O uso dos métodos cirúrgico e rotatório no tratamento da despigmentação gengival ­ relato de dois casos clínicos / The use of surgical and rotary methods to treat gingival depigmentation ­ report of two clinical cases

Este artigo relatou dois tipos diferentes de tratamento para pacientes com despigmentação melânica gengival. No primeiro caso, uma paciente de 21 anos de idade apresentou-se com intensa pigmentação melânica (marrom escuro) na região entre os caninos. O tratamento consistiu na remoção desta faixa de tecido (raspagem gengival) usando-se apenas anestesia local e uma lâmina de bisturi 15C. No segundo caso, um paciente de 22 anos de idade apresentou-se com pigmentação melânica moderada (marrom médio), também na região intercanina superior. O tratamento consistiu na remoção deste tecido utilizando brocas diamantadas 1016HL sob irrigação com soro fisiológico e finalização com broca diamantada 4138. Em ambos os casos, um cimento cirúrgico foi usado para proteção, a dor foi controlada com dipirona, e as áreas foram limpas com solução de clorexidina 0,12%. Após 14 dias, uma coloração rosácea final foi obtida. As duas técnicas apresentadas possuem eficácia imediata satisfatória, agilidade e custo baixo em relação às técnicas mais sofisticadas. Entretanto, os pacientes precisam estar cientes da possibilidade de recorrência da pigmentação melânica.

This article reports on two different treatments for gingival pigmentation. In the fi rst case, a 21 years-old female patient presented with intense pigmentation (dark-brown) at the maxillary canine region. The treatment consisted on removal of this tissue band (gingival peeling) by applying local anesthesia and using a 15C scalpel blade. In the second case, a 22 years-old male patient demonstrated moderate gingival pigmentation (middle-brown) also in the maxillary canine region. The treatment was made by rotary removal with diamond bur 1016HL, application of saline solution, and finishing with a 4138 tapered diamond bur. In both cases, a surgical dressing was applied to protect the operated area. Pain control was provided with dipyrone, and a 0.12% digluconate chlorhexidine solution recommended in the postoperative period. After 14 days, a pink, gingival aspect was generated. Both techniques have immediate efficacy, are fast, and low cost compared to more sophisticated treatments. However, the patients need to be aware of recurrence of gingival pigmentation.

Aesthetic perception of the height of the lip vermilion border by black and white laypeople

AIM: To assess the degree of aesthetic perception of the height of the vermilion border of the lip among laypeople of black and white ethnicity. MATERIAL AND METHODS: in possession of an extraoral photograph of a 25 years old woman with lips at rest, changes were effectuated reducing the height of the lip vermilion in increments of 0.5 mm (0-default to -3.0 mm). To do so, a program for image manipulation (Adobe Photoshop CS4, San Jose, CA, USA) was used. Once the images obtained, they were printed and arranged randomly on a questionnaire to be evaluated by the examiners (n=200). A graduated visual analogue scale of 0 to 10 points for aesthetic evaluation, where 0 represented "not very attractive", 5 "attractive" and 10 "very attractive", was used. To evaluate the differences between the examiners, the Mann-Whitney test was used. RESULTS: There was significant difference between male and female evaluators in evaluating the effect of the height of the vermilion on the attractiveness of the lip. Black and white people were able to identify changes in the height of the vermilion border of the lip, verifying that this height is acceptable till -2mm. Black evaluators gave lower scores to the -3 mm height vermilion than white evaluators, and this has been a clinically significant difference (p < 0.05). CONCLUSION: changes in the height of the vermilion border of the lip are acceptable up to -2mm gap among black and white people of both genders, gradually decaying to major changes and having a preference, mostly, for the greater height of the vermilion border of the lip.