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1.
Stomatologiia (Mosk) ; 99(1): 89-94, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32125310

RESUMEN

Description of the clinical case of the patient with narrowing and deformation of the dentition of the upper and lower jaw and crowded teeth in the frontal part of the lower jaw in combination with a thin gingival biotype. The combined use of diagnostic methods: colorimetric probe, ultrasonic scanning and cone-beam computed tomography, followed by computer 3D-modeling of the treatment plan made it possible to competently plan and implement orthodontic treatment of the patient without complications from periodontal tissues. Combined application of colorimetric probe, ultrasonic and cone-beam computed tomography methods with digital 3D-modeling of the treatment plan allowed to plan and carry out orthodontic treatment of a patient with a thin gingival biotype without periodontal complications.


Asunto(s)
Encía , Maloclusión , Tomografía Computarizada de Haz Cónico , Atención Odontológica , Humanos , Periodoncio
2.
Am J Orthod Dentofacial Orthop ; 157(3): 340-347, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32115112

RESUMEN

INTRODUCTION: This study aimed to evaluate the effect of the relationship between maxillary incisors and lower lip in conjunction with the maxillary gingival display on perception of smile attractiveness. METHODS: The frontal intraoral photograph of ideally aligned teeth was modified using image processing software. Twenty different smiles were obtained with a combination of 10 different maxillary incisor edge-lower lip distances and 10 different maxillary gingival display amounts. Attractiveness of these 20 smiles was evaluated by orthodontists (n = 101), dentists (n = 107), and laypersons (n = 105). Two-way ANOVA was used to compare alterations on smile esthetics, and repeated measures ANOVA was used to evaluate the interaction between the variables. Bonferroni-adjusted pairwise comparisons were applied for determining the differences between the rater groups. RESULTS: Maxillary incisor edge-lower lip distance (P < 0.01), maxillary gingival display amount (P < 0.001), and rater group (P < 0.01) had statistically significant influences on perception of smile attractiveness. Orthodontists prefer to see a minimal amount of mandibular incisor exposure and almost full crowns of maxillary central incisors. Dentists and laypersons are more tolerant of mandibular incisor exposure and maxillary central incisor coverage by the upper lip. None of the rater groups preferred the coverage of maxillary incisor edges or maxillary gingival display. CONCLUSIONS: Elimination of maxillary gingival display helps to improve smile attractiveness, whereas the coverage of maxillary incisor edges has a negative influence.


Asunto(s)
Estética Dental , Incisivo , Labio , Sonrisa , Encía , Humanos
3.
Dent Clin North Am ; 64(2): 341-349, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32111273

RESUMEN

Excessive gingival display or "gummy smile" is a growing concern to dental patients and often considered detrimental to an esthetic smile. Gingival display of more than 4 mm of gingiva is considered by many to be unattractive. The cause of the gummy smile can be multifactorial and must be accurately diagnosed to render appropriate treatment. Factors that contribute to the gummy smile include altered passive eruption, lip length, lip hypermobility, incisal wear/crown length, and vertical maxillary excess and gingival hyperplasia. The purpose of this article is to review the etiology, diagnosis, and surgical approaches in treating the gummy smile.


Asunto(s)
Estética Dental , Labio , Encía , Gingivectomía , Humanos , Sonrisa
4.
Dent Clin North Am ; 64(2): 435-451, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32111279

RESUMEN

Many soft-tissue grafting solutions are available for reconstruction and restoration of volume and esthetics of keratinized attached mucosa at compromised periodontal and peri-implant interfaces. Presence of healthy soft tissues is crucial for functional and esthetic implant success as well as longevity of natural dentition. The options available each provide unique characteristics with different indications. This article is intended to provide an efficient and comprehensive overview of this topic, covering the essentials of periodontal anatomy and physiology, indications for soft-tissue grafting, and keys in recipient and donor-site preparation, and exploring the available procedural arsenal in soft-tissue grafting.


Asunto(s)
Implantes Dentales , Estética Dental , Encía , Humanos
5.
Quintessence Int ; 51(4): 274-284, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32020128

RESUMEN

OBJECTIVE: The aim of this study was to compare and evaluate the clinical results obtained in the maxilla and mandible by taking digital impressions following application of hyaluronic acid fillers for the reconstruction of multiple papillary losses. METHOD AND MATERIALS: Evaluation was made of a total of 200 papilla spaces in 20 patients applied with hyaluronic acid filler injection to consecutive papillae regions in both arches symmetrically. The area of the interdental space and the percentage change in the area value over time was calculated separately for each papilla space by taking digital impressions before the application of hyaluronic acid and at 3, 12, and 24 months after the application. RESULTS: A significant improvement was determined in the area values of both arches at 3, 12, and 24 months compared to the baseline values. In the percentage change at 24 months, irrespective of whether the mandible or maxilla, the highest filling percentage of all the spaces was between the canine and lateral incisors. When the 24-month filling percentages were compared between the maxillae and mandibles, the most significant difference was between the central teeth. CONCLUSION: The results showed that success was obtained in both arches with hyaluronic acid filler injection applied for reconstruction of multiple papilla losses; because the filling percentages in the maxilla at 3 months and 12 months were greater than those in the mandible, it can be suggested that results can be obtained more quickly and at a higher level in the maxilla.


Asunto(s)
Encía , Ácido Hialurónico , Humanos , Incisivo , Inyecciones , Maxilar
6.
Quintessence Int ; 51(4): 286-292, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32080683

RESUMEN

An alternative approach was used to increase the buccal vestibular depth of two edentulous patients, using free epithelialized palatal grafts. Two edentulous patients presented with shallow vestibules and inadequate keratinized tissue width in the mandibular anterior region. These sites were treated with vestibuloplasty followed by placement of an epithelialized palatal graft. In order to minimize graft movement and possible mechanical trauma to the area, the graft was covered with the buccal flap during the initial stages of healing. The patients maintained an increase in the vestibular depth as well as the keratinized tissue width at 14 months and 5 years postoperatively. Successful outcomes in terms of increase in vestibular depth can be achieved with the use of epithelialized palatal graft that is covered during the initial stage of healing. The dental practitioner fabricating the complete denture should be aware of the advantages offered by this alternative surgical technique.


Asunto(s)
Colgajos Quirúrgicos , Vestibuloplastia , Encía , Humanos
7.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(2): 73-79, 2020 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-32074666

RESUMEN

Objective: To establish a quantitative three-dimensional method based on intraoral scan to evaluate the changes of soft tissue, and to evaluate the changes of supracrestal gingival thickness (SGT) in skeletal class Ⅲ patients induced by periodontal regenerative and corticotomy surgery (PRCS). Methods: Twenty-two systematically and periodontally healthy skeletal class Ⅲ patients (4 males and 18 females, aged between 19 and 35 years), who were in need of combined orthodontic-orthognathic treatment and referred to the Department of Periodontology from the Department of Orthodontics and the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from January, 2018 to March, 2019, were collected in the study. The teeth involved were 112 anterior teeth (46 maxillary anterior teeth and 66 mandibular anterior teeth). PRCS in anterior tooth area was conducted before orthodontic decompensation. Probing depth (PD), bleeding index (BI) and keratinized gingiva width (KGW) were recorded before surgery and 6 months post-surgery. The intraoral digital impressions of maxillary and mandibular anterior teeth were obtained by 3-shape intraoral scanner before surgery and 6 months after surgery. The Standard Tessellation Language (STL) files were processed using Geomagic qualify 12.2 software to establish the soft tissue morphological measurement model, and to quantitatively analyze the changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin on the median sagittal measurement plane. Results: Probing depth and bleeding index had no significant difference before and 6 months after operation (P>0.05). KGW in 6-month post-operation group [(5.18±2.32) mm] was significantly higher than that in pre-operation group [(4.22±1.43) mm] (P<0.05). Supracrestal gingival thickness situated 1 to 2 mm apical to the free gingival margin also significantly increased 6 months after surgery (P<0.05). The changes of gingival thickness situated 1 to 2 mm apical to the free gingival margin in the upper anterior area were (0.68±0.56) and (1.00±0.69) mm, respectively. The changes in the lower anterior area were (0.38±0.42) and (0.58±0.45) mm, respectively. The gingival changes of the upper anterior teeth were also significantly higher than those of the lower anterior teeth (P<0.01). Conclusions: The described quantitative measurement based on intraoral scan could be an effective method for quantitative evaluation of the changes of soft tissue. PRCS could safely increase the supracrestal gingival thickness as well as KGW in skeletal class Ⅲ patients who were in need of combined orthodontic-orthognathic treatment.


Asunto(s)
Encía/diagnóstico por imagen , Maloclusión de Angle Clase III , Procedimientos Quirúrgicos Orales , Adulto , Femenino , Humanos , Imagen Tridimensional , Masculino , Maxilar , Adulto Joven
8.
J Biol Regul Homeost Agents ; 34(1 Suppl. 1): 71-77, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32064838

RESUMEN

This article presents a case report of transmucosal implant with a convergent collar (PRAMA) inserted in the anterior maxillary esthetic area. The purpose of this study is to evaluate soft and hard tissue after 12 months. One implant was placed in the esthetic area. The implant was immediately loaded with a screwed provisional prosthesis. After 3 months the definitive screwed prosthesis was inserted. The patient was reassessed 12 months post-implant placement, and during the examination, the soft-tissue texture, color, and amount of keratinized tissue was checked. No statistically significant horizontal dimensional changes of the alveolar ridge were observed between each time-point. Mean soft tissue levels significantly improved between base-line and 12 months. The reduced buccal width of the transmucosal component gives more space to the gingival thickness and promotes stability and give a better seal. The use of transmucosal implant creates a shift of the inflammatory cell infiltrate away from the crestal bone level.


Asunto(s)
Proceso Alveolar , Implantes Dentales , Maxilar , Encía , Humanos , Resultado del Tratamiento
9.
Braz Oral Res ; 34: e013, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32074213

RESUMEN

This study evaluated the effect of a cyclopentenone-type PG, 15-Deoxy-Δ12,14-PG J2 (15d-PGJ2), and lectin (ScLL) on the viability of human gingival fibroblasts (HGFs), and on IL-6 and TGFß-1 release by these fibroblasts, stimulated with lipopolysaccharide (LPS). HGFs were stimulated with LPS 10 µg/ml and treated with 15d-PGJ2 1 and 2 µg/ml, and ScLL 2 and 5 µg/ml, for 1 and 3h, and then evaluated for viability by MTT assay. Supernatant was collected to detect IL-6 and TGFß-1 release, by ELISA. Positive control was cells kept in Dulbecco's Modified Eagle's Medium, and negative control was those kept in LPS. Data were analyzed by ANOVA and Dunnett's test (α = 0.05). No significant difference was found in viability among experimental groups at 1h (p > 0.05). Percentage of ScLL 5 µg/ml viable cells was similar to that of positive control at evaluated periods (p > 0.05), whereas the other groups had lower levels than the positive control (p < 0.05). IL-6 release was statistically higher for ScLL 5 µg/ml and 15d-PGJ2 2 µg/ml at 1h, compared with the other treated groups and positive control (p < 0.05). No significant differences were found among the groups at 3h (p > 0.05), except for ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml, which showed lower IL-6 release compared with that of negative control (p < 0.05). No significant difference was found among the groups for TGFß-1 release (p > 0.05). Results indicated that ScLL 5 µg/ml did not interfere in viability, and ScLL 2 µg/ml and 15d-PGJ2 1 µg/ml demonstrated reduced IL-6 release. Tested substances had no effect on TGFß-1 release.


Asunto(s)
Fibroblastos/efectos de los fármacos , Fibroblastos/metabolismo , Interleucina-6/metabolismo , Lipopolisacáridos/farmacología , Lectinas de Plantas/farmacología , Prostaglandina D2/análogos & derivados , Factor de Crecimiento Transformador beta1/metabolismo , Análisis de Varianza , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Ensayo de Inmunoadsorción Enzimática , Encía/citología , Humanos , Prostaglandina D2/farmacología , Valores de Referencia , Estadísticas no Paramétricas , Factores de Tiempo , Factor de Crecimiento Transformador beta1/efectos de los fármacos
10.
Compend Contin Educ Dent ; 41(2): 92-101, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32017587

RESUMEN

Gingival augmentation therapy is intended to create a healthy band of attached keratinized tissue to inhibit further gingival recession, facilitate plaque control, and improve patient comfort. Although an effective treatment for gingival augmentation procedures, the often-used autogenous epithelialized palatal graft has several drawbacks, including the need for a second surgical site to harvest the graft, the risk of such complications as damage to neurovascular tissue and poor healing of the donor site, and potential color and texture discrepancies of the grafted site. The use of a resorbable xenogeneic collagen-based matrix may be considered as a treatment alternative to augment soft tissue. The authors describe the application of such a graft that is made from purified porcine type I and type III collagen and processed without the addition of chemical cross-linkers. Two cases are presented that demonstrate the clinical advantages of this material compared to autogenous palatal grafts when augmenting the width and thickness of attached keratinized gingiva.


Asunto(s)
Encía , Recesión Gingival , Animales , Colágeno , Tejido Conectivo , Gingivoplastia , Humanos , Paladar (Hueso) , Porcinos
11.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 38(1): 104-107, 2020 Feb 01.
Artículo en Chino | MEDLINE | ID: mdl-32037776

RESUMEN

Hereditary gingival fibromatosis (HGF) is a familial hereditary disease; while it is rare and usually benign, it is also characterized by the slow and progressive development of gingival tissue. This paper reports on the clinical examina-tion and history of HGF in a family of patients.


Asunto(s)
Fibromatosis Gingival , Encía , Humanos
12.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(2): 129-134, 2020 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-32074677

RESUMEN

Research have indicated that inadequate keratinized tissue has a negative effect on patient oral hygiene, resulting in peri-implant inflammation. It has been recommended that an apically repositioned flap alone or in combination with autogenous soft tissue grafts can increase the width of keratinized mucosa around dental implants, which promotes long term peri-implant health. This review summarized research progress on augmentation techniques of keratinized tissue arround implants in recent years, so as to provide reference for clinical practice and research design in the future.


Asunto(s)
Implantes Dentales , Queratinas , Mucosa Bucal/trasplante , Colgajos Quirúrgicos/trasplante , Encía , Humanos , Higiene Bucal
13.
Artículo en Inglés | MEDLINE | ID: mdl-32032416

RESUMEN

This study aimed to create papilla with concentrated growth factor (CGF) in cases in which the interdental papilla was not able to fill the interproximal space (IPS) due to physiologic factors. A three-dimensional digital model of this space with the digital impression obtained from direct intraoral scanning of IPS was created. This study aimed to evaluate the efficacy of CGF in the regeneration of multiple adjacent papillary losses (MAPL), with the change in the IPS area calculated on intraorally scanned images obtained with digital impressions. This study included 160 teeth from 40 patients with 120 papillary losses. Patients were randomly allocated to the test group (TG) (n = 20), with 60 MAPL (three adjacent, lost interdental papillae per patient) receiving minimally invasive surgery with CGF, or the control group (CG) (n = 20), with 60 MAPL without surgery. A total of 480 images were uploaded to a software. The patients' age, gender, Plaque Index, bleeding on probing, and mean probing pocket depth values were evaluated. Papillary area (PA) were calculated between the two central, lateral-central, and lateral-canine teeth at baseline and posttreatment periods of 3, 6, and 12 months in both groups. Papillary filling percentage, keratinized-gingiva width, papillary thickness, thrombocyte, count and mean platelet volume were recorded in TG. Considering the variables in TG and CG, there was no difference in terms of age, gender, and periodontal parameters (P > .05). PA at 3, 6, and 12 months showed statistically significant differences from baseline values in TG (P < .001) but not in CG (P > .05). In TG, a moderate positive correlation was found between the midline papillary thickness and the 3-, 6-, and 12-month filling percentages (r: 0.506, P = .023; r: 0.509, P = .022; and r: 0.515, P = .02, respectively), and a high positive correlation was determined between thrombocyte count and the 6- and 12-month filling percentages (r: 0.733, P < .001; and r: 0.744, P < .001, respectively). CGF provided papillary regeneration in the treatment of MAPL and supported three-dimensional structure of the regenerated interdental papilla throughout 1 year.


Asunto(s)
Encía , Diente , Índice de Placa Dental , Humanos , Colgajos Quirúrgicos
14.
Braz Oral Res ; 34: e012, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049112

RESUMEN

Lipoproteins are important bacterial immunostimulating molecules capable of inducing receptor activator of nuclear factor-κB (RANKL) and osteoclast formation in vitro and in vivo . Although these molecules are present in periodontopathogenic bacteria, their role in periodontitis is not known. In this study, we used Pam2CSK4 (PAM2), a synthetic molecule that mimics bacterial lipoprotein, to investigate the effects of lipoproteins on periodontitis in mice. C57BL/6 male mice were randomly divided into three experimental groups: 1) Negative control group: animals received vehicle injection; 2) Positive control group: animals received injection of Escherichia coli lipopolysaccharide (LPS); 3) PAM2 group: animals received PAM2 injection. All the injections were performed bilaterally every other day into the palatal mucosa between first and second molars. After twenty-four days, the animals were euthanized to assess alveolar bone volume (micro-CT), cellular and extracellular composition in the gingiva (stereometric analysis), and osteoclast numbers (TRAP staining). Treatment with either PAM2 or LPS induced gingival inflammation, as demonstrated by increased infiltration of inflammatory cells and enhanced angiogenesis, associated with a smaller number of fibroblasts and decreased extracellular matrix. Importantly, treatment not only with LPS but also with PAM2 resulted in a larger number of TRAP+ multinucleated osteoclasts and significant loss of alveolar bone. Collectively, our data demonstrate that PAM2 can induce gingival inflammation and bone loss in mice, broadening the avenues of investigation into the role of lipoproteins in the pathogenesis of periodontal disease.


Asunto(s)
Lipopéptidos/farmacología , Periodontitis/etiología , Periodontitis/patología , Receptor Toll-Like 2/antagonistas & inhibidores , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/patología , Proceso Alveolar/efectos de los fármacos , Proceso Alveolar/patología , Animales , Modelos Animales de Enfermedad , Encía/efectos de los fármacos , Encía/patología , Gingivitis/etiología , Gingivitis/patología , Masculino , Ratones Endogámicos C57BL , Osteoclastos/efectos de los fármacos , Osteoclastos/fisiología , Periodontitis/microbiología , Distribución Aleatoria , Fosfatasa Ácida Tartratorresistente , Factores de Tiempo , Microtomografía por Rayos X
15.
Am J Orthod Dentofacial Orthop ; 157(2): 172-177, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32005468

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the impact of being overweight or obese while wearing orthodontic fixed appliances on the prevalence of gingivitis in adolescents. METHODS: A total of 334 adolescents, aged between 12 and 18 years, were recruited from 3 public schools in Cuiabá, Brazil. Participants were divided in dichotomized categories of body mass index (BMI) (under and normal weight or overweight and obesity) and fixed orthodontic appliance usage (yes or no). Gingival inflammation was evaluated by Löe & Silness index. Socioeconomic status was determined by the criteria of the Brazilian Association of Research Companies, and sugar consumption was assessed by a questionnaire of dietary habits. The statistical analysis was performed with P <0.05 considered significant. RESULTS: In a multivariate linear regression model, gingivitis was directly related to BMI (%) variation and orthodontic appliance use. In addition, excess weight seemed to be 2 times more relevant in predicting gingivitis than orthodontic fixed appliance usage. A strong positive correlation was observed between BMI (%) variation and gingival index (ρ = 0.97, P <0.001). CONCLUSIONS: Orthodontic fixed appliance usage and excess weight were associated with increased gingivitis in adolescents; BMI (%) variation was the most significant predictor of gingival inflammation.


Asunto(s)
Gingivitis , Aparatos Ortodóncicos , Adolescente , Brasil/epidemiología , Niño , Encía , Gingivitis/epidemiología , Gingivitis/prevención & control , Humanos , Aparatos Ortodóncicos Fijos
16.
Artículo en Inglés | MEDLINE | ID: mdl-32032404

RESUMEN

The aim of this randomized controlled trial was to compare the clinical outcomes of modified coronally advanced tunnel technique (MCAT) with subepithelial connective tissue graft (SCTG) with and without recombinant human platelet-derived growth factor-BB (rhPDGF-BB) for mandibular multiple recessions. Twenty-four Miller Class I and III recessions were randomly assigned to a group: test (MCAT+SCTG+rhPDGF-BB) or control (MCAT+SCTG). After 6 months, mean recession-depth reduction was higher in the test group (2.08 ± 0.90 mm) than the control (1.83 ± 0.93 mm). Mean root coverage was achieved, favoring the test group (82.6% ± 23.69%) instead of the control (56.2% ± 28.55%). Complete root coverage for the test group was 58.3%, which was significantly superior to control (16.7%). The use of rhPDGF-BB+SCTG using MCAT offered an advantage of a minimally invasive, predictable method for achieving optimal outcomes.


Asunto(s)
Recesión Gingival , Becaplermina , Tejido Conectivo , Encía , Gingivoplastia , Humanos , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
17.
Artículo en Inglés | MEDLINE | ID: mdl-32032407

RESUMEN

This meta-analysis aimed to evaluate the clinical effectiveness of autologous platelet concentrates (APC) + coronally advanced flap (CAF) (Group A) compared with connective tissue graft (CTG) + CAF (Group B), and CAF alone (Group C), in patients with Miller Class I or II gingival recessions. Relevant articles published before December 2018 were retrieved electronically without date or language restriction and screened according to inclusion criteria. Quantitative meta-analysis was conducted comparing the groups. The inverse variance method was applied in fixed or random effects models according to heterogeneity. Sixteen randomized controlled trials were included. Root coverage (RC), clinical attachment level (CAL), gingival thickness (GT), and probing depth (PD) did not differ significantly between Groups A and B. The keratinized gingival width (KGW) of Group A was significantly less than that of Group B. The RC and GT of Group A were significantly greater than that in Group C. CAL and PD for Group A were lower than for Group C. KGW for Group A did not differ significantly from that of Group C. The results suggested that APC + CAF represents a promising alternative for root coverage for Miller Class I and II gingival recession defects. Nevertheless, CTG + CAF exhibits superior outcomes in terms of KGW. Hence, in scenarios lacking keratinized gingiva (Miller Class II), APC + CAF might not be the most suitable therapeutic choice.


Asunto(s)
Recesión Gingival , Tejido Conectivo , Encía , Humanos , Colgajos Quirúrgicos , Raíz del Diente , Resultado del Tratamiento
18.
Artículo en Inglés | MEDLINE | ID: mdl-32032408

RESUMEN

This study aimed to evaluate with laser Doppler flowmetry (LDF) the effect of topical hyaluronic acid (HA) application on the vascularization of free gingival graft (FGG) donor and recipient sites during the early wound healing period and to investigate the effect of HA application on the dimensional change of the FGG. Forty systemically healthy, nonsmoking patients who required FGG due to insufficient amount of attached gingiva in a partial edentulism were randomly assigned to a study group: test (FGG+HA) or control (FGG alone). The LDF values of the donor and recipient sites were measured in both groups before the operation and at 4, 7, 10, 14, and 30 postoperative days. LDF measurement of the graft was performed as soon as the graft was taken from the palatal site. FGG dimensions (width, height, and thickness) were assessed and recorded at baseline and on day 30, as well as the percentage of the changes in these values. LDF values of the recipient site in the FGG+HA group were found to be statistically higher than those in the control group on days 4 and 7 (P = .013 and P = .020, respectively); however, no differences were found for days 10, 14, and 30. Additionally, no differences were found for the LDF values of the palatal site between the FGG+HA and control groups (P > .05) at all examined time points. The height of the graft measured on day 30 was statistically higher in the FGG+HA than the control group (P < .001). The percentage change in thickness and height of the FGG was statistically lower in the FGG+HA than control group (P = .028 and P < .001, respectively). Application of HA on the recipient bed under the FGG at the first week of healing allows the formation of a well-vascularized layer, which acts as a barrier against tissue tensions by functioning as a scaffold between the recipient bed and FGG, thus reducing the shrinkage of the graft, especially in the vertical direction. This study further showed that the graft taken from the donor site had a remaining blood perfusion value of its own.


Asunto(s)
Ácido Hialurónico , Procedimientos Quirúrgicos Orales , Encía , Humanos , Flujometría por Láser-Doppler , Cicatrización de Heridas
19.
J Appl Oral Sci ; 28: e20190145, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049132

RESUMEN

OBJECTIVE: Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. METHODOLOGY: The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. RESULTS: At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. CONCLUSIONS: Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue.


Asunto(s)
Encía/irrigación sanguínea , Microcirculación/fisiología , Preparación del Diente/instrumentación , Ondas Ultrasónicas , Animales , Protocolos Clínicos , Instrumentos Dentales , Perros , Femenino , Humanos , Flujometría por Láser-Doppler/métodos , Microscopía Electrónica de Rastreo , Reproducibilidad de los Resultados , Factores de Tiempo , Preparación del Diente/métodos
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