ABSTRACT
Introducción: La recesión gingival es uno de los defectos estético-funcionales más comunes en la cavidad oral. Se caracteriza por la exposición de la superficie de la raíz debido a un desplazamiento del margen gingival apical a la unión amelocementaria. La literatura reporta un porcentaje de recubrimiento de la raíz favorable en recesiones gingivales clases I y II de Miller; sin embargo, varios estudios no lograron el recubrimiento total, lo que ha sido asociado a varios factores. Objetivo: Identificar los factores asociados al recubrimiento total de recesiones gingivales clases I y II de Miller en dientes tratados con colgajo de reposición coronal. Métodos: Se consultaron las bases de datos PubMed SciELO, Redalyc, Lilacs y Scopus. De 105 investigaciones, se analizaron 7 que cumplieron los criterios de inclusión. Análisis e integración de las informaciones: El metaanálisis dio resultados no concluyentes, debido a la alta heterogeneidad de los estudios. Sin embargo, se detectaron los siguientes factores: el uso de ácido etilendiaminotetraacético (p < 0,0001), la presencia de tejido queratinizado adjunto ≥ 2 mm (p = 0,019), una profundidad de recesión gingival inicial > 3 mm (p = 0,020) y pacientes que fumaban más de 10 cigarrillos diarios (p < 0,05). Conclusiones: Se identificaron el uso de ácido etilendiaminotetracético, la presencia de tejido queratinizado, la profundidad de la recesión y pacientes fumadores como posibles factores que intervienen el recubrimiento total de recesiones gingivales clases I y II de Miller en dientes tratados con colgajo de reposición coronal(AU)
Introduction: Gingival recession is one of the most common esthetic-functional defects of the oral cavity. It is characterized by exposure of the root surface due to displacement of the apical gingival margin to the cementoenamel junction. The literature about the topic reports a percentage of favorable root coverage of Miller class I and II gingival recessions. However, several studies do not report complete coverage, which has been associated to a number of factors. Objective: Identify the factors associated to complete coverage of Miller class I and II gingival recessions in teeth treated with coronally repositioned flap. Methods: A search was conducted in the databases PubMed, SciELO, Redalyc, Lilacs and Scopus. Of a total 105 studies retrieved, seven met the inclusion criteria. Data analysis and integration: The meta-analysis did not achieve conclusive results, due to the high heterogeneity of the studies. However, the following factors were identified: use of ethylenediaminetetraacetic acid (p < 0.0001), presence of adjacent keratinized tissue ≥ 2 mm (p = 0.019), initial gingival recession depth > 3 mm (p = 0.020) and patients who smoked more than 10 cigarettes a day (p < 0.05). Conclusions: Use of ethylenediaminetetraacetic acid, presence of keratinized tissue, recession depth and smoker patients were identified as possible factors involved in the complete coverage Miller class I and II gingival recessions in teeth treated with coronally repositioned flap(AU)
Subject(s)
Humans , Risk Factors , Smokers , Gingival Recession/epidemiology , Databases, BibliographicABSTRACT
AIM: The purpose of this study was to compare the validity of alveolar ridge measurements obtained with ridge mapping (RM) technique against cone beam computed tomography (CBCT) measurements. MATERIALS AND METHODS: Twenty partially edentulous patients were recruited for implant placement in the Clinic of San Martin de Porres University. For all the measurements, a vacuum-formed stent was fabricated for each subject. A buccal and lingual point was made in the stent to provide a reference of measurement for each implant site. RM measurements with the stent were obtained before and after surgical flap reflection. Two calibrated observers made the CBCT images measurements. T-test was used for the statistical analysis. Values <0.05 were considered statistically significant. Also, specificity and sensibility of CBCT and RM were compared. Intra-class correlation coefficient (ICC)_ was measure between CBCT measurements. RESULTS: A total of 62 implants sites were evaluated. No statistical significant differences were obtained with CBCT and RM measurements (P = 0,207). Detecting proper buccal-lingual ridge, the sensitivity and specificity were 59% and 91% for RM while CBCT obtained 92% of sensitivity and 94% of specificity. Concordance was found "good" (ICC 0.82). CONCLUSION: Both methods provide valid measurements. Even though, we found diagnostic limitations in the RM, it demonstrated to be a useful method for its exactitude, low cost, the immediate result and no need of radiation. CBCT was recommended when the bone ridge width and height were in the less than ideal for conventional dental implant placement.
ABSTRACT
Los dientes con restauraciones subgingivales y zonas estrechas de encía queratinizada tienen puntajes altos de inflamación gingival superiores a los dientes con restauraciones similares y áreas de encía insertada ancha. En tales casos, las técnicas de aumento de encía insertada se consideran como técnicas quirúrgicas periodontales preprotesicas; teniendo como objetivos : mejorar la eliminación de la placa alrededor del margen gingival, mejorar la cosmética y reducir la inflamación que circunda a los dientes restaurados Estudios han demostrado buenos resultados y predictibilidad de los injertos de tejido conectivo subepitelial (TCSE) en zonas donde se requiere el aumento de encía queratinizada, logrando ganar de 3 mm de grosor a 3 mm de altura. La toma de un injerto palatino de adecuadas dimensiones, sin embargo, puede complicarse dependiendo de las variaciones anatómicas en tamaño y forma del paladar; o el caso de paladares sometidos previamente a otro tipo de intervenciones. Estas características no ideales pueden dificultar la técnica quirúrgica y crear complicaciones en el sitio donador. Se han descrito varias técnicas para recolectar el injerto de la zona donadora, pero todas ellas en paladares sin previas intervenciones quirúrgicas. El siguiente reporte de caso tiene como finalidad sugerir el uso de la técnica Bosco - Días en este tipo de pacientes. La variación que esta técnica ofrece es la de reposicionar en la zona donadora el epitelio cuidadosamente retirado del injerto obtenido. El objetivo es facilitar la obtención del injerto en tejidos palatinos, además de favorecer la cicatrización y disminución de molestias en el sitio donador.
Teeth with restorations subgingivales and areas close gum queratinizada have high scores higher gingival inflammation of the teeth with restorations and similar areas gum inserted wide. In such cases, the techniques of increased gum inserted regarded as preprotesicas periodontal surgical techniques, with the following objectives: improve the removal of plaque around the gingival margin, improved cosmetics and reduce inflammation around the teeth restored Studies have shown good results and predictability of the connective tissue grafts subepithelial (TCSE) in areas where it requires increased queratinizada gum, making winning 3 mm thickness 3 mm in height. Taking a graft palatal appropriate size, however, may be complicated depending on the anatomical variations in size and shape of the palate, or if palates previously subjected to other interventions. These features not ideal can impede the surgical technique and create complications in the donor site. Several techniques have been described to collect the donor graft in the area, but all of them palates without prior surgery. Following a case report is intended to suggest the use of technical Bosco Dias in these patients. Variation that this technique offers is the repositioning in the area donor epithelium carefully removed graft obtained. The aim is to facilitate the procurement graft in palatal tissue, in addition to supporting Healing and decreased discomfort at the donor site.