Increasing the Thickness of the Collagen Xenogeneic Matrix Prevents Early Matrix Degradation and Improves the Proliferation, Adhesion, and Viability of Human Gingival Fibroblasts and Mesenchymal Stem Cells.

Using autogenous grafts in mucogingival surgeries is related to postoperative morbidity and limited tissue availability, and thus xenogeneic matrices are increasingly used. This in vitro study evaluated the influence of xenogeneic collagen matrix thickness on cell adhesion, morphology, viability, proliferation, and matrix degradation. Matrices were divided into three groups: SLC: single layer of Lumina Coat, as commercially available (2-mm thickness); DLC: double layer of SLC (Lumina Coat); and MG: single layer of Mucograft, as commercially available (4-mm thickness). SEM was used to evaluate the matrix surface topographies. To evaluate the cell viability, proliferation, adhesion, and morphology, human gingival fibroblasts (HGF) and stem cells from human exfoliated deciduous teeth (SHED) were used. Cell viability was evaluated through MTS colorimetric method evaluating HGF and SHED on days 1, 3, and 7. Cell proliferation was assessed by PicoGreen assay, evaluating HGF and SHED on days 3 and 7. Sample degradation was evaluated on days 1, 3, 7, 14, 21, 28, and 35. All groups were biocompatible for HGF and SHED, showing viabilities > 70% on days 1, 3, and 7. DCL promoted HGF viabilities similar to MG (P = .2828) and the highest SHED viability (P < .0001) on day 1. DLC also demonstrated HGF and SHED proliferations higher than the positive control (MG; P < .05) on day 7. SLC was completely degraded on day 14, while DLC and MG presented 48.41% and 20.52% of their initial mass, respectively, on day 35. Increasing the matrix thickness improved HGF and SHED viability and proliferation and prevented early matrix degradation. DLC demonstrated better results than SLC and MG concerning matrix degradation and HGF and SHED viability and proliferation.

Recubrimiento de las recesiones gingivales con la técnica de injerto conjuntivo subepitelial asociado al deslizamiento coronario del colgajo: relato de caso clínico / Coronal positioned flaps associated with free subepitelial conective tissue graft for treatment of gingival recession: clinical case report

Recesión gingival es definida como la localización apical del margen gingival en relación a la unión cemento - esmalte, siendo predominante en la cara vestibular de los dientes. Además de provocar una desarmonía en la estética, puede causar sensibilidad destinaría. Para el tratamiento de recesiones gingivales han sido propuestas técnicas que pueden ser agrupadas en injertos pediculados, injertos libres y regeneración de tejidos guiada. El objetivo de este trabajo es relatar el caso clínico de un paciente con recesiones gingivales generalizadas. Luego de la anamnesis y examen clínico, se atribuye la etiología de las recesiones al cepillado incorrecta y trauma oclusal. Se realizó una adecuada instrucción de higiene bucal y ajuste oclusal. Se procedió a la aplicación de nitrato de potasio al 5 por ciento por dos meses, sin embargo, él paciente se quejaba de sensibilidad y del aspecto estético. Para el recubrimiento de las raíces expuestas fueron realizadas las técnicas de colgajo posicionado coronalmente asociado y no asociado al injerto conjuntivo subepitelial. Luego de un año los dientes muestran ausencia de sangramiento y sensibilidad destinaría, con profundidad de sondaje normal (<3mm). Los resultados de esta técnica se muestran satisfactorios, atendiendo las expectativas del paciente

Gingival recession is defined as the apical location of the gingival in relation to the cement-enamel junction, being predominant in buccal aspect. Other than causing esthetic disharmony, it can cause dentine sensitive. To treat gingival recession, the following techniques can be employed: pedicle gingival graft, free gingival graft, and guided tissue regeneration. The purpose of this study is to present a case report with generalized gingival recession. After anamneses and clinical exam, the etiology of the gingival recession was indicated as incorrect oral hygiene and occlusal trauma. The patient receive adequate oral hygiene instruction and the occlusion was adjusted. Five percent potassium nitrate was applied locally for two months, however, the patient still complained of dentine sensitivity and lack of esthetics. For root coverage, coronal positioned flaps were conduct with or without free subepithelial connective tissue. One year later the teeth presented absence of bleeding and dentine sensitive, with normal probe depth (<3mm). The results of this techniques fulfilled the patients esthetic need and eliminated the dentinal sensitivity