A modified tunnel technique to treat multiple gingival recessions: Case Series.

This case series reports a modified tunnel technique with connective tissue graft for the root coverage of multiple Miller Class I, II, and III gingival recessions. The modified approach presents an innovative suture technique to improve the stability and position of the graft. Ten patients with multiple gingival recessions (n=85 teeth) received surgical root coverage treatment. The gingival recession height and width were measured and presented as median, minimum, and maximum values. The percentage of the root coverage after at least 12 months expressed the treatment effectiveness. The Shapiro-Wilk test evaluated the normality; pared Wilcoxon test determined the exact P-value for the differences in the height of the gingival recession before and after surgical treatment (α = 0.05). An average of 97.9% (± 5.6%, p < 0.0001) root coverage after treatment occurred, and 73 out of 85 recessions presented complete root coverage after 12 months. Treatment of Miller class I and II gingival recessions resulted in root coverage higher than 99 and class III higher than 95% (p < 0.0001). The presented case series report the efficacy of a modified surgical technique promoting more than 95% of root coverage after 12 months in multiple Miller Class I, II, and III gingival recessions. Well-designed blind randomized controlled trials are needed to validate the proposed technique.

A modified tunnel technique to treat multiple gingival recessions: Case Series

Abstract This case series reports a modified tunnel technique with connective tissue graft for the root coverage of multiple Miller Class I, II, and III gingival recessions. The modified approach presents an innovative suture technique to improve the stability and position of the graft. Ten patients with multiple gingival recessions (n=85 teeth) received surgical root coverage treatment. The gingival recession height and width were measured and presented as median, minimum, and maximum values. The percentage of the root coverage after at least 12 months expressed the treatment effectiveness. The Shapiro-Wilk test evaluated the normality; pared Wilcoxon test determined the exact P-value for the differences in the height of the gingival recession before and after surgical treatment (α = 0.05). An average of 97.9% (± 5.6%, p < 0.0001) root coverage after treatment occurred, and 73 out of 85 recessions presented complete root coverage after 12 months. Treatment of Miller class I and II gingival recessions resulted in root coverage higher than 99 and class III higher than 95% (p < 0.0001). The presented case series report the efficacy of a modified surgical technique promoting more than 95% of root coverage after 12 months in multiple Miller Class I, II, and III gingival recessions. Well-designed blind randomized controlled trials are needed to validate the proposed technique.

Resumo Esta série de casos relata uma técnica de túnel modificada com enxerto de tecido conjuntivo para o recobrimento radicular de múltiplas recessões gengivais Classe I, II e III de Miller. A abordagem modificada apresenta uma técnica de sutura inovadora para melhorar a estabilidade e a posição do enxerto. Dez pacientes com múltiplas recessões gengivais (n=85 dentes) receberam tratamento cirúrgico de recobrimento radicular. A altura e a largura da recessão gengival foram mensuradas e apresentadas como valores medianos, mínimos e máximos. A eficácia do tratamento foi expressa como uma porcentagem da cobertura radicular após pelo menos 12 meses. O teste de Shapiro-Wilk avaliou a normalidade; o teste de Wilcoxon pared determinou o valor P exato para as diferenças entre a altura da recessão gengival antes e após o tratamento cirúrgico (α = 0,05). Uma média de 97,9% (± 5,6%, p < 0,0001) de cobertura radicular após o tratamento ocorreu, e 73 das 85 recessões apresentaram cobertura radicular completa após 12 meses. O tratamento das recessões gengivais classe I e II de Miller resultou em recobrimento radicular superior a 99 e classe III superior a 95% (p < 0,0001). A série de casos apresentada relata a eficácia de uma técnica cirúrgica modificada promovendo mais de 95% de cobertura radicular após 12 meses em múltiplas recessões gengivais Classe I, II e III de Miller. Ensaios controlados randomizados cegos bem desenhados são necessários para validar a técnica proposta.

Histomorphometric analysis of hydroxyapatite-coated implants in rabbit cortical bone using longitudinal and transverse histologic sections.

PURPOSE: The aim of this study was to compare the osseointegration percentage of biomimetic hydroxyapatite (HA)-coated implants on longitudinal and transverse histologic sections using scanning electron microscopy. MATERIALS AND METHODS: Ten commercially pure titanium dental implants, measuring 3.75 mm in diameter and 10 mm in length, were coated with HA by the biomimetic process and installed on the proximal metaphysis of the right tibia of 10 adult New Zealand female rabbits (Oryctolagus cunniculus). After a 3-month healing period, the animals were killed and the implants were removed together with the neighboring bone tissue. The specimens were than dehydrated on a crescent concentration of ethanol solution and embedded on resin. The osseointegration percentage of biomimetic HA-coated implants on 1 longitudinal and 1 transverse section were compared, using scanning electron microscopy and computerized histomorphometry. RESULTS: It was verified that there were no statistically significant differences between the results of the different histological section directions (P > 0.05). CONCLUSION: Thus, in this study, the direction of histological sections did not affect bone-implant percentage.

Critérios para a análise histomorfométrica da interface osso/implante em coelhos: revisão de literatura / Histomorphometric analysis criterion for bone/implant interface in rabbits: a literature review

Os estudos experimentais sobre osseointegração devem incluir uma avaliação quantitativa cuidadosa do percentual de contato direto entre o tecido ósseo e o substrato implantado, pois o termo “osseointegração”, sem levar em consideração a quantificação, poderia ser aplicado aos mais diversos materiais. O objetivo deste artigo é avaliar, através da revisão da literatura, os fatores que podem alterar o resultado da análise histomorfométrica da interface osso/implante, quando realizada em coelhos

Experimental studies about osseointegration should include a carefully quantitative evaluation of the direct contact between bone tissue and the implanted substrate, therefore the use of the term “osseointegration”, without considering quantification, could be applied to the most different materials. The purpose of this article is to evaluate the factors that can modify the results of histomorphometric analyses of bone/implant in rabbits

Fatores locais que determinam o fenótipo gengival ao redor de implantes dentários: revisão de literatura / Local factors that determine the gingival phenotype around dental implants: a literature review

A meta da Implantodontia atual deve ser uma restauração implanto-suportada que esteja em harmonia com os tecidos mucoso e ósseo circundantes. O objetivo deste artigo é avaliar os fatores anatômicos, cirúrgicos, protéticos e biológicos que determinam o fenótipo gengival ao redor dos implantes osseointegrados.