naval-Gías L, Castrejón-Castrejón S, Capote-Moreno A, González-García R, Sastre-Pérez J, Muñoz-Guerra MF. A 12-year retrospective analytic study of the implant survival rate in 177 consecutive maxillary sinus augmentation procedures. Int J Oral Maxillofac Implants 2010;25(5):1019-1027.
A retrospective analysis was performed of 272 implants placed in 127 augmented sinuses in 119 patients. The mean follow-up period was 60.7 months, and the cumulative implant survival rate was 93%. Factors in predicting implant failure included peri-implantitis and the presence of complications related to the augmentation procedure. Sinus augmentation is therefore versatile with high predictability independent of the graft material.

Deng F, Zhang H, Zhang H, Shao H, He Q, Zhang P. A comparison of clinical outcomes for implants placed in fresh extraction sockets versus healed sites in periodontally compromised patients: a 1-year follow-up report. Int J Oral Maxillofac Implants 2010;25(5):1036-1040.
Hopeless teeth were extracted form periodontally compromised patients, the sites debrided and implants placed using a surgical guide. An immediate provisional restoration was placed and a definitive restoration delivered after 6 months. A total of 84 implants were placed, 32 of which were in fresh extraction sockets. The implant survival rate was 95.2% (92% and 100% in the maxilla and mandible, respectively); all of the failed implants had been placed in fresh extraction sockets. All prostheses survived and the mean change in bone level at 12 months was -1.12 ± 0.18 μm. A relatively high risk for implant failure in the periodontally compromised maxilla was therefore noted.

Alves CC, Correia AR, Neves M. Immediate implants and immediate loading in periodontally compromised patients – a 3-year prospective clinical study. Int J Periodontics Restorative Dent 2010;30(5):447-455.
In each of 23 periodontally compromised patients, 168 implants were placed (mostly six Straumann implants distributed along the arch according to surgical guide or bone availability); 83 were placed in the maxilla and 85 in the mandible. Most were immediately loaded except nine maxillary implants that underwent delayed loading. The prosthesis was adapted in the first 48 hours and a definitive restoration placed after 2 months. The 3-year cumulative survival rate was 98.74% (98.65% and 98.82% in the maxilla and mandible, respectively); two implants failed. The 3-year cumulative prosthesis survival rate was 100%, indicating that immediate loading is a predictable technique for periodontally compromised patients.

Stappert FJ, Tarnow DP, Tan JH-P, Chu SJ. Proximal contact areas of the maxillary anterior dentition. Int J Periodontics Restorative Dent 2010;30(5):471-477.
Proximal contact area (PCA) between the eight maxillary anterior teeth was calculated by measuring 140 PCA sites and 160 crown lengths in 20 patients. The mean PCA dimensions were 4.2 mm between central incisors, 2.9 mm between central and lateral incisors, 2.0 mm between lateral incisors and canines, and 1.5 mm between canines and first premolars; the corresponding mesial mean proximal area contact portions were 41%, 32%, 20% and 18%, respectively. Significant differences were noted between all PCAs, except for canine/first premolar sites. Natural proximal area contact portions were well defined and should be considered in clinical anterior restorations.


Mattila PT, Niskanen MC, Vehkalahti MM, Nordblad A, Knuuttila MLE. Prevalence and simultaneous occurrence of periodontitis and dental caries. J Clin Periodontol 2010;37(11):962-967.
In a study population of 5,255 subjects as part of a national Health 2000 survey, pocket depths and dental caries were recorded. Periodontal disease (pocket depth ≥ 4 mm) was noted in 64%, severe periodontal disease (≥ 6 mm) in 21% and dental caries in 29%. Dental caries was significantly more prevalent in subjects with periodontal disease, and more so in subjects with severe periodontal disease. Subjects with dental caries were also significantly more likely to have severe periodontal disease. Periodontal disease and dental caries therefore tend to accumulate in the same subjects.

Nedir R, Nurdin N, Vazquez L, Szmukler-Moncler S, Bischof M, Bernard J-P. Osteotome sinus floor elevation technique without grafting: a 5-year prospective study. J Clin Periodontol 2010;37(11):1023-1028.
Osteotome sinus floor elevation was performed without grafting in 17 patients (mean residual bone height 5.4 ± 2.3 mm) and a total of 25 implants (10 mm in length) were placed. Implant survival after 5 years was 100% and the mean increase in peri-implant bone was 3.2 ± 1.3 mm, while implant protrusion into the sinus decreased from 4.9 ± 1.9 mm at baseline to 1.5 ± 0.9 mm. Mean crestal bone loss was 0.8 ± 0.8 mm, which stabilized over 5 years; bone gain after 1 year was noted at 20 implants. Grafting is therefore not required for bone gain of at least 3 mm.

Casarin RCV, Del Peloso Ribeiro E, Nociti FH Jr, Sallum AW, Ambrosano GMB, Sallum EA, Casati MZ. Enamel matrix derivative proteins for the treatment of proximal class II furcation involvements: a prospective 24-month randomized clinical trial. J Clin Periodontol 2010;37(12):1100-1109.
A total of 12 patients with bilateral proximal furcation defects ≥ 5 mm and bleeding on probing were treated with open flap debridement and EDTA alone (control) or in combination with EMD (test). Clinical parameters were evaluated prior to treatment and after 6, 12 and 24 months. No significant differences were observed after 24 months. Probing depth reduction was 1.9 ± 1.6 mm and 1.0 ± 1.3 mm in the test and control groups, respectively, and the gain in relative horizontal clinical attachment level was 1.4 ± 0.9 mm and 0.7 ± 1.3 mm in the test and control groups, respectively. After 24 months, only five class II furcations remained in the test group, compared to 10 in the control group.

Jacobs R, Pittayapat P, Van Steenberghe D, De Mars G, Gijbels F, Van Der Donck A, Li L, Liang X, Van Assche N, Quirynen M, Naert I. A split-mouth comparative study up to 16 years of two screw-shaped titanium implant systems. J Clin Periodontol 2010;37(12):1119-1127.
Clinical and radiographic records from 18 patients who received Astra Tech and Brånemark implants in a split-mouth study were evaluated for up to 16 years. No significant differences were observed between the systems over time. Peri-implant bone density significantly increased after 10 years, while Periotest values significantly decreased. Mean bone loss after 15 years was 0.02 mm and 0.31 mm for the Astra Tech and Brånemark systems, respectively.

Kacer CM, Dyer JD, Kraut RA. Immediate loading of dental implants in the anterior and posterior mandible: retrospective study of 120 cases. J Oral Maxillofac Surg 2010;68(11):2861-2867.
Of 2,904 implants placed in the mandibles of 979 patients in a 2-year period, 256 were immediately loaded; 161 were anterior to the mental foramen and 95 were posterior to the mental foramen. There were four implant failures, three in the anterior and one in the posterior mandible; the survival rate was 99.4% and 97% in the anterior and posterior mandible, respectively

Moon S-H, Um H-S, Lee J-K, Chang B-S, Lee M-K. The effect of implant shape and bone preparation on primary stability. J Periodontal Implant Sci 2010;40(5):239-243.
Two types of dental implants (straight or tapered screw) were placed in bovine rib blocks with different drilling depths: standard preparation, 1 mm over-preparation or 1 mm under-preparation. Implant stability (ISQ) was measured for each implant after insertion. No significant differences were found in the ISQ values between the two implant types, and the depth of bone preparation had no significant influence for the straight screw implants; however, ISQ was significantly increased for the tapered implants with under-preparation and was significantly reduced by over-preparation.

Yi J-M, Lee J-K, Um H-S, Chang B-S, Lee M-K. Marginal bone changes in relation to different vertical positions of dental implants. J Periodontal Implant Sci 2010;40(5):244-258.
A total of 200 implants placed in 107 patients were examined and classified according to the position of the implant-abutment connection (at, below or above bone level). Marginal bone level was assessed after implant placement, second-stage surgery and 6 and 12 months after loading. The mean distance from the microgap to the first BIC was 0.06 ± 0.68 mm, 0.43 ± 0.83 mm, 1.36 ± 0.56 mm and 1.53 ± 0.51 mm at implant placement, second surgery, 6 months post-loading and 12 months post loading, respectively. The change in bone level between placement and 12 months was approximately 2.25 mm in the ‘below bone level’ group, 1.47 mm in the ‘at bone level’ group and 0.89 mm in the ‘above bone level’ group; bone change was therefore larger for implants placed below bone level and smaller for implants placed above bone level.

Khader YS, Al Habashneh R, Al Malalheh M, Bataineh A. The effect of full-mouth tooth extraction on glycemic control among patients with type 2 diabetes requiring extraction of all remaining teeth: a randomized clinical trial. J Periodontal Res 2010;45(6):741-747.
Patients with type 2 diabetes and advanced periodontitis and who required extraction of all teeth were either treated (teeth extracted) or untreated. Of 58 patients, 50 were subsequently included in the analysis. Fasting blood glucose and HbA1c levels were measured at baseline and after 3 and 6 months. HbA1c decreased significantly from baseline to 3 months in the treated group and continued to decrease to 6 months. In contrast, no significant reduction was observed in the untreated group. Full-mouth tooth extraction therefore improved glycemic control in patients with type 2 diabetes, but larger trials are needed to confirm this result.

Atieh MA, Ibrahim HM, Atieh AH. Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis. J Periodontol 2010;81(10):1350-1366.
Database and hand searching was performed for literature on controlled trials of marginal bone level changes and survival of platform-switched implants. The analysis included 10 studies with a total of 1,239 implants. Marginal bone loss was significantly less around platform-switched implants compared to those without platform switching, and there were no differences in implant failure rate between the two groups. A more favorable bone response was detected when the difference in diameter between implant and abutment was ≥ 0.4 mm. Platform switching may therefore help to preserve bone height, but further randomized, controlled trials are necessary to confirm the concept.

Shiau HJ, Reynolds MA. Sex differences in destructive periodontal disease: a systematic review. J Periodontol 2010;81(10):1379-1389.
A literature search was performed for population surveys with prevalence data on periodontal disease in males and females. A total of 12 surveys, with 50,604 subjects, met the inclusion criteria. There was a 9% difference in prevalence of destructive periodontal disease between males and females (37.4% versus 28.1%), and this difference was found to be similar regardless of disease severity or other risk factors. Males are therefore at greater risk of destructive periodontal disease than females.

Shum I, Leung P-C, Kwok A, Corbet EF, Orwoll ES, Phipps KR, Jin L. Periodontal conditions in elderly men with and without osteoporosis or osteopenia. J Periodontol 2010;81(10):1396-1402.
This study enrolled 200 elderly subjects (67 with osteoporosis, 66 with osteopenia and 67 age-matched controls), who were given questionnaires and a full-mouth periodontal examination. Sites with clinical attachment los ≥ 6 mm were significantly more prevalent in the osteoporosis subjects compared to those with osteopenia, and the percentage of sites with interproximal gingival recession ≥ 5 mm was significantly greater in osteoporosis subjects versus controls. The significant associations remained after adjusting for age, supragingival plaque and number of teeth lost.

Koutouzis T, Lundgren T. Crestal bone-level changes around implants placed in post-extraction sockets augmented with demineralized freeze-dried bone allograft: a retrospective radiographic study. J Periodontol 2010;81(10):1441-1448.
Records from 30 patients with implants placed in post-extraction sockets augmented with demineralized freeze-dried bone allograft and from 30 patients with implants placed in native bone were examined. Implant survival was 100% in both groups, and mean marginal bone loss after 12 months was 0.15 mm; no significant differences were found between the groups. Bone loss was therefore minimal around implants placed in post-extraction sockets.

Angaji M, Gelskey S, Nogueira-Filho G, Brothwell D. A systematic review of the clinical efficacy of adjunctive antibiotics in the treatment of smokers with periodontitis. J Periodontol 2010;81(11):1518-1528.
A literature search was performed for trials comparing periodontal therapy with and without adjunctive antibiotics in smokers. The analysis included five randomized controlled trials. For surgical therapy, there was little evidence for adjunctive antibiotics in smokers; however, for non-surgical therapy one study showed improvements after the use of azithromycin, and another study showed significant improvements in probing depths and clinical attachment level with the use of adjunctive doxycycline gel and minocycline spheres. However, overall evidence for an additional benefit of adjunctive antibiotic therapy in smokers was inconclusive, and further trials are necessary.

Andrade PF, Grisi MFM, Marcaccini AM, Fernandes PG, Reino DM, Souza SLS, Taba M Jr, Palioto DB, Novaes AB Jr. Comparison between micro- and macrosurgical techniques for the treatment of localized gingival recessions using coronally positioned flaps and enamel matrix derivative. J Periodontol 2010;81(11):1572-1579.
Gingival recession in 30 patients were treated with coronally positioned flap and EMD; a microsurgical approach was performed in 15 patients (test) and a macrosurgical approach was performed in the other 15 (control). No difference in root coverage was found between the groups after 6 months (98% and 83% for test and control, respectively), but the increase in width and thickness of keratinized tissue was significantly greater in the test group. Both procedures were well tolerated by the patients.

Paolantonio M, Femminella B, Coppolino E, Sammartino G, D’Arcangelo C, Perfetti G, Perinetti G. Autogenous periosteal barrier membranes and bone grafts in the treatment of periodontal intrabony defects of single-rooted teeth: a 12-month reentry randomized clinical trial. J Periodontol 2010;81(11):1587-1595.
A total of 42 patients with at least one intrabony defect ≥ 6 mm were treated with open-flap debridement (OFD), guided tissue regeneration (GTR) or a combined treatment using periosteal membranes and autogenous bone chips (aCPRT). After 1 year, significant changes in clinical parameters were observed in all groups, with significantly greater gains in clinical attachment level and defect bone level and reductions in probing depth in the GTR and aCPRT groups compared to the OFD group. Gingival recession was significantly smaller and the gain in defect bone level was significantly greater in the aCPRT group versus the GTR group.

Barker TS, Cueva MA, Rivera-Hidalgo F, Beach MM, Rossmann JA, Kerns DG, Crump TB, Schulman JD. A comparative study of root coverage using two different acellular dermal matrix products. J Periodontol 2010;81(11):1596-1603.
In 14 patients with Miller Class I or III facial tissue recession, 52 contralateral sites were treated using coronally advanced flap, 26 in combination with Alloderm and 26 in combination with Puros Dermis. Recession coverage significantly improved in both groups after 6 months, with no significant differences between the groups. Both acellular dermal matrix materials were therefore successful in achieving root coverage.

Scotti R, Pellegrino G, Marchetti C, Corinaldesi G, Ciocca L. Diagnostic value of Nobelguide to minimize the need for reconstructive surgery of jaws before implant placement: a review. Quintessence Int 2010;41(10):809-814.
Following bone augmentation, implants were placed in 20 patients to support 29 maxillary and mandibular fixed prostheses and 19 maxillary removable prostheses using NobelGuide, Autocad System and CT measurements of the available bone. Both the Autocad and CT measurements were significantly different from the NobelGuide intervention score, indicating that NobelGuide may be suitable as a diagnostic tool to avoid reconstructive bone surgery prior to implant placement.