Full digital workflow for crown lengthening by using a single surgical guide.

A technique using a digital workflow for performing crown lengthening by using a free software program is presented to digitally design a single surgical guide. The technique consists of obtaining standard tessellation language (STL) files from intraoral scans from a digital design of the new tooth shape and from a cone beam computed tomography (CBCT) scan, after which Digital Imaging and Communications in Medicine (DICOM) files are converted to the STL format. These files are then superimposed and used for surgical planning of the crown-lengthening procedure. The main component of the surgical guide is a labial upper band representing the biological width measurement based on the predicted digitally designed future gingival margin position. Accordingly, the lower edge of the band indicates the level of the main marginal incision, whereas the top of the band indicates the level where the alveolar bone crest must be repositioned by alveolotomy during the surgical crown-lengthening procedure. By performing an adequate diagnosis of the potential restorative outcome, the new position of the gingival margin and the crown shape can be predicted, and whether osteoplasty is needed can be determined.

Esthetic Rehabilitation through Crown Lengthening Surgery and Conservative CAD/CAM Veneers: A Multidisciplinary Case Report.

This case report describes a successful multidisciplinary approach used to improve the smile esthetics of a patient presenting with excessive gingival display, asymmetric gingival margins, and small upper anterior teeth and lower anterior teeth. The treatment combined esthetic crown lengthening, dental bleaching, and restorative dentistry using CAD/CAM veneer. The 6-month follow-up examination confirmed the stability of the modification and absence of adverse effects.

Avaliação imunohistoquímica de proteínas da matriz extracelular na reparação de defeitos agudos de furca classe II em cães / Immunohistochemical evaluation of extracellular matrix proteins in the repair of acute class II furcation defects in dogs

O estudo da reparação periodontal deve se basear em modelos que forneçam os dados necessários para a análise deste fenômeno. O modelo proposto, de defeitos agudos de furca classe II, parece ser o mais indicado, pois possui um grau previsível de regeneração espontânea, fornecendo um ambiente em que é possível o estudo dos fatores que favorecem a regeneração dos tecidos periodontais. O objetivo deste trabalho foi avaliar a qualidade da reparação de defeitos agudos de furca classe II por meio da imunoexpressão de proteínas da matriz extracelular (MEC). Após a elevação de retalhos de espessura total, em quatro cães, foram criados defeitos agudos de furca classe II nos segundos, terceiros e quartos pré-molares de um dos lados da mandíbula. Os retalhos foram posicionados coronariamente e suturados. Após 45 dias, os espécimes foram coletados, descalcificados e analisados, em um plano vestíbulo- lingual, por meio de técnica imunohistoquímica para osteopontina (OPN), sialoproteína óssea (BSP) e osteonectina (BON). Nos tecidos periodontais originais, a marcação para os anticorpos testados foi fracamente positiva na MEC, caracterizando a presença de tecidos maduros. Já no interior dos defeitos, houve diferença na marcação, com marcação mais pronunciada para BSP, OPN e BON. Conclui-se que os resultados evidenciam maior atividade metabólica nos tecidos reparativos.

The study of periodontal repair should be based on models that provide the data required for analysis of thisphenomenon. The proposed model of acute class II furcation defects seems to be the most appropriate, as it provides apredictable degree of spontaneous regeneration, creating an environment where the factors that promote the regeneration of periodontal tissues can be studied. The objective of this study was to evaluate the quality of repair ofacute class II furcation defects, by means of immunoexpression of extracellular matrix (ECM) proteins.After lifting full thickness flaps in 4 dogs, acute class II furcation defects were created in the second, third and fourth premolar in one side of the mandible. The flaps were coronallypositioned and sutured. After 45 days, the specimens were collected, decalcified and analyzed in a buccal-lingual plane, by immunohistochemistry technique for osteopontin (OPN), bone sialoprotein (BSP) and osteonectin (BON). In original periodontal tissues, the marking for the tested antibodieswas weakly positive in the ECM, characterizing the presence of mature tissues. Inside the defects, there was a difference in the marking, with markings more pronounced for BSP, OPN and BON. It was concluded that the results showed greater metabolic activity in the reparative tissues.

Repair of Class II furcation defects after a reparative tissue graft obtained from extraction sockets treated with growth factors: a histologic and histometric study in dogs.

BACKGROUND: Reparative tissue of extraction sockets was proposed as grafting material in the treatment of periodontal defects. Our hypothesis was that the addition of growth factors to extraction sockets improves the regenerative potential of this tissue when used as a graft. The objective of the present study was to analyze qualitatively and quantitatively the repair of acute Class II furcation defects after they receive this grafting material. METHODS: The second and third upper premolars were extracted from four dogs. Platelet-derived growth factor (PDGF)-BB and insulin-like growth factor (IGF)-I, at concentrations of 6 microg/ml each, were applied to the resulting sockets. After 5 days, 24 acute defects (12 control and 12 test defects) were created in the second, third, and fourth lower premolars. Only the test sites received the graft. The flaps were positioned coronally on both sides and sutured. After 45 days, the specimens were collected, decalcified, and processed histologically in a buccal-lingual plane. The parameters were measured horizontally in the buccal-lingual direction. RESULTS: Repair was histologically and histometrically similar in the two groups. No significant difference was observed between the test and control groups in the parameters connective tissue, new cementum, new bone, and junctional epithelium. CONCLUSION: The use of this graft did not show beneficial effects on the repair of acute Class II furcation defects in dogs.

Associação do PDGF e IGF na regeneração periodontal: revisão da literatura / Association of PDGF and IGF on periodontal regeneration: literature review

Os fatores de crescimento são polipeptídeos que podem estimular evento como a proliferação celular. migração e síntese de matriz extracelular que são, sem dúvida, fundamentais para a obtenção da regeneração periodontal. A associação entre dois fatores de crescimento, PDGF (fator de crescimento derivado de plaquetas) e IGF (fator de crescimento semelhante à insulina), tem sido pesquisa da em estudos que visam a regeneração periodontal. apresentado resultados promissores.O objetivo desta revista de literatura foi verificar os efeitos da aplicação da associação PDGF/IGF na regeneração periodontal.