Bone Height Research Articles

Three-dimensional comprehensive evaluation of unilateral alveolar cleft bone grafting with iliac bone and chin bone blocks

In this study, we aimed to provide guidance for selecting bone grafting materials in cases of alveolar clefts. Twenty-nine patients with unilateral complete alveolar clefts were categorized into three groups based on the bone grafting material used: Group A (iliac bone block grafts), Group B (iliac cancellous bone grafts), and Group C (chin bone block grafts). Cone-beam computed tomography (CBCT) data were analyzed using Mimics 19.0 software. Results showed that Group A had the highest bone formation rate, with significant differences observed between Groups A and B, as well as between Groups B and C. Group A and Group C had the highest proportion of Type I in volume assessment, while Group B had the highest proportion of Type III, Significant differences were observed in the distribution of volume assessment scores among the three groups. Bone height measurement results indicated that buccal-side measurement points had a higher proportion of Type I bone height than palatal-side measurement points. Bone width measurement results showed that Type I bone width was highest in Group C, while Type IV bone width was highest in Group B. Significant differences were observed in the distribution of implanted bone width among the three groups. Total grafting scores indicated that Types A and D were predominant in Groups A and C, while Group B had the highest proportion of Type D. Significant differences were observed in the distribution of total grafting scores among the three groups. The comprehensive evaluation method provides accurate assessment of alveolar cleft bone grafting outcomes and is applicable in clinical settings. Based on the results, we consider both iliac bone blocks and chin bone blocks as suitable materials for alveolar cleft bone grafting. Grafting material selection should consider preoperative gap volume measured using CBCT, required bone quantity, donor site complications, and overall clinical needs.

Evaluation of platelet-rich fibrin versus collagen membrane for enhancing healing of secondary grafted alveolar cleft: a randomised controlled trial

The purpose of this study was to compare the efficiency of using autologous platelet-rich fibrin versus a resorbable collagen membrane in secondary alveolar bone grafting. Patients were randomly allocated to the three treatment groups: Group 1 - twelve children in whom the nasal layers of the alveolar clefts were repaired using autologous platelet-rich fibrin with autogenous chin bone; Group 2 - twelve children in whom the nasal layers of the alveolar clefts were repaired using bovine collagen membrane type I (Colla-D) with autogenous chin bone; and Group 3 - twelve children in whom the bony alveolar clefts were grafted with autogenous chin bone after construction of a watertight nasal floor had been completed. The study population comprised 36 patients with alveolar clefts, ranging in age from seven to 12 years. At the last follow-up period all groups had stable healing conditions and good radiological outcomes in terms of the alveolar bone height bordering the teeth (both mesially and distally) and the incorporation of grafting material with the surrounding bone. The use of either a PRF membrane and a collagen membrane as an interpositional layer between the nasal layer and the autogenous chin bone graft enhanced bone formation and density in alveolar clefts compared with the control group.

Evaluating the Efficacy of Platelet-Rich Plasma (PRP) in Accelerating Healing and Reducing Complications in Oral Surgery.

The process of curing and regaining the integrity of damaged tissues is known as healing. An autologous concentration of platelets embedded in plasma is known as platelet-rich plasma (PRP). This study was conducted to evaluate the role of PRP in the fast healing of wounds and complications in oral surgical procedures. A total of 60 patients who underwent different oral surgical procedures were included in this study. PRP was placed in the surgical area after surgical procedures and recalled at the 2nd, 4th, and 6th month postoperatively. There was the assessment of soft tissue healing by measuring the probing depth in teeth adjacent to the surgical area and hard tissue healing in the form of alveolar bone density and alveolar bone height. The assessment of postoperative complications was also conducted. The decrease in the probing depth at different follow-ups was greater in PRP patients showing better and fast soft tissue healing. The increase in alveolar height and alveolar bone density at different follow-ups was greater in the PRP group showing better and fast hard tissue healing. The frequency of complications, such as trismus and pain, was lesser in patients with PRP. The wound healing was at increased rate with reduced complications on using PRP in oral surgical procedures.

Effect of Advanced Platelet-Rich Fibrin and Concentrated Growth Factor on Tissues Around Implants in the Maxillary Anterior Region.

Tissue repair surrounding implants is essential for the cosmetic maxillary anterior zone to respond favorably to implant therapy. Grafting platelets from an individual's blood was developed to overcome the esthetic requirements and speed up healing. Advanced platelet-rich fibrin (APRF) and concentrated growth factor (CGF) are used for good healing. Our aim was to evaluate the impact of APRF and CGF on healing of tissues around dental implants in the anterior region of the maxilla. A total of 60 patients who underwent dental implant placement procedures were included in this study. They were divided into two categories: category 1 consisted of patients who underwent dental implant placement procedures without APRF and CGF (n = 30) and category 2 consisted of patients who underwent dental implant placement procedures with APRF and CGF (n = 30). Assessment of alveolar bone height and bone density was conducted using CBCT at baseline and second, fourth, and sixth month postoperatively. The alveolar height and alveolar bone density in APRF group and CGF group patients was greater compared to control group patients at all follow-ups. APRF and CGF have a positive effect on the tissues around dental implants, promoting faster and better tissue healing around dental implants.

Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months.

Background/Objectives: The aim of this retrospective study was to radiographically evaluate the endo-sinus bone gain (ESBG) following osseodensification procedures using CBCT and compare the results to more conventional sinus lifting techniques. Methods: A total of 72 patients underwent crestal sinus floor elevation procedures and were provided with 102 implants with a sand-blasted and acid-etched surface with microthreads (Medentika® Microcone Implants, Hugelsheim, Germany). Patients were divided into two groups; the osseodensification group (OD; n = 36) and the osseodensified augmentation group (ODA; n = 36). Results: The mean residual bone height (RBH) was 5.71 (1.77) and 4.30 (0.94) mm in the OD and ODA groups, respectively. An ESBG of 3.45 (1.18) and 5.74 (1.31) mm was observed in the OD and ODA groups, respectively, and as compared to the baseline RBH, the ESBG was statistically significant in both groups after 6 months (p < 0.001). Conclusions: Within the limits of this retrospective study, crestal sinus lifting with the osseodensification technique seems to be a fast, effective, and safe method. Longer follow-up studies with full intrasinus bone topography and structure analyses are needed to prove the success rate of endo-sinus bone gain.

Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review

BackgroundTreatment to suppress or lessen effects of puberty are outlined in clinical guidelines for adolescents experiencing gender dysphoria/incongruence. Robust evidence concerning risks and benefits is lacking and there is a...

Autologous leucocyte and platelet rich in fibrin (L-PRF) - is it a competitive solution for bone augmentation in maxillary sinus lift? A 6-month radiological comparison between xenografts and L-PRF.

Much of the research published involves using artificial products, like xenografts and resorbable collagen membranes, after a prior Cone Beam Computer Tomography (CBCT) investigation. Nowadays, more accessible access, less financial costs, a biological approach, and faster healing are objectives that surround this procedure. Leucocytes and platelets rich in Fibrin (L-PRF) are a natural component with a high concentration of growth factors. Due to its regenerative properties and lack of complications, it is used in several medical fields, like orthopedics, dermatology, and oral surgery. This retrospective study aims to compare results in bone height and volume obtained through external sinus lift, either by using xenografts or autologous plasma rich in fibrin, by evaluating the quantity of new bone formation from a radiological point of view. Fifty-eight Caucasian patients were included in this retrospective study; 48 were submitted to xenograft procedure, and 10 were selected for L-PRF grafting material with simultaneous implant placement. Lack of clinical and histological studies performed on patients with L-PRF surgeries limited us in choosing a larger group for the radiological analysis. CBCT evaluation was performed before surgery and 6 months after. All patients selected for the study presented good general and oral health, acute oral and sinus infections excluded; smoking and periodontal disease were also criteria of exclusion. Two operators performed the measurements in pre-established landmarks in different time frames. The two independent groups were compared with the Wilcoxon rank-sum test for quantitative data. Qualitative characteristics were described as counts and percentages. All analyses were performed in an R environment for statistical computing and graphics. Mean bone height gain in the xenograft group in the regions was as follows: 7.44 for the anterior landmark, 12.14 for the median and 8.28 for the distal. The mean group height gained for the L-PRF group was 0.1 anteriorly, -0.18 for the median measurement, and 0.23 distally. We obtained excellent overall reliability for all the height measurements between the two operators. Further studies must be conducted to establish new sets of surgical protocols in case L-PRF alone is found to be a reliable, stable, biological alternative to the well-documented xenografts in external sinus lifts. Radiological results, although promising, must be further applied in long term clinical survival of the implants in the grafted sites. Also, studies combining L-PRF in conjunction with xenograft might bring improved clinical results in terms of reduced postoperative complications and accelerated healing.

Non-surgical treatment of a severe deep bite with aligners and miniscrew: A hybrid approach

This case report describes an orthodontic treatment combining aesthetic aligners with miniscrews and auxiliaries in an adult patient with Class II skeletal pattern and severe deep bite. A 38-year-old hypodivergent male patient with skeletal class II and severe deep bite presented for orthodontic treatment. The patient refused orthognathic surgery and conventional fixed multibracket treatment in favor of aligners in association with the use of miniscrews. The entire treatment was completed within nine months. Smile line and facial profile were improved, and post-treatment panoramic radiography showed good root parallelism, no sign of crestal bone height reduction, and no evidence of apical root resorption. The patient was satisfied with the aesthetic and functional outcomes. This case report illustrates that aligners associated with miniscrews and auxiliaries may be used to treat severe deep bite in certain cases.

A Prospective Report of the Clinical Outcome of TiUnite Implants at 20 Years of Follow-up.

To present a survival analysis of 133 consecutively placed moderately rough implants, all with a total follow-up of 20 years. A total of 133 implants of the same brand placed in 46 patients at the same county clinic in Sweden were followed up prospectively over 20 years and analyzed for survival and bone height, the latter evaluated in periapical radiographs. A total of 7 implants failed, 4 of which were in the same patient. Implant failure was associated with a combination of smoking and bruxism in 5 of the 7 failed cases. A 20-year survival rate of 94.7% was observed. Average marginal bone loss (MBL) at 20 years of follow-up was 0.543 ± 1.193 mm, with 9 implants having more than 2 mm of MBL. A total of 20 patients with 25 implants dropped out of the study; however, if death of the patient is excluded as a dropout reason, only 3 implants in 3 patients were unaccounted for. Good clinical results in the 95% survival range were observed with moderately rough implants over a 20-year follow-up period.

Assessment of the correlation between supracrestal gingival tissue dimensions and other periodontal phenotypes components via the digital registration method: a cross‑sectional study in a Chinese population

BackgroundSupracrestal gingival tissue dimensions (SGTDs) has been considered to be an essential element of periodontal phenotype (PP) components. This study aimed to explore the relationship between SGTDs and other PP components by digital superposition method that integrated cone beam computed tomography (CBCT) with intraoral scanning.MethodsThis cross-sectional study was conducted at the Stomatology Hospital of Fujian Medical University. Participants were recruited based on the inclusion and exclusion criteria. The data obtained from the digital scanner (TRIOS 3, 3Shape, Denmark) and CBCT images were imported into the TRIOS software (Implant Studio, 3Shape, Denmark) for computing relevant parameters. The significant level was set at 0.05.ResultsA total of 83 participants with 498 maxillary anterior teeth were finally included. The mean values of supracrestal gingival height (SGH) and the distance from the cementoenamel junction (CEJ) to the crest of the alveolar ridge (CEJ-ABC) on the buccal site were significantly higher than palatal SGH (SGH-p) and palatal CEJ-ABC (CEJ-ABC-p). Men exhibited taller CEJ-ABC and SGH-p than women. Additionally, tooth type was significantly associated with the SGH, SGH-p and CEJ-ABC-p. Taller SGH was associated with wider crown, smaller papilla height (PH), flatter gingival margin, thicker bone thickness (BT) and gingival thickness (GT) at CEJ, the alveolar bone crest (ABC), and 2 mm apical to the ABC. Smaller SGH-p displayed thicker BT and GT at CEJ, the ABC, and 2 and 4 mm apical to the ABC. Higher CEJ-ABC showed lower interproximal bone height, smaller PH, flatter gingival margin, thinner GT and BT at CEJ, and 2 mm apical to the ABC. Smaller CEJ-ABC-p displayed thicker BT at CEJ and 2 and 4 mm apical to the ABC. On the buccal, thicker GT was correlated with thicker BT at 2 and 4 mm below the ABC.ConclusionSGTDs exhibited a correlation with other PP components, especially crown shape, gingival margin and interdental PH. The relationship between SGTDs and gingival and bone phenotypes depended on the apico-coronal level evaluated.Trial registrationThis study was approved by the Biomedical Research Ethics Committee of Stomatology Hospital of Fujian Medical University (approval no. 2023-24).

ALVEOLAR DISTRACTION OSTEOGENESIS AND IMPLANTOLOGY

Congenital or acquired alveolar abnormalities are the indications for alveolar ridge augmentation. Periodontal disease, traumatic avulsions, post-extraction abnormalities, and/or protracted denture use with ensuing disuse atrophy can all contribute to acquiredalveolar bone loss. The horizontal dimension has suffered the most loss in the majority of these instances. The loss of the buccal bone plate following a traumatised tooth avulsion is a common scenario that results in a horizontal defect. The goal of current implant dentistry standards is to produce natural-looking prosthetic restorations with the best possible functional and aesthetic results. In order to attain gold-standard outcomes, a number of factors have been proposed, including sufficient bone height, width, and anteroposterior projection sufficient amount and quality of soft tissue preservation of the buccal sulcus and sufficient papillae and gingival contour. In the modern practice of dentistry, the preservation and rebuilding of the alveolar bone and surrounding soft tissues for the implantation of dental implants has become essential. An alternate technique for repairing alveolar atrophy is alveolar widening by distraction osteogenesis (DO), which is comparable to alveolar split grafting but does not require the graft. The alveolar bone and associated mucosa have undergone a durable, aesthetically pleasing restoration thanks to the combination of vertical DO and osseointegration.

Immediate implant placement in the anterior mandible: a cone beam computed tomography study

BackgroundThe placement of implants into the alveolar socket right after tooth extraction is called immediate implant placement (IIP). This approach has its particularities depending on which region of the jaws is involved. The anterior mandible region is peculiar due to the presence of mandibular incisors, which have the shortest roots among all permanent teeth.PurposeThis study aimed to investigate the factors that could be associated with the risk of either cortical bone wall perforation or invasion of the 2 mm secure distance from the surrounding anatomical structures (defined as unsafe implant placement), with IIP in the maxillary aesthetic zone, in a cone-beam computed tomography (CBCT) virtual study.Materials and methodsCBCT exams from 239 eligible subjects were investigated. Implants were virtually placed in two distinct positions: prosthetically-driven (along the long axis of the existing tooth) and bone-driven position (according to the available bone and with regard to nearby anatomical structures). Correlation between several variables was tested, and binary logistic regression analysis in order to assess of the possible associations between covariates and unsafe placement was performed.ResultsSafe placing implants was significantly higher for the bone-driven in comparison to the prosthetically-driven position (22.2% vs. 3.3%, respectively), and the 2-mm secure distance from anatomical structures was not possible to respect in the majority of cases (77.6% vs. 82.9%, respectively). Covariates associated with a higher risk of unsafe placement were tooth region (CI in relation to IL and CA), decrease of labial concavity angle (LCA), decrease of mandible basal bone height (MBBH), and decrease in mandibular bone thickness at the tooth apex level (MBT0).ConclusionThe possibility of safely placing immediate implants in the anterior mandible is significantly higher for bone-driven than in prosthetically driven position. Presurgical virtual planning with CBCT is a great tool for minimizing the risk of implant unsafe placement with regards to the anatomical conditions in the mandible.

The Effect of Platelet-Rich Fibrin and Platelet-Rich Plasma in Secondary Alveolar Bone Grafting in Cleft Lip and Palate Patients: A Systematic Review.

(1) Background: Cleft lip, alveolus, and palate are the most common congenital abnormalities in the world, occurring in one in seven hundred live births. Secondary alveolar bone grafting (SABG) is usually performed when the permanent canine root shows one-half to two-thirds of root development. To improve the surgical outcome, supplemental grafting materials such as platelet-rich fibrin (PRF) and platelet-rich plasma (PRP) have been used as an adjunct. This review is designed to assess the efficacy of PRF and PRP in improving the outcome of SABG. (2) Methods: A comprehensive literature search was performed until 13 October 2022 on MEDLINE, EMBASE, The Cochrane Library, and Pubmed. The full text of potentially relevant studies was reviewed, and only randomised clinical trials (RCTs) were included based on the inclusion criteria. (3) Results: A total of 656 studies were screened, of which four were included for final review. All of the four included studies that evaluated the quantitative or qualitative surgical outcome in varied ways. (4) Conclusions: Results of this review suggest that both PRF or PRP and control group (without the use of PRF/PRP) achieved similar successful outcomes in bone height, bone density, and bone volume in both qualitative and quantitative assessment.

Hormone replacement therapy and periodontitis progression in postmenopausal women: A prospective cohort study.

This study aimed to investigate the responses of periodontal environment to hormone replacement therapy (HRT) in postmenopausal women with or without periodontitis. HRT is a common and effective strategy for controlling menopausal symptoms, while the changes of periodontal environment under it, particularly in postmenopausal women with periodontitis, remain unclear. As a prospective cohort study, a total of 97 postmenopausal women receiving HRT were screened, including 47 with and 50 without periodontitis. Correspondingly, 97 women did not receiving HRT were screened as controls during the same period. The full-mouth sulcus bleeding index (SBI), bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) were measured using periodontal probes. The levels of interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) in the gingival crevicular fluid were measured using enzyme-linked immunosorbent assay. In addition, cone beam computed tomography was performed to measure the alveolar bone height (ABH) and bone mineral density (BMD). In postmenopausal women without periodontitis, no significantly changes on periodontal parameters were observed after HRT. In women with stage II periodontitis, SBI, BOP, IL-6, and TNF-α were significant decreased after one year and two years of HRT. Compared to the controls, women with stage II periodontitis who underwent HRT had significantly lower CAL and ABH and higher BMD in the second year. The incidence of at least one site with CAL increase ≥1 mm between baseline and 2 years was significantly lower in the HRT group than in the control group in women with stage II periodontitis. In addition, HRT was significantly associated with a decrease in SBI, BOP, IL-6, and TNF-α in the first year and with a decrease in CAL, SBI, BOP, IL-6, and ABH and an increase in BMD in the second year. In postmenopausal women with stage II periodontitis, HRT is associated with the alleviation of inflammation within two years and the remission of alveolar bone loss in the second year. HRT appears to decrease the incidence of CAL increase ≥1 mm within 2 years in women with periodontitis by inhibiting inflammation and alveolar bone loss.

Changes in the alveolar bone morphology among different patterns of incisor inclination during the alignment phase in orthodontic treatment without premolar extraction.

The present study investigated bone remodelling in the upper and lower incisor regions depending on the inclination pattern during the alignment phase of orthodontic treatment (OT). This prospective clinical study included 71 patients undergoing OT without premolar extraction. Cone beam computed tomography scans were taken before and after the alignment phase and the changes in the inclination, alveolar bone height (ABH) and bone thickness (BT) at levels 2, 3, 4, 6, 8 and 9 mm starting from the cementoenamel junction (CEJ) were determined. Teeth were divided into 'Retroinclination' (lingual crown inclination <0°), 'Proclination-low' (buccal crown inclination between 0° and 5°), or 'Proclination-high' (buccal crown inclination >5°). The alignment phase of OT resulted in ABH loss. The highest ABH loss in the maxilla was observed on the buccal side in the 'Proclination-high' and was 0.71 mm. ABH loss by 1.1 mm was observed in the mandible on the lingual side in the 'Retroinclination' group. The most significant changes in BT by up to 2 mm were observed at levels 6, 8 and 9 mm and these changes exhibited a moderate to strong correlation with the alterations in the inclination of individual incisors. At levels 2, 3 and 4 mm, the highest decrease in BT by up to 0.83 mm was observed on the palatal side of upper incisors in the 'Proclination-high' group. The direction and amount of tooth inclination partially determine changes in the bone parameters during the alignment phase.

Artesunate-loaded thermosensitive chitosan hydrogel promotes osteogenesis of maxillary tooth extraction through regulating T lymphocytes in type 2 diabetic rats.

Type 2 diabetes mellitus (T2DM) causes severe bone loss after tooth extraction as a hyperglycemic environment causes aberrant bone homeostasis. Artesunate (ART) is known to possess anti-inflammation and osteogenic properties. However, its osteogenesis property in alveolar bone remains unclear. This study aimed to explore the osteogenic and immunoregulatory effects of artesunate-loaded thermosensitive chitosan hydrogel (ART-loaded TCH) on maxilla tooth extraction in T2DM rats. T2DM rats were induced by a high-fat diet and streptozotocin. Different concentrations of ART-loaded TCH were applied in tooth extraction sockets. Bone loss and the expression of osteogenic regulatory factors (OPG, ALP, RANK) were evaluated. The immunoregulatory effects of ART-loaded TCH were observed through detecting the infiltration of T lymphocytes and their cytokines. The underlying mechanisms were explored. Results showed that the 150mg/ml ART-loaded TCH group significantly ameliorated maxilla bone height and bone mineral density when compared with the T2DM group (p < 0.05). It also improved the expression of OPG, ALP, and RANK. Although the alteration of CD4+ T, CD8+ T, and CD4+:CD8+ T ratio has no significant difference among groups, the release of Th1 and Th2 in the 150mg/ml ART-loaded TCH group has been significantly regulated than in the T2DM group (p < 0.05). Besides, ART-loaded TCH treatment inhibited the expression of p38 MAPK and ERK1 in T2DM maxilla. Therefore, the results indicated that 150mg/ml ART-loaded TCH could be an effective method to prevent bone loss in T2DM tooth extraction rats by modulating the immunoregulation of Th1 and Th2 and the MAPK signaling pathway.

Current Concepts in Alveolar Ridge Augmentation

Ridge augmentation is a predictable procedure that can correct the defects caused by bone loss in areas with missing teeth. More importantly, this procedure allows the chance to return the natural contours of the soft tissues that existed before the loss of the tooth. It is done in patients with insufficient bone height and width by using various bone substitute materials and bone graft procedures where the successful placement of dental implants is difficult with regards to maintaining an ideal pathway and avoiding important anatomical structures. This review article will be carried out to describe the various techniques of ridge augmentation.

Systematic Analysis of Lower Second Molar Periodontal Health after Autogenous Dentine Graft from Wisdom Tooth Extraction

Introduction: Postoperative complications stemming from lower wisdom tooth extractions are often overshadowed by the immediate need to address pain and existing disease. Nevertheless, an emerging body of evidence suggests the importance of preventing potential periodontal damage to the adjacent second molar resulting from the extraction surgery. To avert periodontal complications involves promoting bone formation within the extracted socket defect. Allogenic and artificial bone, as well as the patient’s bone, have conventionally filled the osseous void post-surgery. These approaches are costly and may extend the patient’s recovery. An Autogenous Dentine Graft (ADG), derived from the recently extracted wisdom tooth, presents, as a particulate with osteoconductive and osteoinductive properties, is ideal for preserving bone integrity. This review assesses the available evidence supporting the use of ADG in safeguarding against periodontal morbidity resulting from the surgical extraction of a lower third molar. Materials and methods: A systematic review of the literature was conducted, focusing on the periodontal health of the second molar and the bone height of the osseous defect postwisdom tooth extraction. Out of 76 identified articles, four studies were selected for the review. Results: Three months post-surgery, the mean periodontal probing depth distal to the second molar was 4.7mm in control sites and 2.83mm in sites treated with ADG. Over 12 months, the mean bone height exhibited a negative loss of 1.25mm in control sites and a positive gain of 0.9mm in sites treated with ADG. Conclusion: Presently, there is insufficient evidence to unequivocally support the use of an autogenous dentine graft following the surgical extraction of a wisdom tooth. However, early results are promising, and given the biocompatibility of a material derived from the patient, ADG is considered a safe option for patients at high risk of an osseous defect. Further research is needed to substantiate these findings and guide clinical decision-making.

Injectable Nanocomposite Hydrogels with Strong Antibacterial, Osteoinductive, and ROS-Scavenging Capabilities for Periodontitis Treatment.

Injectable antibacterial and osteoinductive hydrogels have received considerable attention for promoting bone regeneration owing to their versatile functionalities. However, a current hydrogel with antibacterial, osteoinductive, and antioxidant properties by a facile method for periodontitis treatment is still missing. To overcome this issue, we designed an injectable hydrogel system (GPM) composed of gelatin, Ti3C2Tx MXene nanosheets, and poly-l-lysine using a simple enzymatic cross-linking technique. Physicochemical characterization demonstrated that the GPM hydrogel matrix exhibited excellent stability, moderate tissue adhesion ability, and good mechanical behavior. The GPM hydrogels significantly inhibited the growth of Porphyromonas gingivalis, scavenged reactive oxygen species, attenuated inflammatory responses, and enhanced bone tissue regeneration. Intriguingly, the arrangement of the junctional epithelium, alveolar bone volume, and alveolar bone height in the GPM-treated periodontal disease group recovered to that of the healthy group. Therefore, our injectable hydrogel system with versatile functions may serve as an excellent tissue scaffold for the treatment of periodontitis.

Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis.

To assess the alveolar bone changes and gingival recession following Herbst appliance therapy. Electronic databases such as PubMed, Ovid, Cochrane Library, Lilacs, Scopus, Web of Science, and Embase were searched until August 2022. Hand-searching of major orthodontic journals was performed to identify all peer-reviewed articles potentially relevant to the review. The quality of the selected studies was ranked using the revised Cochrane risk of bias tool for nonrandomized trials-Risk of Bias In Nonrandomized Studies (ROBINS) 1. Five relevant articles (all nonrandomized studies) were considered for qualitative analysis. The risk of bias was low for four studies and moderate for one. The reduction in the vertical alveolar bone height was 0.13 ± 0.07 mm, with the Herbst appliance. The mean difference in the loss of buccal cortical thickness between the Herbst appliance and untreated control group was 0.22 mm [95% confidence interval (CI) of -0.62-0.18]. Subsequent to Herbst appliance therapy, in the mandibular anterior region 0.1 ± 0.5 mm of gingival recession was observed. Herbst appliance treatment produces a negligible reduction in the buccal cortical thickness, vertical alveolar bone height, and gingival recession. Though the changes produced by the Herbst appliance were minimal, they are clinically important considering the young age of the patients warranting periodic periodontal assessment. Kumar MV, Kannan A, Kailasam V. Alveolar Bone and Gingival Changes in Mandibular Anterior Region Following Herbst Appliance Therapy: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2024;17(1):114-120.