{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T05:39:35Z","timestamp":1792474775758,"version":"4.5.0"},"reference-count":25,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe papilla\u2010preserving gingival fiber retention osseous surgery (PP\u2010FibReOS), a biologically driven resective approach intended to eliminate periodontal pockets while maintaining interproximal connective tissue and papillary stability in esthetically demanding maxillary anterior sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Technique<\/jats:title>\n                    <jats:p>PP\u2010FibReOS was implemented in two challenging anterior maxillary scenarios: functional crown lengthening and surgical pocket elimination in a stage IV, grade C periodontitis case. The key feature of this protocol uses a split\u2010full\u2010split buccal flap with selective coronal tissue removal, combined with deliberate preservation of a de\u2010epithelialized interproximal supracrestal fiber complex attached to the palatal flap, which is designed to support papillary volume during healing. Osseous recontouring is performed conservatively, with the flap repositioned in a double\u2010layered papillary complex closure just coronal to the bone crest. At 36\u2010month follow\u2010up, both cases showed shallow probing pocket depths (PPD) of 1\u20133\u2009mm and absence of bleeding on probing, together with stable interdental papilla positions, high clinician\u2010reported esthetic scores (pink esthetic score [PES] 11\u201312), and patient satisfaction ratings of 10\/10.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within the limits of this two\u2010case proof\u2010of\u2010concept report, PP\u2010FibReOS may offer a promising alternative for maxillary resective surgery when preservation of papillary architecture is a primary objective. Larger controlled studies are needed to clarify its indications, limitations, and long\u2010term predictability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>PP\u2010FibReOS provides a possible approach for selected anterior maxillary defects in which pocket elimination or functional crown lengthening must be balanced against preservation of interdental soft\u2010tissue dimensions. In patients with a thick periodontal phenotype, adequate supracrestal connective tissue, and predominantly horizontal or shallow angular defects, a fiber\u2010retentive palatal flap combined with conservative osseous reshaping may help maintain stable, shallow probing pocket depths while limiting increases in clinical crown length and visible loss of papillary fill.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70226","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:50:23Z","timestamp":1782985823000},"page":"2057-2066","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Papilla\u2010Preserving Gingival Fiber Retention Osseous Surgery in the Anterior Maxilla: A Novel Clinical Technique"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7437-6279","authenticated-orcid":false,"given":"Abdusalam E.","family":"Alrmali","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry, University of Michigan School of Dentistry  Ann Arbor Michigan USA"},{"name":"Department of Oral Medicine, Oral Pathology, Oral and Maxillofacial Surgery University of Tripoli School of Dentistry  Tripoli Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4238-1799","authenticated-orcid":false,"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry, University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"137","article-title":"Surgical Periodontal Therapy: Indications, Selection and Limitations","volume":"33","author":"Robertson P. 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