Root coverage procedures for treating single and multiple recession-type defects: An updated Cochrane systematic review.

BACKGROUND: This updated Cochrane systematic review (SR) evaluated the efficacy of different root coverage (RC) procedures in the treatment of single and multiple gingival recessions (GR). METHODS: We included randomized controlled trials (RCTs) only of at least 6 months' duration evaluating Miller's Class I or II GR (≥3 mm) treated by means of RC procedures. Five databases were searched up to January 16, 2018. Random effects meta-analyses were conducted thoroughly. RESULTS: We included 48 RCTs in the SR. The results indicated a greater GR reduction for subepithelial connective tissue grafts (SCTG) + coronally advanced flap (CAF) compared to guided tissue regeneration with resorbable membranes (GTR rm) + CAF (mean difference [MD]: -0.37 mm). There was insufficient evidence of a difference in GR reduction between acellular dermal matrix grafts (ADMG) + CAF and SCTG + CAF or between enamel matrix derivative (EMD) + CAF and SCTG + CAF. Greater gains in the keratinized tissue width (KTW) were found for SCTG + CAF when compared to EMD + CAF (MD: -1.06 mm), and SCTG + CAF when compared to GTR rm + CAF (MD: -1.77 mm). There was insufficient evidence of a difference in KTW gain between ADMG + CAF and SCTG + CAF. CONCLUSIONS: SCTG, CAF alone or associated with another biomaterial may be used for treating single or multiple GR. There is also some evidence suggesting that ADMG appear as the soft tissue substitute that may provide the most similar outcomes to those achieved by SCTG.

Morfologia de implantes dentários com superfície tratada a laser: análise in vivo / Morphology of laser-treated dental implant surfaces: in vivo analysis

Rugosidades criadas em superfícies de implantes de titânio promovem alterações morfológicas que podem favorecer o contato osso/implante. A energia superficial resultante de jateamento com partículas, ataque químico e tratamento por oxidação anódica na superfície dos implantes promove mudanças na resposta das células ósseas. O objetivo deste estudo foi avaliar a resposta do tecido ósseo na superfície de implantes tratados sob irradiação a laser (Nd: YAG). Os implantes submetidos a este método foram analisados sob microscopia eletrônica de varredura (MEV) e confocal 3D, além de avaliação superficial por equipamento de rugosímetro. Foram instalados, em fêmures de ratos Wistar, 30 mini-implantes com tratamento superficial a laser, e confeccionados em titânio grau II. Os animais foram divididos em três grupos, de acordo com os períodos de reparação óssea – 15, 30 e 60 dias. As amostras foram analisadas sob microscopia de luz e MEV. Os resultados demonstraram formação de depósitos de nova matriz óssea preenchidos por pequenas quantidades de fibras colágenas II e III, no grupo 15 dias. Finas camadas de matriz óssea e osteoide em íntimo contato com a superfície das espiras centrais foram identificadas (30 dias), indicando elevada biocompatibilidade. Após 60 dias, o tecido ósseo mostrou características biológicas de maturidade e contato com a superfície. A porosidade superficial com média de 40 µm e profundidade com 5,3 µm demonstrou ser favorável à deposição óssea. O desenvolvimento de novas superfícies tratadas com equipamento a laser promovendo mudanças na energia superficial, assim como a macro e microestruturas, pode estimular novos estudos para o futuro da Implantodontia.

Roughness created implant titanium surfaces promote morphological alterations that may promote bone/implant contact. The surface energy resulting from blasting with particles, chemical attack and treatment by anodic oxidation on implant surfaces, promotes changes in the response of bone cells. The objective of this study was to evaluate the response of bone tissue on the implant surfaces treated under laser irradiation (Nd: YAG). The implants submitted to this method were examined under scanning electron microscopy (SEM), confocal 3-D and superficial evaluation by roughness tester equipment. Thirty mini-implants with superficial laser treatment and made in cp titanium grade II, were installed in Wistar rat femur. The animals were divided into three groups according to the periods of bone repair (15, 30 and 60 days). The samples were examined under light microscopy and SEM. The results demonstrated formation of new bone matrix filled with small amounts of collagen fibers II and III (15 days). Thin layers of bone and osteoid matrix in intimate contact with the surface of central threads were identified (30 days), indicating high biocompatibility. After 60 days the bone tissue showed biological characteristics of maturity and contact with the surface. The porosity surface with an average of 40 µm and depth with 5.3 µm proved to be favorable for bone deposition. The development of new areas treated with laser equipment, promoting changes in surface energy as well as the macro and microstructures, can stimulate new studies for the future of implantology.