RESUMO
Peri-implant soft tissue deformities are an increasingly common phenomenon in the esthetic zone. While the most widely studied esthetic complications are peri-implant soft tissue dehiscences, there are other esthetic concerns in routine clinical practice that require investigation and treatment. Thus, this report on two clinical cases describes a surgical approach using the apical access technique to treat peri-implant soft tissue discoloration and fenestration. In both clinical scenarios, the defect was accessed via a single horizontal apical incision without removing the cement-retained crowns. A bilaminar technique using apical access with a simultaneous connective tissue graft seems to offer promising results for the treatment of peri-implant soft tissue deformities. At the 12-month reevaluation, an increase in peri-implant soft tissue thickness was observed, resolving the pathologies presented.
Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Humanos , Implantação Dentária Endóssea/efeitos adversos , Implantação Dentária Endóssea/métodos , Estética Dentária , CoroasRESUMO
La extrusión quirúrgica es una alternativa terapéutica que persigue el desplazamiento coronal de aquellos dientes con márgenes subgingivales y limitada estructura remanente. El correcto diag nóstico de cada caso y la aplicación de una técnica mínimamente traumática serán clave en el éxito del tratamiento. En la presente revisión, a propósito de un caso con 12 meses de seguimiento, se analizan los factores críticos del procedi miento (AU)
Surgical extrusion is a therapeutic alternative that pursues the coronal displacement of those teeth with subgingival margins and limited remaining structure. The correct diagnosis of each case and the application of a minimally traumatic technique will be key to the success of the treatment. In this review, about a case with 12 months of follow-up, the critical factors of the procedure are analyzed (AU)
Assuntos
Humanos , Masculino , Adulto Jovem , Extrusão Ortodôntica/métodos , Aumento da Coroa Clínica , Resultado do Tratamento , Seguimentos , PrognósticoRESUMO
(1) Background: This study compared the clinical and esthetic results of the double lateral sliding bridge flap (DLSBF) and the laterally closed tunnel (LCT) techniques, with a subepithelial connective tissue graft (SCTG), for the treatment of single Miller class II-III recessions in the mandibular anterior teeth. (2) Methods: This pseudorandomized clinical trial evaluated 14 patients, 7 of whom were part of the DLSBF + SCTG group, with an average follow-up of 58.7 ± 24.0 months, and 7 of whom were in the LCT + SCTG group, with an average follow-up of 16.7 ± 3.3 months. Clinical and esthetic evaluations of the following parameters were performed and the results for the two groups were compared: gingival recession depth, probing depth, keratinized tissue width, gingival thickness, percentage of root coverage and root coverage esthetic score. (3) Results: After the follow-up period, each technique provided evidence of a reduction in recession depth and clinical attachment level, as well as increased keratinized tissue width and gingival thickness, with statistically significant differences (p < 0.05). The analysis showed that gingival recession depth decreased less in the DLSBF group (4.3 ± 1.2 mm to 0.6 ± 1.1 mm) than it did in the LCT group (4.9 ± 1.1 mm to 0.1 ± 0.4 mm), but no significant difference was found between the two groups. Similarly, a greater reduction in the clinical attachment level parameter was observed in the LCT group, while a greater increase in gingival thickness was observed in the DLSBF group. The presence of scars was the only parameter for which statistically significant differences (p < 0.05) between the two study groups were found. (4) Conclusions: Within the limitations of the study, it indicates that the LCT + SCTG technique may be considered an optimal technique in terms of reducing gingival recession depth, complete root coverage and esthetic results for the treatment of single gingival recessions in the mandibular anterior teeth.
RESUMO
El tratamiento de recesiones gingivales utilizando procedimientos de cirugía plástica periodontal es habitualmente requerido en la odontología moderna. El objetivo final de estos procedimientos es la cobertura completa de la raíz y los resultados estéticos agradables. La literatura muestra que el colgajo de avance coronal + injerto de tejido conectivo podría ser considerado como el "gold standard" para el tratamiento de recesiones gingivales unitarias. Sin embargo, en la arcada inferior podemos encontrarnos con limitaciones anatómicas que nos impidan realizar las técnicas convencionales de cirugía mucogingival. En este trabajo se presenta y describe el tratamiento de recesiones gingivales unitarias y múltiples que afectan a la zona anteroinferior, las cuales se trataron mediante la técnica de Edlan-Mejchar modificada. La utilización de la técnica de Edlan-Mejchar modificada muestra resultados positivos para tratar recesiones gingivales en el sector anteroinferior
Treatment of gingival recessions using periodontal plastic surgery procedures is routinely required in modern dentistry. The ultimate goal of these procedures is complete root coverage and pleasing aesthetic results. The literature shows that the coronal advancement flap + connective tissue graft could be considered as the "gold standard" for the treatment of single gingival recessions. However, in the lower arch we can find anatomical limitations that prevent us from performing conventional mucogingival surgery techniques. In this work we present and describe the treatment of single and multiple gingival recessions that affect the lower anterior zone, which were treated using the modified Edlan-Mejchar technique. The use of the modified Edlan-Mejchar technique shows positive results to treat gingival recessions in the mandibular anterior area
