RESUMO
BACKGROUND: An adequate width of attached gingiva is necessary to maintain healthy periodontium, especially in orthodontics or restorative treatments in periodontics. The purpose of this study was to evaluate the width of attached gingiva after clinical application of a cultured gingival graft compared to a periosteal fenestration technique. METHODS: This study was conducted on nine patients (18 sites) with insufficient attached gingiva adjacent to at least two teeth in contralateral quadrants of the same jaw. A small portion (approximately 3 x 2 x 1 mm) of attached gingiva (epithelial + connective tissue) was removed with a surgical blade. After culture of gingival fibroblasts, 2 x 10(5) cells in 250 microl nutritional medium were added to 250 microl collagen gel. One tooth in each patient was randomized to receive a periosteal fenestration technique for gingival augmentation (control) or a tissue-engineered mucosal graft (test). Clinical parameters measured at baseline and 3 months included width of keratinized tissue, probing depth, and width of attached gingiva. RESULTS: An increased amount of keratinized tissue was seen at all treated sites after 3 months. The mean increased amount of attached gingiva was 2.8 mm at test sites and 2 mm at control sites; this difference was significant (P < 0.05). CONCLUSION: Based on the results of this investigation, the tissue-engineered mucosal graft is safe and capable of generating keratinized tissue.
Assuntos
Inserção Epitelial/fisiologia , Gengiva/transplante , Perda da Inserção Periodontal/cirurgia , Engenharia Tecidual/métodos , Vestibuloplastia/métodos , Implantes Absorvíveis , Adulto , Técnicas de Cultura de Células , Inserção Epitelial/cirurgia , Feminino , Fibroblastos/transplante , Gengiva/citologia , Humanos , Masculino , Pessoa de Meia-Idade , Mucosa Bucal/citologia , Mucosa Bucal/transplante , Periósteo/cirurgia , Projetos Piloto , Alicerces TeciduaisRESUMO
Tissue-engineered gingival graft was used for regenerating facial gingiva around an implant at lower left first premolar area with insufficient attached gingiva. Engineered gingival graft was produced by mixing 250 ml bovine skin collagen with 250 ml nutritional medium containing human gingival fibroblasts (2×10(5)). 3 months post-surgery, there were gains in the attached gingiva compared to pre-surgery. The histological examination revealed a keratinized tissue on the treated site. Based on the result of this investigation, this graft was safe and capable of generating keratinized gingiva.