Interdental Papilla Research Articles

Unusual gingival actinomycosis post allogeneic hematopoietic stem-cell transplant: case report

BackgroundAllogeneic hematopoietic stem cell transplant (allo-HSCT) is used to treat several hematological diseases, but immunosuppression during allo-HSCT facilitates opportunistic microbial growth in tissues, such as actinomycosis. An effective diagnosis of opportunistic diseases is essential for correct management of the disease and preservation of the immunosuppressed patient’s life.Case descriptionA 57-year-old female patient was diagnosed with extranodal nasal type NK/T cell lymphoma and underwent curative treatment with allo-HSCT. Twenty-one days after the last clinical follow-up, the patient presented a necrotizing lesion in the papilla region between the first and second molars of the second quadrant. Histopathological analysis showed the presence of a bacterial cluster consistent with Actinomyces infection, and a dense lymphoid infiltrate was also observed. Immunohistochemistry for CD20, CD3, and CD56 was performed to exclude the possibility of the recurrence of extranodal NK/T cell lymphoma. Oral microbiota profiling showed a huge increase in the abundance of Actinomyces bacteria in the subgingival region three weeks prior to appearance of the lesion.ConclusionsOpportunistic infections with an unusual clinical appearance are confounding factors in therapeutic decision-making. We present for the first time a case of actinomycosis in the gingival papilla region following allo-HSCT. We also highlight how microbiota profiling through next-generation sequencing could be used to anticipate bacterial infection diagnosis.

A Surgical Approach to Root Coverage and Correction of Mucogingival Conditions and Deformities in Mandibular Incisors with Isolated Gingival Recession: Free Mucogingival Graft. A Pilot Prospective Cohort Study.

The aim of this study was to present a periodontal plastic surgery approach to treat gingival recessions (GRs) and correct mandibular incisor mucogingival conditions and deformities. Isolated deep GRs (≥ 3 mm) in the mandibular incisors (n = 24 teeth) were treated: 66.6% of sites were recession types 2 or 3, and 58.3% of teeth were malpositioned. Recessions were treated using free mucogingival grafts (FMGs) harvested from the buccal aspect of donor teeth with altered passive eruption or healthy periodontal support, with < 3 mm between the cementoenamel junction and the buccal alveolar crest. Clinical parameters (GR, clinical attachment level, interproximal papilla tip location, keratinized tissue, vestibule depth) and root coverage esthetic score were evaluated at 9 months. FMG significantly reduced GR (P < .001) and increased keratinized tissue (P < .001) without loss of vestibule depth (P > .05). Mean root coverage was 94.37% ± 10.60%, mean residual GR was 0.08 ± 0.65 mm, and the mean root coverage esthetic score was 8.9 ± 1.24. Recession types 2/3 showed significant interproximal clinical attachment gain (P < .05). The interproximal papilla was significantly augmented at sites with papilla loss (P < .001). No clinical attachment loss (P = .346) was detected at donor sites. These results suggest that FMG is a promising root coverage approach for recession types 1, 2, and 3, correcting mucogingival conditions and deformities and reconstructing the interproximal papilla.

ОЦЕНКА ЭСТЕТИЧЕСКОГО РЕЗУЛЬТАТА ПРОТЕЗИРОВАНИЯ НА ОДИНОЧНОМ ДЕНТАЛЬНОМ ИМПЛАНТАТЕ

Objective: A comparative assessment of the aesthetic result of a single dental implant (DI) prosthetics using standard or custom abutments. Methods: A customized gingival former and a custom abutment were applied in patients of the main group, while patients of the control group received a standard gingival former and a stock abutment. The aesthetic assessment was carried out on photographs using the Pink Esthetic Score (PES) and White Esthetic Score (WES) scales. Results: Better aesthetic results were obtained in the main group compared to the control one. At subsequent stages of the study, a further aesthetical improvement was observed compared with the initial assessment result. Conclusion: The formation of a marginal gingiva matching the anatomical shape of the neck of the missing tooth enables to fabricate a customized abutment and a dental crown of the correct anatomical shape. The physiological dimensions and the correct eruption profile of the prosthetic crown contribute to the formation of interdental papillae where they were originally absent. The listed advantages of this method improve the RES and PES results of prosthetics on a single-unit DI. Keywords: Prosthetics on dental implants, crown on a single-unit dental implant, custom abutment, gingival papilla, pink aesthetics, white aesthetics.

Efficacy of Volume Stabilizing Collagen Matrix in Modified Pinhole Surgical Technique - A Case Report

Gingival recession is one of the most popular periodontal diseases. Aesthetics and hypersensitivity are two major concerns with recession. Although there are multiple treatment options, minimally invasive techniques have recently received much attention due to better patient acceptance and pretty much identical outcomes/results when compared to traditional standard treatment options. Here, we report a case of 34-year-old male patient who presented with the chief complaint of sensitivity to warm and cold in the left upper front tooth region. A 2mm hole was created and a full thickness flap was elevated from the apical side of the tooth towards marginal gingiva, leaving the interdental papilla intact. After relieving the gingiva from beneath, it was sutured to the tooth as an anchorage. Many allogenic materials have been used to replace the space between the flap and bone underneath. The prognosis was fair for this procedure. However, the efficacy of a Novel Volume stabilizing collagen matrix with a modified Pinhole technique is unknown. This report has shown promising results for the treatment of Miller's Class I and II gingival recession.

Successful Surgical Management of Periapical Cyst with Accidentally Extruded MTA through Open Apex - A Case Report with One Year Follow up

ABSTRACT An immature tooth with a blunderbuss canal presents a challenge in achieving a hermetic seal. Closure of the wide-open apex with materials such as mineral trioxide aggregate (MTA), biodentine, and endosequence root repair material is required to achieve success. Despite following proper methods, the extrusion of filling material into the periapical region is unavoidable. In this case report, due to a lack of apical stop, MTA was extruded unintentionally. Endodontic surgery was performed to remove the extruded MTA and curettage of the apical lesion was done to remove the cystic lining. Follow-up after regular intervals of 1, 3, 6 months, and 1 year showed resolution of periapical radiolucency with radiopaque corticated borders surrounding the radiolucency. This case report describes the successful surgical management of accidentally extruded MTA through large wide-open apex. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY Surgical planning involved flap design in collaboration with periodontist for preservation of the interdental papilla.

Esthetic improvement through the reconstruction of interdental papillae by adjusting the subgingival contour

Esthetic improvement through the reconstruction of interdental papillae by adjusting the subgingival contour

Relation of CAD/CAM zirconia dental implant abutments with periodontal health and final aesthetic aspects; A systematic review.

Using dental implants to replacing missing teeth and satisfy both functional and aesthetic needs is one of the mainstream dental treatments. New approaches including computer-aided design and computer-assisted manufacture (CAD/CAM) have been introduced to improve these elements. This systematic review aimed to compare CAD/CAM zirconia (Zr) implant abutments with other available abutments in terms of peri-implant health and aesthetics. Five electronic databases (PubMed, Web of Science, Scopus, ProQuest, and Embase) were scoured for clinical studies evaluating Zr abutments reporting on the outcomes of interest including interproximal papilla stability (PS), papilla recession (REC), pink and white esthetic score (PES, WES), marginal bone level (MBL), color, and soft tissue contour. A hand searches in English language journals until September 2020 complemented the search. Two tools of Joanna Briggs Institute and Jaded Score calculation were used for the risk of bias assessment. No quantitative synthesis of the data was done due to high heterogeneity. A total of six studies from the 412 ones obtained from the search were included. The study designs were either prospective cohort (n=3) or randomized clinical trial (n=3). Papilla fill, WES, PES, and the distance from the bone crest of adjacent teeth to the contact point (CPB) and inter-tooth-implant distance (ITD) was not significantly different between Zr CAD/CAM and Zr stock abutments. However, soft tissue stability and REC index were better in Zr CAD/CAM abutments. Higher soft tissue stability can be achieved for Zr compared to titanium abutments with either stock or CAD/CAM abutments. Key words:Dental implants, Dental abutment, Computer-Assisted Design, Computer-Aided Manufacturing, Zirconia abutment, Soft tissue stability.

Gingival Pigmentation Pattern in Correlation to Skin Color in a Group of Kurdish People in Sulaimani City

Background: Melanin pigmentation of the gingiva appears in all ethnicities. Excessive pigmentation is an esthetic concern that has increased awareness about depigmentation procedures. This epidemiological study aims to find the correlation between skin color and gingival pigmentation in Sulaimani Governorate, Kurdistan/Iraq. Subjects and Methods: A total of 820 apparently healthy and non-smokers, including 338 males and 482 females with healthy gingiva, aged between (18-40 years old) were enrolled in this study. Clinical examination on the participants’ gingivae was performed to assess color, and the distribution of pigmentations. Afterward the of participants skin color were visually examined and divided into six groups according to the Fitzpatrick scale. Results: Skin color of (53%) of our participants was medium to light brown. Most of the pigmentations were observed in the attached gingiva and interdental papilla (26.83%) and least being in the marginal gingiva and interdental papilla (9.27%). A statistically significant correlation was found between the participants’ skin color, and the intensity of their gingival pigmentations Conclusion: Darker-skinned subjects haveeavieringival pigmentation compared toair-skinned people in Sulaimani Governorate, Kurdistan/ Iraq. The intensity of gingival pigmentation increases with age with the highest rate of gingival pigmentation was in the upper and lower second premolar to premolar area.

Factors Affecting the Presence or Absence of Interdental Papilla; An in-vivo study. Part II: Influence of Different Parameters on the Presence or Absence of a Black Triangle

Background: The distance from the crest of the bone to the contact point is crucial to the formation of a black triangle. This study looks into the influence of various clinical parameters on the absence of the interdental papilla. Aim: The aim of this study is to assess the different clinical parameters that can contribute to black triangle formation. Objective: The objective of this study is to determine the significance of various clinical parameters in the formation of black triangles. Methods: Patients included were those referred to the radiology department for periapical radiographs from the second premolars to the second premolars in both jaws. All the patients were clinically examined to assess the parameters investigated. Different Parameters were assessed which included tissue phenotype type, interproximal cleaning, and the presence of inflammation. The data was analysed using IBM SPSS version 19 and STATA. Results: It was found that the relative risk of patients who have a thin tissue phenotype is 1.20 times more likely to have a black triangle than patients with a thick tissue phenotype. Lack of interproximal cleaning resulted in 1.46 times more likely to have a black triangle. The presence of gingival inflammation caused1.32 times more likelihood of having a black triangle. Conclusion: The parameters that had a significant association were tissue phenotype, interproximal cleaning, and gingival inflammation. The amount of inflammation, the cleaning habits, and the tissue phenotype of the patient need to be taken into consideration when planning restorative work and care needs to be taken in the treatment planning, consent, and execution.

Clinical Characteristics of the Oral Mucosa of Patients with Red Lichen Planus, Depending on the Anatomical Location

The purpose of the study was to state the clinical characteristics of the oral mucosa in patients with red lichen planus depending on the anatomical localization of the process. Materials and methods. Examinations and a complex of treatment measures were carried out on the basis of the department of Therapeutic Dentistry of the I. Horbachevsky Ternopil National Medical University and the licensed private dental clinic “DVM», Ternopil. 42 patients with red lichen planus were examined. The patients underwent a general clinical dental examination with the registration of indicators in the medical cards of the dental patient, form 043/y, and assessment of the state of oral hygiene according to J. C. Green, J. R. Wermillion, by objectifying the state of periodontal tissues based on index analysis in the modification of C. Parma. Results and discussion. The most typical places of lesions by this nosological unit are the cheeks along the line of teeth closure, the retromolar area. The papules are small silver-grey or white-grey in colour with a characteristic waxy sheen, which is most visible under side lighting conditions. Taking into account the regional features of the structure of the mucous membrane of the back of the tongue, the lesion elements are visualized in the form of plaques that merge into shapes and resemble rings and chains in appearance. When the process spreads to the gums, there is a tendency to an increase in the volume of the interdental gingival papillae and a change in the structure of the gums in the form of maceration and colour of the gums. Features of the clinical picture of the course of this disease on the red border of the lips in the form of a plaque reflect the regional anatomical and morphological features of the red border itself, namely the insignificant thickness of the epithelial plate and the submucosal base. The above-mentioned differences in the clinical picture of red lichen planus should be taken into account at the stage of applying the main clinical methods, as well as the topographic and morphological features of the structure of the mucous membrane at the stage of verification of the lesion elements by a dentist. Conclusion. It is advisable to take into account the visualized differences in the clinical picture of red lichen planus at the stage of application of the main clinical methods as well as the topographical and morphological features of the structure of the mucous membrane at the stage of verification of the lesion elements by a dentist. Thus, in this way, a wide variety of clinical manifestations, complex etiopathogenetic mechanisms of the development of red lichen planus, require a personalized, complex analysis based on an individual approach to each patient, taking into account the aetiology, clinic and regional features of the oral mucosa

A Case of Selecting the Tunnel Technique for Gingival Recession Considering the Interdental Papilla Dimension

A Case of Selecting the Tunnel Technique for Gingival Recession Considering the Interdental Papilla Dimension

Go Micro Aesthetics: A Cross-Sectional Study to Assess Anterior Hard and Soft Tissue Parameters in Young Adults of Bhopal City.

Background In the maxillary aesthetic zone, the symmetry and proportions of hard and soft dental tissue play a crucial role. A dental practitioner should have a thorough knowledge of parameters such as crown length (CL), crown width (CW), zenith point, and gingival angle (GA) to perform teeth restorations. This study aims to assess the anterior hard and soft tissue parameters and determine the crown shape and its correlation with the gingival parameters of young adults' anterior teeth. Methods In the study, 110 patients were assessed and divided into two groups: Group I with 55 females and Group II with 55 males. Using a calibrated vernier caliper, the following parameters were calculated: crown width (CW)/crown length (CL) ratio, gingival angle (GA), distance from the lateral incisor (LI) to the gingival aesthetic line (GAL), interdental papilla height (PH) between the two central incisors (CI), distance between the central incisor (CI) and the lateral incisor (LI), and distance between LI and canine. Results Statistical analysis of data was performed using the independent samples t-test (P<0.05). The mean value of CW, CL, CW/CL ratio, and GA, along with the distance from LIs to GALs and PHs of the anterior teeth, were lower in females than in males. The correlation between the GA and the CW/CL ratio indicated that higher GAs and CW/CL ratios give teeth a square appearance. Moreover, a lower GA and CW/CL ratio will make teeth appear round ornarrow. Conclusion The present study concluded that the mean values of hard and soft dental tissue parameters are higher in males than in females. These values can be used to restore functional aesthetics in accordance with the results of a local population and could help form restorative, aesthetic, and cosmetic procedures while maintaining focus on the size and shape of teeth and the level of gingiva at various significant treatment stages.

The use of shear wave elastography to monitor changes in gingival elasticity associated with initial periodontal therapy in patients with advanced periodontitis: A prospective pilot study

Background/purposeGingival tissue firmness cannot be objectively assessed or monitored in real-time in existing examinations. This study was designed to examine the potential utility of shear wave elastography (SWE) as a means of evaluating and monitoring gingival inflammation in an effort to assess the effects of initial periodontal therapy in patients with advanced periodontitis. Materials and methodsThis pilot study included analyses of 66 sites in 6 advanced periodontitis patients. Patients underwent the SWE examination of the gingiva at the mid-labial and interdental papillae at baseline and at 2, 4, and 6 weeks following initial periodontal therapy. Measured periodontal parameters in these patients include Plaque index (PI), Gingival bleeding index (GBI), Probing depth (PD), and Clinical attachment loss (CAL). ResultsRespective baseline SWE values at the mid-labial gingiva and interdental papilla 25.68 ± 6.82 kPa and 26.78 ± 6.20 kPa, with no significant differences between these two measures. A significant negative correlation between SWE and both PI (r = −0.350, P = 0.004) and GBI (r = −0.287, P = 0.020) was observed at baseline. Initial periodontal therapy contributed to significantly higher SWE values and tougher gingiva, particularly during the first two weeks. Postoperative changes in SWE were negatively correlated with SWE values at baseline (r = −0.710, P < 0.001). ConclusionThese results establish SWE as a sensitive noninvasive approach to quantitatively assessing changes in gingival elasticity in real-time.

Effectiveness of MIST with hydroxyapatite and β-tricalcium phosphate in alveolar bone density and osteocalcin level improvement during treatment of infrabony pockets

The minimally invasive surgical technique (MIST) is a method for periodontal regenerative treatment by minimizing trauma so it can preserve vascular supply of the interdental papillae. This study aims to determine the effectiveness of the MIST method with the addition of a combination of hydroxyapatite and β-tricalcium phosphate (HA + β-TCP) in treatment of infrabony pockets in terms of alveolar bone density and osteocalcin levels of gingival crevicular fluid. The study sample was taken from 20 teeth with infrabony pockets (n = 20), which were divided into two groups: 10 teeth treated with MIST and the other group with open flap debridement (OFD). Both groups received combination of HA + β-TCP. The osteocalcin levels of gingival crevicular fluid were checked on day-0 prior to the flap surgery, day-7 and day-14 after flap surgery using the Human Osteocalcin Elisa Kit. Radiological evaluation of alveolar bone density at day-0 and day-90 was done using cone beam computed tomography. Data of osteocalcin levels were analyzed using two-way ANOVA and continued with LSD Post Hoc test, while data of alveolar bone density reduction were analyzed using the Independent t-test parametric test. The results showed that there was no significant difference (p &gt; 0.05) in the values of alveolar bone density between the MIST and OFD groups on day-0 and day-90, while the osteocalcin levels in both groups showed an increase from day-0 to day-7 and a decrease from day-7 to day-14. There was a significant difference (p &lt; 0.05) on day-0 and 7 and day-7 and 14 between MIST and OFD groups. The MIST method with HA + β-TCP was effective and further increases alveolar bone density and osteocalcin levels of gingival crevicular fluid.

Influence of interdental embrasures on interdental papilla

Background: There is growing attention on anterior esthetics by both dentists and patients, which emphasizes the need for conduct of study encompassing the anatomical features of an embrasure and correlating with papilla fill. Hence the present study has been designed to meet these parameters, including food lodgement.&#x0D; Aim: To assess the influence of anatomical and morphological characteristics of interdental embrasures on interdental papilla and food lodgement.&#x0D; Objectives: were set as the following:&#x0D; 1.Correlation of Modified Papilla Index Score (PIS) with interdental anatomical measurements as follows:&#x0D; a. Distance between Contact Point and Bone Crest (CP-BC). b. Interdental Distance (IDD).c. Embrasure Space Area (EA).d. Crown Form (CF).e. Papilla Length (PL).&#x0D; 2.To determine the optimal dimensions of interdental embrasure between maxillary incisors so as to be completely filled by normal healthy interdental papilla.&#x0D; 3.To correlate occurrence of food lodgement with Modified Papilla Index Score (PIS) and Embrasure Space Area (EA).&#x0D; Materials and methods : 532 patients aged 18-58 years who had fully erupted permanent dentition and healthy gingiva with probing depth ≤ 3mm were included into the study. Quantitative analysis of interdental papillae were done using clinical parameters along with radiographic examination.&#x0D; Results : The clinical and radiographic assessment of 1312 interdental papillae revealed that the interdental anatomical factors viz (which are) CP-BC distance, IDD, EA, CF and PL significantly influenced the degree of papilla fill. The study also highlighted the possible occurrence of food lodgment in patients with open embrasures.&#x0D; Conclusion : Embrasure anatomical parameters and papillary heightvary widely among individuals. Interdental papillary deficiency is a relative phenomenon since it is an outcome of net influence of all the other parameters.

Analysis of dental status in children with type I diabetes mellitus: a literature review

Relevance. Diabetes mellitus is one of the most complex metabolic chronic diseases. Severe forms of type I diabetes mellitus are more common in children and adolescents, and its prevalence is increasing in many countries. Type I diabetes mellitus in children and adolescents remains an essential health issue in many countries despite the achieved scientific and practical results and progress in diabetology. Therefore, its early detection in children is still relevant and is associated with the early diagnosis of endocrinolog ical pathologies.Materials and methods. The study searched the publications in PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), Medline (www.elibrary.ru, www.ncbi.nlm.nih.gov/pubmed) by the specific keywords.Results. In children with diabetes mellitus, vascular changes in periodontal tissues appear earlier than in other organs. On oral examination of children with diabetes mellitus, 50% of cases reveal periodontal lesions, and the lesions are often in the areas of the lower molars. If not treated, the following perio-dontitis signs are present in diabetic children: bleeding of the gingival papillae and the bright red colour of the gingival margin. There may be bulging of granulations from pathological gingival pockets. In most patients with type I diabetes mellitus, cytology of the periodontal pockets and gingival sulci demonstrated inflammatory cytologic responses, changes in the stratified squamous epithelium, and mixed bacterial microflora with leukocytes and erythrocytes.Conclusion. The study of type I diabetes mellitus impact on pathological changes in the oral cavity of children and the development of therapeutic and preventive measures is a relevant issue in pediatric dentistry, which justifies the need to continue research in this area.

The Role of Lead Toxicity on Eruption Rate of Hypofunctional Incisors in Albino Wistar Rats

OBJECTIVES This objective of this study was to evaluate the role of a heavy metal- lead acetate in the eruption rate of hypo functional incisors in albino Wistar rats. METHODOLOGY An experimental study was done in animal house of Post Graduate Medical Institute, Lahore since March 2019 to March 2020. 34 adult albino Wistar rats were randomly divided into two groups (n=17 for each group) i.e., control and lead acetate group. Right mandibular incisors were selected for this study. Selected incisors were marked 1mm above the level of gingival papillae. The incisors were cut above this mark to make it hypo-functional. The readings were measured by digital Vernier caliper. This was considered as day 0. Incisors length was measured at day 0, 3, 6, 12 and 15 and eruption was calculated. The data was analyzed using SPSS version 22. RESULTS Eruption rate was similar throughout the study except last follow up. At the end of this study eruption of incisors in albino Wistar rats in control was 03.30±0.72mm, in lead 02.43±1.19mm. At day 15, the difference between control and lead group was statistically significant (p-value 0.033). CONCLUSION These results reveal that besides other causes of delayed tooth eruption excessive lead intoxication are also acausative factor of delayed tooth eruption.

Clinical aspects of tooth autotransplantation and post-endodontic restoration of autrotransplanted tooth: case-based literature review

Introduction. Tooth autotransplantation allows to maintain a vital status of periodontal ligament, which supports the preservation of the alveolar bone volume, better conservation of the interdental papilla and the possibility of dental movement through orthodontic forces. It has been shown that longevity and prognosis of autotransplanted teeth are comparable with those of dental implants.&#x0D; Objective. To discuss major practically-oriented aspects regarding tooth autotransplantation operation including further post-endodontic restoration based on presented clinical case.&#x0D; Materials and Methods. A bibliographic search was conducted in April 2022 by the using MESH terms equivalent to the keywords “tooth” and “autotransplantation” within the Cochrane Library and PubMed database with the aim to identify publications related with practical aspects of tooth autotransplantation presented in clinical case. Data extraction during content-analysis of selected publications was provided selectively in terms to represent the most practically valuable information regarding tooth autotransplantation operation, principles of tooth autotransplantation surgery and further post-endodontic restoration of autotransplanted tooth taking into account aspects highlighted in present clinical case.&#x0D; Results. Due to the provided literature review it was highlighted that success rate of tooth autotransplantation is highly inţuenced by such factors as the stage of root development, morphology of the tooth, selected surgical procedure, time of extraoral exposure of donor tooth, shape of the recipient socket, vascularity of the recipient site, and the vitality of the periodontal ligament cells, impact of which was considered during presented clinical case.&#x0D; Conclusions. Present clinical case report with accompanied literature review arguments the clinical perspective of tooth autotransplantation procedure as valuable treatment option, and highlights major practically-oriented aspects regarding tooth autotransplantation operation including further post-endodontic restoration of donor tooth. Synergy of tooth autotransplantation and post-endodontic restoration protocols in the hands of an experienced doctor who is ready to carefully follow the scientiŢc evidence-based protocol associated with successful outcome of provided treatment.

Photodynamic therapy for the successful management of cyclosporine-related gum hypertrophy: A novel therapeutic option.

Background:Drug-induced gingival overgrowth is associated with the intake of three classes of drugs: anticonvulsants, immunosuppressants, and calcium channel blockers. It is clinically characterized by hyperplasia of the gingival connective tissue which appears edematous, bloody, and purplish-red in color. In more severe cases, drug-induced gingival hyperplasia negatively affects the patient’s quality of life, making it difficult to eat and practice good oral hygiene. Drug-induced gingival overgrowth therapy is controversial and, in fact, no studies in the literature highlight a well-defined therapeutic protocol. The therapies that are described provide primarily for non-surgical periodontal treatment and second-line surgical treatment. The aim of this work is to highlight a case of drug-induced gingival hyperplasia which was completely resolved thanks to photodynamic therapy which is completely free from side effects.Design and Methods:Photodynamic therapy was performed on an 18 year-old female patient with LEDs at a power of 450–470 nm and 5500 mW/cm2 + 7500 mW/cm2, combined with a Curcuma longa-based photosensitizer. A single session was performed, with applications of approximately 30 s for each interdental papilla.Results:The patient improved markedly after only one cycle of PDT. There was an absence of clinically detectable inflammation, edema, and rubor of the involved dental papillae. At the 4, 6, and 12 week follow-ups there were no recurrences.Conclusions:This case report highlights the first case of drug-induced gingival hypertrophy entirely treated with photodynamic therapy to be described in the literature. Therefore, although it is only a case report, this therapy which is free from side effects should be investigated as an alternative to current therapies.

SURGICAL MANIPULATION OF SOFT AND BONE TISSUE IN CONTEMPORARY DENTAL IMPLANTOLOGY

Adequate and correct manipulation of soft and bone tissues during implant therapy is extremelyimportant. Knowledge of the biological, histological and of course the surgical characteristics of the tissues canlargely be a predictor of the correct implant prosthetic rehabilitation. The main aim of this research was to describeall aspects of surgical manipulation of the soft and bone tissues during the dental implantology procedures. We havemade adequate literature research for articles relevant to our topic-surgical manipulation of the soft and hard tissuesduring the dental implantology procedures published in the last two decades (2001-2021). Kew words used for theresearch were: “surgical manipulation”, “dental implantology”, “soft tissues”, “bone tissues” and their combination.Each implantologist should take into account the biological limitations of each patient, as well as the technicallimitations that may occur during the treatment. Oral soft tissues can be affected during the various stages of theimplant treatment. During the planning of a surgical intervention such as the placement of an implant, regardless ofwhether it is an immediate or a delayed loading implant, it is necessary to have an adequate manipulation of thesurrounding soft tissue and bone structures. When designing the flap should be taken into account the degree ofaccessibility required to access the bone, as well as the final position of the flap. It is also of great importance to takeinto account the preservation of good blood supply to the flap. Based on the exposure of bone after elevation, flapscan be classified as either full-thickness or mucoperiosteal flaps and partial-thickness or mucosal flaps. Dependingon how the interdental papilla will be treated, the incisions can either divide the papilla (conventional incision) orpreserve it (papilla-preserving incision). Based on the placement of flaps after surgery, they can be classified as: 1)nondisplaced flaps, where the flap is returned and sutured to its original position, or 2) displaced flaps, which areplaced apically, coronally, or laterally from their original position. The work in bone is quite complex and requiresknowledge of its morphological and histological characteristics. When working on bone, and especially whenplacing dental implants, it is necessary to note that it is necessary to enable constant cooling. The improvement ofold techniques and the development of new technologies have created a revolution in oral implantology, and now atherapist has numerous therapeutic options that can be incorporated into daily practice to facilitate the surgicalapproach itself. Hard-tissue and soft-tissue dental lasers, which are constantly improving and have a wide range ofindications, are becoming a part of everyday dental practice and also show significant advantages compared toconventional instruments and techniques when placing dental implants. Therefore, over time they will become aninvaluable and irreplaceable tool in modern dental implantology. After the performed extensive and deductiveliterature review, it can be concluded that from particular importance is the correct manipulation of soft and bonetissues during dental implantation. After tooth extraction, the placement of dental implants is largely determined bythe integrity of existing hard and soft tissues, such as the aesthetic outcome from the prosthodontic suprastructureover dental implants. Careful assessment of soft and bone tissue loss during implantation is paramount to the successof aesthetic implant procedures