Carlos E Nemcovsky

Tel Aviv University | TAU · Department of Periodontology

Background Periodontitis is an infectious disease leading to reduced periodontal support, reflected radiographically as marginal bone loss (MBL). Periodontitis is linked to systemic conditions like cardiovascular disease, diabetes, arthritis, etc. Periodontitis elevates the bacterial load and spreads systemic inflammation through infection and infl...

Diabetes is a global epidemic accompanied by impaired wound healing and increased risk of persistent infections and resistance to standard treatments. Therefore, there is an immense need to develop novel methods to specifically target therapeutics to affected tissues and improve treatment efficacy. This study aims to use enzyme‐responsive nanoparti...

Uncontrolled diabetes is characterized by aberrant inflammatory reactions and increased collagenolysis. We have reported that it accelerates the degradation of implanted collagen membranes (CM), thus compromising their function in regenerative procedures. In recent years, a group of physiological anti-inflammatory agents called specialized pro-reso...

Aims: To reveal the heterogeneity of ex vivo-cultured human mesenchymal stromal cells derived from either masticatory or lining oral mucosa. Materials and methods: Cells were retrieved from the lamina propria of the hard palate and alveolar mucosa of three individuals. The analysis of transcriptomic level differences was accomplished using singl...

The aim of the present study was to generate an international and multidisciplinary consensus on the clinical management of implant protrusion into the maxillary sinuses and nasal fossae. A total of 31 experts participated, 23 of whom were experts in implantology (periodontologists, maxillofacial surgeons and implantologists), 6 were otolaryngologi...

Objective: This study compared dental, periodontal, oral, and joint/muscle tenderness among Israeli combat-induced post-traumatic stress disorder (Ci-PTSD) war veterans to non-PTSD patients. Study design: This retrospective three-arm study compared oral and facial manifestations between 100 Israeli veterans with Ci- PTSD (study group) and 103 no...

Background: Dietary habits, food intake and oral health are important factors for general health. The aim of these present study was to assess the association between implant-supported fixed oral rehabilitation and glycemia, by monitoring HbA1c values before and after implant-supported prostheses (ISP) delivery to diabetic individuals. Methods: Ret...

Objectives We previously showed that accelerated degradation of collagen membranes (CMs) in diabetic rats is associated with increased infiltration of macrophages and blood vessels. Since pre-implantation immersion of CMs in cross-linked high molecular weight hyaluronic acid (CLHA) delays membrane degradation, we evaluated here its effect on the nu...

Various free connective tissue graft (CTG) harvesting techniques have been reported. The lining epithelium of the palatal graft may be retrieved either intra- or extraorally. This report presents a series of root coverage cases where deepithelialization was intraorally performed before harvesting the graft with a round diamond bur mounted on a low-...

Objectives: Peri-implant tissue maintenance and treatment is becoming a serious challenge in implantology. With increasing numbers of implants being placed, more cases of peri-implant mucositis and peri-implantitis is seen. A digital survey on peri-implant disease management was issued to experts in periodontology and implantology to identify the t...

Aims To compare the gene expression profiles and proliferation rates of fibroblasts from the oral lining and masticatory mucosae. Materials and methods Primary human fibroblasts were retrieved from the posterior masticatory hard palate and the lining alveolar mucosa of five individuals. The gene expression profile was evaluated using total RNA seq...

The aim of this histomorphometric study was to compare the outcome of sinus floor augmentation procedures using bovine bone mineral and a xenograft enriched with gelatin and a polymer. In 20 patients a single sinus floor elevation procedure with a lateral window approach was performed. In half of the patients, sinuses were grafted with a deproteini...

Background: In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. Methods: This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between...

Accelerated degradation of collagen membranes (CMs) in diabetic rats is associated with increased infiltration of macrophages and blood vessels. Since pre-implantation immersion of CMs in cross-linked high molecular weight hyaluronic acid (CLHA) delays membrane degradation, we evaluated its effect on the number of macrophages and endothelial cells...

Objective Different root modifiers have been proposed in the literature with an attempt to improve the healing process and the success rate of root coverage procedures. The aim of the present retrospective study was to evaluate the effect of three different types of root surface conditioning, namely, tetracycline (TTC), ethylene‐di‐amino‐tetra‐acet...

Aim: To evaluate the hypothesis of a correlation between the preoperative residual alveolar bone height (RBH) and graft maturation after maxillary sinus floor augmentation procedures using two different bone substitutes. Methods: A total of 20 patients who underwent unilateral maxillary sinus floor augmentation with either mineralized deproteini...

The aim of the present study was to evaluate the pulpal and periapical status of vital teeth within the area of a lateral sinus floor elevation (LSFE). The files of patients treated by LSFE between 2009 and 2015 were retrospectively evaluated. The radiographic bone measurements and the periapical status of the teeth adjacent to the LSFE area were e...

This in vitro preliminary study investigated the attachment of Fusobacterium nucleatum and Porphyromonas gingivalis on titanium alloy healing abutments, which differed in their surface macro-morphology: one was groove-marked while the other was completely smooth. Altogether, twenty implant-healing abutments, ten of each macro-morphology, were evalu...

Objective: Stress experienced as an intense and traumatic event can increase the odds of orofacial morbidities that may affect oral, periodontal, or masticatory system health. The aim of this study was to evaluate the dental, periodontal, oral, and bruxism situation among Israeli posttraumatic stress disorder (PTSD) war veterans. Method and mater...

The objective of this study was to evaluate potential risk factors, including the placement of dental implants, for the development of tooth cracks. A series of 212-patients, who were referred for endodontic treatment, were retrospectively screened, of which 72 (34%) patients had been diagnosed with 80-cracked teeth confirmed with an operating micr...

Implants placed with an initially thicker peri‐implant soft tissue have less radiographic marginal bone loss in the short term. A negative correlation was found between mucosal thickness and marginal tissue recession. Different treatment alternatives are available at the time of tooth extraction, namely primary soft tissue closure of the extraction...

Objective Diabetes increases the incidence/severity of periodontal diseases by inducing a chronic inflammation, driven by accumulation of AGEs (advanced glycation end products). We tested whether glycated human serum albumin (G-HSA, a form of AGE), representing a diabetic state, augments the pro-inflammatory response of human gingival fibroblasts (...

The continuous presence of bacteria at the tooth–epithelium or implant–epithelium junction results in a progressive inflammatory process, which leads to the destruction of the gingival connective tissue and subsequently of the alveolar bone, periodontal ligament (PDL) and cementum on the root and/or implant surface. If left undisturbed, this proces...

Background: Membrane durability is critical for regenerative procedures. We reported previously that type 1-like diabetes in rats accelerates the degradation of collagen membranes and we tested here whether this is associated with increased local production of inflammatory molecules as part of a diabetes-induced chronic inflammation around and wit...

In compromised teeth with periodontal–endodontic lesions, the decision to extract or maintain the teeth is complex while considering the endodontic, periodontal and reconstructive aspects of these teeth. Extraction of teeth with untreatable periodontal–endodontic lesions having severe alveolar bone damage can lead to difficulty in their surgical ma...

The decision to extract or maintain compromised teeth with periodontal–endodontic lesions is complex while taking into consideration the endodontic, periodontal, and reconstructive aspects of these teeth. Extraction of teeth with untreatable periodontal–endodontic lesions having severe alveolar bone damage can lead to difficulty in their surgical m...

Free connective tissue grafts, barrier membranes, pedicle flaps, soft tissue allografts, and xenografts have been described for root coverage and augmenting the zone of attached gingiva. The present report evaluated a modified tunnel surgical procedure for root coverage of mandibular anterior teeth where a connective tissue graft was combined with...

Extraction and replacement with a dental implant or preservation of compromised natural teeth through comprehensive treatment is a complex decision and should be made while taking into consideration the endodontic, periodontal and reconstructive aspects of these teeth. Placement of dental implants is associated with several biological complications...

Periodontal regeneration is a complex biological process involving de novo formation of the lost tooth-supporting structures, particularly the periodontium, over previously diseased root surfaces. Regenerative periodontal procedures decrease the progression of periodontitis and requirement of reintervention to facilitate long-term tooth stability a...

Aim To examine the in vitro biokinetics of hyaluronic acid (HA) from a collagen membrane (CM) and to evaluate the in vivo effect of immersion of the CM in HA solution on its degradation in streptozotocin (STZ)‐induced diabetes conditions in a rat calvaria subcutaneous model. Background CM degradation is accelerated in uncontrolled diabetic rats. I...

Endodontic–periodontal lesions occur as a combination of an endodontic infection and periodontal disease in a single tooth. As an endodontic–periodontal lesion is a complex condition, establishing an accurate diagnosis and prognosis of the involved teeth is crucial while treatment planning. Modern endodontic and periodontal treatment modalities can...

Periodontal-endodontic lesions are the combination of pulp involvement and periodontal disease in the same tooth. Diagnosis may become difficult; however, a differential etiological consideration is indispensable for appropriate treatment.

Reconstructive periodontal procedures improve tooth survival while reducing periodontitis progression and re-intervention needs providing long-term outcome stability. Even when periodontal attachment level is largely reduced, natural dentition yields better long-term survival rate and marginal bone level changes compared with dental implants. Perio...

A common dilemma encountered by dental practitioners is the decision whether to extract a compromised natural tooth and replace it with a dental implant, or to attempt preservation of the natural tooth by endodontic periodontal and restorative treatments. This intriguing dilemma has been extensively debated over the years, shifting back and forth....

Over the years, the use of biologics (growth factors) has become more prominent in daily practice. A plethora of documented research from in vitro, in vivo, and clinical trials is available for enamel matrix proteins (EMPs) that now spans over two decades. While the goal of chapter 14 was to introduce the biologic background of enamel matrix deriva...

The periodontium and the dental pulp are closely associated, sharing embryonic, functional, and anatomical interrelationships. Consequently, the relationship of endodontic and periodontal lesions has stirred confusion and debate as dental practitioners have become gradually further aware of the possible associations between the periodontium and the...

The advance of the endodontic disease involves inflammatory reaction of the peri-radicular tissues while the periodontal involves marginal periodontium and results in the progressive loss of the supportive tissues. There are multiple routes of communication between the root canal space and marginal periodontium. By these communications the bacteria...

Following extraction of tooth/teeth with advanced loss of periodontal support, as those with periodontal-endodontic lesions, the remaining bone architecture should be carefully evaluated, especially where implant-supported restoration is planned. Marked resorption of the residual alveolar bone is usually appreciated 3 months after tooth extraction....

This book presents a multidisciplinary evidence-based approach to the management of teeth with lesions of endodontic-periodontal origin. The book opens by addressing the etiology and classification of endodontic-periodontal lesions, and demonstrates its relevance to the daily practice. Specific endodontic, prosthetic, and periodontal considerations...

Clinically, periodontal regeneration may be achieved by the application of barrier membranes, grafts, wound-healing modifiers, and their combinations. Combination therapy refers to the simultaneous application of various periodontal reconstructive treatment alternatives to obtain additive effects. This approach may lead to assemblage of different r...

The extension of sinus floor augmentation beyond the edentulous area, apical to the adjacent teeth, has many therapeutic advantages, but the reliability and safety of the procedure has not been assessed in depth. The present study compares the gain of bone anterior and posterior to the edentulous area and evaluates potential advantages and limitati...

Increased collagenolytic activity, characteristic of uncontrolled diabetes, may compromise collagen membrane (CM) survival. Tetracycline (TTC) possesses anti-collagenolytic properties and delays CM degradation in healthy animals. This study evaluated the degradation of TTC-immersed and non-immersed CMs in diabetic, compared with normoglycemic rats....

This Special Issue entitled “Soft and Hard Tissue Regeneration” will cover both periodontal and implant therapies.[...]

Background: Combination of particulate grafts and collagen membranes is widely used for augmentation of bony defects for implant placement. Fixation of the barrier membrane may avoid complications due to unfavorable mechanical properties and poor stability leading to collapse of the augmented area. Purpose: To evaluate a new simplified method fo...

Background This study presents a series of 18 cases of cracked non-endodontically treated teeth that were diagnosed following the placement of adjacent implant-supported rehabilitation. These findings could suggest a possible cause/related events. ResultsMost of the cases occurred in female patients (61%), over 50 years old (78%, with an average ag...

The progressive inflammatory process, which leads to the destruction of the gingival connective tissue and subsequently of the alveolar bone, periodontal ligament (PDL), and cementum on the root surface, if left untreated will eventually lead to the loss of the involved tooth or implant. Regeneration of lost periodontal tissues has always been the...

Evidence-based dentistry requires application of current evidence in making decisions about the care of individual patients. Long-term preservation of the periodontium is the main objective of periodontal therapy. Before a treatment plan is established, the diagnosis and etiologic factors of the disease as well as the prognosis of the remaining tee...

The decision whether to retain a tooth by additional endodontic and restorative treatments or to extract it and replace it with an implant-supported restoration has been extensively debated, and the common approach to this clinical question has shifted back and forth many times. However, in recent years, it has become clear that implants are more p...

The ultimate goal of conservative dental treatment is to preserve the natural dentition. In complicated cases where a complex multidisciplinary treatment approach may be required, serious dilemmas may rise, and possible further complications and tooth prognosis might be unpredictable. Application of evidence-based approaches in the multidisciplinar...

The main objective of periodontal therapy is long-term preservation of the periodontium. Before a treatment plan is established, diagnosis and etiological factors of the disease as well as the prognosis of the remaining teeth should be determined, while predicting the final functional and esthetic result. An accurate prognosis is most critical when...

This chapter describes evolving experimental approaches that are geared toward periodontal/bone regeneration. Currently, the pinnacle of regenerative periodontal treatment is the use of bone substitutes combined with barrier membranes, which already demonstrates how far we have progressed from the old resective approaches that dominated the field....

This clinically oriented book covers all aspects of the evidence-based decision making process in multidisciplinary management of the natural dentition. The book opens by clarifying the principles of evidence-based decision making and explaining how these principles should be applied in daily practice. Individual chapters then focus specifically, a...

Objectives Increased collagenolytic activity in diabetes may compromise collagen membrane (CM) survival. Tetracycline (TTC) possesses anti-collagenolytic properties and delays CM degradation. This study evaluated macrophage and capillary infiltration within CMs in diabetic rats. Materials and methods Diabetes was induced in 20 Wistar rats by strept...

Objectives The present study evaluated the degradation of collagen matrix (CM) immersed in tetracycline (TTC) or phosphate-buffered saline (PBS) in diabetic and normoglycemic rats. Materials and methods Diabetes was induced in 15 rats by systemic streptozotocin (STZ) (experimental); 15 healthy rats served as controls. One day before implantation 60...

Aims: This review article aims to: 1) provide the biological background necessary to understand the rational for the use of EMD for periodontal regeneration, 2) present animal and human histological evidence of periodontal regeneration following EMD application, 3) provide clinically relevant indications for the use of EMD and 4) discuss future av...

Background: Enamel Matrix Proteins (EMPs) play a role in enamel formation and the development of the periodontium. Sporadic clinical observations of periodontal regeneration treatments with Enamel Matrix Derivative (EMD), a commercial formulation of EMPs, suggest it also promotes post-surgical healing of soft tissues. In vitro studies showed that...

Periodontal wound healing and regeneration are highly complex processes, involving cells, matrices, molecules and genes that must be properly choreographed and orchestrated. As we attempt to understand and influence these clinical entities, we need experimental models to mimic the various aspects of human wound healing and regeneration. In vivo ani...

Figure SB. Following full‐thickness flaps raised and repositioned on each side of the incision, resorbable sutures were performed to replace the soft tissues.

Figure S4. Study group 5 days after surgery.

Figure S3. Study group. 12 days after surgery.

Figure S5. Study group. 12 days after surgery.

Figure SA. Mid‐crestal incision on the maxillary alveolar ridge in the existing edentulous area between the 1st molar and the incisors.

Figure SC. PerioPatch® or placebo patch was placed on the incision line immediately following surgery and replaced every 12 h for the following 3 days.