Periodontal and prosthetic biologic considerations to restore biological width in posterior teeth.

The biologic width is an essential dental space that always needs to be maintained to ensure periodontal health in any dental prosthetic restorations. An iatrogenic partial fixed prosthesis constructed in lower posterior teeth predisposed the development of subgingival caries, which induced violation of the biologic width in involved teeth, resulting in an uncontrolled inflammatory process and periodontal tissue destruction. This clinical report describes a periodontal surgical technique to recover a violated biologic width in lower posterior teeth, by crown lengthening procedure associated with free gingival graft procedure, to ensure the possibility to place a modified partial fixed prosthesis in treated area. The procedure applied to recover the biologic width was crown lengthening with some modifications, associated with modified partial fixed prosthesis to achieve health in treated area. The modified techniques in both surgical and prosthetic procedures were applied to compensate the contraindications to recover biologic width by osteotomy in lower posterior teeth. The result, after 4 years under periodic control, seems to achieve the projected goal. Treating a dental diseased area is necessary to diagnose, eliminate, or control all etiologic factors involved in the process. When the traditional methods are not effective to recover destructed tissues, an alternative, compensatory, and adaptive procedure may be applied to restore the sequelae of the disease, applying a restorative method that respects the biology of involved tissues.

Presence of bacteria in dentinal tubules.

This study demonstrated that a significant number of bacteria is present in the radicular dentinal tubules of periodontally diseased human teeth. Ten periodontally diseased teeth were prepared and stained by Brown and Brenn technique for histological examination. Bacteria were detected in all teeth. It is suggested that bacteria may invade dentinal tubules exposed to periodontal pocket and are very hard to be eliminated by conventional mechanical and chemical periodontal therapy. Contaminated dentinal tubules of periodontally diseased teeth can thus act as active bacterial reservoirs to promote recolonization of mechanically treated root surfaces, which could interfere with the periodontal healing and progression of the disease.

Procedimentos básicos em periodontia: método lógico para estabilizar a doença periodontal avançada / Basic periodontal therapy: logical method to stabilize advanced periodontal disease – case report

Para tratar a doença periodontal, é essencial controlar todos os agentes etiológicos envolvidos que possam desencadear a doença. Os procedimentos básicos são um conjunto de métodos aplicados para eliminar e/ou estabelecer um controle em todos os fatores etiológicos envolvidos no desenvolvimento da doença periodontal. Neste trabalho, alguns detalhes para estabilizar a doença periodontal avançada através dos procedimentos básicos serão analisados e discutidos.

Presence of bacteria in dentinal tubules

This study demonstrated that a significant number of bacteria is present in the radicular dentinal tubules of periodontally diseased human teeth. Ten periodontally diseased teeth were prepared and stained by Brown and Brenn technique for histological examination. Bacteria were detected in all teeth. It is suggested that bacteria may invade dentinal tubules exposed to periodontal pocket and are very hard to be eliminated by conventional mechanical and chemical periodontal therapy. Contaminated dentinal tubules of periodontally diseased teeth can thus act as active bacterial reservoirs to promote recolonization of mechanically treated root surfaces, which could interfere with the periodontal healing and progression of the disease.

Resolução da alteração estética em dente anterior com projeção cervical de esmalte / Resolution of the aesthetic alteration in anterior tooth with cervical enamel projection

As projeções de esmalte são mais prevalentes nas áreas de furca de dentes posteriores, e são consideradas como fatores predisponentes para o início da doença periodontal localizada. Quando em dentes anteriores, podem determinar alterações estéticas semelhantes às recessões gengivais. Neste caso clínico, relatou-se a resolução de uma projeção de esmalte em um dente anterior com alto comprometimento estético, através da aplicação de cirurgia mucogengival.