Saeed Abdelaziz ElRefaei

Objectives: To compare the efficacy of de‐epithelialized gingival graft (DGG) versus subepithelial connective tissue grafts (SCTG) for the treatment of RT1 gingival recessions. Materials and Methods: Five databases were searched with no restrictions for randomized clinical trials (RCTs) directly comparing DGG and SCTG for treating RT1 gingival recessions. Primary outcomes were mean recession coverage (mRC) and complete root coverage (CRC%). Secondary outcomes included keratinized tissue width (KTW) gain, clinical attachment level (CAL) gain, probing depth (PD) change, Root Coverage Esthetic Score (RES), and patient‐reported pain/discomfort (PROs). Random‐effects models (REML) with Hartung–Knapp adjustment were used to calculate mean differences (MDs) with 95% confidence intervals (CIs). Results: Six RCTs ( n = 221 patients) were included. No significant difference was observed in mRC (MD = −0.51 mm; 95% CI: −2.06 to 1.03; p = 0.368; I ² = 95.9%). CRC significantly favored DGG (MD = 4.45%; 95% CI: 1.21–7.69; p = 0.027; I ² = 0%). Small differences in KTW gain and PD reduction favored DGG, although heterogeneity was substantial for PD change. RES and PROs showed no consistent differences. Conclusions: Both DGG and SCTG are effective for correction of RT1 recessions. DGG showed modest advantages in CRC and PD reduction, while other outcomes were comparable. Clinical Significance: Both de‐epithelialized gingival grafts and subepithelial connective tissue grafts provide predictable root coverage for RT1 gingival recessions. De‐epithelialized grafts may offer a modest advantage in achieving complete root coverage without compromising esthetics or patient comfort, supporting their use as a viable alternative in periodontal plastic surgery.

Aim: Limited bone support in suprabony defects hinders predictable regeneration, but adjunctive biologics can improve results. This systematic review and meta‐analysis aimed to evaluate the clinical efficacy of adjunctive biologics combined with open flap debridement (OFD) compared with OFD alone when treating suprabony defects. Materials and Methods: A systematic literature search was performed to identify controlled trials evaluating adult patients presenting horizontal periodontal defects. The primary outcome included residual probing depth (PD). Random‐effects meta‐analyses were performed; heterogeneity was assessed using I ² statistics; risk of bias was evaluated using Cochrane RoB‐2; and evidence of quality was appraised via the GRADE framework. Results: Nine studies comprising 303 patients were included. Adjunctive use of biologics—including enamel matrix derivative (EMD), platelet‐rich fibrin (PRF) and hyaluronic acid (HA)—significantly enhanced clinical outcomes compared to OFD alone, with pooled mean differences favouring EMD and PRF for both residual PD (−0.89 and −0.42 mm) and clinical attachment level (CAL) (−1.32 and −0.69 mm). While subgroup differences were observed, notably with EMD, high heterogeneity was present for CAL and PD, and evidence of certainty ranged from low to very low. Conclusion: Adjunctive biologics improve clinical outcomes in suprabony periodontal defects; however, rigorous standardised trials are needed for reaching firm conclusions.

Background: An amalgam tattoo is an iatrogenic lesion that can lead to esthetic concerns. This paper presents a literature review aimed at exploring treatment options available to clinicians for addressing this unesthetic issue. Methods: The initial search identified 209 potentially relevant publications. After applying specific inclusion and exclusion criteria, 18 papers were analyzed and summarized in a comprehensive table, highlighting significant aspects for comparison. Results: The findings indicate various treatment options reported in the existing literature. Additionally, this paper includes a case report detailing the procedure performed on a 47‐year‐old female with an amalgam tattoo on the buccal aspect of her upper right premolars. Following muco‐abrasion to remove the oral pigmented lesion, a bilaminar mucogingival procedure was performed. Conclusions: At the 8‐year follow‐up, the gingival color and texture blended well with the surrounding soft tissues, the periodontal structures appeared healthy, and the patient was satisfied with the esthetic outcomes. Key points: Discoloration of the oral mucosa caused by amalgam can result in esthetic dissatisfaction for patients. A review of the literature indicates that the bilaminar technique is a more reliable surgical approach for achieving cosmetic results in a single operation. An 8‐year follow‐up case report supports this finding, detailing a procedure that involved muco‐abrasion of the lesion followed by a sliding pedicle flap. Plain language summary: An amalgam tattoo is an iatrogenic lesion associated with esthetic concerns. This paper reviews treatment options for this issue, analyzing 18 relevant publications from an initial search of 209. Additionally, a case report details the treatment of a 47‐year‐old female patient with an amalgam tattoo on her upper right premolars. After muco‐abrasion to remove the lesion, a plastic surgery procedure with a connective tissue graft from the palate was performed. At the 8‐year follow‐up, the gingival color and texture matched the surrounding tissues, the periodontal structures appeared healthy, and the patient was satisfied with the results.

Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development of customized scaffolds tailored to patient needs, potentially overcoming the limitations of conventional methods. Materials and Methods: A scoping review was conducted according to the PRISMA guidelines. Electronic searches were performed in MEDLINE (PubMed), the Cochrane Library, Scopus, and Web of Science up to January 2025 to identify studies on digital technologies applied to bone augmentation. Eligible studies encompassed randomized controlled trials, cohort studies, case series, and case reports, all published in English. Data regarding digital workflows, software, materials, printing techniques, and sterilization methods were extracted from 23 studies published between 2015 and 2024. Results: The review highlights a diverse range of digital workflows, beginning with CBCT-based DICOM to STL conversion using software such as Mimics and Btk-3D^®. Customized titanium meshes and other meshes like Poly Ether-Ether Ketone (PEEK) meshes were produced via techniques including direct metal laser sintering (DMLS), selective laser melting (SLM), and five-axis milling. Although titanium remained the predominant material, studies reported variations in mesh design, thickness, and sterilization protocols. The findings underscore that digital customization enhances surgical precision and efficiency in BR, with several studies demonstrating improved bone gain and reduced operative time compared to conventional approaches. Conclusions: This scoping review confirms that 3D techniques represent a promising advancement in BR. Customized digital workflows provide superior accuracy and support for BR procedures, yet variability in protocols and limited high-quality trials underscore the need for further clinical research to standardize techniques and validate long-term outcomes.