Impact of the periodontal phenotype in premolar and molar sites on bone loss following full‐thickness mucoperiosteal flap: A 1‐year prospective clinical trial

Abstract

Background: Full-thickness mucoperiosteal flap (FTF) elevation could potentially affect the periodontium of the involved teeth; it is not clear if the periodontal phenotype of teeth involved in a FTF may influence these changes. The aim of this study was to evaluate the impact of FTF on teeth periodontium, as well as assessing the impact of periodontal phenotype on bone remodeling. Methods: In this single arm prospective clinical trial, 26 subjects and a total of 52 adjacent teeth were included. Patients receiving implant surgery in the posterior area, at the time of implant site preparation, an FTF was extended one tooth mesial and distal to the planned site, and the flap was elevated both facially and lingually. Vertical and horizontal bone linear changes were measured on both adjacent teeth, using superimposed cone-beam computerized tomography (CBCT) images taken prior to implant placement (T0) and at 12 months (T1). Baseline digital scans of models and DICOM files were superimposed to assess the periodontal phenotype. Results: Vertical bone changes from T0 to T1 were statistically significant (P = 0.013), with changes were significantly higher at the mesial (−0.31 ± 0.30 mm) and facial (P < 0.05) sites. Horizontal dimensional changes 5 mm subcrestally were similar among different locations (P = 0.086) and the bone width loss was higher closest to the crest (P = 0.001). No correlation was found between soft tissue thickness and bone changes. However, bone thickness at baseline appears to influence the extent of horizontal bone remodeling. Overall, the magnitude of bone loss either vertically or horizontally was clinically insignificant (≤0.4 mm). A preventive effect against bone loss maybe expected with bone thickness > 2 mm. Conclusion(s):Marginal bone changes in maxillary and mandibular posterior teeth following FTF at 12 months are very minimal, and mainly influenced by bone rather than soft tissue thickness. Overall, FTF does not seem to have deleterious effects on adjacent teeth periodontium.

Three-dimensional volumetric assessment of hard tissue alterations following horizontal guided bone regeneration using a split-thickness flap design: A case series

“…In different animal studies, authors have demonstrated that the elevation of either full- or split-thickness flaps induces osteoclast activity that causes subsequent bone resorption [ 36 – 41 ]. Similar vertical and horizontal bone loss was observed by Saleh et al [ 42 ] after full-thickness flap elevation during implant placement. In the case of horizontal GBR, similar bone resorption has not previously been described.…”

Influence of healing time on the outcomes of alveolar ridge preservation using a collagenated bovine bone xenograft: A randomized clinical trial

“…Both baseline and final STL‐DICOM files were imported to a software package (Romexis, Planmeca v.5.2.1., Hoffman Estates, IL, USA) and superimposed by matching at least eight points using bone landmarks to allow the visualization of soft and hard tissue structures beneath the overlying surface, as described elsewhere (Couso‐Queiruga, Tattan, et al, 2021 ; Saleh et al, 2022 ). At baseline, a sagittal section was made in the middle of each tooth of interest.…”

Relationship between supracrestal soft tissue dimensions and other periodontal phenotypic features: A cross‐sectional study

“…7,8 The bone phenotype has been recognized as a key prognostic factor in periodontics and implant dentistry, particularly in the context of tooth replacement therapy after tooth extraction. [9][10][11][12][13][14] However, other periodontal phenotypic features related to the vertical dimension of the supracrestal soft tissue deserve specific attention.…”