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1.
Gen Dent ; 69(1): 58-61, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33350957

RESUMO

Gingival recession is a common problem that requires periodontal surgery to restore esthetics. The vestibular incision subperiosteal tunnel access (VISTA) technique is a minimally invasive recession coverage method that has gained popularity. This case series reviews the treatment outcomes in 10 patients with a total of 28 Miller Class I or Class II recession defects in the maxillary anterior region. The defects were treated with the VISTA technique alone without any grafting material. The clinical parameters measured at baseline and at 3- and 6-month follow-up examinations were probing depth, clinical attachment level, Gingival Index, width and thickness of attached gingiva, and height of gingival recession. Statistical analysis (repeated-measures analysis of variance with a post hoc Bonferroni test) revealed that all clinical parameters except probing depth and thickness of attached gingiva showed statistically significant improvement from baseline to the follow-up examinations (P < 0.001). A mean root coverage of 78.99% was achieved. Even when performed without any grafting material, the VISTA technique is a reliable method to obtain recession coverage in the maxillary anterior region.


Assuntos
Retração Gengival , Tecido Conjuntivo , Seguimentos , Gengiva/cirurgia , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
2.
Clin Oral Investig ; 25(1): 145-150, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32572639

RESUMO

INTRODUCTION: This study evaluated the reproducibility of electronic color determination system evaluations of the marginal gingiva, which could be important for adhesive cervical fillings or prosthetic restorations that imitate the gingiva. MATERIAL AND METHODS: In 50 subjects, the L*, a*, and b* color coordinates were evaluated five times at a point in the marginal area of a central incisor using different electronic color determination systems: (SP) Shadepilot, (ES) Easyshade, (CE) Crystaleye, and (SV) X-Rite. The mean color difference (ΔE) and its standard deviation between the five measurements from each participant were calculated separately for each device. Further ICC for interdevice reliability was determined. RESULTS: The L*, a*, and b* color coordinates and ΔE values differed significantly among the systems (p < 0.001). Within each patient and measurement system, ΔE ranged from 1.4 to 3.2 (SD 1.1-2.5), L* from 2.6 to 5.7 (SD 2.6-5.7), a* from 11.9 to 21.3 (SD 3.6-3.9), and b* from 15.1 to 28.9 (SD 1.7-4.3). Interdevice reliability ranged between 0.675 and 0.807. CONCLUSIONS: Color determination of the marginal gingiva using the electronic tooth color determination systems tested herein showed limited reproducibility. The results obtained with the different measurement systems differed enormously. CLINICAL RELEVANCE: These results show that the electronic color measurement devices tested allow no high reproducible determination of color coordinates of the marginal gingiva.


Assuntos
Eletrônica , Gengiva , Cor , Humanos , Reprodutibilidade dos Testes , Espectrofotometria
3.
J Prosthet Dent ; 125(1): 46-55, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32008797

RESUMO

STATEMENT OF PROBLEM: Unsatisfactory adaptation of restorations with subgingival margins can cause problems such as accumulation of biofilm, secondary caries, and inflammation of the periodontal tissue. Therefore, special attention should be given to gingival displacement and impression procedures to optimize marginal fit. PURPOSE: The purpose of this systematic review and meta-analysis was to compare gingival displacement with conventional cords and cordless techniques and determine the reliability of the measurement methodologies. MATERIAL AND METHODS: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and identified studies through September 2018. The studies were submitted to the Cochrane risk-of-bias assessment. The gingival displacement was evaluated by using the Review Manager Software. RESULTS: Nine studies were selected, and the most common risks of bias were random sequence generation, blinding of outcome assessment, and absence of sample size calculation. Most of the studies reported obtaining a width greater than 0.2 mm. CONCLUSIONS: The cord technique resulted in increased displacement when compared with the cordless technique. The evaluation of sulcular width with digital microscope images obtained from sectioned gypsum casts is an adequate and versatile experimental methodology for measuring displacement.


Assuntos
Gengiva , Técnicas de Retração Gengival , Humanos , Reprodutibilidade dos Testes
4.
J Clin Pediatr Dent ; 44(6): 436-441, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378465

RESUMO

BACKGROUND: Plasma cell granuloma (PCG) is a rare benign pseudotumorous proliferation of unclear etiology that is mainly situated in the lungs. Gingival PCG is an even more peculiar lesion that usually occurs in middle-aged or elderly individuals and clinically manifests as a solitary entity. CASE REPORT: A 15-year-old male with no underlying medical conditions presented with multiple gingival masses in the right maxilla, which were initially thought to be epulis. The lesions were resected completely and the excisional biopsies sent for histological examination. Immunohistochemical (IHC) stain revealed dense polyclonal plasma cell infiltration with positive expression of both kappa and lambda light chains, confirming a diagnosis of gingival PCG. Subsequently, the affected gingiva healed uneventfully, with no sign of recurrence over 2 years of follow-up. CONCLUSIONS: The present report depicts an extremely unusual case of gingival PCG occurring in a juvenile with multiple lesions, which is worth attention in clinical pediatric dentistry. Excisional-biopsy and histological investigations are imperative for a confirmative diagnosis and to exclude potential aggressive conditions. Complete resection of lesions seems to be a valid treatment, while long-term clinical follow-up is still needed.


Assuntos
Doenças da Gengiva , Granuloma de Células Plasmáticas , Adolescente , Idoso , Criança , Gengiva , Doenças da Gengiva/diagnóstico , Doenças da Gengiva/cirurgia , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
6.
BMC Oral Health ; 20(1): 305, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33148235

RESUMO

BACKGROUND: It has been demonstrated in non-oral tissues that the locally evoked vasoconstriction could elicit remote vasoconstriction. This study aimed to investigate the spreading vasoconstrictor effects of epinephrine in the gingiva. METHODS: Gingival blood flow (GBF) was measured by laser speckle contrast imager in 21 healthy volunteers. In group A, two wells were fabricated from orthodontic elastic ligature and placed 2 mm apically to the free gingival margin at the mid buccal line of 12 (test side) and 21 (control side) teeth. The GBF was measured in the wells and tightly apical, coronal, distal and mesial to the wells. In group B, the wells were made on the buccal surface of the same teeth, including the gingival sulcus. Four regions were selected for measurement from the gingival margin reaching the mucogingival line (coronal, midway1, midway2 and apical). After the baseline recording, 3 µg epinephrine was applied into the test, and physiological saline into the control well. The GBF was recorded for 14 min. The gingival thickness was measured with a PIROP Ultrasonic Biometer. RESULTS: In group A, the GBF did not increase or decrease after the application of epinephrine. In group B, the GBF significantly decreased in all regions of the test side and remained low for the observation period. The vasoconstriction appeared with delays in more apical regions (at min 1 in the coronal and the midway1, at min 2 in the midway2, at min 4 in the apical region). Similarly, the amount of the decrease at 14 min was the largest close to sulcus (- 53 ± 2.9%), followed by the midway1 (- 51 ± 2.8%) and midway2 (- 42 ± 4.2%) and was the lowest in the apical region (- 32 ± 5.8%). No correlation was found between GBF and gingival thickness. CONCLUSION: Epinephrine could evoke intense vasoconstriction propagating to the mucogingival junction, indicating the presence of spreading vasoconstriction in the human gingiva. The attached gingiva is impermeable to epinephrine, unlike the gingival sulcus. This trial was registered in ClinicalTrials.gov titled as Evidence of Spreading Vasoconstriction in Human Gingiva with the reference number of NCT04131283 on 16 October 2019. https://clinicaltrials.gov/show/NCT04131283.


Assuntos
Gengiva , Vasoconstrição , Epinefrina/farmacologia , Humanos , Vasoconstritores/farmacologia , Vasoconstritores/uso terapêutico
7.
Artigo em Inglês | MEDLINE | ID: mdl-33171749

RESUMO

INTRODUCTION: The administration of several classes of drugs can lead to the onset of gingival overgrowth: anticonvulsants, immunosuppressants, and calcium channel blockers. Among the anticonvulsants, the main drug associated with gingival overgrowth is diphenylhydantoin. MATERIALS AND METHODS: In this study, we compared the effects of diphenylhydantoin and gabapentin on 57 genes belonging to the "Extracellular Matrix and Adhesion Molecule" pathway, present in human fibroblasts of healthy volunteers. RESULTS: Both molecules induce the same gene expression profile in fibroblasts as well as a significant upregulation of genes involved in extracellular matrix deposition like COL4A1, ITGA7, and LAMB3. The two treatments also induced a significant downregulation of genes involved in the expression of extracellular matrix metalloproteases like MMP11, MMP15, MMP16, MMP24, and transmembrane receptor ITGB4. CONCLUSIONS: Data recorded in our study confirmed the hypothesis of a direct action of these drugs at the periodontium level, inducing an increase in matrix production, a reduction in its degradation, and consequently resulting in gingival hyperplasia.


Assuntos
Anticonvulsivantes/efeitos adversos , Fibroblastos/efeitos dos fármacos , Gabapentina/efeitos adversos , Gengiva/efeitos dos fármacos , Hiperplasia Gengival/induzido quimicamente , Crescimento Excessivo da Gengiva/induzido quimicamente , Fenitoína/efeitos adversos , Idoso , Criança , Feminino , Fibroblastos/metabolismo , Expressão Gênica/efeitos dos fármacos , Gengiva/metabolismo , Gengiva/patologia , Crescimento Excessivo da Gengiva/metabolismo , Voluntários Saudáveis , Humanos , Masculino , Projetos Piloto , Regulação para Cima/efeitos dos fármacos , Adulto Jovem
8.
J Oral Sci ; 63(1): 59-64, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33229796

RESUMO

PURPOSE: To establish a digital assessment method for changes in gingiva morphology following initial periodontal therapy. METHODS: Ten periodontal-healthy participants were selected, and digital models obtained by intraoral scanning and digitizing conventional impressions. Using dentition as a reference, best fit alignment between digital models was carried out. Root mean square (RMS) was calculated to evaluate differences in models, and gingival volume discrepancy (GVD) was calculated after combining separated models. Trueness of intraoral scanning used on the gingiva was evaluated using RMS and GVD between intraoral and conventional models with conventional models as references; precision was evaluated among different intraoral models of one participant. Twenty-three periodontitis-affected participants underwent intraoral scanning immediately after supragingival scaling and two weeks after initial periodontal therapy. The GVD of gingiva between two digital models was calculated to assess gingival changes and related factors after therapy. RESULTS: Trueness of intraoral scanning used on the entire gingiva was 83.65 ± 14.43 µm; precision was 70.71 ± 25.58 µm; GVD error measured by digital models was 15.28 ± 10.00 mm³. Gingival volume in periodontitis-affected participants decreased 104.04-1155.09 mm³ after therapy. Probing depth, bleeding index, and keratinized gingival width positively correlated with changes in gingival volume. CONCLUSION: Intraoral scanning can be recommended as a method of evaluating morphological changes in gingiva.


Assuntos
Gengiva , Dente , Humanos , Imageamento Tridimensional
9.
Artigo em Inglês | MEDLINE | ID: mdl-33151183

RESUMO

When it comes to complete root coverage of exposed root surfaces, several limiting factors have been suggested. Although tooth malposition and papillae dimension are capable of influencing root coverage, they have not received sufficient emphasis in the literature. Therefore, the aim of the present commentary is to discuss the impact of tooth malposition and papillae dimension on root-coverage outcomes. This commentary combines evidence from the literature with the authors' experience. Limited evidence is available in the literature regarding the influence of tooth malposition on root-coverage outcomes. Severe buccal displacement and tooth extrusion and/or rotation may limit the amount of achievable root coverage, and the cementoenamel junction should no longer be considered the landmark for root coverage in these cases. The relationship between papillae dimension and root coverage has been tested in different clinical conditions and by applying different root-coverage approaches, thereby resulting in contradictory outcomes. The clinical experience of the authors suggests that having wider papillae is advantageous for coronally advanced flap and tunnel flap preparations and connective tissue graft stabilization. Although scientific evidence and the authors' clinical experience suggest that papillae dimension can play a major role in determining the surgical management of soft tissues and the amount of achievable root coverage, further studies are necessary to evaluate to which extent papillae dimensions contribute to treatment outcomes.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Humanos , Colo do Dente , Raiz Dentária/cirurgia , Resultado do Tratamento
10.
Artigo em Inglês | MEDLINE | ID: mdl-33151190

RESUMO

Several techniques involving the harvesting of a soft tissue graft from the palate have been proposed for regenerating keratinized mucosa (KM) at implant sites. However, patient morbidity and poor esthetic outcomes are considered the main drawbacks of these approaches. Therefore, the aim of this study was to describe and evaluate a new technique for harvesting keratinized tissue from the adjacent labial site (labial gingival graft [LGG]), in combination with a xenogeneic collagen matrix (XCM) or a connective tissue graft (CTG). Eighteen patients were enrolled and participated in this case series. The primary outcomes were KM gain after 12 months and patient-reported satisfaction, esthetics, and morbidity using a visual analog scale (VAS). All treated sites healed uneventfully, showing a mean KM gain of 6.8 ± 2 mm. The average VAS score for patient satisfaction and the self-reported esthetic outcomes were 95.6 ± 6.9 and 93.4 ± 9.2, respectively, and the score for morbidity was 22.8 ± 22.3. However, the VAS score for morbidity dropped to 8.7 ± 8.4 when CTG-treated subjects were excluded. Higher esthetic results were observed when XCM was used instead of CTG and when LGG was harvested from the anterior region of the implant site (P < .05 for both comparisons). LGG with XCM or CTG is a viable technique for regenerating KM at implant sites with high patient satisfaction and esthetics and low morbidity outcomes.


Assuntos
Gengiva , Retração Gengival , Colágeno , Tecido Conjuntivo , Retração Gengival/cirurgia , Humanos , Estudos Prospectivos , Resultado do Tratamento
11.
Artigo em Inglês | MEDLINE | ID: mdl-33151195

RESUMO

Amalgam tattoos are a serious cosmetic problem for patients. A 35-year-old woman came to a private periodontal practice complaining of black pigmentation (amalgam tattoo) above temporary crowns on the lateral and central maxillary incisors and asked that the cosmetic problem be solved before the new permanent crowns were cemented into place. A full-thickness coronoapical incision was made to raise a thick flap; another incision parallel to the surface of the alveolar mucosa made it possible to remove the pigmented connective tissue, which was sent for histologic examination. Due to the fact that the pigmentation extended into the gingival epithelium, the gingiva of the lateral and central incisors was completely removed, with a horizontal incision in the alveolar mucosa from the ends of the distal releasing incisions. Therefore, partially denuded alveolar bone was used as the recipient site for a free gingival graft (FGG). The histologic analysis revealed the presence of amalgam fragments of different sizes in both connective tissue and epithelium. At 6 months, 3 years, and 24 years postoperatively, the periodontal tissues appeared healthy, and the treated area was pink, without pigmentation or scarring, and was perfectly integrated with the adjacent tissues. The patient was very pleased with her appearance. A one-stage procedure, namely an FGG, should be considered an effective treatment of amalgam tattoo providing positive morphologic and cosmetic outcomes over a 24-year follow-up period.


Assuntos
Doenças da Gengiva , Transtornos da Pigmentação , Tatuagem , Adulto , Amálgama Dentário/efeitos adversos , Feminino , Gengiva , Doenças da Gengiva/induzido quimicamente , Doenças da Gengiva/cirurgia , Humanos , Transtornos da Pigmentação/induzido quimicamente
12.
Artigo em Inglês | MEDLINE | ID: mdl-33151201

RESUMO

From a sample of 108 periodontally healthy volunteers with different combinations of morphometric data related to maxillary central anterior teeth and the surrounding soft tissues, this article aims to categorize gingival phenotypes according to tooth and gingival parameters, as well as assess the relationships between tooth shape and gingival characteristics, such as the papillary height (PH) and faciolingual thickness (FLT) of the papilla base. The periodontal phenotypes of 108 volunteers were confirmed using the periodontal probe transmission method for Kan classification. The FLT, PH, and the crown width to crown length (CW/CL) ratio for maxillary anterior teeth were measured. K-clustering was used to classify the anterior tooth shape into three groups: triangular, square, and compound. The mean CW/CL ratio for the maxillary anterior tooth position of the thick phenotype was greater than that of the thin phenotype. The PH and FLT for the maxillary anterior interdental papillae were greater for the thin phenotype group than for the thick phenotype group. A negative correlation was observed between the CW/CL ratio and both PH and FLT (P < .05 for both). However, a significant positive correlation was observed between FLT and PH. CW/CL ratio, FLT, and PH were all associated with the gingival phenotype with significant statistical correlations (P < .05 for all). Triangular teeth were correlated with scallop-shaped gingiva in the faciolingual area, while square teeth were associated with a flat gingiva.


Assuntos
Dentição , Gengiva , Coroas , Humanos , Maxila/diagnóstico por imagem , Odontometria , Coroa do Dente/diagnóstico por imagem
13.
J Clin Pediatr Dent ; 44(5): 352-355, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33181851

RESUMO

Idiopathic gingival fibromatosis (IGF) is a rare, genetically heterogeneous condition that is usually a part of syndrome or, rarely, an isolated disorder. It is characterized by a slowly progressive, non hemorrhagic, fibrous enlargement of keratinized gingiva which usually begins at the time of eruption of permanent dentition, however very few cases involving the primary teeth have been described in literature. Congenital gingival fibromatosis is very rare condition in which the gingival tissues become thickened and erupting teeth remain submerged beneath hyperplastic tissue masses. This case report discusses the rare case of congenital non syndromic idiopathic gingival fibromatosis in a two year old boy who reported with absence of teeth and incompetent lips. Gingivectomy was done using modified microdissection electrocautery needle to remove the excess gingival tissues. Excised tissue has been examined histologically. The patient was followed up for a period of one year and no recurrence was observed.


Assuntos
Fibromatose Gengival , Pré-Escolar , Eletrocirurgia , Fibromatose Gengival/cirurgia , Gengiva , Gengivectomia , Humanos , Masculino , Erupção Dentária
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(11): 819-824, 2020 Nov 09.
Artigo em Chinês | MEDLINE | ID: mdl-33171553

RESUMO

In addition to restoring oral function, stable aesthetic outcome has become the goal of oral implant therapy. To ensure the harmonious appearance of the restoration and the natural tooth and to obtain the ideal hard and soft tissue structure, clinicians should have a clear understanding of the factors that influence the success of aesthetics and apply different technique accordingly. In view of the recent progress in the field of oral implant, the factors affecting the aesthetic outcome of implant treatment were discussed including neck design of implant, design of customized abutment, tissue regeneration and gingival papilla height, so as to provide clinical reference to improving the aesthetic outcome of oral implant treatment.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Coroas , Dente Suporte , Implantação Dentária Endo-Óssea , Estética Dentária , Gengiva , Resultado do Tratamento
15.
Minerva Stomatol ; 69(5): 286-294, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33174712

RESUMO

BACKGROUND: Peri-implantitis treatment is a very challenging topic to discuss. What is certain is that preventive/supportive therapy plays a key-role in peri-implant tissues' health maintenance and non-surgical implant surface mechanical debridement remains one of the solid pillars in the therapeutic pathway. In this perspective, many surface decontaminating methods have been proposed and tested to remove hard and soft bacterial deposits. The aim of this study was to compare four different commonly used non-surgical implant debridement methods in terms of cleaning potential in vitro, using a peri-implant pocket-simulating model. METHODS: Sixty-four dental implants were ink-stained and placed into a simulated peri-implant pocket. Samples were then divided into four groups and treated with different debridement methods: stainless-steel ultrasonic tip (PS), peek-coated ultrasonic tip (PI), sub-gingival air-polishing with erythritol powder (EHX) and sub-gingival air-polishing with glycine powder (GLY). For each treatment group, half of the samples were treated for 5 seconds and the other half for 45 seconds. High-resolution images were taken using a digital microscope and later analyzed with a light processing software for measuring the cleaned area percentage (ink-free). Two different images were captured for every sample: a first image with the implant positioned perpendicular to the microscope lenses (90°) and a second one with the implant placed with a 45° vertical angulation, with the smooth neck towards the ground. Percentage of removed ink was statistically modelled using a generalized linear mixed model with the implant as a random (clustering) factor. RESULTS: A paired comparison between all treatments in terms of debridement potential (cleaned area percentage) was performed. In 5s and with 90° sample angulation EHX/PS comparison showed an odds ratio of 2.75 (P<0.001), PI/EHX an OR of 0.20 (P<0.001), GLY/PS an OR of 2.90 (P<0.001), PI/GLY an OR of 0.19 (P<0.001) and PI/PS an OR of 0.56 (P=0.105). With the same sample angulation and 45s treatment time, the OR was 6.97 (P<0.001) for EHX/PS comparison, 0.14 (P<0.001) for PI/EHX comparison, 4.99 (P<0.001) for GLY/PS, 0.19 (P<0.001) for PI/GLY and 0.95 for PI/PS (P =0.989). With 5s of treatment time and 45° sample angulation, EHX/PS comparison shows a 3.19 odds ratio (P<0.001), PI/EHX a 0.14 odds ratio (P<0.001), GLY/PS a 3.06 odds ratio (P<0.001), PI/GLY a 0.15 odds ratio (P<0.001) and PI/PS a 0.46 odds ratio (P=0.017). With the same sample angulation but 45s treatment time, EHX/PS comparison produced an odds ratio of 4.90 (P<0.001), PI/EHX an OR of 0.20 (P<0.001), GLY/PS an OR of 8.74 (P<0.001), PI/GLY an OR of 0.11 (P<0.001) and PI/PS an OR 0.96 of (P =0.996). CONCLUSIONS: Among the four treatments considered, air-polishing therapy represents the best one in terms of ink removal from the implant surface. Furthermore, increasing the treatment time to 45 seconds, air-polishing resulted considerably more efficient.


Assuntos
Implantes Dentários , Peri-Implantite , Desbridamento , Gengiva , Humanos , Peri-Implantite/terapia , Pós
16.
Oral Health Prev Dent ; 18(1): 929-943, 2020 10 27.
Artigo em Inglês | MEDLINE | ID: mdl-33215484

RESUMO

PURPOSE: To present an update the orofacial manifestations of granulomatosis with polyangiitis (GPA) and present a clinical case with the initial signs in the oral cavity. MATERIALS AND METHODS: A bibliographic search was performed on Pubmed with the keywords 'Wegener's granulomatosis', 'etiology', 'oral manifestations', 'oral cavity', 'gingiva'. The inclusion criteria were papers published in English in the last 10 years that made reference to clinical cases with in which the oral cavity was affected. The quality of the results was assessed with 'The 2013 Care Checklist'. RESULTS: Nineteen clinical cases were analysed. The average quality was 7.68/13 (range 5-10/13). 73.7% of patients were women, the most frequent area for the lesions was the gingiva and the most prevalent lesion was gingival hyperplasia. 68.4% of the patients had this lesion as a first sign, 21.1% as a progression and 10.5% as a recurrence. 68.4% of the lesions resolved once medical treatment was established. CONCLUSION: GPA is a multisystem disorder associated with considerable morbidity and mortality if not treated. Early diagnosis improves the prognosis. The first manifestation of the disease can be seen in the oral cavity. It is important that dentists recognise the oral manifestation in order to improve the prognosis. Key words: granulomatosis, polyangiiitis, Wegener's granulomatosis.


Assuntos
Hiperplasia Gengival , Granulomatose com Poliangiite , Feminino , Gengiva , Granulomatose com Poliangiite/diagnóstico , Granulomatose com Poliangiite/tratamento farmacológico , Humanos , Prognóstico
17.
Bull Tokyo Dent Coll ; 61(4): 221-229, 2020 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-33177270

RESUMO

Preoperative gingival thickness is an important factor in the success of complete root coverage. Here, two cases are reported in which a biotype probe was used to assess the periodontal biotype before performance of a root coverage procedure. Clinical examinations were performed at baseline and at 3, 6, and 12 months postoperatively. The following clinical parameters were evaluated: probing depth, recession height, clinical attachment level, bleeding on probing, and width of keratinized gingiva. At baseline and at 12 months postoperatively, periodontal biotype was estimated using the biotype probe. The root coverage esthetic score was assessed to determine esthetic outcome at baseline and at 3, 6, and 12 months postoperatively. The periodontal biotypes in the mandibular central and lateral incisors were judged to be thin. These teeth presented with Miller Class II gingival recession after orthodontic therapy. Gingival recession was treated with a coronally advanced flap and autogenous connective tissue graft. In both cases, improvements in all clinical parameters and root coverage esthetic scores were evaluated at 3, 6, and 12 months postoperatively. The treated recession showed 100% root coverage. The periodontal biotype changed from one that was thin to one that was thick at the surgical sites. In both the present cases, objective preoperative assessment of the periodontal biotype allowed the appropriate surgical procedure to be selected.


Assuntos
Retração Gengival , Raiz Dentária , Tecido Conjuntivo , Estética Dentária , Seguimentos , Gengiva , Retração Gengival/cirurgia , Humanos , Perda da Inserção Periodontal , Raiz Dentária/cirurgia , Resultado do Tratamento
18.
Sci Rep ; 10(1): 16493, 2020 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-33020540

RESUMO

The combination of biomaterials and stem cells for clinical applications constitute a great challenge in bone tissue engineering. Hence, cellular networks derived from cells-biomaterials crosstalk have a profound influence on cell behaviour and communication, preceding proliferation and differentiation. The purpose of this study was to investigate in vitro cellular networks derived from human gingival mesenchymal stem cells (hGMSCs) and calcium phosphate (CaP) bioceramic interaction. Biological performance of CaP bioceramic and hGMSCs interaction was evaluated through cell adhesion and distribution, cellular proliferation, and potential osteogenic differentiation, at three different times: 5 h, 1 week and 4 weeks. Results confirmed that hGMSCs met the required MSCs criteria while displaying osteogenic differentiaton capacities. We found a significant increase of cellular numbers and proliferation levels. Also, protein and mRNA OPN expression were upregulated in cells cultured with CaP bioceramic by day 21, suggesting an osteoinductible effect of the CaP bioceramic on hGMSCs. Remarkably, CaP bioceramic aggregations were obtained through hGMSCs bridges, suggesting the in vitro potential of macrostructures formation. We conclude that hGMSCs and CaP bioceramics with micro and macropores support hGMSC adhesion, proliferation and osteogenic differentiation. Our results suggest that investigations focused on the interface cells-biomaterials are essential for bone tissue regenerative therapies.


Assuntos
Materiais Biocompatíveis/farmacologia , Regeneração Óssea/efeitos dos fármacos , Fosfatos de Cálcio/farmacologia , Comunicação Celular/efeitos dos fármacos , Gengiva/efeitos dos fármacos , Células-Tronco Mesenquimais/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Adesão Celular/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Humanos , Osteogênese/efeitos dos fármacos , Engenharia Tecidual/métodos
19.
Stomatologiia (Mosk) ; 99(5): 11-18, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034171

RESUMO

PURPOSE OF THE STUDY: The aim of the work is a spectroscopic investigation and comparison of the molecular composition of dentine and gingival fluids as well as of their diagnostic potential for the preventive screening of dentin caries. MATERIAL AND METHODS: Applying infrared spectroscopy including synchrotron radiation the samples of biological fluids taken from the oral cavity (dentine fluid, fluid from the gingival sulcus and blood) were studied for the patients with the progressive dentine caries. The part of this research was undertaken with the infrared microspectroscopy beamline at the Australian Synchrotron. RESULTS: Dentine and gingival fluids were shown to have no less complicated composition than the blood serum. Having all this in mind, in spite that these two fluids are derivatives of the blood serum, and a majority of the molecular groups observed in all of the three fluids can be detected in their IR-spectra, it follows that there is a number of signature modes that are in fact present in the IR spectra of only dentine and gingival fluids. This fact indicates at the molecular exchange between them under certain conditions. It means the high diagnostic potential in the study of the pathologic processes occurring in the oral fluid of a human. We have observed and fixed an increase of thiocyanates and esters in the samples of both dentine and gingival fluids under the development of dentin caries. CONCLUSION: Utilization of the gingival fluid for screening taking into account that its sampling is not such a complicated challenge as dentine fluid sampling will promote a transition to the personalized medicine, the development of high-technology healthcare and technology of the health preservation as a whole.


Assuntos
Cárie Dentária , Dentina , Austrália , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Gengiva , Humanos , Análise Espectral
20.
Int J Nanomedicine ; 15: 7469-7479, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33116482

RESUMO

Background: High-fluoride dentifrice is used to manage root caries, but there is no evidence whether its association with nanohydroxyapatite could provide an additional protection for root caries. Therefore, this study aimed to develop and evaluate the effect of an experimental dentifrice with high fluoride (F-) concentration and nanohydroxyapatite (nano-HA) on root dentin demineralization. Materials and Methods: After formulation of dentifrices, root dentin specimens were randomly assigned to six groups (n = 10) using different dentifrice treatments: placebo; nano-HA without F-; 1,100 µg F-/g; 1,100 µg F-/g + nano-HA; 5,000 µg F-/g; and 5,000 µg F-/g + nano-HA. A pH cycling model was performed for 10 days, in which treatments were performed twice a day. After that period, the longitudinal hardness was evaluated and the area of demineralization (ΔS) was calculated. The formulated dentifrices were evaluated for primary stability, cytotoxicity, and other technical parameters. Two-way ANOVA and Tukey's test with p set at 5% were used for data analysis. Results: The experimental dentifrices were stable and had no cytotoxicity. Regarding dentin demineralization, the placebo group significantly increased ΔS compared to all other treatment groups (p<0.001). The dentifrices containing 5,000 µg F-/g, regardless of the presence of nano-HA, led to a smaller lesion area in relation to the other treatments (p<0.001). Conclusion: The findings of this study suggest that nano-HA reduced dentin demineralization, and dentifrice with 5,000 µg F-/g dentifrices, regardless of the presence of nano-HA, showed a greater reduction in root dentin demineralization.


Assuntos
Dentifrícios/química , Dentifrícios/farmacologia , Dentina/efeitos dos fármacos , Durapatita/química , Fluoretos/farmacologia , Nanopartículas/química , Animais , Densidade Óssea/efeitos dos fármacos , Bovinos , Fibroblastos/efeitos dos fármacos , Fluoretos/administração & dosagem , Gengiva/citologia , Dureza , Humanos , Concentração de Íons de Hidrogênio , Espectroscopia de Infravermelho com Transformada de Fourier , Desmineralização do Dente/tratamento farmacológico , Raiz Dentária/efeitos dos fármacos , Difração de Raios X
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