RESUMEN
Splinted and unsplinted overdenture attachment systems have unique advantages and disadvantages. The aim of the present systematic review was to determine the influence of splinted and unsplinted overdenture attachment systems on the marginal bone loss, prosthetic complications and implant survival rate. PubMed/MEDLINE, Scopus and Cochrane databases were searched for articles published up to October 2017, using the following search terms: "overdenture AND attachment OR overdenture AND bar OR overdenture splinted." The PICO question "Do splinted overdenture attachment systems promote better clinical results in comparison to unsplinted systems?" was evaluated. Eligible studies included randomized controlled clinical trials, prospective studies with at least 10 participants and a minimum follow-up of 6 months, and studies published in English that compared splinted and unsplinted attachment systems within the same study. The 95% confidence interval (CI) was considered for all outcomes analysed. After completion of the different steps in the article selection process, nine articles were included in the qualitative and quantitative analyses. A total of 984 implants were placed in 380 patients (mean age: 62.8 years). The meta-analysis demonstrated no statistically significant differences between splinted and unsplinted attachment systems with regard to marginal bone loss (P = .39; MD: -0.11; 95% CI: -0.37 to 0.14), complications (P = .31; RR: 1.26; CI: 0.80-1.99) and implant survival rate (P = .14; RR: 0.37% CI: 0.10-1.36). In addition, splinted and unsplinted overdenture attachment systems achieved similar results with regard to marginal bone loss, prosthetic complications and implant survival rate.
Asunto(s)
Pérdida de Hueso Alveolar/fisiopatología , Prótesis Dental de Soporte Implantado , Retención de Dentadura/instrumentación , Oseointegración/fisiología , Pérdida de la Inserción Periodontal/fisiopatología , Implantes Dentales , Diseño de Dentadura , Ajuste de Precisión de Prótesis , Prótesis de Recubrimiento , Humanos , Pérdida de la Inserción Periodontal/diagnósticoRESUMEN
The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p < 0.01) was observed between the LAP group and the other two groups. There was significantly less bleeding and recession in the LAP group than in the patients with the generalized forms of periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.
Asunto(s)
Periodontitis Agresiva/fisiopatología , Periodontitis Crónica/fisiopatología , Salud Bucal/estadística & datos numéricos , Calidad de Vida , Adolescente , Adulto , Factores de Edad , Análisis de Varianza , Estudios Transversales , Femenino , Recesión Gingival/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Valores de Referencia , Índice de Severidad de la Enfermedad , Factores Sexuales , Perfil de Impacto de Enfermedad , Estadísticas no Paramétricas , Pérdida de Diente/fisiopatología , Adulto JovenRESUMEN
Abstract The purpose of this cross-sectional study was to investigate the effect of different forms of periodontal diseases on Oral Health-Related Quality of Life (OHRQoL). Fifty-two patients with Aggressive Periodontitis (AP) or Chronic Periodontitis (CP) were included: nine patients with Localized Aggressive Periodontitis (LAP), thirty-three patients with Generalized Aggressive Periodontitis (GAP) and ten patients with Generalized Chronic Periodontitis (GCP). Oral Health Impact Profile questionnaires (OHIP-14) were distributed after a clinical examination that measured the following periodontal parameters: tooth loss, bleeding on probing (BoP), probing depth (PD), gingival recession (REC) and clinical attachment level (CAL). The global OHIP-14 score means were 10.6 for LAP, 16.5 for GAP, and 17.5 for GCP. A statistically significant difference (p < 0.01) was observed between the LAP group and the other two groups. There was significantly less bleeding and recession in the LAP group than in the patients with the generalized forms of periodontitis. LAP, GAP and GCP have an impact on patient quality of life when measured using the OHIP-14. Patients with GAP and GCP had poorer OHRQoL than LAP patients.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Adulto Joven , Periodontitis Agresiva/fisiopatología , Salud Bucal/estadística & datos numéricos , Calidad de Vida , Factores de Edad , Análisis de Varianza , Periodontitis Crónica/fisiopatología , Estudios Transversales , Recesión Gingival/fisiopatología , Pérdida de la Inserción Periodontal/fisiopatología , Índice Periodontal , Valores de Referencia , Índice de Severidad de la Enfermedad , Factores Sexuales , Perfil de Impacto de Enfermedad , Estadísticas no Paramétricas , Pérdida de Diente/fisiopatologíaRESUMEN
BACKGROUND: Although the detrimental effects of tobacco on the periodontal tissues have been reported extensively, little is known about the potential beneficial effect of smoking cessation on periodontal health. The aim of this systematic review is to evaluate the effect of smoking cessation on periodontitis progression and response to periodontal therapy. METHODS: Two independent reviewers completed the review process through title (n = 118), abstract (n = 24), and whole-paper selection (n = 5). Sources include Medline and EMBASE databases (up to December 2012) and a reference list of selected studies. Prospective studies comparing progression rates of periodontitis between smokers and quitters and clinical trials evaluating the effect of smoking-cessation programs, alone or in combination with periodontal treatment, were included. At least 1 year of follow-up was required for inclusion. RESULTS: Of 331 potentially relevant publications, five studies fulfilled the inclusion criteria. Because of heterogeneity of the studies, a meta-analysis could not be performed. One study reported that the progression of clinical attachment loss (AL) ≥3 mm during a 6-year period was approximately three times higher among smokers than quitters (P <0.001). Two studies (10 and 20 years of follow-up) observed a decrease in radiographic bone loss of ≈30% among quitters when compared with smokers. Among individuals receiving non-surgical periodontal treatment, quitters were more likely to have periodontal probing depth reductions (P <0.05) than non-quitters/oscillators. No differences in AL were observed. CONCLUSION: Based on the limited available evidence, smoking cessation seems to have a positive influence on periodontitis occurrence and periodontal healing.
Asunto(s)
Índice Periodontal , Cese del Hábito de Fumar , Pérdida de Hueso Alveolar/fisiopatología , Progresión de la Enfermedad , Humanos , Pérdida de la Inserción Periodontal/fisiopatología , Bolsa Periodontal/fisiopatología , Periodontitis/fisiopatología , Periodontitis/terapiaRESUMEN
INTRODUCTION: To assess, in vivo, the influence of periodontal attachment loss and gingival recession on responses to pulp sensibility tests (PSTs) with cold stimuli in mandibular incisors in adult patients. METHODS: This cross-sectional study included 45 patients aged 30 to 60 years treated at a university dental health service. In each patient, 1 mandibular incisor was randomly selected for analysis. One calibrated dentist performed all periodontal assessments. Periodontal attachment loss and gingival recession were measured at 6 sites of the selected tooth followed by application of the PST on the buccal surface of the tooth by an independent operator. Each patient was asked to indicate a score for pain intensity on a numeric visual analog scale. The Pearson correlation coefficient was used to investigate and quantify the correlation between predictor variables (periodontal attachment loss and gingival recession) and reported pain. Simple and multiple linear regression analyses were performed to determine the impact of periodontal attachment loss and gingival recession on PST pain scores. RESULTS: Multivariate analysis showed that periodontal attachment loss contributed significantly to the prediction of pain in response to the PST (P < .001). Increases of 1 mm in periodontal attachment loss resulted in a decrease of approximately 0.5 score on the pain scale. Gingival recession also contributed as a predictor of the outcome (P < .001) with a decrease of approximately 0.7 in pain scores for every 1-mm increase in gingival recession. The correlations were in the opposite direction than expected. CONCLUSIONS: Periodontal attachment loss and gingival recession strongly influenced reported pain in response to PST with cold stimuli. The effect of both variables was constant (ie, responses to PST decreased gradually with increases in periodontal attachment loss and gingival recession).
Asunto(s)
Prueba de la Pulpa Dental/métodos , Pulpa Dental/fisiopatología , Recesión Gingival/fisiopatología , Pérdida de la Inserción Periodontal/fisiopatología , Adulto , Frío , Estudios Transversales , Femenino , Recesión Gingival/clasificación , Humanos , Incisivo/fisiopatología , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Umbral del Dolor/fisiología , Pérdida de la Inserción Periodontal/clasificación , Bolsa Periodontal/clasificación , Bolsa Periodontal/fisiopatología , Estimulación FísicaRESUMEN
BACKGROUND: To our knowledge, prospective studies (matched for sex, smoking, and diabetes) that investigated the influence of compliance in the progression of periodontitis and tooth loss in periodontal maintenance therapy (PMT) programs were not previously reported. METHODS: A total of 58 regular complier (RC) and 58 erratic complier (EC) individuals were recruited from a prospective cohort with 238 patients under PMT and matched by sex, diabetes, and smoking habits. A full-mouth periodontal examination that included bleeding on probing (BOP), probing depths (PDs), clinical attachment levels, and number of teeth were determined at all PMT visits during a 3-year interval. The influence of variables of interest was tested through multivariate logistic regression. RESULTS: The progression of periodontitis and tooth loss was significantly lower among RC compared to EC patients. A higher progression of periodontitis was observed among EC patients who smoked. The final logistic model for the progression of periodontitis in the RC group included smoking (odds ratio [OR]: 4.2) and >30% of sites with BOP (OR: 2.8), and the final logistic model for the progression of periodontitis in the EC group included smoking (OR: 7.3), >30% of sites with BOP (OR: 3.2), PDs of 4 to 6 mm in 10% of sites (OR: 3.5), diabetes (OR: 1.9), and number of lost teeth (OR: 3.1). CONCLUSIONS: RC patients presented a lower progression of periodontitis and tooth loss compared to EC patients. This result highlighted the influence of the pattern of compliance in maintaining a good periodontal status. Moreover, important risk variables such as smoking and diabetes influenced the periodontal status and should be considered when determining the risk profile and interval time for PMT visits.
Asunto(s)
Periodontitis Crónica/fisiopatología , Cooperación del Paciente , Adolescente , Adulto , Pérdida de Hueso Alveolar/fisiopatología , Pérdida de Hueso Alveolar/prevención & control , Estudios de Casos y Controles , Periodontitis Crónica/prevención & control , Estudios de Cohortes , Índice de Placa Dental , Profilaxis Dental , Complicaciones de la Diabetes/fisiopatología , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Defectos de Furcación/fisiopatología , Defectos de Furcación/prevención & control , Hemorragia Gingival/fisiopatología , Hemorragia Gingival/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Higiene Bucal , Pérdida de la Inserción Periodontal/fisiopatología , Pérdida de la Inserción Periodontal/prevención & control , Bolsa Periodontal/fisiopatología , Bolsa Periodontal/prevención & control , Estudios Prospectivos , Recurrencia , Retratamiento , Medición de Riesgo , Fumar , Pérdida de Diente/etiología , Adulto JovenRESUMEN
OBJECTIVE: To assess the systemic bone mineral density (BMD) and the periodontal situation in postmenopausal women, to understand the possible role of osteoporosis as a risk factor for periodontal disease. METHODS: The sample was comprised of 47 postmenopausal women, divided into 3 groups: 14 patients with normal bones (G1), 17 with osteopenia (G2) and 16 patients with osteoporosis (G3). Data was obtained using bone mineral density (BMD), obtained by dual energy x-ray absorptiometry (DXA) in the lumbar area (L1-L4). Periodontal condition was evaluated by Gingival Index (GI), Plaque Index (PI) and Clinical Attachment Level (CAL). Results were analyzed and submitted to statistical treatment, through the One Way ANOVA: (alpha=0.05) test and the Pearson's Correlation test (alpha=0.01). RESULTS: GI, PI and CAL variables did not disclose a significant difference in the periodontal situation of postmenopausal women A significant correlation between periodontal parameters GI, PI and CAL (p<0,001) was observed, however no significant correlation was detected between periodontal parameters (GI, PI and CAL) and systemic bone condition of postmenopausal women, evaluated by BMD (p>0.01). CONCLUSION: The periodontal situation of postmenopausal women does not depend on the systemic bone mass and there is no significant correlation between BMD and periodontal parameters. However, further longitudinal surveys are required to understand osteoporosis as a risk factor of periodontal disease.
Asunto(s)
Densidad Ósea/fisiología , Osteoporosis Posmenopáusica/complicaciones , Enfermedades Periodontales/etiología , Posmenopausia/fisiología , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Enfermedades Óseas Metabólicas/complicaciones , Enfermedades Óseas Metabólicas/diagnóstico , Enfermedades Óseas Metabólicas/fisiopatología , Estudios Transversales , Índice de Placa Dental , Femenino , Humanos , Persona de Mediana Edad , Osteoporosis Posmenopáusica/fisiopatología , Pérdida de la Inserción Periodontal/diagnóstico , Pérdida de la Inserción Periodontal/fisiopatología , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/fisiopatología , Índice Periodontal , Factores de RiesgoRESUMEN
OBJETIVO: Analisar a densidade mineral óssea sistêmica (DMO) e a situação periodontal em mulheres na pós-menopausa, visando compreender o papel da osteoporose como um fator de risco à doença periodontal. MÉTODOS: A amostra da pesquisa foi constituída por 47 mulheres na pós-menopausa, que foram divididas em três grupos: 14 com osso normal (G1), 17 no grupo com osteopenia (G2) e 16 pacientes com osteoporose (G3), através da avaliação da densidade mineral óssea (DMO), aferida pela absormetria de dupla emissão com raios-X na área lombar (L1-L4). A condição periodontal foi avaliada pelo índice gengival (IG), índice da placa (IP) e o nível de inserção clínica (NIC). Os resultados tabulados foram analisados e submetidos ao tratamento estatístico, através do teste ANOVA a um critério (α=0,05) e o teste de correlação de Pearson (α=0,01). RESULTADOS: Verificou-se não haver diferenças significativas na situação periodontal em mulheres na pós-menopausa, através das variáveis IG, IP e NIC. Observou-se correlação significativa entre os parâmetros periodontais IG, IP e NIC entre si (p<0,001), contudo não foi detectada correlação significativa entre os parâmetros periodontais (IG, IP, NIC) e a condição sistêmica do osso das mulheres na pós-menopausa, avaliada através da DMO (p>0,01). CONCLUSÃO: A situação periodontal em mulheres na pós-menopausa não depende da massa óssea sistêmica, não havendo correlação significativa entre DMO e os parâmetros periodontais, sendo necessárias pesquisas longitudinais para considerar a osteoporose como um fator de risco à doença periodontal.
OBJECITVE: To assess the systemic bone mineral density (BMD) and the periodontal situation in postmenopausal women, to understand the possible role of osteoporosis as a risk factor for periodontal disease. METHODS: The sample was comprised of 47 postmenopausal women, divided into 3 groups: 14 patients with normal bones (G1), 17 with osteopenia (G2) and 16 patients with osteoporosis (G3). Data was obtained using bone mineral density (BMD), obtained by dual energy x-ray absorptiometry (DXA) in the lumbar area (L1-L4). Periodontal condition was evaluated by Gingival Index (GI), Plaque Index (PI) and Clinical Attachment Level (CAL). Results were analyzed and submitted to statistical treatment, through the One Way ANOVA: (α=0.05) test and the Pearson's Correlation test (α=0.01). RESULTS: GI, PI and CAL variables did not disclose a significant difference in the periodontal situation of postmenopausal women A significant correlation between periodontal parameters GI, PI and CAL (p<0,001) was observed, however no significant correlation was detected between periodontal parameters (GI, PI and CAL) and systemic bone condition of postmenopausal women, evaluated by BMD (p>0.01). CONCLUSION: The periodontal situation of postmenopausal women does not depend on the systemic bone mass and there is no significant correlation between BMD and periodontal parameters. However, further longitudinal surveys are required to understand osteoporosis as a risk factor of periodontal disease.
Asunto(s)
Anciano , Anciano de 80 o más Años , Femenino , Humanos , Persona de Mediana Edad , Densidad Ósea/fisiología , Osteoporosis Posmenopáusica/complicaciones , Enfermedades Periodontales/etiología , Posmenopausia/fisiología , Análisis de Varianza , Enfermedades Óseas Metabólicas/complicaciones , Enfermedades Óseas Metabólicas/diagnóstico , Enfermedades Óseas Metabólicas/fisiopatología , Estudios Transversales , Índice de Placa Dental , Osteoporosis Posmenopáusica/fisiopatología , Pérdida de la Inserción Periodontal/diagnóstico , Pérdida de la Inserción Periodontal/fisiopatología , Enfermedades Periodontales/diagnóstico , Enfermedades Periodontales/fisiopatología , Índice Periodontal , Factores de RiesgoRESUMEN
AIM: To assess orthodontic intrusion effects on periodontal tissues in dogs' pre-molars with class III furcations treated with open flap debridement (OFD) or with guided tissue regeneration (GTR) associated to bone autograft (BA). MATERIAL AND METHODS: Class III furcations were created in the pre-molars of seven mongrel dogs. After 75 days, teeth were randomly treated with OFD or GTR/BA. After 1 month, metallic crowns were assembled on pre-molars and connected apically to mini-implants by nickel-titanium springs. Teeth were randomly assigned to orthodontic intrusion (OFD+I and GTR/BA+I) groups or no movement (OFD and GTR/BA) groups. Dogs were sacrificed after 3 months of movement and 1 month retention. RESULTS: All class III furcations were closed or reduced to class II or I in the intrusion groups, while 50% of the lesions in non-moved teeth remained unchanged. Intruded teeth presented higher probing depth and lower gingival marginal level than non-moved teeth (p<0.01). Clinical attachment gain was reduced in the intrusion groups by the end of retention (p<0.05). OFD+I presented smaller soft tissue area and larger bone tissue area than other groups (p<0.05). CONCLUSION: Orthodontic intrusion with anchorage via mini-implants improved the healing of class III furcation defects after OFD in dogs. GTR/BA impaired those results.
Asunto(s)
Diente Premolar/cirugía , Trasplante Óseo/métodos , Defectos de Furcación/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Colgajos Quirúrgicos , Técnicas de Movimiento Dental/métodos , Proceso Alveolar/patología , Proceso Alveolar/fisiopatología , Animales , Diente Premolar/fisiopatología , Desbridamiento , Cemento Dental/patología , Cemento Dental/fisiopatología , Perros , Defectos de Furcación/patología , Defectos de Furcación/fisiopatología , Recesión Gingival/fisiopatología , Recesión Gingival/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Retenedores Ortodóncicos , Alambres para Ortodoncia , Pérdida de la Inserción Periodontal/fisiopatología , Pérdida de la Inserción Periodontal/cirugía , Ligamento Periodontal/patología , Ligamento Periodontal/fisiopatología , Bolsa Periodontal/fisiopatología , Bolsa Periodontal/cirugía , Distribución Aleatoria , Estrés Mecánico , Factores de Tiempo , Técnicas de Movimiento Dental/instrumentación , Trasplante Autólogo , Resultado del TratamientoRESUMEN
This study aimed to evaluate in rats the impact of cigarette smoke inhalation (CSI) and nicotine administration (NA) on a periodontal healing model in the absence of a plaque biofilm. Wistar rats (n = 42) were assigned to three groups: Group 1, control (n = 14); Group 2, NA (3 mg kg(-1)) (n = 14); and Group 3, CSI (n = 14). Thirty days after CSI and NA exposure, fenestration defects were created buccally to the distal root of the first mandibular molar. The animals were killed 21 d later and their mandibles were processed for histological examination. The percentage of bone fill and the density of newly formed bone were assessed histometrically. Intergroup analysis demonstrated that compared to the control and NA groups, CSI was associated with a reduced rate of bone repair. No new cementum had been formed along the root surface in any of the three groups. It is concluded that cigarette smoke reduces the self-healing capacity of periodontal tissues.
Asunto(s)
Enfermedades Periodontales/fisiopatología , Periodoncio/fisiopatología , Fumar/fisiopatología , Pérdida de Hueso Alveolar/patología , Pérdida de Hueso Alveolar/fisiopatología , Proceso Alveolar/patología , Proceso Alveolar/fisiopatología , Animales , Monóxido de Carbono/efectos adversos , Modelos Animales de Enfermedad , Masculino , Nicotina/efectos adversos , Agonistas Nicotínicos/efectos adversos , Osteoblastos/patología , Osteoblastos/fisiología , Pérdida de la Inserción Periodontal/patología , Pérdida de la Inserción Periodontal/fisiopatología , Enfermedades Periodontales/patología , Periodoncio/patología , Distribución Aleatoria , Ratas , Ratas Wistar , Humo/efectos adversos , Fumar/patología , Cicatrización de Heridas/fisiologíaRESUMEN
BACKGROUND: The goal of this investigation was to histologically and histometrically evaluate the healing process of gingival recessions treated by guided tissue regeneration with bioabsorbable polylactic acid membranes (GTR group) and to compare it to that obtained with coronally positioned flaps (CPF group). METHODS: Gingival recessions were surgically created on the buccal aspect of the upper cuspids of 5 mongrel dogs. The defects (5x7 mm) were exposed to plaque accumulation for 3 months. The contralateral defects were then randomly assigned to each group. After 3 months of healing, the dogs were sacrificed and the blocks were processed. The histometric parameters evaluated included length of sulcular and junctional epithelium, connective tissue adaptation, new cementum, new bone, and defect coverage. RESULTS: The extension of the epithelium was 1.9 +/- 0.8 mm for the GTR-group and 3.0 +/- 0.9 mm for the CPF-group (P = 0.16). The connective tissue adaptation was 0.1 +/- 0.1 and 0.8 +/- 0.5 mm in the GTR group and CPF group, respectively (P = 0.051). The new cementum was 3.8 +/- 1.5 mm and 2.4 +/- 0.3 mm in the GTR group and CPF group, respectively (P= 0.16). Bone formation was 1.1 +/- 0.5 mm in the GTR group and 1.4 +/- 0.2 mm in the CPF group (P = 0.53). Histologically, the defect coverage observed was similar, 90.5% and 91.9% for the GTR group and the CPF group, respectively. No statistical differences in any of the parameters could be detected. CONCLUSIONS: Within the limits of this study, it can be concluded that both procedures resulted in a favorable healing response with no significant difference between the treatments.
Asunto(s)
Implantes Absorbibles , Recesión Gingival/cirugía , Regeneración Tisular Guiada Periodontal/métodos , Ácido Láctico , Membranas Artificiales , Polímeros , Animales , Regeneración Ósea , Tejido Conectivo/fisiología , Cemento Dental/fisiología , Perros , Inserción Epitelial/fisiología , Epitelio/fisiología , Femenino , Pérdida de la Inserción Periodontal/fisiopatología , Poliésteres , Distribución Aleatoria , Regeneración , Colgajos QuirúrgicosRESUMEN
Fueron usados principios de regeneración guiada de tejidos con el objetivo de conseguir eliminación de bolsa periodontal persistente luego de procedimientos de raspaje y aplanamiento radicular en area de incisivos centrales superiores. Durante la cirugía de este caso clínico se usó membrana de colágeno y hueso liofilizado bovino; fue lograda la eliminación de la bolsa, así como una considerable ganancia de inserción, durante un período de observación clínica y radiográfica de 8 meses. Junto con el relato del caso clínico, se discuten las indicaciones de este tipo de cirugía en áreas e compromiso estético (AU)
Asunto(s)
Humanos , Masculino , Adulto , Pérdida de la Inserción Periodontal/diagnóstico , Pérdida de la Inserción Periodontal/fisiopatología , Regeneración Tisular Dirigida/métodos , Raspado Dental , Colgajos Quirúrgicos , Membranas Artificiales , Liofilización/métodos , Bolsa Periodontal/patología , Tetraciclina/uso terapéutico , Ácido Cítrico/uso terapéutico , Colágeno/uso terapéutico , Periodontitis/cirugía , Raíz del Diente/cirugía , Raíz del Diente/efectos de los fármacos , Incisivo/cirugía , Aplanamiento de la RaízRESUMEN
Principios de regeneración guiada de tejidos fueron usados con el objetivo de conseguir eliminación de bolsa periodontal persistente luego de procedimientos de raspaje y aplanamiento radicular en área de incisivos centrales superiores. Durante la cirugía de este caso clínico se usó membrana de colágeno y hueso liofilizado bovino; fue lograda la eliminación de la bolsa así como una considerable ganancia de inserción, durante un período de observación clínica y radiográfica de 8 meses. Junto con el relato del caso clínico, se discuten las indicaciones de este tipo de cirugía en áreas de comprometimiento estético