Supracrestal tissue attachment (STA) is a relatively new term that was introduced in 2017 following the World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions, co-sponsored by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP), which included expert participants from all over the world. It has replaced the term biological width, and refers to the junctional epithelium and supracrestal connective tissue. This article provides an updated review of the anatomy of STA, highlights the negative effects of violation and discusses its clinical relevance in restorative dentistry, including the use of crown lengthening. The impact of implants on STA is highlighted, and a summary of the relevance of STA in implant dentistry is also discussed. CPD/Clinical Relevance: To allow dental practitioners to have more confidence providing adequate function, comfort, and aesthetics in the dentition, while maintaining periodontal health.

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Diagnosing the cause of paraesthesia can be challenging. A patient with an unremarkable medical history, non-smoker and no known allergies, presented with paraesthesia in the distribution of the mental nerve with no obvious dento-alveolar pathology. After further investigations the patient was found to have multiple brain metastases and a solitary mandibular deposit, with the primary site being an adenocarcinoma of the lung. CPD/Clinical Relevance: As dental professionals, knowledge of head and neck manifestations of systemic conditions is required if prompt diagnosis and treatment is to occur, which will subsequently improve patient health outcomes.

Following a review of periodontal wound healing, this article discusses techniques designed to optimise periodontal wound healing, including guided-tissue regeneration and periodontal regeneration using enamel matrix derivatives. Enamel matrix derivatives are porcine derived, and are thought to stimulate differentiation, proliferation, migration and mineralization in cells found in periodontal tissues. This article charts the development in surgical techniques to optimise outcomes from regenerative techniques, in addition to explaining complications and how they can be avoided. Recent research relating to use of enamel matrix derivatives as an adjunct to non-surgical periodontal therapy is described, and while the evidence is limited to a single research study, the present article discusses the potential use of this technique in practice, accepting that a cost–benefit analysis would be required for individual patients. CPD/Clinical Relevance: An update for practitioners on developments in use of enamel matrix derivatives in dentistry to allow informed decision-making on the utility and value of using flapless techniques.