Barbell Technique for Three-Dimensional Bone Augmentation.

Introduction: Appositional bone augmentation is considered a challenging surgical problem to correct for the deficient alveolar ridge. To overcome this challenge, a novel concept was recently published called "Barbell Technique." This technique has been used more commonly for horizontal bone augmentation. To our knowledge, this is the first report on using the Barbell Technique for vertical bone augmentation. Case Report. This report describes and demonstrates the clinical feasibility of the use of this concept in the reconstruction of a tridimensional alveolar ridge defect in the anterior maxilla. Due to the severity of the defect, both hard and soft tissue deficiencies required augmentation. The first surgery involved a soft tissue grafting procedure while in the second surgical procedure, hard tissue augment was performed using the Barbell device to provide both vertical and horizontal support for the hard tissue graft. The donor material consisted of equal volume of xenograft and autogenous bone used to fill the defect and covered with a collagen barrier membrane. After a healing period of 9 months, the site was reopened. Bone formation clinically verified the correction of alveolar bone contour and volume permitted placement of two titanium implants after the removal of Barbell device. Conclusion: This case report demonstrates successful vertical and horizontal bone augmentation of a critical size defect in the anterior maxilla, correcting both hard and soft tissue contours, and providing the tissues needed to support dental implants in the anterior maxilla.

Long-term evaluation (up to 7 years) of the use of a collagen matrix to treat gingival recession associated with noncarious cervical lesion: Report of two cases.

INTRODUCTION: Gingival recession (GR) is a relevant clinical condition due to its high prevalence worldwide, which leads to aesthetic demands and dentin hypersensitivity. Collagen matrices have been associated with different designs of coronally advanced flaps (CAFs) to treat GR defects. However, the literature lacks long-term follow-up of this treatment option. The aim of this study is to present the long-term follow-up (up to 7 years) of two GR defects (associated or not with noncarious cervical lesion) treated with a CAF and a collagen matrix (CM). CASE PRESENTATION: Case 1 underwent a CAF associated with a CM to treat a single GR defect. After 7 years, Case 1 presented with 3 mm of recession reduction, which corresponds with the 85.7% of root coverage. Case 2 presented two GR defects associated with noncarious cervical lesions (NCCLs). The NCCLs were partially restored with resin composite and then underwent a modified CAF for multiple defects and a CM. After 5 years of follow-up, Case 2 presented with 1.5 and 2.5 mm of recession reduction, which corresponds with the average 83.3% defect coverage. CONCLUSION: These two cases may show that CMs can provide long-term stable outcomes in the treatment of GR defects. Why is this case new information? One of the cases is the first one to describe a 7 years of follow-up after CAF+CM to treat gingival recession defects. What are the keys to successful management of this case? Correct material handling. Adequate restorative protocol and surgical technique. What are the primary limitations to success in this case? Diagnose Patient compliance.

Maxillary Sinus Elevation Using the Bone Ring Technique with Immediate Implantation: A Case Report.

Compared to other areas of the oral cavity, an edentulous posterior maxilla poses a unique challenge for implant placement. The most important aspect to consider is the maxillary sinus. This paper describes a case in which the bone ring technique was used to raise the floor of the maxillary sinus, followed by immediate implantation. A 37-year-old woman presented with a ridge defect in the left maxilla and the absence of teeth 26 and 27 (FDI tooth-numbering system) on the same side. The treatment plan involved the extraction of tooth 25, periodontal regeneration on the distal face of tooth 24, and concomitant raising of the maxillary sinus (using the bone ring technique) with simultaneous implantation. The bone ring technique promotes bone augmentation, raises the maxillary sinus, and reduces the surgical time, surgical costs, and length of the rehabilitation period. In the case presented herein, bone tissue stability around the implants, ridge maintenance, and gingival margin stability were found at the 1-year follow-up after rehabilitation.

Tratamento de mucosite periimplantar pela técnica de enxerto gengival livre: relato de caso / Treatment of peri-implant mucositis through free gingival graft technique: case report

A Mucosite peri-implantar é considerada a precursora da peri-implantite, ela é uma lesão inflamatória da mucosa peri-implantar na ausência de perda óssea marginal contínua. O objetivo desse relato de caso, foi descrever o tratamento da mucosite periimplantar através da cirurgia de enxerto gengival livre. Foi proposto, portanto, um tratamento reabilitador envolvendo uma abordagem multidisciplinar de forma a resgatar e restabelecer estética, função e bem-estar através do enxerto gengival livre para melhorar as características de mucosa e viabilizar uma previsibilidade de uma prótese definitiva implantosuportada em condições teciduais mais estáveis. O uso do EGL para aumento da gengiva queratinizada na cirurgia de implantes em paciente idosos é uma solução prática e segura para a manutenção da saúde periodontal ao redor do implante... (AU)

Peri-implant mucositis is considered the precursor of peri-implantitis, it is an inflammatory lesion of the peri-implant mucosa in the absence of continuous marginal bone loss. The purpose of this case report was to describe the treatment of peri-implant mucositis through free gingival graft surgery. Therefore, a rehabilitation treatment involving a multidisciplinary approach was proposed in order to rescue and reestablish aesthetics, function and well-being through the free gingival graft to improve the characteristics of the mucosa and enable a predictability of a permanent implant prosthesis under more stable tissue conditions. The use of EGL to increase keratinized gingiva in implant surgery in elderly patients is a practical and safe solution for maintaining periodontal health around the implant... (AU)

Segundo molar superior com cinco canais / Maxillary second molar with five canals

Um segundo molar superior com cinco raízes é apresentado. Soma-se a esta rara alteraçao morfológica a presença de duas pérolas de esmalte

Estudo da anatomia da câmara pulpar e canais radiculares / Anatomic study of the dental pulp cavity and root canals

Setenta e três dentes incisivos inferiores, de humanos, extraídos e montados em blocos de resina de poliéster, foram observados radiograficamente nos sentidos vestíbulo-lingual e mésio-distal. A segunda radiografia em muitos casos nos revelou a presença de um segundo canal, confirmada da exploração clínica. Esta freqüência é de 30,3//no incisivo lateral e 20//no incisivo central. É de capital importância detectar a presença deste segundo canal, bem como, instrumentá-lo ou obturá-lo ou corretamente sem o que o tratamento endodôntico fracassará

Teste elétrico pulpar / Pulp eletric test

Os autores avaliaram um aparelho unipolar para o teste elétrico pulpar. Para tanto, utilizaram dentes de pacientes que necessitam de tratamento endodôntico. A análise de colaboração e sangramento da polpa permitiu conferir a vitalidade pulpar. Foi possível estabelecer a confiabilidade de 96 por cento do teste elétrico pulpar

Método eletrônico de determinaçäo do comprimento de trabalho / Electronic determination of root canal length

Este trabalho, foi realizado com o intuito de verificar a capacidade do Foramatrom III em registrar a ponta do instrumento 0,5 mm aquém do forame apical, em 21 canais. Os resultado foram avaliados através de lupa esteroscópica e radiografias. A avaliaçäo através de lupa esteroscópica, apontou que o Foramatrom III foi fiel em 38,1 por cento dos registros dos instrumentos no cnal radicular, 0,5 ,, aquém do forame. A avaliaçäo radiográfica indicou uma precisäo de 42,8 por cento . As radiograficas tomadas pela técnica da bissetriz foram fieis e, 61,9 por cento dos casos

Cimentos endodônticos / Endodontics cements

Os autores avaliaram o tempo de presa e o escoamento de dois cimentos obturadores de canais radiculares. Um à base de hidróxido de cálcio (Sealapex) e outro a base de óxido de zinco e eugenol (Endofill), fórmula do cimento de Grossman. Cada cimento foi dividido em dois grupos: sem umidade (I) e com umidade (II). Houve diferença acentuada nos tempos de presa entre os dois cimentos obturadores e os dois grupos. Ambos os cimentos obturadores apresentaram escoamento adequado e uniforme