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1.
Artigo em Inglês | MEDLINE | ID: mdl-33819325

RESUMO

The present clinical and histologic case reports describe the periodontal plastic approaches used for the correction of gingival deformities following free gingival grafting (FGG) procedures. Five patients with poor esthetic and functional outcomes following soft tissue grafting voluntarily requested corrective treatment due to differences in color, texture, thickness, and mucogingival junction (MGJ) alignment between grafted and adjacent tissue, or because of food retention apical to the grafted site. Plastic surgical approaches included eliminating the thick borders the graft, aligning the MGJ, and reducing the excessive apicocoronal dimension of the graft. Histologic images confirmed the morphologic differences between the graft and adjacent alveolar mucosa. After intervention, all treated sites achieved a satisfactory esthetic appearance and function, with a soft tissue anatomy indistinguishable from those of adjacent sites. All patients agreed that their goals for the treatment were completely fulfilled.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Bucais , Procedimentos Cirúrgicos Reconstrutivos , Cirurgia Plástica , Tecido Conjuntivo , Estética Dentária , Gengiva/cirurgia , Retração Gengival/cirurgia , Humanos
2.
Oral Health Prev Dent ; 19(1): 235-243, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33829721

RESUMO

PURPOSE: This systematic review addressed flap designs in endodontic surgery which can have an impact on the Oral Health Related Quality of Life (OHRQoL). MATERIALS AND METHODS: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) to identify all studies up to November 2019 that investigated the effect of flap designs on gingival recession and quality of life among healthy adults. RESULTS: The initial search identified 2701 references. Ten studies were included in this systematic review; two were randomised clinical trials and eight were non-randomised clinical trials. Studies showed that sulcular incision increases the risk of gingival recession and decreases OHRQoL. Two studies were included in the meta-analysis in relation to gingival recession. The pooled results demonstrated that submarginal incision showed a decreased weighted mean difference in gingival recession by 0.31 mm (95% CI: 0.12 - 0.51) (p = 0.002) compared to sulcular incision. CONCLUSION: Sulcular incision flap unfavourably affect the level of gingiva and OHRQoL. All nonrandomised studies had a statistically significant bias and the sample sizes in all studies were relatively small. More gingival recession and lower OHRQoL were associated with sulcular incision. Additional investigations are warranted to provide more evidence.


Assuntos
Retração Gengival , Qualidade de Vida , Adulto , Assistência Odontológica , Gengiva/cirurgia , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos
3.
Oral Maxillofac Surg Clin North Am ; 33(2): 197-209, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33750651

RESUMO

The delineation of excessive gingival display and review of current treatment options. Discussion over periodontal and prosthetic treatments, mucosal stripping procedures, myotomies, Botox therapy, and orthognathic procedures for correction of the "gummy smile."


Assuntos
Toxinas Botulínicas Tipo A , Estética Dentária , Gengiva/cirurgia , Humanos , Lábio , Sorriso
4.
Clin Oral Investig ; 25(4): 1655-1675, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33515121

RESUMO

INTRODUCTION: Preserving peri-implant tissues after immediate implant placement (IIP), especially in aesthetic zones, is a topic of interest. OBJECTIVES: This systematic review investigated the effects of currently available surgical procedures for preserving peri-implant tissue or ensuring dimensional stability following immediate implant placement. MATERIALS AND METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement's guidelines were followed, and articles were sought on the PubMed and Cochrane databases with no date restrictions. Only randomised clinical trials that evaluated changes in soft and hard tissues around immediately placed implants were included. Statistical analyses were performed, and the studies´ quality was assessed using the Cochrane Collaboration tool. The agreement between reviewers was assessed based on Cohen's kappa statistics. RESULTS: Of the 14 studies that met the inclusion criteria, 11 were analysed in the meta-analysis (kappa = 0.814; almost perfect agreement). The use of connective tissue grafts resulted in a significantly greater improvement of the facial gingival level (MD = -0.51; 95% CI: -0.76 to -0.31; p = < .001), and the placement of bone grafts significantly reduced the horizontal resorption of the buccal bone (MD = -0.59; 95% CI: -0.78 to -0.39; p < .001). CONCLUSION: Connective tissue grafts and bone grafts positively influence tissue preservation around immediately placed implants. Neither the flapless technique nor palatal implant positioning resulted in significant improvements to any of the investigated parameters. Additional longitudinal studies are required. CLINICAL RELEVANCE: This meta-analysis is useful for discerning the effects of soft tissue augmentation, bone grafting, the flapless technique, and palatal implant positioning on preserving peri-implant tissues after immediate implant placement.


Assuntos
Implantes Dentários , Carga Imediata em Implante Dentário , Implantação Dentária Endo-Óssea , Estética Dentária , Gengiva/cirurgia , Preservação de Tecido
5.
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
6.
BMJ Case Rep ; 13(12)2020 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-33370955

RESUMO

The application of free connective tissue graft (CTG) is the gold standard in the treatment of gingival recession in the area of teeth and implants. The aim of this case report is to demonstrate a possible mucosal overgrowth complication in the soft tissue grafting area. A 24-year-old patient underwent the treatment of gingival recession in the tooth 2.3 region by an envelope technique using a free CTG from the hard palate region. Seven years after the surgery, a mucosal overgrowth was observed, which developed asymptomatically and did not cause any problems to the patient.


Assuntos
Tecido Conjuntivo/transplante , Gengiva/cirurgia , Crescimento Excessivo da Gengiva/etiologia , Retração Gengival/cirurgia , Complicações Pós-Operatórias/etiologia , Adulto , Doenças Assintomáticas , Feminino , Humanos , Estudos Longitudinais , Palato Duro/transplante , Transplante Autólogo/efeitos adversos , Resultado do Tratamento , Adulto Jovem
7.
Chin J Dent Res ; 23(3): 205-214, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32974621

RESUMO

This report describes the cases of two patients with a maxillary lateral incisor with palatogingival groove and extensive endodontic-periodontal lesions. Although it is reported that acceptable periodontal status is of great importance in case selection in intentional replantation, it is suggested in this report that intentional replantation could be chosen instead of immediate extraction if extensive endodontic-periodontal lesions exist in a tooth with palatogingival groove. The gingival margin position and gingival papilla were well preserved and the bone defect was almost completely repaired. This was beneficial to the aesthetic prosthodontic treatment and implantation, although external root resorption was observed.


Assuntos
Reimplante Dentário , Raiz Dentária/cirurgia , Gengiva/cirurgia , Humanos , Incisivo/cirurgia , Tratamento do Canal Radicular
8.
J Esthet Restor Dent ; 32(3): 280-290, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311199

RESUMO

OBJECTIVE: The aim of this systematic review and meta-analysis was to evaluate the soft tissue outcomes of connective tissue graft (CTG) combined with immediate implant placement and restoration (IIPR) in the esthetic zone. MATERIALS AND METHODS: Following the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement, randomized controlled trials (RCTs) were searched for in electronic databases and complemented by hand searching. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool and data were analyzed using statistical software. RESULTS: A total of 180 studies were identified, of which, four trials were included with 144 implant sites in 144 participants. Overall meta-analysis showed that CTG in conjunction with IIPR had a significantly greater gingival thickness than IIPR alone. The IIPR with CTG had less recession and higher esthetic pink score compared to IIPR group, but the difference was not statistically significant. No significant differences in implant failure rate were found between IIPR with and without CTG. CONCLUSIONS: The use of CTG in conjunction with IIPR in the esthetic zone significantly improved the thickness of the gingival tissues compared to IIPR without CTG. No significant differences were observed in the level of soft tissues around immediately placed implants with or without CTG. CLINICAL SIGNIFICANCE: The use of connective tissue graft with IIPR can be considered to improve the soft tissue profile and minimize mucosal recession in esthetic zone.


Assuntos
Implantes Dentários , Tecido Conjuntivo , Implantação Dentária Endo-Óssea , Estética Dentária , Gengiva/cirurgia
9.
Clin Implant Dent Relat Res ; 22(3): 325-332, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32346981

RESUMO

BACKGROUND: Immediate implantation is generally a predictable treatment, but sometimes there are significant tissue alterations at the surgical site which compromise clinical outcomes. PURPOSE: This study aimed to investigate the association between tissue alterations and different clinical parameters in esthetic areas following immediate implant placement and provisionalization. MATERIALS AND METHODS: Clinical parameters were measured at 36 non-grafted immediate implant sites enrolled in a randomized controlled trial. Alterations of bone and soft tissue were measured at 12 months after the treatment. Stepwise linear regression analysis was performed to analyze the association between different clinical parameters and outcomes of interest. RESULTS: Gingival thickness 3 mm apical to the gingival margin (GT3) was positively associated with recession of mid-buccal gingival margin, while vertical distance between the buccal gingival margin and the crest (GM-bone) was negatively associated (P = .03, .01). Flap elevation and older age were positively associated with recession of the interproximal gingival margin (P = .04, .01). Horizontal defect dimension was positively associated with buccal ridge dimensional reduction while gingival thickness at free gingival margin (GT1) was negatively associated (P = .01, .04). Regarding interproximal bone level change, none of the clinical parameters was significantly associated. CONCLUSIONS: Gingival phenotype was the only parameter significantly associated with both buccal gingival recession and buccal ridge dimensional reduction. It is important to assess clinical parameters before and during immediate implant procedure.


Assuntos
Implantes Dentários para Um Único Dente , Estética Dentária , Retração Gengival , Carga Imediata em Implante Dentário , Idoso , Implantação Dentária Endo-Óssea , Gengiva/cirurgia , Humanos , Alvéolo Dental/cirurgia
10.
Orv Hetil ; 161(3): 110-115, 2020 Jan.
Artigo em Húngaro | MEDLINE | ID: mdl-31928061

RESUMO

In everyday dental practice, sterility is essential. Sterilizing different materials can require different methods. In the case of heat sensitive and elastic materials, most common techniques are not suitable because they need to be treated on lower temperature, not to lose their physical properties. For instance, if rubber dam is divested of elasticity, it is useless in restorative dentistry thereafter. Sterilizing rubber dam sheets is not a frequent process, but in certain cases it can be necessary. In such a situation, dentists have to choose between rare and hard-to-reach options. In our referral, we summarize the possibilities of sterilization, focusing on plasma sterilization and hydrogen-peroxide vapor sterilization. During the treatment of our presented case with a deep subgingival fracture line, affecting the crown and the root surface as well, we applied a rubber dam sheet, sterilized with hydrogen-peroxide vapor in order to use adhesive technique. Orv Hetil. 2020; 161(3): 110-115.


Assuntos
Gengiva/lesões , Diques de Borracha , Esterilização , Odontologia , Odontólogos , Gengiva/cirurgia , Humanos
11.
J Clin Periodontol ; 47(3): 362-371, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31811742

RESUMO

BACKGROUND: Aim of this study was to compare coronally advanced flap (CAF) and composite restoration of the cement-enamel junction (CEJ) with or without connective tissue graft (CTG) for treatment of single maxillary gingival recession with non-carious cervical lesion (NCCL). MATERIAL AND METHODS: Thirty patients with single gingival recessions and previously restored NCCL were randomly allocated to the two groups. A masked examiner evaluated recession reduction (RecRed), complete root coverage (CRC), keratinized tissue (KT) gain, increase in gingival thickness (GT), patient satisfaction and Root coverage Esthetic Score (RES). RESULTS: No significant difference for RecRed and CRC was detected at 12 months. CAF + CTG resulted in greater increase of KT width and thickness (p < .001). An interaction between baseline GT and type of treatment was reported, suggesting that when baseline GT was ≤0.84 mm adding CTG led to higher RecRed, while for values >0.84 mm the use of CAF was associated with better outcomes. Similarly, CAF alone provided better final RES score for baseline GT > 0.82 mm. CONCLUSION: Both procedures were effective for root coverage at single RT1 recession with previously restored CEJ. Adding a CTG under CAF should be considered for Rec with thin gingival phenotype.


Assuntos
Retração Gengival/cirurgia , Tecido Conjuntivo , Esmalte Dentário , Estética Dentária , Seguimentos , Gengiva/cirurgia , Humanos , Perda da Inserção Periodontal , Raiz Dentária/cirurgia , Resultado do Tratamento
12.
J Invest Surg ; 33(1): 49-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29856665

RESUMO

Aim: The aim of this study was to evaluate the effect of Hypericum perforatum (HP) oil on wound-healing process in rabbit palatal mucosa. Materials and Methods: Thirty-six New Zealand albino rabbits were randomly allocated to following groups; (1) HP oil (test, n = 18) and (2) olive oil (control, n = 18). Palatinal excisional wounds were created and the oils were topically applied (0.1 ml, 30 s, twice a day). Gingival biopsies were excised, and analyzed for re-epithelialization (RE) and granulation tissue maturation (GTM) on days 3, 7, and 14 after surgery. Levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF-2) were assessed using the immunohistochemical method. Apoptotic cells (ACs) were evaluated using TUNEL staining. Enzyme-linked immunosorbent assay was used to assess tissue catalase (CAT) and malondialdehyde (MDA) levels. Results: RE and GTM were completed earlier in the HP oil group than in the control group. The number of positively stained cells/vessels was higher in olive oil than in the test group on day 3 for FGF-2 and on days 3 and 7 for VEGF (p < 0.05). In contrast, on day 14, a higher number of vessels was observed in the HP oil group than in the control group. HP oil treatment reduced the number of ACs compared to olive oil (p < 0.05), but the difference during the healing period did not reach significance. Tissue CAT and MDA levels between groups were not different, and also the results were the same when the levels were analyzed by the evaluated time periods (p > 0.05). Conclusions: The results of this study demonstrated that topical HP oil treatment did not provide an additional benefit to its base, olive oil, in the early phase of secondary wound healing.


Assuntos
Hypericum/química , Mucosa Bucal/efeitos dos fármacos , Óleos Vegetais/administração & dosagem , Reepitelização/efeitos dos fármacos , Ferida Cirúrgica/tratamento farmacológico , Administração Tópica , Animais , Biópsia , Modelos Animais de Doenças , Gengiva/efeitos dos fármacos , Gengiva/patologia , Gengiva/cirurgia , Humanos , Masculino , Mucosa Bucal/cirurgia , Palato/efeitos dos fármacos , Palato/patologia , Palato/cirurgia , Coelhos
13.
Lasers Med Sci ; 35(2): 395-402, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31273569

RESUMO

The aim of this triple-blind randomized clinical trial was to evaluate the efficacy and safety of diode laser during circumvestibular incisions for Le Fort I osteotomy in orthognathic surgeries in comparison with conventional techniques using electrocautery and scalpel. Patients were randomly allocated to one of three groups based on the technique employed to perform incisions: diode laser, electrocautery, and scalpel. The parameters used to evaluate the efficacy and safety of diode laser were incision velocity, duration of surgery, bleeding rate, alterations in postoperative functions, pain, edema, wound clinical healing, and infection. Thirty patients were enrolled in the study (10 per group). Regarding bleeding, the incisions performed with diode laser promoted a lower bleeding rate compared with scalpel and electrocautery (p = 0.00). The diode surgical laser was effective during the incision procedure, but required a longer time to perform the incisions compared with the other techniques evaluated (p < 0.05). No statistically significant difference was detected between groups regarding total surgical time or other safety parameters (p > 0.05). Thus, diode laser proved to be effective and safer during circumvestibular incisions for Le Fort I osteotomy than conventional devices.


Assuntos
Lasers Semicondutores/efeitos adversos , Lasers Semicondutores/uso terapêutico , Cirurgia Ortognática , Osteotomia , Adolescente , Adulto , Eletrocoagulação , Feminino , Gengiva/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Complicações Pós-Operatórias/etiologia , Ferida Cirúrgica/etiologia , Resultado do Tratamento , Cicatrização , Adulto Jovem
14.
J Periodontol ; 91(1): 9-16, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31461778

RESUMO

This state-of-the-art review presents the latest evidence and the current status of autogenous soft tissue grafting for soft tissue augmentation and recession coverage at teeth and dental implant sites. The indications and predictability of the free gingival graft and connective tissue graft (CTG) techniques are highlighted, together with their expected clinical and esthetic outcomes. CTGs can be harvested from the maxillary tuberosity or from palate with different approaches that can have an impact on graft quality and patient morbidity. The influence of CTGs on soft tissue thickness and keratinized tissue width are also discussed.


Assuntos
Implantes Dentários , Retração Gengival/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Tecido Conjuntivo , Estética Dentária , Gengiva/cirurgia , Humanos , Plásticos
15.
Int J Oral Implantol (Berl) ; 13(4): 401-409, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33491370

RESUMO

Purpose: Few case reports have been published on creeping attachment around dental implants. This study aimed to assess changes in the level of the mucosal margin following placement of free gingival grafts around single implants exhibiting mucosal recession with < 2 mm keratinised mucosa compared to that of implants with ≥ 2 mm keratinised mucosa.
Materials and methods: A total of 12 subjects with one or more implants were included. Nineteen implants displaying implant thread and/or prosthetic abutment exposure with < 2 mm keratinised mucosa were treated using free gingival grafts (FGG group), and 11 implants exhibiting ≥ 2 mm keratinised mucosa did not receive free gingival grafts (control group). The width of keratinised mucosa and the amount of mucosal recession were measured by a blind evaluator (MC).
Results: A continual reduction in mucosal recession was observed at the 6- and 12-month followups in all except two of the FGG group implants, while no change in the level of the mucosal margin was observed in the control group. This postoperative coronal migration of the mucosal margin resulted in a 0.7-mm mean reduction in mucosal recession after 12 months in the FGG group.
Conclusion: The level of the mucosal margin around implants exhibiting mucosal recession along with a lack of keratinised mucosa migrated coronally following free gingival grafts, and creeping attachment was observed in a number of patients.

.


Assuntos
Implantes Dentários , Procedimentos Cirúrgicos Bucais , Implantação Dentária Endo-Óssea , Gengiva/cirurgia , Humanos , Membrana Mucosa
16.
Cancer Biomark ; 26(3): 375-383, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31594213

RESUMO

BACKGROUND: p16 has often been found to be overexpressed in patients oral squamous cell carcinoma (OSCC), but its prognostic value between anatomic subsites is still unclear. OBJECTIVE: The aim of this study was to investigate the diagnostic and prognostic values of p16 in OSCC originating from tongue, gingiva or buccal mucosa. METHODS: A total of 147 OSCC patients with tumors arising from the tongue, gingiva or buccal mucosa were enrolled in this study. p16 expression was detected using immunohistochemistry (IHC), and the presence of HPV16 was determined by real-time PCR in p16 positive patients. The correlation of p16 expression with the clinical parameters was evaluated. RESULTS: Only one p16 positive patient with a cut off value of 25% and 75% was HPV16 positive. Although overall survival (OS), recurrence free survival (RFS) and metastasis free survival (MFS) had no significant differences between the p16 positive and negative patients, p16 negative patients (cut off value 25%) had more RFS in the buccal mucosa cancer (p= 0.03) than the p16-positive patients. CONCLUSIONS: The prevalence of HPV16 in Chinese OSCC patients was low. p16 overexpression decoupled from HPV infection was not a prognostic marker for OSCC patients except for patients with the buccal mucosa cancer.


Assuntos
Biomarcadores Tumorais/metabolismo , Inibidor p16 de Quinase Dependente de Ciclina/metabolismo , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Inibidor p16 de Quinase Dependente de Ciclina/análise , DNA Viral/isolamento & purificação , Intervalo Livre de Doença , Feminino , Seguimentos , Gengiva/patologia , Gengiva/cirurgia , Papillomavirus Humano 16/genética , Papillomavirus Humano 16/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/patologia , Mucosa Bucal/cirurgia , Neoplasias Bucais/mortalidade , Neoplasias Bucais/cirurgia , Neoplasias Bucais/virologia , Prognóstico , Reação em Cadeia da Polimerase em Tempo Real , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Carcinoma de Células Escamosas de Cabeça e Pescoço/virologia , Língua/patologia , Língua/cirurgia
17.
J Appl Oral Sci ; 27: e20180584, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596366

RESUMO

OBJECTIVES: This study aimed to compare two different soft tissue replacement grafts in their ability to treat gingival recession defects and successfully integrate with the surrounding tissues. METHODOLOGY: Nine beagle dogs were included and followed up to 10 weeks. Sites for intervention were allocated to one of the grafting materials investigated. Treatment consisted of coronally advanced flap combined with one of the two soft tissue substitutes on a previous surgically created defect. Materials employed were porcine-derived acellular dermal matrix (ADM) [Novomatrix™ (Test)] and collagen-based matrix (CBM) [Mucograft® (Control)]. Animals were sacrificed at 2, 6, and 10 weeks postoperatively and compared using descriptive histology and histomorphometric outcomes. RESULTS: Macroscopic findings were similar between test and control groups at all intervals. After 10 weeks, both groups demonstrated successful incorporation of the grafting materials without signs of rejection and with comparable tissue integration. The histomorphometric data were similar between groups at 2 weeks; however, the test group provided greater root coverage and increase in tissue thickness than the control at 6- and 10-weeks post surgically. CONCLUSIONS: Both porcine-derived ADM and CBM revealed similar histological outcomes with successful integration and absence of adverse events. Test group provided superior outcomes regarding root coverage and increase in tissue thickness.


Assuntos
Derme Acelular , Colágeno/uso terapêutico , Retração Gengival/cirurgia , Animais , Vasos Sanguíneos/patologia , Cães , Gengiva/patologia , Gengiva/cirurgia , Retração Gengival/patologia , Teste de Materiais , Valores de Referência , Reprodutibilidade dos Testes , Retalhos Cirúrgicos , Suínos , Fatores de Tempo , Resultado do Tratamento
18.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 89-95, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538454

RESUMO

The use of digital tools offers a new perspective to daily clinical activities even though sometimes different clinical approaches are necessary. This case report of a maxillary anterior rehabilitation demonstrates the application of a gingival displacement technique to enhance the recording of subgingival finish line by means of an intraoral optical scanner (IOS). The temporary restoration was used as a guide for the radiosurgery tip in order to displace the gingiva in a guided and mini-invasive approach. It was then possible to create the space between the tooth structure and the soft tissues for the light beam of the IOS to properly detect the finish lines of the dental preparation. Six single porcelain fused to zirconia crowns were delivered. This technique could be considered as a solution of complex cases with subgingival dental preparation to be detected by means of an IOS.


Assuntos
Técnica de Moldagem Odontológica , Planejamento de Prótese Dentária , Gengiva/cirurgia , Radiocirurgia , Desenho Assistido por Computador , Estética Dentária , Humanos
19.
Cell Tissue Bank ; 20(4): 501-511, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31446503

RESUMO

The ultimate goal of any periodontal plastic surgery aimed to treat gingival recession is predictable recession coverage and esthetic outcome. Due to the post-operative morbidity and discomfort related to subepithelial connective tissue graft, various other methods have been introduced including the use of fetal membranes. The fetal membranes have shown promising results in medicine and recently in the field of regenerative dentistry and could possibly become a viable alternative to autogenous grafts. This article reports a series of cases of Miller's class I gingival recession that were treated by chorion membrane combined with coronally advanced flap and evaluated using objective variables for post-operative healing and esthetics. Nine systemically healthy subjects with ten Miller's class I buccal gingival recession were included in the study. Clinical parameters were recorded at baseline, 3 months and 6 months post-surgery; wound healing index (WHI) was recorded one week post-surgery. At the end of 6 months, the percentage of root coverage and the root coverage esthetic score (RES) were calculated. The results showed statistically significant (p < 0.05) improvement in most of the parameters. The mean percentage of root coverage obtained was 62.20 ± 21.99% ranging from 33.3 to 100%. The WHI showed excellent healing score and RES assessed at the end of six months showed superior esthetic results. The chorion membrane along with coronally advanced flap is a predictable procedure for root coverage with better post surgical healing and superior esthetics.


Assuntos
Córion/transplante , Gengiva/cirurgia , Retração Gengival/cirurgia , Raiz Dentária/cirurgia , Cicatrização , Adulto , Gengiva/patologia , Retração Gengival/patologia , Gengivoplastia/métodos , Humanos , Período Pós-Operatório , Adulto Jovem
20.
Biotech Histochem ; 94(6): 389-397, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31423894

RESUMO

A peripheral (gingival) fibroma, a gingival cyst and hyperplastic gingivitis occurred simultaneously in a man with metastatic medullary thyroid carcinoma (MCT). The gingival growths and hyperplasia appeared to be related to poor oral hygiene rather than to the MTC. Despite the patient's improved oral hygiene, the hyperplastic gingivitis and peripheral fibroma recurred, and a new peripheral fibroma and gingival cyst developed, which prompted reconsideration of a link with the MTC. MTC cells secrete calcitonin (CT), procalcitonin (ProCT) and growth factors; the patient's serum CT and ProCT were several fold higher than normal. The patient's salivary CT and ProCT also were elevated, but α-amylase and epidermal growth factor (EGF) were not, compared to three healthy controls. A possible link between the MTC and gingival hyper-reactivity due to CT and/or ProCT promoting inflammatory cytokines, and the utility of salivary ProCT as an indicator of periodontitis in this patient were explored further. Unstimulated whole saliva and serum were collected from the patient followed by a standard periodontal examination before periodontal treatment, and 3 weeks and 3 months after treatment. This cycle was repeated 7 months after the previous periodontal treatment. The saliva was assayed for ProCT and the serum was assayed for ProCT, high sensitivity C-reactive protein (CRP), interleukin-6 (IL-6) and proadrenomedullin (ProADM). The results were analyzed for correlations among the severity of periodontitis and the biomarkers/cytokines. Only the salivary ProCT was correlated with the severity of periodontitis, i.e. it was higher just before and lower at 3 weeks and 3 months after each periodontal treatment. The patient's salivary ProCT content also was much higher than reported elsewhere. The other biomarkers/cytokines were within normal ranges. Our findings indicate that salivary ProCT is independent of serum ProCT and therefore may be a useful marker for moderate to severe periodontitis in patients with MTC. The greatly elevated salivary and serum CT and ProCT, and a trend toward correlation between the serum CRP and ProCT suggest a pro-inflammatory link between the MTC and the hyperreactive gingiva in this patient. Further studies are warranted to determine whether hyperplastic gingivitis and gingival growths, such as cysts and fibromas, occur with unusual frequency in patients with MTC.


Assuntos
Calcitonina/sangue , Carcinoma Neuroendócrino/patologia , Gengiva/patologia , Saliva/metabolismo , Neoplasias da Glândula Tireoide/patologia , Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Carcinoma Neuroendócrino/secundário , Gengiva/cirurgia , Gengivite/diagnóstico , Gengivite/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Periodontite/metabolismo , Neoplasias da Glândula Tireoide/secundário
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