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1.
Int J Esthet Dent ; 17(3): 254-265, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36047884

RESUMO

Digital guides (also known as stents) have become commonly used in daily dental practice. CBCT, digital impressions, and stereolithographic models are considered extremely helpful to create guides for the planning and resolution of surgical cases. In recent years, in periodontal surgery and in particular for the treatment of altered passive eruption (APE), there has been an increasing use of digitally designed guides to improve esthetic outcomes and achieve more predictable results. Digital custom-made guides can be used to improve safety and precision in crown lengthening procedures in patients with APE who have high esthetic expectations. Although most approaches described in the literature show guides used for primary flap or gingivectomy design, the precision of bone recontouring and ostectomy plays a key role in soft tissue rebound and in the final esthetic outcome. The present article describes a new approach using two different guides for soft tissue design in patients with APE.


Assuntos
Aumento da Coroa Clínica , Hominidae , Animais , Aumento da Coroa Clínica/métodos , Estética Dentária , Gengivectomia/métodos , Humanos , Motivação
2.
Artigo em Inglês | MEDLINE | ID: mdl-36044688

RESUMO

Maxillary canines are the second most commonly impacted teeth, with mandibular third molars being the most commonly impacted teeth. One-third of the impacted maxillary canines are labially impacted, and the remaining two-thirds are palatally impacted. Palatally impacted canines (PICs) comprise approximately 1% to 2.5% of the general population. These impactions can be managed with preventive, interceptive techniques or surgical uncovering. If preventive or interceptive measures are unsuccessful in allowing the canine to erupt, there are many techniques that can be employed to uncover the PIC. Canines that are very superficially impacted can be uncovered with a simple gingivectomy. Canines that are more deeply impacted will require flap reflection, bone removal, and the placement of some type of orthodontic bracket. Most often, the surgeon will attach a chain to the impacted tooth so the orthodontist can immediately begin movement with some form of traction device. The preorthodontic uncovering technique (POUT) allows spontaneous eruption of the impacted tooth without active orthodontic force. When this technique is employed early (approximately 6 months before orthodontic treatment is initiated), it will save considerable time and trauma in erupting these teeth. Research has shown that this technique decreases orthodontic treatment time to properly position these teeth. In addition, this technique has been shown to be healthier for the bone and root structure of the impacted tooth and surrounding teeth. This article elucidates the benefits of the POUT when uncovering simple and very complicated PICs.


Assuntos
Dente Impactado , Dente Canino/cirurgia , Gengivectomia , Humanos , Maxila/cirurgia , Erupção Dentária , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia
3.
Head Face Med ; 18(1): 23, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35799195

RESUMO

OBJECTIVE: To compare the efficacy of three surgically assisted permanent anterior tooth eruption methods (laser surgery, electrosurgery and routine surgery) in children. METHOD: Sixty-three orthodontic children with retarded permanent anterior tooth were selected and according to the random number table divided into three groups: laser surgery group (group A), electrosurgery group (group B) and routine surgery group (group C). The total operative time (min), the duration of pain after gingival excision (d), Visual Analogue Scale (VAS) pain intensity scores (0-10 cm), and gingival healing time (d) were all recorded. Six months after treatment, periodontal indexes of the three groups, including gingival indexes (GI), plaque indexes (PLI), probing depth (PD) were checked by the same periodontist and recorded. RESULTS: Surgical records showed that compared with group C, there were statistically significant differences in operative time, pain duration, pain intensity and healing time in group A and B (P < 0.05). There was no significant difference in these four results between group A and group B. Periodontal examination indicators 6 months after surgery showed no statistical differences in GI, PLI and PD among group A, B and C. Oral clinical examination found that the three groups of patients with different treatment, dental eruption was normal. CONCLUSION: All the three treatments can effectively solve the problem of delayed eruption of permanent anterior teeth in children. Particularly, laser surgery and high-frequency electrosurgery have good efficacy, little pain and high operability, which can be considered as a better method to aid teeth eruption.


Assuntos
Gengivectomia , Erupção Dentária , Criança , Gengiva , Humanos , Dor , Índice Periodontal
4.
Lasers Med Sci ; 37(7): 2999-3009, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35661938

RESUMO

To compare the efficacy between the surgical techniques of gingivectomy with high-power laser (HPL) and conventional gingivectomy for correction of a gummy smile (GS) due to altered passive eruption (APE). This was a case series of six female patients diagnosed with GS associated with APE. For the conventional gingivectomy procedure and for the one using the diode laser (808 nm, 2 W, in continuous mode), the six upper anterior teeth were divided into two groups (control (CG)-# 11, # 12, # 13, and test (TG)-# 21, # 22, # 23). Analyses of intraoperative bleeding and levels of pain and postoperative tissue repair were performed. The thermal pattern analysis was performed using infrared thermography. The level of significance was set at p < 0.05. There was no intraoperative bleeding in the TGs (p = 0.002). The CG showed tissue repair significantly better than the TG on the 14th postoperative day (p = 0.004). There were no statistically significant differences regarding the level of postoperative pain between the groups (p > 0.05). Regarding the thermographic analysis, there were also no statistically significant differences (p > 0.05). HPL gingivectomy was more effective, regarding the absence of intraoperative bleeding, while the conventional technique promoted better tissue repair. No significant differences were observed in the other parameters, possibly due to the minimal damage caused by gingivectomy, with either HPL or the conventional procedure, as there was no removal of bone tissue.


Assuntos
Gengivectomia , Hominidae , Animais , Estética Dentária , Feminino , Gengiva , Humanos , Lasers Semicondutores/uso terapêutico , Sorriso
5.
Dent Clin North Am ; 66(3): 399-417, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35738735

RESUMO

Excessive gingival display (EGD) is the extensive exposure of the gingiva during a smile. It is a common concern among patients, which may compromise the esthetic outcome of the dental treatment. Dental lasers demonstrate several advantages for soft tissue dental surgery compared with conventional surgical methods related to their technical characteristics. Owing to the excellent coagulation, especially of the surgical lasers, reduced to no need of anesthesia or suturing and faster healing, they demonstrate optimal clinical results. Nevertheless, good knowledge of laser-tissue interaction is required to obtain the best predictable results without gingival recession or bone tissue damage.


Assuntos
Gengivectomia , Sorriso , Estética Dentária , Gengiva/cirurgia , Humanos , Lasers
6.
J Clin Pediatr Dent ; 46(2): 119-124, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-35533227

RESUMO

Few long-term reports exist concerning the treatment of idiopathic gingival fibromatosis, which is a rare autosomal dominant genetic disorder associated with non-inflammatory, benign, and chronic fibrous gingival proliferation and which causes serious esthetic problems. The aim of this study was to report a case of idiopathic gingival fibromatosis treated with a gingivectomy using an inverse bevel flap method and comprehensively followed up for 15 years. A female patient visited a pediatric dentist at 7 years of age; however, a gingivectomy was not performed until the age of 20 years because of an uncertain prognosis. Now, more than 15 years after the gingivectomy, there has been no significant recurrence and the disease is well managed. Treatment by gingivectomy with an inverse bevel flap approach may provide long-term prevention of recurrence of gingival fibromatosis into adulthood. The aim of this study was to obtain new findings on the pathogenesis and prognosis of this rare disease and to review the case reports previously published.


Assuntos
Fibromatose Gengival , Gengivectomia , Adulto , Criança , Odontólogos , Feminino , Fibromatose Gengival/genética , Fibromatose Gengival/cirurgia , Seguimentos , Gengiva , Gengivectomia/métodos , Humanos , Adulto Jovem
7.
Clin Oral Investig ; 26(6): 4243-4261, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35347420

RESUMO

OBJECTIVE: To systematically review the literature regarding the clinical efficacy of reducing excessive gingival display (EGD) using the surgical lip repositioning technique (LRT) and its modifications. The question to address was: "What is the clinical efficacy of the surgical LRT and its modifications in patients with EGD?" MATERIAL AND METHODS: Four databases (MEDLINE-PubMed, Scopus, EMBASE, and CENTRAL) were searched up to December 2021 (PROSPERO-CRD42020205987). Randomized, non-randomized controlled and prospective case series with a minimum of 6-month follow-up were eligible for inclusion. Two meta-analyses were performed using the mean difference (MD) between baseline and different follow-up periods (6 and 12 months). Subgroup analyses were performed using the different modifications of LRT. RESULTS: The electronic research retrieved 783 studies. Only 13 met the inclusion criteria and were included in the statistical analysis. Six modifications of the original LRT were identified. An overall EGD reduction of -3.06 mm (95%CI: -3.71-2.40), -2.91 mm; (95%CI: -3.66-2.15) and -2.76 mm; (95%CI: -3.83--1.70) was achieved after 6, 12, and 36 months, respectively, compared to baseline (P < 0.01). Meta-analysis revealed that the use of LRT with periosteal suturing showed the greatest decrease in EGD with 5.22 mm (95% CI: 4.23-6.21; P < 0.01) at 6 months and 4.94 mm (95% CI: 3.86-6.02; P < 0.01) at 12 months. CONCLUSIONS: Both the original LRT and its different modifications reduce EGD and provide good results and overall patient satisfaction at 6, 12, and 36 months of follow-up. CLINICAL RELEVANCE: Evaluating the different modifications of the LRT can be a guiding aspect for the clinical and surgical approach to be used in patients with EGD.


Assuntos
Gengivectomia , Sorriso , Estética Dentária , Gengiva , Gengivectomia/métodos , Humanos , Lábio/cirurgia , Resultado do Tratamento
8.
J Dent Child (Chic) ; 89(1): 41-45, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35337399

RESUMO

Idiopathic gingival fibromatosis (IGF) is a rare, benign, slow-growing proliferation of the gingival tissues involving both maxillary and mandibular gingiva. It is exacerbated during the eruptive phase of both primary and permanent dentitions. The purpose of this article is to report the case of a 10-year-old boy who presented with IGF whose gingival enlargement covered the occlusal surfaces of many teeth and displaced the erupting dentition, compromising the patient's cosmetics, function, speech and development. The treatment involved gingivectomy and gingivoplasty, combining both surgical and laser methods. The case showed remarkable esthetic and functional im provement, without signs of recurrence one year post-treatment.


Assuntos
Fibromatose Gengival , Crescimento Excessivo da Gengiva , Criança , Fibromatose Gengival/diagnóstico , Fibromatose Gengival/cirurgia , Gengiva , Crescimento Excessivo da Gengiva/cirurgia , Gengivectomia , Gengivoplastia , Humanos , Masculino
9.
Rev. ADM ; 79(1): 54-58, ene.-feb. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1362610

RESUMO

Introducción: La hiperplasia gingival es una condición benigna caracterizada por el aumento de volumen de la encía. Algunos fármacos, factores genéticos, aparatología y placa dentobacteriana son factores que pueden inducir esta condición. Objetivo: Devolver la anatomía a la encía brindando una mejor estética y permitiendo una óptima higiene oral. Material y métodos: Paciente masculino de 20 años de edad con antecedentes de fenitoína presenta aumento de volumen en la encía. Resultados: Se obtuvieron resultados estéticos y funcionales satisfactorios con el tratamiento quirúrgico y el uso de membrana de celulosa oxidada. Conclusión: En el manejo de la hiperplasia gingival es importante el enfoque no quirúrgico como control de placa dentobacteriana y medidas de higiene del mismo paciente (AU)


Introduction: Gingival hyperplasia is a benign condition characterized for the grown on the gingival volume. Some drugs, genetic, orthodontic and dental plaque are some factors that can induce this condition. Objective: To return the gingival anatomy, providing a better aesthetic allowing also good oral hygiene. Material and methods: A male 20 years of age with medical history of phenytoin display grown on the gingival volume. Results: Aesthetic and functional results were achieved with the surgical treatment and the oxidized cellulose membrane. Conclusion: In the gingival hyperplasia management is important de non-surgical approach, as dental plaque control and oral hygiene of the patient (AU)


Assuntos
Humanos , Feminino , Adulto , Fenitoína/efeitos adversos , Celulose Oxidada , Hipertrofia Gengival/induzido quimicamente , Gengivectomia , Estética Dentária , Membranas Artificiais , México
10.
Niger J Clin Pract ; 25(1): 110-113, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35046204

RESUMO

INTRODUCTION: LipStaT® lip repositioning surgery using a diode laser for the management of gummy smiles offers promising and consistent long-term results. OBJECTIVE: To describe the technique through a clinical case, including its indications, preoperative evaluation, surgical approach, and recommendations after the intervention. CASE REPORT: A 29-year-old woman with excessive gingival display (EGD) of 4 mm when smiling; the LipStaT® technique was performed with a 940 nm diode laser to remove a strip of mucosa by ablating the epithelial tissue, and thus, achieve aesthetic, harmonic and functional results. The inflammation and postoperative pain were treated with the diode laser assisted lymphatic drainage technique. After follow-up, a satisfactory tissue response was observed, and no pain or inflammation was reported. CONCLUSION: The use of a 940 nm diode laser proved to be an effective treatment option for patients with a gummy smile, allowing control of intraoperative bleeding and improvement of the healing process obtaining predictable long-term results.


Assuntos
Estética Dentária , Lábio , Adulto , Feminino , Gengiva , Gengivectomia , Humanos , Lasers Semicondutores/uso terapêutico , Sorriso
11.
Artigo em Inglês | MEDLINE | ID: mdl-35060967

RESUMO

This study compares the clinical outcomes of Er,Cr:YSGG (2,780 nm) laser-assisted open-flap (OF) and flapless (FL) esthetic crown lengthening (ECL) for the treatment of altered passive eruption. Thirty-six healthy patients requiring ECL were randomly divided into two groups: OF and FL. Gingivectomy and ostectomy were performed with an Er,Cr:YSGG laser in both groups. The periodontal condition and gingival margin level (GML) were assessed at baseline, immediately postsurgery, and at 1, 3, and 9 months postsurgery. The effect of periodontal phenotype and tooth location on GML and supracrestal gingival tissue dimension were evaluated. A significant difference was detected in the mean of GML at all time points, except between 3 and 9 months. The main tissue rebound after 9 months was 0.25 ± 0.3 mm in the OF group and 0.26 ± 0.3 mm in the FL group (no significant difference) and was significantly higher in thick periodontal phenotypes. Er,Cr:YSGG laser-assisted ECL is a predictable technique that achieved similar outcomes using flap and flapless approaches, providing esthetic and restorative opportunities for clinicians.


Assuntos
Aumento da Coroa Clínica , Lasers de Estado Sólido , Estética Dentária , Gengivectomia , Humanos , Coroa do Dente
12.
J Orthod ; 49(2): 221-227, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34476986

RESUMO

The present case series demonstrates the efficacy of an 810 nm diode laser for the surgical management of oral soft tissues related to orthodontic treatment. Three orthodontic patients aged 16-23 years underwent operculectomy, ablation of soft-tissue overgrowth over orthodontic appliance and gingivectomy along with gingival recontouring procedures, respectively, using the 810 nm diode laser. In each case, an initiated laser fibre tip was utilised to ablate the tissue at the treatment site by making a light contact with the tissue (average power output = 1-1.6 W, continuous wave emission mode, fibre diameter = 400 µm, spot size = 0.0013 cm2, energy density = 124.9-199.9 J/cm2, irradiance = 796-1273 W/cm2, total energy dose = 300-480 J). The maximum total length of treatment was 300 s (5 min). None of the patients reported any instantaneous or delayed postoperative complications over six months. Utilisation of the 810 nm diode laser for surgical management of oral soft tissues related to orthodontic treatments can be considered safe, effective and justifiable over the conventional scalpel technique; however, it must be performed by trained and experienced clinicians only.


Assuntos
Terapia a Laser , Lasers Semicondutores , Gengiva/cirurgia , Gengivectomia/métodos , Humanos , Lasers Semicondutores/uso terapêutico , Aparelhos Ortodônticos
13.
Quintessence Int ; 53(4): 328-341, 2022 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-34927405

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effect of platelet-rich fibrin (PRF), concentrated growth factors (CGF), and autologous fibrin glue (AFG) application on early wound healing after gingivectomy and gingivoplasty operations. METHOD AND MATERIALS: In this split-mouth study, gingivectomy and gingivoplasty surgery were performed on 19 patients. The postoperative PRF, CGF, and AFG applied areas were compared with the control regions. On days 0, 7, 14, and 28, the surgical area was stained with a plaque-disclosing agent and evaluated in the ImageJ program. Wound healing was evaluated with H2O2 test, visual analog scale for pain, and Landry, Turnbull, and Howley (LTH) wound healing index on days 7, 14, and 28. The patients were asked to evaluate their esthetic perceptions on a visual analog scale. RESULTS: The amount of staining at days 7 and 14 was found to be significantly higher in the control group than in the test groups, but there was no difference between the test groups. LTH index values of the control group at days 7, 14, and 28 were found to be significantly lower than the test groups. There was no significant difference between the groups in the epithelialization assessment performed with the H2O2 test. It was observed that the use of platelet concentrate at day 7 reduced postoperative early pain. Patients were highly satisfied with postoperative esthetics. CONCLUSION: After gingivectomy and gingivoplasty operations, PRF, CGF, and AFG application were found to have positive effects on wound healing. However, PRF, CGF, and AFG applications were not superior to each other in terms of secondary wound healing.


Assuntos
Adesivo Tecidual de Fibrina , Gengivectomia , Gengivoplastia , Peptídeos e Proteínas de Sinalização Intercelular , Fibrina Rica em Plaquetas , Cicatrização , Adesivo Tecidual de Fibrina/farmacologia , Adesivo Tecidual de Fibrina/uso terapêutico , Humanos , Peróxido de Hidrogênio/farmacologia , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , Cicatrização/efeitos dos fármacos
14.
Braz. dent. sci ; 25(3): 1-8, 2022. ilus
Artigo em Inglês | LILACS, BBO - Odontologia | ID: biblio-1380203

RESUMO

Os lasers de diodo tornaram-se ferramentas clínicas populares devido ao seu tamanho compacto, acessibilidade, facilidade de uso e versatilidade. O objetivo deste artigo é apresentar as diversas aplicações de um laser de diodo na prática diária e destacar os aspectos técnicos do uso do laser de diodo para o mesmo. Esta série de casos relata o manejo de seis diferentes situações clínicas com laser de diodo: anquiloglossia, bolsa periodontal, zênites gengivais desiguais, mucocele, hipersensibilidade dentinária e gengiva hiperpigmentada. Os pacientes foram tratados com laser de diodo de 940 nm com potência de 0,5 W a 2 W dependendo do caso. A cicatrização pós-operatória transcorreu sem intercorrências na maioria dos casos e foram observados resultados favoráveis. O laser de diodo ofereceu vantagens cirúrgicas como ­ campo seco, desinfecção do sítio cirúrgico e cirurgia sem sutura. Além disso, os autores observaram melhor satisfação do paciente devido à mínima dor ou edema pós-operatório e alívio imediato em caso de hipersensibilidade dentinária. Este artigo apresenta as aplicações cirúrgicas e não cirúrgicas do laser de diodo juntamente com os aspectos técnicos. Embora a literatura disponível não forneça evidências substanciais para comparação direta do laser de diodo com as técnicas convencionais, é seguro concluir que o laser de diodo é uma ferramenta eficiente para uso rotineiro em odontologia.(AU)


The diode lasers have become popular clinical tools because of their compact size, affordability, ease of use and versatility. The aim of this paper is to put forth the various applications of a diode laser in day to day practice and highlight the technical aspects of diode laser use for the same. This case series reports management of six different clinical situations with diode laser namely ­ ankyloglossia, periodontal pocket, unequal gingival zeniths, mucocele, dentinal hypersensitivity and hyper-pigmented gingiva. The patients were treated with 940 nm diode laser with power settings from 0.5 W to 2 W depending on the case. The post-operative healing was uneventful in most cases and favourable outcomes were observed. The diode laser offered surgical advantages like ­ dry field, disinfection of surgical site and suture-less surgery. In addition, the authors observed better patient satisfaction owing to minimal post-operative pain or swelling and immediate relief in case of dentinal hypersensitivity. This paper presents both surgical and non-surgical applications of diode laser along with the technical aspects. Even though the available literature does not lend substantial evidence for direct comparison of diode laser with conventional techniques, it is safe to conclude that diode laser is an efficient tool for routine use in dentistry.(AU)


Assuntos
Humanos , Adulto , Bolsa Periodontal , Sensibilidade da Dentina , Estética Dentária , Terapia a Laser , Anquiloglossia , Gengivectomia
15.
Kathmandu Univ Med J (KUMJ) ; 19(74): 278-281, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34819452

RESUMO

For obtaining adequate retention for restoring cases like subgingival caries or extensive caries that shortens the tooth, short clinical crown, and fractures, it is usually necessary to disclose more tooth structure. Crown lengthening procedure is done to increase the clinical crown length for restorative or esthetic reasons without breaching the biologic width. These procedures are also utilized to improve the appearance and retention of restorations placed within the esthetic zone. We report a case of crown lengthening surgery with an internal bevel gingivectomy which was done in our department without compromising tooth support and esthetics.


Assuntos
Aumento da Coroa Clínica , Gengivectomia , Coroas , Estética , Estética Dentária , Humanos
16.
BMC Oral Health ; 21(1): 473, 2021 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-34565352

RESUMO

BACKGROUND: Hereditary gingival fibromatosis (HGF) is rare in clinical practice, and the long-term results of the combined orthodontic-periodontal treatment of HGF are rarely reported. CASE PRESENTATION: This study reports for the first time the results of seven years of follow-up in a seven-year-old girl with HGF. The diagnosis was confirmed by clinical signs, family history and histopathological examination. First, periodontal scaling and oral hygiene reinforcement were performed regularly in the mixed dentition stage. Next, gingivoplasty was performed on the permanent dentition. Two months after the surgery, treatment with fixed orthodontic appliances was conducted. The teeth were polished on a monthly basis, and oral hygiene was reinforced to control gingival enlargement. Gingival hypertrophy recurred slightly, and gingivectomies were performed in the months following the start of orthodontic treatment. Follow-up was performed for 24 months with orthodontic retention, and gingival enlargement remained stable after the combined treatment. CONCLUSIONS: The risk of gingival hyperplasia recurrence during and after orthodontic treatment is high, but satisfying long-term outcomes can be achieved with gingivectomy, malocclusion correction, and regular follow-up maintenance.


Assuntos
Fibromatose Gengival , Hiperplasia Gengival , Criança , Feminino , Fibromatose Gengival/genética , Fibromatose Gengival/cirurgia , Seguimentos , Gengivectomia , Humanos , Higiene Bucal
17.
Gen Dent ; 69(2): 52-55, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33661115

RESUMO

A "gummy smile," considered to be exposure of more than 3.0 mm of gingival tissue during a forced smile, negatively affects smile esthetics. The present case series describes the clinical indications and technique for applying botulinum neurotoxin type A (BoNTA) to correct a gummy smile and assesses the outcomes and satisfaction levels of 3 patients. The patients were told about the risks and benefits of the procedure and advised that their gummy smile was likely to recur within 6 months posttreatment. After the exposed gingival tissue of the patients was measured with a ruler, photographs were taken, and the patients recorded their pretreatment level of satisfaction with their smile on a visual analog scale (VAS), the patients were treated with BoNTA. The BoNTA was diluted in 1 mL of sterile saline according to the manufacturer's instructions, and an extraoral point of application was marked 1 mm lateral to each of the patient's nasal wings, close to the insertion of the elevator muscles of the upper lip and the nasal wings. At each location, 4 U was injected by tilting the syringe 45° in relation to the skin. Fourteen days after treatment, the gingival tissue exposed during a smile was again measured with a ruler, new photographic records were taken, and the patients' level of satisfaction with the treatment and the esthetic result was determined. Repositioning of the upper lip was observed in all patients. No adverse effects or complaints were reported. All 3 patients reported that they were satisfied with the outcome and wanted to continue therapy with BoNTA as needed. The results of the reported cases suggest that the application of BoNTA constitutes a safe, effective treatment for the correction of gummy smile and is well accepted by patients. However, for the treatment to be successful, it is essential that clinicians master the facial topographic anatomy and the technique to be employed.


Assuntos
Estética Dentária , Sorriso , Gengiva , Gengivectomia , Humanos , Lábio
18.
Clin Adv Periodontics ; 11(3): 145-149, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33538102

RESUMO

INTRODUCTION: Dentofacial esthetics demands have increased tremendously in the past decade. Psychological impact of unsatisfactory esthetic appearance can manifest in decreased sense of self-esteem and can negatively affect social and professional interactions. Esthetic awareness of dental patients has extended to include requests of gingival color modification. Gingival pigmentation can be physiological due to ethnic pigmentation or can be a result of various pathological processes. Different surgical modalities, tools and materials have been used in management of gingival pigmentation. This case report is introducing a simple, cost effective, minimally invasive technique of gingival sculpting for the purpose of significantly reducing gingival pigmentation. CASE PRESENTATION: A healthy 32-year-old male patient presented with a chief complaint of gingival pigmentation that is causing him distress and low self-esteem. Gingival sculpting technique was used. This simple technique uses a combination of two methods, bur abrasion and scalpel blade with copious irrigation. The procedure resulted in minimal intra and postoperative complications and excellent esthetic results achieved instantly and maintained at 3 months postoperatively. High patient esthetic satisfaction was achieved. CONCLUSION: Gingival sculpting is minimally invasive procedure that can be performed at any dental office. It renders excellent esthetic results using minimal chair time and down time for the patient. It is well tolerated by the patient with minimal bleeding, postoperative pain, and rapid healing time. Long-term follow-up is needed to ensure stability and lack of recurrence.


Assuntos
Doenças da Gengiva , Terapia a Laser , Adulto , Estética Dentária , Gengiva/cirurgia , Gengivectomia , Humanos , Masculino
19.
J Esthet Restor Dent ; 33(3): 446-457, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33325589

RESUMO

To synthesize the available evidence regarding lip repositioning surgery (LRS) and quantify the short- and long-term reduction in excessive gingival display (EGD) with the procedure. Additionally, evaluate the effect of myotomy on the results. Seven electronic databases were searched up to May 2020 by two independent reviewers. Studies evaluating the exclusive use of LRS to treat EGD were included. After risk of bias assessment, the data were quantitatively evaluated with random-effects meta-analysis. The initial database search yielded 368 studies, of which 16 were selected for full-text review. Finally, eight studies were included. The random effects model exhibited an EGD reduction of 2.87 mm (95% CI: 1.91-3.82) after 3 months of LRS. These results decreased after 6 months (2.71 mm; 95% CI: 1.95-3.47) and 12 months (2.10 mm; 95% CI: 1.48-2.72). Meta-analysis comparing the performance of myotomy showed greater EGD reduction at 6 months than without myotomy (P < 0.02). LRS is an effective approach for treating EGD, and it has satisfactory results up to 6 months. After this period, the effectiveness appears to progressively decrease over time indicating substantial relapse at 12 months. Myotomy seems a suitable alternative to increase the stability of LRS. Lip repositioning surgery is an effective procedure to improve smile esthetics in the short-term (up to 6 months). After this period, the efficacy of LRS seems to decrease progressively, and an approximately 25% relapse may be expected after 12 months. Clinicians should combine the procedure with other approaches, such as plastic periodontal surgeries, restorative procedures, or botulin toxin injections for more predictable and stable outcomes.


Assuntos
Gengivectomia , Lábio , Estética Dentária , Gengiva , Sorriso
20.
Photobiomodul Photomed Laser Surg ; 39(2): 94-99, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32898459

RESUMO

Objective: Diode laser (DL) is a frequently preferred tool for soft tissue incision and ablation in oral surgery. The aim of this study was to find the most effective irradiation time protocol to avoid potential harmful temperature rise in pulp during DL-assisted gingivectomy. Materials and methods: Ninety human freshly extracted teeth (30 anterior, 30 premolar, and 30 molar) were irradiated using a 940 nm DL with power output of 1 and 2 W and exposure time of 10, 20, 30, 40, 50, and 60 sec per specimen. Intrapulpal temperature was evaluated with thermocouple. Additionally, the effect of dark deposits on root surface for intrapulpal temperature rise was investigated. Temperature differences with every 10 sec were evaluated for three different teeth types, and statistical analyses were performed. Results: Anterior and premolar teeth exceeded the threshold values earlier than molar teeth for both 1 and 2 W. Despite the significant differences among the types of teeth, at 10 sec, temperature rise recorded for all types of teeth was below the critical value of 5.6°C, which cause pulp damage. Dark deposits on teeth surface boosted thermal effect of DLs (p < 0.01). Conclusions: Gingivectomy with DLs at 1 W on anterior, premolar, and molar teeth for 20, 40, and 60 sec, respectively, generates acceptable temperature rise; however, it should be <10, 20, and 40 sec at 2 W, respectively. Especially in the anterior teeth, DLs should be performed with caution to avoid pulp damage.


Assuntos
Gengivectomia , Lasers Semicondutores , Dente Pré-Molar , Temperatura Corporal , Humanos , Temperatura
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