Impact of aggressive periodontitis and chronic periodontitis on oral health-related quality of life.

The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p < 0.01) was observed between the LAP group and the other two groups. There was significantly less bleeding and recession in the LAP group than in the patients with the generalized forms of periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.

Impact of aggressive periodontitis and chronic periodontitis on oral health-related quality of life

Abstract The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p < 0.01) was observed between the LAP group and the other two groups. There was significantly less bleeding and recession in the LAP group than in the patients with the generalized forms of periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.

Continuous eruption of maxillary teeth and changes in clinical crown length: A 10-year longitudinal study in adult women.

BACKGROUND: Continuous physiologic eruption of teeth may become a main aesthetic issue for implants inserted in the maxillary anterior region. PURPOSE: To study maxillary tooth vertical changes during a 10 years period by 3-dimensional superimposition of digital dental casts. MATERIAL AND METHODS: Alginate impressions were taken at both baseline and at the 10-year follow-up in a sample of 24 adult Swedish women (average age of 48 years at T0). The upper arch plaster casts were digitized with a 3-dimensional scanner and then superimposed on the palate and the palatal rugae. Occlusal and gingival anatomic structures were digitized for each upper tooth from first molar to first molar. The vertical changes of these structures gave an indication of tooth extrusion and apical or coronal displacement of the gingival margin. RESULTS: A trend was found for eruption in the anterior region (+0.3 mm on average) while a slight extrusion if not any was found in the first molars and premolars area. Vertical displacement of the gingival margin showed also a positive trend from first molars to incisors. Negative average values, corresponding clinically to gingival recession, were found on first molars (-0.36 mm) and premolars (-0.15 mm), while no displacement was detected in the anteriors. Clinical crown lengths increased in all teeth and it is mainly due to gingival recession for first molars and premolars, while for the incisors the eruption is coupled to a slight equivalent gingival coronal migration. CONCLUSIONS: During a 10-year period, continuous eruption takes place in female adult subjects, especially in the upper incisors area while gingival recession occurred in first molars and premolars area leading to crown length elongation. Implant placement in the anterior area of the maxilla may have an aesthetic impact even in mature adults due to the continuous eruption of the adjacent teeth.

Cutting-Edge Implant Rehabilitation Design and Management: A Tapered Abutment Approach.

Soft-tissue recession around an implant rehabilitation over time has been considered a physiologic phenomenon. The divergent profile of the abutment and the abutment's dis/reconnections are the most critical predisposing and precipitating factors regarding such gingival recession. Recent publications have discussed how tapered and marginless abutments that allow no disconnections and increase soft-tissue thickness could prevent implant rehabilitations from experiencing gingival recession. The objective of this article is to demonstrate the biologic rationale of tissue behavior surrounding tapered abutments and their clinical application.

Evaluation of the papilla level adjacent to implants placed in fresh, healing or healed sites: A systematic review.

A better understanding of factors that can lead to papilla formation or recession, such as the type of site where the implant was placed, is of fundamental importance to the aesthetic success of the rehabilitation. The aim of this study was to perform a systematic review of the literature regarding the formation or recession of papilla adjacent to implants placed in fresh, healing or healed sites. The protocol for this study was registered in the PROSPERO database (registration number CRD 42016033784). An electronic search was performed by two independent reviewers who applied the inclusion and exclusion criteria on the PubMed/MEDLINE, Scopus, and Embase databases from January 2005 up to February 2016. The initial screening yielded 1,065 articles, from which 15 were selected for a systematic review after applying the inclusion and exclusion criteria. Nine studies compared fresh and healed sites, four studies compared healing and healed sites, one study compared fresh and healing sites, and one study analysed all three sites. The majority of studies identified by this systematic review showed no difference between groups after the longer follow-up period. The sites where the implants were placed did not have a long-term influence on papilla formation or recession.

Comparative study of diseases of the stomatognathic system and specific parameters of osteoporosis.

UNLABELLED: What are the specific parameters of dental health that present with modifications in osteoporosis (OP)? Both OP and a decreased bone mass can affect dental health. A low mineral density may lead to the loss of dentures because the jaw is exposed to the effects of periodontitis and without strong sustainability the teeth may lose their stability. INTRODUCTION: We compared the values of the periodontal index (IP) with a T score for women presenting with OP at menopause and those without OP. We found that there is a relation between OP and the loss of bone mass at the oral-facial level. METHODS: The study included 87 patients, aged between 35 and 75 years. We correlated gums and IP with the T score for the two groups. RESULTS: We found a significant difference between the values of the IP index for the group with OP in comparison with the control group. Thus a correlation between OP and IP was confirmed. CONCLUSIONS: IP was statistically significantly higher in women at menopause with OP than those without OP. Gum retraction was significantly higher in women at menopause with OP than in the control group. There was thus a real correlation between bone mineral density (BMD) and IP, while between BMD and dental mobility we found no correlation.

Evaluation of changes in the width of gingiva in children and youth. Review of literature.

Comprehensive health care in children and youth includes periodic oral examinations. The mucogingival complex undergoes significant changes during development. The factors that impact the width of attached and keratinized gingiva during this period of life are: tooth eruption phase, the position in the arch, the type of frena attachment and oral hygiene. Along with the child's development the width of attached and keratinized gingiva increases, except for the period of tooth replacement, when a temporary narrowing of attached gingiva of erupting permanent teeth is observed. The understanding of physiological processes of the mucogingival complex is prerequisite for diagnostics and treatment of gingival abnormalities in children and youth. Therefore close cooperation between paediatrician and dental specialists: paedodontist, orthodontist and periodontologist is essential.

Tratamiento de lesión cervical no cariosa y recesión gingival a través de colgajo posicionado coronalmente / Non-carious cervical lesion and gingival recession treatment using a coronally positioned flap

El caso que se desarrolla a continuación, tiene por objetivo mostrar el resultado clínico de un paciente con biotipo gingival grueso, que fue sometido a cirugía periodontal, utilizando la técnica de colgajo posicionado coronalmente (CPC) en el tratamiento de una lesión cervical no cariosa y recesión gingival individual en el sector anterosuperior. Un clínico no debe olvidar que cada caso es diferente, por tanto, es necesario evaluar las dimensiones y espesor del tejido periodontal, el tipo y tamaño de la recesión gingival, especialmente cuando se encuentra presente una lesión cervical no cariosa. En vista de los resultados, consideramos que el CPC, en biotipos gingivales gruesos, es efectivo para proporcionar una reducción significativa de la recesión individual en el sector anterosuperior y el tratamiento de lesión cervical no cariosa a corto plazo

Non-carious cervical lesion and Gingival Recession treatment using a Coronally Positioned Flap. The case developed below is intended to show the clinical outcome of a thick gingival biotype patient who underwent a periodontal surgery using the coronally positioned flap (CPF) technique in the treatment of a non-carious cervical lesion and single gingival recession in the anterior upper sector. A clinician should not forget that each case is different, therefore, it is necessary to evaluate the size and thickness of the periodontal tissue, the type and size of gingival recession, especially when non carious cervical lesions are present. In view of the results, we consider that in thick gingival biotypes, CPF is effective providing a significant reduction of an individual recession in the anterior upper sector and a non-carious cervical lesion treatment in the short term

Association of Keratinized Mucosa and Periimplant Soft Tissue Stability Around Implants With Platform Switching.

PURPOSE: To investigate the influence of the width of keratinized mucosa (KM) on clinical parameters around dental implants with platform switching. METHODS: One hundred eighteen patients with 320 implants participated in the evaluation. The width of KM, modified sulcus bleeding index (mBI), plaque index (PLI), mucosal recession (MR), and the compliance to the implant maintenance therapy (IMT) were evaluated. RESULTS: A wide band of KM (KM width ≥ 2 mm) was associated with a significant lower mBI (0.12 ± 0.37; P < 0.0001), PLI (0.45 ± 0.56; P = 0.001), and less MR (0.06 ± 0.23; P < 0.0001) than a narrow band of KM (KM width < 2 mm) (Papilla Bleeding Index [PBI], 0.39 ± 0.60; PLI, 0.69 ± 0.63; MR, 0.27 ± 0.44). By "regular" and "irregular" IMT, a statistically significant difference was found between wide and narrow width of KM, for the mBI (wide vs narrow; 0.11 ± 0.31 vs 0.31 ± 0.52, P = 0.004 and 0.14 ± 0.45 vs 0.49 ± 0.69, P = 0.002, respectively). CONCLUSION: Absence of keratinized mucosa was associated with significant higher PLI, mBI, and MR. The IMT does not reject the protective role of KM against inflammation.

Stem Cells Cultured on Beta Tricalcium Phosphate (ß-TCP) in Combination with Recombinant Human Platelet-Derived Growth Factor - BB (rh-PDGF-BB) for the Treatment of Human Infrabony Defects.

Knowledge gained from the field of tissue engineering, helped to develop a biological substitute that promotes tissue regeneration. The usual biological substitute consists of stem cells, growth factors and an appropriate scaffold. The present randomized controlled clinical and radiographic study was undertaken to evaluate the effectiveness of mesenchymal stem cells cultured on beta tricalcium phosphate (ß-TCP) in combination with rh-PDGF-BB in treatment of infrabony defect in humans. A total of 24 infrabony defects in 14 systemically healthy patients were selected for the present study. The selected defects exhibited a probing pocket depth (PPD) of ≥ 5 mm and depth of infrabony component ≥ 3 mm as assessed by clinical and radiographic measurements and later confirmed by intrasurgical measurement. Baseline measurements included were Plaque Index (PI), Papillary Bleeding Index (PBI), Probing Pocket Depth (PPD), Relative gingival marginal level (RGML), Relative Clinical Attachment Level (R-CAL) and Radiographic Defect Depth (DD) and linear bone growth (LBG). 6 weeks after initial therapy, the defects were randomly assigned to either test group or control group. The control group was treated by an open flap debridement (OFD) only, while the test group was treated by a Stem cells cultured on ß-TCP in combination with rh-PDGF-BB. All the measurements recorded preoperatively were repeated at 6 months after the surgery. The efficacy of each treatment modality was investigated through statistical analysis. Mean probing pocket depth reduction was significantly greater in test group (4.50 ± 1.08 mm) compared to the OFD group (3.50 ± 0.90 mm). Mean gains in clinical attachment level was 3.91 ± 1.37 mm in the test group and 2.08 ± 0.90 mm in the control group. The mean increase in gingival recession (GR) was less in test group (0.58 ± 0.79 mm) compared to OFD group (1.4 ± 0.66 mm). Radiographic defect depth reduction was greater in the test group (3.50 ± 0.67 mm) with 88.33% defect fill compared to control group (1.83 ± 0.38 mm) with only 52.77% defect fill. Linear bone growth (LBG) was significantly improved by 3.58 mm in test group, while in control group, it was 1.83 mm. Regenerative approach using Stem cells cultured on ß-TCP in combination with rh-PDGF-BB for the treatment of human infrabony defects resulted in a significant added benefit in terms of CAL gains, PPD reductions greater radiographic defect fill and improvement in Linear bone growth (LBG) compared to the OFD alone.

Low bone mineral density in young individuals is associated with greater gingival inflammation and recession.

Most patients with osteoporosis are postmenopausal women or senile people who are deemed to have primary osteoporosis. However, young women, males, and atypical cases need further work up to evaluate the risk factors for secondary osteoporosis. A growing body of literature has accumulated regarding the role of osteoporosis in the onset and progression of periodontal disease and tooth loss. We hypothesized that secondary/idiopathic osteoporosis in young patients will be associated with worse periodontal status. Patients and controls who were seen in the general internal medicine outpatient clinic and who were less than 47 years of age were recruited between December 2005 and June 2011. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Blood samples were obtained for bone turnover markers and secondary causes of low BMD. Periodontal variables were assessed. Forty-five women whose mean age was 33.9 ± 7.7 years were enrolled. The osteoporotic group consisted of 12 patients, the osteopenic group 17 patients, and the control group 16 subjects. Significantly higher gingival recession (GR), gingival bleeding time index, and hence gingival inflammation were noted in patients with secondary osteoporosis compared to healthy subjects. In logistic regression analysis, having osteoporosis was determined as the single risk factor for increased bleeding time (b = 0.871, p = 0.008), while having osteoporosis (b = 0.181, p = 0.001) and age (b = 0.010, p < 0.001) were significant parameters with regard to GR. In conclusion, low BMD in young individuals was associated with greater gingival inflammation and recession when compared to those individuals with normal BMD values.

Efetividade de duas pastas dessensibilizantes no controle da hipersensibilidade dentinária em pacientes com recessão gengival / Effectiveness of two desensitizing pastes in the control of dentin hypersensitivity in patients with gingival recession

O objetivo desta investigação foi avaliar clinicamente em humanos a efetividade de duas pastas dessensibilizantes à base de cálcio no controle da hipersensibilidade dentinária em pacientes com recessão gengival. A pesquisa caracterizou-se como um estudo clínico, cuja população alvo foi composta por 27 pacientes da clínica de periodontia do curso de odontologia da UNIVALI, não incluindo indivíduos com desordens gerais ou dentais, que poderiam interferir no diagnóstico de hiperestesia dentinária como cárie, dentes trincados ou lascados, restaurações fraturadas, sensibilidade pós-restauração e dentes em hiperfunção. Foram avaliados 115 elementos dentais com hipersensibilidade grau 2 (moderada) e 3 (severa) os quais foram divididos em 2 Grupos. O Grupo I formado pelos dentes tratados com o dessensibilizante Colgate Sensitive Pró-Alívio (Colgate) e o Grupo II foi constituído pelos dentes tratados com o dessensibilizante Desensibilize Nano P (FGM). Todos os dentes examinados receberam 2 aplicações tópicas (1 por semana). Os produtos foram aplicados com taça de borracha em baixa velocidade e foram avaliados quanto à redução da hipersensibilidade imediatamente após a primeira aplicação, antes da segunda aplicação, imediatamente e 7 e 14 dias após a segunda aplicação. Os dados foram tabulados, submetidos à análise estatística e revelaram uma efetividade maior para o produto Colgate Sensitive Pró-Alívio logo após as aplicações, com uma diminuição de sua ação em longo prazo, já o produto Nano-p, obteve um menor efeito imediato comparado ao outro produto, no entanto, manteve seu nível de ação no controle da hipersensibilidade dentinária com o passar do tempo...

The objective of this investigation was to evaluate clinically the effectiveness of two desensitizing agents based on calcium in the control of dentinal hypersensitivity in patients with gingival recession. The research was characterized as a clinical study, whose target population was composed of 27 patients of the clinic of periodontics of the dentistry course of UNIVALI, excluding individuals with general and dental disorders which could interfere in the diagnosis of dentin hypersensitivity such as caries, cracked or chipped teeth, fractured restorations, sensitivity after restoration and hyperfunctional teeth. There were evaluated 115 dental elements with hypersensitivity grade 2 (mild) and 3 (severe) were divided into 2 groups. The Group I was formed by the teeth treated with desensitizing Colgate Pro-Relief (Colgate) and Group II was composed of teeth treated with desensitizing Desensitize Nano P (FGM). All examined teeth received two topical applications (1 per week). The products were applied with rubber cup at low speed and were evaluated according reduction of the hypersensitivity immediately after the first application, before the second application immediately and 7 and 14 days after second application. The data were tabulated, statistically analyzed and showed a greater effectiveness for the product Colgate Pro-Relief after applications, with a decrease of its action in the long run, but the product Nano-p, had a lesser action compared to the immediate effects of the other product, however, maintained its activity level to control dentinal hypersensitivity in the course of time...

The natural history of periodontal attachment loss during the third and fourth decades of life.

AIM: To describe changes in the occurrence of periodontal attachment loss (AL) through ages 26, 32 and 38 in a complete birth cohort. MATERIALS AND METHODS: Systematic periodontal examinations conducted at ages 26, 32 and 38 in a longstanding New Zealand cohort study (N = 1037). Periodontitis extent data were used to assign participants to periodontitis trajectories using group-based trajectory analysis. RESULTS: Eight hundred and thirty-one individuals were periodontally examined at all three ages; the prevalence and extent of AL increased as the cohort aged. Between 26 and 32, one in nine participants had 1+ sites showing new or progressing AL; that proportion almost doubled between ages 32 and 38. Four periodontitis trajectory groups were identified, comprising 55.2%, 31.5%, 10.7% and 2.5% of the cohort; these were termed the "Very low", "Low", "Moderately increasing" and "Markedly increasing" trajectory groups respectively. Those who had smoked tobacco at all ages from 15 through 38 were at higher risk of being in the "Moderately increasing" or "Markedly increasing" trajectory groups. There was a similar risk gradient for those who were in the highest 20% of cannabis usage. CONCLUSIONS: Periodontitis commences relatively early in adulthood, and its progression accelerates with age, particularly among smokers.

Influência do tabagismo no resultado de recobrimento radicular: uma revisão sistemática / Influence of smoking on root coverage outcomes: a systematic review

Introdução: A recessão gengival tem a prevalência maior que 50% em adultos, em uma comparação entre fumantes e não-fumantes. Estudos epidemiológicos mostram que os fumantes apresentam piores parâmetros clínicos periodontais do que os não fumantes, dentre eles a extensão e severidade de recessões gengivais. O objetivo do trabalho foi realizar uma revisão sistemática visando estabelecer a influência do cigarro sobre o recobrimento radicular. Material e Métodos: Foi realizada uma pesquisa nas bases de dados Pubmed e Cochrane, através do cruzamento dos seguintes descritores: gingival recession, root coverage, smoking, cigarette e tobacco, além de uma busca manual em revistas de periodontia. Os critérios de inclusão dos artigos foram organizados quanto ao hábito de tabagismo, características da recessão gengival e parâmetros para recobrimento radicular, sendo que todos os estudos deveriam ser clínicos e controlados. A busca foi finalizada com 7 artigos. Foram avaliados os parâmetros clínicos de recobrimento completo (RC), recessão gengival inicial (RGI), recessão gengival final (RGF), alteração da recessão gengival (ARG), porcentagem de recobrimento radicular (RR) e alteração na quantidade de tecido queratinizado (TQ).Resultados: Os resultados mostram que fumantes comparados aos não-fumantes, obtêm menor porcentagem de sítios com completo recobrimento radicular (6% e 43%,respectivamente), apresentam uma menor alteração no tamanho da recessão gengival(2,0mm e 2,7mm, respectivamente) e permanecem com maior recessão gengival residual(1,4mm e 0,6mm, respectivamente).Conclusões: Independente da técnica cirúrgica utilizada, ambos os grupos apresentam uma melhora na recessão gengival, porém os resultados apresentados pelos indivíduos fumantes não são tão satisfatórios quanto os não fumantes.

Introduction: The prevalence of gingival recession is 50% larger in adults smokers than non smokers. Epidemiological studies show that smokers have worse periodontal clinical parameters than non-smokers, including the extent and severityof gingival recession. The aim of this study was a systematic review aimed to establish the influence of smoking on the root guards. Methods: Thus, we conducted a search in the databases Pubmed and Cochrane databases, by crossing the following key words: gingival recession, root coverage,smoking, cigarette and tobacco, and a manual search magazines in periodontics. Inclusion criteria for the inclusion in this review were organized on the smoking habits, characteristics of gingival recession, root parameters and for coating, and all the clinical studies should be controlled . The search end with 7 articles. Were assessed using clinical parameters of complete coating (RC), gingival recession initial(RGI), gingival recession period (RGF), change in gingival recession (ARG), covering percentage root (RR) and change the amount of keratinized tissue (TQ). Results: The results of this study show that smokers compared to nonsmokers, get a smaller percentage of sites with complete root coating (6% and 43% respectively) and show a smaller change in the size of the gingival recession (2.0 mm and 2.7 mmrespectively). Conclusions: Within the limits of this study can be concluded that regardless of surgical technique, both groups show an improvement in gingival recession, but the results reported by smokers are not as satisfactory as those submitted by non-smokers.

Response of pulp sensibility test is strongly influenced by periodontal attachment loss and gingival recession.

INTRODUCTION: To assess, in vivo, the influence of periodontal attachment loss and gingival recession on responses to pulp sensibility tests (PSTs) with cold stimuli in mandibular incisors in adult patients. METHODS: This cross-sectional study included 45 patients aged 30 to 60 years treated at a university dental health service. In each patient, 1 mandibular incisor was randomly selected for analysis. One calibrated dentist performed all periodontal assessments. Periodontal attachment loss and gingival recession were measured at 6 sites of the selected tooth followed by application of the PST on the buccal surface of the tooth by an independent operator. Each patient was asked to indicate a score for pain intensity on a numeric visual analog scale. The Pearson correlation coefficient was used to investigate and quantify the correlation between predictor variables (periodontal attachment loss and gingival recession) and reported pain. Simple and multiple linear regression analyses were performed to determine the impact of periodontal attachment loss and gingival recession on PST pain scores. RESULTS: Multivariate analysis showed that periodontal attachment loss contributed significantly to the prediction of pain in response to the PST (P < .001). Increases of 1 mm in periodontal attachment loss resulted in a decrease of approximately 0.5 score on the pain scale. Gingival recession also contributed as a predictor of the outcome (P < .001) with a decrease of approximately 0.7 in pain scores for every 1-mm increase in gingival recession. The correlations were in the opposite direction than expected. CONCLUSIONS: Periodontal attachment loss and gingival recession strongly influenced reported pain in response to PST with cold stimuli. The effect of both variables was constant (ie, responses to PST decreased gradually with increases in periodontal attachment loss and gingival recession).

Merkel cells and permanent disesthesia in the oral mucosa after soft tissue grafts.

Connective tissue grafts are routinely procedures in the treatment of gingival defects. The clinical success of the gingival tissue graft procedures anyway should ensure not only the aesthetic integration between the tissues but also the physiological activity of the graft in terms of sensitivity and immunity because the skin and the mucosae constitute the first natural aspecific borders against pathogens. The aim of this paper was to investigate nervous net recovery after connective graft procedure, in relation with sensorial alteration in the injured area. Results showed that there is a close link among the number of Merkel cells and the alteration of sensations. Merkel cells can be found isolated standing in the basal layer, supposed to have neuroendocrine functions in the epithelia or in larger group not associated with nerves; when found in association with nerves they are named Merkel complexes, acting as slow adapter mechanical receptor. Our data can be explained in two ways: Merkel cells increase as a consequence of tissue injury, a sort of "SOS cells" that secrete neuroendocrine signals to guide tissue healing; as an alternative the presence of the Merkel cells could be read as a derailment of tissue regeneration with the stop of cellular differentiation in the direction of an abnormal proliferation, a sort of mad stem cell.

Tratamento de recessões múltiplas em região com alta demanda estética / Treatment af multiple gingival recessian defects in areas with esthetic demands

A presença de recessões gengivais múltiplas representa uma importante queixa estética dos pacientes. A abordagem cirúrgica para o tratamento desses defeitos deve ser direcionada de maneira que a resolução do caso seja efetivada como o menor número de cirurgias e evitandose, se possível, a necessidade de remoção de tecido doador de outras regiões, a fim de otimizar o tratamento e minimizar a morbidade associada ao procedimento. Deste modo, o objetivo do presente artigo foi relatar um caso de recobrimento de recessões gengivais múltiplas para obtenção da estética, promovendo mínima morbidade e desconforto ao paciente.

Multiple gingival recession defects represent an important complaining about smile esthetics. The surgical approach to resolution of these defects should treat ali gingival recessions at the same time and soft tissue grafts should be avoided, optimizing the treatment and minimizing patient morbidity regarding with the surgical procedure. Then, the purpose of this paper was to report on a case with multiple gingival recessions successfully treated, achieving satisfactory aesthetics and minimal patient morbidity.

Intrusion of teeth with class III furcation: a clinical, histologic and histometric study in dogs.

AIM: To assess orthodontic intrusion effects on periodontal tissues in dogs' pre-molars with class III furcations treated with open flap debridement (OFD) or with guided tissue regeneration (GTR) associated to bone autograft (BA). MATERIAL AND METHODS: Class III furcations were created in the pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with OFD or GTR/BA. After 1 month, metallic crowns were assembled on pre-molars and connected apically to mini-implants by nickel-titanium springs. Teeth were randomly assigned to orthodontic intrusion (OFD+I and GTR/BA+I) groups or no movement (OFD and GTR/BA) groups. Dogs were sacrificed after 3 months of movement and 1 month retention. RESULTS: All class III furcations were closed or reduced to class II or I in the intrusion groups, while 50% of the lesions in non-moved teeth remained unchanged. Intruded teeth presented higher probing depth and lower gingival marginal level than non-moved teeth (p<0.01). Clinical attachment gain was reduced in the intrusion groups by the end of retention (p<0.05). OFD+I presented smaller soft tissue area and larger bone tissue area than other groups (p<0.05). CONCLUSION: Orthodontic intrusion with anchorage via mini-implants improved the healing of class III furcation defects after OFD in dogs. GTR/BA impaired those results.

Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance.

BACKGROUND: Limited evidence exists on the significance of residual probing pocket depth (PPD) as a predictive parameter for periodontal disease progression and tooth loss. AIM: The aim of this study was to investigate the influence of residual PPD >or=5 mm and bleeding on probing (BOP) after active periodontal therapy (APT) on the progression of periodontitis and tooth loss. MATERIAL AND METHODS: In this retrospective cohort, 172 patients were examined after APT and supportive periodontal therapy (SPT) for 3-27 years (mean 11.3 years). Analyses were conducted using information at site, tooth and patient levels. The association of risk factors with tooth loss and progression of periodontitis was investigated using multilevel logistic regression analysis. RESULTS: The number of residual PPD increased during SPT. Compared with PPDor=7 mm 37.9 and 64.2, respectively. At patient level, heavy smoking, initial diagnosis, duration of SPT and PPD>or=6 mm were risk factors for disease progression, while PPD>or=6 mm and BOP>or=30% represented a risk for tooth loss. CONCLUSION: Residual PPD>or=6 mm represent an incomplete periodontal treatment outcome and require further therapy.