ABSTRACT
Resumen Introducción: La recesión gingival puede estar relacionada con la enfermedad periodontal o condiciones mucogingivales ocasionando hipersensibilidad, caries radicular y problemas estéticos. La combinación de la técnica en túnel y el injerto de tejido conectivo subepitelial puede considerarse una opción para el tratamiento de recesiones gingivales múltiples. Presentación del caso: Paciente de sexo femenino de 38 años de edad, al interrogatorio refiere tener hipersensibilidad dentaria en los dientes superiores (13, 14, 22, 23, 24) que presentan recesión gingival. A la valoración periodontal se observan recesiones gingivales clase I y III de Miller en cuadrante I y II, el diagnóstico periodontal es periodonto sano. Para realizar la cobertura radicular se planea combinar la colocación de injerto de tejido conectivo subepitelial con técnica en túnel, siendo un procedimiento adecuado cuando las papilas interdentales son amplias, además de ser una técnica de alta predictibilidad para lograr la cobertura radicular. En este caso, se decidió iniciar por el segundo cuadrante, ya que eran los sitios con mayor hipersensibilidad dentaria y un mes después realizar el tratamiento en el primer cuadrante. Conclusiones: La técnica que se aplicó permitió eliminar la hipersensibilidad dentaria en un 100% considerando como única desventaja el doble sitio quirúrgico del sitio donador. Es importante mencionar que además de lograr mejoría en la hipersensibilidad dentaria, se mejoraron las condiciones estéticas.
Abstract Introduction: Gingival recession can be associated to periodontal disease or muco-gingival conditions causing hypersensitivity, root caries and esthetic problems. A combination of the tunneling technique with sub-epithelial connective tissue graft can be considered an option for multiple gingival recession treatment. Case presentation: A 38 year old female patient who informed of suffering hypersensitivity in upper teeth (13, 14, 22, 23, 24), exhibiting gingival recession. Periodontal evaluation revealed Miller class I and III gingival recessions in quadrants I and II. Periodontal diagnosis was healthy periodontium. In order to achieve root coverage, placement of sub-epithelial connective tissue graft with tunneling was planned. This represents a suitable procedure in cases when interdental papillae are wide, moreover, it constitutes a high predictability technique in order to achieve root coverage. In the present case, it was decided to initiate treatment on the second quadrant since it lodged sites with greater dental hypersensitivity, to be followed a month later by treatment on the first quadrant. Conclusions: This applied technique allowed for 100% elimination of tooth hypersensitivity, only considering a disadvantage the double surgical site of the donor site. It is important to mention that, in addition to achieving improvement in tooth hypersensitivity, esthetic appearance was improved.
ABSTRACT
O recobrimento radicular é indicado por razões estéticas, para reduzir a hipersensibilidade de raiz e para criar ou aumentar tecido queratinizado. Várias técnicas cirúrgicas têm sido descritas, com a decisão dependendo de parâmetros clínicos anatômicos e técnicos. A principal meta terapêutica é alcançar uma cobertura completa da raiz com um resultado estético satisfatório. Uma abordagem previsível para o recobrimento radicular é a técnica de tunelização associada ao enxerto de tecido conjuntivo subepitelial, matriz dérmica acelular (MDA) ou outros biomateriais. Neste relato de caso com controle clínico de seis anos foi realizada a recuperação do tecido gengival perdido na região do dente 13, com o uso de uma técnica minimamente invasiva: a técnica de túnel associado ao enxerto de tecido conjuntivo subepitelial. Esta associação resultou em um importante ganho de inserção e, além do recobrimento radicular, foram melhoradas a hipersensibilidade e a estética na região.
The root coverage is indicated for aesthetic reasons, to reduce root hypersensitivity and to create or to increase keratinized tissue. Several surgical techniques have been described, with the decision depending on anatomical clinical and technical parameters. The main therapeutic goal is to achieve full coverage of the root with a satisfactory cosmetic result. A predictable approach to root coverage is a tunneling technique associated with subpeithelial connective tissue graft, acellular dermal matrix (ADM) or other biomaterials. In this case report with a 6-year clinical follow-up, the gingival tissue lost at the tooth 13 region was recovered using a minimally invasive technique (tunneling + subepithelial connective tissue graft). This association contributed to a signifi cant attachment level recovery and, besides root coverage, hypersensitivity and esthetics were improved in the operated site.
Subject(s)
Male , Connective Tissue/transplantation , Free Tissue Flaps , Gingival Recession/therapy , Tissue Transplantation/methodsABSTRACT
PURPOSE: The objective of this study was to evaluate the efficacy of the subperiosteal tunneling technique with iliac block bone graft for bone augmentation in an edentulous alveolar ridge. PATIENTS AND METHODS: Total of 8 sites in 7 patients were included in this study. The bone height was evaluated by CBCT preoperatively and 4 months after operation. Total of 11 implants were inserted and evaluated clinically and radiographically. RESULTS: Mean value of the increased bone height was 6.29 mm and no implant failure was observed. There were no complications such as soft tissue dehiscence, exposure of the grafted bone and infection. CONCLUSION: We have achieved excellent clinical outcomes by this technique, so we concluded that it is useful for augmentation of severely deficient alveolar ridge.