Evaluation of peri-implant condition in periodontally compromised patients.

AIMS: The aim of the study is to evaluate the profile of peri-implant tissues in periodontally compromised patients. SETTINGS AND DESIGN: In vivo - cross sectional study design. MATERIALS AND METHODS: Fifty-eight implants were evaluated, clinically and radiographically, installed in seven individuals treated by the same team of professionals, during the years 1997 and 2005 in a private dental clinic in Vitória, ES, Brazil; that time of data collection, all implants were at least 10 years of functional loading. The variables related to the dental implants evaluated were: visible Plaque Index, Gingival Bleeding Index (GBI), probing pocket depth, bleeding on probing, and bone level, to relate them to the classification of dental implants. STATISTICAL ANALYSIS USED: The Chi-square and Kruskal-Wallis test were adopted. RESULTS: The total of 58 implants were classified: 11 (18.9%) as healthy and 12 (20.7%) as clinically stable. The other 35 implants (60.4%) had some type of peri-implant inflammation, 20 of them (34.5%) were diagnosed with peri-implant mucositis and 15 (25.9%) with peri-implantitis. Among the variables studied, the results showed statistically significant differences for implant location (P = 0.001) and GBI (P = 0.03). Most of the maxillary implants (85.7%) were classified for some type of peri-implant disease. For the implants which resulted in Score 1 for GBI, most of them (75.0%) were also classified for some type of peri-implant disease. CONCLUSIONS: Dental implants placed in periodontally compromised patients may have high long-term survival rates. However, most implants were classified with some type of peri-implant inflammation.

Condição bucal e qualidade de vida em pacientes alcoolistas e não alcoolistas ­ estudo caso-controle / Buccal condition and quality of life in alcoholic and non-alcoholic patients ­ case-control study

Objetivo: estudar as concepções dos pacientes alcoolistas, alcoolistas cirróticos e cirróticos não alcoolistas quanto à percepção de qualidade de vida, condição periodontal, perda dentária e uso ou não de prótese dentária. Material e métodos: estudo caso-controle com 194 pacientes, com idades entre 25 e 73 anos, atendidos no Serviço de Gastroenterologia do Hospital Universitário Cassiano Antônio de Moraes (Hucam/Ufes), quanto aos parâmetros: profundidade de sondagem, nível de inserção clínica, índice de placa visível, sangramento gengival, sangramento a sondagem, supuração, mobilidade dentária, lesões de furca e questionário OHIP-14. Resultados: a condição clínica dos pacientes mostrou predomínio de má qualidade de vida marcada por perda dentária extrema. Foram observadas perdas de inserção periodontais, predominância de placa dentária (p=0,002) e bolsas periodontais profundas (< 6 mm) no grupo-caso (p=0,035). Alguns parâmetros do OHIP-14 com significância (p < 0,001) foram observados com a condição clínica médica, especialmente nas categorias dos problemas ao falar, sentimento de constrangimento social e mastigação. Uma comparação foi realizada para avaliar a percepção dos pacientes alcoolistas e desdentados em relação ao OHIP-14, utilizando apenas as primeiras (nunca) e as últimas (sempre) respostas. A resposta "nunca" apresentou maiores percentuais nas questões 1 (91,8%); 2 (82,7%); 6 (69,4%); 7 (70,7%); 8 (88,3%); 9 (80,0%); 12 (90,4%); 13 (69,2%); e 14 (89,8%). A pergunta 5 obteve a resposta "sempre" como a maior porcentagem (73,3%) para o mesmo grupo. Conclusão: a condição clínica dos pacientes mostra efeitos significativos ao se correlacionar os parâmetros do OHIP-14 com a condição periodontal deteriorada e ausência considerável de próteses dentárias.

Objective: in the present study we studied the conceptions of alcoholic, cirrhotic alcoholic and non-alcoholic cirrhotic patients regarding perception of quality of life, periodontal condition, tooth loss and use of dental prosthesis. Material and methods: we evaluated 194 patients aged 25-73 years, attending the Gastroenterology Department of the University Hospital Cassiano Antônio de Moraes (Hucam/Ufes), regarding the parameters: probing pocket depth, clinical attachment loss, visible plaque, marginal gingival bleeding, bleeding on probing, suppuration, dental mobility, furcation lesions, and OHIP-14 questionnaire. Results: the clinical condition of the patients showed a predominance of poor quality of life marked by extreme dental loss. Periodontal attachment losses, predominance of dental plaque (p=0.002) and signifi cant deep pockets ( 6 mm) were observed in the case group (p=0.035). Some OHIP-14 parameters with signifi cance (p < 0.001) were also observed with the medical clinical condition, especially in the categories of speech problems, feeling of social embarrassment and chewing. A comparison was made to evaluate the perception of alcoholic and edentulous patients in relation to OHIP-14 using the fi rst (never) and the last (always) answers. The answer "never" presented higher percentages in questions 1 (91.8%); 2 (82.7%); 6 (69.4%); 7 (70.7%); 8 (88.3%); 9 (80.0%); 12 (90.4%); 13 (69.2%); and 14 (89.8%). Question 5 obtained the answer "always" as the highest percentage (73.3%) for the same group. Conclusion: the clinical condition of patients shows signifi cant effects when correlating with OHIP-14 parameters with the medical clinical condition, deteriorated periodontal condition and considerable absence of dental prostheses.

A 3-Year Retrospective Evaluation of the Clinical Performance of Fiber Posts

This retrospective study evaluated the clinical outcome of 139 teeth restored with carbon fiber posts after 3 years of placement, considering the amount of remaining dentin as the main variable. Eighty-one patients received the fiber posts within a period of 16 months and were recalled after 3 years. The tooth type, amount of remaining dentin, and prosthetic crown material were evaluated. No loss of post or core retention was detected after 3 years of follow up. During the observed time, root or post fracture and secondary caries were not recorded. Only one failure concerning endodontic treatment was detected. The amount of remaining dentin was not an important characteristic in the restorative failure of endodontically treated teeth restored with carbon fiber posts within 3 years.

Resumo Este estudo avaliou de forma retrospectiva o desfecho clínico de 139 dentes restaurados com pinos de fibra de carbono após 3 anos em função, considerando a quantidade de dentina coronária remanescente como principal variável. Oitenta e um indivíduos receberam a cimentação dos pinos entre Janeiro de 2004 e Janeiro de 2005, e foram chamados para reavaliação após 3 anos. O tipo de dente restaurado, quantidade de dentina remanescente e material restaurador coronário foram avaliados. Nenhum caso de perda de retenção do pino e/ou núcleo foi encontrado durante o período de avaliação. Fraturas na raiz ou no pino e cáries secundárias também não foram registrados. Uma única falha foi encontrada em relação ao tratamento endodôntico. A quantidade de dentina remanescente não foi um fator importante para falha na restauração de dentes tratados endodonticamente, restaurados com pinos de fibra de carbono, após 3 anos de serviço clínico.

A 3-Year Retrospective Evaluation of the Clinical Performance of Fiber Posts.

This retrospective study evaluated the clinical outcome of 139 teeth restored with carbon fiber posts after 3 years of placement, considering the amount of remaining dentin as the main variable. Eighty-one patients received the fiber posts within a period of 16 months and were recalled after 3 years. The tooth type, amount of remaining dentin, and prosthetic crown material were evaluated. No loss of post or core retention was detected after 3 years of follow up. During the observed time, root or post fracture and secondary caries were not recorded. Only one failure concerning endodontic treatment was detected. The amount of remaining dentin was not an important characteristic in the restorative failure of endodontically treated teeth restored with carbon fiber posts within 3 years.

Healing patterns after subgingival placement of a resin-modified glass-ionomer restoration: a histometric study in dogs.

The aim of this study was to evaluate, clinically and histometrically, the effects of subgingival placement of a resin-modified glass-ionomer restoration during flap surgery. Nine dogs were included in this study. The mandibular canines were randomly assigned to receive either a transgingival resin-modified glass-ionomer restoration (test group) or no restoration (control group). The apical margins of the restorations in the test group and a reference notch on those in the control group were placed at the level of the bone crest. Clinical parameters were recorded 7 days before sacrifice. The dogs were sacrificed after 107 days, and undecalcified sections were obtained for histologic evaluation. Clinically, both groups presented significant clinical attachment loss and an increase in probing depth, but differences between groups were not statistically significant (P > .05). Histologically, a significant difference between groups was observed for length of epithelium (test, 4.05 ± 0.57 mm; control, 3.36 ± 0.63 mm; P = .01). The test group showed more bone resorption (2.02 ± 1.47 mm) when compared with the control group (0.74 ± 0.37 mm) (P = .048). It can be concluded that even with the claimed favorable properties of resin-modified glass ionomer, the presence of the restoration within the biologic width causes increased migration of the apical epithelium and bone resorption.

Platelet-rich plasma in the treatment of Class II furcation defects: a histometrical study in dogs.

OBJECTIVE: This study was designed to evaluate the potential adjunctive benefits of platelet-rich plasma (PRP) when used with guided-tissue regeneration (GTR) and bioactive glass (BG) in the treatment of Class II furcation lesions. MATERIAL AND METHODS: Bilateral Class II furcation lesions were surgically created and allowed to become chronic in the mandibular third premolars of 9 dogs. The defects were randomly assigned to: A) GTR+BG and B) GTR+BG+PRP. Similar defects were created in the maxillary third premolars and received the same treatments after 45 days. Dogs were sacrificed 90 days after the first treatment. The histometric parameters evaluated were: connective tissue adaptation, new cementum, new bone, mineralized bone area, non-mineralized bone area, and residual BG particle area. RESULTS: Data analysis showed a superior length of new cementum and a greater mineralized bone area for group B in both periods (p<0.05). The non-mineralized bone area was greater in the control group (p<0.05) in both periods. CONCLUSION: Within the limits of this study, it can be concluded that the use of PRP in the treatment of Class II furcation defects may enhance the amount of new cementum and provide a more mineralized bone in a shorter period of time.

Platelet-rich plasma in the treatment of Class II furcation defects: a histometrical study in dogs

OBJECTIVE: This study was designed to evaluate the potential adjunctive benefits of platelet-rich plasma (PRP) when used with guided-tissue regeneration (GTR) and bioactive glass (BG) in the treatment of Class II furcation lesions. MATERIAL AND METHODS: Bilateral Class II furcation lesions were surgically created and allowed to become chronic in the mandibular third premolars of 9 dogs. The defects were randomly assigned to: A) GTR+BG and B) GTR+BG+PRP. Similar defects were created in the maxillary third premolars and received the same treatments after 45 days. Dogs were sacrificed 90 days after the first treatment. The histometric parameters evaluated were: connective tissue adaptation, new cementum, new bone, mineralized bone area, non-mineralized bone area, and residual BG particle area. RESULTS: Data analysis showed a superior length of new cementum and a greater mineralized bone area for group B in both periods (p<0.05). The non-mineralized bone area was greater in the control group (p<0.05) in both periods. CONCLUSION: Within the limits of this study, it can be concluded that the use of PRP in the treatment of Class II furcation defects may enhance the amount of new cementum and provide a more mineralized bone in a shorter period of time.

Autologous periodontal ligament cells in the treatment of Class III furcation defects: a study in dogs.

AIM: This study aimed to evaluate, histomorphometrically, the use of periodontal ligament cells (PDL cells) in the treatment of class III furcation defects. MATERIAL AND METHODS: PDL cells were obtained from the mandibular tooth extracted from each dog (7), cultured in vitro and phenotypically characterized. Bilateral class III furcation defects were created at mandibular 3rd and 4th premolars and were randomly assigned to: CONTROL GROUP: coronally positioned flap, GTR Group: GTR, Sponge Group: carrier + GTR, Cell Group: carrier + PDL cells + GTR. RESULTS: After 3 months of healing, data analysis demonstrated that the Cell Group presented a superior length of new cementum (4.82 ± 0.61 mm; 3.66 ± 0.95 mm; 2.87 ± 0.74 mm and 1.70 ± 0.60 mm, p < 0.001), a greater extension of periodontal regeneration (3.43 ± 1.44 mm; 2.33 ± 0.95 mm; 1.52 ± 0.39 mm and 0.69 ± 0.59 mm, p = 0.001) and a larger area of new bone (5.45 ± 1.58 mm(2) ; 3.94 ± 1.52 mm(2) ; 2.91 ± 0.56 mm(2) and 1.89 ± 0.95 mm(2) , p = 0.0012), when compared with Sponge, GTR and CONTROL GROUP, respectively. CONCLUSION: The PDL cells in association with GTR may significantly promote periodontal regeneration in class III furcation defects surgically created in dogs.

Autologous periodontal ligament cells in the treatment of class II furcation defects: a study in dogs.

AIM: The goal of this study was to histologically investigate the use of periodontal ligament cells (PDL cells) in tissue engineering to regenerate class II furcation defects. MATERIAL AND METHODS: PDL cells were obtained from the mandibular tooth extracted from each dog (seven), cultured in vitro and phenotypically characterized with regard to their biological properties. Following, bilateral class II furcation lesions were created at maxillary 3rd premolars and were randomly assigned to the test group [PDL cells+guided tissue regeneration (GTR)] or the control group (GTR). After 3 months, the animals were euthanized to evaluate the histometric parameters. RESULTS: In vitro, PDL cells were able to promote mineral nodule formation and to express bone sialoprotein, type I collagen and alkaline phosphatase. Histometrically, data analysis demonstrated that the cell-treated group presented a superior length of new cementum (6.00 ± 1.50 and 8.08 ± 1.08 mm), a greater extension of periodontal regeneration (3.94 ± 1.20 and 7.28 ± 1.00 mm), a lower formation of connective tissue/epithelium (2.15 ± 1.92 and 0.60 ± 0.99 mm), a larger area of new bone (7.01 ± 0.61 and 9.02 ± 2.30 mm(2)) and a smaller area of connective tissue/epithelium (5.90 ± 1.67 and 4.22 ± 0.95 mm(2)), when compared with control group. CONCLUSION: PDL cells in association with GTR may significantly promote periodontal regeneration in class II furcation defects in dog.

Platelet-rich plasma plus bioactive glass in the treatment of intra-bony defects: a study in dogs.

OBJECTIVE: This study was designed to evaluate, histomorphometrically, the association of platelet-rich plasma (PRP) and bioactive glass (BG) in the treatment of periodontal intrabony defects. MATERIAL AND METHODS: Nine mongrel dogs were included in the study. Three-wall intrabony defects were surgically created at the mesial and distal aspect of first mandibular molar and exposed to plaque accumulation for 1 month. The defects were randomly assigned to the groups: control, BG, PRP, PRP+BG. Dogs were sacrificed 90 days after the surgeries. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, defect extension and area of new bone filling the defect. RESULTS: A superior area of new bone was observed in PRP+BG and BG (13.80 ± 2.32 mm² and 15.63 ± 2.64 mm², respectively) when compared to the other groups (8.19 ± 1.46 mm² and 8.81 ± 1.47 mm² for control and PRP, respectively). No statistically significant differences were observed in the remaining parameters. CONCLUSIONS: Within the limits of this study, it may be concluded that PRP failed to provide statistically significant improvements in the histometric parameters.

Platelet-rich plasma plus bioactive glass in the treatment of intra-bony defects: a study in dogs

OBJECTIVE: This study was designed to evaluate, histomorphometrically, the association of platelet-rich plasma (PRP) and bioactive glass (BG) in the treatment of periodontal intrabony defects. MATERIAL AND METHODS: Nine mongrel dogs were included in the study. Three-wall intrabony defects were surgically created at the mesial and distal aspect of first mandibular molar and exposed to plaque accumulation for 1 month. The defects were randomly assigned to the groups: control, BG, PRP, PRP+BG. Dogs were sacrificed 90 days after the surgeries. The histometric parameters evaluated were: length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, defect extension and area of new bone filling the defect. RESULTS: A superior area of new bone was observed in PRP+BG and BG (13.80±2.32 mm² and 15.63±2.64 mm², respectively) when compared to the other groups (8.19±1.46 mm² and 8.81±1.47 mm² for control and PRP, respectively). No statistically significant differences were observed in the remaining parameters. CONCLUSIONS: Within the limits of this study, it may be concluded that PRP failed to provide statistically significant improvements in the histometric parameters.

Peri-implant reconstruction using autologous periosteum-derived cells and guided bone regeneration.

AIM: This investigation evaluated the bone healing in peri-implant defects treated with periosteum-derived cells (PCs) and guided bone regeneration (GBR). MATERIAL AND METHODS: PCs were harvested from six beagle dogs and characterized in vitro with regard to their osteogenic properties. The animals were subjected to teeth extraction in the mandible, and after 3 months of healing, implant sites were drilled, bone dehiscences were created and implants were placed. Dehiscences were randomly assigned to: PCs+GBR, GBR, PCs and non-treated defects. After 3 months, the implants/adjacent tissues were processed. Bone-to-implant contact (BIC) bone fill (BF) within implant threads, and bone area (BA) in a zone lateral to the implant were obtained. RESULTS: In vitro analyses confirmed the osteogenic potential of PCs. Histometrically, no statistically significant differences were observed among the PCs+GBR, GBR and PCs groups for both BF and BIC (p>0.05), whereas these groups showed statistically higher values, as compared with the non-treated group (p<0.05). With respect to BA, the PCs+GBR and GBR groups presented significantly higher means, as compared with the PCs and non-treated groups (p<0.05). CONCLUSION: Although successful outcomes have been promoted by using the combined approach, PCs in conjunction with membranes did not provide additional benefit during peri-implant bone regeneration, when compared with the therapeutic approaches used alone.

Engenharia tecidual: um novo paradigma da regeneração periodontal / Tissue engineering: a new paradigm for periodontal regeneration

O periodonto é uma complexa estrutra constituída por diferentes tecidos - tecido epitelial, tecido conjuntivo, tecido cementário e tecido ósseo. A doença periodontal é um processo inflamatório nos tecidos periodontals de suporte e proteção, resultando em destruição de osso e ligamento periodontal, formação de bolsas e recessões gengivais. Os estudos existentes na literatura, até o presente momento, têm demonstrado que, embora seja possível modificar os eventos de cura de várias maneiras, a regeneração periodontal completa e desejada dos defeitos periodontals, ainda é um objetivo difícil de ser alcançado. O estudo da engenharia tecidual tem sugerido a possibilidade de uso da terapia celular como alternativa para as técnicas regenerativas até então utilizadas. O conhecimento dos conceitos básicos de regeneração periodontal e dos princípios necessários para o sucesso da engenharia tecidual, bem como a compreensão do seu princípio biológico tornam-se necessários para o entendimento deste novo paradigma da terapia periodontal regenerativa. Sendo assim, o objetivo deste artigo é discutir o potencial das células do ligamento periodontal quando utilizadas com o propósito de promover a regeneração periodontal.

Platelet-rich plasma and connective tissue grafts in the treatment of gingival recessions: a histometric study in dogs.

BACKGROUND: The aim of this study was to histometrically evaluate the healing process of gingival recessions treated with platelet-rich plasma (PRP) in combination with a subepithelial connective tissue graft (SCTG) and to compare it to that obtained with SCTG alone. METHODS: Six mongrel dogs were used in the experiment. Gingival recessions (5 x 7 mm) were surgically created and exposed to plaque accumulation for 1 month. Contralateral defects were randomly assigned to the test group (SCTG + PRP) or the control group (SCTG). Dogs were sacrificed 45 days after the surgeries, and the blocks containing the experimental specimens were processed for histologic analysis. The histometric parameters evaluated were length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, and defect extension. RESULTS: A greater length of new cementum was observed in the sites treated with PRP (2.18 +/- 0.78 mm) compared to the control group (1.19 +/- 0.62 mm) (P < or =0.05). No statistically significant differences were observed in the remaining parameters. The extension of total epithelium (sulcular and junctional epithelium) was 2.04 +/- 0.57 mm for the test group and 2.49 +/- 0.82 mm for the control group. The new connective tissue adjacent to the root without cementum formation was 0.29 +/- 0.28 mm and 0.23 +/- 0.18 mm for the test and control groups, respectively. Bone position was -0.57 +/- 0.95 mm for the test group and -0.46 +/- 1.34 mm for the control group. CONCLUSION: Within the limits of this study, the combination of PRP with SCTG was more effective in promoting new cementum formation than the graft alone.

Coronally positioned flap plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: a randomized controlled clinical trial.

BACKGROUND: The aim of this randomized clinical trial was to evaluate the treatment of gingival recession associated with non-carious cervical lesions by a coronally advanced flap alone (CAF) or in combination with a resin-modified glass ionomer restoration (CAF+R). METHODS: Nineteen subjects with bilateral Miller Class I buccal gingival recessions associated with non-carious cervical lesions were selected. The recessions were assigned randomly to receive CAF or CAF+R. Bleeding on probing (BOP), probing depth (PD), relative gingival recession (RGR), clinical attachment level (CAL), non-carious cervical lesion height (CLH), and dentin sensitivity (DS) were measured at baseline; 45 days; and 2, 3, and 6 months postoperatively. Keratinized tissue width (KTW) and keratinized tissue thickness (KTT) were measured at baseline and 6 months. The height of the non-carious cervical lesion located on the root and crown were estimated, allowing calculation of root coverage. RESULTS: Both groups showed statistically significant gains in CAL and soft tissue coverage. The differences between groups were not statistically significant for BOP, PD, RGR, CAL, KTW, and KTT after 6 months. The percentages of CLH covered were 56.14% +/- 11.74% for CAF+R and 59.78% +/- 11.11% for CAF (P >0.05). The root and crown surfaces affected by the non-carious cervical lesion were 1.67 +/- 0.31 mm and 0.96 +/- 0.29 mm, respectively, for CAF+R and 1.59 +/- 0.37 mm and 1.01 +/- 0.33 mm, respectively, for CAF. The estimated root coverage was 88.02% +/- 19.45% for CAF+R and 97.48% +/- 15.36% for CAF (P >0.05). CAF+R reduced DS significantly compared to CAF (P <0.05). CONCLUSIONS: Both procedures provided similar soft tissue coverage after 6 months. Despite the fact that a greater reduction in DS was observed after CAF+R, longitudinal observations are necessary to confirm these results.

Periodonto e lesões cervicais não-cariosas: uma abordagem multidisciplinar / Periodontum and the noncarious cervical lesions: a multidisciplinary approach

Embora pouco exploradas na literatura, as lesões cervicais não-cariosas têm uma relação muito próxima com o periodonto. Essas lesões podem influenciar negativamente o periodonto, exigindo um olhar crítico do clínico sobre as possíveis modificações na terapia. O objetivo desse trabalho é avaliar as informações disponíveis na literatura sobre a relação entre lesões cervicais não-cariosas e o periodonto, verificar os pontos mais importantes dessa relação e descrever uma técnica de recobrimento radicular associado à restauração de uma lesão cervical não-cariosa.

The noncarious cervical lesions may be related to the periodontum. These lesions can negatively affect the periodontum, requiring a critical view by the clinicians about the modifications of the therapy. The aim of this study was to evaluate the available information on the literature about the relationship between noncarious cervical lesions and the periodontum. The root coverage technique associated with a noncarious cervical lesion restoration is presented and discussed.

Periodontal surgery and glass ionomer restoration in the treatment of gingival recession associated with a non-carious cervical lesion: report of three cases.

BACKGROUND: Buccal gingival recession is a prevalent problem in populations with a high standard of oral hygiene and is very often associated with a non-carious cervical lesion, complicating treatment. The purpose of this report is to show three cases treated by an integrated periodontal and restorative dentistry approach. METHODS: Three patients with Miller Class I gingival recessions associated with non-carious cervical lesions were enrolled for treatment. One patient received a coronally positioned flap and a resin-modified glass ionomer restoration, and two patients were treated with a coronally positioned flap, resin-modified glass ionomer restoration, and connective tissue graft. Probing depth (PD), relative gingival recession (RGR), and clinical attachment level (CAL) were measured at baseline and at 6 and 8 months after surgery. RESULTS: After the healing period, all patients showed CAL gain and reduction in RGR. No difference was observed on PDs compared to baseline. No signs of gingival inflammation or bleeding on probing were seen. The patients were satisfied with the final esthetics and had no more dentin hypersensitivity. CONCLUSION: This report indicates that teeth with Miller Class I gingival recessions associated with non-carious cervical lesions can be successfully treated by an integrated periodontal and restorative dentistry approach; however, longitudinal randomized controlled clinical trials must be performed to support this approach.

Recobrimento radicular sobre raiz restaurada. Relato de caso / Root coverage procedure on restored root. Case report

Estudos epidemiológicos mostram que as recessões gengivais estão freqüentemente associadas a algum tipo de desgaste na região cervical dos elementos dentais causadas por lesões cervicais não-cariosas. Essa situação em que ambos os defeitos estão presentes cria um conflito quanto ao tratamento mais apropriado. O objetivo desse trabalho é relatar um caso clínico em que uma recessão gengival associada à lesão cervical não-cariosa foi tratada em uma única seção com retalho posicionado coronariamente e restauração da lesão cervical não-cariosa com ionômero de vidro modificado por resina. Após seis meses do procedimento, o paciente relatou a resolução da hipersensibilidade cervical e estava satisfeito com a estética obtida com o tratamento.

Gingival recessions are frequently associated with a cervical wear caused by non-carious cervical lesions. This common situation leads to a dilemma concerning selection of the best treatment option. The aim of this case report is to describe the treatment of a gingival recession associated with a non-carious cervical lesion treated with coronally advanced flap and a resin modified glass ionomer restoration in a single session. After six month post operative, the patient was satisfied with the achieved esthetic and reported resolution of the dentin sensitivity.

Avaliação clínica da associação do plasma rico em plaquetas (PRP) com o enxerto de tecido conjuntivo subepitelial em retrações gengivais criadas em cães / Association between subepithelial connective tissue graft and platelet enriched plasma (PRP): Clinical assessment in dogs

O objetivo do presente trabalho foi avaliar clinicamente a associação do plasma rico em plaquetas(PRP) como enxerto de tecido conjuntivo subepitelial quando utilizado no recobrimento radicular de defeitos do tipo retração em cães. Foram incluídos nove cães, fêmeas, de raça indefinida nas quais foram criados cirurgicamente defeitos de retração Classe I de Miller nos caninos superiores. Durante um mês os defeitos foram cronificados Após este período foram divididos aleatoriamente em dois grupos de tratamento: Grupo1:enxerto de tecido conjuntivo subepitelial associado ao PRP; Grupo2: enxerto de tecido conjuntivo subepitelial. A avaliação dos parâmetros de altura da retração, largura da retração, altura de tecido queratinizado e espessura de tecido queratinizado mostraram que o enxerto de tecido conjuntivo subepitelial associado ao posicionamento coronário do retalho é efetivo para o tratamento das retrações criadas cirurgicamente em cães.Não havendo diferença significativas quando comparado ao grupo associado ao PRP; concluiu-se que neste modelo de estudo, não há benefícios na adição do plasma rico em plaquetas no recobrimento radicular.