Root coverage using epithelial embossed connective tissue graft.

In periodontal practice, root coverage after marginal soft tissue recession requires daily clinical decisions. Numerous longitudinal human studies have been presented to support the efficacy and predictability of different mucogingival surgical techniques for root coverage. Over the years, root coverage procedure using the subepithelial connective tissue graft with variations has emerged as the favorite surgical technique. In the case presented in this report, subepithelial connective tissue graft with embossed epithelium was used to cover Miller's class II gingival recession in the upper right canine. The design is such that embossed epithelium exactly fits the recession site and the connective tissue portion is tucked below the gingival margin of the recipient site. In this technique, coronal advancement of flap is not needed. Wider zone of attached gingiva at the recipient site was achieved by this technique.

Clinical investigation of mucosal thickness stability after soft tissue grafting around implants: A 3-year retrospective study.

Purpose: To assess the long-term stability of gingival grafts placed around dental implants at the time of second surgery uncovering and to further investigate the association between mucosal thickness (MTh) by demographic variables and clinical investigation. Materials and Methods: Fourteen patients with submerged dental implants covered by inadequate keratinized mucosa were studied. The subjects underwent a periimplant plastic surgery (PPS) at the second-stage dental implant surgery and free gingival autograft orsubepithelial connective tissue graft were used according to the patients' clinical situation. Clinical measurement of MTh was assessed by bone sounding with a periodontal probe using customized acrylic stents andthe values were recorded at baseline (day of graft) and at 0.5, 1.5, 4, 12, 24 and 36 months after grafting. Results: At 12 months postoperatively, the mean MTh was 2.89 mm, with a mean additional increase of 1.75 mm when compared with baseline (P=0.0001). No statistically significant differences in MTh were found between the 12- and the 36-month observations (P=0.09). In addition, at 36 months, a thin mucosa was associated with a greater increase in the MTh compared with a thick mucosa (2.14 and 0.64 mm, respectively, P=0.006). Similarly, the mandibular sites were associated with a greater increase in the MTh in comparison with the maxillary sites (2.17 and 0.81 mm, respectively; P=0.02). Conclusions: Within the limitations of this investigation, the data suggest that PPS at the second-stage dental implant surgery could results in additional increases in MTh, especially when it is performed in areas where the mucosa is of a thin biotype.

Formacão de cisto epidermóide (colesteatoma) com implantacão de tecido epitelial junto ao osso femural de ratos / Growth of cholesteatoma by implantation of epithelial tissue along the femoral bone of rats

O colesteatoma é um cisto epidermóide, caracterizado por tecido epidérmico queratinizado, com capacidade de migracão e erosão de estruturas adjacentes. OBJETIVO: Verificar o crescimento do cisto epidermóide (colesteatoma) quando se implanta fragmento de pele do pavilhão auricular junto ao osso femoral de ratos. FORMAL DE ESTUDO: experimental. MATERIAL E MÉTODO: Foram selecionados 10 ratos, os quais foram submetidos à implantacão de fragmento de pele do pavilhão auricular na coxa e mantidos por 3 meses, seguido de remocão do tecido implantado após este período. Cada fragmento ressecado dos animais foi incluso em parafina, corado em hematoxilina-eoxina e preparado em lâminas para efetivacão de estudo anatomopatológico. RESULTADO: Aspecto macroscópico: aspecto granulomatoso, de coloracão amarelada, de forma arredondada e amolecida. Aspecto microscópico: estrutura cística com revestimento constituído por epitélio escamoso estratificado. O cisto apresenta camada mais interna córnea, com descamacão de queratina, seguida da camada granulosa e camadas escamosa e basal mais externamente. CONCLUSAO: O cisto epidermóide (colesteatoma) pode se desenvolver a partir de tecido epitelial transplantado junto ao osso femoral de ratos.