Coronally advanced flap with two different techniques for the treatment of multiple gingival recessions: A pilot prospective comparative case series.

OBJECTIVES: The objective of this prospective study was to compare the clinical outcomes of coronally advanced flap (CAF) using two different surgical strategies in the treatment of multiple gingival recessions. METHOD AND MATERIALS: Ten patients presenting with a total of 81 Miller class I gingival recessions were included. Recessions were randomly treated according to a split-mouth design by means of CAF with oblique interdental incisions (OBL technique), or CAF with horizontal interdental incisions (HOR technique). Marginal gingival recession (REC), clinical attachment level (CAL), pocket probing depth (PPD), height of keratinized tissue (HKT), and thickness of keratinized tissue (TKT) were measured at baseline, and 3 and 6 months after treatment. Patient-centered outcomes concerning morbidity and improvement in the esthetic appearance were recorded using a visual analog scale (VAS). RESULTS: Both groups showed significant reductions in REC and gains in CAL throughout the study (P < .05). At 3 months, OBL-treated sites showed greater root coverage than HOR-treated sites (P < .05), although no intergroup differences were observed at 6 months (P > .05). There was an increase in HKT only in the OBL group at 6 months from baseline (P < .05). No differences between therapies were revealed concerning morbidity (P > .05), whereas a higher satisfaction with the esthetic appearance was reported for the OBL technique 6 months postsurgery (P < .05). CONCLUSION: Although both surgical approaches may provide satisfactory root coverage, use of the OBL technique promoted additional benefits in terms of esthetic perception after the management of multiple gingival recessions.

Papillon-Lefèvre syndrome in 2 siblings: case report after 11-year follow-up.

The purpose of this case report was to describe the clinical long-term outcome, 11 years after periodontal therapy, of 2 siblings diagnosed with Papillon-Lefèvre syndrome. Sibling 1 was a 14-year-old boy with severe periodontal bone loss in his permanent dentition. Sibling 2 was a 7-year-old girl with mixed-dentition and also suffering from periodontal disease. Both were treated with a combination of nonsurgical and antimicrobial therapy. Annual re-evaluations were performed for 11 years. Both siblings improved their periodontal status, but a low level of compliance with treatment over time by sibling 1 resulted in further tooth loss and recurrent periodontal disease. Sibling 2 experienced good periodontal healing in her primary and, later, permanent teeth due in part to proper compliance with oral hygiene instructions. Periodontal health was achieved, and no tooth loss occurred during follow-up. Papillon-Lefèvre syndrome subjects can be successfully treated with nonsurgical/antimicrobial therapy, but treatment outcome could be related to age at diagnosis and compliance with oral hygiene procedures.

Terapia fotodinâmica no tratamento da doença periodontal e peri-implantar / Photodynamic therapy in the treatment of periodontal disease and peri-implant disease

O tratamento periodontal consiste na remoção das bactérias periodontopatogênicas, por meio de raspagem e alisamento radicular (RAR), cujos resultados são bastante satisfatórios. Contudo, determinados sítios periodontais e peri-implantares podem não responder bem à terapia não cirúrgica, ocasionando a permanência de bolsas residuais. Dessa forma, alternativas vêm sendo propostas como adjuvantes à terapia mecânica, como o uso de antimicrobianos locais e sistêmicos, o uso de laser isolado e associado a um corante fotossensibilizador, processo conhecido como terapia fotodinâmica ou PDT (photodynamic therapy). Vários estudos têm mostrado que essa nova terapia parece ser uma abordagem terapêutica original e interessante, podendo ser um tratamento alternativo tanto na terapia da periodontite quanto da peri-implantite, apresentando reduzida morbidade e mínimo desconforto trans e pós-operatório. Contudo, é necessária maior quantidade de investigações clínicas controladas e randomizadas, a fim de comprovar a eficácia da terapia fotodinâmica como adjuvante ou como único tratamento para a resolução de doenças periodontais e peri-implantares.

Descontaminação de boca toda e debridamento periodontal como alternativas para o tratamento da periodontite / Full-mouth disinfection and full-mouth debridement for treatment of periodontitis disease

O tratamento periodontal consiste na remoção das bactérias periodontopatogênicas, por meio de raspagem e alisamento radicular, cujos resultados são bastante satisfatórios. Contudo, o tratamento convencional por quadrantes além de ser longo, pode permitir a translocação bacteriana de uma região ainda não tratada para outra que já foi. Visando diminuir esses inconvenientes foi introduzida a descontaminação de boca toda: tratamento dentro de 24h e com uso intensivo de clorexidina. Uma modificação desse protocolo foi também sugerida: o debridamento da boca toda com o ultrassom - raspagem leve, em sessão única de 45 a 60 minutos e com o uso do aparelho de ultrassom. Essas novas abordagens, com e sem o uso de antissépticos, tem apresentado resultados semelhantes ao tratamento convencional, tornando-se, portanto, boas alternativas para o paciente com periodontite, trazendo vantagens em relação à duração e custo do tratamento, cabendo ao profissional e ao paciente a escolha da modalidade adequada.

Periodontal treatment consists of removal of periodontopathogens, through scaling and root planing, whose results are quite satisfactory. However, the conventional staged quadrant-wise scaling root planing approach besides being long, can allow bacterial translocation of untreated quadrant to another that has already been treated. Aiming to reduce such inconvenience was introduced the full-mouth disinfection: treatment within 24 hours and intensive use of chlorhexidine. A modification of the protocol was also suggested: full-mouth ultrasonic debridement: single session of ultrasonic instrumentation of 45 to 60 minutes. These new approaches, with and without the use of antiseptic, has produced results similar to conventional treatment, becoming therefore good alternatives to the patient with periodontitis, bringing advantages to the duration and cost of the treatment, giving the opportunity to the professional and the patient to choose the appropriate approach.