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1.
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
2.
Artigo em Inglês | MEDLINE | ID: mdl-33819320

RESUMO

Modern dentistry is focused on patient needs, with the current trend shifting from merely restoring the loss of function to pursuing the esthetic satisfaction of patients and professional operators, as well as achieving optimal and stable results. Ideal smile esthetics depend on the balance between white and pink components, and therefore papilla reconstruction is one of the most challenging goals in periodontal plastic surgery and restorative procedures. The present case report proposes a surgical technique for the combined treatment of RT2 and RT3 recession defects and interdental papilla loss by means of a modified coronally advanced flap with an interdental subepithelial connective tissue graft.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Reconstrutivos , Tecido Conjuntivo , Estética Dentária , Gengiva , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Resultado do Tratamento
3.
Artigo em Inglês | MEDLINE | ID: mdl-33819324

RESUMO

Numerous surgical techniques for root coverage have been suggested with different degrees of success, as assessed by the proportion of complete root coverage. Mandibular incisors, teeth with a high frequency of gingival recession defects (GRDs), were associated with the least favorable outcomes due to unfavorable anatomical conditions. In the present series of three cases, a modified version of the free gingival graft technique for the purpose of root coverage at mandibular incisors is illustrated. The purpose of the modification of the original technique was to achieve improved blood supply from the recipient site to the graft, with the ultimate aim of enhancing predictability and outcomes of the procedure. In all included cases, complete or almost complete root coverage was achieved at challenging GRDs in the mandibular incisor area.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Bucais , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Humanos , Incisivo/cirurgia , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
4.
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
5.
Artigo em Inglês | MEDLINE | ID: mdl-33819329

RESUMO

This randomized controlled clinical trial with a 1-year follow-up evaluated gingival thickness changes around teeth after use of dermal allograft and xenograft matrix. A total of 116 teeth (19 patients) were separated into two groups. One group received xenogeneic collagen matrix (n = 48), while the other received allogeneic acellular dermal matrix (n = 68) via a coronally advanced flap (CAF). Gingival thickness (GT), keratinized gingival width (KGW), pocket depth (PD), and clinical attachment loss (CAL) were measured on the day of surgery (baseline) and at 3 weeks, 2 months, 6 months, and 1 year postoperative. The two groups were compared using repeated-measures ANOVA (P < .05). The mean GT at 1 year was 1.59 ± 0.31 mm in the xenogeneic group and 1.63 ± 0.33 mm in the allogeneic group (P = .60). The mean change in GT was 1.08 mm in the xenogeneic group and 1.13 mm in the allogeneic group, which was clinically relevant and statistically significant compared to baseline values (P < .001). However, changes in GT were not significantly different between the two groups at any time point (P > .05). The GT increased in all cases treated with allogeneic and xenogeneic enriched collagen matrix. Both soft tissue substitutes were equally effective in acheiving optimal GT.


Assuntos
Retração Gengival , Transplante de Células-Tronco Hematopoéticas , Colágeno , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Humanos , Raiz Dentária , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-33819332

RESUMO

The aim of the present case series was to evaluate the outcomes of the modified coronally advanced tunnel technique (MCAT) using the width of keratinized tissue (KTW) as an indicator to apply the connective tissue graft (CTG) specifically. Seven patients requiring treatment for the presence of multiple gingival RT1 recession defects in the maxilla were enrolled in the study. A total of 36 recessions were treated with MCAT, and the CTG was applied in 16 sites presenting < 2 mm of KTW at baseline. The mean root coverage from baseline to 1 year postsurgery was 90% for the sites treated with MCAT alone and 93.7% for those treated with MCAT+CTG. The increase of KTW was higher in the sites treated with CTG than in the sites treated without it. Within the limitations of the present case series, it can be concluded that the proposed surgical technique is extremely effective in gaining root coverage and reducing the amount of connective tissue harvested from the donor site.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Humanos , Maxila/cirurgia , Retalhos Cirúrgicos , Raiz Dentária , Resultado do Tratamento
7.
Artigo em Inglês | MEDLINE | ID: mdl-33819336

RESUMO

This randomized split-mouth preliminary clinical trial aimed to evaluate periodontal parameters and gingival blood flowmetry, comparing sites that received subepithelial connective tissue graft from the palate after deepithelialization (DE) or obtained with parallel incision (PI). Periodontal parameters were evaluated at baseline and 6 months postoperative. Gingival blood flows were analyzed by laser Doppler flowmetry (LDF) at baseline and 2, 7, and 14 days postoperative. Statistical and LDF analyses were performed with R version 3.5.1 and MATLAB software, and clinical parameters through ANOVA and Wilcoxon signed-rank tests. LDF showed superior decrease in power spectral density (PSD) for DE after 2 days. After 7 days, PSD returned to initial values only for PI, and DE had not returned to the initial values by day 14. Despite major initial revascularization challenges for DE sites, both grafts promoted satisfactory root coverage in the treatment of multiple gingival recessions.


Assuntos
Retração Gengival , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Humanos , Reologia , Raiz Dentária/cirurgia , Resultado do Tratamento
8.
Quintessence Int ; 52(4): 284-291, 2021 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-33655740

RESUMO

OBJECTIVE: The objective of this study was to systematically review the literature regarding the effect of root coverage procedures on tooth survival and periodontal outcomes. DATA SOURCES: A systematic search of the literature was performed according to the PRISMA guidelines. A PICO-based search strategy was performed in six databases. Eligibility criteria included studies comparing tooth survival and periodontal outcomes of teeth treated with root coverage procedures versus teeth that had no treatment. The search resulted in 3,646 articles; 212 articles were downloaded for review, and six articles (three studies) were included. Only a single study reported on tooth survival and found no difference between teeth that underwent root coverage procedures versus those that did not. Although the surgeries described in each study were mostly successful in reducing recession and increasing keratinized gingiva, teeth which did not undergo surgery did not seem to have a clinically significant change in recession. The study with the longest follow-up (18 to 35 years) showed an average increase in recession of 0.5 ± 0.9 mm and a decrease in keratinized tissue of 0.3 ± 0.8 mm in the control group. CONCLUSION: This systematic review highlights the need for randomized controlled trials to assess the influence of root coverage surgeries on tooth longevity in order to better inform evidence-based practice. When compared to no surgical intervention, there is presently no evidence to suggest that root coverage surgeries increase tooth longevity. Furthermore, the amount of recession does not appear to increase a clinically significant amount over time without surgical intervention in the presence of proper maintenance and home care.


Assuntos
Retração Gengival , Tecido Conjuntivo , Seguimentos , Gengiva , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Raiz Dentária/cirurgia , Resultado do Tratamento
9.
Quintessence Int ; 0(0): 402-410, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491386

RESUMO

Objective: The aim was to evaluate the efficacy of periodontal regenerative therapy using enamel matrix derivatives (EMDs) in aggressive periodontitis patients, and to determine the contribution of maintenance via periodic supportive periodontal treatment. Method and materials: In total, 28 patients were evaluated, comprising 74 intrabony sites. In 50 sites EMD gel was applied, and in 24 sites EMD was combined with deproteinized bovine xenograft. Patients were assigned to a supportive periodontal treatment program; 18 patients fulfilled the program, defined as the well-maintained (WM) group; 10 did not comply, defined as the nonmaintained (NM) group. Probing depth (PD), clinical attachment level (CAL), and radiographic bone level (BL) were recorded. Data were compared presurgically (T0), 6 months postsurgery (T1), and 3 to 10 years posttreatment (T2). Results: Both surgical modalities achieved similar PD reduction, CAL gain, and BL gain, maintained over time. T1 to T2 showed a mean gain/loss of 0.21 ±â€¯0.5 mm and 0.04 ±â€¯1.1 mm, and -0.65 ±â€¯3.0 mm and -0.73 ±â€¯3.0 mm for PD and CAL, respectively, at the WM/NM groups, respectively. BL gain was 21.6% and 11.5% for the WM/NM groups, respectively (P < .05). The courses of the PD, CAL, and BL differed between the WM and NM groups during the observation periods (P < .05). Conclusion: Periodontal regeneration via EMD with/without the combination of deproteinized bovine xenograft can be maintained in aggressive periodontitis cases. It appears that periodic supportive periodontal treatment is a determinant factor in achieving this task.


Assuntos
Periodontite Agressiva , Perda do Osso Alveolar , Proteínas do Esmalte Dentário , Retração Gengival , Periodontite Agressiva/cirurgia , Perda do Osso Alveolar/cirurgia , Animais , Bovinos , Seguimentos , Retração Gengival/cirurgia , Regeneração Tecidual Guiada Periodontal , Humanos , Perda da Inserção Periodontal/cirurgia , Bolsa Periodontal/cirurgia , Resultado do Tratamento
10.
J Esthet Restor Dent ; 33(1): 152-157, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33459477

RESUMO

OBJECTIVE: To address the myths and realities of soft tissue grafting with the tunnel technique in the mandibular anterior region. MATERIALS AND METHODS: Myths associated with use of the tunnel technique for soft tissue grafting in the mandibular anterior region are identified and examined. Explanations for the misunderstandings are presented and documented with case examples and evidence from scientific studies. RESULTS: Six myths are described and the realities are presented. CONCLUSIONS: This report demonstrates that the tunnel technique can be successfully used in the mandibular anterior region in the presence of anatomic features thought to favor the use of more invasive surgical methods. CLINICAL SIGNIFICANCE: Soft tissue grafting in the mandibular anterior region has complicating anatomical features including a strong frenal attachment, shallow vestibule and thin tissue. These features may be successfully managed with a free gingival graft, but that procedure results in an uncomfortable experience for the patient. The tunnel technique, especially when combined with an acellular dermal matrix, dramatically improves the patient experience and esthetic outcome without compromising the clinical outcome.


Assuntos
Retração Gengival , Procedimentos Cirúrgicos Bucais , Retração Gengival/cirurgia , Humanos , Mandíbula/cirurgia , Retalhos Cirúrgicos
11.
Clin Oral Investig ; 25(4): 1613-1626, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33474623

RESUMO

OBJECTIVE: This review aimed to evaluate the effects of enamel matrix derivative (EMD) in association with coronally advanced flap (CAF) or CAF + connective tissue graft (CTG) when compared with CAF alone or CAF + CTG for the treatment of gingival recessions (GR) in maxillary teeth. METHODS: Five databases and gray literature were searched up to April 2020, to find randomized clinical trials comparing the clinical effects of CAF + EMD versus CAF alone (first group) or CAF + CTG + EMD versus CAF + CTG (second group) in the treatment of Miller class I and II or Cairo type I gingival recessions (GR). Random effects model of mean differences was used to determine the GR reduction, gain in keratinized tissue width (KTW), and gain in clinical attachment level (CAL). The trial sequential analysis (TSA) was implemented to determine the optimal information size (OIS) and imprecision using the GRADE approach. Bayes factors were calculated as complementary statistical evidence of p value. RESULTS: From 1349 titles identified, 9 trials representing 336 GR were included. The meta-analysis showed a statistically significant difference for GR reduction and CAL gain in favor CAF + EMD (p ≤ 0.05). The additional effect of EMD showed a statistically significant difference in GR reduction in favor CAF + CTG + EMD (p ≤ 0.05). The differences in KTW gain proved to be not statistically significant in both comparison groups. The OIS were not met among meta-analyses. Evidence certainty according the GRADE approach proved to be moderate for GR reduction and gain in CAL, but very low for gain in KTW. CONCLUSION: The adjunctive application of EMD in the treatment of GR in maxillary teeth either with CAF or CTG provided moderate certainty evidence in favor of their use for reduction in GR and gain in CAL at 6 and 12 months. However, their effect on the increase in keratinized tissue band height showed very low evidence certainty for its use. CLINICAL RELEVANCE: To know if EMD could improve the results for root coverage.


Assuntos
Proteínas do Esmalte Dentário , Retração Gengival , Teorema de Bayes , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Gengivoplastia , Humanos , Raiz Dentária , Resultado do Tratamento
12.
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
13.
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
14.
Stomatologija ; 21(2): 58-64, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33242031

RESUMO

AIM: To compare and evaluate the effects of two different approaches on treating gingival recessions: coronally advanced flap (CAF) with platelet rich-fibrin (PRF) membrane and coronally advanced flap (CAF) with connective tissue graft (CTG). MATERIAL AND METHODS: A systematic literature review was performed of randomized control trials in English identified in MEDLINE (PubMed), Cochrane Central Register of Controlled Trials (Cochrane Library), Springer Link, Science Direct and Google Scholar databases, published between 2015 and 2020. Studies had to be performed in vivo with follow-up periods of ≥6 months. RESULTS: 153 publications were found, out of which 8 were identified as relevant to the theme. Six of these studies evaluated periodontal parameters such as probing depth (PD), clinical attachment level (CAL), recession depth (RD), keratinized tissue width (KTW) and gingival thickness (GT). In 3 studies discomfort and aesthetic scores were analyzed as subjective parameters. 1 study histologically evaluated different techniques of gingival recession treatment. CONCLUSION: Both techniques are effective in the treatment of Miller's class I and II gingival recessions. Although the CTG technique may provide better results in KTW and GT, PRF avoids a donor site, which means a major decrease in postoperative discomfort.


Assuntos
Retração Gengival , Fibrina Rica em Plaquetas , Tecido Conjuntivo , Estética Dentária , Retração Gengival/cirurgia , Humanos , Resultado do Tratamento
15.
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
16.
Compend Contin Educ Dent ; 41(9): e1-e4, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33001660

RESUMO

Recession defects can affect both tooth and implant sites. The objective of connective tissue grafting is to correct recession defects and develop a soft-tissue architecture that is both stable and natural in appearance. By protecting the integrity of the interdental papillae, tunnel techniques are intended to maximize esthetic results. The use of an acellular dermal matrix (ADM) allows treatment of multiple adjacent recession defects without the need for a palatal donor site. The dental literature is scarce on the use of ADMs to treat recession affecting implant sites. The purpose of this article is to discuss and demonstrate the use of a modified tunnel technique and a double layer of an ADM in the treatment of recession defects affecting multiple teeth and an implant.


Assuntos
Derme Acelular , Implantes Dentários , Retração Gengival/cirurgia , Estética Dentária , Gengivoplastia , Humanos
17.
Stomatologiia (Mosk) ; 99(5): 46-49, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034176

RESUMO

The results of a comparative assessment of the state of hemomicrocirculation and oxygen metabolism in the mucous membrane of the alveolar crest after contour plastics of the gums during dental implantation using a connective tissue graft from the upper jaw, a connective tissue transplant from the palate and the collagen matrix collagen matrix are presented. During contouring with the use of connective tissue graft (CTG) from the upper jaw and collagen matrix in the mucous membrane of the alveolar mandible, the level of tissue blood flow decreases, which characterizes the development of ischemia, which is stopped after 3 weeks, when using a connective tissue graft (CTG) from the palatine, the level of tissue blood flow rises, which indicates the development of hyperemia, which is stopped for more than 3 weeks. According to oximetry data after contouring with the use of various surgical techniques, the level of oxygenation and oxygen metabolism is reduced by 8-38%, which characterizes the development of hypoxia, which is stopped after 3 weeks when using CTG from the hillock of the upper jaw and collagen matrix for more than 3 weeks when applying CTG from the palatine.


Assuntos
Retração Gengival , Processo Alveolar/cirurgia , Tecido Conjuntivo , Implantação Dentária , Retração Gengival/cirurgia , Humanos , Membrana Mucosa
18.
J Endod ; 46(12): 1824-1831, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32918961

RESUMO

INTRODUCTION: The aim of this study was to investigate the impact of the incision type, with or without a coronally repositioning flap (CRF), on soft tissue healing and crestal bone remodeling after endodontic microsurgery (EMS). METHODS: Clinical pictures and cone-beam computed tomography images from 47 patients (120 teeth) taken before surgery and at the follow-up appointment were included in this study. Clinical pictures were qualitatively evaluated by 2 endodontists for the gingival marginal level (GML) (recession, same position, or coronal root coverage), papillary height (same position/receded), and for presence/absence of scars for each tooth. Cone-beam computed tomography images were used to calculate the changes in the distance between the cementoenamel junction and the crestal bone level (CBL) between the preoperative and follow-up scans. Statistical analyses were performed to determine a correlation between patient-related factors (age, sex, tooth type, position, and presence/absence of a crown), incision techniques, and changes within the CBL. RESULTS: Gingival recession was more prevalent in mandibular teeth, molar teeth, and teeth that received intrasulcular or papilla-based incisions (P < .05). Scar formation was affected by the flap design (P < .05). CRF was the only technique resulting in coronal root coverage (P < .05). There were no changes observed in the papillary height between the various flap designs. There was also no statistically significant difference in the crestal bone height between the preoperative and follow-up scan measurements (P > .05). CONCLUSIONS: Soft tissue changes are evident after EMS and can be affected by the flap design selected, as well as the site being treated. Application of CRF can improve the position of GML after EMS. There are insignificant changes within the CBL at the facial aspect of the root after EMS.


Assuntos
Retração Gengival , Microcirurgia , Estudos de Coortes , Retração Gengival/diagnóstico por imagem , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Colo do Dente/diagnóstico por imagem , Raiz Dentária
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(7): 444-447, 2020 Jul 09.
Artigo em Chinês | MEDLINE | ID: mdl-32634881

RESUMO

During the orthodontic treatment, if the root moves lingually, the risk of buccal gingival recession is low. On the contrary, if the root moves buccally, the thin buccal bone probably leads to the buccal gingival recession. In patient without gingival recession, bony dehiscence and fenestration make the situation complicated. Both of the directions show high risk of gingival recession. The present article, from the point of view of periodontal soft tissue, introduces the periodontal soft tissue augmentation technique related to orthodontic treatment and the timing of the surgery.


Assuntos
Retração Gengival/cirurgia , Humanos , Periodonto
20.
J Esthet Restor Dent ; 32(7): 681-690, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32706184

RESUMO

OBJECTIVE: To assess the clinical efficacy and esthetic outcome of porcine-derived dermal collagen matrix in comparison with connective tissue graft in the treatment of multiple adjacent gingival recessions (MAGR), 6 and 12 months after the surgery. MATERIALS AND METHODS: Twenty patients with bilateral type I MAGR were treated randomly with porcine-derived dermal collagen matrix (test site) or connective tissue graft (control site) in combination with a modified coronally advanced tunnel technique. The primary objectives were to evaluate the mean and complete root coverage. The secondary objectives were to assess keratinized tissue width, gingival thickness gain, and root coverage esthetic score. RESULTS: Six and 12 months postoperatively, both groups achieved significant improvements in all clinical parameters compared to baseline, with no statistically significant differences between the groups. Mean root coverage change (Δ12m - 6 m) was statistically significant between the groups in favor of connective tissue graft, and twice as many patients exhibited a complete coverage of all recessions in the control group than the test group. CONCLUSION: The porcine-derived dermal collagen matrix combined with a modified coronally advanced tunnel technique resulted in satisfactory clinical and esthetic outcomes, which were similar to connective tissue graft. CLINICAL SIGNIFICANCE: Porcine-derived dermal collagen matrix (XDM) may be proposed as a substitute for connective tissue graft in multiple adjacent recession treatment due to successful root coverage, a significant increase of gingival thickness, and high esthetic outcomes. The clinical benefits for the use of XDM could be: (a) second surgical wound avoidance, (b) patient discomfort decrease, and (c) lower complications' rate.


Assuntos
Retração Gengival , Animais , Colágeno , Tecido Conjuntivo , Gengiva , Retração Gengival/cirurgia , Humanos , Retalhos Cirúrgicos , Suínos , Raiz Dentária , Resultado do Tratamento
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