RESUMEN
BACKGROUND: Gingival recession (GR) is described as an apical displacement of the gingival margin in relation to the cementoenamel junction, exposing the root surface to the oral cavity environment. This study aimed to evaluate the clinical results of a bilateral root coverage (RC) of GR associated with an autogenous connective tissue graft (aCTG) alone or combined with low-level laser therapy (aCTG + LLLT). METHODS: This cross-sectional, split-mouth, double-blind, clinical pilot study featured three individuals who attended a periodontics post-graduate program with the main complaint of GR and dental hypersensitivity (DHS). Of these, only one patient met the inclusion criteria and the parameters evaluated were: DHS, the keratinized tissue's thickness and width clinical attachment level (CAL), probing on depth (PD), and bilateral GR based on Cairo RT I. The patient was evaluated by a first clinical evaluator and the treatment was randomly divided into two groups, G1: aCTG only (control group, n = 3 teeth per side) and G2: aCTG + LLLT (test group, n = 3 teeth per side). LLLT used a diode laser (660 nm) with a dose of 3 J/cm2 per point and 4 s per point was applied in four different periods, preoperatively; transoperatively and immediately postoperatively, the application was performed in three points (eight applications) on alternate days for 7 days and a 90-day follow-up was performed for clinical evaluations of the periodontal parameters and the collected data were analyzed by Kruskal-Wallis and Dunn tests. RESULTS: the RC mean percentage was <95% in both groups after 90 days. Comparing treatment sides, G1 (n = 3/3, 100%) had a higher prevalence of RC than G2 had (n = 3/3, 95%). DHS significantly decreased after 90 days in both groups. Both groups showed an improvement in the other periodontal parameters evaluated during the short-term follow-up; mainly, PD had a statistically significant (p Ë 0.05) increase after 90 days and a CAL decrease during this period; KTW and KTT also had a significant increase in both groups (p Ë 0.05). CONCLUSIONS: the results indicated that aCTG + LLLT might have an additional benefit to GR root coverage within the evaluated time and this section also includes the within-study limitations.
RESUMEN
Introdução: As técnicas de enxerto gengival livre têm como principal objetivo a criação/aumento da faixa de mucosa ceratinizada. Quando se utiliza o tratamento químico da raiz e o correto posicionamento do enxerto no leito receptor podem acarretar em um fenômeno incomumdenominado de Creeping Attachment. Objetivo: descreverum caso de recobrimento radicular apósum enxerto gengival livre e Creeping Attachment. Relato do caso: Paciente sexo masculino, 28 anos de idade, não fumante e sem alterações sistêmicas apresentouse a faculdade de odontologia Universidade Federal de Santa Catarinacom a queixa principal de comprometimento estético e hipersensibilidade dentinária na região anterior-inferior. No exame clínico verificou-se uma recessão gengival unitária no dente 41, classificada como classe I de Miller. Logo indicou-se a cirurgia de enxerto gengival livre, obtido da região de palato duro, visandouma melhora estética efuncional, bem como a remissão da hipersensibilidade. Conclusão: Diante dos resultados clínicos podemos concluir que o enxerto gengival livre é uma técnica previsível e de fácil realização para o aumentoda faixa de mucosa queratinizada para posterior recobrimento radicular, contudo apesar de incomum o fenômeno Creeping Attachment deve ser esperado como alternativa a etapade recobrimento radicular. (AU)
Introduction: Free gingival graft techniques have as main objective the creation / increase of the keratinized mucosa band. When using the chemical treatment of the root surfaceand the correct positioning of the graft in the recipiente bed can lead to anuncommon phenomenon calledCreeping Attachment. Objective: This scientific paper describes a clinical case of root coverage after a free gingival graft and Creeping Attachment. Case Report: A 28-year-old male patient, non-smoker, was assisted in the Federal University of Santa Catarina by students and teachers of dentistry presented the main complaint the aesthetic impairment and dentin hypersensitivity in the anterior region of the jaw. In the clinical examination was observed an unitary gingival recession in tooth 41, classified as Miller class I. The gingival graft surgery, obtained from the hard palate region, was then indicated to improve the esthetic and functional condition, as well as to promove the end of symptoms of hypersensitivity. Conclusion: Inview of the clinical results we can conclude that the free gingival graft is a predictable and easy to perform technique to increase the line of keratinized mucosa for the subsequent root coverage. However, although the Creeping Attachment phenomenon is uncommon, it should be expected as an alternative to the root coverage (AU)
Asunto(s)
Humanos , Masculino , Adulto , Periodoncia , Regeneración Tisular Guiada Periodontal , Trasplantes , Recesión GingivalRESUMEN
Objective Enamel matrix derivative (EMD) is used clinically to promote periodontal tissue regeneration. However, the effects of EMD on gingival epithelial cells during regeneration of periodontal tissues are unclear. In this in vitro study, we purified ameloblastin from EMD and investigated its biological effects on epithelial cells. Material and Methods Bioactive fractions were purified from EMD by reversed-phase high-performance liquid chromatography using hydrophobic support with a C18 column. The mouse gingival epithelial cell line GE-1 and human oral squamous cell carcinoma line SCC-25 were treated with purified EMD fraction, and cell survival was assessed with a WST-1 assay. To identify the proteins in bioactive fractions of EMD, we used proteome analysis with two-dimensional gel electrophoresis followed by identification with liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Results Purified fractions from EMD suppressed proliferation of GE-1 and SCC-25. LC-MS/MS revealed that ameloblastin in EMD is the component responsible for inhibiting epithelial cell proliferation. The inhibitory effect of ameloblastin on the proliferation of GE-1 and SCC-25 was confirmed using recombinant protein. Conclusion The inhibitory effects of EMD on epithelial cell proliferation are caused by the biological activities of ameloblastin, which suggests that ameloblastin is involved in regulating epithelial downgrowth in periodontal tissues. .
Asunto(s)
Humanos , Animales , Ratones , Proteínas del Esmalte Dental/farmacología , Células Epiteliales/efectos de los fármacos , Periodoncio/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Supervivencia Celular/efectos de los fármacos , Células Cultivadas , Cromatografía Líquida de Alta Presión , Electroforesis en Gel Bidimensional , Células Epiteliales/citología , Encía/citología , Encía/efectos de los fármacos , Regeneración Tisular Guiada Periodontal/métodos , Periodontitis/tratamiento farmacológico , Valores de Referencia , Reproducibilidad de los Resultados , Tinción con Nitrato de Plata , Factores de TiempoRESUMEN
O enxerto de osso em neoformação é uma técnica que visa regeneração periodontal, descrita inicialmente na década de 60 e posteriormente na de 80. Tem a intenção de transportar, em grande quantidade, células vivas capazes de formar osso de um sítio doador, em um alvéolo natural ou artificial, para o defeito ósseo que se deseja tratar. Este trabalho constitui-se em uma revisão da literatura sobre o enxerto ósseo em neoformação, que bjetiva, baseado em evidências científicas, avaliar a eficácia desse tipo de enxerto ósseo, na busca pela regeneração periodontal. Ao buscar referências bibliográficas sobre o assunto, pôde-se perceber que são escassos os estudos que pesquisam o enxerto ósseo em neoformação. Inúmeros são os trabalhos sobre o uso de enxertos ósseos autógenos em periodontia, mas a maioria não chega sequer a citar o enxerto em neoformação. Tal fato nos leva a concluir que esta técnica ainda precisa de comprovação científica acerca de sua real eficácia.
The rewly forming bone autograft is a periodontal regeneration technique described initially in the 60s and later in the 80s. It porposes to carry forming bone cells still alive and in a large amount of a donor site in a natural or artificial socket to a periodontal bone defect. This work is a literature review on the rewly forming bone autograft, which aims, based on scientific evidence, assess the effectiveness of this type of bone graft in the quest for periodontal regeneration. The bibliographic search on the subject, showed that there are few research studies that look at the newly forming bone autograft. Many are the works on other types of bone grafts, but most do not even quote newly forming bone autograft. This fact leads us to conclude that this technique still needs scientific proof of its real effectiveness.