American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment

Kao, Richard T.; Curtis, Donald A.; Kim, David M.; Lin, Guo‐Hao; Wang, Chin‐Wei; Cobb, Charles M.; Hsu, Yung‐Ting; Kan, Joseph Y K; Velásquez, Diego; Ávila‐Ortiz, Gustavo; Yu, Shuangying; Mandelaris, George A.; Rosen, Paul S.; Evans, Marianna; Gunsolley, John C.; Goss, Katie; Ambruster, Jeanne; Wang, Hom‐Lay

doi:10.1002/jper.19-0577

Cited by 59 publications

(66 citation statements)

References 60 publications

(200 reference statements)

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“…2,3 As concluded in multiple clinical studies and expert consensuses, periodontal phenotype modification (ie, thin to thick) promotes long-term gingival stability. 2,3,16,20,21,44…”

Section: Bilaminar Procedures: Bilaminar Procedures Are Rcmentioning

confidence: 99%

“…However, current clinical evidence does not support their use to obtain periodontal phenotype modification 2,3 . As concluded in multiple clinical studies and expert consensuses, periodontal phenotype modification (ie, thin to thick) promotes long‐term gingival stability 2,3,16,20,21,44 …”

Section: Evidence‐based Strategies To Classify and Manage Non‐proximamentioning

confidence: 99%

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An evidence‐based system for the classification and clinical management of non‐proximal gingival recession defects

Ávila‐Ortiz

2020

Journal of Periodontology

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Gingival recession defect (GRD) may be defined as an apical migration of the gingival margin respective to the cementoenamel junction resulting in partial exposure of the root surface to the oral cavity, which may have important esthetic, functional, and periodontal health implications. A novel system for the classification and management of non-proximal GRDs is proposed in this article. This evidence-based system consists of two essential components: (1) Establishment of the GRD type based on the midbuccal/midlingual attachment level respective to the interproximal bone level, and (2) Assessment of the gingival phenotype according to the width of attached gingiva and gingival thickness. Each category of this new classification system is linked with treatment recommendations substantiated by relevant literature pertaining to the outcomes of validated root coverage procedures in specific scenarios, which can be used as a guide for clinical decision-making in daily practice.

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“…2,3 As concluded in multiple clinical studies and expert consensuses, periodontal phenotype modification (ie, thin to thick) promotes long-term gingival stability. 2,3,16,20,21,44…”

Section: Bilaminar Procedures: Bilaminar Procedures Are Rcmentioning

confidence: 99%

Section: Evidence‐based Strategies To Classify and Manage Non‐proximamentioning

confidence: 99%

An evidence‐based system for the classification and clinical management of non‐proximal gingival recession defects

Ávila‐Ortiz

2020

Journal of Periodontology

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“…SFOT should be considered when dentoalveolar bone augmentation is required to correct dentoalveolar deficiencies during decompensation orthodontia. Because SFOT can be considered a periodontal regenerative and dentoalveolar bone constructive surgery, 29,30 it conceivably can be performed as a part of phenotype modification therapy involving bone grafting (PhMT-b) 31 post-orthodontia. This would be likely considered in cases where camouflage orthodontia (defined as tooth movement to mask an underlying skeletal discrepancy) was carried out and periodontal tissue deterioration resulted.…”

Section: Decision Processmentioning

confidence: 99%

Surgically Facilitated Orthodontic Therapy (SFOT): Diagnosis and Indications in Interdisciplinary Dentofacial Therapy Involving Tooth Movement

Mandelaris

Huang

Relle

et al. 2020

Clin Adv Periodontics

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What are the key considerations for the interdisciplinary dentofacial therapy (IDT) team in the diagnostic process to evaluate a patient for surgically facilitated orthodontic therapy (SFOT)? Summary: SFOT creates a demineralized bone matrix and augments dentoalveolar deficiencies in the management of dentofacial disharmony malocclusion. Numerous indications and contraindications exist which are essential to the periodontal surgeon for proper case selection. A collaboratively focused workup by an IDT team is equally essential. Cone beam computed tomography (CBCT) and orthodontic simulation software which identifies changes in the dentoalveolar complex influenced by tooth movement are critical in providing transparency to the patient and IDT team during the treatment planning process. Such transparency can aid the team in assessing goals and outcomes that consider and respect foundational dentoalveolar parameters while contributing to sustainable outcomes. Conclusions: The SFOT IDT decision making process is complex, yet full of opportunities. Embracing SFOT IDT with innovative and novel 3D technology can optimize conditions leading to long-term outcomes that align with periodontal stability as well as patient goals and preferences which permeate beyond the achievement of "straightening teeth". Transparency of complex IDT through 3D CBCT and orthodontic simulation software engenders "collaborative accountability" and can improve patient communication which is critical to developing meaningful and essential treatment plans.

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“…However, the presence of keratinized tissue may help reduce a patient's inflammatory response associated with peri-implant mucositis, comfort during mastication, and ease of plaque removal. 5,6 Two dental implant cases are presented where PhMT has been performed in either a reactive or proactive manner involving subepithelial connective tissue grafting to increase periimplant keratinized tissue. The resulting outcome created an improved environment conducive to maintaining long-term peri-implant health and function while also trying to maintain esthetics when PhMT is performed proactively.…”

Section: Introductionmentioning

confidence: 99%

“…This recent BEC panel also found limited evidence linking peri‐implantitis to a lack of peri‐implant keratinized tissue. However, the presence of keratinized tissue may help reduce a patient's inflammatory response associated with peri‐implant mucositis, comfort during mastication, and ease of plaque removal 5,6 . Two dental implant cases are presented where PhMT has been performed in either a reactive or proactive manner involving subepithelial connective tissue grafting to increase peri‐implant keratinized tissue.…”

Section: Introductionmentioning

confidence: 99%

The Merit to Phenotypic Modification Treatment for Dental Implants: Two Case Reports

Rosen

2020

Clin Adv Periodontics

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to address whether the conversion of a thin to a thick tissue phenotype through various phenotype modification therapy (PhMT) can positively influence peri-implant health. Case Series: PhMT was applied to two dental implant cases using subepithelial connective tissue grafting to increase peri-implant keratinized tissue. These cases demonstrated that when PhMT was used in either a reactive or proactive manner, the keratinized tissue improvement can support long-term peri-implant health. Conclusion: PhMT can prevent further gingival recession and provide a more stable environment conducive to maintaining peri-implant health.

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American Academy of Periodontology best evidence consensus statement on modifying periodontal phenotype in preparation for orthodontic and restorative treatment

Cited by 59 publications

References 60 publications

An evidence‐based system for the classification and clinical management of non‐proximal gingival recession defects

An evidence‐based system for the classification and clinical management of non‐proximal gingival recession defects

Surgically Facilitated Orthodontic Therapy (SFOT): Diagnosis and Indications in Interdisciplinary Dentofacial Therapy Involving Tooth Movement

The Merit to Phenotypic Modification Treatment for Dental Implants: Two Case Reports

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