Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 19.027
Filtrar
1.
Int J Periodontics Restorative Dent ; 40(5): 749-756R, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32926005

RESUMO

This investigation was designed to evaluate the long-term effectiveness of human placental allograft in root coverage procedures in terms of clinical and esthetic outcomes. Thirteen patients with 28 maxillary or mandibular recession defects > 4 mm deep were reexamined at 6 months and 5 years postoperatively. Overall, mean percentage of root coverage decreased from 65.58% ± 16.45% to 49.75% ± 19.40% with a greater stability of the gingival margin in the mandible. At 5 years, 18 sites maintained at least 2 mm of keratinized tissue. Gingival color and texture blended well with adjacent soft tissue area in 78.6% of treated sites.


Assuntos
Retração Gengival , Aloenxertos , Tecido Conjuntivo/transplante , Estética , Feminino , Gengiva , Humanos , Gravidez , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
2.
Compend Contin Educ Dent ; 41(8): 426-431, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32870699

RESUMO

A gingival fenestration is a localized perforation of keratinized gingival tissue that may result in underlying bone resorption and root exposure. This case report describes treatment of mandibular lingual gingival fenestrations caused by traumatic forces from an ill-fitting removable partial denture that rested on a thin periodontal phenotype. A subepithelial connective tissue graft was used to correct these fenestrations. At the 2-year follow-up, the gingival tissues presented in a state of health.


Assuntos
Retração Gengival , Tecido Conjuntivo , Seguimentos , Gengiva , Humanos , Raiz Dentária
3.
Clin Oral Investig ; 24(10): 3395-3406, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32851531

RESUMO

OBJECTIVES: This study aimed to conduct a network comparison of the clinical effect of connective tissue graft (CTG) substitutes on the treatment of gingival recessions using coronally advanced flap. MATERIALS AND METHODS: An electronic search without language or dates restrictions was performed in five databases and in Grey literature for articles published until May, 2020. The eligibility criteria comprised randomized controlled trials (RCTs) that analyzed the clinical outcomes of CTG substitutes when compared with coronally advanced flap (CAF) for the treatment of Miller class I and II (Cairo RT I) gingival recessions. A pairwise and network meta-analysis were conducted for each periodontal parameters to assess and compare the outcomes among different treatment arms for the primary and secondary outcomes. This systematic review (SR) was registered in INPLASY under number INPLASY202060075. RESULTS: Twenty-seven studies were included in the present SR. All analyzed CTG substitutes showed superior results when comparing with CAF alone for all periodontal parameters. However, when compared in a network, the acellular dermal matrix (ADM) demonstrated the best treatment ranking of probability results, followed by platelet-rich fibrin (PRF), enamel matrix derivative (EMD), and xenogeneic collagen matrix (XCM) for root coverage (RC). CONCLUSION: This SR observed that the association of biomaterials increases the effectiveness of RC in comparison with CAF alone. Based on the treatment ranking, although all the biomaterials analyzed showed a positive effect for RC, the ADM demonstrated the best results. CLINICAL RELEVANCE: To know the effectiveness of CTG substitutes for the treatment of gingival recessions.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Humanos , Metanálise em Rede , Raiz Dentária , Resultado do Tratamento
4.
J Med Life ; 13(2): 219-224, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742517

RESUMO

Periodontal disease is a chronic bacterial infection characterized by persistent inflammation, connective tissue breakdown, and alveolar bone destruction. The current study aimed to compare the connective tissue metabolism indices in rats with comorbidity-free periodontitis and in animals with periodontitis in a setting of hyper-and hypothyroidism. 12-14-week-old inbred white male rats (n=48) were included in the experiment. They were randomly divided into the following groups: control, animals with a model of periodontitis, animals with periodontitis in a setting of hyperthyroidism, animals with periodontitis in a setting of hypothyroidism. Serum levels of free thyroxine, free triiodothyronine, and thyroid-stimulating hormone were assayed using ELISA kits manufactured by Vector Best (Russia) to confirm the hyper- and hypothyroid status. Collagenolytic activity, the content of glycosaminoglycans, free hydroxyproline, and fucose, unbound with proteins in blood serum were assayed using the spectrophotometric method. We have found the increasing of collagenolytic activity by 46.1% (р<0.001), the content of free hydroxyproline by 74.1% (р<0.001), the content of glycosaminoglycans by 1.8 times (р<0.001), the content of fucose, unbound with proteins by 2.8 times (р<0.001) in rats with periodontitis vs. the control group. The development of periodontitis in a setting of thyroid dysfunction leads to an even more significant increase in the destruction of connective tissue, which is confirmed by a significant increase in the content of studied indices vs. euthyroid animals, both in hyperthyroidism and hypothyroidism.


Assuntos
Tecido Conjuntivo/metabolismo , Periodontite/complicações , Glândula Tireoide/fisiopatologia , Animais , Comorbidade , Masculino , Ratos , Hormônios Tireóideos/metabolismo
5.
Zhonghua Wai Ke Za Zhi ; 58(7): 555-557, 2020 Jul 01.
Artigo em Chinês | MEDLINE | ID: mdl-32610427

RESUMO

An estimate of about 50% of new liver cancer cases worldwide occur in China every year.Surgical resection is still the major treatment choice for longer survival of patients with hepatocellular carcinoma. Blocking hepatic blood flow and reducing intraoperative bleeding ensure the success of the operation. Anatomic separation of hepatic hilar region is the precondition of hepatic inflow occlusion. The hepatic hilar plate system involves a thick layer of connective tissue covering the hepatic inflow ducts of hepatic hilar region. The descending part of hilar plate assists in reducing the anatomical difficulty of the hepatic hilar region. The "forth porta hepatis" that is hidden in the hepatic hilar plate system involves the accumulation area of "short hepatic portal veins" .The communicating branch vessels between the hepatic inflow vessels form the anatomical basis in reducing the indocyanine green fluorescence stain effect.The relatively fixed position of the hepatic portal plate is considered as a positioning marker for accurate liver resection. The intrahepatic Glisson sheath is connected with thick connective tissue of the hepatic portal panel system, and is regarded as the physical barrier in limiting the proliferation and hypertrophy of hepatocytes and continuation of hepatic portal panel system in the liver.This paper summarizes the anatomy and application of hepatic hilar plate system during hepatobiliary surgery.


Assuntos
Carcinoma Hepatocelular/cirurgia , Hepatectomia/métodos , Neoplasias Hepáticas/cirurgia , Fígado/anatomia & histologia , Fígado/cirurgia , Perda Sanguínea Cirúrgica/prevenção & controle , China , Tecido Conjuntivo/anatomia & histologia , Tecido Conjuntivo/cirurgia , Hepatectomia/efeitos adversos , Humanos , Fígado/irrigação sanguínea , Veia Porta/anatomia & histologia , Veia Porta/cirurgia
6.
Zhongguo Zhen Jiu ; 40(7): 765-70, 2020 Jul 12.
Artigo em Chinês | MEDLINE | ID: mdl-32648402

RESUMO

OBJECTIVE: To observe the effect of electroacupuncture (EA) preconditioning on the expressions of tyrosine kinase Lyn and spleen tyrosine kinase (Syk) in mast cells of subcutaneous loose connective tissue in the rats with urticaria and explore the potential biological mechanism of EA in the intervention of urticaria. METHODS: A total of 32 SD rats were randomized into a blank group, a model group, an EA group and a positive medication group, 8 rats in each one. Except of the blank group, the passive cutaneous anaphylaxis (PCA) was adopted to prepare the model of urticaria in the rats of the rest three groups. In the EA group, EA was applied to bilateral "Quchi" (LI 11), "Xuehai" (SP 10) and "Zusanli" (ST 36), with disperse-dense wave, 2 Hz/15 Hz in frequency and 1 mA in current intensity, once daily, for 20 min each time, consecutively for 7 days. In the positive medication group, loratadine (1 mg•kg-1•d-1) was for intragastric administration, once daily, consecutively for 7 days. The samples were collected for index detection 30 min after PCA antigen challenge in the rats of each group. Spectrophotometer was adopted to determine the effusion quantity of Evans blue in the allergized site of skin. HE staining was used to observe the morphological changes in the allergized site of skin. Toluidine blue staining was provided to observe mast cell degranulation in subcutaneous loose connective tissue in the allergized site of skin. Immunohistochemistry was applied to determine the protein expressions of Lyn and Syk during degranulation of mast cells. RESULTS: In the rats of the odel group, the eipdermis of allergized site was thickening, cells were disorganized in hierarchy and inflammatory cells were infiltrated largely in the dermis. In the positive medication group and the EA group, the epidermis was getting thin, cell arrangement was clear and the inflammatory cell infiltration was obviously alleviated as compared with the model group. Compared with the blank group, the OD value of skin dye effusion quantity, the degranulation rate of mast cells and the positive expressions of Lyn and Syk were all increased in the model group (P<0.01). Compared with the model group, the OD value of skin dye effusion quantity, the degranulation rate of mast cells and the positive expressions of Lyn and Syk were all reduced in the EA group and the positive medication group (P<0.01). Compared with the positive medication group, the degranulation rate of mast cells was increased significantly in the EA group (P<0.01). CONCLUSION: Electroacupuncture at "Quchi" (LI 11), "Xuehai" (SP 10) and "Zusanli" (ST 36) reduces vascular permeability and gives play to the role of anti-allergy by the way of regulating and controlling the degranulation of mast cells in the rats with urticaria and the effect mechanism of electroacupuncture may be related to the inhibition of protein expressions of Lyn and Syk in mast cells.


Assuntos
Tecido Conjuntivo/metabolismo , Eletroacupuntura , Mastócitos/metabolismo , Quinase Syk/metabolismo , Urticária/terapia , Quinases da Família src/metabolismo , Pontos de Acupuntura , Animais , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
7.
Chin J Dent Res ; 23(2): 151-156, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32548606

RESUMO

Three patients diagnosed with peri-implant disease after osseointegration exhibited soft tissue oedema and fistulae. Treatment options for controlling the fistulae were investigated. Free subepithelial connective tissue grafts (SCTGs) and microinvasive surgery were used to improve the soft tissue biotype of the patients with fistulae. After SCTG surgery, the fistulae disappeared. The clinical outcomes were stable and aesthetic outcomes were satisfactory after 3-5 years of follow-up. Based on this study, utilising SCTG to improve the tissue biotype may be an effective clinical approach for controlling fistulae occurring during peri-implant disease.


Assuntos
Tecido Conjuntivo , Peri-Implantite , Gengiva , Humanos
8.
Artigo em Inglês | MEDLINE | ID: mdl-32559045

RESUMO

The free gingival graft (FGG) has been used predictably for gingival procedures aimed to increase the width of keratinized tissue (KT). Several soft tissue alternatives, such as xenografts and allografts, have been studied and proven to be successful with varying degrees. This pilot clinical case series evaluated the efficacy, safety, and initial clinical outcomes (measuring KT width) of a piscine xenograft material (Omega3 Wound, Kerecis) compared to the FGG (harvested from the patient palate) in correcting mucogingival deformities around teeth. A convenience sample of six subjects with unilateral or bilateral lack of KT were enrolled in the study. The primary objective of this pilot study was to determine the gain in width of KT. Secondary objectives included investigating the probing depth, recession depth, bleeding on probing, and inflammation score. There were three FGG sites and six xenograft sites. In bilateral-site treatments, FGG or piscine xenograft were randomly assigned. For unilateral sites, the piscine xenograft was used. Postoperatively, the patients returned for follow-up at 1, 2, 4, 12, 24, 48, and 52 weeks. All six subjects completed the 12-month study and reported uneventful healing. On average, the xenograft sites had a 3.25-mm gain in KT width, and the FGG had an average gain of 3.67 mm. This pilot clinical series showed the piscine xenograft to be safe and efficacious during healing and to increase the width of KT. Future studies may include a more robust study design with a greater number of subjects.


Assuntos
Retração Gengival/cirurgia , Procedimentos Cirúrgicos Bucais , Tecido Conjuntivo , Gengiva , Gengivoplastia , Humanos , Projetos Piloto , Resultado do Tratamento
9.
Oral Maxillofac Surg ; 24(3): 363-368, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32533408

RESUMO

Eruption sequestrum (ES) is a single or even multiple, small whitish calcified masses found within the soft tissue of the opercula overlying the crown of erupting permanent molars of children. We herein report a well-documented case of ES, offering a review of published cases in the English literature. An otherwise healthy 6-year-old girl was seen for routine dental examination. A fragment of hard whitish tissue was observed in the gingiva overlying the erupting lower first permanent molar, which showed radiographic appearance of a faint round radiopacity above and separated from the occlusal surface of the related tooth. The patient was submitted to an excisional biopsy, and gross examination showed a hardened whitish fragment surrounded by gingival mucosa. Microscopic examination revealed odontogenic epithelium in association with chronic inflammatory infiltrate and small blood vessels in the connective tissue. Small concentric basophilic calcifications, round osteodentin, and pulp-like structures were also observed. The microscopic evaluation of additional cases of ES may improve the understanding of this uncommon inflamed odontogenic hamartoma.


Assuntos
Hamartoma , Dente Molar , Criança , Tecido Conjuntivo , Feminino , Gengiva , Humanos , Coroa do Dente
10.
Clin Oral Investig ; 24(8): 2543-2557, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32591868

RESUMO

OBJECTIVES: The aim of this systematic review and meta-analysis was to compare the use of platelet-rich fibrin (PRF) with other commonly utilized treatment modalities for root coverage procedures. MATERIALS AND METHODS: The eligibility criteria comprised randomized controlled trials (RCTs) comparing the performance of PRF with that of other modalities in the treatment of Miller class I or II (Cairo RT I) gingival recessions. Studies were classified into 5 categories as follows: (1) coronally advanced flap (CAF) alone vs CAF/PRF, (2) CAF/connective tissue graft (CAF/CTG) vs CAF/PRF, (3) CAF/enamel matrix derivative (CAF/EMD) vs CAF/PRF, (4) CAF/amnion membrane (CAF/AM) vs CAF/PRF, and (5) CAF/CTG vs CAF/CTG/PRF. Studies were evaluated for percentage of relative root coverage (rRC; primary outcome), clinical attachment level (CAL), keratinized mucosa width (KMW), and probing depth (PD) (secondary outcomes). RESULTS: From 976 articles identified, 17 RCTs were included. The use of PRF statistically significantly increased rRC and CAL compared with CAF alone. No change in KMW or reduction in PD was reported. Compared with PRF, CTG resulted in statistically significantly better KMW and RC. No statistically significant differences were reported between the CAF/PRF and CAF/EMD groups or between the CAF/PRF and CAF/AM groups for any of the investigated parameters. CONCLUSIONS: The use of CAF/PRF improved rRC and CAL compared with the use of CAF alone. While similar outcomes were observed between CAF/PRF and CAF/CTG for CAL and PD change, the latter group led to statistically significantly better outcomes in terms of rRC and KTW. In summary, the use of PRF in conjunction with CAF may represent a valid treatment modality for gingival recessions exhibiting adequate baseline KMW. CLINICAL RELEVANCE: The data indicate that the use of PRF in conjunction with CAF statistically significantly improves rRC when compared with CAF alone but did not improve KMW. Therefore, in cases with limited baseline KMW, the use of CTG may be preferred over PRF.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Humanos , Fibrina Rica em Plaquetas , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
11.
Quintessence Int ; 51(9): 710-719, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32577705

RESUMO

OBJECTIVES: To evaluate the healing of multiple adjacent type 1 and 2 gingival recessions (RT1 and RT2) treated with the modified coronally advanced tunnel (MCAT) or the laterally closed tunnel (LCT) in conjunction with a cross-linked hyaluronic acid and subepithelial palatal connective tissue grafts. METHOD AND MATERIALS: Fifteen healthy patients exhibiting multiple adjacent mandibular or maxillary RT1 and RT2 of a depth of ≥ 2 mm, were treated with the MCAT or LCT in conjunction with cross-linked hyaluronic acid and subepithelial palatal connective tissue grafts. Results were assessed at baseline and after a minimum of 6 months. The primary outcome variable was root coverage. Esthetic outcomes were evaluated on photographs using the root coverage esthetic score. RESULTS: Postoperative pain and discomfort were low and no complications occurred. Data analyses were performed at patient level. After a mean follow-up of 17 ± 5.4 months, statistically significant root coverage was obtained in all 15 cases (P < .0001). Complete root coverage was obtained in 3 out of 15 cases (20%). Root coverage amounted to > 95% in three patients, was between 90% and 95% in four patients, and reached 87.5% in another patient. In three further patients root coverage measured 75%, 77%, and 64.6%, respectively. Mean root coverage measured 85.1 ± 23.2%. Mean keratinized tissue width increased from 2.5 ± 1.0 mm to 3.7 ± 0.7 mm (P < .0001) from baseline to follow-up, while mean probing depth showed no statistically significant changes (1.3 ± 0.5 mm vs 1.5 ± 0.5 mm). The mean root coverage esthetic score was 7.9 ± 1.9, while in the three cases exhibiting complete root coverage, a maximum root coverage esthetic score (10) was given for all treated teeth. CONCLUSION: Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of multiple mandibular and maxillary RT1 and RT2.


Assuntos
Retração Gengival , Ácido Hialurônico , Tecido Conjuntivo , Gengiva , Humanos , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
12.
BMC Evol Biol ; 20(1): 73, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576155

RESUMO

BACKGROUND: Small leucine-rich repeat protein (SLRP) family members contain conserved leucine-rich repeat motifs flanked by highly variable N- and C-terminal regions. Most class II and III SLRPs have tyrosine-rich N-terminal regions and some of these are sulfated. However, the evolutionary origin and conservation of the tyrosine-rich and acidic terminal regions remain undetermined. In this study, we present the most comprehensive multiple sequence alignment (MSA) analyses of all eight class II and III SLRPs to date. Based on the level of conservation of tyrosine residues and adjacent sequences, we predict which tyrosine residues are most likely to be sulfated in the terminal regions of human class II and III SLRPs. RESULTS: Using this novel approach, we predict a total of 22 tyrosine sulfation sites in human SLRPs, of which only 8 sites had been experimentally identified in mammals. Our analyses suggest that sulfation-prone, tyrosine-rich and acidic terminal regions of the class II and III SLRPs emerged via convergent evolution at different stages of vertebrate evolution, coinciding with significant evolutionary events including the development of endochondral bones and articular cartilage, the aquatic to terrestrial transition, and the formation of an amnion. CONCLUSIONS: Our study suggests that selective pressures due to changes in life conditions led to the formation of sulfotyrosine-rich and acidic terminal regions. We believe the independent emergence and evolution of sulfotyrosine-rich and acidic N- and C-terminal regions have provided each class II and III SLRP member with novel vital functions required to develop new specialized extracellular matrices and tissues in vertebrate species.


Assuntos
Tecido Conjuntivo/metabolismo , Evolução Molecular , Proteínas/química , Proteínas/metabolismo , Sulfatos/metabolismo , Tirosina/metabolismo , Animais , Humanos , Proteoglicanas/química , Proteoglicanas/genética , Proteoglicanas/metabolismo , Vertebrados/metabolismo
13.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(3): 564-569, 2020 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-32541993

RESUMO

OBJECTIVE: To study the biodegradation properties of multi-laminated small intestinal submucosa (mSIS) through in vitro and in vivo experiments, comparing with Bio-Gide, the most widely used collagen membrane in guided bone regeneration (GBR) technique, for the purpose of providing basis to investigate whether mSIS meets the requirements of GBR in dental clinics. METHODS: The degradation properties were evaluated in vitro and in vivo. In vitro degradation was performed using prepared collagenase solution. Morphology of mSIS and Bio-Gide in degradation solution were observed and the degradation rate was calculated at different time points. In in vivo experiments, nine New Zealand rabbits were used for subcutaneous implantation and were divided into three groups according to observation intervals. Six unconnected subcutaneous pouches were made on the back of each animal and were embedded with mSIS and Bio-Gide respectively. At the end of weeks 4, 8, and 12 after operation, gross observation and HE staining were used to evaluate the degree of degradation and histocompatibility. RESULTS: In vitro degradation experiments showed that mSIS membrane was completely degraded at the end of 12 days, while Bio-Gide was degraded at the end of 7 days. Besides, mSIS maintained its shape for longer time in the degradation solution than Bio-Gide, indicating that mSIS possessed longer degradation time, and had better ability to maintain space than Bio-Gide. In vivo biodegradation indicated that after 4 weeks of implantation, mSIS remained intact. Microscopic observation showed that collagen fibers were continuous with a few inflammatory cells that infiltrated around the membrane. Bio-Gide was basically intact and partially adhered with the surrounding tissues. HE staining showed that collagen fibers were partly fused with surrounding tissues with a small amount of inflammatory cells that infiltrated as well. Eight weeks after operation, mSIS was still intact, and was partly integrated with connective tissues, whereas Bio-Gide membrane was mostly broken and only a few residual fibers could be found under microscope. Only a small amount of mSIS debris could be observed 12 weeks after surgery, and Bio-Gide could hardly be found by naked eye and microscopic observation at the same time. CONCLUSION: In vitro degradation time of mSIS is longer than that of Bio-Gide, and the space-maintenance ability of mSIS is better. The in vivo biodegradation time of subcutaneous implantation of mSIS is about 12 weeks and Bio-Gide is about 8 weeks, both of which possess good biocompatibility.


Assuntos
Materiais Biocompatíveis/metabolismo , Animais , Regeneração Óssea , Tecido Conjuntivo , Mucosa Intestinal , Intestino Delgado , Membranas Artificiais , Coelhos
14.
Quintessence Int ; 51(6): 456-463, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32368762

RESUMO

OBJECTIVES: To clinically evaluate the healing of mandibular Miller Class I and II isolated gingival recessions treated with the modified coronally advanced tunnel (MCAT) or laterally closed tunnel (LCT) combined with hyaluronic acid (HA) and subepithelial connective tissue graft (SCTG). METHOD AND MATERIALS: Twelve healthy patients exhibiting one isolated mandibular Miller Class I or II (Cairo Class 1) gingival recession of a depth of ≥ 3 mm, were consecutively treated with the MCAT or LCT in conjunction with HA and SCTG. Treatment outcomes were assessed at baseline and at least 6 months postoperatively. The primary outcome variable was complete root coverage (CRC). RESULTS: Postoperative pain and discomfort were low and no complications such as postoperative bleeding, allergic reactions, abscesses, or loss of SCTG occurred. After a mean follow-up of 18.9 ± 10 months, statistically significant (P < .0001) root coverage was obtained in all 12 defects. CRC was measured in six out of the 12 cases (50%), four cases showed a root coverage of over 95%, while the remaining two cases reached 80% and 85%. Mean root coverage was 96.09%. Mean keratinized tissue width increased from 1.6 ± 0.8 mm to 4.9 ± 1.3 mm (P < .0001) from baseline to follow-up, while mean probing depth showed no statistically significant changes (1.8 ± 0.9 mm vs 1.3 ± 0.5 mm). CONCLUSION: Within their limits, the present results indicate that the described treatment approach may lead to predictable root coverage of isolated mandibular Miller Class I and II (Cairo Class 1) gingival recessions. (Quintessence Int 2020;51:456-463; doi: 10.3290/j.qi.a44492).


Assuntos
Retração Gengival , Ácido Hialurônico , Tecido Conjuntivo , Gengiva , Humanos , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
15.
Indian J Dent Res ; 31(2): 209-216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32436899

RESUMO

Introduction: The main goal of periodontal plastic surgery is obtaining complete root coverage (CRC) and an optimal appearance. Aim: The aim of this study was to evaluate the effectiveness of a three-dimensional porcine collagen matrix (PCM) with coronally advanced flap (CAF) in treating of Miller type I and II gingival recession (GR). Materials and Methods: Twenty patients were enrolled in this study, presenting 40 Miller type I and II GR. Patients were randomized into test group (PCM + CAF) and control group [connective tissue graft (CTG + CAF)]. Clinical parameters such as recession depth (RD), probing depth, clinical attachment level (CAL), and width of keratinized gingiva (WKG) were evaluated at baseline and 12 months later. Root coverage percentage (RC%) and CRC were assessed at 12 months post surgically. Statistical analysis was performed using independent t-test for intergroup comparison. Statistical significance was set at 0.05. Results: The mean RD at 12 months was 0.20 mm for the test group and 0.12 mm for the control group, whereas the mean RC% was 94.22% for PCM + CAF and 96.48% for CTG + CAF. CRC was higher in CTG + CAF with 80%. CAL gain was 2.05 and 2.07 mm in the test and control sites, respectively. The gain of WKG was 1.35 and 1.30 mm in the test and control sites, respectively. Patient esthetic satisfaction at 12 months post surgically in both groups was equivalent. Conclusion: Within the limits of this study, using of PCM + CAF in treating GR is a successful and effective treatment option and could serve as an alternative to CTGs.


Assuntos
Colágeno , Retração Gengival , Animais , Tecido Conjuntivo , Estética Dentária , Seguimentos , Gengiva , Humanos , Suínos , Raiz Dentária , Resultado do Tratamento
16.
Int J Oral Maxillofac Implants ; 35(3): 461-478, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32406642

RESUMO

PURPOSE: The aim of this study was to investigate the effect of implant and surgical characteristics on the mucosal vertical dimension components. Mucosal vertical dimension consists of the sulcular epithelium and the supracrestal tissue attachment, which can be clinically measured from the gingival margin to the bone-to-implant contact. Connective tissue attachment is measured from the apical border of attached epithelium to the first bone-to-implant contact, while epithelial vertical dimension is measured from the mucosal margin to the apical border of attached epithelium. MATERIALS AND METHODS: An electronic and manual search for relevant articles published from January 1980 to May 2019 was performed. Animal studies of ≥ 10 implants followed by histometric analysis were included. Quality assessment was performed using the ARRIVE guidelines, and risk of bias assessment was performed using SYRCLE guidelines. Subgroup meta-analysis was performed to analyze the influence of different surgical approaches and implant design. RESULTS: A total of 38 articles were included. The mean value and corresponding standard error of mucosal vertical dimension, supracrestal tissue attachment, connective tissue attachment, and epithelial vertical dimension were 3.39 ± 0.07 mm, 2.9 ± 0.12 mm, 1.35 ± 0.04 mm, and 2.0 ± 0.06 mm, respectively. Supracrestal and subcrestal bone-level implants had significantly higher mucosal vertical dimension than equicrestal bone-level implants. Platform-switching implants demonstrated significantly lower mucosal vertical dimension compared with non-platform-switching implants. CONCLUSION: Within its limitations, this review showed that equicrestal implants had a smaller mucosal vertical dimension than subcrestal and supracrestal implants, and platform-switching implants possessed a smaller mucosal vertical dimension.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Animais , Tecido Conjuntivo , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Dimensão Vertical
17.
Artigo em Inglês | MEDLINE | ID: mdl-32233184

RESUMO

The aim of this present prospective study was to evaluate the outcomes of the multiple coronally advanced flap (MCAF) with a site-specific application of connective tissue graft (CTG) for the treatment of multiple gingival recession defects with or without the presence of noncarious cervical lesions (NCCLs). Analysis of periodontal conditions was performed in order to determine if the cementoenamel junction (CEJ) restorations could affect adequate plaque control as well as maintenance over time. A total of 93 gingival recessions were treated, 61% of which presented a NCCL restored with composite resin positioned 1 mm apical to the position of the anatomical CEJ. The surgical treatment involved MCAF+CTG for 54 sites and MCAF alone for 39 sites. At 12 months, complete root coverage (CRC) and periodontal parameters of restored and nonrestored teeth were assessed, and the differences between the two groups were not significant. It can be concluded that the proposed treatment modality does not produce a negative effect on periodontal condition and amount of CRC, thus resulting in a satisfactory esthetic result.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Humanos , Estudos Prospectivos , Colo do Dente , Raiz Dentária , Resultado do Tratamento
18.
Int J Periodontics Restorative Dent ; 40(3): e103-e110, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32233187

RESUMO

The aim of this study was to compare the use of gingival unit graft (GUG) with free gingival graft (FGG) for treating wide gingival recession and increasing keratinized tissue. This randomized controlled trial with a split-mouth design included 30 localized bilateral recessions (Miller Classes I and II) that were randomly treated with GUG or FGG. Both grafts were fixed by cyanoacrylate glue. Probing depth, clinical attachment level, vertical recession depth, and keratinized tissue width were recorded at baseline and 1 and 6 months after surgery. The postoperative mean percentage of root coverage at 1 and 6 months was better on GUG side, and KTW significantly increased on the same side 1 month after surgery (P < .05). GUG might be an acceptable modality for increasing keratinized tissue and treating recession.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Bucais , Tecido Conjuntivo , Assistência Odontológica , Seguimentos , Gengiva , Humanos , Raiz Dentária , Resultado do Tratamento
19.
Int J Periodontics Restorative Dent ; 40(3): e127-e135, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32233197

RESUMO

The aim of this systematic review was to assess in patients with gingival recessions and noncarious cervical lesions (NCCLs) whether restoration of NCCLs may influence the percentage of root coverage following surgical root coverage procedures compared to surgical root coverage procedures without subsequent restoration. Four studies (randomized controlled trials) assessing the effects of NCCL restoration in combination with surgical root coverage procedures were included. Meta-analyses showed no significant differences in overall root coverage, CAL gain, and KTW change between test and control groups. In teeth with NCCLs and gingival recessions, restoration of NCCLs does not affect the clinical outcomes of surgical root coverage.


Assuntos
Retração Gengival , Tecido Conjuntivo , Diagnóstico Bucal , Gengiva , Humanos , Raiz Dentária , Resultado do Tratamento
20.
Indian J Dent Res ; 31(1): 67-72, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32246685

RESUMO

Introduction: One of the most common aesthetic concerns associated with the periodontal tissue is gingival recession. Covering the root surface exposed during the disease process with soft and hard tissue surgeries may decrease these problems. The aim of the study was to compare the clinical outcome of coronally advanced flap (CAF) procedure in root coverage with platelet-rich fibrin (PRF) or subepithelial connective tissue graft (SCTG) for the treatment of Miller's Class-I gingival recession. Materials and Methods: The split mouth design consisted of 15 patients with a total of 30 sites with bilateral Miller's Class-I recession on anterior teeth. They were randomly assigned into PRF group (test) or SCTG group (control). Statistical Analysis: The values obtained were tabulated and analyzed using Mann--Whitney U-test and repeated measure ANOVA test. All the statistical tests were carried out using SPSS software. Results: It was observed that both the autogenous grafts healed without any complications and at the end of 6 months the grafts were stable and recession coverage between 88-100% was achieved. Conclusion: CAF procedure with either PRF or SCTG were both effective in the treatment of Miller's Class-I gingival recessions. CAF with SCTG showed better root coverage than CAF with PRF. Use of PRF offered additional benefit of avoiding second surgical site. Therefore, PRF can be considered as a viable alternative to SCTG in certain cases.


Assuntos
Retração Gengival , Fibrina Rica em Plaquetas , Tecido Conjuntivo , Estética Dentária , Gengiva , Humanos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA