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1.
J Oral Maxillofac Surg ; 78(10): 1682-1691, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32615098

RESUMEN

PURPOSE: The objective of this systematic review was to evaluate the risk of development of gingival recession (GR) as a result of the combined orthodontic-orthognathic approach. MATERIALS AND METHODS: The PubMed, Google Scholar, ClinicalTrials.gov, and Cochrane Library databases were searched. Included articles mentioned gingival parameters in their materials and methods sections; specifically, they evaluated GR, which was measured before and after the surgical procedure. Study parameters such as methodology, evaluation period, sample characteristics, and follow-up were extracted by 2 authors independently. RESULTS: In total, 133 relevant articles were identified from the databases; after screening and full-text analysis, 9 studies were included in this systematic review. Meta-analysis could not be conducted because of considerable heterogeneity in methods. The incidence of GR in the range of 0.5 to 3.0 mm as a significant clinical finding after orthognathic surgery showed statistically significant differences in all included articles. Among patients with GR, the mean age was 23.0 to 29.5 years and the mandibular incisors were the most common site. However, no case of recession greater than 3.0 mm was associated with surgery. CONCLUSIONS: On the basis of the findings of this review, GR of approximately 0.5 to 3.0 mm is a common finding after the combined orthodontic-orthognathic approach. Although periodontal damage up to 3 mm can be observed as an isolated finding in mainly the incisors, true recession is not associated with orthognathic surgery in general.


Asunto(s)
Deformidades Dentofaciales , Recesión Gingival , Procedimientos Quirúrgicos Ortognáticos , Adulto , Recesión Gingival/etiología , Humanos , Incisivo , Factores de Riesgo , Adulto Joven
2.
BMC Oral Health ; 20(1): 116, 2020 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-32299404

RESUMEN

BACKGROUND: The biologic width is defined as the coronal dimension to the alveolar bone that is occupied by healthy gingival tissue. The objective of the present study was to correlate radiographic findings of biologic width invasion with the periodontium status. METHODS: It were included 14 patients with restored teeth with biological width invasion, on the proximal sites, observed clinically and radiographically. 122 proximal sites were evaluated, 61 in the test group (biological width invasion) and 61 in the control group (adequate biological width). Smokers and patients presenting periodontal disease or restorations with contact in eccentric movements, horizontal over-contour or secondary caries were excluded from the sample. The invasion of the biologic width was diagnosed when the distance from the gingival margin of restoration to the bony crest was less than 3 mm. Intrabony defect and bone crest level, as well as, their vertical and horizontal components were radiographically evaluated when present. Plaque index, bleeding on probing, probing depth, gingival recession height, keratinized gingival height and thickness, and clinical attachment level were clinically evaluated. Data were subjected to Spearman's Correlation and Wilcoxon's test. RESULT: The most prevalent tooth with biological width invasion was the first molar. There was a statistically significant correlation between the bone crest (p < 0.001), vertical (p < 0.001) and horizontal (p = 0.001) components. In the test group, there was a statistically significant correlation between bleeding on probing (p < 0.001; r = 0.618) and width of gingival recession (p = 0.030; r = - 0.602) with the intraosseous component; and between keratinized gingival height and bone level (p = 0.037; r = - 0.267). In the control group, there was a correlation between plaque index (p = 0.027; r = - 0.283) with bone level and correlation between keratinized gingival thickness and bone level (p = 0.034; r = - 0.273) and intrabony component (p = 0.042; r = 0.226). CONCLUSION: A statistically significant relationship was found between bleeding on probing and gingival recession in patients who presented intrabony defects due to the invasion of biological width, which may be also related to the thickness of the keratinized gingiva.


Asunto(s)
Pérdida de Hueso Alveolar/diagnóstico por imagen , Productos Biológicos , Recesión Gingival/diagnóstico por imagen , Periodoncio/patología , Adulto , Pérdida de Hueso Alveolar/etiología , Estudios de Casos y Controles , Índice de Placa Dental , Femenino , Estudios de Seguimiento , Encía/diagnóstico por imagen , Encía/patología , Recesión Gingival/etiología , Recesión Gingival/patología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/diagnóstico por imagen , Pérdida de la Inserción Periodontal/etiología , Periodontitis/diagnóstico por imagen , Periodontitis/etiología , Prevalencia , Radiografía
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(4): 271-275, 2020 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-32268629

RESUMEN

With the increase of adult patients seeking for orthodontic treatment, the influence of periodontal tissue on orthodontic treatment has gradually become the focus. For patients with periodontitis, it is essential to controlling the severity of periodontitis prior to orthodontic treatment. Periodontal disease can cause additional bone loss and make the orthodontic treatment complicated. Reducing the risk of orthodontic treatment in this situation is our major concern. In addition to periodontitis, orthodontic treatment may also cause gingival recession. On the other hand, the alveolar bone defects such as bone fenestration and bone dehiscence are common in some patients without periodontitis. For these patients, we should take more care of the interrelationship between bone defects and orthodontic treatment. This article briefly demonstrates the risk considerations of periodontal supporting tissue in orthodontic therapy focusing on the influence of periodontitis, gingival recession and alveolar bone fenestration and dehiscence.


Asunto(s)
Pérdida de Hueso Alveolar , Recesión Gingival , Periodontitis , Procedimientos Quirúrgicos Reconstructivos , Técnicas de Movimiento Dental , Adulto , Recesión Gingival/etiología , Recesión Gingival/cirugía , Humanos , Periodontitis/etiología , Periodontitis/cirugía , Periodoncio , Factores de Riesgo
4.
Braz. dent. sci ; 23(1): 1-8, 2020. tab
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1049727

RESUMEN

Objective: Periodontal diseases are very common dental disease. Many risk factors may play significant role in the periodontal disease initiation and progression. This study was performed to evaluate the effects of khat chewing, smoking, age and gender on periodontal status among Yemeni adults. Material and Methods: This cross-sectional study was performed on 1231 patients attending the outpatient dental polyclinics of University of Science and Technology during the academic years 2017/2018. All completed sheets were collected throughout the year by the supervisors. Data cleaning, descriptive statistics, and inferential statistics were then performed. Results: Khat chewers were more frequent than non-chewers counterparts (60.7% vs. 39.3%). The prevalence of smoking was 25.5% (297 patients). Study results indicated that periodontitis is more associated with female gender and participants aged more than 35 years old. Results also showed that female and age older participants aged more than 35 years were significantly associated with gingival recession. Mean number of the teeth with gingival recession in male patients were higher than in females. Male gender and patients aged more than 35 years old were significantly associated with furcation involvement. Conclusion: The present study has shown females gender and age older than 35 seem to be risk factors of periodontal diseases. Males has more teeth affected by gingival recession and more furcation involvement (AU)


Objetivo: As doenças periodontais são patologias dentárias com alta prevalência. Diversos fatores de risco podem desempenhar papel significativo no início e progressão das doenças periodontais. Este estudo foi realizado para avaliar os efeitos da mastigação de khat, tabagismo, idade e gênero na condição periodontal de adultos iemenitas. Material e Métodos: Este estudo transversal foi realizado em 1231 pacientes atendidos nas policlínicas odontológicas ambulatoriais da Universidade de Ciência e Tecnologia durante os anos acadêmicos de 2017/2018 através de um questionário para coleta de dados préestabelecido. Todas os questionários preenchidos foram coletados ao longo do ano pelos supervisores. A apuração dos dados, estatística descritiva e estatística inferencial foram realizadas. Resultados: os mastigadores de Khat foram mais frequentes do que as não-mastigadores (60,7% vs. 39,3%). A prevalência de tabagismo foi de 25,5% (297 pacientes). Os resultados do estudo indicaram que a periodontite está mais associada ao gênero feminino e aos participantes com mais de 35 anos de idade. Os resultados também mostraram que participantes do gênero feminino e acima de 35 anos foram significativamente associadas à recessão gengival. O número médio de dentes com recessão gengival em pacientes do gênero masculino foi maior que no feminino. O gênero masculino e os pacientes com mais de 35 anos de idade foram significativamente associados ao envolvimento da furca. Conclusão: O presente estudo mostrou que o gênero feminino e a idade acima de 35 anos parecem ser fatores de risco para doenças periodontais. Pacientes do gênero masculino têm mais dentes afetados pela recessão gengival e mais envolvimento de furca.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Enfermedades Periodontales/epidemiología , Tabaquismo/epidemiología , Catha , Masticación , Enfermedades Periodontales/etiología , Periodontitis/etiología , Periodontitis/epidemiología , Tabaquismo/complicaciones , Yemen/epidemiología , Estudios Transversales , Factores de Riesgo , Distribución por Sexo , Defectos de Furcación/etiología , Defectos de Furcación/epidemiología , Distribución por Edad , Catha/efectos adversos , Recesión Gingival/etiología , Recesión Gingival/epidemiología
5.
Braz Oral Res ; 33(suppl 1): e073, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31576957

RESUMEN

Soft tissue defects around dental implants, such as papilla or volume loss, peri-implant recession and alterations of the ridge color and/or texture, lead to esthetic and functional complaints. Treatments of these defects in implants are more demanding than in teeth because peri-implant tissue exhibits different anatomical and histological characteristics. This narrative review discusses the proposed treatments for soft tissue defects around implants in the current literature. Several clinical and pre-clinical studies addressed methods to augment the quantity of the peri-implant keratinized mucosa. Autogenous grafts performed better than soft tissue substitutes in the treatment of soft tissue defects, but there is no clinical consensus on the more appropriate donor area for connective tissue grafts. Treatment for facial volume loss, alterations on the mucosa color or texture and shallow peri-implant recessions are more predictable than deep recessions and sites that present loss of papilla. Correction of peri-implant soft tissue defects may be challenging, especially in areas that exhibit larger defects and interproximal loss. Therefore, the regeneration of soft and hard tissues during implant treatment is important to prevent the occurrence of these alterations.


Asunto(s)
Pérdida de Hueso Alveolar/terapia , Prótesis Anclada al Hueso/efectos adversos , Interfase Hueso-Implante , Implantes Dentales/efectos adversos , Recesión Gingival/terapia , Pérdida de Hueso Alveolar/etiología , Pérdida de Hueso Alveolar/patología , Interfase Hueso-Implante/patología , Cara/patología , Recesión Gingival/etiología , Recesión Gingival/patología , Humanos , Reproducibilidad de los Resultados , Resultado del Tratamiento
7.
Eur J Orthod ; 41(6): 559-564, 2019 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-31220233

RESUMEN

AIM: The development of gingival recessions has been associated with orthodontic treatment; however, a clear etiology is still unknown. The aim of the present study was to further clarify potential association between the development of labial and lingual recessions and inclination of the lower incisors during orthodontic treatment, vertical facial morphology, width of the alveolar bone process, height and width of their symphysis after orthodontic treatment and at long-term retention. METHODS: On dental casts and good quality lateral cephalograms of 126 orthodontically treated patients, relevant measurements were performed and gingival recessions were assessed and recorded before, immediately after treatment and at long-term retention. RESULTS: Taking into account the whole sample at three different occasions, on the buccal side, the lateral incisors have significantly less recessions than the central incisor. On the lingual side, tooth 32 presented with lower risk of recession compared to all other three incisors. No association was found between the width of the alveolar bone process at the apex (Wapex), at the level of the crest (Wcrest) and at mid of the root (Wmid), the width (D), the vertical skeletal pattern (AnsPns-Go'Me) and the onset of buccal or lingual recessions. Development of new recessions was clearly associated with males and with increasing age. The symphysis height (Me-Wcrest) was statistically related with the onset of lingual recessions on 32 and 42. The ratio between the symphysis height and the width at the crest level demonstrated a statistically significant association with the presence of buccal and lingual recessions. Excessive proclination (≥10°) of the lower incisors demonstrated an association with the onset of recessions in 25 per cent of the cases. CONCLUSION: Based on the sample of this study, there is some evidence that increased symphysis height (Me-Wcrest), and ratio between the symphysis height and the width at the crest level as well as big change of lower incisor inclination during treatment are associated with the development of recessions.


Asunto(s)
Recesión Gingival/etiología , Cefalometría , Humanos , Incisivo , Masculino , Mandíbula , Técnicas de Movimiento Dental/efectos adversos
8.
J Orofac Orthop ; 80(1): 1-8, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30242441

RESUMEN

PURPOSE: Aim of the present study was to investigate the prevalence of gingival recession and related factors in teeth with low occlusal function (open bite and infraversion) after orthodontic treatment. METHODS: From January 2014 to December 2017, 403 patients received orthodontic treatment. Their gingival recession and related factors before and after treatment were retrospectively analyzed. RESULTS: The prevalence of gingival recession in patients with infraversion and open bite after orthodontic treatment were 80.6 and 75.0%, respectively; these values were 43.4 and 47.5% before treatment, respectively. Notably, the Miller index of gingival recession increased after orthodontic treatment (P < 0.05). The risk of gingival recession in patients with infraversion or open bite after orthodontic treatment was remarkably higher than the risk in other patients (odds ratio [OR] = 16.712 and 5.073, respectively); the gingival recession rate was related to treatment with tooth extraction (OR = 2.043), as well as gingival biotype (OR = 0.341) and gingival index (GI) before orthodontic treatment (OR = 97.404; P < 0.05). CONCLUSIONS: Patients with these two types of low occlusal function are more likely to exhibit gingival recession after orthodontic treatment. Moreover, the prevalence of gingival recession after orthodontic treatment is higher among patients who have undergone tooth extraction during orthodontic treatment, and among those who exhibit thin gingival biotype and high gingival index before orthodontic treatment.


Asunto(s)
Recesión Gingival/etiología , Maloclusión/terapia , Mordida Abierta/terapia , Técnicas de Movimiento Dental/efectos adversos , Adolescente , Femenino , Recesión Gingival/epidemiología , Humanos , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Técnicas de Movimiento Dental/métodos , Adulto Joven
9.
Implant Dent ; 27(5): 575-581, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30113343

RESUMEN

PURPOSE: The aim of this study was to assess if there is an association between buccal mucosa thickness and periimplant attachment loss after 1 year of function. MATERIALS AND METHODS: A total of 28 patients (14 periimplantitis implants and 14 healthy implants) were included. The buccal mucosal thickness was assessed using K-files at 3 mm apical to the soft tissue margin of the implant. Probing depth, recession (REC), clinical attachment level (CAL), bleeding on probing, and radiographic bone loss on mesial and distal sites of the implant were recorded. RESULTS: The data showed that there was a statistically significant difference in midfacial REC between thin and thick buccal mucosa groups. However, the CAL was not statistically significant different between both groups. In addition, there was no statistically significant difference in mesial and distal bone loss between implants with thin and thick mucosa. CONCLUSION: When the midfacial soft tissue thickness was thin, the midfacial REC was greater and the CAL also tended to be higher. There was no association between buccal mucosa thickness and periimplant bone loss on mesial and distal sites of the implant after 1 year of function.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea , Mucosa Bucal/patología , Pérdida de la Inserción Periodontal/etiología , Anciano , Estudios Transversales , Implantación Dental Endoósea/efectos adversos , Femenino , Recesión Gingival/etiología , Recesión Gingival/patología , Humanos , Masculino , Periimplantitis/complicaciones , Periimplantitis/patología , Pérdida de la Inserción Periodontal/patología , Índice Periodontal , Radiografía Dental
10.
Orthod Fr ; 89(2): 137-144, 2018 06.
Artículo en Francés | MEDLINE | ID: mdl-30040613

RESUMEN

INTRODUCTION: Orthodontic-surgical treatment can present risks to the dental organ and the periodontium. Despite the low incidence of such cases, these complications can compromise a treatment plan. Practitioners should be aware of these potential complications, take them into account during treatment in order to reduce their negative impact and, if necessary, manage them by orthodontic-surgical collaboration. MATERIALS AND METHODS: In this article, the authors present several potential complications that can occur during treatment. CONCLUSION: The information given to the patient about the risks inherent in the implementation of an orthodontic-surgical protocol must necessarily include the risks of lesion to the dental organ and the periodontium.


Asunto(s)
Ortodoncia Correctiva/efectos adversos , Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Enfermedades Estomatognáticas/etiología , Adulto , Pérdida de Hueso Alveolar/epidemiología , Pérdida de Hueso Alveolar/etiología , Femenino , Recesión Gingival/epidemiología , Recesión Gingival/etiología , Humanos , Masculino , Persona de Mediana Edad , Ortodoncia Correctiva/estadística & datos numéricos , Procedimientos Quirúrgicos Ortognáticos/estadística & datos numéricos , Procedimientos Ortopédicos/efectos adversos , Procedimientos Ortopédicos/estadística & datos numéricos , Enfermedades Estomatognáticas/epidemiología , Resorción Dentaria/epidemiología , Resorción Dentaria/etiología
11.
Clin Oral Implants Res ; 29(8): 881-893, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30043456

RESUMEN

OBJECTIVES: To assess the rate of biologic complications and implant survival in edentulous patients treated with implant-supported fixed complete dental prostheses (IFCDPs) after a mean observation period of 5.2 years (range: 1-12 years). MATERIALS AND METHODS: A single-visit clinical and radiographic examination was performed to assess types and rates of biologic complications with ceramic IFCDPs (Group 1) and metal-resin IFCDPs (Group 2). RESULTS: Of 457 rough surface dental implants supporting 71 IFCDPs (52 patients), six had failed, yielding an implant survival rate of 98.7% after a mean observation period of 5.2 years after definitive prosthesis insertion. The most frequent minor biologic complication was soft tissue recession (7.7% annual rate), inflammation under the IFCDP (7.4% annual rate), and peri-implant mucositis (6.3% annual rate). The most frequent major biologic complication was peri-implantitis (2.0% annual rate), in 46/457 implants (10.1%) supporting 19 IFCDPs and late implant failure (0.3% annual rate). The frequency of biologic complications was not statistically different between Group 1 and Group 2. The presence of high plaque index had significant effect on bone loss. CONCLUSIONS: After a mean exposure time of 5.2 years postdefinitive prosthesis insertion (range: 1-12 years), implant survival rate of 98.7% was achieved. The six implant failures in three patients occurred after 5 years and affected the prosthesis survival. Soft tissue recession was the most frequent minor biologic complication, whereas peri-implantitis was the most frequent major biologic complication. A 10-year implant-based mucosal recession rate of 77% (95% CI: 68.2-87.9) and a 10-year implant-based peri-implantitis rate of 20% (95% CI: 16.9-24.9) were found.


Asunto(s)
Prótesis Dental de Soporte Implantado/efectos adversos , Fracaso de la Restauración Dental , Dentadura Completa/efectos adversos , Diseño de Prótesis Dental , Femenino , Estudios de Seguimiento , Recesión Gingival/etiología , Humanos , Inflamación/etiología , Arcada Edéntula , Masculino , Periimplantitis/etiología , Radiografía Panorámica , Estudios Retrospectivos
12.
Prog Orthod ; 19(1): 17, 2018 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-29911278

RESUMEN

BACKGROUND: The present systematic review was carried out to determine the correlation between gingival recession/bone height and incisor inclination in non-growing post-orthodontic patients compared to adult untreated subjects or patients treated with different methodologies. MATERIALS AND METHODS: PubMed, EMBASE, Web of Science, Scopus, Cochrane, and OpenGrey databases were searched without time and language restriction. Search terms included orthodontic, incisor, inclination, angulation, proclination, and gingival. Articles involving human participants and adult subjects receiving orthodontic treatment with fixed appliance, having incisors position, bone height and/or gingival recessions evaluated pre- and post-treatment were included. Two authors independently extracted data using predefined forms. Risk of bias in individual studies was assessed with the Newcastle-Ottawa Scale. RESULTS: Two observational studies were included in the qualitative analysis. The heterogeneity in outcome assessment among the studies did not allow performing a meta-analysis. The two studies, while observing some effects of orthodontic treatment on the development of gingival recession, reported that these effects were not statistically or clinically significant. CONCLUSIONS: There is no strong scientific evidence concluding that proclination of incisors by means of fixed orthodontic appliances can affect periodontal health. Further prospective studies are required to elucidate this statement. PROTOCOL: PROSPERO database registration number CRD42016042369 .


Asunto(s)
Recesión Gingival/etiología , Incisivo/fisiopatología , Técnicas de Movimiento Dental/efectos adversos , Humanos , Mandíbula
13.
Am J Orthod Dentofacial Orthop ; 153(5): 645-655, 2018 May.
Artículo en Inglés | MEDLINE | ID: mdl-29706212

RESUMEN

INTRODUCTION: The aims of this study were to retrospectively investigate the long-term development of gingival recession in a cohort of orthodontic patients and to compare the prevalence of gingival recession in orthodontically treated patients 10 to 15 years posttreatment to that of untreated subjects with malocclusion. METHODS: The sample included 88 patients with mean ages of 12.1 years (SD, 2.4 years) at pretreatment, 15.1 years (SD, 2.4 years) at posttreatment, and 27.9 years (SD, 2.5 years) 10 to 15 years posttreatment. The control group comprised 102 untreated patients seeking orthodontic treatment with a mean age of 28.7 years (SD, 3.1 years). Gingival recession was evaluated on study models. RESULTS: The prevalence of both labial/buccal and lingual/palatal gingival recession increased during orthodontic treatment with further increases during the long-term posttreatment period; 98.9% of the orthodontically treated participants had at least 1 labial/buccal recession, and 85.2% of the patients had at least 1 lingual/palatal recession 10 to 15 years posttreatment. In addition, the proportion of patients with multiple labial/buccal or lingual/palatal recession sites increased considerably in the same time period. The prevalences of labial/buccal gingival recession were similar in the orthodontically treated patients 10 to 15 years posttreatment and the untreated controls. Study group patients with a crossbite before treatment showed 2.73 more recessions (95% CI, 0.28-5.17; P = 0.029) than did those without a transverse discrepancy. Untreated subjects with crowding greater than 3 mm per arch had 3.29 more recessions (95% CI, 0.73-5.68; P = 0.012) to 4.92 more recession sites (95% CI, 1.70-8.15; P = 0.003) than did those with mild or no crowding. CONCLUSIONS: Within the limitations of this study, it seems that, in regard to the prevalence of gingival recession, orthodontically treated patients are not compromised in the long term compared with those with malocclusion that was untreated for many years.


Asunto(s)
Recesión Gingival/etiología , Ortodoncia Correctiva/efectos adversos , Adolescente , Adulto , Niño , Estudios de Cohortes , Femenino , Humanos , Masculino , Estudios Retrospectivos , Factores de Tiempo , Adulto Joven
14.
Dental Press J Orthod ; 23(1): 79-86, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29791688

RESUMEN

INTRODUCTION: The surgically assisted rapid maxillary expansion is a procedure that reduces the resistance of the sutures correcting the posterior crossbite in adults. OBJECTIVE: The aim of this study was to evaluate the periodontal status of 17 adults submitted to this procedure. METHODS: The clinical attachment level (CAL), gingival recession, attached gingiva and bleeding were evaluated in maxillary first premolars and molars, central and lateral incisors of right and left sides before surgery, 5 days and 6 months after. Means, standard deviation, medians, minimum and maximum values were compared among the evaluations using the Friedman and McNemar tests. RESULTS: There was a statistically significant increase in CAL in the right central incisor, right and left premolars and right and left molars. There was a statistically significant increase in gingival recession in the right and left premolars and molars. The amount of attached gingiva significantly decreased in right premolars and right and left molars. There was increase in bleeding in most of the teeth. CONCLUSION: Results indicated that the surgically assisted rapid maxillary expansion might cause alterations in periodontal tissue.


Asunto(s)
Recesión Gingival/etiología , Maxilar/cirugía , Técnica de Expansión Palatina/efectos adversos , Pérdida de la Inserción Periodontal/etiología , Adulto , Femenino , Hemorragia/etiología , Humanos , Masculino , Persona de Mediana Edad , Técnica de Expansión Palatina/instrumentación
15.
Clin Implant Dent Relat Res ; 20(3): 322-332, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29359880

RESUMEN

BACKGROUND: Implant stability is commonly related to insertion torque. Recently, it has been suggested that higher insertion torque may lead to greater bone resorption. PURPOSE: The aim of the present randomized clinical study was to evaluate the role of different insertion torque values in terms of implant success, marginal bone loss, and facial soft tissues recession. MATERIALS AND METHODS: Patients requiring a single dental implant were recruited and randomized to receive one of two implants with the same macro-geometry but different cutting designs. First group consists of a 90 degrees cutting groove know as self-tapping implant, and the second group known as Blossom™ cutting groove. (Intra-Lock, Boca Raton, Florida). The insertion torque (IT) was assessed and two groups followed: high-IT (≥50 Ncm) group and regular-IT (<50 Ncm) group. After 3 months, all the implants were restored. At baseline, buccal bone thickness (BBT) was recorded. During the 3-year survey, the following outcomes had been registered: implant failures and success, radiographic marginal bone level around dental implant (MBL) and facial soft tissue level (FSTL). RESULTS: A hundred and sixteen implants were placed in healed sites. The overall survival rate after 3 years was 96.5%. The Cumulative Success Rate was 91.3% for the High IT group and 98.2% for the Regular IT group. The mean marginal bone loss and facial soft tissue recession, at a 3-year evaluation, were significantly greater for the High-IT group and in the mandible than that reached in the Regular-IT group and in the maxilla. CONCLUSION: Present findings showed that implants placed with higher insertion torque in mandible led to greater bone resorption and mucosal recession than that registered for implants placed with a regular IT. Moreover, sites with a thick buccal bone wall (≥1 mm) showed smaller recession at the facial soft tissue level after 3 years.


Asunto(s)
Pérdida de Hueso Alveolar/etiología , Implantación Dental Endoósea/efectos adversos , Implantes Dentales de Diente Único/efectos adversos , Recesión Gingival/etiología , Torque , Adulto , Implantación Dental Endoósea/métodos , Fracaso de la Restauración Dental , Femenino , Encía/patología , Humanos , Carga Inmediata del Implante Dental , Estudios Longitudinales , Masculino , Mandíbula/cirugía , Maxilar/cirugía , Persona de Mediana Edad , Resultado del Tratamiento
16.
Eur J Orthod ; 40(2): 185-192, 2018 04 06.
Artículo en Inglés | MEDLINE | ID: mdl-28637273

RESUMEN

Objective: To evaluate if the morphology of the mandibular symphysis is associated with the development of gingival recession. Materials and methods: A cohort of 177 patients was followed longitudinally for up to 5 years post-treatment. Based on the width of the symphysis, participants were divided into three groups: narrow (n = 57); average (n = 63), and wide symphysis (n = 57). Morphology of the symphysis and inclination of incisors were measured on lateral cephalometric radiographs before treatment (Ts), at the end of treatment (T0) and 5 years after treatment (T5). Gingival recession and the change of clinical crown heights in mandibular incisors were measured on plaster models made at TS, T0, and T5. Results: From TS to T5 the change in inclination was comparable in the narrow, average, and wide groups. At T5, gingival labial recession was present in 19.3 per cent of patients with narrow symphysis, 20.6 per cent with average symphysis, and 14 per cent of patients with wide symphysis. The difference was not significant. The mean change of clinical crown height was <1 mm (TS - T5). The regression model showed some evidence that incisor inclination at Ts might have been associated with the change of mean clinical crown height (-2.51, 95% CI: -4.6 to -0.4, P = 0.02). The logistic regression model demonstrated that H1 (Height 1) might be associated with the development of gingival recession (OR = 0.75, 95% CI: 0.58 to 0.96, P = 0.03). Conclusion: Within the limitations of this study, there is no evidence that the overall morphology of the mandibular symphysis is associated with gingival recession development.


Asunto(s)
Recesión Gingival/etiología , Incisivo/patología , Mandíbula/patología , Adolescente , Cefalometría/métodos , Niño , Estudios de Cohortes , Femenino , Recesión Gingival/patología , Humanos , Estudios Longitudinales , Masculino , Ortodoncia Correctiva/efectos adversos , Estudios Retrospectivos
17.
J Prosthet Dent ; 119(1): 82-88, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28478985

RESUMEN

STATEMENT OF PROBLEM: Gingival recession after soft tissue displacement for impression making in fixed prosthodontics may pose a problem for treatment success in the esthetic areas of the mouth. Knowledge about the soft tissue reaction of common gingival displacement methods is limited. PURPOSE: The purpose of this clinical randomized controlled trial (RCT) was to evaluate changes in the marginal soft tissue height with 3 different gingival tissue displacement techniques for definitive impression making of natural teeth. MATERIAL AND METHODS: A total of 67 individuals were randomized to 3 groups. In test group 1 (P; n=22), only aluminum chloride paste was used to displace the gingiva. In test group 2 (CP; n=23), a cord was inserted, and aluminum chloride paste was also used. In the control group (C; n=22), 2 cords were used to displace the gingiva (double-cord technique). Clinical measurements of the gingival position were made before treatment began and at 30 ±10 days after prosthesis delivery. Study casts were fabricated at different stages of the treatment, standardized photographs were made, and changes in the buccal gingival position were measured using graphics editing software. In addition, the participants' perception of the clinical procedure and the technicians' evaluation of the die preparation were recorded. One-way ANOVA models were applied to compare the response variables among the groups: (a) the position of the gingival margin (millimeters), (b) mean probing pocket depth (millimeters), (c) gingival thickness (millimeters), (d) amount of keratinized tissue (millimeters), and (e) mean changes in gingival margin height (millimeters). Unpaired t tests were also used to compare the mean values between groups. For comparisons between different categories, chi-square tests were performed (α=.05 for all tests). RESULTS: In the period between impression and delivery, a minor gain in gingival height of 0.058 mm (±0.13 SD) for P and 0.013 mm (±1.19 SD) for CP. However, a minor gingival recession of 0.049 mm (±0.13 SD) was reported for group C. The results for all groups showed that 21% of abutment teeth gained >0.1 mm in gingival height, 58% had stable gingival height (0 ±0.10 mm), 21% showed minor gingival recession (0.1 to 0.5 mm), and no abutment teeth showed moderate or severe gingival recession (>0.5 mm). The incidence of minor gingival recession was 8% in group P, 23% in group CP, and 32% in group C (P=.015). Fifteen participants (24%) experienced some discomfort after the procedure. The differences between the groups were not significant (P>.05). The laboratory technicians found the definitive die preparation significantly more challenging for group P (visual analog scale [VAS], 79) and CP (VAS, 82) than group C (mean VAS, 93; P=.003). CONCLUSIONS: Minor or moderate gingival recession (<1 mm) is more likely to occur when conventional cords are used during impression making. However, the laboratory technicians found the die preparation significantly less challenging when the double-cord technique was used than when impressions were made using the paste displacement technique.


Asunto(s)
Compuestos de Aluminio , Astringentes/administración & dosificación , Cloruros , Encía/anatomía & histología , Recesión Gingival/prevención & control , Técnicas de Retracción Gingival , Adulto , Anciano , Anciano de 80 o más Años , Cloruro de Aluminio , Compuestos de Aluminio/administración & dosificación , Cloruros/administración & dosificación , Recesión Gingival/etiología , Humanos , Persona de Mediana Edad , Adulto Joven
18.
Eur J Orthod ; 40(4): 444-450, 2018 07 27.
Artículo en Inglés | MEDLINE | ID: mdl-29145570

RESUMEN

Aim: To assess the association between tooth wear (TW) and gingival recession (GR). Materials and Methods: Two hundred and ten orthodontically treated participants (100 males) were evaluated. GR and TW were rated independently by four raters on plaster models at four time points: before treatment (T1), mean age 13.8 years (SD = 3.7); after treatment (T2), mean age 16.7 years (SD = 3.9); 3 years after treatment (T3), mean age 19.7 years (SD = 4.2); and 7 years after treatment (T4), mean age 23.9 years (SD = 4.8). Univariable and mulitvariable random effects logistic regression analyses were performed with scores for GR as dependent variables and with TW, age, gender, dental segments (maxillary and mandibular anterior and posterior segments), time points, and Angle classification as independent variables. Method reliability was assessed with kappa statistics. Results: Mandibular incisors, mandibular and maxillary first premolars and maxillary first molars were most vulnerable to GR. The prevalence of GR increased during the observation period. At T1 20.5% participants had one or more recession sites, at T4 85.7 % of the participants had at least one GR. There was evidence of association between moderate/severe TW and GR-for a tooth with moderate/severe wear, the odds of recession were 23% higher compared to a tooth with no/mild wear (odds ratio 1.23; 95% CI: 1.08-1.40; P = 0.002). Age, dental segment, and time were also significant recession predictors, whereas gender was not. Conclusions: There is evidence that moderate/severe TW is associated with the presence of gingival recession. Clinical significance of this can be limited.


Asunto(s)
Recesión Gingival/etiología , Ortodoncia Correctiva/efectos adversos , Desgaste de los Dientes/etiología , Adolescente , Adulto , Niño , Femenino , Estudios de Seguimiento , Recesión Gingival/patología , Humanos , Incisivo/patología , Masculino , Maloclusión , Mandíbula/patología , Reproducibilidad de los Resultados , Estudios Retrospectivos , Desgaste de los Dientes/patología , Adulto Joven
19.
Ned Tijdschr Tandheelkd ; 124(12): 653-656, 2017 Dec.
Artículo en Holandés | MEDLINE | ID: mdl-29257838

RESUMEN

Maintaining healthy teeth and soft oral tissue is important. Clinical research has shown manual toothbrushes with end-rounded filaments to cause significantly less gingival abrasions than those without end-rounding. Tapered filaments are an alternative to end-rounded filaments, but there is no solid evidence for their effectiveness. For the interdental spaces that the toothbrush doesn't reach, the use of special oral hygiene aids is advised. Clinical studies of gingivitis patients have shown that both interdental brushes and plastic-rubber bristles reduce gingivitis after 4 weeks of use. Plastic-rubber bristles result in a significant improvement in the tendency for interdental bleeding compared with interdental brushes, and they cause less abrasion of the gingiva. Other factors that can potentially traumatise soft and hard oral tissue are oral piercings. Wearing oral piercings is not without risk. Tongue and lip piercings are associated with the risk of gingival recession, and tongue piercings are associated with tooth fractures. To prevent the risk of complications, patients should be discouraged from wearing oral piercings.


Asunto(s)
Encía/lesiones , Recesión Gingival/etiología , Higiene Bucal , Cepillado Dental/efectos adversos , Dispositivos para el Autocuidado Bucal , Dentífricos/efectos adversos , Dentífricos/química , Diseño de Equipo , Humanos , Salud Bucal , Cepillado Dental/instrumentación
20.
Minerva Stomatol ; 66(6): 255-266, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28975771

RESUMEN

BACKGROUND: Peri-implantitis is a frequent disease that may lead to implant loss. The aim of this case series was to evaluate the clinical results of a new non-surgical treatment protocol. METHODS: Fifteen patients with dental implants affected by peri-implantitis were treated with a multiple anti-infective non-surgical treatment (MAINST) which included two steps: 1) supra-gingival decontamination of the lesion and sub-gingival treatment with a controlled-release topical doxycycline; 2) after one week, a session of supra and sub gingival air polishing with Erythritol powder and ultrasonic debridement (where calculus was present) of the whole oral cavity was performed along with a second application of topical doxycycline around the infected implant. Primary outcome measures were: implant failure; complications and adverse events; recurrence of peri-implantitis; secondary outcome measure were presence of Plaque (PI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD). Recession (REC), Relative Attachment level (RAL). RESULTS: Neither implant failure nor complications nor adverse events were reported. Statistically (P<0.01) and clinically significant reductions between baseline and 1 year of PI (100% vs. 13.9%, 95% CI: 72.4% to 93.7%); BOP (98.5% vs. 4.5%, 95% CI: 85.4% to 98.5%) and PPD (7.89 vs. 3.16 mm, 95% CI: -5.67 to -3.77), were detected. At baseline, all 15 patients had a PPD>5 mm at the affected implant(s), whereas only 3.7% at 3-month follow-up a PPD>5 mm, and none at 6 and 12 months. CONCLUSIONS: Within the limits of this study, the MAINST protocol showed improvement of clinical parameters for the treatment of peri-implantitis, which were maintained for up to 12 months.


Asunto(s)
Antiinfecciosos/uso terapéutico , Doxiciclina/uso terapéutico , Eritritol/uso terapéutico , Periimplantitis/terapia , Administración Tópica , Adulto , Antiinfecciosos/administración & dosificación , Clorhexidina/uso terapéutico , Protocolos Clínicos , Terapia Combinada , Implantación Dental Endoósea , Índice de Placa Dental , Pulido Dental/métodos , Fracaso de la Restauración Dental , Raspado Dental , Doxiciclina/administración & dosificación , Eritritol/administración & dosificación , Femenino , Encía/efectos de los fármacos , Encía/patología , Bolsa Gingival/tratamiento farmacológico , Bolsa Gingival/terapia , Recesión Gingival/etiología , Recesión Gingival/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Antisépticos Bucales , Periimplantitis/tratamiento farmacológico , Desbridamiento Periodontal , Índice Periodontal , Polvos
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